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Ultrastructure of lymphocyte-mediated fat-cell lysis in erythema nodosum-like lesions of Behçet's syndrome.

In this study, biopsy specimens from 18 patients with Behçet's syndrome were examined by electron microscopy with particular attention to the appearance of the lymphocyte-macrophage infiltrate into the interlobules of subcutaneous fat in erythema nodosum-like lesions. Electron microscopic evaluation revealed vacuolization changes of fat cells with detachment of their cell membrane from the basal lamina that permitted lymphocytes and macrophages to enter into this developed space. We believe that the detachment of fat cells from the basal lamina precedes invasion by lymphocytes which, in turn, attracts macrophages into the space. This eventually leads to fat-cell lysis accompanied by activation of macrophages, which causes further inflammation, completing the picture of panniculitis in the erythema nodosum-like lesions in Behçet's syndrome.

Adipose Tissue↗

Plasma exchange in severe erythema nodosum leprosum.

Four patients with severe erythema nodosum leprosum were treated by plasma exchange and/or fresh frozen plasma infusions after failure of classical therapy. After the procedures, the patients improved rapidly; with a follow-up between 4 and 7 years after the last plasma exchange, no clinical relapse was noted. The replacement fluids were variable; the most beneficial procedure seemed to be plasma exchange replaced with fresh frozen plasma. Elimination of circulating immune complexes, replacement of a lacking plasma factor are possible mechanisms of action. Plasma exchange may also work like a regulator of immune mechanisms, since it has been shown that there is a depression of suppressor cells in erythema nodosum leprosum.

Adult↗

[Effect of various kinds of tar and tar concentrations on anthralin erythema].

The effect of tar on anthralin-induced erythema was epicutaneously tested in ten patients. 3%, 5%, or 10% crude coal tar or coal tar solution was added to vaseline containing anthralin. A 5% or 10% tar preparation significantly suppressed the anthralin erythema induced by 0.5 to 1.0% anthralin having been applied for 24 hrs. In these concentrations, coal tar solution was at least as effective as coal tar itself.

Adolescent↗

Erythema infectiosum in a village primary school: clinical and virological studies.

In a questionnaire response to an outbreak of erythema infectiosum in a village primary school, 55 (46%) of the 121 pupils reported an illness with rash. Three of the 12 members of staff also developed a rash. Onset in most affected children was indicated by the classical ;slapped cheek' appearance of erythema infectiosum with subsequent spread of the rash to the extremities. However, in 17 (35%) of 49 children who provided additional clinical data, the rash spread either in the reverse direction or not at all. Nineteen children (39%) reported recurrence of the rash.Serological studies confirmed that human parvovirus was the cause of the outbreak. Forty-six (44%) of 104 children investigated had significant levels of virus-specific immunoglobulin (lg)M and/or lgG antibodies consistent with recent infection. Most infections occurred in older children. Human parvovirus infection was also confirmed in five of the 12 adults. These studies revealed a substantial number of subclinical episodes - 14 (22%) of 64 subjects who remained well had serological evidence of recent infection with human parovovirus. Significantly, 43 individuals (37% of those investigated) remained seronegative despite frequent exposure to infection within the school. This finding, together with the observed temporary interruption of the outbreak which coincided with school holidays substantiates the view that human parvovirus has a relatively low infectivity and requires close person-to-person contact for its transmission.

Adult↗

Bullous erythema multiforme associated with Hemophilus influenzae pneumonia.

A 68-year-old woman with Hemophilus influenzae pneumonia experienced a bullous dermatosis. Further evaluation revealed bullous erythema multiforme of the minor type which resolved concurrently with treatment of the pneumonia. Clinicians should be aware that H. influenzae may be one of the bacterial agents known to cause erythema multiforme.

Aged↗

Erythema nodosum in Sweet's syndrome.

A 36-year-old man had Sweet's syndrome associated with plaques on the legs that were typical of erythema nodosum both clinically and histologically. To our knowledge, true erythema nodosum has not previously been recognized as part of Sweet's syndrome.

Adult↗

[Lesions of the nervous system in tick-borne erythema annulare].

The authors examined thirty-two patients with tick-borne erythema annulare which developed after tick bites. The disease had a peculiar nosological form and was characterized by tick sticking, an incubation period, the presence in the majority of patients of the temperature reaction and manifestations of general infection in the acute period, the development of migrating erythema annulare, frequent lesions (26 patients) of the nervous system in the form of the radicular symptoms, serous meningitis, pareses of the facial muscles, etc. Electrophysiological examination of patients revealed marked changes. Serological tests for tick-borne encephalitis proved negative. The time-course of the disease in the majority of patients was favourable. The disease was characterized by all features typical of an infection lesion, with neurological disorders being predominant, which requires further investigation.

Adult↗

Erythema multiforme associated with trazodone therapy: case report.

A 63-year-old woman with treatment-resistant depression was started on trazodone and subsequently developed erythema multiforme (EM), with lesions predominant on the distal parts of the limbs and involvement of the hands and feet, as well as her palms and soles. The patient's treatment course and subsequent remission are described. It is suggested that trazodone therapy be discontinued immediately upon notice of EM. This patient was also taking lithium, which has not been implicated in erythema multiforme.

Depressive Disorder↗

A syndrome with nodular erythema, elongated and thickened fingers, and emaciation.

A 5-year-old boy had a nodular erythema, elongated and thickened fingers, and emaciation. His condition was a rare congenital disease inherited as an autosomal recessive trait. Eleven cases have been previously reported in the Japanese literature. The onset is early in childhood, and nodular erythema is an essential and initial finding. Growth retardation and emaciation progress slowly with age. The characteristic clinical features include large eyes, nose, lips, and ears, disproportionately long and thick fingers, and the loss of adipose tissue from the upper half of the body. Cardiomegaly and hypertrophy of the periosteum of the phalanges have been described in some cases.

