ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00959.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground.The present study reports the incidence of trichocutaneous disorders studied in 500 patients infected with HIV I in a large university‐based setting. Correlation of these findings with immunologic function at the time of diagnosis is presented. Unusual presentations and therapeutic interventions are discussed. Prognosis as related to various trichocutaneous disorders is elaborated.Methods.All patients in this study werehivipositive by Western blot assay. T‐cell subsets were evaluated by monoclonal antibodies against T‐cell surface markers. Hair disorders were analyzed by means of light hair pull test, hair mount, polarizing microscopy, trichogram, scalp biophsy, and cultures for bacteria, fungi, and mycobacteria as indicated. Trichologic manifestations were classified based upon immunologic correlation of absolute level of helper T cells/mm3.Results.The majority of hair disorders in the study population occurred with helper T cell numbers of less than 150/mm3. Papulosquamous problems including seborrheic dermatitis and psoriasis were most commonly noted followed by disorders of cell growth cycle regulation and trichokeratinization, i.e., telogen effluvium and loose anagen syndrome.Conclusions.Multiple trichocutaneous disorders occur in the setting of retroviral infection. Most of these disorders occur in the setting of progressive immunoincompetence. The awareness of the disorders described here will aid the clinician in both the recognition and management of pilar aberrations in the appropriate clinical se

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00960.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground.Tinea capitis is a dermatophyte infection of the scalp, eyebrows, and eyelashes caused by species ofMicrosporumandTrichophyton.The purpose of this study was to discover the incidence and causal agents of tinea capitis in Saudi Arabia.Methods.Hair roots, skin scrapings, and pus swabs were collected from patients clincially diagnosed with tinea capitis and were processed for fungus.Results.Of 372 patients with tinea capitis investigated in Saudi Arabia, 240 were found to be positive by direct microscopic examination, and the causal agent was isolated from 237 patients. Tinea capitis accounted for 47.7% of all superficial mycoses, and 97% of it occurred in children below 15 years of age. Inflammatory lesions were found in 35% of cases, and 10 of them presented with kerion celsi. Favus‐type lesion was found in one.Microsporum caniswas the most common etiologic agent, responsible for 82.3% of the infections.Trichophyton violaceumwas the next most common agent (13.9%), followed by M. audouini (2.2%); T. mertagrophytes, T. rubrum, T. verrucosum, and T. simii were isolated from one patient each. This is the first report of T. simii infection in a Saudi man.Conclusions.Although none of the patients owned pets, the predominance of M. canis may be explained by the large number of cats in the neighborhood. The disappearance of favus due to T. schoenleinii may be due to improved socio‐economic conditions. Our results agreed with two previous repo

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00961.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground.While significant risk factors for malignant melanoma may initially develop or are first seen in childhood, the actual occurrence of this neoplasm in prepubertal children is uncommon.Methods.A retrospective study of malignant melanoma in Puerto Ricans up to 16 years of age occurring from 1973 to 1990 was carried out by identifying those cases in the Puerto Rico Cancer Registry.Results.A total of seven cases were found consisting of three boys and four girls with ages ranging from 22 months to 16 years and comprising 0.94% of the total melanomas. In three of the seven cases, there was a history of a previously existent small congenital melanocytic nevus on the area. Three cases were Clark's level I, two level II, and in two cases with proved metastatic disease, Clark's level of invasion were not reported. Those cases with Clark's level I and II had a 100% 5‐year survival.Conclusions.Although rare, malignant melanoma in children can be as aggressive as in adults. Among the known factors predisposing to malignant melanoma, three out of seven cases developed within a small congenital nevus, two of which occurred during the first decade of life. Due to the rarity of this event in our population, it appears unreasonable to excise all small congenital nevi during the first decade of life. Even for those who advocate excision of all small congenital nevi, the evidence at present suggests that such small nevi very rarely undergo malignant change before puberty and therefore a policy of observation in childhood and offering excision around the time of puberty is perfectly logica

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00962.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground.The nail area is commonly affected by malignant melanoma. The prognosis of malignant melanoma of the nail is poor, becuase at the time of diagnosis most lesions are in the advanced stage. Correct diagnosis of early lesions could improve the prognosis.Methods.For 3 years, all patients with nail pigmentation at the dermatology clinic were screened for five specific criteria for the diagnosis of early lesions of malignant melanoma. Histologic examination was performed on 10 of 29 lesions.Results.Five of the 29 lesions were advanced malignant melanoma, easily diagnosed clinically. Two of the remaining 24 lesions fulfilled most of our clinical criteria of early malignant melanoma of the nail apparatus; that is, they appeared as melanonychia striata during adulthood, were wide in breadth measuring 9 and 11 mm, and showed variegated shades of brown. Periungual pigmented macule (Hutchinson's sign) was observed in one of the two cases. Total resection of the lesions was performed, followed by skin grafting.Conclusions.Histologically, an increased number of atypical melanocytes, mainly arranged as solitary units, were observed only in the epithelia of the nail matrix and of the nail‐bed, confirming that these lesions were “ungual” malignant melanoma in situ. Such an early lesion of malignant melanoma of the nail apparatus can be completely cured with conservative excision, and the phalanx of the affected digit can be pres

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00963.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground.Paraneoplastic pemphigus is a recently described variant of pemphigus, in which classic immunologic features of pemphigus are associated with subepidermal erythema multiforme‐like bullae.Case Reports.Two patients with underlying malignant neoplasm had a bullous disease, which had clinical and histologic features suggestive of bullous pemphigoid while direct immunofluorescence revealed intercellular deposits of IgG and C3 throughout the malpighian layer of epidermis, a pattern usually diagnostic for pemphigus. Indirect immunofluorescence studies were negative. One mg/kg/day prednisone was enough to cure the eruption in a couple of weeks without any recurrence.Conclusions.The disease differs from the recently reported paraneoplastic pemphigus and from other bullous diseases associating circulating pemphigus‐like antibodies with clinical, histologic, and often even immunologic features of bullous pemphig

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00964.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00965.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00966.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00967.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb00968.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY