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Biomedical subjects

R P Rapini

Publications and source records attributed to R P Rapini.

At least 19 recordsLinked to original sources
PubMed1992

Papulonodular dermal mucinosis in lupus erythematosus.

We report two cases of lupus erythematosus (LE) in which a truncal papulonodular eruption predominated. Histologically the lesions were characterized by diffuse dermal mucin without the usual inflammatory or epidermal changes of LE. It is uncommon in LE for dermal mucin to be present in a sufficient quantity to produce a papulonodular eruption in the absence of typical epidermal changes.

Adult↗
PubMed1992

Zosteriform and epidermotropic metastasis. Report of two cases.

We report two cases of zosteriform metastasis to the skin. One patient had epidermotropic papulovesicular metastases from a presumed cutaneous adnexal neoplasm. The second patient had painful zoster-like papulovesicles from metastatic breast cancer. Previously reported dermatomal or zosteriform metastases are reviewed.

Adenocarcinoma↗
PubMed1992

Treatment of cutaneous squamous cell carcinomas by intralesional interferon alfa-2b therapy.

BACKGROUND AND DESIGN: Intralesional recombinant interferon alfa-2b has been shown to be effective in the treatment of actinic keratoses and basal cell carcinomas. This open-label study was designed to evaluate the effectiveness and cosmetic result of this therapy on actinically induced, primary cutaneous squamous cell carcinomas. Thirty-six squamous cell carcinomas (28 invasive lesions and 8 in situ lesions) ranging in size from 0.5 to 2.0 cm in the longest dimension were treated with interferon alfa-2b 1.5 million units injected intralesionally three times per week for 3 weeks. Eighteen weeks following therapy, the treatment sites were excised and examined for histologic evidence of remaining tumor. RESULTS: Thirty-three (97.1%) of 34 evaluable lesions revealed an absence of squamous cell carcinoma histologically after therapy, although three biopsy specimens (8.8%) obtained after treatment showed actinic keratoses, for an overall complete response rate of 88.2%. The lesion not eliminated after treatment was an invasive squamous cell carcinoma. The investigators and patients independently judged 93.9% of cases to have a very good or excellent cosmetic result. Adverse reactions were limited to those influenzalike symptoms well recognized to occur with interferon therapy and these were well tolerated. Only one patient discontinued therapy due to side effects. CONCLUSIONS: This trial demonstrates that intralesional interferon is effective in the treatment of small sun-induced squamous cell carcinomas with well-tolerated side effects and a highly acceptable cosmetic result.

Adult↗
PubMed1992

Psoriasiform eruption from intramuscular botulinum A toxin.

Botulinum A toxin is used intramuscularly in the treatment of spastic neuromuscular disorders, strabismus, and laryngeal dystonia. The toxin has recently been reported as being useful for the cosmetic removal of glabellar furrows. The clinical effect of the toxin lasts four months or longer. Systemic side effects are rare and usually transient. We report the case of a psoriasiform eruption temporally related to the injection of botulinum A toxin into the medial rectus muscle to treat an ocular motility disorder. To our knowledge, this is the first case of a psoriasiform dermatitis caused by this agent.

Adolescent↗
PubMed1992

Elephantiasis nostras.

Elephantiasis nostras is characterized by edema, skin fibrosis, and massive enlargement of a body part. Lymphatic obstruction, most commonly due to surgery, radiation, infection, or neoplasms, is important in its pathogenesis. The diagnosis of elephantiasis nostras can often be made based on the clinical findings, but examination of tissue may be helpful to rule out associated conditions, especially malignancies. Mainstays of therapy are elevation, use of pressure devices, and administration of antibiotics. Although medical and surgical treatments are limited in their value, pneumatic pumps are effective in refractory cases.

Adult↗
PubMed1992

Concurrent Sweet's syndrome and erythema nodosum: a report, world literature review and mechanism of pathogenesis.

Sweet's syndrome (acute febrile neutrophilic dermatosis) and erythema nodosum are reactive dermatoses whose pathogenesis is currently undefined. Although there are several associated conditions that both of these disorders have in common, the appearance of Sweet's syndrome and erythema nodosum in the same person is rare. Only 8 individuals with biopsy confirmed lesions of both dermatoses were described in the world literature. We describe a 30-year-old woman with biopsy confirmed lesions of Sweet's syndrome on her hand and erythema nodosum on her legs. She had been taking an oral contraceptive and an appetite suppressant during the 5 months before these dermatoses appeared. Both cutaneous lesions rapidly responded to topical corticosteroid ointment and have not recurred since her medications were discontinued. The association of Sweet's syndrome and erythema nodosum is reviewed, their similarities discussed, and a pathogenesis is proposed.

Adult↗
PubMed1991

Crusted scabies in a patient with chronic graft-versus-host disease.

We describe a 20-year-old man with chronic graft-versus-host disease and progressive cutaneous changes. His skin became more lichenified despite therapy with azathioprine, prednisone, and cyclosporine. Although it was initially thought that lichenoid graft-versus-host disease had developed, it was subsequently discovered that the patient had crusted (Norwegian) scabies.

Adult↗
PubMed1991

Newer variants and simulants of basal cell carcinoma.

Basal cell carcinoma (BCC) has characteristic clinical and histopathologic findings that facilitate accurate diagnosis. There are, however, many variants and simulants of BCC that may cause clinical and/or histopathologic confusion. These entities often have features in common with BCC, with nodular or sclerosing basaloid islands, peripheral palisading, stromal retraction, (pseudo)-glandular formation, and/or prominent mucin. Recently described BCC variants, including signet-ring BCC and granular cell BCC, are discussed. Less commonly appreciated basaloid simulants, including ameloblastoma, cloacogenic carcinoma, and mucinous carcinoma, are described. Distinguishing among these variants and simulants of BCC is important because treatment and prognosis of each may vary.

Basal Cell Carcinoma↗
PubMed1991

Crusted (Norwegian) scabies.

Crusted (Norwegian) scabies, a rare variant of ordinary scabies, is a highly contagious infection in which the skin is infested with thousands to millions of mites. The infection is frequently overlooked because of its atypical presentations. Patients with cognitive deficiency or an immunodeficiency disorder (including immunosuppressive therapy) are predisposed to developing crusted scabies. The infection often presents as generalized dermatitis with crusted hyperkeratosis on the palms and soles. Diagnosis is made by examining skin scrapings from the crusted lesions. Lindane is the scabicide most widely used in the treatment of crusted scabies. Eradication frequently requires repeated applications, and care must be taken to avoid lindane toxicity. Permethrin cream is as efficacious as lindane in the treatment of ordinary scabies. Because of its wider margin of safety, permethrin may become the preferred treatment for crusted scabies.

Hexachlorocyclohexane↗
PubMed1991

Chronic tophaceous gout with severely deforming arthritis: a case report with emphasis on histopathologic considerations.

The dramatic clinical presentation of a patient with severe deforming arthritis secondary to chronic tophaceous gout is described. Polarization microscopic examination and use of the De Galantha stain identified the dermal amorphous material as urate crystals. When the possibility of gout is entertained and a lesional biopsy specimen is examined to confirm the diagnosis, it is useful to fix the fresh tissue in absolute ethanol and process the specimen using an anhydrous technique to preserve the crystals.

Acute Disease↗