Biomedical subjects
Publications and source records attributed to R B Odom.
Bullous pemphigoid in children appears to be the same disease as its adult counterpart based on a case in a 3-year-old boy. Generalized tense bullae over the skin and oral mucosa, characteristic direct and indirect immunofluorescence, elevated IgE levels, blood eosinophilla, and therapeutic response to corticosteroids parallel the disease in adults. The long-term prognosis, however, is still unknown. A review of bullous pemphigoid in children is presented.
Allergic eczematous contact dermatitis developed in the external auditory canals and external ears of a woman who wore bilateral "in-the-ear" hearing aids. Patch tests demonstrated that methyl methacrylate monomer was the offending chemical. Heat curling the resin increased polymerization and reduced the amount of residual acrylic monomer, thus alleviating the problem.
Three cases of erythema chronicum migrans in soldiers who had returned from active duty in Central Europe were seen within a ten-week period in San Franciso. Typically, the lesions cleared in less than five days with penicillin in two cases and erythromycin in another.
A husband and wife contracted larva migrans while vacationing on the Gulf of Mexico. Subsequently, migratory pulmonary infiltrates and peripheral eosinophilia (Loeffler's syndrome) developed in both patients. Their cutaneous lesions were treated with topical thiabendazole and resolved within two weeks. The pulmonary complication was treated symptomatically and resolved during the next eight weeks.
A 68-year-old man had lesions of Kaposi's sarcoma that developed continually in a localized area after excisional surgery, electrosurgery, and radiotherapy of previous lesions. His lesions cleared with intralesional injections of vincristine sulfate without any systemic and only minor local side effects. Newly developed lesions, which did not occur on the sites of previous treatment, were also responsive to this form of therapy.
Fourteen patients with 26 keratoacanthomas (KA) were treated weekly with intralesional injections of fluorouracil. Twenty-five lesions cleared in an average of three weeks (range, two to eight weeks) after an average of 2.8 injections. One KA failed to respond after five weekly injections and was excised. No recurrences or meaningful side effects were observed. It appears that treatment of KA with intralesional fluorouracil injections is a safe, effective, and convenient mode ot treatment yielding excellent cosmetic results.
A 63-year old man developed a delayed cutaneous reaction at the sites of intramuscular injections of a phytonadione (vitamin K) preparation. The patient was tested with the drug and its components by intradermal and epicutaneous application. Sensitivity to the pure phytonadione and not the other components of the preparation was documented by patch tests.
Transitory blanching of nonacral skin has been observed after contact with a 3% solution of H2O2. This phenomenon was reproducible in all tested whites, but was not reproducible in black skin. Blanching developed within 30 to 300 seconds after contact with H2O2 and lasted from 10 to 30 minutes. It is proposed that the topical application of H2O2 induces a transient vasoconstriction of vessels in the superficial dermis.
Observations surrounding the clinical manifestations and pathological studies of a neonate who died at 9 weeks of age, indicate that distinctive cutaneous, histopathologic, and ultrastructural findings occur when graft-vs-host reaction (GVHR) complicates combined immune deficiency syndrome (CIDS). The prominence and specificity of the epidermal lesions, particularly a necrotic cell that occurs in association with satellite lymphocytes ("satellite cell necrosis" (SCN)), lead us to recommend that a cutaneous biopsy be performed to facilitate an early definitive diagnosis. Dermatologists can recognize GVHR at the bedside and establish the diagnosis with the pathological findings obtained from the skin biopsy.
An allergic contact dermatitis from fluorouracil developed in two patients 8 and 18 days respectively after institution of topical fluorouracil therapy. The character of the usual irritant dermatitis changed to that of an allergic dermatitis. Epicutaneous patch tests and intradermal tests with fluorourcil were reactive. Histologic specimens of positive test sites revealed the changes expected in allergic contact dermatitis. Twelve control subjects failed to react to intradermal fluorouracil tests.
Pseudofolliculitis of the bearded area is a common dermatoses among black men. Acne keloidalis probably represents this same condition, but is located in the nape area. Pseudofolliculitis of the pubic area (pseudofolliculitis pubis) has been reported. We wish to report pseudofolliculitis including the entire scalp and to add the term pseudofolliculitis capitis for this heretofore unreported entity.
In 1967, Kawasaki reported an acute, febrile, mucocutaneous condition accompanied by swelling of cervical lymph nodes that afflicted infants and young children in Japan. He called the entity mucocutaneous lymph node syndrome. In 1974, the condition was reported in Hawaii, and several cases have been reported subsequently from the continental United States and other countries. One percent to two % of patients had died suddenly of cardiac failure. Rickettsia-like bodies have been demonstrated from skin and lymph node biopsy specimens, and the pathologic features suggest a relationship to infantile periarteritis nodosa.
We designed a prospective and retrospective study to determine the incidence of allergic contact dermatitis to topical application of fluorouracil. Intracutaneous and epicutaneous skin tests of various fluorouracil concentrations were given to patients who were to be treated with the drug for actinic keratoses (group A) and to patients who had previously been treated with fluorouracil for actinic keratoses (group B). Six patients in group B had allergic contact dermatitis to topical fluorouracil. The common clinical characteristic of the six patients was a severe pruritic eruption at the site of fluorouracil application. Allergic contact dermatitis should be suspected in the presence of severe pruritus or a severe eczematous response in patients treated with topical fluorouracil.
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Nine patients experienced profuse hair loss two of five months after starting a vigourous weight reduction program resulting in weight loss of 11.7 to 24.75 kg. Telogen counts of 25% to 50% were observed. Regrowth of hair occurred within several months. Three patients had experienced hair loss closely following a successful weight reduction program on several occasions. Rigorous caloric restriction with subsequent inadequate energy supply of the hair matrix is thought to be the cause for the precipitation of the telogen effluvium of the crash dieter.
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The typical patient with fat necrosis of the scrotum is a prepuberal heavy set male subject who has extratesticular scrotal masses, usually bilateral, with mild to moderate pain but no systemic complaints or symptons related to voiding. The masses are firm, tender and do not transmit light. With a firm diagnosis expectant treatment will allow spontaneous resolution of the lesions. If doubt exists appropriate surgical intervention is advocated. Hypothermic injury, such as swimming in frigid water, is the most probable etiologic agent.
A 21-year-old woman developed huge atrophic striae in the axillary and inguinal areas from the topical application, with occlusion, of potent corticosteroid preparation applied to the axillary or inguinal areas. It is postulated that the mechanism is systemic absorption of enough medication to produce a state of hyperadrenalism with subsequent striae formation as a sequela.