Dermatologica最新文献

Macroscopic discrimination between amelanotic malignant melanoma (aMM) and the so-called granuloma pyogenicum (GP) is often uncertain since reliable criteria for a clear differentiation of either growth are lacking. In a search of such criteria we analysed the data of 57 consecutive in-patients with cutaneous aMM and of 83 with GP presenting at our Department during the years 1970-1988. The following items were compared with each other: duration from growth onset to definite diagnosis, site of growth, age and sex of the patients. Significant differences (p less than 0.01) between either growth were found for all items evaluated. Our results substantiate the hitherto gained impression of a remarkably shorter median history of GP as compared to aMM (5 vs. 26 weeks). Furthermore, aMM prevailed in elder (age greater than 50 years) particularly female (70%) patients, whereas GP developed about equally in both sexes and at all ages. Site distribution was also found to differ for either growth (GP predominantly in the head and neck region, rarely on lower limbs; aMM in all areas, rarely on the trunk). These data yield additional measures for clinical distinction between aMM and GP.

Nodular xanthomas on both elbows and a streak-like xanthoma on the intergluteal area developed in a 4-year-old girl with type IIa hyperlipoproteinemia. She had no disease associated with secondary hypercholesterolemia and no family history of hypercholesterolemia. Her xanthomas regressed under fat restriction diet and cholestyramine therapy. She was diagnosed as having pseudohomozygous type II hyperlipoproteinemia. The low-density lipoprotein (LDL) receptor activities of her cultured fibroblasts in terms of binding, internalization and degradation rate of LDL were normal. These results are consistent with a new syndrome of pseudohomozygous type II hyperlipoproteinemia and suggest that the mechanism of hypercholesterolemia, which induced xanthoma, differs from familial hypercholesterolemia.

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rare and chronic skin disorder, which may trouble the patient considerably. The condition is generally believed to be resistant to therapy, although some authors have reported success with several treatments. including dithranol and etretinate. The present case, a classical presentation of ILVEN, again illustrates the refractoriness to various treatments, including an experimental treatment with topical 13-cis-retinoic acid. A review of the literature on therapeutic possibilities of ILVEN is presented. Based on our own observations and literature data, it is attractive to hypothesize that a positive result with treatments such as dithranol and retinoids should be interpreted as an antipsoriatic effect in ILVEN with superimposed psoriasis.

We have raised a polyclonal antibody to the 170-kD epidermal growth factor receptor. We found an intercellular pattern of immunoreactivity in the epidermis as well as a positivity of the cytoplasm of keratinocytes and eccrine secretory cells. In some samples, a nuclear labelling was evidenced in these type of cells. There is a close resemblance in the topographical distribution of these cells with nuclear labelling and those synthesizing DNA under phytohaemagglutinin stimulation.

Dermatomyositis is a rare disease complicating pregnancy. We treated a patient in whom two pregnancies were complicated by dermatomyositis. In the first of the two gestations, a mild form of the disease arose in the last trimester. In the second gestation, the disease was inactive following treatment with 0.3 mg/kg/day prednisolone. Both the mother and two children have since been doing well.

Two groups of cells, one rounded or oval and the other spindle-shaped, were found in a case of plexiform fibrohistiocytic tumor. Immunohistochemistry was strongly positive for alpha smooth muscle actin in most cells of both types but stronger in the spindle-shaped cells, suggesting a myofibroblastic origin. This was in correlation with electron microscopic findings which revealed fibroblasts, myofibroblasts and some undifferentiated mesenchymal cells. However, factor XIIIa was negative suggesting that this tumor does not originate from dermal dendrocytes.

Ninety psoriasis patients, who were either completely cleared of or manifested only a minimal presence of disease signs following 3-4 weeks of twice daily treatment with augmented betamethasone dipropionate (ABD) ointment 0.05%, were enrolled in this multicenter, double-blind, placebo-controlled study. The study was designed to determine if an intermittent pulse dose regimen of ABD ointment could safely and effectively maintain a remission disease status when treatment was applied in three consecutive applications 12 h apart, once a week for a maximum treatment period of 6 months. The disease of 60% of the patients in the active treatment group was successfully controlled for 6 months, while 80% of the placebo-treated patients experienced exacerbation of disease signs. No serious local or systemic treatment-related adverse experiences were reported. ABD ointment 0.05%, when applied using the intermittent treatment regimen described here, was shown to be a clinically beneficial and well-tolerated method of long-term (up to 6 months) maintenance therapy for psoriasis patients.

This review focuses on dermatoses that are caused by the presence of sweat--a previously underemphasized subject. A working classification based on 'internal sweating' (extravasated sweat in the dermis and epidermis) and 'external sweating' (sweat on skin surface) is proposed. Clinical observations suggest that transient acantholytic dermatosis is the consequence of extravasated sweat; we speculate that it is an example of sweat-related, protease-induced epidermal acantholysis. Neutrophilic eccrine hidradenitis may represent a sweat-related drug reaction. We emphasize the well-recognized phenomenon of 'sweat retention syndrome' in a new scenario: hospitalized febrile patients, increasing use of chemotherapy, new life style. The concept of 'sweat-gland-mediated cutaneous inflammation' is proposed.