Acrodermatitis enteropathica in a patient with the acquired immunodeficiency syndrome.
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Acquired Immunodeficiency Syndrome↗
Biomedical subjects
A C Huntley
Publications and source records attributed to A C Huntley.
Chronic urticaria.
Urticaria affects 15% to 20% of the population once or more during a lifetime. Chronic urticaria is a frequent recurrent eruption over a period greater than 6 weeks; the cause remains a mystery in more than 75% of cases. Urticaria and angioedema may be produced by immunologic or nonimmunologic means. Urticarial vasculitis, contact urticaria, mastocytosis, physical urticarias, dermatographism, cholinergic urticaria, localized heat urticaria, cold urticaria, aquagenic urticaria, and vibratory angioedema all require specific evaluation and treatment. Chronic idiopathic urticaria is usually controlled by antihistamines; depending on the circadian rhythm of the eruption, sedative or nonsedative antihistamines are prescribed. Some patients will require a combination of H1 and H2 antagonists, or even parenteral corticosteroids.
Angioedema↗
Quantitative determination of skin thickness in diabetes mellitus: relationship to disease parameters.
It has been suggested that thick skin on the dorsum of the hands and fingers is a common finding in diabetes mellitus, and that affected persons have an increased prevalence of diabetic retinal microvascular disease. Using high resolution ultrasonography, we were able to quantitatively demonstrate increased skin thickness on the hands and feet of many of our diabetic patients. In our limited series, however, there was no correlation with retinal disease. The general occurrence of thick skin on the extremities of persons with diabetes mellitus is apparently independent from the thick skin syndromes which are associated with disease complications.
Adult↗
Cutaneous manifestations of diabetes mellitus.
Diabetes mellitus is a common condition, and persons who have this ailment are commonly encountered by dermatologists and primary care physicians. Because glucose attaches to long-lived proteins, it may have a profound effect on the tertiary structure of the protein. Chronic hyperglycemia may be responsible for the pathogenesis of many diabetic complications. It has been suggested that increased cross-linking of collagen in diabetic patients is responsible for the fact that their skin is generally thicker than that of nondiabetics. Advanced glycosylation end-products are probably responsible for yellowing of skin and nails. Increased viscosity of blood caused by stiff red blood cell membranes results in engorgement of the postcapillary venules in the papillary dermis, which is detected as erythema of the face or as periungual erythema. It is suggested that these skin changes may eventually be used as a reflection of the patient's current (as well as past) metabolic status.
Diabetes Mellitus↗
Metastatic Crohn's disease.
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Crohn Disease↗
Allergic contact dermatitis. Common allergens.
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Allergens↗
Fatty acid metabolism in fasting elephant seal pups.
The turnover of two plasma free fatty acids (FFA) were measured in 5 northern elephant seal pups (Mirounga angustirostris) after approximately 2 months of post-weaning fasting. Turnover was determined using simultaneous bolus injections of 14C-palmitate, 3H-oleate and Evans blue (EB) administered via an indwelling extradural intravertebral catheter. At this time in their natural fast, the seals exhibited plasma FFA levels and turnover values higher than reported for other marine mammals and most terrestrial carnivores. There was no consistent difference between plasma FFA turnover measured by palmitate or oleate tracers. The results imply that FFA metabolism is the primary source of energy during fasting. This is interesting in light of previous observations of minimal ketoacid accumulation and low levels of glucose and protein energy production during fasting in these juvenile seals.
Animals↗
Electrophysiological and behavioral correlates of sleep in the desert iguana, Dipsosaurus dorsalis Hallowell.
The circadian behavior of the desert iguana, Dipsosaurus dorsalis, was investigated on the basis of behavioral observation and electrophysiological recording. D. dorsalis adequately complies with accepted criteria for both behavioral sleep and paradoxical sleep. At 20 degrees C, 12% of the photophase is spent in sleep, 95% of the scotophase is spent in sleep. Paradoxical sleep occurs at all times of the year, but only at temperatures of 20 and 30 degrees C. Amounts of behavioral sleep are affected by both temperature and time of year. Total sleep increases with decreased day length and decreased temperature. Daytime sleep increases with decreased temperature.
Animals↗
Toxic shock syndrome as a complication of dermatologic surgery.
