Biomedical subjects

A L Kayne

Publications and source records attributed to A L Kayne.

5 recordsLinked to original sources

PubMed1990

Refractory parastomal ulcers: a multidisciplinary approach.

Chronic parastomal ulcers in patients with ileostomy or colostomy stomas are unusual. Previous reports have implicated infections, fistulas, recurrent inflammatory bowel disease (IBD), pyoderma gangrenosum, and trauma. Over the past 8 years we have evaluated 10 cases of such refractory parastomal ulcers that occurred at a mean of 11 years after stomal surgery. Eight patients had had an ileostomy for IBD while two had undergone colostomy for colon cancer. Five patients with IBD were diagnosed as having pyoderma gangrenosum ulcerations. They required systemic treatment for a mean of 25 weeks to effect ulcer healing. The other five patients had either parastomal ulcers on the basis of dermatoses (contact dermatitis, eczema, or bullous pemphigoid) or contact ulcers due to face-plate pressure and parastomal dermatitis. These patients received topical treatment with healing of ulcers in a mean of 4 weeks. We conclude that parastomal ulcers occurring in patients without IBD or IBD patients without classic pyoderma gangrenosum require early dermatologic evaluation as they respond relatively quickly to appropriate local therapy.

Chronic Disease↗

PubMed1987

Localized bullous pemphigoid. A mimic of acute contact dermatitis.

A case of localized bullous pemphigoid that mimicked an acute contact dermatitis around a stoma site is presented. The diagnosis was confirmed by direct immunofluorescence and by indirect immunofluorescence on 1.0 mol/L of sodium chloride split skin. A review of the literature demonstrates 30 previous well-documented cases of localized bullous pemphigoid. As in our case, local factors such as trauma, ultraviolet light, or topical therapy seem to be frequently implicated in the production of lesions. The possibility that these patients might otherwise have subclinical bullous pemphigoid was considered. The disease has a benign course and generally responds to cessation of exacerbating factors and initiation of topical steroid therapy.

Adhesives↗

PubMed1984

Association of juvenile xanthogranuloma with juvenile myeloid leukemia.

Multiple cutaneous xanthomas developed in a patient at the age of 10 months, and juvenile chronic myeloid leukemia (JCML) developed at the age of 30 months. The xanthomas were histopathologically consistent with a diagnosis of juvenile xanthogranuloma (JXG). A review of other cases of JCML with JXG indicates that the cutaneous lesions have many clinical and histopathologic similarities to sporadic JXG but are more often multiple or papular and confluent. In addition to JXG, a few children with JCML also have multiple café-au-lait spots and a family history of neurofibromatosis.

Female↗

PubMed1977

Unusual cutaneous manifestations of sarcoidosis.

The diagnosis of sarcoidosis is best established when there is evidence of granulomatous involvement in two or more organs. Three patients with unusual cutaneous manifestations of sarcoidosis, including palmar and follicular lesions, nonscarring alopecia, and widespread plaque or erythrodermic sarcoidosis, are reported. In all three patients the skin biopsy was important in establishing the diagnosis.

Adult↗

PubMedDate not supplied

Chronic parastomal ulcers: spectrum of dermatoses.

Parastomal ulcers that develop after stoma surgery have reportedly been associated with recurrent inflammatory bowel disease and chronic infection. We report 13 patients with refractory parastomal ulcers, which occurred at a mean of 11 years after surgery. Parastomal ulcers in eight patients were the result of dermatologic conditions (e.g., contact dermatitis, bullous pemphigoid, lichen sclerosus et atrophicus, eczema, or psoriasis) or contact ulcers from dermatitis of the skin around the stoma and faceplate pressure. These ulcers healed after treatment with topical medications at a mean of 4 weeks. Five patients with inflammatory bowel disease had pyoderma gangrenosum ulcerations, which healed with systemic treatment at a mean of 25 weeks. Thus nonpyoderma gangrenosum parastomal ulcerations that occur late after stoma surgery require early enterostomal therapy nursing intervention and dermatologic evaluation, since they respond rapidly to appropriate local therapy.

Administration, Topical↗