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Psoriasis and other common dermatoses in leprosy.

The medical records of all 309 leprosy patients who have been under the care of the Government Hospital for Hansen's disease in Jerusalem, Israel during the last 30 years, were surveyed. None of the patients showed clinical evidence of psoriasis on numerous examinations conducted during periods of follow-up of up to more than 4 decades. If this finding proves to be reproducible also in other groups of leprosy patients in other regions of the world, this would suggest that psoriasis is very rare among leprosy patients and that psoriatic subjects might have a natural protection against the development of leprosy. This could possibly be explained as the result of the hyperactivity of the reticuloendothelial and phagocytic systems which seems to be an integral part of the psoriatic constitution.

Adolescent↗

Overheating in bed as an important factor in many common dermatoses.

BACKGROUND: Extensive questioning of patients with a wide variety of skin disorders led to the impression that nocturnal overheating was probably an important factor in the initiation and the perpetuation of many skin disorders. METHODS: In order to test the hypothesis, 12 "clean-skinned" subjects (6M/6F) aged 18 to 45 years were monitored electronically every 30 seconds during an 8 hour sleep period (2300 to 0700 hours), sleeping under a standard 10 tog duvet. RESULTS: All the subjects were too hot by 3 to 4 degrees C. All showed changes in their EEG patterns with reduced REM sleep, increased awakenings, and all showed changes in their sleep stage patterns. In addition, they all showed evidence of increased sweating in the "heat-sink" area. CONCLUSIONS: The mechanisms where by such changes could be implicated in the precipitation and perpetuation of skin disease are discussed. "Lifestyle" modification as a very effective, noninvasive, therapeutic regime is recommended. Further research along these lines would probably be very valuable and instructive.

Adolescent↗

Histologic spectrum of cutaneous involvement in patients with myelogenous leukemia including the neutrophilic dermatoses.

BACKGROUND: Cutaneous manifestations of myeloid leukemia can be specific or nonspecific. The study was designed to determine the prevalence and histologic appearance of cutaneous lesions in patients with myeloid leukemia and various myeloproliferative disorders. METHODS: The histologic changes of cutaneous lesions in 52 patients with myelodysplastic syndrome, polycythemia vera, and myeloid, myelomonocytic, or monocytic leukemia are presented in this study. RESULTS: Two types of cellular infiltrates were identified. In the first group, the most common pattern was a diffuse involvement by the leukemic cells through the entire dermis with preservation of a "grenz zone" in the superficial dermis. Two cases exhibited a Kaposi's sarcoma-like pattern, with prominent slit-like blood-filled spaces lined by myeloblasts against a fibrocellular stroma. The second group of lesions was characterized by dense, neutrophilic dermal infiltrates resembling acute neutrophilic dermatosis (Sweet's syndrome) or pyoderma gangrenosum. In two of these cases, scattered immature blast cells admixed with the mature neutrophilic elements were identified. CONCLUSIONS: Awareness of these different morphologic features and application of special stains are of value in the evaluation of suspicious cutaneous infiltrates in patients with myeloid leukemia and various myeloproliferative disorders.

Adult↗