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  • 1
    Electronic Resource
    Electronic Resource
    Topical imidazoquinoline therapy of cutaneous squamous cell carcinoma polarizes lymphoid and monocyte/macrophage populations to a Th1 and M1 cytokine pattern (2004)
    Oxford, UK : Blackwell Science Ltd
    Clinical and experimental dermatology 29 (2004), S. 0 
    Details
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Imidazoquinolines are topical immune response modifiers. Imiquimod (IMI), the first imidazoquinoline, is approved for the treatment of genital human papillomavirus disease and has shown success as a therapeutic agent for cutaneous premalignant and malignant tumours. To define the pattern of polarization of the local immune response to invasive cutaneous squamous cell carcinoma (SCC) we pretreated 10 SCCs that were 〉 3 cm in diameter for 2 weeks with IMI. The tumours were treated on Monday, Wednesday and Friday and excised the next Monday. A battery of immunohistochemical markers was used to define the mononuclear cell populations in the diagnostic, and the excisional biopsy specimens. The total inflammatory infiltrate was increased after IMI therapy: the greatest increase was in the CD8 T cells with a marked relative decrease in the CD68 monocytic/macrophages; the majority of the CD8 T cells showed expression of cytotoxic granules, T cell-restricted intracellular antigen (TIA) and granzyme B. The relative numbers of monocytes/macrophages were decreased after therapy with IMI with a decrease in CD68+, CD23+, and CD14+ cells and an increase in MAC-397+, and factor XIIIa+ cells. The epidermal dendritic cells showed a 〉 75% decrease in CD1a+ cells. The immunohistochemical marker profile after IMI therapy is consistent with that induced by a Th1 and M1 cytokine polarization pattern. This cytokine pattern is known to be more effective in defence against tumours as well as viral infections.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2230.2004.01593.x
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  • 2
    Electronic Resource
    Electronic Resource
    Neonatal lupus erythematosus: factors which may lead to clinical disease in the foetus even in the absence of disease in the mother (2001)
    Oxford, UK : Blackwell Science Ltd
    Clinical and experimental dermatology 26 (2001), S. 0 
    Details
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Neonatal lupus erythematosus (NLE) occurs in neonates of mothers who, in almost all cases, have auto-antibodies to the SSA/Ro associated proteins, but who may have no clinical disease. However, only a small percentage of mothers with SSA/Ro antibodies have affected babies, predisposing factors specific to the foetus or neonate (i.e. HLA pattern) and/or fetal maternal interactions have been proposed to be important. We present a mother with a family history of autoimmune disease, but without clinical disease, whose baby developed cutaneous NLE. Autoantibody determinations as well as the HLA-DR/DQ were performed in the mother and baby. Factors other than the HLA-DR/DQ status of the mother appear to be important in determining whether or not the neonate will develop NLE. Auto-antibodies to endogenous antigens common to the mother, transiently expressed developmental antigens, and the isotype specificity of transferred antibodies may be important in determining disease in the baby.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2230.2001.00851.x
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  • 3
    Electronic Resource
    Electronic Resource
    Peroxisomal proliferator-activated ligand therapy for HIV lipodystrophy (2001)
    Oxford, UK : Blackwell Science Ltd
    Clinical and experimental dermatology 26 (2001), S. 0 
    Details
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Lipodystrophies associated with HIV disease have been reported in recent years and have included a general redistribution of fat with more central fat and increased dorsocervical fat. These lipodystrophies are commonly associated with hyperlipidemia and in some cases with insulin resistant diabetes. Although a similar redistribution of fat is seen in hypercortisolism, in general, serum and urinary cortisol levels are normal in these HIV-positive patients. However cortisol/dehydroepaindrosterone (DHEA) ratios are increased in HIV disease and may result in a relative hypercortisolism. Seven HIV-positive male patients on multidrug antiviral therapy including HIV protease inhibitors had developed increased central and dorsocervical fat over 1 year. All patients had increased serum lipids and three had insulin resistant diabetes. Four patients were treated initially with DHEA 100–200 mg/day, with addition of a cyclo-oxygenase (COX) inhibitor (indomethacin 100 mg/day) and three others were treated from the onset with a combination of DHEA 200 mg/day and a COX inhibitor (indomethacin 100 mg/day or naprosyn 1000 mg/day). All patients reported moderation or normalization of their serum lipids and some moderation of blood sugars while on DHEA alone. More marked improvement in blood sugar and noticeable decreases in the dorsocervical fat; however, occurred only with addition a COX inhibitor. Both DHEA and COX inhibitors have a number of mechanisms of action; among these is their role as a peroxisome proliferator-activator receptor ligand. Dysregulation of peroxisome function is associated with the spectrum of biochemical changes seen within these HIV associated lipodystrophies. Use of HIV protease inhibitors is reported in the majority of patients with these lipodystrophies, and protease inhibitors may accentuate the underlying peroxisome dysregulation. Supplementation with DHEA and a COX inhibitor may improve peroxisomal function.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2230.2001.00784.x
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  • 4
    Electronic Resource
    Electronic Resource
    Common variable immunodeficiency treated with a recombinant human IgG, tumour necrosis factor-α receptor fusion protein (2001)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 144 (2001), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Common variable immunodeficiency (CVI) is characterized by a failure in B-cell differentiation and impaired immunoglobulin secretion, but with a variable clinical presentation, including the development of sarcoidal granulomas and autoimmune diseases, as well as an increased incidence of malignancies. We present a 21-year-old white man who carried a diagnosis of juvenile rheumatoid arthritis and presented 6 years later with scarring alopecia showing sarcoidal granulomas. Further work confirmed the diagnosis of CVI, and with increasing systemic symptoms, it was elected to treat the patient with a tumour necrosis factor (TNF)-α antagonist, a TNF-α receptor IgG1 fusion protein. The patient showed improvement in his systemic symptoms and some hair regrowth after 3 months of therapy, and continued improvement in his systemic disease with only mild scalp hair thinning in the areas of prior involvement after almost 1 year of therapy. CVI and sarcoid may have overlapping clinical and immunological findings. Previous therapies for CVI, including intravenous immunoglobulin, have not altered the mortality of the disease. TNF-α is a primary cytokine and is elevated in CVI, and specific inhibition of TNF-α in this patient was effective in moderating his disease, including his skin disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2001.04092.x
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  • 5
    Electronic Resource
    Electronic Resource
    The cutaneous cellular infiltrate to stingray envenomization contains increased TIA+ cells (2000)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 143 (2000), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Stingrays result in approximately 2000 stings annually in the U.S.A., and thus are one of the most important venomous marine animals. After envenomization, there is immediate, intense pain with subsequent oedema, cyanosis followed by local erythema and petechiae. Progressive local necrosis and ulceration is variable, sometimes leading to gangrene. To characterize the inflammatory infiltrate at the site of a stingray injury, we examined tissue obtained approximately 4 days after stingray envenomization. Routine histology and immunohistochemical stains for lymphoid markers, including CD3, CD4, CD8, CD20, KP-1 and TIA were performed, and demonstrated a central area of haemorrhagic necrosis with a surrounding infiltrate of lymphoid cells and eosinophils. Approximately one-third of the mononuclear cells were TIA+, and these cells appeared mainly to correspond to the cells which were CD3+ and CD4+. The inflammatory cells, including the lymphoid populations, suggest that an immunological reaction may contribute to the delayed healing of stingray injuries.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2000.03848.x
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  • 6
    Electronic Resource
    Electronic Resource
    Histopathologic features seen in sulfur mustard induced cutaneous lesions in hairless guinea pigs (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cutaneous pathology 22 (1995), S. 0 
    Details
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sulfur mustard (SM), a chemical warfare agent first used early in the 20th century, has re-emerged in the past decade as a major threat around the world. At present, there are no effective therapeutic measures for SM exposure. Because the skin as well as other interface epithelial surfaces are the first tissues effected as this agent is absorbed, reactions within the skin are an area of active research into the mechanism of action of this alkylating agent. The euthymic hairless guinea pig has been used as the animal model for the study of SM induced injuries because of morphologic similarity of its skin to human skin, with a multiple layer epidermis, and because this animal has a normal immune system. We reviewed 102 biopsy specimens from 51 animals exposed to three different dose times of saturated SM vapor. Histopathologic evidence exists for increased programmed cell death as well as cellular necrosis, subepidermal blister formation, and delayed re-epithelialization secondary to problems with adhesion. Information obtained from this study adds to the body of information important in the investigation of the mechanisms of action of SM.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0560.1995.tb00748.x
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  • 7
    Electronic Resource
    Electronic Resource
    Cutaneous Hyalohyphomycosis Secondary to Paecilomyces Species Treated with Voriconazole in an Immune Compentent Host (2005)
    Oxford, UK; Malden, USA : Blackwell Publishing Ltd/Inc.
    Journal of cutaneous pathology 32 (2005), S. 0 
    Details
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Paecilomyces, a hyalohyphomycosis, is an uncommon cause of cutaneous and subcutaneous infections. Most cases reported have occurred in patients with impaired host defenses or following a surgical procedure, and have proven highly resistant to anti fungal therapies. A 60-year-old man presented with scattered non-healing verrucous lesions as well as ulcers and excoriations on the upper extremities and trunk. The lesion had begun shortly after the patient was scratched by prickly okra. The patient had no underlying health problems and he was on no medication. Histology revealed epidermal hyperkeratosis, acanthosis, with papillomatosis with intraepidermal micro-abscess formation. Within the dermis there was a mixed acute and chronic granulomatous infiltrate. With GMS stain numerous pleomorphic yeast forms and pseudohyphael forms were seen. Cultures confirmed Paecilomyces species. The patient was treated with Voriconazole with complete resolution of his lesion. Paecilomyces is an emerging fungal pathogen, which in our immune competent patient manifest as widespread cutaneous disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0303-6987.2005.320gw.x
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  • 8
    Electronic Resource
    Electronic Resource
    Genetic Identity Analysis, a Procedure that may Have Applications in Clinical Practice (2005)
    Oxford, UK; Malden, USA : Blackwell Publishing Ltd/Inc.
    Journal of cutaneous pathology 32 (2005), S. 0 
    Details
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Genetic identity analysis is a procedure that may be done on paraffin blocks to determine genetic identity or non-identity of tissues. On occasion biopsy specimens from different patients are mixed up. This becomes a major problem if the subsequent diagnoses require further therapy or have other significant medical implications. We recently had such a case in which three biopsy specimens from a middle age man were possibly mixed up with that from a pre-teen age boy. The biopsy from the pre-teen was originally reported as a malignant skin tumor. Initially, the three biopsy specimens from the middle age man were sent for genetic identity analysis, which showed that one biopsy specimen was genetically different. The biopsy specimen from the pre-teen was then sent, and found to be genetically similar to the two genetically identical specimens originally submitted for the middle age man. Further confirmation of genetic identity could have been obtained by obtain further samples from both patients, but was not felt necessary in this case. We review the procedure used for genetic identity analysis as well as its other applications for this procedure in clinical practice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0303-6987.2005.320gx.x
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  • 9
    Electronic Resource
    Electronic Resource
    Majocchi's granuloma (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cutaneous pathology 18 (1991), S. 0 
    Details
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Majocchi's granuloma (nodular granulomatous perifolliculitis) is a well recognized but uncommon infection of dermal and subcutaneous tissue by fungal organisms (dermatophytes) usually limited to the superficial epidermis. The organism usually associated with Majocchi's granuloma is Trichophylon rubrum; however, other dermatophytes including T. mentagrophytes (variety granulosum), T. epilans, T. violaceum, M. audouinii, M. gypseum, M. ferrugineum, and M. canis may be the causative agent. A review of 17 cases revealed not only the variety of possible organisms but also a marked variation from the usual hyphal forms. The morphologic variations including yeast forms, bizarre hyphae, mucinous coatings, and the Splendore-Hoeppeli phenomenon may be factors which allow the dermatophytes to persist and grow in an abnormal location. Also, there is evidence that Majocchi's granuloma may occur in two distinct groups of patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1600-0560.1991.tb00598.x
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  • 10
    Electronic Resource
    Electronic Resource
    Treatment of disseminated granuloma annulare with a 5-lipoxygenase inhibitor and vitamin E (2002)
    Oxford, UK : Blackwell Science Ltd
    British journal of dermatology 146 (2002), S. 0 
    Details
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary Histologically, granuloma annulare (GA) is a common non-infectious necrobiotic granulomatous reaction pattern that correlates with a number of different, but relatively specific clinical presentations. The cause or causes of GA are unknown: when localized, it is usually self-limiting, but it may be persistent when disseminated. We present three women who had had disseminated GA for more than 1 year. One patient had previously been treated with isotretinoin with no response. All three patients were treated with vitamin E 400 IU daily and zileuton 2400 mg daily. All responded within 3 months with complete clinical clearing. The anti-inflammatory and immune regulatory effects of vitamin E and zileuton may be an effective treatment in some patients with prolonged disseminated/generalized GA.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2133.2002.04590.x
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