Search PubMed⌕ Search

Biomedical subjects

R K Winkelmann

Publications and source records attributed to R K Winkelmann.

At least 163 records · Page 9Linked to original sources
PubMed1985

Secondary neuroendocrine carcinomas of the skin. An immunohistochemical comparison with primary neuroendocrine carcinoma of the skin ("Merkel cell" carcinoma).

Since the initial clinical presentation of visceral neuroendocrine carcinoma is occasionally a cutaneous metastasis, diagnostic confusion with primary neuroendocrine carcinoma of the skin (Merkel cell carcinoma) may ensue. In this study, seven cases of secondary cutaneous neuroendocrine carcinoma were immunohistochemically compared with twenty-one Merkel cell carcinomas for ten antigenic moieties that have been associated with endocrine tumors. Six of seven secondary tumors stained for bombesin, leucine enkephalin, methionine enkephalin, or beta-endorphin, none of which was detected in the primary cutaneous neuroendocrine carcinomas. These data suggest that immunohistochemical study may be useful in separating primary from secondary neuroendocrine tumors of the skin and may assist in directing clinical attention to the most probable site of visceral neoplasia.

Adult↗
PubMed1985

Cytophagic panniculitis and B cell lymphoma.

A 43-year-old woman had multiple, painful nodules of the legs and edema of both lower extremities for 3 years and leukopenia for 8 years. This histologic findings of lobular histiocytic panniculitis with "beanbag" cells were typical of cytophagic panniculitis. This case is unique in that B cell lymphoma developed in the spleen, as verified by immunoperoxidase staining, and demonstrates that the disease not only may be a progressive disease per se but also may be associated with nonhistiocytic malignancy.

Adult↗
PubMed1985

Eosinophilic histiocytosis: a variant form of lymphomatoid papulosis or a disease sui generis?

Five patients are reported on whose clinical skin disease consisted of polymorphous papulonodular lesions healing with a depigmented scar. Although all cases had been termed lymphomatoid papulosis after clinical or histologic examination, the lesions consisted principally of masses of histiocytes and eosinophils. Individual lesions healed spontaneously or with minimal treatment, but the chronic course of disease was not altered by any therapy used. Follow-up 3 to 17 years later indicated persistent or recurrent disease, and one patient died of histiocytic malignancy. Eosinophilic histiocytosis is the microscopic picture of an unusual group of patients with chronic papulonodular necrotic skin disease that may deserve to be considered a disease pattern per se.

Adolescent↗
PubMed1985

Factitial traumatic panniculitis.

We report five cases of factitial panniculitis produced by blunt trauma. Localized forms include Secrétan's syndrome and l'oedeme bleu, which are usually unilateral and involve the hand and forearm, respectively. When the lesions are more generally distributed, the self-induced nature may be less apparent. These patients may have been diagnosed as having Weber-Christian disease, pancreatic fat necrosis, or superficial thrombophlebitis. The microscopic picture of organizing hematoma may be supplemented by the appearance of amorphous polysaccharide masses commingled with iron pigment.

Adolescent↗
PubMed1985

Acral arteriovenous tumor. A clinicopathologic review.

We reviewed 47 cases of a distinctive, benign vascular tumor, acral arteriovenous tumor. Study of the clinical histories of patients with this tumor emphasized the difficulty of making a clinical diagnosis. Most of the tumors were asymptomatic and were found in generally healthy middle-aged or elderly male patients. Distribution was acral; 79% of the tumors were located on the head or extremities. Histologic study showed a component of capillary nevus in some cases in addition to the typical venous and arteriovenous channels.

Adult↗
PubMed1985

Neutrophilic urticaria.

