Correlation of nipple eczema in pregnancy with atopic dermatitis in Northern India: a study of 100 cases

Abstract Background Nipple eczema is a less common presentation of atopic dermatitis. No studies in the literature have correlated nipple eczema in pregnancy as a manifestation of atopic dermatitis. Objective To evaluate whether nipple eczema presenting in pregnancy is a manifestation of atopic dermatitis. Methods This was a prospective observational study including 100 women who presented with nipple eczema for the first time during pregnancy. The exclusion criteria were any patient with previous history of nipple eczema, those already on oral or topical treatment for atopic dermatitis or nipple eczema, and other disorders mimicking eczema. Patients were divided into two groups ‒ nipple eczema with atopic dermatitis and without atopic dermatitis. Demographic data, clinical features, total leukocyte count, differential leukocyte count, absolute eosinophil counts, and serum IgE levels were compared between the two groups to detect association between nipple eczema in pregnancy and atopic dermatitis. Results Out of 100 patients, 39 were diagnosed with atopic dermatitis, whereas 61 were ruled out to have any features suggestive of atopic dermatitis. There were no statistically significant differences in mean age, mean duration of symptoms, and serum IgE levels. In patients with atopic dermatitis, bilateral symptoms were noted more commonly than in patients without the disease, but this was statistically insignificant. Study limitations Lack of long term follow-up and no large studies in literature to compare results. Conclusion Nipple eczema in pregnancy follows a similar pattern as in other age groups. The clinical profile of patients is similar in cases with and without atopic dermatitis.

Serum c-erbB-2 protein in breast cancer patients.

Measurements of c-erbB-2 protein were done in sera of 20 normal women, 22 benign breast disease patients and in respectively 43 and 51 samples from primary breast cancer patients obtained prior to and after surgical interventions. Mean value of serum c-erbB-2 in non-malignant women was insignificantly different from the value in the breast cancer group. Positivity rate of serum c-erbB-2 in the cancer group was 13.8 per cent. Increasing postoperative serum c-erbB-2 concentrations were in good association with severity, progressiveness and relapse of breast cancer independently of other variables such as age, menopausal status, tumor size, axillary node invasion, ER or PR status. Pretreatment serum c-erbB-2 positivity was inversely correlated to ER status but relation to other prognostic parameters of breast cancer was not found. Agreement between c-erbB-2 measured in serum by enzymeimmunoassay and in tissue by immunohistochemical assay was also found. Our data confirmed that in primary breast cancer patients, monitoring of circulating c-erbB-2 protein levels after operation are useful for detecting the recurrence and/or metastasis of the disease especially in ER positive breast cancer. Pretreatment serum c-erbB-2 concentrations do not have benefit for early diagnosis of the tumor.

Significance of serum ferritin and lactate dehydrogenase in benign and malignant disease of breast.

Serum ferritin (SF) and lactate dehydrogenase (LDH) was estimated in 117 patients presenting with a breast lump and in 40 controls. Both pre and post treatment values were determined. Both the values were significantly higher in breast malignancies (p = 0.00) and also corresponded with the clinical stage and bulk of the tumour. The fall in post treatment values was proportional to the response to therapy. Persistent rise in values in the post treatment period was indicative of local recurrence of metastasis.

Carcinoembryonic antigen: an invaluable marker for advanced breast cancer.

Serial serum Carcinoembryonic antigen (CEA) levels were measured in 150 individuals (50 patients with breast cancer, 50 benign breast diseases and 50 other controls). These levels were correlated with clinicopathological parameters and follow-up information. Serum CEA levels were independent of the primary tumor status, their histology, lymphoreticular response and the patients' characteristics as well as the age, sex and the menstrual status. However, the nodal status, number of involved nodes and the grade of the tumors had significant influence on the level of serum CEA. Breast cancer patients especially those with metastasis had significantly higher serum CEA levels as compared to the controls and those with localised disease, irrespective of the site of metastasis. These levels were lowered appreciably by the disease regression and were raised or stable during the disease progression. Receiver operating characteristic (ROC) curve showed metastasis to be more frequent in patients with pretreatment serum CEA levels above 25 ng/ml and persistent post treatment CEA levels above 15 ng/ml. Serum CEA level was found to be a valuable prognostic indicator for advanced breast cancer and serial serum CEA levels provided an average lead time of about 3.9 months before the clinical appearance of metastasis.

Efficacy of low fat diet in the treatment of benign breast disease.

BACKGROUND. Previous studies have shown that lipid abnormalities have a role in the pathogenesis of benign breast disease. However, few investigators have tried to reduce dietary fat to treat this disorder. METHODS. Between 1990 and 1993, we conducted a prospective cohort study to find out the efficacy of a low fat diet (less than 15% fat-derived calories) in the treatment of benign breast disease in patients who had been symptomatic for 6 months or more. The study was conducted in two phases. In the first phase 36 patients were alternately assigned to control and treatment groups for 6 months and in the second phase 121 patients (including all those in phase I) were given treatment (median follow up 25 months, range 3 to 39 months). Detailed lipid profiles were studied at the time of presentation and at 4 and 5 months. RESULTS. Phase I results showed that after 6 months none of the patients in the control group had experienced any alteration in their symptoms and signs but in the treatment group 12 out of 17 improved. In phase II improvement in pain (68 out of 97; 70%), nodularity (51 out of 79; 64%) and discharge (15 out of 19; 80%) was seen. There was a significant decline in the mean values of total cholesterol and high-density lipoproteins at the end of 5 months of treatment. CONCLUSION. A low fat diet improves the symptoms as well as the lipid profile in patients with benign breast disease.

Significance of serum immunoglobulin levels in conglomeration with trans-sternal phlebography in the phlebography management of breast cancer.

The study was conducted on 63 patients with breast lump and twenty normal healthy females. In benign breast disease, a significant (P < 0.001) rise in serum IgA, significant (P < 0.001) decrease in IgG and no change in IgM levels was seen before operation. A significant decrease (P < 0.001) in serum IgA and significant increase in IgG and IgM was observed post operatively. In carcinoma breast, a significant (P < 0.001) elevation in IgA, IgG and IgM levels was found pre-operatively with a concomitant decrease in serum IgA and IgG and increase in serum IgM levels, post operatively. Trans-sternal phlebography (TSP) carried out with 95.23% success has revealed significant (P < 0.001) change in the staging of carcinoma breast. The increased levels of serum immunoglobulins associated with the patients of carcinoma breast with metastasis has led to conclude that these levels, if punctuated with TSP findings can lead to better assessment of the staging of carcinoma breast and thereby its management.

Circulating immune complexes in breast cancer patients

El objetivo de este trabajo fue evaluar la presencia de complejos inmunes circulantes (CIC) en el suero de pacientes con cáncer de mama, Los CIC de 146 pacientes con cáncer de mama se detectaron por el método de combinación a I-Clq. Se consideraron como valores elevados aquellos que excedieron la media aritmética (x+2DS) de los valores obtenidos en el grupo control (11%). Los valores elevados de combinación a Clq radioactivo fueron detectados antes del tratamiento en los 3 grupos estudiados con la siguiente incidencia: N0: 42%; N1: 67%; N2: 86%. En los primeros 12 meses post-tratamiento los niveles de CIC descendieron en los 3 grupos: N0: 18%; N1: 9%; N2: 23%. Sin embargo, a partir de los 12 meses post-tratamiento la incidencia fue en N0: 14%; N1: 62%; N2: 78%. Estos resultados fueron comparados con los valores obtenidos en el suero de 45 pacientes con displasia de mama