ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02785.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.tb02786.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.tb02787.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.tb02788.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground. Cordylobia anthropophaga(Blanchard) is a nonhematophagous dipteron belonging to the Calliphoridae family. It produces a mylasis called “tumbu fly” or “ver de Cayor” or “mango fly” or “skin maggot fly.”Case Reports. We describe two women, 24 and 23 years of age, affected by cutaneous myiasis caused by the larva ofCordylobia anthropophaga. In both cases the myiasis was contracted in Senegal and was characterized by a single lesion localized to the flank and the thigh respectively. From each of these lesions a single larva was extracted.Discussion. This myiasis represents a typical example of tropical disease that In the past was unknown to Western

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02789.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground. Psoriasis has been associated with depressive disease and case reports of completed suicide.Methods. 217 consenting psoriasis patients completed the Carroll Rating Scale for Depression (CRSD), a 52‐item self‐rated scale, with four of the Items directly addressing wishes to be dead and suicidal ideation. The patients also self‐rated the severity of their psoriasis.Results. 9.7% of patients reported a wish to be dead, and 5.5% reported active suicidal ideation at the time of the study. The death wish and suicidal ideation were associated with higher depression scores (P<0.0001) and higher patient self‐ratings of psoriasis severity (P<0,05). Patient self‐reports of psoriasis severity correlated directly with the overall depression scores (r = 0.39), P<0.0001).Conclusions. The comorbidity between depressive symptoms, suicidal ideation, and psoriasis severity is in contrast with reports that severe depression and suicidal ideation are mainly a feature of life‐threatening medical disorders such as malignancies. Our finding may have important implications in the management o

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02790.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground. Identification of the nine‐banded armadillo as a potential source of massive numbers ofMycobacterium lepraeled to the development of a candidate bacterin vaccine for possible immunoprophylaxis.Methods. Volunteers were from a leprosy‐hypoendemic, nonBCG‐using area (USA). They had been vaccinated intradermally 3 years earlier with a candidate antileprosy bacterin vaccine of irradiated and autoclavedMycobacterium lepraeobtained from experimental nine‐banded armadillos. They were tested for dermal responsiveness to standard lepromin A.Results. Values for induration and erythema appeared slightly greater for the vaccinated group; however, the differences were not statistically significant, indicating no appreciable ‘anamnestic’ effect on either Fernandez (early) or Mitsuda (late) reactions after 3 years.Conclusions. Because previous studies had demonstrated that administration of this bacterin produced no humoral changes, it now appears less probable that laboratory methods will be of much help in assessing even possible effectiveness of such

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02791.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackground. Leprosy has been identified as an important health problem in the pediatric age group. The study of leprosy in children is imperative as it may unravel the missing links in the natural evolution of the disease and dispel the uncertainty of the precise incubation period.Methods. The study was undertaken on patients attending the Urban Leprosy Centre. There were 161 children in the age group of 0 to 14 years, amongst 3184 cases of leprosy, detected between 1981 and 1991. The diagnosis in each was formed after meticulously recording the clinical features, slit‐skin smear examination, and histopathologic characteristics. In addition, a detailed history of duration of the disease was elicited by complement recall method.Results. The study revealed an incidence of 5.06% amongst leprosy patients, in an urban setting. The boys:girls ratio was 2.6:1. The mean duration of the disease was 1.2 years in paucibacillary and 2.8 years in multibacillary. History of intra‐ or extrafamilial contact was elicited in 8.7%. The typical lesion was a “hypopigmented macule,” either of indeterminate, tuberculoid, borderline tuberculoid, or borderline borderline leprosy. Borderline lepromatous, lepromatous, and polyneuritic leprosy were uncommon.Conclusions. Leprosy in children is a well‐established distinct entity. Any hypopigmented macule in pediatric age group should arouse suspicion of leprosy. The diagnosis is clinical. Other investigative parameters, namely slit‐skin smear, and histopathology may supplement but not supplant th

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02792.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

