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Biomedical subjects

W B Shelley

Publications and source records attributed to W B Shelley.

At least 19 recordsLinked to original sources
PubMed1995

Estrogen dermatitis.

BACKGROUND: Autoimmune progesterone dermatitis includes pruritus, urticaria, papulovesicular eruptions, and bullous erythema multiforme. Sensitivity to estrogen has not been described, although it was probably first recognized almost 50 years ago. OBJECTIVE: Our purpose was to assess sensitization to selected hormones in women with a significant premenstrual flare of skin lesions. METHODS: Intradermal skin tests to 18 hormones and control substances were performed in seven patients and four control subjects and read for immediate urticarial and delayed type reactions. Six other control subjects had only estrone and progesterone skin tests. The effect of the antiestrogen tamoxifen on the course of the dermatosis was studied. RESULTS: Seven women exhibiting severe premenstrual exacerbations of papulovesicular eruptions, urticaria, eczema, or generalized pruritus proved to have an unrecognized sensitivity to estrogen. Five patients had a positive delayed tuberculin-type skin test to estrogen. Two patients with generalized chronic urticaria had only an urticarial reaction to intradermal estrogens. Antiestrogen therapy with tamoxifen proved effective in all five patients, whereas elimination of oral estrogen therapy cured the other two patients. CONCLUSION: Women can become sensitized to their own estrogens; the major clue is worsening of the skin problem premenstrually. Positive intradermal skin tests to estrogens are diagnostic. Tamoxifen is a specific therapy. We have named this disorder estrogen dermatitis.

Adult↗
PubMed1995

Occult Streptococcus pyogenes in cellulitis: demonstration by immunofluorescence.

A 23-year-old man developed cellulitis and ascending lymphangitis of the right leg. Blood cultures and skin saline aspirates were sterile. Gram stain of the aspirate did not show any bacteria. Direct and indirect immunofluorescent staining with polyclonal and monoclonal antibodies to Streptococcus pyogenes revealed streptococci in the reticular dermis. The cellulitis resolved following treatment with intravenous cefazoline.

Adult↗
PubMed1995

Painful fingers, heat intolerance, and telangiectases of the ear: easily ignored childhood signs of Fabry disease.

Generalized anhidrosis with heat collapse, painful fingers, and angiokeratomas were the presenting signs in a 23-year-old man who was shown by enzyme studies and electron microscopy to have Fabry disease. His 6-year-old brother had the early diagnostic findings of episodic painful fingers, heat intolerance, and retroauricular telangiectasia. Both had an absence of alpha-galactosidase. Over 6 years of observation, the older brother developed progressive renal failure and the younger one developed acrodynia and anhidrosis. Their mother had diminished alpha-galactosidase activity and several angiomatous papules on one breast. A review of Fabry disease emphasizes the need for skin inspection for angiomas and telangiectasia, and enzyme assay in patients with inexplicable complaints or findings. Carrier females are most easily recognized by the presence of unique corneal opacities.

Adult↗