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At least 1,675 records · Page 93Linked to original sources
PubMed1998

Acrokeratoelastoidosis of Costa: a primary disease of the elastic tissue?

A 24-year-old black woman from Uganda was seen for treatment of multiple papules on her hands and feet. The lesions corresponded microscopically to foci of hyperkeratosis and acanthosis. Acid orcein stain revealed marked elastic fiber fragmentation. Acrokeratoelastoidosis of Costa (AKE) was diagnosed. The same damage to the elastic fibers was also present in an additional specimen from grossly uninvolved skin. On electron microscopy there were pronounced changes of the elastic fibers with elastolysis in both specimens. This case with generalized damage of the dermal elastic tissue supports the view that elastorrhexis is the key feature of AKE. Accordingly, the disease could be regarded as a primary elastic tissue disorder. The marginal acral keratoderma that is seen in AKE patients could represent epidermal changes secondary to chronic trauma.

Adult↗
PubMed1989

Outcome of carbon dioxide laser therapy for persistent cutaneous viral warts.

Twenty-two adults with persistent, symptomatic viral warts on the hands or feet which had failed to respond to conventional therapy were treated by carbon dioxide (CO2) laser ablation under local anaesthesia. Four patients did not return for follow-up treatment. Of the remaining 18 patients, 12 had plantar warts, the other six had warts on the hands that were mainly periungual. The median duration of the warts prior to laser treatment was 5 years. The areas treated were solitary in eight and multiple in 10 cases. After an average follow-up period of 10 months (minimum 6 months), all of the treated areas were clear of warts in 10 patients (56%), some had cleared in three, and all the treated warts had relapsed in the other five patients. Side-effects were commonly observed, especially post-operative pain, temporary loss of function of the treated part and scarring. The use of the CO2 laser may clear otherwise resistant viral warts but a significant morbidity may occur with this method of treatment.

Adolescent↗
PubMed2004

The effect of regional cooling on toxicity associated with intravenous infusion of pegylated liposomal doxorubicin in recurrent ovarian carcinoma.

OBJECTIVE: The purpose of this study is to determine if regional cooling reduces palmar-plantar erythrodysesthesia (PPE) associated with intravenous infusion of pegylated liposomal doxorubicin (PLD). METHODS: A retrospective review over 3 years identified 20 women who were treated with single-agent intravenous PLD for recurrent ovarian carcinoma. During PLD infusion, patients kept ice packs around their wrists and ankles, and consumed iced liquids. These steps were continued for 24 h after completion of chemotherapy. All patients were instructed not to ingest hot food or liquids, to avoid contact with hot water, and to minimize friction on the hands and feet for 72 h posttreatment. RESULTS: Seventeen of the twenty patients (85%) followed the regional cooling protocol, and three of twenty (15%) did not. In the group who underwent regional cooling, 16/17 (94%) had none to mild PPE (grades 0-2), and 1/17 (6%) had moderate to severe PPE (grades 3-4). Of the three patients without regional cooling, 1/3 (33%) had grades 0-2 PPE and 2/3 (67%) had grades 3-4 PPE (P = 0.047). CONCLUSIONS: Regional cooling may reduce the frequency and severity of PPE associated with intravenous PLD infusion for recurrent ovarian carcinoma. Prospective, randomized evaluation is needed to confirm this observation.

Antibiotics, Antineoplastic↗
PubMed2003

[A patient with recurrent gastric cancer who developed TS-1 induced hand-foot syndrome].

Hand-foot syndrome (HFS) is a rare adverse reaction to oral fluoropyrimidine TS-1, which contains the dihydropyrimidine dehydrogenase (DPD) inhibitor. We treated a recurrent gastric cancer patient with chronic renal failure who developed grade 2 HFS, grade 2 conjunctivitis and grade 3 stomatitis soon after TS-1 administration. Those symptoms improved with the administration of vitamin B6, topical emollient therapy, and so on. We thought that the continuous elevation of serum 5-FU concentration, due to the accumulation of DPD inhibitor from the renal dysfunction, led to the development of HFS, although the participation of 5-FU metabolites such as F-beta-alanine cannot be ruled out.

Adenocarcinoma↗
PubMed1994

Papular-purpuric 'gloves and socks' syndrome: not only parvovirus B19.

We previously described an acute dermatosis characterized by pruritic erythematous and slightly papular lesions on the hands and feet in a 'gloves and socks' distribution associated with oral aphthoid lesions and fever (papular-purpuric 'gloves and socks' syndrome = PPGSS). We strongly suspected a viral origin, but serologic tests for a large panel of viruses remained negative. Subsequently, 2 cases of PPGSS with serologic evidence of a parvovirus B19 infection have been reported in the literature. Since then we observed 5 additional patients with a PPGSS. Parvovirus B19 infection could be confirmed in only 2 cases. Our findings suggest that the PPGSS can be another, yet undescribed manifestation of parvovirus infection. However, this cannot be shown in all the cases. As the papular acrodermatitis of childhood, this syndrome may be caused by various viral agents.

Adolescent↗
PubMed2002

[Verrucae vulgares. Treatment with 585 nm flashlamp pumped pulsed dye laser].

BACKGROUND AND OBJECTIVE: Various approaches have been taken in the management of verrucae vulgares, but a treatment of choice has not been established. PATIENTS/METHODS: Over a period of 12 months, 99 Patients with recalcitrant or untreated verrucae vulgares on their hands or feet (2:1) were treated with a 585 nm flashlamp pumped pulsed dye laser (FPDL) every 2 to 4 weeks. Laser parameters were: energy density 8 J/cm2, spot size 7 mm, pulse duration 450 microseconds. No topical measures were employed during the course of laser treatment. RESULTS: 93 patients finished the study, as 6 were lost to follow-up. Up to 8 laser treatments led to 63% total remission and 22% partial remission, 15% did not respond to this type of management. Relapses were not found in a follow-up period of 2 to 6 months. CONCLUSIONS: FPDL is efficient for the removal/reduction of verrucae vulgares and does not requires less patient compliance than other treatment options.

Adolescent↗
PubMed1999

Occupational allergic contact dermatitis from unsaturated polyester resin in a car repair putty.

BACKGROUND: Unsaturated polyester (UP) resins are widely used as cements in car repair painting to produce a smooth surface before the final painting. We report two car painters with hand and face dermatitis who were sensitized to a UP resin used for car repair cements. METHODS: Patch testing with commercial substances and ingredients and extracts from UP resins was used to verify the sensitivity. RESULTS: Both patients showed an allergic patch test reaction to a UP resin. They also had an allergic patch test reaction to diethyleneglycol maleate (DEGM), an extract of a UP resin. CONCLUSIONS: Both patients had been patch tested elsewhere with negative results because UP resins had not been used for patch testing. Accordingly, patients with dermatitis who have been exposed to UP resins need to be patch tested with UP resins. The specific chemical causing allergic contact dermatitis in our patients was DEGM.

Automobiles↗
PubMed1990

Dermatoses among floral shop workers.

Concern about the increasing incidence of hand dermatitis in floral shop workers in the United States and its possible association to the plant Alstroemeria, a flower that has become popular since its introduction in 1981, prompted investigation of the prevalence and cause of hand dermatitis in a sample of floral workers. Fifty-seven floral workers were surveyed, and 15 (26%) reported hand dermatitis within the previous 12 months. Sixteen floral workers (eight with dermatitis) volunteered to be patch tested to the North American Contact Dermatitis Group Standard and Perfume Trays, a series of eight pesticides and 20 plant allergens. Of four of seven floral designers and arrangers who reported hand dermatitis, three reacted positively to patch tests to tuliposide A, the allergen in Alstroemeria. Patch test readings for all other plant extracts were negative. A positive reading for a test to one pesticide, difolatan (Captafol), was noted, the relevance of which is unknown.

Adolescent↗
PubMed1984

[Ketoconazole and onychomycosis].

We have treated 48 cases of onychomycosis (of which 37 were caused by dermatophytes, 10 by yeasts and one by Scopulariopsis brevicaulis) with 200 mg ketoconazole daily. We obtained recovery in 65 p. 100 of the cases of onyxis caused by dermatophytes and in 80 p. 100 of the cases of onychomycosis due to Candida. The one patient presenting an infection with Scopulariopsis brevicaulis recovered in 13 months. The average duration necessary to obtain complete recovery was 6 1/2 months for onychomycosis of the hands due to dermatophytes and 12 1/2 months for those of the feet. Perionyxis due to Candida needed 2 months of treatment with this drug, however 6 months of treatment were necessary to obtain recovery for onycholysis due to Candida. Biological tests remained normal and the side-effects were minimal and essentially gastrointestinal in our study. Ketoconazole is an effective treatment for onychomycosis: it is active against the different mycotic agents infecting nails and well tolerated by the patient. Several minor effects such as itching, nausea, headache and more serious reactions such as erythrodermia and hepatitis have been reported. Regular control and biological tests are therefore necessary. Patients with other diseases should avoid the use of ketoconazole for treatment of onychomycosis.

Adolescent↗
PubMed1994

[Classification of limited hyperkeratoses].

