Biomedical subjects
R M Hurwitz
Publications and source records attributed to R M Hurwitz.
The evolution of perforating folliculitis in patients with chronic renal failure.
The evolution of perforating folliculitis in six patients with chronic renal failure was investigated with special attention to clinical and histopathologic changes in early, evolving, and mature lesions. Different and distinct histologic features at each stage were found. The earliest lesions, follicular pustules, evolved into perforating folliculitis that eventuated in prurigo nodularis. A combined treatment consisting of an anti-staphylococcal antibiotic by mouth, phototherapy, and application of a topical corticosteroid lotion proved helpful in controlling the generalized pruritus and the evolution of the lesions in these cases.
Cutaneous pathology of the toxic shock syndrome.
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Streptococcal cellulitis proved by skin biopsy in a coronary artery bypass graft patient.
There has been a question about the etiology and pathogenesis of recurrent cellulitis of the lower leg in patients following coronary artery bypass graft surgery. We observed a similar patient who had gram-positive cocci in chains, consistent with streptococci, within the dermis in a tissue biopsy specimen taken from the site of cellulitis. In addition, our patient had a second skin infection, namely, tinea pedis, which may be the portal of entry for streptococci. Concurrent treatment with a systemic antibiotic and a topical antifungal cream was effective in clearing both infections.
Necrotic cellulitis. A localized form of septic vasculitis.
Cutaneous biopsy specimens from two patients with localized, bacterial, necrotic cellulitis showed a neutrophilic vasculitis with fibrin thrombi, changes indistinguishable from those seen in a third patient with bacterial septicemia. Additional clinical information may be needed before a definitive diagnosis of localized or systemic septic vasculitis can be made with certainty. The clinical and microscopic features of the lesions and their pathologic mechanisms are discussed.
Black-spot poison ivy dermatitis. An acute irritant contact dermatitis superimposed upon an allergic contact dermatitis.
A black spot in the epidermis over a blister of poison ivy dermatitis is an uncommon finding. Four patients with the phenomenon are described. Histologic and histochemical studies were made on biopsy material and the blackish deposit on the skin surface was compared with black deposits in and on leaves of the species of poison ivy. This examination revealed a yellow, amorphous substance on the stratum corneum of the lesions and a similar substance in and on leaves of the poison ivy plant, Toxicodendron radicans ssp. negundo. Associated with the pigmentary deposits there were distinct changes of acute irritant contact dermatitis superimposed upon allergic contact dermatitis. Our findings support the view that the black material is the oleoresin of the plant, and that this substance behaves both as an irritant and an allergen.
Verrucae vulgares and acyclovir ointment.
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Toxic shock syndrome or toxic epidermal necrolysis? Case reports showing clinical similarity and histologic separation.
A case of toxic shock syndrome and a case of drug-induced toxic epidermal necrolysis with renal involvement are described. The two patients had similar early clinical manifestations and therefore posed a difficult differential diagnosis. Diagnostic distinction is important because therapy differs considerably. A skin biopsy in each case proved helpful in establishing the correct diagnosis, since there appears to be a different histologic pattern for each condition: superficial perivascular dermatitis for toxic shock syndrome and an interface dermatitis for toxic epidermal necrolysis.
Perforating folliculitis in association with hemodialysis.
Five patients developed pruritic, keratotic, perforating follicular papules and nodules within 2 months of starting maintenance hemodialysis. Clinically and histologically, the papules and nodules showed the features of perforating folliculitis with superimposed prurigo nodularis, a condition not previously described in patients on maintenance dialysis. The patients with perforating folliculitis constituted 10% of our patients on dialysis during the period of this study. Notably, all five patients were black and had chronic renal failure secondary to diabetic nephropathy. The precise pathogenesis of perforating folliculitis in these patients is unclear at this time.
Group A streptococcal meningitis in an infant: report of a case associated with a community outbreak due to M-type 4 organisms.
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Acquired cheilitis glandularis simplex. Case report.
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Tropical bacterial pyoderma in Vietnam. An improved therapeutic regimen.
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Robert Recorde, M.D. (1510?-1558). Tudor physician, mathematician, and pedagogue.
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Migration of axonal protein: absence of a protein concentration gradient and effect of inhibition of protein synthesis.
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Black-spot poison-ivy dermatitis.
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