ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00574.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackgroundNotalgia paraesthetica is an uncommon sensory neuropathy of unknown aetiology that appears to be mediated by peptidergic nerves.ObjectiveTo investigate both functional and anatomical aspects of notalgia paraesthetica using laser Doppler velocimetry and immunohistochemistry and to assess the effect of treatment on these parameters.MethodsBasal blood flow and response to local heating were recorded in 7 patients with notalgia paraesthetica from within the affected area and the contralateral side as control. Biopsies were taken from both sites for immunohistochemistry with S100 protein. PGP9.5 and CD la. Measurements were repeated after treatment with topical capsaicin.ResultsAll patients benefited from capsaicin treatment suggesting that the symptoms of notalgia paraesthetica are mediated by peptidergic sensory nerves. Basal blood How and response to local heating were generally reduced in the affected areas prior to treatment but this did not achieve statistical significance. These differences were less obvious following treatment. The density of CD1a immunoreactive epidermal Langerhans cells and small nerve fibres in the upper dermis both appeared to be slightly increased in the majority of patients within the affected area. No significant change was noted in 3 patients who were rebiopsied after treatment.ConclusionsWe conclude that in notalgia paraesthetica there is a localised functional abnormality of peptidergic sensory nerves. The relevance of the subtle histological findings is unclear.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00575.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractObjectivesTo study the histology of the skin lesions of secondary syphilis.BackgroundSecondary syphilis is becoming less prevalent in developed countries and clinicians not familiar with the condition may resort to biopsy to elucidate the nature of a rash. It is therefore important that Dermatopathologists are aware of the histological features of secondary syphilis.DesignPatients with secondary syphilis, who attended clinics held by one of us during a 10 year period and who consented to biopsy, were studied.SubjectsTwenty‐eight individuals.MethodsSkin biopsies of representative lesions. Routine histological processing.ResultsThe most common finding was that of an erythema multiforme pattern of papillary oedema and perivascular lympho‐histiocytic infiltration (19 cases including the 2 men with HIV infection). The tissue reaction was mild in patients with macular lesions. Focal lichenoid tissue reaction (4 cases), a pseudolymphomatous appearance (1 case), and granuloma formation (3 cases) were noted in other patients. The histology of a condyloma latum was typical.ConclusionsOur study serves to emphasise the importance of clinicopathological correlation in the assessment of a skin rash and to remind pathologists of secondary syphilis as an aetiological factor in macular and papular skin lesions. The mimicry of several other conditions confounds the specificity of the changes and shows that syphilis is a theoretical candidate in considering the aetiology of the changes seen. Careful scrutiny of all the histopathological features may permit a relatively refined differential diagnosis to be established and, either prospectively or retrospectively, alert the clinician to the appropriate additional investigative techniques which will allow a sound diagnosis to be attai

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00576.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractAimsTo evaluate the use of the Digene Hybrid CaptureTMsystem, a chemiluminescent hybridization assay for the analysis of low and intermediate/high risk human papillomavirus (HPV) DNA, on paraffin‐embedded tissues and to investigate possible reasons for reaction failure.MethodsFifty cervical biopsies were tested by an in situ hybridization (ISH) method using probes for HPV 6/11. 16/18, 31/33/51 and by the Digene Hybrid CaptureTMsystem.ResultsThe ISH was able to detect HPV in 23 out of the 50 biopsies. Eight samples were positive with the HPV 6/11 probe, 4 with the 16/18 probe. 6 with the 31/33/51 probe and 5 had mixed infections. With the Hybrid CaptureTMsystem, having taken the mixed infections into account. 40 samples gave concordant results, while total and partial discordances were observed in 6 and 4 samples respectively. The relative sensitivity of the new assay was 91.6% and specificity 84.2% for low risk HPVs; and 80% and 94.3% respectively for intermediate/high risk HPVs. Agreement rates on HPV positivity for either low risk or intermediate/high risk types were 86% and 94% respectively in comparison with ISH results.ConclusionThe Hybrid CaptureTMsystem is simple, reliable in use and suitable for routine discrimination of HPVs in tissue sections from paraffin‐embedded blocks. It might thus be of clinical value in the diagnosis and prognosis of HPV infect

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00577.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA whitish, indurated, oval plaque, lasting for 1.5 year, was observed in the right paraumbilical skin of a middle‐aged man in otherwise good health. No erythema was present or referred. Histological examination revealed massive deposits of a globular, slightly basophilic, amorphous substance in the dermis, accompanied by a slight perivascular mononuclear cell infiltrate and scattered mast cells. Special staining with Alcian blue at pH 2.5 confirmed the intense deposition of mucin involving the entire dermis. sparing epidermis, adnexa and perivascular areas. No abnormal laboratory results indicating lupus erythematosus or thyroid dysfunction were present. Morphea was excluded on clinical and histological grounds. A plaque‐like form of cutaneous mucinosis was diagnosed. Plaque‐like mucinosis and reticular erythematous mucinosis (REM) syndrome are currently considered to be the same disease, although some authors noted a different response lo treatment. Clinical presentation of our case was unusual: no erythema preceded or accompanied the plaque growth, which had a whitish, indurated, morphea‐like appearance from the beginning but with preservation of hair follicles, quite different from archetypical REM syndrome based on clinical

