Subject(s)
Antineoplastic Agents/therapeutic use , Cyclopropanes/therapeutic use , Melanoma/drug therapy , Melanoma/secondary , Orbital Neoplasms/pathology , Skin Neoplasms/drug therapy , Skin Neoplasms/secondary , Humans , Infant , Male , Melanoma/congenital , Orbital Neoplasms/congenital , Treatment OutcomeABSTRACT
BACKGROUND: Localized scleroderma is a rare but potentially disfiguring and disabling condition. Systemic treatment should be started early in those with active disease in key functional and cosmetic sites, but disease activity is difficult to determine clinically. Superficial blood flow has been shown to correlate with disease activity in localized scleroderma. OBJECTIVES: To examine whether superficial blood flow measured by laser Doppler imaging (LDI) has the potential to predict disease progression and therefore select patients for early systemic treatment. METHODS: A group of 20 individuals had clinical assessment and scanning LDI blood-flow measurements of 32 affected body sites. After a mean follow-up of 8.7 months their clinical outcome was compared with the results of the initial LDI assessment. RESULTS: Eleven out of 15 patients with an assessment of active LDI had progressed clinically, and 16 out of the 17 scans with inactive LDI assessment had not progressed, giving a positive predictive value of 73% and a negative predictive value of 94%. CONCLUSIONS: We believe that LDI can be a useful tool in predicting disease progression in localized scleroderma, and it may help clinicians to decide which patients to treat early.
Subject(s)
Scleroderma, Localized/physiopathology , Adolescent , Adult , Blood Flow Velocity/physiology , Child , Child, Preschool , Disease Progression , Female , Humans , Laser-Doppler Flowmetry/methods , Male , Microcirculation/physiology , Prospective Studies , Young AdultSubject(s)
Antibodies, Monoclonal/adverse effects , Dermatologic Agents/adverse effects , Pityriasis Lichenoides/chemically induced , Antibodies, Monoclonal/pharmacology , Dermatologic Agents/pharmacology , Humans , Infliximab , Male , Middle Aged , Tumor Necrosis Factor-alpha/antagonists & inhibitorsSubject(s)
Anti-Bacterial Agents/administration & dosage , Immunosuppressive Agents/administration & dosage , Pyoderma Gangrenosum/diagnosis , Pyoderma Gangrenosum/therapy , Acute Disease , Adult , Combined Modality Therapy , Disease Progression , Early Diagnosis , Female , Follow-Up Studies , Humans , Lower Extremity , Recurrence , Risk Assessment , Severity of Illness Index , Skin Transplantation/methods , Time Factors , Treatment OutcomeABSTRACT
Cutaneous extravascular necrotizing granuloma, an unusual palisading dermal granuloma, was first described by Churg and Strauss in 1951 in association with the syndrome of allergic granulomatosis (Churg-Strauss syndrome), for which it was though to be pathognomonic. It has subsequently been described in association with a number of autoimmune and immunoreactive diseases, and is regarded as a cutaneous marker of systemic pathology. To our knowledge, only one patient has been reported with clinical features confined to the skin. We report a 46-year-old woman with recurrent cutaneous lesions over a 10-year period and the classic histopathological pattern, but no underlying systemic disease.
