1/9. quality of life improvement in a patient with severe atopic dermatitis treated with photopheresis.Atopic dermatitis is a common skin disease characterized by severely pruritic eczematous patches, papular and lichenified plaques, excoriations, cracks, and erosions. photopheresis has been shown to ameliorate the signs and symptoms of atopic dermatitis in some patients. We describe successful results with photopheresis for refractory disease in a patient who chronicled his quality of life weekly for more than 15 years before and during extracorporeal photochemotherapy.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
2/9. A woman with dermatitis and dissociative periods.A nineteen year old female with pustular eczema and dissociative spells is presented. The patient has a three year history of severe dermatitis beginning shortly after her marriage. Central dynamic issues appear to be difficulty separating from her mother and an ambivalent identification with a hostile father. The patient also describes fugue-like episodes which occur with emerging aggressive feelings. Psychological testing supported these hypotheses. The relevant literature describing the correlation between aggression and skin disease is reviewed. A final uniform formulation was tentatively proposed that this patient, in addition to a strong genetic component for atopic dermatitis, had her illness abetted by inability to cope with aggressive affects.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
3/9. Hazards of steroid therapy in hepatic failure.Three patients with extensive skin disease and liver failure are described. Two were treated with large amounts of topical corticosteroids and one with a small oral dose of betamethasone. The former two patients developed Addisonian crises when they failed to apply the topical steroids and all three patients developed aseptic necrosis of bone. This report emphasizes that the hazards of steroid therapy may be increased in patients with hepatic failure.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
4/9. Alcohol and smoking: risk factors for infectious eczematoid dermatitis?risk factors for infectious eczematoid dermatitis (IED) were analyzed in a study of males aged 19-50 years. The subjects were 43 IED patients and 226 controls with other skin diseases from the dermatological outpatient clinics of three University hospitals in finland. The patients' lifestyles were assessed by a self-administered questionnaire pertaining to two specified periods: the period 12 months before the onset of the skin disease and the period 12 months before the examination date. Recalled mean alcohol intake before the onset of the skin disease was 39.2 g/day for the IED patients and 17.1 g/day for the controls (p = 0.04). The average number of cigarettes smoked daily was 17.7 for the IED patients and 10.4 for the control patients (p = 0.001). The IED patients significantly reduced their alcohol intake after the onset of the skin disease. In logistic regression analysis, IED associated with alcohol intake and smoking but not with coffee consumption, life events, age, marital status, or social group. The odds ratio for IED at an alcohol intake of 50 g/day as against no intake, was 1.7 (95% confidence interval 1.03-2.7), and the odds ratio at a tobacco consumption rate of 20 cigarettes/day as against no use of tobacco, was 2.1 (1.2-3.7). We conclude that alcohol intake and smoking appear to be risk factors for infectious eczematoid dermatitis among males.- - - - - - - - - - ranking = 4keywords = skin disease (Clic here for more details about this article) |
5/9. A typical case of sezary syndrome mimicking an eczema.An 87-year-old woman was admitted with buccal pain that had started a few weeks before. She had been treated with topical steroids and antihistamines for an undetermined skin disease characterised by generalized erythroderma associated with pruritis for years. Her total white cell count was 13,290/mm3 with 19 % Sezary cells among the lymphocytes. Skin biopsy showed an infiltrate of inflammatory cells forming a dense band below the epidermis characterised by the presence of atypical lymphoid cells with large convoluted nuclei, and significant epidermotropism. immunophenotyping studies in peripheral blood identified a large increase in CD4 cells; CD7- T cells. Clonal T- cell receptor gamma gene rearrangement was detected on skin biopsy and bone marrow and on the skin biopsy with the PCR method. This case illustrates the misleading skin presentation of the sezary syndrome in the elderly.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
6/9. Severe hypertension in childhood due to prolonged skin application of a mineralocorticoid ointment.We report the case of a 9-year-old boy suffering from exzematous dermatitis who was treated for 6 years with a daily dose of 100 mg of a dermatological ointment containing 9 alpha-fluoroprednisolone-21-acetate. At examination the patient's blood pressure was persistently 230/160 mm Hg and was considered essential in origin after secondary forms of arterial hypertension had been excluded. Treatment with nifedipine and labetalol lowered the blood pressure to 150/100 mm Hg. When we became aware of the dermatological treatment, we advised its discontinuance. In the subsequent 7 days, the blood pressure fell to hypotensive levels (75/40 mm Hg) and then became normal a few days after discontinuance of the antihypertensive therapy. This case suggests that prolonged use of topical steroids, commonly prescribed for skin diseases, may cause hypertension, especially in childhood.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
7/9. Skin communication: early skin disorders and their effect on transference and countertransference.eczema in the first year of life results in a basic disturbance of the earliest mother-infant relationship, a disturbance that is renewed with every transitional phase of the life-cycle. The pervasive fear of disintegration or loss of the self, and the need to be contained and held, affects subsequent character formation. Infants who experience extended periods of bodily soothing learn to translate psychic pain into visible bodily suffering and so arouse concern and care. This is illustrated by direct observation of women patients suffering from skin diseases and their interaction with women doctors in hospital. In the analysis of patients who have had such an infantile experience, whether they know it or not, a disturbance in concepts of the self linked with narcissistic difficulties and acute sensitivity to object relationships may be anticipated. The mother's human disappointment in her baby's appearance gives rise to an unsatisfying and unsatisfactory self image which remains unaltered in the true self. Transference and countertransference problems derived from the analysis of a female patient are described in order to illustrate these themes.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
8/9. prolidase deficiency: a multisystemic hereditary disorder.prolidase deficiency is a rare hereditary disorder with a wide spectrum of clinical manifestations including skin ulcers, eczematous eruptions, characteristic facies, mental retardation, splenomegaly, and susceptibility to infections. We report two new cases of prolidase deficiency. Our patients had the typical manifestations of prolidase deficiency. One also had lupus erythematosus. Prolidase activity was either normal or half-normal in all family members. The skin disease in our patients did not respond to topical glycine/proline ointment or to oral vitamin C.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |
9/9. Occupational dermatoses in cheese makers: frequent association of irritant, allergic and protein contact dermatitis.BACKGROUND: Few data are available on occupational dermatoses in cheese makers. OBJECTIVE: The purpose of the present study was to investigate occupationally related skin diseases in cheese makers. METHOD: In a retrospective study we analyzed 400 patients with occupational dermatoses which presented for expert opinion evaluation at our institution (1990-1995). RESULTS: Four patients with hand eczema acquired in cheese dairies were identified. All patients had a decreased alkali resistance. Atopy was a further risk factor in 2 patients. Three out of 4 patients were patch test positive for occupationally related substances and demonstrated also immediate skin test reactions to various milk products. Therefore, these patients had concurrent allergic contact and protein contact dermatitis. CONCLUSION: The diagnosis of concurrent allergic and protein contact dermatitis has to be considered in occupational dermatoses related to cheese making.- - - - - - - - - - ranking = 1keywords = skin disease (Clic here for more details about this article) |