ABSTRACT
The three cutaneous reaction patterns of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis share many clinical features. Each is multifactorial in etiology; together they account for most severe cutaneous drug eruptions. In some respects, they can represent a progression in the severity of drug eruptions. Controversy continues to cloud the clinical delineation, etiology, and treatment.
ABSTRACT
The clinical and microbiological features of 31 cases of mycetoma seen in 8 years at a Riyadh hospital are described. Eighteen were due to Streptomyces somaliensis, 10 to Madurella mycetomatis and one each to Actinomadura madurae, Nocardia asteroides, and an unidentified species of Cladosporium. No immune defects were detected in the patients. Eleven had osteolytic lesions and 17 required surgery. Only seven patients were cured. Streptomyces infections were seen from all parts of Saudi Arabia outside the Rub Al Khali, but Madurella occurred mostly in highland regions where rainfall is higher.
Subject(s)
Mycetoma , Actinomycetaceae/isolation & purification , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Extremities/pathology , Female , Follow-Up Studies , Geography , Humans , Male , Middle Aged , Mitosporic Fungi/isolation & purification , Mycetoma/immunology , Mycetoma/microbiology , Mycetoma/pathology , Mycetoma/therapy , Nocardia asteroides/isolation & purification , Saudi Arabia , Streptomyces/isolation & purification , Time FactorsABSTRACT
Two cases of orf occuring in one family are reported. The patients developed characteristic skin lesions one week after sustaining cuts while slaughtering a sheep. The diagnosis of orf was confirmed by electron microscopy which revealed numerous large oval virus particle characteristics of parapox virus. This we believe is the first report of orf in Saudi Arabia.
ABSTRACT
A retrospective analysis was made of the radiologic features of 30 cases of mycetoma. Conventional radiographs, computerized tomography (CT), and isotope bone scans were assessed. Soft-tissue swelling was the only abnormality in 27%. Periosteal reaction was present in 67%, sclerosis in 53%, endosteal reaction in 50%, and cortical erosions in 43%. Cavities which were found in 33% are important as predictors of the causative micro-organism. Conventional radiographs are essential to the management of mycetoma as bone involvement makes non-surgical cure unlikely. The role of CT in diagnosis and management appears to be minor, except when the thigh is involved. Isotope bone scanning appears to have no value in either diagnosis or management.
Subject(s)
Mycetoma/diagnostic imaging , Adult , Bone and Bones/diagnostic imaging , Female , Foot Diseases/diagnostic imaging , Humans , Leg/diagnostic imaging , Male , Middle Aged , RadiographySubject(s)
Angiomatosis/pathology , Cerebral Cortex/diagnostic imaging , Sturge-Weber Syndrome/pathology , Adult , Calcinosis/complications , Glaucoma/complications , Humans , Infant , Male , Melanosis/complications , Nevus, Pigmented/complications , Radiography , Sturge-Weber Syndrome/diagnostic imagingABSTRACT
In a multiclinic double-blind trial, 305 patients with moderate to severe acne vulgaris were treated with oral tetracycline hydrochloride, 250 mg (N: 103), a 1% solution of clindamycin phosphate (N: 105), or placebo (N: 97) twice daily for 8 weeks. The response to treatment was evaluated by lesion counts and overall clinical improvement at 2, 4, 6, and 8 weeks. Both topical clindamycin and oral tetracycline significantly reduced papule and pustule counts compared to placebo; they were rated significantly higher than placebo on the physician's and the patient's overall evaluation at the end of the treatment period. No serious side effects were reported with any of the study medications.
Subject(s)
Acne Vulgaris/drug therapy , Clindamycin/administration & dosage , Tetracycline/administration & dosage , Administration, Oral , Administration, Topical , Adolescent , Adult , Clinical Trials as Topic , Double-Blind Method , Female , Humans , Male , Random Allocation , Time FactorsABSTRACT
The clinical findings in the case of three patients with subungual exostoses are summarized and the historical references to this condition are presented herein.