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00578.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackgroundPatients with chronic renal failure, regardless of its cause, with/without hemodialysis/peritoneal dialysis, showed cutaneous alterations. Two patients had a follicular hyperkeratotic papular eruption, with clinical and histological features of perforating folliculitis.MethodsA dermatological examination and multiple skin biopsies were done.ResultsWe diagnosed acquired perforating folliculitis in two chronic renal failure patients on hemodialysis. The lesions were located predominantly on the lower extremities with hyperkeratotic papules and small nodules. Microscopically, the papule always affected the follicular structure. The follicle was widely dilated and packed with keratotic material, necrotic debris and degenerated basophilic coarse connective fibers passing which passed through follicular perforations.ConclusionAcquired perforating folliculitis is a cutaneous manifestation in chronic renal failure, with/without hemodialysis treatment, that can mimic essential primary perforating folliculitis. Transepidermal elimination mechanisms and the distinction between primary and acquired perforating dermatoses arc discussed.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00579.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThis report presents 2 patients with a rare form of bullous pemphigoid on (heir palms and soles. To date, at least 16 cases of dyshidrosiform pemphigoid have been reported. The first case was accompanied by a bacterial fool infection, the second by contact dermatitis. The possibility that dyshidrosiform bullous pemphigoid was induced by these trigger factors is discussed.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00580.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractCutis marmorata teleangiectatica congenita (CMTC) is a very rare vascular malformation closely related to port wine stains. It is present at birth, asymmetrical distribution and limb involvement are common. We report here on a 6–month‐old female patient exhibiting the typical clinical appearance of CMTC in a segmental pattern. To date 10 such cases have been reported. CMTC must be distinguished from other vascular malformations with asymmetrical distribution and – in case of a segmental pattern – particularly from unilateral dermatomal superficial teleangiectasia. Because of the tendency of such naevi to spontaneous improvement and localization of vascular dilatations in the dermis and subcutis no treatment was initiated at this point

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00581.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe immunological features of drug‐induced bullous pemphigoid appear to be similar to those of idiopathic bullous pemphigoid (BP), with presence of circulating and tissue‐bound antibodies showing anti‐basement membrane zone specificity. We describe a 28‐year‐old woman who developed a widespread blistering eruption with marked involvement of the mucous membranes shortly after commencing treatment with oral flucloxacillin. The eruption gradually cleared following drug withdrawal and treatment with oral corticosteroids. Indirect immunofluorescence showed circulating IgG anti‐basement membrane zone (BMZ) antibody and C3 which bound to the dermal aspect of salt‐split skin, and direct immunofluorescence (IMF) of perilesional skin showed a linear band of C3 at the BMZ. Western immunoblotting of the patient's serum showed positive reactivity with a 180 kDa antigen in epidermal extracts and no reactivity with dermal extracts. The dermal‐binding pattern on indirect IMF with salt‐split skin only occurs in a minority of patients with BP and has not been described previously in a

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00582.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractWe report two cases of known dermatitis herpetiformis (DM) who presented with atypical clinical dermatological features. The first case, a 31‐year‐old woman, presented with an itchy urticated eruption on the abdomen and trunk, while the second case, a 50‐year‐old woman developed a scaly psoriasiform eruption on the extensor aspects of her knees and elbows. In each case, direct immunofluorescence of a perilesional skin biopsy showed a fibrillar pattern of IgA deposition at the basement membrane zone. Pre‐embedding immunoelectron microscopy of these 2 specimens, using a 1 nm gold probe and silver enhancement, showed colloid gold panicle deposition around microfibril bundles in the dermal papillae. Recent studies have shown that fibrillin, a 350 kDa glycoprotein, is also associated with these microfibril bundles.Serological tissue typing in our first case confirmed the presence of HLA‐B8. B18. DR3 and DQw2 antigens consistent with dermatitis herpetiformis. In the second case, there was a notable absence of the antigens B17 and B27 typically found in psoriasis but HLA‐AI, BX and DQ1 antigens were present, as commonly seen in dermatitis herpetiformis. Our findings would suggest that cases of dermatitis herpetiformis with fibrillar IgA deposition at the BMZ on direct IMF may show an atypical clinical presentation. In addition, our imunoelectron microscopy findings may provide a further clue to an ultrastructural abnormality in

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1996.tb00583.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY