A palmar injury that failed to heal. Diagnosis: basal cell carcinoma of the palm.
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Biomedical subjects
Publications and source records attributed to S Lateo.
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Ectopic calcification following liver transplantation has been reported to occur in various internal organs but there have been few reports of skin involvement. The pathogenesis is uncertain with previous reports suggesting that the calcifications could be either dystrophic or metastatic. The large amount of intravenous calcium needed to correct hypocalcaemia secondary to blood product transfusion is thought to play a central role. We report a case of calcinosis cutis developing after liver transplantation in a 22-year-old woman at sites where no intravenous calcium had been administered. In previously published cases serum calcium and phosphate levels were reported as normal. In our case serum calcium levels were also within or below normal limits with the exception of a transient rise in the immediate post-operative period. Our case supports earlier hypotheses that short-lived and often undetected elevations in the calcium-phosphate product are implicated in this condition.
AIMS: To measure pimecrolimus blood concentrations and to evaluate tolerability and efficacy in children and infants treated topically for atopic dermatitis with pimecrolimus cream 1% for three weeks. METHODS: Three open label, non-controlled, multiple topical dose studies were conducted in children aged 8-14 years (study A, ten patients), and in infants aged 8-30 months (study B, eight patients) and 4-11 months (study C, eight patients). Pimecrolimus blood concentrations were determined on days 4 and 22 of treatment, and at end of study. Efficacy was assessed using the Eczema Area and Severity Index (EASI). RESULTS: Pimecrolimus blood concentrations were consistently low, typically (81%) below 1 ng/ml, with more than half of the measurements below the assay limit of quantitation (0.5 ng/ml) in studies A and B. The highest blood concentration measured throughout the three studies was 2.6 ng/ml. The cream was well tolerated, locally and systemically. The most common adverse event suspected to be related to study medication was a transient mild to moderate stinging sensation at the application site in 5/26 patients. There was no indication of any systemic adverse effect. The patients responded well to therapy with a rapid onset of action, usually within four days. Median reductions of EASI from baseline at day 22 were 55% (study A), 63% (study B), and 83% (study C). CONCLUSION: Three weeks treatment of children and infants with extensive atopic dermatitis, using pimecrolimus cream 1% twice daily, is well tolerated and results in minimal systemic exposure, at which no systemic effect is expected.
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