ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04434.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04435.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04436.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04437.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground. Widespread hypopigmented macules are rarely seen in heavily pigmented patients with Darier's disease. Previous hypotheses concerning the cause of decreased pigmentation suggest it is a postinflammatory phenomenon or that the hypomelanosis is evidence of sub‐clinical acantholysis.Patients. This report presents 2 patients: a new case of disseminated guttate leukoderma in a black patient with Darier's disease and the first such case in a patient with transient acantholytic dermatosis (Grover's disease). Direct immunofluorescence and electron‐microscopic studies were carried out on lesional biopsies.Observations. Numerous small hypopigmented macules were observed in two black patients followed for acantholytic disorders. Three biopsies of the hypopigmented macules revealed acantholysis, while one showed only decreased melanin. Direct immunofluorescence studies were negative. Electron‐microscopic studies of the leukodermic macules showed sparse melanocytes and melanosomes that were mostly pigmented stage IV melanosomes.Conclusions. Disseminated guttate leukoderma can occur in transient acantholytic dermatosis, as well as in Darier's disease. It is readily apparent on darkly pigmented skin because of contrast. The etiology of this phenomenon is still un

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04438.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground. It is estimated that over 100,000 new cases of squamous cell carcinoma are diagnosed in the United States annually. This number is compounded by an increasing concern over the ozone layer depletion and the continued sunbathing behavior of many individuals. This could be particularly acute in Hawaii, which may have the highest rates of skin cancer in the country. We believe the updated information on skin cancer is essential to address the magnitude of the problem.Methods. A prospective 5‐year population‐based incidence study was conducted on Kauai, Hawaii, between 1983 and 1987 to investigate the frequency of squamous cell carcinomas in resident Caucasians.Results. A total of 58 residents, 37 men and 21 women, were identified with an initial episode of squamous cell carcinoma during the 5‐year period. The average annual incidence rate per 100,000 Kauai Caucasian residents, standardized to the 1980 U.S. white population, was 153 for men and 92 for women with a combined rate of 118. The average patient age was 66.4 years. The head and neck was the most common anatomic site, with the extremities second. Subsequent new squamous cell carcinoma occurred in 13.8% of patients. Only one patient (2%) developed a recurrence after treatment. Twenty‐five patients (43%) had basal cell carcinoma simultaneously or at other earlier times.Conclusions. In Kauai the incidence rate of squamous cell carcinoma is the highest yet documented in the United States. No consistent trend in incidence rates was appreciated during this 5‐ye

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04439.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground. A number of lifestyle factors are important in the etiology of basal cell carcinoma. Previous studies have investigated smoking, alcohol, diet, and sun exposure as possible contributing factors. No previous studies have investigated case‐controlled lifestyle influences in basal cell carcinomas referred for Mohs micrographic surgery.Methods. Cases were obtained from Mohs‐referred basal cell carcinoma patients. Matched controls were selected from a busy dermatology clinic. The only criteria for selection of controls was never having had cancer previously. Cases and controls were surveyed regarding lifestyle characteristics.Results. Forty‐six age, sex, and skintype‐matched controls were compared. Sun exposure, alcohol, and smoking were not significant factors. Dietary fat, fiber, and the vitamins A, C, and beta carotene, as well as selenium showed important, but not significant differences. Caffeine consumption was higher in the cancer group.Conclusions. Our findings agree with previously published studies in regard to antioxidant consumption as a protective factor for basal cell carcinoma. Caffeine consumption was higher in the cancer p

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04440.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground. During the past 2 1/2 years we observed six patients who had a reactive serology for syphilis, of which four developed widespread noduloulcerative and two vesiculonecrotic lesions. The purpose was to report the occurrence oflues maligna, a rare form of secondary syphilis, in five patients infected with the human immunodeficiency virus (HIV) and in one patient with risk factors for infection.Methods. Tzanck preparations, viral cultures, and skin biopsies were performed to evaluate the etiology of the lesions.Results. Syphilis serology titers ranged from 1:32 to 1:128 and in one instance was as low as 1:8. Such titers can also be found in patients with the latent form of syphilis. Therefore, confirmation of the clinical diagnosis oflues malignawas dependent on skin biopsies that were compatible with secondary syphilis and negative viral studies that excluded varicella, disseminated varicella‐zoster or herpes simplex.Lues malignatakes an aggressive course in HIV‐infected patients since four of the patients required hospitalization and the two patients who refused to complete treatment, subsequently developed more severe skin and constitutional symptoms.Conclusions. HIV‐infected patients are at risk for developinglues maligna. Despite its malignant presentation,lues malignalesions respond rapidly to treatment with penicillin. Secondary syphilis should be added to the list of diseases known to be more aggressive in HIV‐infected p

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04441.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground and Objective. Anetoderma has been reported in patients with HIV‐1 disease. In patients with autoimmune disease, anetoderma has been associated with increased levels of antiphospholipid antibodies (APL) that include anticardiolipin antibodies (ACA) and lupus anticoagulant (LA). This has led to speculation that the autoimmune phenomena seen in HIV‐1 disease and the immune dysregulation induced by HIV‐1 disease may play a role in the development of these lesions. We have seen both primary and secondary lesions of anetoderma in patients followed for HIV‐1 disease. In this study, we wanted to determine whether there was an association in the development of anetoderma and elevated anticardiolipin antibodies (ACA) in HIV‐1 patients.Methods. Quantitative ACA levels were measured in eight HIV‐1‐infected patients with anetoderma and four HIV‐1‐infected patients without anetoderma.Results. Anticardiolipin antibodies were moderately elevated in seven of eight patients with lesions and were borderline in the four HIV‐1‐positive patients without lesions of anetoderma.Conclusions. There appears to be a correlation between increased ACA and the development of cutaneous lesions of anetoderma in HIV‐I disease. Patterns of immune dysregulation, including APL, may predispose to the development of lesions of anetoderma in HIV‐1‐positive patients. Although some of the lesions appear to represent primary anetoderma, the majority of our patients develop lesions in areas secondary to w

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04442.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractBackground. A study on HIV/AIDS‐related mucocutaneous manifestations has been carried out in three different ethnic and geographic areas, namely Brazil, Denmark, and Thailand.Methods. The Brazil cohort comprised 110 patients, the Danish cohort 150, and the Thai cohort 206 patients. The majority of the Brazil and Thai cohort patients belonged to groups III and IV according to the CDC clinical staging system, whereas the patients in Denmark called their doctors earlier and only 8% were classified in groups III and IV.Results. In all three areas the number of mucocutaneous diseases correlated well with the progression of the HIV disease. Ethnic differences were not identified, whereas geographic differences related to skin infections were marked. In the Asian cohort a generalized fungal infection was detected with characteristic mucocutaneous symptoms caused byPenicillium marneffei.Conclusions. Teaching efforts about mucocutaneous signs as markers of HIV infection may be of value, particularly in developing areas, to allow earlier diagnosis. In future guidelines for classification of HIV/AIDS‐related mucocutaneous diseases geographic considerations should be inclu

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1995.tb04443.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY