RESUMEN
Palmoplantar pustulosis is characterized by a chronic eruption of sterile pustules on palms and soles. The disease affects mainly women in the sixth and seventh decade of life. Some authors consider palmoplantar pustulosis a separate entity, whereas others consider it a condition in the spectrum of psoriasis. Aim of this study was to summarize the most recent data about PPP which aimed at establishing the nosological position of palmoplantar pustulosis. A systematic search of published literature was carried out. General characteristics of patients with PPP in different populations were present. We reviewed histological, immunological and genetic studies, as well as treatment options for PPP. PPP presents with clinical features, which are not present in psoriasis; however, the common coexistence of psoriasis vulgaris and/or positive family history for psoriasis indicates at least a close relationship between PPP and psoriasis. At present, there are not sufficient data to exclude PPP from psoriasis group.
Asunto(s)
Pie/patología , Mano/patología , Enfermedades Cutáneas Vesiculoampollosas/patología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Cutáneas Vesiculoampollosas/inmunologíaRESUMEN
BACKGROUND: The nosologic position of subacute cutaneous lupus erythematosus (SCLE) is controversial. More than four American Rheumatism Association (ARA) criteria for systemic lupus erythematosus (SLE) are found in a proportion of patients diagnosed as having SCLE; thus such cases could be classified as SLE. OBJECTIVE: Our purpose was to determine whether ARA criteria for SLE are helpful in differentiating SCLE from SLE and whether cutaneous and visceral changes, immunologic findings, and photosensitivity provide a basis for diagnosis of SCLE. METHODS: A cohort of 143 patients (79 with SCLE, 58 with SLE, and six with overlapping features of SCLE and SLE) was studied clinically, histologically, and immunologically as well as by phototesting. The patients were observed for up to 10 years, and the course of the disease and response to therapy were evaluated in each group. RESULTS: SCLE differed from SLE by cutaneous changes, significantly less frequent kidney involvement, serositis and arthritis, and the rare presence of double-stranded DNA, U1RNP, and Sm antibodies characteristic of SLE. Ro(SS-A) and La(SS-B) antibodies were detected with similar frequency, and photosensitivity was not related to the presence of Ro antibody. In contrast, photoreproduction (appearance of LE lesion in irradiated area) was significantly more frequent in patients with SCLE. The course of SCLE in older patients was less severe than in younger patients, and aggressive therapy was usually not required. CONCLUSION: Patients with SCLE (although the majority fulfill more than four ARA criteria for SLE) show significant differences from those with SLE in terms of cutaneous and visceral involvement, immunologic findings, photosensitivity, course of the disease, and the requirement for therapy. Therefore SCLE should be recognized as a separate subset. However, cases of overlapping SLE and SCLE suggest a close relation.
Asunto(s)
Lupus Eritematoso Cutáneo/diagnóstico , Lupus Eritematoso Sistémico/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos Antinucleares/análisis , Artralgia/complicaciones , ADN/análisis , Diagnóstico Diferencial , Femenino , Humanos , Riñón/patología , Lupus Eritematoso Cutáneo/tratamiento farmacológico , Lupus Eritematoso Cutáneo/inmunología , Lupus Eritematoso Cutáneo/patología , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/inmunología , Lupus Eritematoso Sistémico/patología , Masculino , Persona de Mediana Edad , Trastornos por Fotosensibilidad/complicaciones , Ribonucleoproteínas/inmunología , Serositis/complicaciones , Piel/patologíaRESUMEN
The incidence of various types of urticaria. In 1734 patients with urticaria the incidence of the types of this condition is analysed. The sex of the patients and the mean age at oneset of symptoms are given.
Asunto(s)
Urticaria/epidemiología , Adulto , Edad de Inicio , Femenino , Humanos , Incidencia , Masculino , Polonia/epidemiología , Urticaria/clasificaciónRESUMEN
BACKGROUND: Comparisons of cases of systemic lupus erythematosus (SLE) with cases of rheumatoid arthritis and other rheumatologic disorders affords the basis of the 1982 revised criteria of the American Rheumatism Association (ARA) for classifying SLE cases. We address three questions: Do comparisons of LE cases with non-LE cases that have suggestive skin lesions yield criteria for use in dermatology clinics for primary classification of cases with photo distributions of skin lesions? Do comparisons of SLE with cutaneous LE cases yield the same or similar criteria to the revised ARA criteria for SLE? How should subacute cutaneous LE cases be evaluated for signs of significant systemic involvement? METHODS: Discriminant analyses on 168 cases with skin lesions suggestive of LE were performed using data based on the ARA criteria for SLE and study factors for cutaneous LE suggested by the European Academy of Dermatology and Venereology. RESULTS: These yielded two sets of criteria: (1) The 11 preliminary, dermatologic first step criteria (10 plus 1 for discoid lesions and histology) serve to classify cases as LE or non-LE. (2) The 11 preliminary, dermatologic second step criteria classify LE cases as cutaneous LE or systemic LE. Interestingly, 5 of 11 of these second step criteria differ from the 11 ARA criteria for systemic LE. These second step criteria afford a useful means of distinguishing between subacute cutaneous LE cases with or without significant systemic involvement. CONCLUSIONS: The study factors included in both the first and the second step criteria fall into three groups, notably clinical criteria, laboratory criteria, and "added study factors." The latter factors distinguish between the groups compared (LE vs. non-LE and cutaneous vs. systemic LE) but not as well as the study factors included as "criteria."
Asunto(s)
Lupus Eritematoso Cutáneo/clasificación , Lupus Eritematoso Sistémico/clasificación , Humanos , Lupus Eritematoso Cutáneo/patología , Lupus Eritematoso Discoide/clasificación , Lupus Eritematoso Discoide/patología , Lupus Eritematoso Sistémico/patología , Piel/patologíaRESUMEN
Chromosome analysis of a benign, unilateral, renal angiomyolipoma revealed the karyotype 44,XX,-8, -12, -14, -21, +der (8q14q), + der(12)(12pter----12q14-15::12q24----12q14-15::+ ++21q21----21qter). This indicates that structural changes of 12q13-15, which are so frequently observed in the common malignant and benign lipogenic tumors, may also occur in the rarer variants of these neoplasms.
Asunto(s)
Hemangioma/genética , Neoplasias Renales/genética , Lipoma/genética , Aneuploidia , Deleción Cromosómica , Cromosomas Humanos Par 12/ultraestructura , Cromosomas Humanos Par 21/ultraestructura , Femenino , Hemangioma/patología , Humanos , Neoplasias Renales/patología , Lipoma/patología , Persona de Mediana EdadRESUMEN
A group of 140 cases of various forms of lupus erythematosus (LE) were examined for 24 variables, including the 11 criteria of the American Rheumatism Association (ARA) for the classification of systemic lupus erythematosus (SLE), and 13 additional criteria suggested by the European Academy of Dermatology and Venerology (EADV) for studies of cutaneous LE with or without systemic involvement. The EADV study factors included skin histopathology and immunopathology, complement and IgG levels, and other laboratory tests, as well as selected clinical findings, most notably the papulosquamous and/or annular lesions that characterize subacute cutaneous LE (SCLE). The patients examined included 50 SLE, 35 SCLE, 30 discoid LE (DLE), 25 disseminated DLE (DDLE), and 17 polymorphous light eruption (PMLE) cases. Preliminary analyses of the data reveal the following: (1) The SCLE cases differed significantly from SLE, DLE, and DDLE in 10 of 11 ARA criteria (all but photosensitivity). (2) The frequencies of positive findings in SCLE also differed significantly for 11 of 13 EADV study factors. (3) While no significant differences appeared in the frequency of photosensitivity between the five study groups, photo-testing revealed significant increases in the frequency of persistence of the photo reactions for 10 days and their Koebnerization in the SCLE cases. (4) The presence of SS-A (Ro)/SS-B (La) antibodies had some predictive value for the appearance of systemic involvement in SCLE, as seen by the increased frequencies of five or more ARA criteria, although highly significant differences from SLE occurred in the absence of renal involvement and lower frequency of ANA and LE band test.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Lupus Eritematoso Cutáneo/clasificación , Dermatología , Europa (Continente) , Humanos , Lupus Eritematoso Cutáneo/inmunología , Lupus Eritematoso Discoide/clasificación , Lupus Eritematoso Sistémico/clasificación , Lupus Eritematoso Sistémico/inmunología , Trastornos por Fotosensibilidad/clasificación , Sociedades Médicas , Estados Unidos , VenereologíaRESUMEN
