ABSTRACT
A 35-year-old woman from Virginia presented with purplish, tender toes. She was diagnosed with pernio and successfully treated, initially with nifedipine and subsequently with management of the affected area's environment. Clinical presentations and treatment strategies are discussed below.
Subject(s)
Chilblains/diagnosis , Foot Diseases/diagnosis , Adult , Chilblains/therapy , Female , Foot Diseases/therapy , Humans , Nifedipine/therapeutic use , Physical Therapy Modalities , ToesABSTRACT
Pilomatricoma is an uncommon, benign growth with origination from the hair matrix that may have several clinical presentations and is frequently misdiagnosed. This case of a rapidly growing pilomatricoma in a 26-year-old was particularly deceptive, generating a differential diagnosis, principally of malignant tumors. The typical features, variants, histogenesis, differential diagnosis, and therapy are reviewed.
Subject(s)
Arm , Hair Diseases/diagnosis , Pilomatrixoma/diagnosis , Skin Neoplasms/diagnosis , Adult , Diagnosis, Differential , Hair Diseases/pathology , Humans , Male , Pilomatrixoma/pathology , Skin Neoplasms/pathologyABSTRACT
Depleted uranium (DU) is a dense heavy metal used primarily in military applications. Although the health effects of occupational uranium exposure are well known, limited data exist regarding the long-term health effects of internalized DU in humans. We established an in vitro cellular model to study DU exposure. Microdosimetric assessment, determined using a Monte Carlo computer simulation based on measured intracellular and extracellular uranium levels, showed that few (0.0014%) cell nuclei were hit by alpha particles. We report the ability of DU-uranyl chloride to transform immortalized human osteoblastic cells (HOS) to the tumorigenic phenotype. DU-uranyl chloride-transformants are characterized by anchorage-independent growth, tumor formation in nude mice, expression of high levels of the k-ras oncogene, reduced production of the Rb tumor-suppressor protein, and elevated levels of sister chromatid exchanges per cell. DU-uranyl chloride treatment resulted in a 9.6 (+/- 2.8)-fold increase in transformation frequency compared to untreated cells. In comparison, nickel sulfate resulted in a 7.1 (+/- 2.1)-fold increase in transformation frequency. This is the first report showing that a DU compound caused human cell transformation to the neoplastic phenotype. Although additional studies are needed to determine if protracted DU exposure produces tumors in vivo, the implication from these in vitro results is that the risk of cancer induction from internalized DU exposure may be comparable to other biologically reactive and carcinogenic heavy-metal compounds (e.g., nickel).