Subject(s)
Exostoses/diagnosis , Nails , Toes , Adolescent , Adult , Exostoses/complications , Exostoses/surgery , Female , Humans , Male , Nail Diseases/complicationsABSTRACT
A total of 113 patients with nummular eruptions of unknown origin were collected over a period of 8 years. This number was reduced to 82 patients by exclusion of known clinical entities which became unmasked during the study. All 82 patients were found to have varicose veins and/or edema of the lower extremities. Autoeczematization may be the common denominator.
Subject(s)
Eczema/pathology , Skin/pathology , Adult , Aged , Eczema/etiology , Edema , Female , Humans , Male , Middle Aged , Varicose VeinsABSTRACT
Nine patients exhibiting the characteristic clinical patterns in cutaneous atypical mycobacterial infections are presented. The verrucous plaque, sporotrichoid, ulcerated abscess, and scrophulous presentations are illustrated. The history, clinical appearance and treatment of cutaneous 'atypical' mycobacterial infections are reviewed.
ABSTRACT
The office procedure of creating tunnel grafts for attachment of hairpieces is not without complications. Early complications such as a hematoma under a graft, bacterial infection, and maceration of the epithelium lining the tunnels tended to be acute, but minor. Late complications, such as cutting in of the clips into the roofs of tunnels or stretching of the tunnel-graft roof, were mainly of a mechanical nature. Recommendations for reducing the indicence of such complications are made.
Subject(s)
Hair , Postoperative Complications , Scalp/surgery , Skin Transplantation , Adult , Aged , Hematoma/etiology , Humans , Male , Middle Aged , Postoperative Care , Skin Diseases/etiology , Sweating , Transplantation, AutologousABSTRACT
Two cases of nodular angioblastic hyperplasia with eosinophilia and lymphofolliculosis are presented. The position of such lesions in a histopathologic classification is discussed. The possible relationship to Kimura's disease and low-grade angiosarcoma is considered.
Subject(s)
Ear Neoplasms/pathology , Hemangioendothelioma/pathology , Skin Neoplasms/pathology , Child , Ear, External/pathology , Female , Humans , Middle AgedABSTRACT
A new procedure for attaching a hairpiece to the scalp is described. Two skin-lined tunnels in the anterior and posterior scalp are built, using a strip of free full-thickness donor skin fron the postauricular area. Silicone-coated metal clips, suitably fashioned from .062'' Kirschner's wire, are then attached to the hairpiece. The metal clips are inserted into the skin-lined tunnels and thereby anchor the hairpiece to the scalp.
Subject(s)
Hair , Scalp/surgery , Skin Transplantation , Alopecia/therapy , Humans , Transplantation, AutologousABSTRACT
Two patients who presented with tender hyperkeratotic papules involving their weight-bear.ing amputation stumps were studied. Although these clinical findings are common in the experience of prosthetists, the author has been unable to find any documentation of these findings in the literature. All attempts at relining and reshaping the cups of the original offending prostheses by experienced prosthetists were unsuccessful. The eruption cleared only after entirely new prostheses were designed. It would appear that this condition is due to a poorly fitting prosthesis.
Subject(s)
Amputation Stumps , Artificial Limbs , Leg Dermatoses/etiology , Adult , Humans , Keratosis/etiology , Leg , Leg Dermatoses/pathology , Male , Middle Aged , Pigmentation Disorders/etiology , Pressure/adverse effectsABSTRACT
Ninety-five patients with perioral dermatitis were studied from an epidemiological aspect. Consistent clearing of the eruption was obtained with oral tetracycline in combination with a topical sodium sulfacetamide-sulfur-hydro-cortisone lotion. Comparison of the study group of patients to a group of 50 control patients revealed highly significant quantitative differences in the cosmetic preparations used by the two groups. This latter finding would suggest that lubricating and moisturizing products play some part in the etiology of perioral dermatitis.
