Biomedical subjects
Publications and source records attributed to W F Bergfeld.
Pyoderma gangrenosum (PG) is a characteristic ulcerative condition of unknown etiology. Four cases are reported of patients with PG who responded to minocycline hydrochloride therapy. Possible mechanisms for this apparently efficacious modality are discussed.
In summary, the presenting signs of diffuse hair loss was thinning of the scalp hair with associated receding of frontal and temporal hairlines. The majority of patients experienced telogen efflivium between the ages of twenty and sixty years. The hair loss could be classified according to the multiple presumptive etiologic factors; hereditary, hormonal, or systemic disorders, drugs, nutritional deficits, neoplasms, physical and chemical trauma, and psychological disorders. Of the 129 women evaluated, 30 percent had concomitant systemic disorders or precipitating causes. This report stresses the importance of a full hiar loss evaluation and an attempt to identify the etiologic factors or disease states that may precipitate or exacerbate an existing condition such as androgenic alopecia. It is hoped that the outlines for the initial history and examination presented in this report will help to direct the physician's evaluation of hair loss problems in women.
Histiocytic medullary reticulosis (HMR) is a rare, progressive, fatal reticuleondothelial proliferative disorder. It was diagnosed in a 10-year-old boy who had pityriasis lichenoides et varioliformis acuta of Mucha-Haberman which was controlled by dapsone for 2 years. One month after cessation of dapsone therapy, cutaneous tumors associated with fever, lymphadenopathy, and hepatosplenomegaly developed. Tissue biopsy specimens of skin, liver, spleen, lymph nodes, and a bone marrow aspirate demonstrated histiocytic erythrophagocytosis and atypical histiocytosis compatible with HMR. A rapidly progressing, fatal course followed despite intensive chemotherapy.
This discussion has highlighted some of the cutaneous disorders that are found in football and wrestling participants in an exaggerated form. These disorders may occur in any person, of course, and are not limited to football or wrestling participants. Also, football and wrestling participants may have any cutaneous disorder; their disorders are not limited to those mentioned in this review. The dermatologist should be alert to contagous disorders in these participants, especially because of the close contact their activities necessitate and the potential epidemic spread of these disorders. One must also be alert to the possibility that a condition may be masked by the minor trauma of the sport. It is re-emphasized that these disorders are exaggerated because of the increased perspiration, heat, friction, secretion of fatty acids, body contact, special gear, climatic conditions, and trauma. Fortunately, the participants are normally healthy individuals who respond quickly to the appropriate therapy.
In summary, PUVA therapy is an exciting, acceptable, and effective therapy for the treatment of psoriasis vulgaris. The histologic changes in the skin secondary to PUVA therapy appeared to be an accentuated solar damage of skin. Whether this therapy also enhances the incidence of skin cancers will be answered only by continued observation of these treated patients. The fear of all those engaged in PUVA therapy is that the potentiation of cutaneous neoplasia will not be recognized for many years, as was the case in superficial x-ray therapy. Obviously, careful monitoring of PUVA patients and their clinical response will help reduce UVA exposure as well as decrease the amount of psoralen ingested, and may indeed avoid the prolonged use of PUVA therapy and hopefully lessen the potential longterm cutaneous changes and possible superficial skin cancers.
Tumor cells from a 10-year-old boy was suspected histiocytic medullary reticulosis were examined and were found to have receptor sites for complement, the ability to phagocytize latex beads, and the electron microscopical picture of immature histiocytes. These findings strongly support the diagnosis of histiocytic medullary reticulosis. This disorder and the method of examination of the tumor cells are discussed.
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Cutaneous mastocytosis appears to occur sporadically; however, familial inheritance has been reported in 50 families since the mid-1880s. We report four cases of telangiectasia macularis eruptiva perstans (TMEP) occurring in three generations of a family. Whereas most patients with TMEP manifest in adulthood, all of the members of this family developed initial lesions during childhood. This is the third documented instance of familial mastocytosis affecting members of three generations, and the first report of familial TMEP. Although the inheritance pattern is unknown, the presentation of disease in this family further supports the hypothesis of an autosomal dominant mode of transmission with incomplete penetrance.