CD 271, a naphthoic acid, is a powerful modulator of epidermal differentiation. This double-blind, randomized study compared the efficacy and safety of two concentrations (0.03% w/w and 0.1% w/w) of CD 271 alcoholic gel, with 0.025% w/w tretinoin gel in 72 male patients with acne vulgaris over a period of 12 weeks. Efficacy was measured by counting facial inflammatory and non-inflammatory lesions and by grading the severity of the acne at each visit. Skin tolerance was assessed with subjective symptoms, such as burning and pruritus, as well as clinical assessment of erythema, dryness and scaling on the treated areas. The alcoholic 0.1% CD 271 gel was as effective as 0.025% tretinoin gel in reducing total comedone counts (83% reduction for both products after 12 weeks' treatment). The reduction in the number of inflammatory lesions and the total number of acne lesions were significantly greater with 0.1% CD 271 gel than with tretinoin gel (69% and 79% for 0.1% CD 271, 50% and 73% for tretinoin gel, respectively, P less than 0.05). All three treatments were well tolerated and there were no changes in any major blood parameters. No CD 271 could be detected in blood plasma at the end of the study (detection limit = 1 ng/ml).
Asunto(s)
Acné Vulgar/tratamiento farmacológico , Antiinflamatorios no Esteroideos/administración & dosificación , Naftalenos/administración & dosificación , Adapaleno , Administración Tópica , Adolescente , Adulto , Método Doble Ciego , Humanos , Masculino , Naftalenos/uso terapéutico , Tretinoina/administración & dosificación , Tretinoina/uso terapéuticoRESUMEN
Cytogenetic analysis of a polycystic unilateral renal lymphangioma was performed by short-term culture and banding methods. The tumor's cells showed an isochromosome of the long arm of chromosome #7 and monosomy of X chromosome, whereas the peripheral lymphocytes stimulated with phytohemagglutinin showed a normal female karyotype, 46,XX. These karyotypic anomalies suggest that lymphangioma, although clinically benign, may have malignant potential.
Asunto(s)
Aberraciones Cromosómicas , Trastornos de los Cromosomas , Cromosomas Humanos Par 7 , Neoplasias Renales/genética , Linfangioma/genética , Aberraciones Cromosómicas Sexuales , Cromosoma X , Preescolar , Bandeo Cromosómico , Femenino , Humanos , Cariotipificación , Neoplasias Renales/patología , Linfangioma/patologíaRESUMEN
The insecticidal effect was tested of a shampoo with 0.33% of pyrethrum extract and a shampoo with 1% malathion. The study was carried out in 222 patients and better results were observed with the pyrethrum shampoo which required only one application.
Asunto(s)
Chrysanthemum cinerariifolium , Preparaciones para el Cabello/administración & dosificación , Infestaciones por Piojos/tratamiento farmacológico , Malatión/administración & dosificación , Extractos Vegetales/administración & dosificación , Adulto , Niño , Femenino , Humanos , Masculino , Cuero Cabelludo/efectos de los fármacosRESUMEN
The clinico-morphological features in 13 patients (nine female) with neuroendocrine carcinoma of the skin are presented. The mean age was 64.9 years. The limbs were the most common site of primary tumour, followed by the face. The clinical course was characterized by a high incidence of regional lymph node metastases (69%) and recurrences (46%). Seven of the patients died of tumour, with a mean survival time of 13 months. Histologically, a solid pattern of tumour growth was most common. The cells were usually small and uniform. Squamous cell differentiation was found in one tumour. The cell of all tumours reacted positively for cytokeratins and neuron-specific enolase. The positive reaction frequently had a ball-like globular pattern, corresponding to inclusion-like bodies seen on light microscopy and to paranuclear whorls of intermediate filaments observed on electron microscopy. Neurosecretory granules were seen on electron microscopy in the 11 cases examined and in one case a 'Luse body' was found in the intercellular space.
Asunto(s)
Carcinoma de Células de Merkel/patología , Neoplasias Cutáneas/patología , Anciano , Carcinoma de Células de Merkel/diagnóstico , Carcinoma de Células de Merkel/metabolismo , Citodiagnóstico , Femenino , Humanos , Inmunohistoquímica , Cuerpos de Inclusión/patología , Queratinas/metabolismo , Masculino , Microscopía Electrónica , Persona de Mediana Edad , Fosfopiruvato Hidratasa/metabolismo , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/metabolismoRESUMEN
In a contralateral study a new coal tar gel was compared with a topical corticosteroid in the treatment of psoriasis. In 45 patients treated for four weeks, the coal tar gel proved significantly more effective.
Asunto(s)
Antiinflamatorios/uso terapéutico , Alquitrán/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Hidrocortisona/análogos & derivados , Psoriasis/tratamiento farmacológico , Administración Tópica , Enfermedad Crónica , Alquitrán/administración & dosificación , Evaluación de Medicamentos , Geles , Humanos , Hidrocortisona/uso terapéuticoRESUMEN
Responses to ultraviolet B (UVB; 290-320 nm) were tested in 227 patients with main forms of lupus erythematosus (LE): discoid LE (DLE), discoid disseminated LE (DDLE), systemic LE (SLE), and subacute cutaneous LE (SCLE). Four parameters were evaluated: minimal erythema dose (MED), its distribution, persistence of erythema, and photoreproduction of lesions. Patients with LE differed considerably from controls in their UVB reactivity. In addition, there were significant differences between various LE forms, even after a single UV exposure. Lowered MED in comparison to controls was observed most frequently in SLE patients (64.4%) and least frequently in DLE patients (32.1%). Prolonged persistence of erythema induced by 1-2 MED was a constant finding in SCLE. In SLE and DDLE, it was observed in more than 80% of patients, and in DLE in 56.7% of examined cases. Photoreproduction of lesions after single UVB exposure was observed most frequently in SCLE (62.5%) and only in 10% of DLE patients.
Asunto(s)
Lupus Eritematoso Cutáneo/complicaciones , Trastornos por Fotosensibilidad/diagnóstico , Rayos Ultravioleta , Adolescente , Adulto , Anciano , Niño , Eritema/etiología , Femenino , Humanos , Lupus Eritematoso Discoide/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Masculino , Persona de Mediana Edad , Trastornos por Fotosensibilidad/etiología , Dosis de RadiaciónRESUMEN
The effects of etretinate treatment on natural killer cell activity, on angiogenic capability of peripheral blood mononuclears and on neutrophil adherence were studied in 20 patients with various forms of psoriasis. In all forms of active psoriasis, etretinate was found to affect first the angiogenic reaction and PMN adherence, whereas NK cell activity usually normalized only after a long-term therapy. The earliest normalization of all three parameters was noticed in pustular psoriasis, and it was correlated with the clinical improvement. In two cases of palmo-plantar pustular psoriasis, in 5 cases of arthropathic variety, and in 5 cases of common psoriasis, the normalization preceded clearing of the skin lesions.
Asunto(s)
Etretinato/uso terapéutico , Células Asesinas Naturales/inmunología , Neovascularización Patológica/patología , Neutrófilos/inmunología , Psoriasis/tratamiento farmacológico , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/inmunologíaRESUMEN
Various external photosensitizers have been compared in local PUVA therapy of 280 patients with psoriasis treated in Moscow at the Central Research Institute for Skin and Sexually Transmitted Diseases, the USSR Ministry of Health, and in Warsaw at the Dermatology Hospital. In Moscow 127 patients have been administered 0.3% ammifurin solution, 73 ones 0.1% psoralen solution; in Warsaw 50 patients have been administered 0.1% puvaderm ointment (Basan) made in Finland and 30 patients 0.1% oxoralen emulsion manufactured in Austria. A good clinical effect has been achieved in 252 patients (90%). Ammifurin 0.3% solution and puvaderm 0.1% ointment have proved to be the most effective. External photosensitizers are recommended for local or as a supplement to total PUVA therapy.
Asunto(s)
Terapia PUVA/métodos , Psoriasis/tratamiento farmacológico , Adolescente , Adulto , Anciano , Evaluación de Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia , Fármacos Sensibilizantes a Radiaciones/uso terapéutico , U.R.S.S.RESUMEN
Ten children, five with generalized pustular psoriasis and five with erythrodermic disease, were treated with etretinate and observed for up to seven years. In all those with pustular psoriasis, complete clearing was obtained in three weeks to four months, but in one child maintenance therapy had to be introduced twice, for one year each time. In those with erythrodermic psoriasis, the results were favorable only in two, and in two it was necessary to introduce Re-PUVA. Clinical side effects were slight, and laboratory examinations did not disclose any significant abnormalities. In one child who was treated intermittently for seven years, focal osteoporosis of one tibia was disclosed by radiography. No adverse effects on children's development were noticed.
Asunto(s)
Etretinato/uso terapéutico , Psoriasis/tratamiento farmacológico , Niño , Preescolar , Dermatitis Exfoliativa/complicaciones , Dermatitis Exfoliativa/tratamiento farmacológico , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Humanos , Masculino , Terapia PUVA , Psoriasis/complicacionesRESUMEN
Coexpression of keratin and vimentin was found in carcinoma cells of 13 fine needle aspirates of metastatic lesions that showed some cytologic features considered to be consistent with a renal or thyroid origin, but in which a large number of other possible primary sites would have to be taken into account on the basis of the morphologic evidence alone. Immunochemistry thus narrowed the cytologic differential diagnosis to thyroid, renal, endometrial and ovarian carcinomas, which are known to show true coexpression of keratin and vimentin. In most cases, clinical data available at the time of the fine needle aspiration supported the thyroid or renal origin of the carcinoma cells found in the aspirates. In two cases, which lacked significant clinical information, the diagnosis of metastatic renal cell carcinoma was provided on the basis of the combined morphologic and immunocytochemical evidence. In these two cases, computed tomography or ultrasonography revealed kidney tumors, which were removed and confirmed histologically to be clear cell carcinomas.
Asunto(s)
Adenocarcinoma/diagnóstico , Carcinoma Papilar/diagnóstico , Carcinoma de Células Renales/diagnóstico , Neoplasias Renales/diagnóstico , Neoplasias de la Tiroides/diagnóstico , Adenocarcinoma/análisis , Adenocarcinoma/patología , Adenocarcinoma/secundario , Adulto , Anciano , Biopsia con Aguja , Carcinoma Papilar/análisis , Carcinoma Papilar/patología , Carcinoma Papilar/secundario , Carcinoma de Células Renales/análisis , Carcinoma de Células Renales/patología , Carcinoma de Células Renales/secundario , Femenino , Técnica del Anticuerpo Fluorescente , Humanos , Inmunohistoquímica , Filamentos Intermedios/clasificación , Queratinas/análisis , Neoplasias Renales/análisis , Neoplasias Renales/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias de la Tiroides/análisis , Neoplasias de la Tiroides/patología , Tomografía Computarizada por Rayos X , Ultrasonografía , Vimentina/análisisRESUMEN
Concentrations of arachidonic acid ranging from 0.1% to 2% were applied under occlusive dressings to psoriatic plaques in 45 patients. Alleviation of the clinical symptoms of psoriasis including complete clearing in some cases was obtained with the use of 0.5% to 2% arachidonic acid applied under occlusion every 24 to 48 hours five to seven times. Histologic examination showed polymorphonuclear leukocytes penetrating into the stratum corneum and formation of microabscesses or wide-spread accumulations of polymorphonuclear leukocytes in the stratum corneum, with its eventual destruction. The parakeratotic horny layer became detached; this was followed by restoration of the granular layer and an apparently normal stratum corneum. While arachidonic acid metabolites can be proinflammatory and proproliferative, they may also be important in the healing process for psoriasis.