1/106. Three new cases of transient bullous dermolysis of the newborn.We present 3 new patients with transient bullous dermolysis of the newborn (TBDN), which is a form of dystrophic epidermolysis bullosa. TBDN may be diagnosed by electron microscopy showing a sublamina densa cleavage; immunofluorescence antigenic mapping demonstrating bullous pemphigoid antigen, laminin- 1, and type IV collagen along the epidermal roof of subepidermal clefts; and indirect immunofluorescence with monoclonal antibodies revealing intraepidermal type VII collagen. Although intraepidermal type VII collagen has been reported in other forms of dystrophic epidermolysis bullosa, we believe that the presence of type VII collagen in a striking intraepidermal granular array is a finding unique to TBDN. Our cases demonstrate the importance of immunodermatologic studies in the diagnosis of bullous disorders that are seen at birth because accurate diagnosis carries prognostic implications. This variant of epidermolysis bullosa, in contrast to other forms of dystrophic epidermolysis bullosa, is a benign, self-limited disease.- - - - - - - - - - ranking = 1keywords = bullous (Clic here for more details about this article) |
2/106. Intraepidermal expression of basement membrane components in the lesional skin of a patient with dystrophic epidermolysis bullosa.The patient was a 15-year-old male. Since birth, he had developed blistering and erosion of the skin. biopsy skin specimen of the bullous lesions showed subepidermal blister formation. Electron microscopic examination revealed that tissue separation had occurred at the sublamina densa level. By indirect immunofluorescence using antibodies specific for alpha 6 integrin, laminin 5, type IV collagen, and type VII collagen, all of these basement membrane components were detected as coarse granular intracytoplasmic deposits only in the basal and suprabasal cells of the blister roof. In the non-blistered regions, these basement membrane components showed a linear pattern similar to that seen in normal skin. These findings suggest that intraepidermal expression of basement membrane components was closely related to the blister formation. The biological meaning of intraepidermal expression of basement membrane components were also discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = bullous (Clic here for more details about this article) |
3/106. Severe subepidermal blistering disorder with features of bullous pemphigoid and herpes gestationis.Herpes gestationis (HG) and bullous pemphigoid (BP) are blistering disorders with similar features, including urticarial lesions that progress to blisters and immunodeposition of C3 in a linear pattern at the basement membrane zone. Among their differences, HG is distinguished by its association with pregnancy, the puerperium, or hormonal perturbation. We describe the immunopathologic findings and clinical course in a multiparous woman with a severe blistering eruption. The patient was not pregnant. Malignancy evaluation was negative, and hormonal testing was normal. Histologic examination demonstrated a subepidermal bulla with eosinophils. Direct immunofluorescence showed C3 in a strong linear band at the dermal-epidermal junction. Indirect immunofluorescence demonstrated circulating IgG and IgG3 antibodies to basement membrane zone (epidermal component on salt-split skin), and complement-fixing IgG. immunoprecipitation demonstrated antibodies to a 180-kd keratinocyte protein antigen. By clinical definition, this patient has BP. However, her disease presentation demonstrated features of both BP and HG.- - - - - - - - - - ranking = 0.71428571428571keywords = bullous (Clic here for more details about this article) |
4/106. Spontaneous regression of a bulla with the development of adenocarcinoma of the lung.Spontaneous regression of a bulla in the lung is rare. We describe a case of spontaneous regression associated with the development of adenocarcinoma of the lung in a 59-year-old male smoker. The bulla had begun to regress spontaneously at least six months before lung cancer was detected on a chest radiograph. He underwent left upper lobe lobectomy with mediastinal node dissection. The tumor arose within the bulla, extending along the bulla wall. He has been alive for more than eight years with no evidence of recurrence. This case suggests that spontaneous regression of a bulla should be recognized as one of the early radiographic signs of the development of lung cancer in patients with bullous lung disease.- - - - - - - - - - ranking = 0.14285714285714keywords = bullous (Clic here for more details about this article) |
5/106. transillumination blisters in a neonate.transillumination with a high-intensity fiberoptic light source is an effective means of diagnosing pneumothoraces and localizing arteries and veins for blood sampling. It has been used for these purposes in neonatal intensive care units since the 1970s. Thermal burns were reported in association with the technique initially, but this complication now occurs infrequently because of numerous safety precautions. We present a case of thermal blisters induced by transillumination in a neonate. This entity is an important addition to the differential diagnosis of vesicobullous eruptions in the neonate.- - - - - - - - - - ranking = 0.14285714285714keywords = bullous (Clic here for more details about this article) |
6/106. lung cancer associated with pulmonary bulla. case report and review of literature.A few reports have suggested the possible association between lung cancer and bullous disease. We report a surgical case of lung adenocarcinoma located in close proximity to pulmonary bullae. A 48-year-old nonsmoker, asymptomatic male was found to have a pulmonary tumor mass and giant bulla in the right lung. thoracotomy identified a tumor arising from a firm, scarred and contracted area close to the bulla wall. Based on this report and review of other cases in the literature, we emphasize the need for physicians to be aware of the potential development of lung cancer in patients with pulmonary bulla. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 0.14285714285714keywords = bullous (Clic here for more details about this article) |
7/106. Large lung bullae in marijuana smokers.The case histories are presented of four men with multiple large upper zone lung bullae but otherwise relatively preserved lung parenchyma. Each had a history of significant exposure to marijuana. In three of the four cases the tobacco smoking load had been relatively small, suggesting a possible causal role for marijuana in the pathogenesis of this unusual pattern of bullous emphysema.- - - - - - - - - - ranking = 0.14285714285714keywords = bullous (Clic here for more details about this article) |
8/106. Bullous amyloidosis: the mechanism of blister formation revealed by electron microscopy.BACKGROUND: Few electron microscopic studies of blister lesions in bullous amyloidosis have been reported, and the mechanism of blister formation remains to be elucidated. This study was designed to examine the nature of bullous amyloidosis ultrastructurally, and clarify the pathogenesis of blister formation. methods: We examined a 47-year-old woman with IgD-lambda type myeloma, suffering from bullous lesions on her hands and feet caused by trauma or rubbing. light and electron microscopic studies were performed. RESULT: Ultrastructurally, amyloid deposits aggregated under the lamina densa. Keratinocyte protrusions penetrated the dermis through the gap in the lamina densa and enfolded amyloid deposits. Amyloid globules were found in enlarged intercellular spaces of keratinocytes. desmosomes were sparsely distributed in some areas of the epidermis. CONCLUSION: These results indicate that keratinocytes enfold the amyloid globules and take them in the intercellular space of epidermis, and that the breakdown of the lamina densa and widening of the intercellular space between keratinocytes induce skin fragility. Trauma or rubbing of her hands and feet appears to act as the localized precipitating factor of blister formation in bullous amyloidosis.- - - - - - - - - - ranking = 0.57142857142857keywords = bullous (Clic here for more details about this article) |
9/106. mycosis fungoides bullosa: report of a case and review of the literature.mycosis fungoides, the most common type of cutaneous T-cell lymphoma, can manifest in a variety of clinical and histologic forms. Presentation with vesiculobullous lesions is extremely rare. We report the ninth documented case of mycosis fungoides bullosa in which other concomitant autoimmune blistering diseases were ruled out by negative immunofluorescence. All previously reported cases in the world literature since the first in 1887 are reviewed. We recommend the following defining criteria for the disease: (1) clinically apparent vesiculobullous lesions, with or without typical mycosis fungoides lesions (patches, plaques, tumors); (2) typical histologic features of mycosis fungoides (atypical lyphoid cells, epidermotropism, Pautrier's microabscesses) with intraepidermal or subepidermal blisters; (3) negative immunofluorescence (both direct and indirect, if possible) to rule out concomitant autoimmune bullous diseases; (4) negative evaluation for other possible causes of vesiculobullous lesions (eg, medications, bacterial or viral infection, porphyria, phototherapy).- - - - - - - - - - ranking = 0.57142857142857keywords = bullous (Clic here for more details about this article) |
10/106. Infected lung bulla with elevated cancer antigen 125 both in serum and aspirated fluid.A 78-year-old man was admitted to the hospital for treatment of an infected lung bulla. Cancer antigen 125 (CA125) was elevated in both his serum and fluid aspirated from the bulla. Concomitant resolution of the high serum CA125 level and the bullous fluid was observed after combination treatment of antibiotics and percutaneous fluid drainage, suggesting the appearance of CA125 in response to a localized inflammatory reaction in the bullous cavity.- - - - - - - - - - ranking = 0.28571428571429keywords = bullous (Clic here for more details about this article) |
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