We studied 241 consecutive skin biopsies from patients with urticaria. Ten of the 241 specimens showed inflammation of dermal venules primarily with polymorphonuclear leukocytes, without evidence of necrotizing vasculitis. We speculated that this finding might represent an early histological form of urticarial vasculitis. However, review of the clinical histories and laboratory data from these 10 cases showed that most were associated with dermographism, normocomplementaemia, and negative direct immunofluorescence. These findings suggest that urticarial lesions with the histological picture of neutrophils in vessel walls may imply the presence of physical urticaria.

Adult↗
PubMed1985

Patch tests in Sézary syndrome and mycosis fungoides.

A retrospective series of 34 patients with the diagnoses of Sézary syndrome, pre-Sézary syndrome, or mycosis fungoides had had patch testing. Of these, 27 had at least 1 positive reaction (11 of 12 with pre-Sézary syndrome, 6 of 10 with Sézary syndrome, and 10 of 12 with mycosis fungoides). The highest average number of positive reactions was observed in patients with pre-Sézary syndrome (4.7 per patient). There was no predominance of positive reactions to any one allergen, but 13 of the 27 patients reacted to a metal allergen. Only 1 of 5 patients who had photopatch testing had a positive result. This retrospective study revealed delayed contact hypersensitivity responses in this group of patients and should serve as a basis for prospective consideration of contact dermatitis factors in patients with mycosis fungoides and Sézary states.

Allergens↗
PubMed1985

The histology and immunopathology of dermographism.

Twelve patients with dermographism were studied by histological examination. Six spontaneous lesion showed perivascular lymphocytosis. Biopsy of 6 induced lesions showed neutrophiles at 15-30 min and lymphocytes at 1 h or more. One patient biopsied both at 15 min and 2 h showed both microscopic pictures successively. Immunofluorescence of spontaneous or induced lesions in 5 patients was not significant. Studies of T cell subsets of an induced lesion at 30 min showed a moderate number of T helper cells. Mast cell and eosinophile changes were not important. These studies of dermographism imply successive changes with time in perivascular cellular pathology.

Adult↗
PubMed1985

Cholinergic urticaria shows neutrophilic inflammation.

Three patients with cholinergic urticaria were studied by biopsy and neutrophilic urticaria was observed in two. Direct immunofluorescence was negative in 1 patient, and monoclonal antibody studies identified a large population of OKM-1 antibody positive cells.

Antibodies, Monoclonal↗
PubMed1985

Solid facial edema as a complication of acne vulgaris.

Persistent solid edema of the face in four healthy young adults seemed to be secondary to preexisting acne vulgaris. Elastic compression and intensive acne therapy were of minimal benefit in resolving the edema. Facial inflammation accompanying acne should be recognized as a rare complication of the acne process.

Acne Vulgaris↗
PubMed1985

Monoclonal antibody studies in the skin lesions of patients with anetoderma.

In all five patients studied, monoclonal antibody studies of cryostat sections of skin biopsy specimens of anetoderma lesions revealed inflammatory cells reacting with anti-Leu-1, pan-T-cell antibody, and anti-Leu-3a, the helper/inducer T-cell antibody. Small numbers of suppressor cells were present in only three biopsy specimens. Four specimens showed OKM1, antibody-reacting cells (monocytes). The age of the lesion was not correlated with inflammation or the T-cell subsets identified.

Adult↗
PubMed1984

Gianotti-Crosti syndrome. A review of ten cases not associated with hepatitis B.

Studies of data from ten cases of infantile acrodermatitis and from eight cases reported in the North American literature disclose distinctive papular dermatosis of the face and extremities, often related to virus infection. None of our eight patients who were tested had evidence of hepatitis B infections, although transaminase values were elevated in two. All five patients who were tested had lymphocytosis. Six patients had antecedent upper respiratory tract symptoms. Data from our cases and from the other previously reported cases indicate that the eruption is a virus-related response. Although the hepatitis virus has been the most frequently encountered causative agent to date, other viruses, including Epstein-Barr virus, coxsackievirus, and parainfluenza virus, may produce a similar cutaneous response.

Acrodermatitis↗
PubMed1984

Anetoderma. Clinical findings, associations, and long-term follow-up evaluations.

