Subject(s)
Sweet Syndrome/pathology , Child, Preschool , Female , Humans , Pain/etiology , Sweet Syndrome/complications , TibiaABSTRACT
Transjugular intrahepatic portosystemic shunt (TIPS) is a recently introduced angiographic technique for achieving portal decompression. New invasive radiographic procedures such as TIPS can result in radiation exposure equal to that received by patients during radiation therapy. With these high doses of radiation, patients are at increased risk for radiodermatitis and long-term sequelae, such as scarring and carcinoma. Ours is the first reported case of radiodermatitis after TIPS.
Subject(s)
Angiography/adverse effects , Portasystemic Shunt, Transjugular Intrahepatic/adverse effects , Radiodermatitis/etiology , Radiography, Interventional/adverse effects , Carcinoma/etiology , Cicatrix/etiology , Follow-Up Studies , Humans , Hypertension, Portal/surgery , Male , Middle Aged , Neoplasms, Radiation-Induced/etiology , Radiation Dosage , Radiation Injuries/etiology , Risk FactorsABSTRACT
OBJECTIVE: To examine ocular signs, symptoms, and results of tear analysis in patients with cutaneous rosacea before, during, and after doxycycline therapy. DESIGN: Before-after trial. SETTING: General community. PATIENTS OR OTHER PARTICIPANTS: Thirty-nine patients with cutaneous rosacea underwent dermatologic and ocular examinations, testing of tear break-up time, and Schirmer testing at baseline and 4, 8, and 12 weeks. Six patients did not complete the study. Baseline tear break-up time and results of Schirmer test were compared with those of 13 patients without rosacea who were matched for age and sex. INTERVENTION: Patients with rosacea were given doxycycline, 100 mg daily for 12 weeks. MAIN OUTCOME MEASURE: Statistically significant (P, .05) improvement in tear break-up time. RESULT: The most frequent ocular symptoms were dryness, itching, blurred vision, and photosensitivity, all of which improved significantly with treatment. All patients had signs of ocular disease, most commonly erythema and telangiectasia, meibomian gland dysfunction, and ciliary base injection. Significant improvement (P,.05) for scales, erythema and telangiectasia, ciliary base injection, bulbar injection, papillary hypertrophy, and punctate epithelial erosions was seen. Average tear break-up time for the patients with rosacea was 5.7 seconds, which improved to 10.8 seconds after 12 weeks of treatment (P = .007). Baseline tear break-up time was significantly lower than for the comparison group of normal subjects (P = .001). There was no correlation between severity of cutaneous disease and ocular disease. CONCLUSIONS: All patients with cutaneous rosacea had some degree of ocular involvement. Tear break-up time is abnormal in patients with rosacea. Ocular erythema and telangiectasia, meibomian gland dysfunction, and short tear break-up time in patients with cutaneous rosacea are indicators of ocular rosacea. Doxycycline, 100 mg daily, will improve ocular disease and increase the tear break-up time.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Doxycycline/therapeutic use , Eye Diseases/drug therapy , Rosacea/drug therapy , Adult , Aged , Eye Diseases/etiology , Eye Diseases/physiopathology , Female , Humans , Male , Middle Aged , Rosacea/complications , Rosacea/physiopathology , Tears/metabolismABSTRACT
Borrelia burgdorferi, the etiologic agent of Lyme disease, has also been associated with other cutaneous conditions. Acrodermatitis chronica atrophicans and lymphadenosis benigna cutis are also caused by B. burgdorferi. Recent evidence links some cases of progressive facial hemiatrophy of Parry-Romberg, benign lymphocytic infiltrate of the skin (Jessner-Kanof), lichen sclerosus et atrophicus, morphea, and Shulman syndrome with borreliae. This article reviews the manifestations of the diseases definitely linked to borreliosis and the evidence linking borreliae to progressive facial hemiatrophy, benign lymphocytic infiltrate, lichen sclerosus et atrophicus, morphea, and Shulman syndrome.
Subject(s)
Borrelia burgdorferi Group , Lyme Disease/complications , Acrodermatitis/microbiology , Chronic Disease , Humans , Lyme Disease/microbiology , Lyme Disease/physiopathology , Lymphoid Tissue/microbiologyABSTRACT
Lyme disease is increasingly being reported throughout the United States and many parts of the world. Borrelia burgdorferi, the etiologic agent of Lyme disease, is a spirochete that, not unlike the treponema of syphilis, can cause a spectrum of disease from the initial skin lesion, through widely varied symptoms and signs, to chronic neurologic and arthritic disability. The borrelial spirochete and Lyme disease are the subject of this review. A subsequent article will review other definite and possible cutaneous manifestations of borreliosis.
Subject(s)
Lyme Disease , Animals , Bites and Stings/microbiology , Borrelia burgdorferi Group/immunology , Borrelia burgdorferi Group/isolation & purification , Child , Disease Reservoirs , Disease Vectors , Enzyme-Linked Immunosorbent Assay , Female , Humans , Lyme Disease/complications , Lyme Disease/drug therapy , Lyme Disease/immunology , Lyme Disease/microbiology , Male , Pregnancy , Seasons , Sex Factors , Tetracyclines/therapeutic use , Ticks/microbiology , Time Factors , United StatesABSTRACT
A 16-year-old otherwise healthy girl developed a localized area of brittle, easily broken hairs on the scalp. In addition, the hair appeared to "come out in clumps," and the overall texture of the hair changed from soft and naturally curly to straight and stiff. An unusual hair shaft abnormality was demonstrated by routine light and electron microscopy, for which we can find no report of similar cases. The case and associated findings are presented.
Subject(s)
Hair Diseases/pathology , Adolescent , Female , Hair/pathology , Hair Diseases/etiology , Humans , Microscopy, Electron, ScanningSubject(s)
Creatine Kinase/blood , Tretinoin/adverse effects , Adult , Humans , Isotretinoin , Male , Physical ExertionABSTRACT
Safe therapeutic measures for Mucha-Habermann's disease in children are lacking. Three patients with the disease were treated with erythromycin for systemic effect. Although the series is small and uncontrolled, this approach seemed effective. An anti-inflammatory mechanism related to inhibition of chemotaxis is speculated.
Subject(s)
Erythromycin/therapeutic use , Pityriasis/drug therapy , Child , Child, Preschool , Female , Humans , MaleABSTRACT
A 26-year-old man had mal perforans pedis as the principal manifestation of spina bifida occulta with an associated intradural lipoma. Two lumbosacral dimples and a tuft of hair overlying the spina bifida led to the diagnosis. We include a review of the causes of mal perforans and a review of spina bifida occulta and associated abnormalities.
Subject(s)
Foot Diseases/complications , Leg Ulcer/complications , Spina Bifida Occulta/complications , Adult , Foot Injuries , Humans , Male , Spina Bifida Occulta/diagnosis , Wounds, PenetratingSubject(s)
Cosmetics/adverse effects , Facial Dermatoses/chemically induced , Adult , Female , Humans , MaleABSTRACT
Toxic epidermal necrolysis consists of two distinct clinical entities. The Ritter type, seen mostly in children under age 10, is the severest manifestation of staphylococcal disease. A toxin has been isolated which is postulated to be the cause for clinical lesions. High epidermal necrosis occurs. Treatment is with one of the penicillinase-resistant penicillins, and prognosis is good. The Lyell type is seen mostly in adults, is drug-related, and may be the severest form of the Stevens-Johnson syndrome. Full-thickness epidermal necrosis occurs. Treatment consists of withdrawing the offending drug. Good nursing care is essential. Prognosis is guarded.
