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PubMed1976

[Dermatoses with transepithelial perforation (author's transl)].

The histologic concept of epidermal elimination of particulate matter was formulated by Pinkus in 1954. Mehregan enlarged on this by recognizing its fundamental role in a variety of skin diseases. The importance of this epidermal reaction pattern in five "perforating" dermatoses is stressed. Also, it is shown that active participation of the corium and epithelio-mesenchymal interaction are required for the iniation of this mechanism. The histological differentiation and histogenesis of the presented dermatoses are discussed.

Collagen Diseases↗
PubMed2002

[Oral antibiotics with antiinflammatory/ immunomodulatory effects in the treatment of various dermatoses].

A range of antibiotics has been shown to modify host functions apart from the antimicrobial potency. They may directly influence phagocyte and lymphocyte function, as well as chemotaxis. Effects on the generation and release of various cytokines involved in the inflammatory process have been studied both in vivo and in vitro. However, the molecular mechanisms have not been elucidated in detail. It is suggested that antibiotics can exert immunopharmacological effects on the basis of structure-activity relationships independent of their antibacterial activity. We present a collection of clinical studies and case reports dealing with the potential benefits of systemic antibiotics in the treatment of selected dermatoses which have primarily been classified as non-infectious. Generally accepted treatments such as dapsone in dermatitis herpetiformis and leukocytoclastic vasculitis or chloroquine in lupus erythematosus have not been considered. Based on existing clinical trials with a higher number of cases the following antibiotics have been shown to be effective: erythromycin in bullous pemphigoid and pityriasis rosea as well as tetracyclines in pemphigus vulgaris, bullous pemphigoid and pustulosis palmaris et plantaris. However, most reports have to be viewed critically due to the uncontrolled study design, particularly in dermatoses with a tendency to spontaneous resolution. Despite this lack of evidence-based data, it is important for the clinician to know about the potential use of antibiotics for various skin disorders as a primary treatment option or steroid-sparing therapeutic adjunct. In clinical practice the use of antibiotics depends on various factors including the severity of the disease, the patient's age, contraindications to conventional therapeutic regiments and economic considerations.

Adjuvants, Immunologic↗
PubMed2005

Concurrent occurrence of Sweet's syndrome and erythema nodosum: an overlap in the spectrum of reactive dermatoses.

Simultaneous occurrence of Sweet's syndrome and erythema nodosum is very rare. We describe a case of a young male with a recent history of streptococcal infection who presented with concurrent Sweet's syndrome and erythema nodosum. Although the exact pathogenesis of these dermatoses is not yet clear, their similarities and simultaneous occurrence suggest a possible common underlying mechanism and may represent a continuum of reactive dermatoses. Evaluation of the role of cytokines in the etiopathogenesis of these conditions will be useful for further assessment and treatment of these conditions. Like the association of acanthosis nigricans and certain cancers and diabetes, Sweet's syndrome and erythema nodosum may be associated with certain malignancies, autoimmune disorders, or inflammatory bowel disease. Early recognition of these skin lesions can guide a search for underlying disorders. Patients with Sweet's syndrome should undergo an age-appropriate work-up for malignancy.

Adult↗
PubMed1990

Use of mupirocin ointment in the treatment of secondarily infected dermatoses.

A double-blind, randomized, vehicle-controlled study was conducted to evaluate the safety and efficacy of 2% mupirocin ointment in the treatment of secondarily infected dermatoses. One hundred six patients were enrolled, 92 of whom were evaluable for efficacy. There was a significantly greater rate of eradication of Staphylococcus aureus and total pathogens in mupirocin-treated patients than in control subjects. Analysis of the clinical data relative to all pathogens showed a significant difference in skin infection evaluations performed at the interim and follow-up visits, which favored the mupirocin-treated groups. In those patients infected with S. aureus or Streptococcus pyogenes, there was a significant difference at end-point that favored mupirocin in seven clinical ratings and the skin infection evaluation at follow-up. Mild local adverse effects were noted in a small percentage of patients in each group. Mupirocin appears to be safe and effective for the treatment of secondarily infected dermatoses, especially in those infections caused by Staphylococcus aureus.

Adolescent↗
PubMed1991

Double-blind bilateral paired comparison of 0.05% halobetasol propionate cream and its vehicle in patients with chronic atopic dermatitis and other eczematous dermatoses.

Six investigators evaluated 0.05% halobetasol propionate cream and its vehicle in 111 patients with chronic atopic dermatitis and several other eczematous dermatoses. Patients applied treatment twice daily to bilateral lesions for 14 days. Investigators graded pruritus, erythema, scaling, papulation, and lichenification using 4-point severity scales on days 0, 7, and 14. On day 14 patients provided an assessment of efficacy for both treatments. Statistically significant differences favoring halobetasol propionate over the vehicle were seen for all signs and symptoms (p less than 0.001). Substantial improvements were achieved by the active treatment by day 7 (p less than 0.001). Patients assessments of efficacy were significantly higher for halobetasol cream than for vehicle (p less than 0.001). No instances of systemic effects or skin atrophy were reported and adverse experiences were limited to burning or stinging and other minor, nonspecific complaints distributed uniformly between active treatment and vehicle. These results demonstrate that 0.05% halobetasol propionate cream is highly effective in the treatment of atopic dermatitis and other eczematous dermatoses.

Administration, Cutaneous↗
PubMed1992

Differential expression of adhesion molecules on infiltrating cells in inflammatory dermatoses.

BACKGROUND: Adhesion molecules and their ligands are involved in coordination of the activities of the immune system. OBJECTIVE: To evaluate whether adhesion molecules are relevant in the pathogenesis of inflammatory dermatoses, we analyzed the expression pattern of many of these molecules. METHODS: The expression of 10 members of the integrin and immunoglobulin superfamilies was mapped by means of immunohistochemical techniques in biopsy specimens of psoriasis (n = 15), pityriasis lichenoides (n = 11), parapsoriasis en plaques (n = 11), contact dermatitis (n = 7), and lichen planus (n = 5). RESULTS: In all investigated skin diseases, almost every infiltrating cell expressed lymphocyte function-associated antigens 1 and 3 as well as very late activation (VLA) antigens 4 and 5. The subepidermal infiltrate differed with regard to the expression of VLA-1, VLA-3, and VLA-6, which was high in lichen planus and moderate or absent in the other dermatoses. The intraepidermal lymphocytes in psoriasis and pityriasis lichenoides were VLA-1 positive, whereas the subepidermal infiltrate lacked this marker. CONCLUSION: The differential upregulation of adhesion molecules in the mononuclear infiltrate and on keratinocytes demonstrates their importance in the pathogenesis of cutaneous inflammation.

Antigens, Differentiation↗
PubMed1993

Cutaneous markers of internal malignancy. II. Paraneoplastic dermatoses and environmental carcinogens.

A variety of cutaneous disorders may reflect the presence of an internal disease. The ability to recognize those that may indicate an underlying malignancy is of particular importance. In part I of this series malignant involvement of the skin, either direct or metastatic, and the genodermatoses with malignant potential were reviewed. In this portion, we describe the paraneoplastic dermatoses as well as the cutaneous effects of some environmental carcinogens associated with internal malignancy. In addition, several uncommon and controversial associations between benign dermatoses and internal malignant disease will be discussed.

Carcinogens, Environmental↗
PubMed1993

Clinical features of inflammatory dermatoses in human immunodeficiency virus type 1 disease and their correlation with Walter Reed stage. Military Medical Consortium for Applied Retroviral Research.

BACKGROUND: As part of a military study of the natural history of human immunodeficiency virus type 1 (HIV-1) disease, all patients entered in the study were examined for cutaneous changes associated with HIV-1 infection. OBJECTIVE: Our purpose was to characterize and record the types of inflammatory dermatoses in a large number of HIV-1-infected patients to determine whether there was a correlation with the stage of disease. METHODS: The clinical findings in each case were compared with the results of cultures and biopsy specimens and correlated with Walter Reed stage. RESULTS: Most of the inflammatory dermatoses were maculopapular eruptions often with prominent follicular involvement, and in some there was a lichenoid component. With increasing Walter Reed stage, many eruptions become papulosquamous, some with psoriasiform scale and some with a hypertrophic lichenoid appearance. CONCLUSION: Although most of the inflammatory eruptions were nonspecific clinically, most cases showed features resembling those in graft-versus-host disease.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Ki-1-positive anaplastic large-cell lymphoma can mimic benign dermatoses.

BACKGROUND: Regressing atypical histiocytosis is a recently described disease characterized by recurrent nodules or ulcers. The cutaneous lesions appear abruptly and then regress only to return in a manner reminiscent of lymphomatoid papulosis. Immunophenotypic analysis has revealed that most cases are a form of anaplastic large-cell Ki-1-positive (CD30+) lymphoma. OBJECTIVE: We describe two patients with Ki-1-positive anaplastic large-cell lymphoma that had clinical and pathologic features of regressing atypical histiocytosis and mimicked benign dermatoses (pyoderma gangrenosum and morphea), causing a delay in confirming the true diagnosis. A third case that was readily recognized as a lymphoma is also presented. METHODS: The clinical and histopathologic findings were recorded. In addition, T-cell receptor gene rearrangement and immunophenotyping were determined in the index case. RESULTS: The index patient and second patient were diagnosed as having Ki-1-positive anaplastic large-cell lymphoma by immunophenotyping and underwent cyclophosphamide, doxorubicin, prednisone, and vincristine (CHOP) chemotherapy with complete remission. The patient detected by chart review died of her disease without receiving antineoplastic therapy; disseminated lymphoma was diagnosed at autopsy. Studies on paraffin-embedded tissue were consistent with Ki-1-positive anaplastic large-cell lymphoma. CONCLUSION: Regressing atypical histiocytosis may clinically resemble some benign dermatoses. Recent evaluation of these cases has shown that many represent a form of Ki-1-positive anaplastic large-cell lymphoma. Multiple skin biopsy specimens with immunophenotyping and gene rearrangement studies are required to arrive at the diagnosis.

Adult↗
PubMedDate not supplied

Life-threatening dermatoses in travelers.

Life-threatening dermatoses in travelers relates to infections, or allergic or drug reactions. Of the infectious dermatoses, most are parasitic or viral- because of the short time frame. Bacterial infections usually have a longer incubation. More significant are allergic reactions from environmental or dietary causes, and drug reactions, especially those drugs taken for prophylaxis from tropical diseases. All of these can be fulminant and therefore an awareness and early therapeutic intervention is mandatory.

Critical Illness↗
PubMedDate not supplied

Common dermatoses in moderately pigmented skin: uncommon presentations.

Several common dermatoses appear different in people of color. Most international literature, especially the reputed textbooks, are replete with photographs of skin diseases in fair-skinned patients. The orientation of Western dermatologists to common diseases in pigmented skin therefore is needed. The reverse is also true. Dermatologists who work in pigmented skin communities are known to have initial problems with fair skin. It is therefore important to have a judicious balance of entities seen in both of these skin types in major international literature, especially in textbooks. In addition, common dermatoses may appear strange and confusing particularly when they are in their advanced form. People with pigmented skin living in developing countries often present with diseases that appear greatly altered, because of various reasons. Main ones are treatment taken at home with household remedies, especially topical therapy, inappropriate treatment given by general practitioners with sparse knowledge of dermatology, and injudicious steroid use. All these factors lead to exacerbation of the disease or superimposed irritation or infection, which all contribute to a different appearance. Equally important is the delay in seeking treatment because of financial constraints.

Acne Vulgaris↗
PubMedDate not supplied

Less well-defined dermatoses of pregnancy.

Over the past several decades, many specific and nonspecific dermatoses of pregnancy have been described. The lack of a well-defined clinical and histological features as well as reproducibility in some of these entities has led to confusing reports in the literature. In this review article, an account of these nonspecific dermatoses of pregnancy will be presented in an attempt to shed light on their nosology and to better categorize them in view of the recent literature findings.

Female↗
PubMed1995

Psychotherapy for intractable inflammatory dermatoses.

BACKGROUND: Most patients with inflammatory dermatoses respond to conventional treatment. Recalcitrance may indicate underlying emotional factors after infection, contact allergy, and noncompliance have been ruled out. Psychiatric treatment has been reported to be effective. OBJECTIVE: The purpose was to determine whether insight-oriented psychotherapy, by effecting last change, would provide long-term cutaneous and psychiatric improvement. METHODS: On the basis of emotional distress attributed to a recalcitrant inflammatory dermatosis, four patients were referred for psychiatric evaluation. The effect of adding insight-oriented psychotherapy as the only change in the treatment regimen of each patient was studied. Each patient served as his or her own control. RESULTS: In each patient clearing of the previously recalcitrant dermatosis accompanied psychiatric improvement. CONCLUSION: In selected cases of recalcitrant inflammatory dermatoses, insight-oriented psychotherapy may provide lasting cutaneous improvement and improved life adjustment and psychologic well-being.

Acne Vulgaris↗
PubMed1983

Dermatoses among poultry workers: "chicken poison disease".

To investigate the causes of skin eruptions affecting poultry workers, we reviewed our medical records and surveyed a southcentral Pennsylvania poultry processing plant. Examination of the records of routine patch test clinic patients seen from January, 1981, to July, 1982, revealed three poultry workers with allergic contact dermatitis and one with irritant contact dermatitis. We then examined one hundred fifty workers at a poultry processing plant, noting the presence of occupational dermatoses, with special interest in the occurrence of contact dermatitis. We found thirteen dermatoses in nine workers. These included Candida infections, irritant contact dermatitis, allergic contact dermatitis, abrasions and cuts, warts, and dyshidrotic eczema.

Adult↗
PubMed1983

The invisible dermatoses.

It is understandable that clinically normal skin may show abnormalities when examined with the light microscope, but paradoxical that biopsy of a clinically significant skin disorder may show a histologic picture that looks like normal skin. From the perspective of the dermatopathologist, the invisible dermatoses are clinically evident skin diseases that show a histologic picture resembling normal skin. A strategy for approaching the problem of the invisible dermatoses is to first examine the epidermis for fungi, cornoid lamellae (disseminated superficial actinic porokeratosis), and absence of the granular layer (dominant ichthyosis vulgaris). The cutis is then studied for hyalin deposition (macular amyloidosis), mast cells, microfilaria, dermal melanocytosis, silver granules, and absence of sweat glands (anhidrotic ectodermal dysplasia). Special stains may be required to uncover conditions like anetoderma and nevus elasticus. Comparison of the specimen with normal skin may disclose atrophoderma, lipoatrophy, vitiligo, or café au lait spot. Finally, technical problems should be considered, including sampling errors and mixup of specimens, either by the clinician or the laboratory.

Biopsy↗
PubMed1989

Specific dermatoglyphic patterns: a characteristic manifestation of acantholytic dyskeratotic dermatoses.

Palmar and finger prints were obtained in patients with acantholytic dyskeratotic dermatoses. Identical patterns were found with Darier's disease, Grover's disease, Galli-Galli disease, acrokeratosis verruciformis of Hopf, and warty dyskeratoma. Because dermatoglyphic patterns are a genetically determined individual characteristic, we propose that acantholytic dyskeratotic dermatoses with identical dermatoglyphic patterns are variable manifestations of a single disorder, despite their broad spectrum of clinical manifestations.

Acantholysis↗
PubMed1996

A clinicopathologic approach to granulomatous dermatoses.

Reaching a diagnosis or formulating a differential diagnosis in dermatopathology involves combining information from clinical and pathological sources. Traditionally, this process is presented as a chronologic progression from the patient's complaint, through the evaluation of findings, terminating in the microscopic examination of the biopsy specimen. However, dermatopathologists often find the sequence reversed. They must first form an impression of the diagnosis from the slide and then supplement it with clinical information. The purpose of this article is to present the spectrum of granulomatous dermatoses from a pathologic perspective. The dermatoses are categorized into five groups on the basis of histologic patterns.

Biopsy↗
PubMed1987

Zoonotic dermatoses of dogs and cats.

Zoonotic dermatoses in dogs and cats are an important cause of skin disease in human beings. In addition, human dermatoses may occasionally be transmitted to dogs and cats. The veterinarian and the physician form a critical "health care team" in the proper management of these disorders.

Animals↗