Localized unilateral hyperhidrosis.
We describe a case of localized unilateral hyperhidrosis on the forehead in a 52-year-old woman. The pathophysiology of this unique clinical picture and its treatment are described.
Female↗
Biomedical subjects
T Rufli
Publications and source records attributed to T Rufli.
[Ross syndrome].
We report on a 25-year-old patient with hyporeflexia, progressive segmental hypohidrosis and dry, scaly skin mimicking tinea manuum on the affected palm. This case is the fourth with Ross syndrome and skin manifestations as a result of segmental hypohidrosis.
Adult↗
Adverse skin reactions to nicotine in a transdermal therapeutic system.
Nicotine in a transdermal therapeutic system (TTS) has been introduced recently to help people to stop smoking. 14 volunteers (10 male, 4 female) with a history of former adverse skin reactions to this device were investigated. Skin tests for contact urticaria and patch tests for contact allergy were done with the individual components of the TTS. Contact sensitization to nicotine was identified in 5 and to the TTS itself in 1 individual. Irritant reactions due to occlusion were present in 9 subjects. The optimal test agent and concentration for elucidating the adverse skin reaction was an aqueous solution of 10% nicotine base. Atopy, as diagnosed by history and skin prick tests to common inhalant allergens, and contact sensitization to standard patch test allergens, were each identified in 6 subjects. Nicotine should be added to the expanding list of transdermally delivered drugs which may elicit contact dermatitis.
Administration, Cutaneous↗
Follicular mucinosis associated with mycosis fungoides.
We report a patient who developed erythematous indurated plaques with alopecia on the face and multiple well-demarcated infiltrated scaling lesions on the trunk and extremities. Skin biopsy showed a mucinous degeneration of the follicular outer root sheaths and sebaceous glands consistent with the diagnosis of follicular mucinosis. A histologic examination of a specimen from the left forearm showed microscopic changes of mycosis fungoides. The present case confirms the need of multiple skin biopsies in the evaluation of patients with follicular mucinosis.
Aged↗
Tumor of follicular infundibulum.
Tumor of the follicular infundibulum is a rare, benign proliferative follicular disorder. A case of multiple lesions in a 37-year-old woman is reported. The diagnosis was made histologically.
Adult↗
[Oral hairy leukoplakia in patients with kidney transplantation].
Oral hairy leukoplakia was initially reported only in HIV-infected patients and was considered pathognomonic for HIV infection. The presence of Epstein-Barr virus and the decrease in Langerhans cells seem to be necessary for the development of oral hairy leukoplakia. HIV antigen is not present in oral hairy leukoplakia. We report on seven renal transplant recipients with oral hairy leukoplakia. In six of these patients no HIV infection was present. All patients showed marked immunosuppression following a vigorous immunosuppressive regimen. Five patients each had several rejection episodes, which were treated with further immunosuppressive therapy in addition to the basic immunosuppressive regimen. One patient was infected with HIV from the renal graft and another suffered from liver cirrhosis with portal hypertension caused by chronic hepatitis B infection. We believe that oral hairy leukoplakia is a marker for severe immunosuppression that is not necessarily associated with HIV infection. Organ transplant recipients undergoing dermatological check-up should be examined for oral hairy leukoplakia.
Adult↗
[Morphaea profunda].
A 47-year-old woman with a solitary morphoea profunda on the flexor aspect of the left thigh is described. Clinically the lesion is characterized by a circumscribed, deeply indurated sclerotic plaque. The main histopathological features were sclerotic collagen changes and a striking accumulation of inflammatory cells in the deep dermis as well as in the subcutaneous tissue. Plasma cells and T- and B-lymphocytes were the predominant cellular components of the infiltrate. The patient had an elevated serum titre of antibodies to Borrelia burgdorferi. The patient was treated with penicillin, which brought about a remarkable improvement. These findings provide further support for the concept that in some cases morphoea profunda may be a manifestation of Borrelia infection.
Antibodies, Bacterial↗
[Non-bullous erythroderma (congenital) ichthyosiforme with perinuclear shells].
A congenital dermatosis with an unusual course is described in a 5-year-old girl. During the first months of life she was found to have erythrokeratodermatic plaques, which developed into a non-bullous (congenital) ichthyosiform erythroderma (CIE) within 1 year. Since then, the clinical picture has remained stable. Histologically, the upper epidermal layers showed ballooning and vacuolization of the keratinocytes, glycogen storage, and focal parakeratotic keratinization. Conspicuous ultrastructural alterations consisted in the formation of shells of fine-filamentous, cross-linked material of unknown nature, binuclear keratinocytes, perinuclear edema formation, and the occurrence of lipid droplets in the horny layer. The n-alkane value was within the normal range. Our histological and ultrastructural findings are largely in accordance with those in a case of "congenital reticular ichthyosiform erythroderma". The disorder seems to represent a special genotype in the heterogeneous group of the non-bullous CIEs. We suggest naming it "non-bullous (congenital) ichthyosiform erythroderma with perinuclear shells".
