ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb02994.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb02995.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb02996.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground. Necrolytic acral erythema (NAE) is a distinctive skin lesion that was found to affect the dorsa of the feet of seven patients having active viral hepatitis C. Necrolytic acral erythema occurs in the form of well circumscribed dusky erythematous areas that develop flaccid blisters in their early stages and a hyperkeratotic surface in their chronic form. Microscopically, lesions of NAE are similar to those of other necrolytic erythemas such as necrolytic migratory erythema, pellagra, and zinc deficiency.Method. Seven patients with NAE were included in this study. These patients underwent microscopic examination of punch biopsy specimens of the affected skin, abdominal sonography,ctscan of pancreas, and a liver biopsy. Blood samples were obtained for complete blood picture, serum glucose, zinc, amino acids, liver function tests, and markers of hepatitis.Results. All patients withnaewere found to have hepatitis C byelisaandpcr.Conclusions. Necrolytic acral erythema is a distinctive type of necrolytic erythemas that was observed to occur almost exclusively with viral hepatitis C. Therefore, it should be considered an important cutaneous marker of hepatitis C, particularly in areas showing a high incidence of this form of hepatitis.

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb02997.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground.The presence of a genetic factor in the determination of leprosy has long been debated. This study tests whether the HLA‐linked control of susceptibility to leprosy and/or for the types of leprosy could be confirmed.Materials and Methods.In 15 multicase families, the method of DeVries et al., 1976, was used to detect nonrandom segregation of parental HLA haplotypes in their affected and healthy siblings. Linkage analyses, for two and three alleles were performed by the computer program LIPED.Results.For the affected siblings, the segregations of the parental HLA haplotype were significantly nonrandom from the healthy parents and random from the affected parents, indicating that affected siblings were sharing their HLA haplotypes (segregated from the healthy parents) more than expected. The segregations to the healthy siblings from both the healthy and affected parents were random. Healthy siblings inherited the haplotypes shared among the leprosy siblings randomly as expected. There were excess DR2/DR2homozygote individuals among tuberculoid siblings. The highest lod score was achieved when we considered our suggested three‐alleles model for the susceptibility to the different types of leprosy.Conclusions.A closely HLA‐linked gene on chromosome number 6 with multiple alleles (3 or more) in recombination fraction between 0.05 and 0.1 with 70 to 100% penetrance may be responsible for the susceptibility to the different types of leprosy, whereas the susceptibility to leprosy per se maybe the responsibility of non‐HLA linked gene/s. DR2/DR2homozygote individuals may be relatively at high risk of developing leprosy or tuberculoid

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb02998.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground. Deposition of calcium in skin is currently categorized into a group of disorders referred to as calcinosis cutis. Divisions between types and subtypes within this confusing classification are predominantly based on morphologic differences in the calcification and serve to obscure pathogenesis. This is especially evident in a subtype of calcinosis cutis, known as tumoral calcinosis. Calcifications in cases of tumoral calcinosis share the following characteristics, but without evidence of a common pathogenesis: large size, juxtaarticular location, progressive enlargement over time, a tendency to recur after surgical removal, and an ability to encase adjacent normal structures. The goal of this study was to formulate a pathogenesis‐based classification for cases of tumoral calcinosis.Methods. In a literature review 121 cases of tumoral calcinosis were identified. These cases, along with a case evaluated in our clinic, were reviewed retrospectively, and their features compared.Results. Analysis suggests three pathogenetically distinct subtypes of tumoral calcinosis: (1) Primary normophosphatemic tumoral calcinosis: patients have normal serum phosphate, normal serum calcium, and no evidence of disorders previously associated with soft tissue calcification; (2) primary hyperphosphatemic tumoral calcinosis: patients have elevated serum phosphate, normal serum calcium, and no evidence of disorders previously associated with soft tissue calcification; and (3) secondary tumoral calcinosis: patients have a concurrent disease capable of causing soft tissue calcification. Justification for this classification is based on the presence or absence of disorders known to promote soft tissue calcification and statistically significant differences in family history, mean calcification number, mean serum phosphate level, and calcification recurrence after excision.Conclusions.A classification for tumoral calcinosis is devised that outlines potential pathogenetic mechanisms and predicts response to therapy and prognosis. Analysis of other forms of calcinosis cutis may reveal definable pathogenetic differences that suggest a coherent classification for all cutaneous calcinose

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb02999.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstactBackground. In 1990 a new disease‐associated antinuclear antibody was first recognized as a specific immunologic marker for a chronic form of ulcerative stomatitis (cus).Methods. Another case is reported herein and the subject of chronic ulcerative stomatitis with stratified epithelium‐specific antinuclear antibodies (SES‐ANA) is reviewed. Intraoral biopsies from this patient were submitted for microscopic examination and direct immunofluorescence. Indirect immunofluorescence studies were also performed. Serial SES‐ANA titers were obtained with the patient on maintenance treatment with hydroxychloroquine. A skin biopsy of a recent lichenoid eruption was obtained and skin explants grown in the serum of this patient were studied in tissue culture with reference to SES‐ANA binding and complement fixation.Results. Biopsy and serum studies confirmed a diagnosis of cus with SES‐ANA in the patient reported. Skin biopsy showed lichen planus. The patient was treated with hydroxychloroquine with a favorable response. Serial SES‐ANA titers did not parallel the disease activity. Among the substantive observations made from skin explants cultured in the serum of this patient was widespread fixation of C3 to the nuclei of basal cells.Conclusions. The case described herein extends the findings in cus to include lichenoid skin lesions. Records show that at least four of 11 cases of cus had skin lesions, whereas all had oral lesions. Stratified epithelium‐specific antinuclear antibodies serve as the key marker of cus. Skin explants grown in the serum of this cus patient bind SES‐ANA in tissue culture. Sections of explants fix complement. Titers of SES‐ANA have been reported to parallel disease activity in one case, but not in the present case. Thus, there appears to be case‐to‐case variation. The treatment of choice for cu

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb03000.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground. Seborrheic dernnatitis (SD) is a frequent complication of infection with the human immunodeficiency virus (HIV). Most studies examining the cause of SD have concentrated on the roles ofPityrosporum ovaleand sebaceous lipids. Previous studies of skin surface lipid from patients with SD have produced conflicting results, with some authors reporting an abnormal lipid composition and others finding little or no abnormality.Methods. The composition of skin surface lipid was studied in 15 HIV‐positive and 10 HIV‐negative men with SD, in 14 HIV‐positive men without SD, and in 16 unaffected controls. Total lipids were extracted from unaffected forehead skin into petroleum ether and separated into lipid classes by thin layer chromatography. The lipid classes were quantitated by densitometry after charring with sulfuric acid.Results.Patients, HIV‐positive with SD, had significantly lower proportions of free fatty acid (FFA) and higher levels of triglyceride than normal controls. Patients, HIV‐positive without SD, had a significantly increased proportion of FFA compared to HIV‐positive patients with SD. Patients with SD, both HIV‐positive and HIV‐negative, had a similar pattern of skin surface lipid. Levels of FFA were lower and those of triglyceride higher than in the patients unaffected by SD, whether HIV‐positive or not. There was no significant difference found between groups in free cholesterol, wax esters, and squalene.Conclusions. Abnormalities of skin surface lipid composition may play a part in the development of SD in both HIV‐positive a

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb03001.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb03002.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb03003.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY