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Biomedical subjects

R Kubba

Publications and source records attributed to R Kubba.

16 recordsLinked to original sources
PubMed1989

Dissemination in cutaneous leishmaniasis. 3. Lymph node involvement.

In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients (12%), two lymph node areas were involved. The affected lymph nodes were typically solitary, firm, mobile, nontender, only moderately enlarged, and appeared to persist beyond the clinical healing of the associated skin lesions. The results of pathologic and immunopathologic studies carried out on eight lymph nodes obtained from this group of patients supported the leishmanial etiology. Although amastigotes were only demonstrated in two lymph nodes, the leishmanial antigen was found in all eight specimens. The lymph node involvement is another manifestation of dissemination in infection with a dermotropic leishmania. It appears that in some cases, instead of the parasite, it may be the leishmanial antigen that disseminates and produces lymphadenitis.

Adolescent↗
PubMed1989

Leishmaniasis.

Leishmaniasis is a parasitic infection caused by many species of the protozoa Leishmania. It occurs in endemic foci scattered throughout Asia, Africa, the Americas, and the Mediterranean countries. The disease is complex and may simulate many skin and systemic diseases. With awareness and suspicion, however, leishmaniasis is relatively easy to diagnose. Undiagnosed, it causes considerable morbidity and mortality. Treatment is often difficult, and current therapies leave much to be desired.

Acute Disease↗
PubMed1988

Dissemination in cutaneous leishmaniasis. II. Satellite papules and subcutaneous induration.

In a field study of cutaneous leishmaniasis (CL) due to Leishmania major, zymodeme Lon-4, in an endemic focus in Saudi Arabia, 80 patients in a group of 643 patients (12.44%) were found to have multiple, inflammatory, satellite papules (SP) around one or more CL lesions. The SP often appeared to erupt after commencement of antileishmanial treatment. They showed a range of morphology and pathology, and comparisons with corresponding CL lesions showed important differences. Amastigotes were seen in only one of seven biopsy specimens. Another morphologic feature, subcutaneous induration (SCI), was noted on routine palpation in 20 patients in the same patient group (3.11%). The SCI either was radiating all around the lesion and appeared as an "iceberg nodule" or was present as a "tonguelike" process proximal to the CL lesion. Amastigotes were seen in four of nine biopsy specimens of SCI. SP and SCI represent reactions to local dissemination of the parasite or its antigenic products, and as morphologic features aid in the clinical diagnosis of CL.

Humans↗
PubMed1987

Clinical diagnosis of cutaneous leishmaniasis (oriental sore).

Cutaneous leishmaniasis (oriental sore) is characterized by slowly evolving inflammatory lesion(s) that are nodular, noduloulcerative, or ulcerative and that heal spontaneously with scar(s) in 3 to 12 months. In the course of a comprehensive study of cutaneous leishmaniasis due to Leishmania major in an endemic focus in Saudi Arabia, seven clinical features of diagnostic value were identified and their approximate frequency in a selected group of 475 patients was determined. These features were: exposed site location, 84%; pairing or clustering of lesions, 61.72%; skin crease orientation, 35.37%; volcanic nodules, 30.32%; satellite papules, 19.37%; subcutaneous nodules, 11.37%; and "iceberg" nodules, 4.63%. This information should serve the process of clinical diagnosis and may be relied upon when the procedures for parasite detection are negative or unavailable.

Humans↗
PubMed1987

Dissemination in cutaneous leishmaniasis. I. Subcutaneous nodules.

In a study of cutaneous leishmaniasis (CL) caused by Leishmania major in Saudi Arabia, 10% of the patients were found to have subcutaneous nodules (SCN). The SCNs were usually inconspicuous, painless, and proximal to the primary skin lesions; when multiple, they showed a "sporotrichoid" configuration or appeared as "beaded cords." Their number ranged from 1-16 (average 3 25 +/- 2.50; mean +/- 1 SD). In some patients, the SCNs seemed to be triggered by antileishmanial treatment. The clinical picture and pathologic findings suggest that SCNs in patients with CL represent lymphatic dissemination, a phenomenon not widely recognized.

Adolescent↗
PubMed1987

Peripheral nerve involvement in cutaneous leishmaniasis (Old World).

A review of 288 skin biopsy specimens from cutaneous leishmaniasis lesions caused by Leishmania major showed assorted nerve changes in 14 biopsy specimens (5%). Ten patients had perineural inflammatory cell infiltrate consisting of either lymphocytes or a mixture of lymphocytes, plasma cells, and macrophages. Four patients had inflammatory cell invasion of the nerves (neuritis), and in one of them the inflammation was granulomatous and associated with nerve destruction. Amastigotes were seen inside the nerves in two patients. Sensory testing of 50 consecutive patients with cutaneous leishmaniasis identified two patients with diminished sensations over the lesions.

Adult↗
PubMed1986

Immunohistological investigations in chronic cutaneous leishmaniasis in Saudi Arabia.

The distribution and numbers of IgG-, IgA-, IgM-, and lysozyme-positive cells were investigated by the immunoperoxidase method in paraffin-sections of 13 cases of chronic cutaneous leishmaniasis of low parasite load from Saudi Arabia. The majority of the peroxidase-positive plasma cells contained IgG, whereas the numbers of IgA+ and IgM+ plasma cells were not so numerous. Small groups of squamous epithelial cells showed immunoreactivity for IgG and IgA. Similar positive staining was observed extracellularly in the oedematous upper dermis, in the endothelial cells, and in the perivascular space. The activated macrophages showed strong and diffuse peroxidase staining for lysozyme, whereas epithelioid cells and multinucleated giant cells were negative or had finely granular and considerably weaker staining. It is suggested that humoral immunity also participates in the elimination of the parasites and an immunologically induced necrosis might be responsible for the ulceration of the skin in cutaneous leishmaniasis. It is also assumed that the lysozyme immunoreactivity can be a marker of the activation state of the macrophages.

Adolescent↗
PubMed1984

Cutaneous leishmaniasis in Al-Hassa, Saudi Arabia.

Cutaneous leishmaniasis of the classical noduloulcerative variety is endemic in Al-Hassa, Saudi Arabia. In a clinical study in which 56 Saudi patients and 66 non-Saudi patients were examined, it was found that the Saudi patients were considerably younger and had significantly milder disease compared with the non-Saudi patients.

Adolescent↗
PubMed1981

Antinuclear antibodies and PUVA photochemotherapy.

Sequential testing for antinuclear antibody (ANA) in a group of 99 patients receiving long-term methoxsalen (PUVA [methoxsalen plus ultraviolet light]) therapy showed positive tests for ANA in the serum samples of 42 patients. In 22 patients, the ANA was persistent; in seven patients, it was transient; and in the other 13 patients, it developed near the end of the observation period. A causal association between the occurrence of ANA and PUVA therapy is suggested by the incidence of ANA, its conversion from a negative to positive ANA test in 31 of 42 patients, and its statistically significant correlation with the duration of PUVA therapy. The ANA titers were 1:80 or greater in only 12 patients. The staining pattern was homogeneous in 39 patients, speckled in two patients, and nucleolar in one patient. In patients with a positive ANA test, the serologic tests for antibodies to DNA and extractable nuclear antigens were negative. Patients with positive ANA tests were significantly older than patients with negative ANA tests. Symptomatic systemic disease has not developed in any patient with a positive ANA test in this group.

Adult↗
PubMed1981

Cutaneous complications of orthopedic implants. A two-year prospective study.

In a two-year prospective study of cutaneous problems in orthopedic implant recipients, cutaneous eruptions of unknown cause that bore good temporal relationships with implant surgery occurred in 19 patients. Two clinical patterns were observed. A transient "exanthematic" dermatitis was seen in six patients; in two of them, it recurred after each surgical implant procedure. A persistent reaction was seen in 13 patients. Metal sensitivity was found in two patients and considered to be relevant. Allergic cutaneous complications of orthopedic implants are rare. However, in an implant recipient in whom a cutaneous problem develops, the likelihood of the cutaneous problem being allergic in nature is slightly greater if the implant is of the static type, if there is a history of metal sensitivity, if the cutaneous eruption shows a predilection for the anatomic zone of the implant, and if the eruption is eczematous and has developed late and persisted.

Adult↗
PubMed1980

Immunologic evaluation in mycosis fungoides. Before and after PUVA therapy.

Eight patients with mycosis fungoides (seven in plaque stage and one with tumors) were successfully treated with methoxalen-ultraviolet-A (PUVA) photochemotherapy. A selective immunity evaluation had been carried out prior to starting treatment and was repeated sevedn to 33 months (mean, 22 months) later. The results of pre-PUVA and post-PUVA therapy evaluation were compared. The delayed hypersensitivity responses improved in all eight patients, and four patients who were anergic before treatment manifested a normal response after PUVA therapy. The T lymphocyte counts were reduced in four patients before PUVA therapy (mean +/- SD, 66.72% +/- 9.78%) and in seven patients after PUVA (mean +/- SD, 54.43% +/- 10.86%; P = .03). The results of mitogen stimulation studies with phytohemagglutinin, pokeweed mitogen, and concanavalin A were equivocal. The levels of serum immunoglobulins were not affected. One patient had a positive antinuclear factor test of low titer.

Adult↗
PubMed1979

Initial experiences with a total knee prosthesis implanted without bone cement.

Prosthetic loosening and stem fractures have been the most frequently encountered complications of knee arthroplasties using the Guepar Hinged prothesis. The insufficient intramedullary fixation of the stem and the use of cement in the femur and tibia are primarily responsible for these complications. In our clinic, we have used an altered Guepar Hinged prothesis since 1975. The femoral and tibial stems are lengthened with medullary nails, resulting in stems with high bending and torsional stress capacities. The fixation strength of these special long stems in the medullary cavities is such that we no longer use cement for this prosthesis. The initial results of our cementless implantation of these special long-stem knee prostheses, and the advantages of this method are reported.

Arthritis↗
PubMed1976

Congenital triangular alopecia.

Three new cases of congenital triangular alopecia are reported and the differential diagnosis of this rare developmental defect is discussed.

Alopecia↗