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[Palmoplantar pustulosis disclosing acute monocytic leukemia].
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A clinical and laboratory study of ciclopirox olamine (8% Batrafen) in the treatment of onychomycosis.
Ciclopirox olamine, a new synthetic substituted pyridone derivative, is an antimycotic agent with activity against a broad spectrum of pathogenic and nonpathogenic fungi. The clinical efficacy and safety of 8% ciclopirox olamine nail liquor were evaluated in 100 cases with finger (or great toe) onychomycosis. After 16 weeks and 24 weeks of treatment for finger and great toe onychomycosis, respectively, the overall therapeutic results were excellent in 36 cases, good in 17, fair in 24, and poor in 23. The period of treatment was extended in 31 cases; among them, 10 cases showed further improvement. As for in vitro inhibitory activity, the MIC of ciclopirox olamine against T. rubrum and C. albicans was 1 to 4 mg/L and 1 to 16 mg/L, respectively. This study indicates that 8% ciclopirox olamine nail liquor, with its satisfactory efficacy and lack of side effects, is a good remedy for onychomycosis.
Autoimmune progesterone dermatitis.
Seven patients had autoimmune progesterone dermatitis. The morphological findings illustrate the polymorphous nature of the disease in which urticaria, erythema multiforme, and dyshidrosiform lesions were seen. Recurrence of the eruption five to ten days prior to the menses with spontaneous resolution following the menses was present in all cases. Intradermal skin testing to progesterone was done to confirm the diagnosis. Six of the seven patients has a history of use of artificial progestational hormones prior to the beginning of their eruption. It is postulated that the artificial progesterones may have been the trigger for the development of their autosensitivity. Treatment with conjugated estrogens resulted in remission of the disease in five of the seven cases reported.
Tegafur-induced acral hyperpigmentation.
Four patients with colorectal cancer treated with tegafur (a fluoropyrimidine structurally similar to 5-fluorouracil) noted a macular, spotted hyperpigmentation limited to the palms, soles, nails, and glans penis. Histopathologic examination disclosed epidermal basal hyperpigmentation with a lentiginous pattern. Mucocutaneous lesions resolved spontaneously two months after treatment was discontinued. This peculiar phenomenon seems to represent a previously unreported side effect of this cytotoxic drug.
[Cryosurgery in the treatment of verrucae].
The paper reports the A. experience of 1460 cases of verrucae treated with cryosurgery. A hyperdry nitrogen monoxide method was used which enables a temperature of approximately -80 degrees C to be obtained. The large number of cases treated allowed the A. to present a statistical picture which was highly significant with regard to the mean number of applications, mean freezing time and, lastly, the mean healing time for different types of verrucae. The study confirms that cryosurgery is the elective treatment for this type of pathology.
[Plurality of human papillomaviruses (author's transl)].
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An outbreak of chromium ulcer in a manufacturing plant.
On May 23, 1989, managers of a manufacturing plant requested an investigation of an outbreak of hand ulceration and skin discoloration among workers. The plant has manufactured kitchen ranges for 30 years and employs approximately 633 hourly workers. The affected employees worked in the enamel department, where metallic range tops are coated with a "ground coat" or sprayed with an enamel coloring, and then baked in ovens at 1200F. Our evaluation included physical examinations, environmental sampling, and a questionnaire eliciting information concerning skin ulceration job history, demographics, and use of protective practices. We identified 10 enamel department workers (13.5%) who developed chromium ulcers between January 1st and June 30th, 1988. Ulcers were found on hands, forearms, periumbilical area and/or axillae. Within the enamel department, workers who handled conveyer hooks used to suspend range tops as they passed through the oven were at greatest risk (rate ratio (RR) = 12.44, 95% confidence interval (CI) = 2.90-53.35). Workers who wore gloves were protected from developing ulcers (RR = 0.08, 95% CI = 0.01-0.60). Normally, trivalent chromium (Cr+3) does not cause skin ulcers unless it is oxidized to hezavalent chromium Cr+6). The enamel used contained only Cr+3, not Cr+6, but analysis of hooks that had passed through the oven revealed Cr+6 on their surface. A mechanical failure of the oven resulted in the formation of sharp edges of the parts and consequently causing the abrasion of exposed skin. We believe Cr+3 was converted to Cr+6 during the baking process which associated with the mechanical failure of the oven causing this outbreak.
[Annular erythematous lesion on the hand].
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[Systemic calciphylaxis and acquired perforating disease in a uremic patient].
We show the case of a patient suffering from a chronic renal failure in hemodialysis. He had a ischemic necrosis that was quickly progressive in his fingers and toes. It was necessary to amputate them. Diffuse vascular calcifications were recorded so radiologically than pathologically. PTH and phosphocalcic product were raised. Parathyroidectomy was practised with a quick initial improvement but immediately new distal ischemic lesions and keratotic papules with histologic perforation, that became necrosed, appeared in his buttocks and inferior extremities. The coexistence of acquired perforating disease and calciphylaxis in uremic patients has not been reported until now.
[Atopic dermatitis: the role of mechanical trauma].
A case of atopic dermatitis was observed in a patient in whom clinical observation and radioimmunoassays failed to demonstrate any possible role of allergic mechanisms. The lesions were caused exclusively by contact with the irritating substances and mechanical pressure, even, at times, by pressure of clothes.
[Undiagnosed early secondary syphilis with horny palmar and plantar papules].
A 20-year-old female patient is described who contracted syphilis in a rape attempt. She consulted a dermatovenereologist twice but the disease was not diagnosed, for despite the fact that the patient had hard chancre fragments on the posterior adhesion of the vagina, polyscleradenitis, abundant roseolar eruption on the trunk skin, horny palmar and plantar papular efflorescence, erythematous syphilitic tonsillitis, she was not examined nor serological tests were carried out. The condition was diagnosed as callosity and acute respiratory viral disease, antihistaminic and antibiotic drugs were prescribed. The condition was diagnosed only in a month after the first visit to a doctor.
[Mycetoma of the hand].
A case with a rare localization of mycetoma, on the hand, is described. A 31-year-old male patient developed this condition in 5 months after injury with a rope. Surgical treatment for a phlegmon of the left hand was ineffective. After microscopic and bacteriologic studies the dermatologists have diagnosed a pseudomycotic (actinomycotic) mycetoma of the left hand and lower third of the left arm. Streptomycin, penicillin, and actinolysate therapy essentially improved the course of the process. A review of literature on the etiology, epidemiology, clinical picture and therapy of mycetoma is presented.
Mitoxantrone induced hyperpigmentation.
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[Prevalence of superficial cutaneous mycoses in the Mosan region].
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Primary involvement of the palms and soles in leprosy--report of two cases.
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