1/9. Human T-cell lymphotropic virus-1-associated renal disease in Jamaican children.This report documents the clinicopathological features in two Jamaican children who presented with infective dermatitis, glomerulonephritis, renal failure and human T-cell lymphotropic virus (HTLV-1) seropositivity. Severe hypertension with hypertensive encephalopathy was the most impressive clinical feature. Histological findings from renal biopsy specimens in both cases revealed significant glomerulosclerosis with fibrosis, chronic inflammatory cell infiltrates in the interstitium, and arteriolar hypertensive changes. Membranoproliferative glomerulonephritis (MPGN) was demonstrable in case 1 and marked focal glomerulosclerosis in case 2. Case 1 developed end stage renal failure and died within 3 years of diagnosis. Case 2 remains hypertensive and in chronic renal failure. Although a causal relationship between HTLV-1 infection and renal disease cannot be proven by these two cases, it appears that renal involvement in children with HTLV-1 infection is severe, with the potential for chronic renal failure and malignant hypertension. HTLV-1 nephropathy should be suspected in children with infective dermatitis and renal disease.- - - - - - - - - - ranking = 1keywords = halo (Clic here for more details about this article) |
2/9. Migratory necrolytic dermatitis presenting after cephalosporin administration in a patient with a pancreatic head mass.Migratory necrotizing dermatitis is one of the most distressing presenting symptoms of glucagonomas. This rare functioning pancreatic endocrine tumor is third in incidence after insulinomas and gastrinomas and is often malignant at the time of diagnosis. Elevated serum glucagon levels cause decreased amino acid levels which is believed to be the principal cause of the dermatitis. Other symptoms include anemia, visual scotomata and mild diabetes mellitus. Medical treatment alone including octreotide and amino acid supplementation has been reported to eliminate the dermatitis. Nonetheless, surgical resection or debulking remains the definitive treatment when possible. Because of its rarity, diagnosis may be delayed by years accounting for the high rate of metastasis at presentation. Reported here is the case of a 77-year-old man who presented with a migratory necrotizing dermatitis after antibiotic treatment and whose diagnosis of a glucagonoma was then delayed for over 1 year.- - - - - - - - - - ranking = 4keywords = halo (Clic here for more details about this article) |
3/9. Halo eczema surrounding seborrhoeic keratoses: an example of perilesional nummular dermatitis.Two patients developed halo eczema around isolated seborrhoeic keratoses and in one individual similar halo eczema developed around the nipples. This phenomenon which was previously described with melanocytic naevi has been associated with a number of different central lesions and can be readily recognised. Both the clinical pattern and histopathology suggest that this phenomenon may represent a localised form of nummular dermatitis with a predilection for elevated lesions.- - - - - - - - - - ranking = 2keywords = halo (Clic here for more details about this article) |
4/9. Halo dermatitis around a melanocytic naevus: Meyerson's naevus.A case of halo dermatitis (eczema) around a pigmented naevus is reported. This appears to be a not uncommon condition which is not described in major dermatology textbooks. The relevant literature is reviewed, and the eponym 'Meyerson's naevus' is suggested.- - - - - - - - - - ranking = 8.6392113920352keywords = halo, naevus (Clic here for more details about this article) |
5/9. Contact dermatitis due to budesonide: report of five cases and review of the Japanese literature.BACKGROUND. Contact allergy to corticosteroids has recently gained increased attention. methods. Five cases of contact dermatitis due to budesonide, a nonhalogenated steroid, are described. The Japanese literature was reviewed for reports on this allergy, and the occurrence due to budesonide was compared with that of other dermocorticosteroids. RESULTS. budesonide use can cause contact dermatitis. CONCLUSIONS. Although budesonide may be beneficial because of its anti-inflammatory effects, clinicians should be alert to its potential for causing contact dermatitis.- - - - - - - - - - ranking = 1keywords = halo (Clic here for more details about this article) |
