Cases reported "Warts"

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1/3. Topical treatment of common warts in an hiv-positive patient with imiquimod 5% cream.

    Human immunodeficiency virus (hiv) infects and destroys crucial components of the immune system, leaving patients susceptible to a number of viral, bacterial and fungal diseases. Viral warts are caused by human papillomavirus infection and are a common skin disease that afflicts hiv-infected patients. Treatment modalities currently rely on destruction of the infected tissue or interruption of cell division; however, frequent recurrence is a particular challenge in hiv-infected patients. We report the case of a 41-year-old hiv-positive man with multiple common warts located on his hands and feet. Following 5 months of treatment with imiquimod, an immune response modifier, as a 5% cream, complete clearance of all warts was achieved. Mild erythma, itching and burning at the application site was observed in the early stages of treatment. The patient showed no relapse of warts at the 30-month follow-up visit.
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ranking = 1
keywords = skin disease
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2/3. carbon dioxide laser surgery for skin disease.

    Since it was developed in the 1960s, the carbon dioxide (CO2) laser has had an important role in the practice of dermatology. The CO2 laser has some advantages over conventional techniques used in dermatologic surgical treatment. It routinely provides a bloodless surgical field as well as unusual surgical precision. Although the CO2 laser is specifically indicated for certain conditions, in other situations, only marginal benefit may be noted in comparison with standard techniques such as scalpel surgical procedures, dermabrasion, cryosurgery, and electrosurgery. In this article, we briefly review the history and physics of the CO2 laser, its operation, and safety principles and discuss dermatologic conditions that are treated with the CO2 laser. We also describe 8 representative cases from our experience with more than 800 cases of CO2 laser treatment in the practice of dermatology at the Mayo Clinic since 1986.
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ranking = 4
keywords = skin disease
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3/3. Isotopic response.

    BACKGROUND--The occurrence of a new skin disorder exactly at the site of another one, already healed and unrelated, was first described in 1955. In 1985, Wolf et al. recognized that we are dealing with a dermatologic phenomenon and established a precise definition for this phenomenon. Fifty-eight cases corresponding to the definition of this phenomenon have been reported until now. methods--The new phenomenon, for which the term "isotopic response" has been suggested, has been defined. Cases corresponding to the definition have been analyzed with special emphasis on the diseases involved, the time intervals, and the locations of the diseases. Eight new cases are described. RESULTS--A total of 58 cases of isotopic response have been described. The first disease in most of the patients was herpes zoster; in three cases it was herpes simplex, in two varicella, and in one, thrombophlebitis. The second disease, which appeared exactly at the site of the first, already healed disease, was in most reported cases a carcinoma (26 cases, in particular 15 cases of breast carcinoma, 5 basal cell carcinomas (BCC), 4 squamous cell carcinomas (SCC), 2 basosquamous carcinomas), or granuloma annulare (16 cases). Additional diseases were Kaposi's sarcoma (2 cases), pseudolymphoma (2 cases), sarcoid (2 cases), tinea (2 cases), tuberculoid and vasculitis granuloma (1 case), angiosarcoma, metastasis, bowen's disease, lymphoma, leukemia cutis, and acne (1 case each). The diseases did not show any predilection for a particular location. The interval between the first and second disease was extremely variable (ranging from days to years) and showed no particular features. In the eight additional cases described in the present report, the first disease was herpes simplex (6 cases) or herpes zoster (2 cases). The second disease was viral warts (3 cases) or squamous cell carcinoma (2 cases). Additional diseases were furunculosis, contact dermatitis, and molluscum contagiosum (1 case each). CONCLUSIONS--The new term, "isotopic response," describes the occurrence of a new skin disorder at the site of another, unrelated, and already healed skin disease. It is suggested that the term "isotopic response" be included in the lexicon (glossary) of dermatology. Introducing the new term and classifying all the cases under a single key word, will make it possible to locate and collect them easily and to search for the mechanism underlying this phenomenon.
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ranking = 1
keywords = skin disease
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