During a 4 year period, we observed three patients, aged 74, 47, and 55, with an average 12‐year history of chronic itching and prickling skin discomfort. The dorsal and paimar surface of the hands and feet were involved without observable cutaneous lesions. We followed the patients for 1.5 years in our department. None of the subjects was dermographic, had personal or family history of atopy, or took drugs. The symptoms were not related to the degree of skin dryness, serum IgE levels, exercise, neoplasias, or high environmental temperature and low humidity caused by central heating or seasonal variations. No neurologic alterations were observed in a complete neurologic examination. Emotional upset did not induce symptoms. Upon psychiatric evaluation, the patients showed no alterations in their personality profile. Water exposure did not modify the symptoms. The wheals and pruritus induced by the intradermal injection of 1:10,000 histamine phosphate did not differ from those in three controls1Immersion of one hand and foot for 5 days per week for 2 weeks in water at different temperatures (0–45°C) for varying lengths of time and the administration of one minimum erythemal dose of ultraviolet light (280–340 nm) to the controlateral part of the body three times per week for 3 weeks both failed to reduce the severity of the discomfort. Biopsy specimens were taken from the symptomatic skin of the three subjects and from three controls. The specimens were routinely stained with hematoxylineosin for mast cells, elastic fibers, and glycosaminoglycans. There were no significant differences between the two groups. Cutaneous fibrinolytic activity, which is due to the release of cutaneous plasminogen activators, was similar in both groups.2Direct immuno‐fluorescence staining (dif) for neuropeptides substance P (sp) (Fig. 1), vasointestinal polypeptide (vip), and calcitonin gene related peptide (CGRP) showed an increased number of pep‐tidergic fibers in affected skin. After 2 weeks of three times daily application of 0.25% capsaicin in cold cream (8‐methyl‐N‐ vanillyl‐6‐nonenamide, known to interfere with the storage and release of neuropeptides), the symptoms disappeared completely, and neuropetidergic fibers were no longer de‐tectable in the skin, as shown bydif.The application of cold cream alone on the contralateral part of the body did not modify DIF or the clinical symptoms. After suspension of capsaicin treatment, a relative to absolute refractory period of 10 to 18 days was observed, and the symptoms reappeared. Previous treatments with systemic Hi (with and without H2) antihistamines, antide‐pressants, hypnotics, and topical corticosteroid prepara‐tions did not achieve significant results. The increased number of neuropeptidergic fibers in the affected acral skin, the dramatic action of capsaicin in reducing the storage of neuropeptides in the same cutaneous fibers, and the com‐plete disappearance of the clinical symptoms suggest that the cases reported here represent a distinct clinical entity, which could be called or described as neurop

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02793.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A 22‐year‐old woman was referred to dermatology from oncology for an opinion regarding the sudden matting of scalp hair of 10 days duration. A case of primary infertility for 7 years, this patient was undergoing chemotherapy with doxorubicin, cyclophosphamide, and cisplatin after operative removal of a papillary cystadenoma (clear ceil type) from her left ovary 40 days previously.She had noticed a sudden matting of her hair 3 to 4 hours after using a soap containing Acacia concinna for washing her hair. All efforts to disentangle the matted hairs were futile. She was feeling very uncomfortable because of the heavy solid mass of tangled hair. She told of rubbing her wet hair and using a wet towel to cover her hair after use of the soap. She denied earlier use of the soap, shampoo, setting lotions, bleaches, or hair dye. She had not cut her hair since early childhood.Examination showed a huge, firm almost stony mass of severely tangled hair on her scalp, which was more marked over the vertex and occipital areas (Figs. 1 and 2). The hairs in the frontal area were free, thin, and straight. The skin over the entire scalp was normal. On light microscopy, a few hairs showed features of trichorrhexis nodosa. Routine hematology was normal. The patient was unable to tolerate the pain and discomfort because of the stony hard mass. She shaved her head and offered her hair in a temple, as is a common custom in parts of South In

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1993.tb02794.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY