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At least 1,621 records · Page 90Linked to original sources

Plastic and reconstructive surgery in epidermolysis bullosa: clinical experience with 110 procedures in 25 patients.

We present clinical experience with 110 reconstructive procedures in 25 patients with epidermolysis bullosa, a group of rare heritable disorders characterized by marked fragility of the skin and mucosa. We discuss management of hand and foot deformities unique to epidermolysis bullosa patients, excision of squamous cell carcinoma, and reconstruction of oral, nasal, and ocular tissues. All patients underwent these procedures without major surgical or anesthetic complications. We analyze surgical outcome and formulate guidelines to avoid damaging the skin and mucosa.

Adolescent↗

[Costa's acrokerato-elastoidosis. Ultrastructural study (author's transl)].

Acrokerato-elastoidosis described by Costa is characterized by numerous little keratotic points and translucent horny wheals on the dorsal aspect of hands and (or) feets. The ultrastructural study shows lesions of the elastic tissue which is very rarefied with an abnormal structure, but also demonstrates alterations of the fibroblasts that contain dense granules at the periphery of their cytoplasm without elastic extracellular fibers, suggesting a trouble in the secretion or the excretion of the elastic material.

Acrodermatitis↗

Deprivation hands and feet.

A survey of preschool children in three inner city day nurseries serving deprived areas found 13 children with pink oedematous hands and feet--'deprivation hands and feet'. The children and their families were compared with similar children in the nurseries. Growth and development were poor compared with accepted norms, but not notably different from controls. The families of the affected children were exceptional in being at a considerable social disadvantage. Other children in the families of these children also showed the sign.

Child Development↗

[Hyperkeratosis lenticularis perstans. A clinical case and review of the literature].

A case of a woman of 55-years-old with verrucous lesions localized on the dorsa of her feet and hands is reported. The light microecopy reveals marked hyperkeratosis with some degree of parakeratosis, epidermal atrophy and light lympho-histiocytic infiltrate in the papillary dermis. A diagnosis of hyperkeratosis lenticularis perstans is made on the basis of the physical examination and histologic findings. A brief review of the literature on the genetic, ultrastructural characteristics and pathogenesis of the disease is made.

Female↗

[A new systemic combination chemotherapy to be provided at home for patients with unresectable recurrent colorectal cancer].

We compared the effectiveness of 5-FU + l-LV with CDDP + 5-FU as a systemic chemotherapy for unresectable recurrence of colorectal cancer. The protocol we carried out in one group was as follows: (Group 1) 5-FU 2,000 mg mixed with l-LV 100-200 mg in the disposable balloon pump was administered continuously for 1 week. In the other group, (Group 2) we administered CDDP 5 mg/day every 5 days for a week and continuous 5-FU 500 mg/day for 3 weeks in the hospital, and in the outpatient clinic CDDP 5 mg/day every 2 days for a week with UFT-E 300-600 mg/day, orally, everyday. The response rate of Group 1 was 18.8% and that of Group 2 was 19.3%; the median survival time (MST) was 10.8 months for Group 1 and 8.4 months for Group 2. There were no significant differences between the 2 groups regarding these parameters. Hand foot syndrome (HFS) was observed in 43.8% of the patients, and stomatitis in 37.5% of all cases as adverse effect of systemic chemotherapy using 5-FU + l-LV. But the grade of the adverse effect was low and patients could continue with this systemic chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗

[A 28-year-old patient with exanthema on hands and feet].

We report on a case of papular-purpuric gloves and socks syndrome (PPGSS). Our 28-year-old female patient showed a typical exanthema on hands and feet followed by high fever, cervical swelling of lymph nodes and general symptoms. Clinical and paraclinical tests led to a diagnosis of PPGSS. This is, in most cases, caused by viral infections, in particular by the parvovirus B19. After recovering, the daughter of our patient suffered from erythema infectiosum, a typical infection caused by parvovirus B19.

Adult↗

Papular-purpuric "gloves and socks" syndrome caused by parvovirus B19 infection in Brazil: a case report.

Papular-purpuric "gloves and socks" syndrome (PPGSS) is a novel, rare, self-limiting dermatosis caused by human parvovirus B19. It consists of pruritic edema and erythema of the hands and feet in a gloves-and-socks distribution, and it is associated with oral lesions and fever. We present a case of PPGSS in a 22-year-old Brazilian woman. Clinical and laboratory evaluation, including serological tests, PCR and gene sequencing, confirmed the presence of human parvovirus B19.

Adult↗

Acanthosis nigricans: a new cutaneous sign in severe atopic dermatitis and Down syndrome.

Acanthosis nigricans (AN) occurs associated with many different systemic diseases, such as endocrine disorders and internal malignant neoplasms. To our knowledge, the association of AN with severe atopic dermatitis (AD) or Down syndrome has not been described before. This 82-month retrospective study included 1038 patients: AN was present in 4.9% of atopic patients and 50.9% of subjects with Down syndrome. AN was more frequent in patients with severe AD and in 100% of cases of hand dermatitis and juvenile plantar dermatosis, located on the interphalangeal and metacarpophalangeal joints, whereas in Down syndrome other flexures were also affected. The pathogenesis of AN in AD is unknown, but in Down syndrome it seems to be related to obesity. Possible insulin resistance underlyng the pathogenesis of AN in these patients is still unknown.

Acanthosis Nigricans↗

[Papular-purpuric gloves and socks syndrome].

In 1990, we first described the papular-purpuric "gloves and socks" syndrome (PPGSS). It is characterized by an itching erythema and edema of the hands and feet together with oral mucosal lesions and fever. The skin lesions subsequently become purpuric and resolve spontaneously after a few days. In more than half of the patients, an acute parvovirus B 19 infection has been proven. In a few cases of PPGSS, other viral infections have been found, for example hepatitis B and measles. We report on a patient with PPGSS and review the literature.

Acrodermatitis↗

[Idiopathic pustular and bullous variants of Sweet syndrome].

We report on the case of a 62-year-old patient with disseminated pustular plaques affecting especially his face and hands. These lesions exhibited severe blistering later in the course. The diagnosis of an unusual variant of an acute febrile neutrophilic dermatosis (Sweet's syndrome) was histologically confirmed. Pustular lesions are known to occur in Sweet's syndrome. Secondary development into bullous lesions, however, has not previously been described. No associated disease has so far been detected.

Biopsy↗

Clinical evaluation of atopic hand-foot dermatitis.

Clinical manifestations of atopic hand-foot (H-F) dermatitis have not been well studied. This study examined 108 atopic dermatitis (AD) patients with H-F dermatitis between May 1997 and July 1999 at our AD clinic to determine the clinical characteristics of atopic H-F dermatitis and to assess its etiologic associations. It usually began in childhood with an early onset of AD. Pruritus was the most frequent symptom, and erythema, scales, lichenification, hyperkeratosis, fissures, and keratolysis exfoliativa were also common signs. Both the hands and feet were involved in 47 (44.0%) patients, and either hand or foot involvement was observed in 15 (13.9%) and 46 (42.6%) patients, respectively. Palmar or plantar surfaces were more frequently involved than the dorsal aspects. The great toe was affected more often than the other toes. Two-thirds of patients presented with manifestations of the ichthyosis triad and sandpaper-like skin lesions on the elbow, knee, and lateral malleolus. Palmar or plantar hyperhidrosis was reported in 15% and 20%, respectively. The ichthyosis triad-associated group showed a significantly higher incidence of sandpaper-like (thickened, roughened) skin lesions, and these patients had lesions on the dorsal hands or heels and lateral malleolus more frequently than ichthyosis triad-absent patients. The hyperhidrosis-associated group showed an association with glassy lesions, localized to palmar or plantar areas. Atopic H-F dermatitis is associated with the nonallergic etiologies of AD and clinical subgroups can be identified on the basis of nonallergic backgrounds.

Child↗

Corticosteroid injections into the hands and feet.

Sixty-four patients who received corticosteroid injections into the hands and feet were followed up for a period of up to three years. Injections offer a safe, popular, limited advance in the treatment of chronic eczema and psoriasis in these areas. The periods of remission varied from a few weeks to several months. The concurrent use of topical treatment was reduced although most patients continued to use them. No subcutaneous atrophy was observed and no serious side effects occurred. Most patients were willing to receive the injections again.

Eczema↗

Papular-purpuric "gloves and socks" syndrome.

We report five cases of an acute, self-limiting dermatosis that has not been previously described. It consists of a pruritic edema and erythema of the hands and feet in a gloves-and-socks distribution and is associated with oral lesions and fever. The clinical course is characterized by the rapid development of petechial purpura and clearing of lesions within 1 to 2 weeks. The disease appears to affect only young and otherwise healthy persons and occurs mostly during the spring. The etiology is unknown but might be of infectious origin.

Adolescent↗

[Keratosis lichenoides chronica. Bath PUVA therapy].

We describe the case of a 51-year-old male patient with characteristic lesions of keratosis lichenoides chronica confined to the back of his hands and feet. The lichenoid papules, linear hyperkeratotic ridges and erythematosquamous plaques appeared first in early childhood and recurred after a short episode of spontaneous remission. They didn't respond to various topical treatment modalities over the years. After a local PUVA therapy all lesions disappeared with no recurrence for over two years now. Our case report indicates a new promising indication for bath-PUVA-therapy.

Balneology↗

[Plantar-palmar erythrodysesthesia. A new and relatively frequent side effect in antineoplastic treatment].

Palmar-plantar erythrodysesthesia (PPE, hand-foot syndrome) is a relatively frequent cutaneous toxicity related to antineoplastic treatment with e.g. fluorouracil, capecitabine, and liposomal doxorubicin. It usually presents as paresthesia and painful erythema of the palms and soles and may lead to ulceration of the skin. The symptoms are dose-dependent, and the condition may be dose-limiting. Two cases of chemotherapy-associated PPE are presented.

Antimetabolites, Antineoplastic↗

Chemotherapy-induced acral erythema: desquamating lesions involving the hands and feet.

Patients receiving very high doses of chemotherapeutic drugs, particularly cytarabine (cytosine arabinoside, ara-C, Cytosar), may develop chemotherapy-induced acral erythema, a painful toxic rash of the palmar surfaces of the hands that progresses to edema, blister formation, and desquamation. In more severe cases, the feet are involved, and they show similar changes. Plastic surgeons may be consulted because of the hand involvement and the clinical resemblance, after desquamation, to a very superficial second-degree burn. In patients who have had bone marrow transplantation, this diagnosis must be distinguished from graft-versus-host reaction--a desquamating skin lesion that can affect a similar anatomical area but that is progressive and productive of serious consequences. Acral erythema appears to be self-limited and requires only supportive treatment.

Adolescent↗

[Recurrent palmoplantar hidradenitis in childhood].

We describe five cases of recurrent palmoplantar hidradenitis in children. The pathogenesis of this highly characteristic disease presenting with painful erythematous papules and nodules involving palms of the hands, soles of the feet, or both is not clear at the moment. One possible mechanism is a temporal relationship between exposure to dampness and cold, which also applied in four of these children. The self-limited disease tends to reappear. After thoroughly informing the children and their parents on avoiding provoking factors, all children experienced freedom from the disease during a 12-month follow-up.

Child↗

[Papular purpuric gloves and socks syndrome. A case report].

Papulo-purpuric gloves and socks syndrome, a typical maculopurpuric exanthema limited to hands and feet, mainly associated with Parvovirus B19 infection, has not, until now been reported in the literature in relation to pediatric cases in Italy. The case of a 10-year old girl with all the characteristics of the papulo-purpuric gloves and socks syndrome, as well as being IgM positive anti Parvovirus B19, is reported. This syndrome, despite its spontaneous remission, should be included in the differential diagnosis of maculopurpuric exanthemas.

Child↗