Biomedical subjects
Publications and source records attributed to S J Hodge.
We treated three patients with inflammatory linear verrucose epidermal nevus. The lesions were either verrucose or psoriasiform and all had an inflammatory component. Histologic features included psoriasiform acanthosis with spongiosis and parakeratosis. Features that distinguish this entity and the differential diagnoses are discussed.
Purpura fulminans is the cutaneous manifestation of acute activation of the clotting mechanism resulting in massive hemorrhage due to an intravascular consumption coagulopathy. Peripheral necrotizing purpura is a warning signal, and early recognition of the clinical situation and heparin therapy may be lifesaving. Clinical manifestations and histologic features of this condition, along with its pathogenesis, treatment, and differential diagnosis are discussed.
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A 21-year-old woman with eventually fatal malignant atrophic papulosis (Degos disease) was treated primarily with the fibrinolytic agents phenformin hydrochloride and ethylestrenol. In spite of therapy, primarily central nervous system manifestations led to the patient's death.
The effectiveness of orally administered prostaglandin E2 in inducing labor was studied in 60 patients with uncomplicated, full-term pregnancies, using three dosage schedules. Although 40 patients did deliver, 11 patients' amniotic membranes ruptured at a time considered by the investigators to introduce an undesired variable in attempting to evaluate the drug. Twenty (33%) failed to deliver despite adequate Bishop scores. Side effects were noted in 45% of patients. No significant advantage for induction of labor occurred with the three dosage schedules used.
A 27-year-old patient developed superficial basal cell epitheliomas approximately 20 years after taking Fowler's solution. One of the lesions was successfully treated with topical 2% 5-fluorouracil soultion under occlusion. Sequential biopsies of the lesion before, during and after therapy were examined by light and electron microscopy, and the changes at various stages are described. Changes occurred only in tumor cells and adjacent epidermis, and only after occlusion of 5-FU. After one week of occlusive therapy, focal discontinuities in the basal lamina and intercellular spaces were wider with reduction and condensation of tonofilaments. Mitochondrial degeneration was seen along with irregularities in nucleoli. These changes were most prominent after two weeks of occlusive therapy, and many degenerating keratinocytes were seen detached from other cells. One month after cessation of therapy, the entire area was excised, and no evidence of tumor was seen.
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Intraepithelial epithelioma (IEE) is a distinct histologic expression of a variety of epithelial processes. The most common intraepidermal tumors giving rise to this histologic pattern are seborrheic keratosis and actinic keratosis, although several others were seen in our series. We report a total of 33 cases of IEE seen during a 10-year period and a review of the literature.