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Biomedical subjects

Whitney A High

Publications and source records attributed to Whitney A High.

28 records · Page 2Linked to original sources
PubMed2004

Idiopathic bilateral auricular ossificans: a case report and review of the literature.

Petrification of the auricle results in a rigid and immalleable ear. The etiology of such a finding is usually ectopic calcification. The condition has been associated with injurious processes, such as cold injury, and with various endocrinopathies, including Addison disease. In a significant number of cases, ossification occurs without knowledge of the precipitating cause or event. True auricular ossification is a rare occurrence, with only 12 histologically confirmed cases in the literature. We herein present the clinical and pathologic findings of another case. A 60-year-old man with diet-controlled diabetes presented with a 10-year history of slowly and insidiously stiffened auricles. He denied any precipitating historical events. Routine testing did not demonstrate systemic abnormalities. Radiographic examination revealed opacities consistent with bony structure in the auricles of the ears, with the right more prominent than the left. Histologic sampling demonstrated ossification with deposition of trabecular bone in proximity to normal elastic cartilage.

Ear Diseases↗
PubMed2003

Rapidly enlarging growth of the proximal nail fold.

BACKGROUND: Squamous cell carcinoma (SCC) of the nail unit is a rare but often underappreciated neoplasm. Treatment can be delayed due to confusion with paronychia and verruca. Infection with human papilloma virus (HPV) has been associated with this malignancy. OBJECTIVE: To describe the development of a superficially invasive SCC of the proximal nail fold in a patient infected with HIV, to report the association of a previously unrecognized HPV genotype, and to review key etiologic, diagnostic, and therapeutic points as related to SCC of the proximal nail fold. RESULTS: This is the first report of HPV 26 coinfection in monogamous sexual partners, both of whom are HIV infected and have demonstrated lesions of malignant degeneration consistent with SCC. CONCLUSION: SCC must be considered in the differential diagnosis of nail fold neoplasm. An immunocompromised condition such as HIV/AIDS may predispose to malignant degeneration of lesions caused by infection with HPV.

Adult↗
PubMed2003

Fatal interstitial pulmonary fibrosis in anti-Jo-1-negative amyopathic dermatomyositis.

Amyopathic dermatomyositis (DM) describes a subpopulation with the cutaneous eruption of DM, but without muscle involvement. Interstitial pulmonary fibrosis is a recognized complication of DM, often correlated with antisynthetase enzymes, such as anti-Jo-1. We describe a case of fatal IPF in a patient with anti-Jo-1 antibody-negative amyopathic DM.

Antibodies, Antinuclear↗
PubMed2003

Late-stage nodular erythema elevatum diutinum.

Erythema elevatum diutinum (EED) is a rare chronic vasculitic process of unknown etiology that presents as bilateral, symmetrical, periarticular, red-brown papules and plaques, often over dorsa of joints. Early histologic changes are characterized by leukocytoclastic vasculitis. With chronicity, the lesions develop dense neutrophilic infiltrate and fibrosis. We describe an unusual case of late-stage nodular EED present for 35 years in a seronegative 75-year-old man. Asymptomatic papules and plaques measuring from 0.7 to 9.0 cm were seen over the interphalangeal joints, elbows, knees, and ankles. The histologic findings were characterized by predominant concentric fibrosis that formed well-circumscribed dermal and subcutaneous nodules. Awareness of this unusual presentation of EED helps to avoid misdiagnosis as cutaneous neoplasms.

Aged↗
PubMed2003

Contact dermatitis education in dermatology residency programs: can (will) the American Contact Dermatitis Society be a force for improvement?

BACKGROUND: Contact dermatitis accounts for a considerable portion of outpatient clinic visits to dermatologists. The state of education in contact dermatitis at the level of dermatology residency training in the United States has not been examined. OBJECTIVE: To assess the state of education in contact dermatitis in dermatology residency programs in the United States. METHOD: Cross-sectional survey of directors and chief residents of 105 dermatology training programs accredited by the American College of Graduate Medical Education. RESULTS: Seventy-seven percent of directors and 74% of chief residents responded to the survey. In general, both sets of respondents gave concordant responses although responses from directors were more positive. With respect to didactic education, the vast majority of programs (> 73%) held lecture conferences on contact dermatitis. Less than one-third included contact dermatitis-focused journals in journal club conferences. A bare majority of programs (57% of directors, 53% of chief residents) identified a faculty expert in contact dermatitis, with almost all experts conducting patch-test clinics and providing lectures on contact dermatitis. Seventy-five percent of experts were members of the American Contact Dermatitis Society (ACDS). Although residents in most programs (> 78%) performed patch tests to diagnose contact dermatitis, there were 14 programs in which none of their graduates performed such tests. Moreover, only 27% of programs had rotations dedicated to contact dermatitis and/or patch testing. Finally, directors and chief residents predicted that most graduates will incorporate the TRUE Test and not the more extensive or customized patch tests in their practices. CONCLUSIONS: Several opportunities for improving contact dermatitis education in residency programs were identified, including recruitment or development of more faculty experts in contact dermatitis, creation of rotations dedicated to contact dermatitis, and greater inclusion of contact dermatitis-focused journals in journal club conferences. As the principal interest group for contact dermatitis in the United States, the ACDS is the logical organization to spearhead improvement of contact dermatitis education in residency programs.

Clinical Competence↗
PubMed2002

Dislocation after revision total hip arthroplasty : an analysis of risk factors and treatment options.

BACKGROUND: Dislocation is a leading and underemphasized cause of failure in revision total hip arthroplasty. Although this fact is generally well recognized, we are aware of no detailed assessments of this problem to date. Our purpose therefore was to evaluate the risk factors leading to instability after revision as well as the expected outcome of various treatment strategies. METHODS: Data were obtained from 1548 revision arthroplasties in 1405 patients who were followed for a minimum of two years (range, 2.0 to 16.4 years; mean, 8.1 years) or until dislocation occurred. Revisions specifically performed because of instability were excluded from the analysis. Risk factors were recorded along with treatment strategies and their success. The statistical relevance of both sets of variables was calculated. RESULTS: A dislocation occurred after 115 (7.4%) of 1548 revision hip arthroplasties. The use of an elevated rim liner was associated with significant decreases (p < 0.05) in dislocation following revision of femoral and acetabular components. The presence of trochanteric nonunion was a significant risk factor for subsequent dislocation (p < 0.001). Revisions with 32-mm and 28-mm-diameter femoral heads were both more stable than was revision with a 22-mm-diameter head (p < 0.05 for each). Surgery was the initial treatment for twelve of the 115 dislocations. Six of the twelve hips had no further instability. Of the 103 postoperative dislocations initially managed nonoperatively, only thirty-six did not redislocate. Thirty-eight of the sixty-seven hips that had an additional dislocation after closed treatment had repeat surgery for treatment of the instability. Only eleven of the thirty-eight hips were stable at one year after surgery. Overall, at the time of the final assessment, sixty-five (57%) of the 115 hips were stable, forty-one (36%) remained unstable, and the status of nine (8%) was unknown. CONCLUSIONS: The risk factors for instability after a total hip revision are not the same as those after a primary procedure. The extent of the soft-tissue dissection is probably the most important variable since head size and trochanteric nonunion are related to "soft-tissue tension." Modular acetabular components with an elevated rim help to stabilize a hip undergoing a revision procedure.

Age Distribution↗