Cyclosporine in the treatment of psoriasis.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to R D Baughman.
Explore the source record for details and available documents.
Cowden's disease (multiple hamartoma syndrome) is a syndrome involving abnormalities of multiple organ systems. Transmitted in an autosomal dominant pattern, it carries a high frequency of mammary carcinoma in early middle age in affected women. The hyperkeratotic cutaneous and gingival markers of the disease are its principal overt manifestations. Prophylactic bilateral total mastectomy with optional immediate reconstruction is recommended for women Cowden's disease. An illustrative family with the disease is presented in which one affected young woman was found to have invasive mammary carcinoma with regional metastasis at the time of prophylactic mastectomy.
The function of kidneys stored for 48 to 72 hours in hypertonic crystalloid, intracellular solution, Euro-Collins (360 mOsm./l.), was compared with those stored in a new hyperosmolar (520 mOsm./l.) colloid solution designated as TP-II. The TP-II solution contained less K2HPO4 (1.05 gm./l.) and KH2PO4 (317 gm./l.) and more glucose (40 gm./l.) than the Euro-Collins, and also had an albumin concentration of 4.3 gm./dl. Kidneys obtained from beagle dogs were flushed with either Euro-Collins or TP-II solution (4C). Hypothermic storage followed for either 48 or 72 hours, prior to autotransplantation into the iliac fossa and contralateral nephrectomy. Four experimental groups were transplanted as follows: group 1 (n = 8) and group 2 (n = 7) received kidneys that were flushed with 250 ml. of Euro-Collins or TP-II solution, respectively, prior to 48 hours hypothermic storage. Group 3 (n = 5) and group 4 (n = 5) received kidneys that were flushed in the same way as those in groups 1 and 2, respectively, but were stored for a 72-hour period. TP-II appears to be superior to Euro-Collins for hypothermic storage of kidneys for periods as long as 48 hours. When hypothermic storage times are extended to 72 hours, the number of kidneys with normal function after transplantation is reduced for both solutions, however, TP-II solution has a slight advantage over Euro-Collins solution. Further studies will hopefully clarify this issue and lead to the application of TP-II in the clinical setting.
We describe herein a patient in whose family 11 of 20 members have a palmoplantar keratoderma. The pathologic findings in the proband were those of epidermolytic hyperkeratosis. As in the other families described, the disease was found to be inherited as an autosomal dominant trait. All involved family members had hyperkeratosis of the palms and soles as infants. Light microscopy showed hyperkeratosis, hypergranulosis with large irregular keratohyalin granules, and large clear spaces in the cells of the granular and upper spinous layers. Our electron microscopic findings showed that the clear spaces were areas of cytoplasm filled with a fibrillar material and cellular organelles; abnormal clumps of tonofilaments and keratohyalin were also present. We consider this disorder to be a form of keratoderma rather than a localized ichthyosis.
Fibrosis of the liver developed to a degree that contraindicated further treatment with methotrexate in 11 of 43 patients who had been receiving maintenance therapy with methotrexate for psoriasis. Liver biopsy had been performed prior to initiation of methotrexate therapy and was repeated at 12- to 18-month intervals. In this retrospective study, age of the patient and duration of therapy have been found to be significant factors in those patients receiving only the weekly oral dosage schedule. Yearly biopsies of the liver are recommended for patients who receive methotrexate throughout their courses of therapy.
Group B beta-hemolytic streptococcus (GBS) has emerged as a major cause of neonatal infections. Serious GBS infections in adults occur most frequently when predisposing illness is present. Recurrent erysipelas caused by GBS is reported in a woman who had chronic lymphedema after a radical hysterectomy and radiation therapy. Type III GBS was identified from cultures of vulvar vesicles, vaginal mucosa, and blood. Prophylactic penicillin V potassium therapy prevented further episodes of erysipelas. Group B beta-hemolytic streptococcus should be considered a possible cause of erysipelas or cellulitis.
A recently described method that enumerates variant 6-thioguanine resistant peripheral blood lymphocytes present in vivo in man as a potential marker of somatic cell mutations occurring in vivo was used to study 18 psoriatic patients receiving PUVA therapy, 16 conventinally treated psoriatic patients, 10 vitiligo patients receiving PUVA therapy and 7 untreated individuals with vitiligo. Variant lymphocyte frequencies determined for these individuals were compared with those determined for groups of 10 concurrent and 63 cumulative healthy control individuals. Variant frequencies were elevated in psoriatic and vitiligo patients receiving PUVA therapy and in conventionally-treated psoriatic patients. They were not elevated over control values in untreated vitiligo patients.
Among 24 psoriatic patients treated with PUVA therapy, five developed bullae. Direct and indirect immunofluorescence studies supported the diagnosis of bullous pemphigoid in one patient. In the others, the blisters were a phototoxic acral eruption.
A 12-year-old girl developed a severe inflammatory fungal infection of the scalp caused by Trichophyton verrucosm. The infection resulted in scarring alopecia. The natural history, differential diagnosis, pathogenesis, and treatment of this infection of the skin are reviewed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
We report a 15-year-old primagravida female with a history of chronic plaque psoriasis who developed impetigo herpetiformis at 28 weeks gestation. Culture of a needle aspirate from a tender, enlarged cervical lymph node grew Staphylococcus aureus. The patient improved rapidly on wet dressings, topical midpotency corticosteroids, and intravenous nafcillin. The remainder of her pregnancy was uncomplicated. We speculate that both pregnancy and infection led to this pustular flare of her psoriasis.