In 16 patients with anetoderma, a clinicohistologic entity related to a local dermal defect of elastic tissue, old lesions did not heal, and new lesions often continued to form for many years, despite various forms of treatment. Systemic lupus erythematosus, which occurred in one patient, must be ruled out in patients with anetoderma. Discoid lupus erythematosus occurred later in one patient. Other associated findings, noted in one patient each, included cataract, congenital hip dislocation, congenital fusion of the vertebrae at C2-3, diverticulum of the midesophagus, Addison's disease (before the onset of anetoderma), and mitral valve prolapse. Our results and a review of the literature indicate that patients with anetoderma must be examined for associated eye, bone, heart, pulmonary, digestive tract, and endocrine abnormalities for a better assessment of their skin disorders.

Adolescent↗
PubMed1984

Ophthalmic features of necrobiotic xanthogranuloma with paraproteinemia.

Necrobiotic xanthogranuloma of the skin is associated with paraproteinemia and, often, with plasma proliferative disorders, including multiple myeloma. Other commonly recognized systemic abnormalities include hepatosplenomegaly, a highly increased erythrocyte sedimentation rate, and leukopenia. Fifteen of 16 patients (seven men and nine women with a mean age of 54 years) with this condition had ophthalmic manifestations. Thirteen patients had lesions affecting the skin of the eyelids and periorbital tissue; on casual examination these lesions resembled plane xanthoma. Unlike plane xanthoma, however, the lesions of necrobiotic xanthogranuloma were almost always indurated. Further, the lesions frequently became inflamed, leading to superficial ulceration. Deeper lesions occasionally involved the orbit. Yellow lesions were sometimes visible in the episcleral tissues where they were associated with recurrent symptoms of scleritis and episcleritis. Biopsy specimens of the skin lesions disclosed a distinctive pattern of subepidermal granulomatous masses with focal aggregates of histiocytes and giant cells surrounded by hyaline necrobiosis. Surgical excision of the eyelid lesions was often followed by recurrence and increased activity of the lesions. Low-dose chemotherapy is likely to produce a favorable response, with regard to both the skin lesions and the paraprotein abnormalities.

Adult↗
PubMed1984

Morphologic heterogeneity of malignant lymphomas developing in mycosis fungoides.

From an extensive series of patients with mycosis fungoides, we identified 12 in whom subsequently developing extracutaneous (lymph nodal) lymphoma manifested morphologic features other than those of so-called cutaneous T-cell lymphoma. Six patients had features diagnostic of Hodgkin's disease, two had morphologic and cytochemical features consistent with T-cell lymphoma but without the morphologic features ascribed to cutaneous T-cell type, and four had morphologic characteristics most consistent with B-cell lymphoma. Although in most cases of mycosis fungoides the lymphomas exhibit morphologically distinctive features of mycosis cells, we propose that in occasional cases this morphologic correlation is not present.

Adult↗
PubMed1984

The anticentromere antibody: disease specificity and clinical significance.

Serum samples from 539 subjects were screened for the presence of the anticentromere antibody on a human laryngeal carcinoma (HEp-2) cell line (Antibodies, Inc.). The antibody was present in 61 patients (11%), most of whom had features of limited scleroderma or the CREST syndrome (calcinosis cutis, Raynaud's phenomenon, esophageal dysfunction, sclerodactyly, and telangiectasia), either independently or in association with primary biliary cirrhosis. The antibody was rarely found in patients with rapidly advancing or diffuse scleroderma. The anticentromere antibody is therefore a useful prognostic indicator in patients with early scleroderma, as it may help to predict what pattern of scleroderma will evolve. Screening for this antibody should be conducted in all patients with Raynaud's phenomenon, primary biliary cirrhosis, and scleroderma. Other previous studies have indicated a similar disease specificity and prognostic importance of this antibody.

Antibodies, Antinuclear↗