A classification of limited hyperkeratoses (LH) was developed for practical use in out-patient surgical practice on the basis of literature data and personal studies and observations over 630 patients. Hyperkeratoses are classified according to the etiological sign (mechanical damage to the skin, diseases and deformities of the locomotor apparatus-neurotrophic, genetic, miscellaneous), clinical course (acute LH-soft corn, uncomplicated and infected and chronic LH-dry corn or callus, uncomplicated and complicated with suppuration, formation of fistula, malignization), according to shape (spherical, ellipsoid, cone-shaped), according to localization (hand and foot, unilateral, bilateral, combined, palm, finger, toe, interdigital), according to size (small, moderate, large), and according to number (solitary, multiple). The cause of the disease in 452 patients was the mechanical effect of poorly fitting shoes and trauma caused by various objects. In 19 patients LH occurred as the result of a pathological condition of the locomotor apparatus (exostosis, flexion contracture of the toes, amputation stump, etc.). In 70 cases LH was a consequence of diseases of the peripheral nervous system. There were rare causes in the remaining patients. Various methods of treatment are suggested, including the use of a laser scalpel, depending on the classification signs of the disease. Removal of the etiological factors is a very significant measure in the treatment and prevention of LH.

Foot Dermatoses↗
PubMed2006

Onychomycosis in primary school children: association with socioeconomic conditions.

Onychomycosis in childhood is reported to be unusual. The aim of this study was to determine the prevalence of onychomycosis in primary school children and to make comparison between different socioeconomic status in the rural and urban areas of the city. Hand and foot nails of 23235 children aged 7-14 were examined. Onychomycosis was suspected and nail scrapings for mycological examination were taken in 116 of them. Hyphae or spores were seen in 41 (0.18%) by direct microscopic examination, and mycological cultures were positive in 24 (0.1%) of them. Toenails were affected in all of the fungal culture positive cases. Trichosporon spp, Trichophyton rubrum, Candida albicans and Candida glabrata grew in 11, 6, 5 and 2 of the cultures respectively. Onychomycosis prevalence was significantly higher in the children living in the rural areas (p = 0.016) [Odds ratio = 3.43 (%95 CI 1.11<OR<11.84)], and onychomycosis was more frequent in boys than girls (p = 0.001) [(Odds ratio = 5.85 (1.66<OR<24.61)].

Adolescent↗
PubMedDate not supplied

The hand-foot syndrome--a frequent secondary manifestation in antineoplastic chemotherapy.

The hand-foot syndrome (HFS) (palmoplantar erythrodysesthesia) designates acute, painful erythemas of the palms and soles of the feet caused by antineoplastic chemotherapies. The most frequent trigger substances are 5-fluoruracil and its derivates. At maximum severity, the HFS is bullous to erosive or ulcerous in character. The pathogenesis has not yet been clarified. Histologically, the HFS is characterized by a toxic keratinocyte reaction. Furthermore, there is sub-basal edema with a tendency to bullae, dilated blood and lymph capillaries and usually only mild perivascular lymphocytic infiltration. Early recognition and delineation from other differential diagnoses is prerequisite to targeted management of the disease. Depending on the severity, HFS requires dose reduction, interruption or switch in the antineoplastic chemotherapy.

Antineoplastic Agents↗
PubMed1996

[Erythema elevatum and diutinum in Crohn disease].

A 35-year-old woman suffering from Crohn's disease for 3 years developed painful erythematous nodular lesions predominantly on the dorsa of her hands and feet, as well as on her elbows and wrists. The clinical features and histopathological picture of leukocytoclastic vasculitis were both highly suggestive of erythema elevatum diutinum. No improvement of the skin lesions was observed during treatment with high doses of oral steroids. In contrast, treatment with dapsone resulted in a marked reduction of skin lesions. During a new attack of her Crohn's disease the erythema elevatum diutinum lesions flared again. The parallel clinical course of erythema elevatum diutinum and Crohn's disease, as well as the detection of immune complexes and neutrophilic granulocytes in lesions of both diseases, strongly suggest a common etiology. This hypothesis is discussed in context with this case and the recent literature.

Adult↗
PubMed2006

[Fluconazole and treatment of onychomycosis. About 86 cases].

Systemic treatment of onychomycosis is based these last years on the new drug utilization aiming to decrease the length of the treatment and secondary effects particularly with fluconazole. The aim of our study is to determine the efficiency and the tolerance of the fluconazole (Funzol) managed to the dose of 150 mg per week in the treatment of onychomycosis. It is a multicentric and prospective study done to different department of dermatology in Tunisia. Are included adult patients with clinical and mycologic documented onychomycosis. They are treated during 12 to 24 weeks for the fingernail and 24 to 36 weeks for the toenail. The assessment of the efficiency and the tolerance of the drug was clinic and biologic. During this survey, 86 patients are included, 55 female and 31 male with mean age of 43.5 years. Onychomycosis seat to hands in 30 cases (34.8%) with a predominance of Candida species (73%), to toes in 68 cases (79%) witch due in 85% of cases to dermatophytic agent (85%). At 6 months, clinical cure rate is observed in 51% of cases. After 9 months, at the end of therapy, 84% of patients were judged clinical successes and culture was negative in 82% of cases. Some minimal secondary effects are signalled in 11% of cases to 6 weeks and 10% to 12 weeks not justifying the stop of the treatment. So this study confirms the efficiency and the good tolerance of fluconazole in the treatment of onychomycosis.

