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T G Berger

Publications and source records attributed to T G Berger.

At least 91 records · Page 5Linked to original sources
PubMed1991

Human immunodeficiency virus-associated eosinophilic folliculitis. A unique dermatosis associated with advanced human immunodeficiency virus infection.

We studied 13 patients with human immunodeficiency virus (HIV) infection and a chronic pruritic folliculitis that was unresponsive to systemic treatment with bactericidal anti-staphylococcal antibiotics. The skin eruption was characterized by multiple urticarial follicular papules scattered on the trunk (100%), the head and neck (85%), and the proximal aspect of the extremities (62%). Absolute peripheral eosinophil counts were increased in six of 13 patients; a relative peripheral eosinophilia was present in 10 of 13 patients. Serum IgE levels were elevated in all seven patients tested (range, 88 to 9050 IU). Histopathologic features included a folliculitis with eosinophils. Pathogenic bacteria were not consistently found by routine bacterial skin cultures, cultures of skin biopsy specimens, or histopathologic evaluation. CD4 counts were decreased in all of the 12 patients tested (less than 300 cells per cubic millimeter) and were below 250 cells per cubic millimeter in 10 patients. A clinical response was noted to astemizole, to ultraviolet light in the B range, and to topical clobetasol propionate. These observations demonstrate that HIV-associated eosinophilic folliculitis is a unique HIV-related cutaneous disorder that is characterized by a culture-negative, chronic, pruritic folliculitis and a characteristic histopathologic picture. Of special importance, because it is associated with CD4 counts of less than 250 to 300 cells per cubic millimeter, eosinophilic folliculitis appears to be an important clinical marker of HIV infection and, particularly, of patients at increased risk of developing opportunistic infections. We suggest that the term eosinophilic pustular folliculitis (Ofuji's disease), previously used to describe this dermatosis in HIV-infected patients, should be discarded.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Bacillary angiomatosis.

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Acquired Immunodeficiency Syndrome↗
PubMed1991

Bacterial, viral, fungal, and parasitic infections in HIV disease and AIDS.

Infectious complications are the most common cutaneous manifestations of HIV infection. In this article, the bacterial, viral, fungal, and parasitic infections seen in HIV-infected patients are described and illustrated. The relation of these infections to the overall health of the patient and current therapies that have been found beneficial are outlined.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cryotherapy for cutaneous Kaposi's sarcoma (KS) associated with acquired immune deficiency syndrome (AIDS): a phase II trial.

To assess the response and toxicity of liquid nitrogen cryotherapy for cutaneous lesions of Kaposi's sarcoma (KS) associated with AIDS, we evaluated 20 subjects with biopsy-proven KS in a phase II clinical trial. Subjects had two to four cutaneous KS indicator lesions treated with liquid nitrogen cyrotherapy. Treatment was repeated at 3 week intervals, allowing adequate healing time. On average, subjects received three treatments per lesion with a mean follow-up time of 11 weeks (range of 6-25 weeks). One treatment consisted of two freeze-thaw cycles, with thaw times ranging from 11 to 60 s per cycle. A complete response was observed in 80% of treated KS lesions and lasted a minimum of 6 weeks following the completion of therapy. Greater than 50% cosmetic improvement of KS was observed. Histopathology of treated lesions correlated poorly with cosmetic improvement. Response was not predicted by tolerance to zidovudine therapy, CD4+ cell count, presence of B symptoms, or previous chemotherapy. Subjects without prior history of opportunistic infection (OI) were more likely to have a better response than those with a prior history of OI. Subjects tolerated cryotherapy well. Blistering occurred frequently, but local pain was limited and relieved by acetaminophen. Secondary infection did not occur. Based on this study, we recommend cryotherapy to subjects with cutaneous KS lesions. Liquid nitrogen cryotherapy is easily applied as a primary therapy, and may also have a role in the treatment of cutaneous KS lesions that respond slowly or show incomplete cosmetic improvement with systemic therapies.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir therapy in patients with the acquired immunodeficiency syndrome (AIDS).