We report a case of toxic shock syndrome occurring after an excisional skin biopsy in an otherwise healthy woman. Her clean-appearing wound grew Staphylococcus aureus and was implicated as the source of toxin. Dermatologists should be aware that toxic shock syndrome may occur as a complication of simple dermatologic surgery.
Adult↗
Finger pebbles: a common finding in diabetes mellitus.
Several authors have now described the relatively common occurrence of thickening of the skin on the dorsum of the fingers and hands in persons with diabetes mellitus, and skin thickening in these patients has been documented histologically for other body locations. To date, the presence of finger and hand skin thickening has been determined by an examination difficult to objectify--palpation and attempted tenting of the affected area. In a survey of sixty subjects with diabetes, it was found that forty-five patients (75%) have a visual marker for skin thickening, that is, a pebbly appearance of the knuckle and distal finger skin. Similar changes were present in eleven of control subjects (21%). A limited histologic study indicates that the epidermis and papillary dermis are primarily responsible for this thickening. A pebbly appearance of volar finger skin may be a more easily recognized marker of diabetic skin thickening.
Biopsy↗
Keratotic lupus erythematosus: treatment with isotretinoin.
We describe a patient with a distinct verrucous variant of chronic discoid lupus erythematosus manifested by skin lesions resembling keratoacanthomas. The diagnosis of keratotic lupus was confirmed by characteristic immunofluorescence and ultrastructural findings and by an initial response to antimalarial therapy. Combination therapy with isotretinoin and hydroxychloroquine resulted in control of her previously refractory skin lesions, and the isotretinoin apparently played a key role in this improvement.
Aged↗
Granulomatous tertiary syphilis.
A 65-year-old woman presented with progressive acute organic brain syndrome and peculiar scarring skin lesions that on biopsy revealed a lymphocytic and granulomatous deep dermal infiltrate. The serologic examination was diagnostic for, and the therapeutic response consistent with, syphilis. This case of tertiary syphilis serves as a reminder of a not-yet-extinct entity.
Aged↗
Abnormal lipogenesis in thyroid hormone-deficient epidermis.
Striking skin changes can accompany hypothyroidism, among them a scaly ichthyosis. The pathogenesis of these disorders is unknown. Since altered sterol metabolism has been associated with other scaling dermatoses, we tested the hypothesis that altered epidermal lipogenesis may accompany hypothyroidism and induce the observed scaling. Thyroidectomized (TX) rats were sacrificed 53 days postthyroidectomy, and the rate of incorporation of the radiolabeled precursor, [14C]acetate, into epidermal lipids was determined. Approximately 2-fold decreases in incorporation of precursor into both polar and neutral lipids were observed in the TX epidermis; the most significant decreases, however, were in the neutral lipids, particularly the sterol and sterol-ester moieties. Total cholesterol pool size was also reduced in the TX epidermis. Similar decreases in sterol biosynthesis were noted in human keratinocytes cultivated in medium devoid of thyroid hormone. These findings demonstrate that lipid metabolism, and notably sterol synthesis, is altered in epidermal keratinocytes deprived of thyroid hormone, and suggest that, as in other scaling disorders, this abnormal sterologenesis may lead to the clinically observed ichthyosis that can accompany hypothyroidism.
Animals↗
Efficacy of tolciclate solution in patients with tinea pedis.
Forty patients with tinea pedis were treated for six weeks in a double-blind study with a tolciclate or placebo solution. The tolciclate solution demonstrated moderate efficacy compared with placebo. The finding of positive KOH preparations in a significant number of tolciclate-treated patients with persistently negative cultures suggests that the vehicle used (polyethylene glycol-400) may not provide adequate penetration of this effective antifungal agent. No adverse effects were noted.
Administration, Cutaneous↗
Amcinonide vs. betamethasone dipropionate ointments in the treatment of psoriasis.
A randomized, double-blind study compared the efficacy and safety of amcinonide and betamethasone dipropionate ointments, applied twice daily for two weeks, in the treatment of patients with moderate to severe psoriasis. Thirty-four patients were enrolled; thirty patients had had psoriasis for more than one year, and in the majority of patients, it was stable or slowly exacerbating. Significant improvement from baseline was observed with both ointments at weeks 1 and 2. The two drugs showed comparable cosmetic acceptability. Adverse cutaneous symptoms experienced were burning (both groups), itching (amcinonide), and stinging (beta-methasone); no serious adverse effects were reported.
Administration, Topical↗