Adolescent↗
PubMed1991

Successful 2-week treatment with terbinafine (Lamisil) for moccasin tinea pedis and tinea manuum.

A new orally active antifungal agent, terbinafine, was used in the treatment of tinea pedis ('dry type' or moccasin type) and tinea manuum. Fifty-three adults over the age of 16 years with fungal infections of the feet and/or hands were treated with either oral terbinafine, 250 mg, or placebo, once daily for 2 weeks. The diagnosis of fungal infection was confirmed by examination of skin scrapings by microscopy and culture. Of these, 28 patients were evaluable for efficacy. At 8 weeks, 12 out of 14 (86%) patients who received terbinafine were mycologically negative (microscopy and culture) compared to one out of 14 (7%) patients on placebo (P less than 0.001, Fishers exact test, one-sided). At the end of the study 71% of patients in the terbinafine group were judged to have received effective therapy compared to 0% in the placebo group (P less than 0.001). Terbinafine was well tolerated, and more side-effects were seen in the placebo group.

Adult↗
PubMed1982

Late effects of X-ray treatment of warts.

Five to 22 years after warts on hands and feet were treated by X ray, 1122 patients with a total of 3675 warts were re-examined. X-Ray therapy had been given as one dose of 3000 r using 29 kV with a 0.3-mm Al filter; 19% of the warts had been given two treatments. Sequelae were seen in 4.8% of the sites where warts had been given one X-ray treatment and in 12.2% of the sites after two treatments. These side effects include hyperkeratosis in the pressure areas of palms and soles and atrophy primarily in areas with a thin cutis. There was no evidence of malignant transformation in any treatment site, and there were no deep-seated side effects such as ostitis or tendinitis.

Adolescent↗
PubMed1997

Occupational contact dermatitis to propacetamol. Allergological and chemical investigations in two new cases.

BACKGROUND AND OBJECTIVE: In 2 new cases of occupational contact dermatitis due to a recently described allergen (propacetamol), a prodrug which is a soluble diethylglycidyl ester of paracetamol, an allergological investigation was performed to elucidate the nature of the allergen involved in the propacetamol contact sensitivity. OBSERVATIONS: Two nurses with eczema of the hands and face had positive patch tests to Pro-Dafalgan. Every day the nurses prepared injections of Pro-Dafalgan (propacetamol dissolved in sodium citrate). The sensitization was due to propacetamol and not to the solvent. To elucidate which part of propacetamol was responsible for the sensitization, the 2 nurses were patch-tested with diethylamine, paracetamol (diluted in different vehicles) and some of their chemical analogues and potential impurities which were all negative. CONCLUSIONS: Propacetamol induces airborne contact dermatitis with no evidence of sensitization to paracetamol or diethylglycine, possibly because of either the presence of unknown impurities and/or an antigenic structure related to the covalent bond of the prodrug.

Acetaminophen↗
PubMed1997

Dermatography with bleomycin as a new treatment for verrucae vulgaris.

BACKGROUND: Common warts are caused by infection with human papillomaviruses (HPVs). Many, largely ineffective, treatment modalities have been tried in the past. The cytostatic drug bleomycin has been found to selectively affect squamous cell and reticuloendothelial tissue, but the method of its delivery directly into affected tissue such as warts has been of little efficacy. This study assessed the efficacy of a new mode of intralesional administration of bleomycin by dermatography. METHODS: The warts of patients were treated with increasing concentrations of bleomycin using the van der Velden Derma-Injector, a modified tattooing machine, under local or block anesthesia. The effects of the procedure were evaluated 1, 24, and 48 h later and the patients followed for up to 2 years. RESULTS: Thirteen patients with warts on the hands and/or feet, resistant to conventional therapy, were entered into the study, and two patients dropped out. Of the 11 remaining patients, seven went into full remission that was maintained for at least 2 years. One patient showed moderate progress and in three patients little progress was noted and dermatography was stopped. The dosage of bleomycin varied between 0.1 and 1.0 mg/mL. CONCLUSIONS: Dermatography proved to be an effective technique for intralesional administration of bleomycin in more than two-thirds of patients resistant to conventional therapy. Treatment failures in this study could in part be explained by a defective immune system in the patients. Dermatography is a technique that can be learned by any skillful dermatologist or plastic surgeon.

Adolescent↗