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Biomedical subjects

W D James

Publications and source records attributed to W D James.

At least 145 records · Page 8Linked to original sources
PubMed1986

Gianotti-Crosti syndrome associated with infections other than hepatitis B.

Although the Gianotti-Crosti syndrome (GCS) is regularly associated with hepatitis B infection elsewhere, in North America that association is rarely made. Accordingly, we studied nine children with acral, symmetrical eruptions typical of GCS for evidence of other infections. All were negative for hepatitis B surface antigen. Viral cultures were done in nine patients, and viruses isolated in two. One patient with a respiratory prodrome had respiratory syncytial virus (RSV) isolated, and a second patient studied simultaneously showed serological evidence of RSV infection. A third patient with both respiratory tract and gastrointestinal tract symptoms yielded a polio-vaccine enterovirus. Two patients with fever and pharyngitis had group A beta-hemolytic streptococci isolated from the throat. Skin biopsies were done in three cases, and findings were consistent with GCS. Electron microscopy of two lesional biopsy specimens failed to demonstrate viral particles. Epstein-Barr virus serological findings were negative in six cases and showed evidence of past infection in three cases. This study strengthens the observation that hepatitis B is not the causative agent of GCS in this country and suggests that multiple infectious agents may be associated with this distinctive exanthem.

Acrodermatitis↗
PubMed1986

Skin reactions induced by trimetrexate, an analog of methotrexate.

We have observed three forms of skin toxicity induced by the new antifol trimetrexate in a Phase I trial. They are: radiation recall, cellulitis at the infusion site, and generalized skin eruptions with erythroderma. A total of 25 episodes of some form of skin reaction occurred in 31 patients. The generalized eruption began about four days after drug administration and cleared within a week. The mechanism of skin toxicity of trimetrexate and other antifols is unknown.

Cellulitis↗
PubMed1986

Bart's syndrome: microscopic, ultrastructural, and immunofluorescent mapping features.

Bart's syndrome has been clinically described as the association of congenital localized absence of skin (CLAS), epidermolysis bullosa (EB), oral mucosal lesions, and dystrophic nails. Transmission occurs through an autosomal dominant gene with complete penetrance but variable expression. It has been difficult to classify this type of EB because of lack of microscopic and ultrastructural studies on affected family members. This is the first report of microscopic, ultrastructural, and immunofluorescent mapping studies of an affected individual with the complete inherited syndrome initially described by Bart. This study is also the first to document the association of CLAS and dominant dystrophic epidermolysis bullosa by histology, electron microscopy, and immunofluorescent mapping. Our two patients and one other affected family member had diminution or absence of a specific basement membrane antigen as defined by immunofluorescence with a monoclonal antibody (KF-1) in perilesional skin.

Adolescent↗
PubMed1986

Multiple hamartoma syndrome (Cowden's disease) associated with non-Hodgkin's lymphoma.

A 70-year-old woman with the multiple hamartoma syndrome is described. Diagnosis was based on the clinical presentation and histopathologic examination of cutaneous trichilemmomas. The case is reported to document the association of Cowden's disease with non-Hodgkin's lymphoma. This is the first known report of the occurrence of trichilemmomas in the sacral area. The literature concerning the association of the multiple hamartoma syndrome with malignancy is reviewed.

Aged↗
PubMed1986

Contact urticaria to O-phenylphenate.

Contact urticaria is a form of immediate hypersensitivity reaction that is being noted with increasing frequency. This report illustrates an unusual presentation of contact urticaria in the form of an immediate reaction to a component of plaster cast material. The substance involved was ortho-phenylphenate, a preservative. It has not been previously implicated in a contact urticaria reaction.

Adult↗
PubMed1985

Plaquenil-induced erythroderma.

A patient who developed exfoliative erythroderma 11 days after the initiation of hydroxychloroquine treatment for psoriatic arthritis is presented. Our experience with her and the continued controversy regarding the incidence of adverse reactions in psoriatic patients to antimalarials prompted a detailed review of the literature. We conclude that the use of antimalarials in patients with psoriasis is associated with a high incidence of severe cutaneous adverse reactions. These medications should not be used in psoriatic patients if other less toxic, effective therapies are available.

Adult↗
PubMed1985

A papular eruption associated with human T cell lymphotropic virus type III disease.

The clinical spectrum of human T cell lymphotropic virus type III (HTLV-III) disease is associated with myriad cutaneous findings, commonly of infectious origin. A clinically characteristic, yet histologically nonspecific, papular eruption was observed in seven of thirty-five patients followed up for HTLV-III disease (acquired immunodeficiency syndrome and the related complex). Noncoalescing 2- to 5-mm skin-colored papules of the head, neck, and upper trunk typify the lesions. Histologically, a chronic perivascular infiltrate of mononuclear cells was regularly present. The eruption was often, but not always, pruritic. The clinical course was chronic. Many patients had persistent lesions for more than 9 months; however, the number of papules tended to wax and wane with time. Although the cause of this eruption is unknown, it is sufficiently distinct and frequent to be recognized by clinicians as a cutaneous sign of human retrovirus infection.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Treatment of gram-negative folliculitis with isotretinoin: positive clinical and microbiologic response.

Thirty-two patients with gram-negative folliculitis were treated with 0.47 to 1.0 mg/kg/day of isotretinoin. Serial microbiologic evaluations demonstrated rapid clearing of the face and nasal mucosa of gram-negative rods. The clinical response was rapid, complete, and induced prolonged remissions. Twenty-six of thirty-two patients developed Staphylococcus aureus nasal carriage by the end of the 20-week treatment course. Isotretinoin has decided advantages over previously reported therapies for gram-negative folliculitis.

Acne Vulgaris↗
PubMed1984

Acute idiopathic thrombocytopenic purpura.

A 35-year-old man had hemorrhagic bullae of the buccal and sublingual mucosa as the first sign of acute idiopathic thrombocytopenic purpura. Twenty-four hours later the more typical cutaneous manifestations of petechiae of the lower extremities were present. Although it is unusual for the initial symptoms of this disease to be limited to the oral region, the physician and dentist should be keenly aware of the clinical appearance described in this article, as it may be the only clue of an underlying systemic disease.

Acute Disease↗
PubMed1984

Nodular (keloidal) scleroderma.

Two patients with progressive systemic sclerosis (PSS) developed keloidal-like nodules within areas of thickened skin. This extremely unusual event is most likely a keloidal response to the early inflammatory component of scleroderma in patients who are either genetically at risk for keloid formation or in areas of the skin that have a high predilection for keloid formation such as the chest.

Adolescent↗
PubMed1984

Allergic contact dermatitis to compound tincture of benzoin.

Nineteen cases of allergic contact dermatitis to compound tincture of benzoin are described. Patch testing to individual components revealed positive reactions to all ingredients except aloe. An alternative preparation, Mastisol, was successfully used without primarily inducing allergy. It should be considered for use before benzoin because once allergy to benzoin exists, cross-reactions to Mastisol usually occur. This is probably due to the presence of a common ingredient, styrax gum.

Adolescent↗