6/9. Treatment of the gonococcal arthritis-dermatitis syndrome.Ninety-eight patients with the gonococcal arthritis-dermatitis syndrome were prospectively treated with penicillin g, at least 10 million units intravenously per day, followed by ampicillin, 2.0 g orally per day, to complete at least 10 days of treatment (33 patients); ampicillin, 3.5 g orally plus probenecid 1.0 g, followed by ampicillin, 2.0 g per day orally for at least 7 days (29 patients); lower doses of parenteral penicillin g (20 patients); oral tetracycline (6 patients); parenteral cephalosporins (5 patients); and other regimens (5 patients). The response to treatment was equally rapid and complete in each group. At least 90% of the patients in each group had subjective improvement and defervescence within 2 days, and all patients followed for at least 2 weeks achieved complete clinical and bacteriologic cure. patients with purulent synovial effusions improved significantly more slowly than patients with nonpurulent effusions or with no effusions, regardless of which treatment was used.- - - - - - - - - - ranking = 1keywords = halo (Clic here for more details about this article) |
7/9. Variant B human herpesvirus-6 associated febrile dermatosis with thrombocytopenia and encephalopathy in a liver transplant recipient.Human herpesvirus 6 (HHV-6) is a recently discovered virus the pathogenicity of which in solid organ transplant recipients has not been defined. We describe a unique febrile syndrome due to disseminated invasive variant B HHV-6 infection in a liver transplant recipient with evidence of direct tissue invasion by the virus. Acute febrile illness characterized by life-threatening thrombocytopenia, progressive encephalopathy and skin rash developed in association with invasive HHV-6 infection in a liver transplant recipient. HHV-6 was isolated from the patient's peripheral blood in cell culture; variant B HHV-6 dna was detected in the patient's peripheral blood mononuclear cells (PBMC) at a concentration greater than 1000 virus genomes per 10(6) PBMC. A bone marrow biopsy was also positive for HHV-6, documenting direct tissue invasion. Intravenous ganciclovir for three weeks led to a prompt clinical response. Although larger studies are warranted, our case suggests that HHV-6 should be considered in the diagnostic evaluation of patients with fever, cytopenia, and encephalopathy, particularly since HHV-6 is susceptible to ganciclovir and foscarnet.- - - - - - - - - - ranking = 6keywords = halo (Clic here for more details about this article) |
8/9. pellagra: an analysis of 18 patients and a review of the literature.The clinical and laboratory features of 18 adult pellagrins are reviewed. Only four patients (22%) had the full trial of dermatitis, diarrhea and dementia. dermatitis alone occurred in six(33%), dementia in five(28%) and dermatitis and diarrhea in three(17%). In one patient, dermentia was the initial sign of a relapse. steatorrhea was found in six patients and was usually associated with marked alopecia. edema without evidence of cardiac failure was present in seven patients. A diffuse increase in slow wave activity on the electroencephalogram was characteristic in patients with dementia. fever occurred in 14 patients, and an infection was documented in 10 of these. Common laboratory abnormalities included a normochromic, normocytic anemia, lymphopenia, eosinopenia hyperuricemia, and low serum levels of albumin, urea, cholesterol, carotene, potassium, calcium, and magnesium. Adrenal and thyroid function were normal, but a low serum T4, high serum free T4, and an elevated T3 resin uptake were frequently observed. These abnormalities were corrected with treatment of the underlying nutritional disorder. In two patients initially treated with thiamine alone, and in one who received inadequate amounts of niacin and protein, there was marked deterioration of mental function, which responded to administration of niacin and proper diet.- - - - - - - - - - ranking = 1keywords = halo (Clic here for more details about this article) |
9/9. Malignant melanoma in stasis dermatitis.Two cases of malignant melanoma arising in established stasis dermatitis are described. One case was clinically thought to be melanocytic whereas the other was not. Histologically, both showed similar features with background varicose change of epidermal atrophy, sloughing of the epidermis, intense proliferation of small thick walled blood vessels, lymphocytic infiltrate and dermal fibrosis. In the superficial aspects of the biopsies there was little clue to the diagnosis of melanoma. In the deeper aspects of case 1, groups of melanocytes were present in the reticular dermis which mimicked benign naevus cells. S-100 protein staining confirmed the melanocytic nature of these lesions, their extent and the epidermal involvement. The latter features supported a malignant diagnosis. These lesions can be overlooked clinically as well as histologically.- - - - - - - - - - ranking = 0.76392113920352keywords = naevus (Clic here for more details about this article) |