Biomedical subjects

Ted Rosen

Publications and source records attributed to Ted Rosen.

24 records · Page 2Linked to original sources

PubMed2002

Treatment of a large superficial basal cell carcinoma with 5% imiquimod: a case report and review of the literature.

BACKGROUND: Large superficial basal cell carcinomas (BCCs) may be difficult to treat surgically due to the potentially large resulting defect after removal. Imiquimod, an immune response modifier, when applied topically, has been demonstrated to be successful in treating superficial BCCs. There is no published experience on the treatment of larger superficial BCCs (greater than 2 cms2) with imiquimod at this time. OBJECTIVE: To assess the clinical and histologic regression, as well as the short- and long-term effects of topical imiquimod on large superficial BCC. METHOD: A 52-year-old white female with a 30 cm2 biopsy proven superficial BCC of 28 years duration on the right dorsal arm was treated with 5% imiquimod three times a week for 12 weeks. Clinical follow-up was conducted 1, 4, 6, and 10 months after treatment, as well as histologic assessment of recurrence at 4 months after treatment. RESULTS: Apparent clinical and histologic clearance was achieved. The treatment was well-tolerated and the patient completed the treatment schedule without a rest period, despite erosion of the lesion in the last week of treatment. CONCLUSION: This report describes the first case of a large superficial BCC (30 cm2) successfully treated with topical imiquimod and with a 10 month follow-up.

Adjuvants, Immunologic↗

PubMed2002

Treatment of squamous cell carcinoma in situ of the penis with 5% imiquimod cream: a case report.

A patient with widespread in situ squamous cell carcinoma of the glans penis was successfully managed with topical application of 5% imiquimod cream. Therapy with topical immune response modifiers may prove beneficial in cases of superficial cutaneous carcinoma and may, if future studies confirm our findings, play a role in settings in which more destructive techniques may result in cosmetic defects or functional impairment. The use of imiquimod for intraepithelial squamous cell carcinoma of the anogenital area seems particularly logical because of the strong correlation between this neoplasm and infection with human papillomavirus.

Adjuvants, Immunologic↗

PubMed2002

Disseminated cutaneous sporotrichosis treated with itraconazole.

A 72-year-old Hispanic man with diabetes presented with a 4-week history of a tender non-healing ulcer on the fifth digit of the left hand and a 3-day history of fever, chills, malaise, anorexia, and tender fluctuant nodules on the abdomen and left elbow. The patient, an avid gardener, was using prednisone and methotrexate for a debilitating seronegative polyarthropathy. A diagnosis of disseminated cutaneous sporotrichosis was made based on epidemiologic risk factors, clinical appearance, histopathologic examination, and a positive fungal culture. Use of prednisone was discontinued, the dosage of methotrexate was decreased, and use of oral itraconazole 400 mg/day was instituted. The patient's lesions cleared within 5 months, and no recurrence was noted during a 3-month follow-up. This case illustrates the typical association of the rare entity of disseminated cutaneous sporotrichosis with immunosuppression, an unusual lack of internal involvement, and a gratifying response to itraconazole.

Antifungal Agents↗

PubMedDate not supplied

Endemic treponematosis: review and update.

Despite major efforts to eradicate these disorders, yaws, bejel, and pinta (endemic treponematosis) remain serious health issues in many regions of the world. Aside from prominent skin manifestations, these diseases may also lead to significant osseous, neurologic, and ophthalmologic complications. Although progress has been made in differentiating the causative species in a research setting, a simple, specific, and sensitive diagnostic test remains elusive. Parenteral penicillin, in appropriate dosage, is the treatment of choice; alternative antibiotics such as tetracycline and erythromycin may also be effective.

Diagnosis, Differential↗

PubMedDate not supplied

Cheilitis glandularis in an African-American woman: response to antibiotic therapy.

A 52-year-old black woman presented with a 2-day history of lower lip swelling 5 days after starting a new medication, lisinopril. She had never experienced similar episodes in the past. She denied shortness of breath, tightening of the throat, swelling of the tongue, generalized cutaneous eruption, urticaria, or pruritus. She also denied symptoms consistent with facial paresis. Her past medical history was significant for hepatitis C infection, coronary artery disease, and hypertriglyceridemia. She had a 15 pack-year smoking history and denied both alcohol and drug abuse. She had never received a blood transfusion and was HIV negative. Physical examination disclosed a tender, swollen, and erythematous lower lip with induration, oozing, and crusting (Figure 1). Pinpoint openings evident throughout the lip surface exuded a clear, sticky, mucoid secretion. Tongue, parotid glands, and regional lymph nodes were normal. The working diagnosis was angioedema secondary to lisinopril. The presumptive offending drug was discontinued, and conservative therapy (topical clobetasol ointment, oral ranitidine, and oral fexofenadine) was initiated. Despite treatment, signs and symptoms persisted unabated. One week after initial presentation, a punch biopsy of her lower lip was taken to rule out granulomatous cheilitis and sarcoidosis. Histopathology included diffuse lymphohistiocytic infiltrate, minimal microabscess formation, and notable absence of granulomata. There was neither hypertrophy nor detectable abnormality of the salivary glands, with the exception of infiltrating mononuclear cells. Based on the clinical history and compatible pathologic findings, a diagnosis of cheilitis glandularis was made. Specifically, crusting and erosion clinically suggested a diagnosis of the superficial suppurative subtype of cheilitis glandularis. The patient received oral penicillin (dicloxacillin, 1.0 g/d) combined with oral fluoroquinolone (ciprofloxacin, 1.0 g/d). Within 2 weeks of starting the antibiotics, the lip swelling significantly decreased (Figure 2) and the patient was left with a mildly indurated nodule at the labial commissure. Following a 4-week course of continued antibiotic treatment, the lip returned to near baseline state. At both 6-month and 1-year follow-up visits, the lip remained normal.

Angiotensin-Converting Enzyme Inhibitors↗

PubMedDate not supplied

Rapid treatment of tinea nigra palmaris with ciclopirox olamine gel, 0.77%.

A 48-year-old white woman presented with the abrupt onset of an asymptomatic but cosmetically distressing eruption on the palm. Physical examination disclosed a 2.5 x 2.0-cm macular brown patch on the central left palm (Figure 1). Potassium hydroxide examination revealed brown-pigmented, septate, branching filamentous hyphae. Clinical and microscopic findings were classic for tinea nigra palmaris. Medical, family, and social history were all unremarkable. The patient applied ciclopirox olamine gel, 0.77% b.i.d. for 3 days. Following this brief therapeutic intervention, the lesion resolved completely (Figure 2). She remained clear during the ensuing 14-month follow-up.

Antifungal Agents↗