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Biomedical subjects

R G Sibbald

Publications and source records attributed to R G Sibbald.

10 recordsLinked to original sources
PubMed1989

Granuloma annulare in patients with human immunodeficiency virus infections.

We present four cases of granuloma annulare occurring in patients with human immunodeficiency virus (HIV) infection. These patients had either an extensive localized form or generalized granuloma annulare. The patient with generalized granuloma annulare was clinically reminiscent of the previously described papular eruption seen in HIV-positive patients. In several patients with the localized form, Kaposi's sarcoma was considered in the differential diagnosis. In all patients, however, the eruptions were surprisingly transient. The similarity of the localized form of granuloma annulare to Kaposi's sarcoma and the generalized micropapular form to the papular eruption of acquired immunodeficiency syndrome seen in HIV-positive patients illustrates the usefulness of skin biopsies in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Lymphomatoid granulomatosis.

The clinical and pathologic appearance of seven patients with lymphomatoid granulomatosis who had skin lesions when first seen is reviewed. Six patients subsequently developed systemic disease. Although the gross morphology of the skin lesions is variable, the pathology is distinctive. An adequate deep biopsy shows the characteristic lymphohistiocytic infiltrate with variable numbers of atypical cells. Angiodestruction is less evident in the skin compared to other organs. The infiltrate surrounds and invades not only vessels but also nerves and epidermal appendages. The skin biopsy specimen can be differentiated from the lymphomatous infiltrates and Wegener's granulomatosis. Two of the patients who developed systemic disease were diagnosed by skin biopsy but clinicians failed to institute therapy, preferring to wait for other organ involvement. In addition, two patients developed lymphoma, one of which was confirmed at autopsy and one on subcutaneous and bone marrow biopsy 5 years after the initial skin diagnosis. Lymphomatoid granulomatosis can be diagnosed by performing a skin biopsy. Appropriate chemotherapy may result in a high percentage of complete remissions and therefore the dermatopathologist can play an important role in the early diagnosis of this potentially fatal disease.

Adult↗
PubMed1985

Physical urticaria.

Physical urticarias provide a reproducible model for the study of mediators of inflammation. They also provide a diagnostic and therapeutic challenge for the clinician. Patient diaries using a daily notebook or monthly calendar can be useful in assessing triggering factors and frequency of reactions, along with the effects of therapeutic agents and procedures. It is not uncommon to see more than one physical urticaria in the same patient. All physical tests that relate to the patient's symptoms should be performed. Repeat physical testing may also be useful. Except for hereditary forms, there is a tendency for patients to improve spontaneously, although often not for several years. Once the symptoms have been controlled through medication, smaller doses may be sufficient to maintain control. Therefore, an attempt should be made to reduce dosage and thus minimize side effects. Single nightly doses of antihistamines may control urticaria, while minimizing the inconvenience caused by drowsiness. However, the clinician must remember that because the beneficial effect of antihistamines is through competitive inhibition of histamine at the H1 or H2 peripheral receptor level, continuous blood levels of antihistamines must be maintained. The new insights into the pathophysiologic mechanisms of the physical urticarias that continue to be learned will help researchers and clinicians to develop more rational and effective approaches to treatment.

Adolescent↗
PubMed1978

Cutaneous vasculitis.

In this paper the current concepts of cutaneous vasculitis are reviewed, with emphasis on clinical patterns, strict pathologic criteria and mechanisms of injury. A plea is made to classify vasculitis not as syndromes but (a) according to organ involvement (limited cutaneous or complicated multisystem), (b) by cause, (c) by pathologic description and (d) by anatomic depth and type of vessel involvement.

Adult↗
PubMedDate not supplied

Infections caused by Trichophyton raubitschekii: clinical and epidemiological features.

Thirty-eight cases of human infection with the recently described dermatophyte species Trichophyton raubitschekii were studied and a description is presented of the clinical and epidemiological features of infection with this organism. Results revealed the usual preponderance of males (2:1) but a high proportion of individuals of Asian origin (60.5%) in the infected population. Tinea corporis, tinea cruris and tinea pedis were the most common infections. T. raubitschekii differed significantly from the more common Trichophyton rubrum and T. mentagrophytes in being more strongly associated with tinea corporis. Some T. raubitschekii infections produced inflammatory lesions while others clinically resembled those caused by the related species T. rubrum and T. mentagrophytes. T. raubitschekii could be distinguished from related species by means of special mycological procedures in the laboratory.

Adolescent↗