Imiquimod therapy for elastosis perforans serpiginosa.
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Adjuvants, Immunologic↗
Biomedical subjects
Stephen M Purcell
Publications and source records attributed to Stephen M Purcell.
Prevention of nosocomial infection during dermoscopy?
BACKGROUND: Dermatoscopes are applied directly to cutaneous or mucocutaneous surfaces with immersion fluid (IF) such as oil or alcohol to reduce light reflection. Recently, Staphylococcus aureus has been isolated from dermatosopes that used mineral oil as the IF. Thus, dermatoscopes might be a potential source of nosocomial infection. OBJECTIVE: In this study we propose the use of an alcohol-based antibacterial gel to reduce nosocomial infection transmission while optimizing optical resolution during dermatoscopic examination. MATERIALS AND METHODS: Aerobic bacterial cultures were performed on three dermatoscopes used in an outpatient setting after routine examination of 31 patients with an alcohol-based antibacterial gel as IF. RESULTS: There was no bacterial growth after using the antibacterial gel with the dermatoscopes. The optical resolution for the antibacterial gel appeared equal to the 'dermatoscopy oil' and superior to alcohol wipes. CONCLUSIONS: Alcohol-based antibacterial gel appears to inhibit bacterial colonization while offering excellent optical resolution during dermoscopic examination. The use of alcohol-based IF appears to obviate the risk of nosocomial infections.
Cross Infection↗
Nonsyndromic segmental multiple infundibulocystic basal cell carcinomas in an adolescent female.
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Adolescent↗
Acral persistent papular mucinosis.
Acral persistent papular mucinosis is a rare subtype of localized lichen myxedematosus. For half a century, this disease has endured a controversial and constantly evolving classification. We describe a patient who presented with discrete, flesh-colored papules on the hands, wrists, and forearms in a distribution consistent with acral persistent papular mucinosis. Histology was also constant with this disease, showing a well-circumscribed deposition of mucin in the upper and mid dermis that spared a small grenz zone. The changing nomenclature and diagnostic requirements of acral persistent papular mucinosis that have allowed it to remain a topic of debate are examined through a comprehensive review of the literature. All reported cases are reviewed.
Female↗
Full-face carbon dioxide laser resurfacing in the management of a patient with the nevoid basal cell carcinoma syndrome.
BACKGROUND: Multiple surgical procedures are often a source of discomfort, pain, and disfigurement for patients with the nevoid basal cell carcinoma syndrome (NBCCS). OBJECTIVE: The patient with NBCCS had approximately 45 identifiable basal cell carcinomas on her face. Multiple Mohs surgeries were performed to remove the largest tumors. A tumor-free plane was not achieved in several lesions despite removal of multiple tissue layers. The treatment of the remaining tumors presented a significant challenge. METHODS: Full-face CO2 laser resurfacing was performed after curettage and local laser ablation of all visible tumors. RESULTS: The patient healed well postoperatively. She developed six basal cell carcinomas on her face during the 10-month follow-up period. These were easily treated with Mohs surgery and imiquimod cream. CONCLUSION: CO2 laser resurfacing is a useful surgical modality for treatment of multiple facial basal cell carcinomas in the patients with NBCCS. It allows treatment of all the facial lesions in a single session and minimizes suffering resulting from repeated surgical procedures. Additionally, the layer of skin damaged by ultraviolet radiation is removed, allowing for easier management after resurfacing.
Adult↗
Protracted calciphylaxis, Part I.
Calciphylaxis is a serious and often lethal condition that mostly affects patients with renal disease. Patients with calciphylaxis typically have variable degrees of cutaneous necrosis on initial presentation. An unusual, protracted course of calciphylaxis without cutaneous ulcerations has been encountered in the case of a 46-year-old woman. Thirteen additional cases with similar presentation will be discussed in part II of this article. Calciphylaxis may include several clinical presentations, ranging from an acute, rapidly fatal course to an indolent, more benign variant.
Biopsy↗
Protracted calciphylaxis, Part II.
An unusual protracted course of calciphylaxis without cutaneous ulcerations has been encountered in 14 cases. Calciphylaxis may include several clinical presentations ranging from an acute, rapidly fatal course to an indolent, more benign variant. Calciphylaxis should be included in the differential diagnosis for patients with kidney disease presenting with a clinical picture of panniculitis. Patients with renal disease with a characteristic clinical presentation with or without cutaneous ulcerations should undergo an urgent biopsy to confirm the diagnosis.
Adult↗
A novel GJA 1 mutation in oculo-dento-digital dysplasia with curly hair and hyperkeratosis.
Oculo-dento-digital dysplasia (ODDD) is a rare autosomal dominant congenital disorder mainly affecting the development of the face, eyes, skeletal system, heart and dentition. ODDD has been mapped to chromosome 6q22-q24 and germline mutations have been identified in the connexin 43 gene, GJA1. Abnormalities of the skin, hair, and nails have been recognized in ODDD but are often easily overlooked. We report an ODDD patient with curly hair, early trichorrhexis nodosa and discrete keratoderma. Molecular genetic studies revealed a novel GJA1 mutation affecting the amino terminus of the gap junction protein alpha-1 (Cx43). In the light of the cutaneous findings in our patient and based on recent ectodermal dysplasia classification systems, we propose to include ODDD in the group of ectodermal dysplasias.
Abnormalities, Multiple↗