Four patients with human immunodeficiency virus (HIV) infection who received chronic oral acyclovir therapy for suppression of recurrent varicella zoster or herpes simplex virus infection developed persistent disseminated hyperkeratotic papules that failed to heal with intravenous or high-dose oral acyclovir therapy. Varicella zoster virus, resistant to acyclovir in vitro, was isolated from skin lesions of all four patients. Three patients were adults in whom the acquired immunodeficiency syndrome (AIDS) had been diagnosed 12 to 20 months before isolation of acyclovir-resistant varicella zoster virus. The fourth patient was a perinatally HIV-infected child who developed primary varicella infection at age 7 years when profoundly immunosuppressed (absolute CD4+ lymphocyte count less than 50 cells/microL). Mean antiviral susceptibilities (ED50 values) of the four clinical isolates compared with the ED50 values of the reference strain Oka were 85 compared with 3.3 mumol/L for acyclovir, 1.4 compared with 0.8 mumol/L for vidarabine, and 123 compared with 117 mumol/L for foscarnet. When assayed by [125I]-dC plaque autoradiography, 90% to 100% of the viral isolate populations had altered or no measurable thymidine kinase function. Acyclovir-resistant varicella zoster virus infection may complicate long-term oral acyclovir administration in patients with AIDS and may be associated with the appearance of atypical hyperkeratotic papules.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Nail and mucocutaneous hyperpigmentation with azidothymidine therapy.

Hyperpigmentation developed in six patients while they were receiving azidothymidine. All demonstrated hyperpigmentation of the nails; hyperpigmentation of the skin (two patients) and oral mucosa (two patients) also developed. The degree of nail pigmentation was related to the intrinsic skin color of the patient. Mucosal hyperpigmentation developed only in dark-skinned blacks. The pigmentation was due to increased melanin in the epidermis and dermis.

Acquired Immunodeficiency Syndrome↗
PubMed1990

A comparative histopathologic study of photodistributed and nonphotodistributed lichenoid drug eruptions.

This study compares the histopathologic characteristics of photodistributed and nonphotodistributed lichenoid drug eruptions in 13 patients. Both types have been said to be, in an unknown proportion, different from idiopathic lichen planus in that they can involve the deep as well as the superficial plexus, can contain eosinophils, and have parakeratotic scale. We found that these features were most often present in nonphotodistributed lichenoid drug eruptions and were seldom present in photodistributed eruptions. Thus a biopsy specimen that shows the classic features of lichen planus should not be used as evidence against a drug eruption, especially if the lesions are photodistributed.

Adult↗
PubMed1990

Osteolytic lesions and bacillary angiomatosis in HIV infection: radiologic differentiation from AIDS-related Kaposi sarcoma.

Bacillary angiomatosis is a newly recognized multisystem bacterial infectious disease seen in the setting of human immunodeficiency virus (HIV) infection. The disease is marked by cutaneous vascular lesions that contain a bacterium similar to the cat scratch disease bacillus. Antibiotic therapy leads to the resolution of both cutaneous and systemic manifestations. Of 17 HIV-infected patients with cutaneous lesions of bacillary angiomatosis, six (35%) had symptomatic osteolytic bone lesions that improved following antibiotic therapy. The authors describe the appearance of the bone lesions on radiographs, computed tomographic (CT) scans, magnetic resonance (MR) images, and radionuclide studies. Osteolytic lesions are a relatively common feature of bacillary angiomatosis in patients with HIV infection. The presence of bone lesions aids in differentiation of bacillary angiomatosis from acquired immunodeficiency syndrome-related Kaposi sarcoma, which has similar cutaneous abnormalities but no associated bone lesions.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Dermatologic manifestations of HIV infection.

Nearly all patients infected with the human immunodeficiency virus (HIV) will develop cutaneous or mucous membrane manifestations. Oral cavity lesions associated with HIV disease include candidiasis, hairy leukoplakia and Kaposi's sarcoma. Skin infections such as herpes simplex, herpes zoster, molluscum contagiosum, Staphylococcus aureus folliculitis and warts are often more severe than usual and may be refractory to therapy. Seborrheic dermatitis is the most common cutaneous eruption. The appearance of Kaposi's sarcoma in a patient younger than 60 years of age or in any individual with laboratory evidence of HIV infection is diagnostic of acquired immunodeficiency syndrome. Serious drug reactions may occur, despite the depressed cellular immunity associated with HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Postoperative Trichosporon beigelii soft tissue infection.

A case of postsurgical cutaneous infection with Trichosporon beigelii in an apparently immunocompetent individual is reported. This is a rare surgical complication and the first report of localized skin infection by this organism postoperatively.

Adult↗