Child, Preschool↗

[Etiologic and epidemiologic questions posed by erythema chronicum migrans and Lyme disease. Apropos of 4 cases at the Regional Hospital Center, Rennes].

The authors give 4 observations, made in Rennes (France), of 3 cases contracted in France and 1 in Canada, cases they think to be related, for 3 at least, to the infectious entity described by American authors under the name of Lyme disease. If 1 of these cases was limited to an erythema chronicum migrans, the 3 others showed a beginning evolution towards a classical Lyme disease. In 2 of these 3 last cases, the infection was perhaps cut short by a quickly applied therapy by antibiotics. They discuss the different hypotheses about the negative Borrelia serologic reactions in 3 of the 4 cases. A possible arboviral aetiology is evocked. In only one of the 4 cases, a tick-bite can be asserted, the role in the the transmission of this kind of arthropods being strictly excluded in 2 of the 3 other cases (transmission likely by a mosquito and by a biting fly (tabanid?)). The authors put the question of the possibility of transmission, for erythema chronicum migrans and Lyme disease, by arthropods other than ticks.

Adult↗

[Chronic polyarthritis and erythema anulare centrifugum Darier].

A casuistic contribution considers possible aethiopathogenetic factors of an erythema anulare centrifugum Darrier in a 47 year-old female patient suffering from a seronegative rheumatoid arthritis. The course is traced until the erythema fades and disseminated leucoderma appears.

Adrenal Cortex Hormones↗

Erythema annulare centrifugum and Hodgkin's disease: association with disease activity.

The skin lesions of erythema annulare centrifugum developed in a 58-year-old woman who had Hodgkin's disease. Response of the neoplasm to vinblastine sulfate was accompanied by disappearance of the skin lesions. When therapy was discontinued, both disorders recurred, and both responded to reinstitution of vinblastine therapy. To our knowledge, this case is the first reported association of erythema annulare centrifugum and Hodgkin's disease. The cutaneous manifestation in this patient were a nonneoplastic concomitant of her neoplastic disorder.

Erythema Multiforme↗

[Histochemical study of fat in erythema nodosum].

Histochemical study of fat in the adipocytes of the subcutaneous adipose tissue in 12 patients with erythema nodosum revealed an upset balance of the oxidation process in fat and accumulation of free peroxide and aldehyde groups. The imbalance in the oxidation processes in the adipocytes in the areas of hemorrhages is apparently associated with haemin catalysis. The accumulation of incomplete oxidation products in lesions is believed to be a local process caused by pathological changes in the blood vessels. The toxicity of the products of peroxide oxidation should be taken into consideration in treating patients with erythema nodosum.

Adipose Tissue↗

Effects of emollients on ultraviolet-radiation-induced erythema of the skin.

Several commonly used emollients were studied as to their effectiveness in absorbing and filtering erythema-causing ultraviolet radiation in the 280 to 315 nm range (UVB). Planter's Peanut Oil (Standard Brands) and Mazola Corn Oil (Best Foods Inc) had no effect; Alpha Keri Bath Oil (Westwood Pharmaceuticals), mineral oil, and Johnson's Baby Oil (Johnson & Johnson Co) had minimal effects. Vaseline Petroleum Jelly (Chesebrough-Ponds Inc), petrolatum, and hydrophilic ointment substantially reduced the erythema that was induced by exposure to low doses of UVB radiation. Therefore, these emollients may interfere with the therapeutic effects of the ultraviolet radiation component of the Goeckerman treatment when it is administered in low doses to patients with psoriasis.

Dermatologic Agents↗

[Erythema elevatum diutinum, a variant of cutaneous vasculitis].

A 59 year-old man with erythema elevatum diutinum which we consider a variant of cutaneous vasculitis, is reported. An excellent therapeutic effect with Dapsone (DDS) was obtained in this case. Clinical and histopathological similarities among erythema elevatum diutinum, extracellular cholesterosis and granuloma annulare are discussed.

Dapsone↗

Erythema nodosum in chlamydial infections.

Twelve patients suffering from erythema nodosum who had diagnostic titres or seroconversions in chlamydial complement fixation test are described. Eleven had respiratory infections. The twelfth had sterile pyuria, symptoms of pelvic inflammatory disease and exceptionally high antibody titres against Chlamydia trachomatis in an immunofluorescence test. The simple chlamydial complement fixation test is recommended for the screening of cases of erythema nodosum.

Adolescent↗

Herpetiform eruption with leukocytoclasis: a distinctive clinico-pathological variety of erythema multiforme.

Six patients are described who experienced a prodromal period suggesting an infective process, followed by a distinctive polymorphous cutaneous eruption. The most striking lesion, present in all of them and giving the eruption a distinctive herpetiform appearance, included closely grouped vesicles resting on an erythematous base. Histopathological examination of these lesions showed features of dermal and epidermal types of erythema multiforme but with prominent leukocytoclasis. We suggest that the clinico-pathological picture of our patients may be considered a distinctive clinico-pathological variety of erythema multiforme.

Adult↗

Erythema craquelé provoked by corticosteroids on normal skin.

The provocation of erythema craquelé after cessation of long-term continuous steroid application to normal skin was investigated in 58 healthy subjects, usually under occlusion. No correlation was demonstrated between the erythema craquelé and skinfold thickness measured with the Harpenden technique.

Adrenal Cortex Hormones↗