Cell Nucleus↗
[Pain and itching of the right breast following a fall on the right side of the thorax].
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Accidental Falls↗
[AIDS and other sexually transmitted diseases. A videocasette from the University Dermatology Department in Zürich].
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Acquired Immunodeficiency Syndrome↗
Syphilis and HIV infection.
Treponema pallidum and HIV are both sexually transmitted agents of infectious diseases with epidemiological similarities. Ulcerous genital diseases such as primary syphilis facilitate transmission of HIV. An increasing number of case reports gives evidence that in HIV-infected patients secondary syphilis runs a more severe course and may present as syphilis maligna and that neurological complications of secondary and tertiary syphilis seem to occur more frequently and at an earlier stage. The clinical evaluation, interpretation of serology and choice of treatment schedules must take these considerations into account.
HIV Infections↗
[The dermatologic check-up].
The aim of dermatologic check-up is the early diagnosis of asymptomatic potentially dangerous skin changes. An early melanoma may be cured by simple excision. Dermatologic signs in general medicine are very important. Paraneoplastic symptoms in patients with glucagonoma consist of the typical necrolytic migratory erythema. Acrokeratosis Bazex is seen in patients with larynx carcinoma and dermatomyositis or acanthosis nigricans may occur in patients with internal malignancy. Spider angioma, jaundice, changes in hair pattern and white nails may be cutaneous signs of liver disease or necrobiosis lipoidica may be found in diabetic patients. Renal transplants and patients with HIV infection should be submitted for a dermatological check-up every six months. In these people several malignant tumors are seen more often than in control people.
Adolescent↗
[Early diagnosis of malignant melanoma of the skin. A pilot study from Basel].
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Education, Medical, Continuing↗
[Chlamydia diagnosis in clinical practice. Chlamydia trachomatis EIA and direct immunofluorescence (MikroTak) in comparison with cell culture].
The correct obtaining of material is decisive for microbiological diagnosis. The new immunologic methods, enzyme immunoassay (Chlamydiazyme) and the direct immunofluorescence with monoclonal antibodies (MikroTrak) for the detection of Chlamydia trachomatis have several advantages over cell culture. In 457 tests of urethral smears from men with all 3 methods, sensitivity and specificity were compared with cell cultures as method of reference. Tests with Chlamydiazyme yielded a concordance of 87.1%, a sensitivity of 81.5% and an specificity of 87.8%. Tests with MikroTrak were almost identical with a concordance of 86.9%, a sensitivity of 81.3% and a specificity of 87.5%. With both methods, the positive predictive value with 43.8% and 43.3% respectively is low. Frequent positive results with the immunological methods, which could not be verified by cell cultures, must be interpreted as failure of the culture method under practice conditions. The correlation of results with the clinical course supports this assumption.
Adult↗
Efficacy and tolerance of a miconazole-benzoyl peroxide cream combination versus a benzoyl peroxide gel in the topical treatment of acne vulgaris.
62-65% reduction in the number of lesions was obtained in the treatment of 52 patients with acne vulgaris in this randomized single-blind study comparing a 5% benzoyl peroxide/2% miconazole cream (BPO-MCZ) with a 5% benzoyl peroxide gel (BPO). While BPO gel was equally effective in male and female patients (66 and 73% reduction of lesions), the BPO-MCZ cream was significantly more effective in the latter (50 vs. 74% mean reduction of lesions). Tolerance was significantly better with the BPO/MCZ cream preparation, particularly in females.
Acne Vulgaris↗
Oral hairy leukoplakia in a HIV-negative renal transplant patient: a marker for immunosuppression?
We report the case of a 58-year-old renal transplant patient who developed oral hairy leukoplakia. Examination for HIV-1 and HIV-2 infection was negative. Biopsy of the lateral tongue showed ballooned prickle cells and electron microscopy revealed herpes-type viruses. In situ hybridization and examinations with the Southern blot technique yielded Epstein-Barr virus. Serology for Epstein-Barr virus was reactive. Immunological investigation of the patient showed a marked decrease of T-helper and T-suppressor cells as the result of immunosuppressive regimen. Oral hairy leukoplakia may be a marker for severe immunosuppression but is not necessarily associated with HIV infection.
Female↗
[Early summer meningoencephalitis, rickettsial diseases, Borrelia infections: diseases carried by ticks].
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Animals↗