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Biomedical subjects

A P Truhan

Publications and source records attributed to A P Truhan.

18 recordsLinked to original sources
PubMed1993

Magnetic resonance imaging. Its role in the neuroradiologic evaluation of neurofibromatosis, tuberous sclerosis, and Sturge-Weber syndrome.

BACKGROUND: Magnetic resonance imaging (MRI) has rapidly become a major diagnostic technique, displacing computed tomography (CT) as the primary neuroimaging modality in many disorders of the central nervous system. Neuroimaging studies are valuable in the diagnosis and management of neurofibromatosis, tuberous sclerosis, and Sturge-Weber syndrome. This article reviews the technique of MRI and its role in identifying the characteristic central nervous system manifestations of these neurocutaneous syndromes. OBSERVATIONS: MRI offers superior soft-tissue contrast without the use of ionizing radiation. It provides more detailed imaging than CT of the characteristic central nervous system lesions of neurofibromatosis, tuberous sclerosis, and Sturge-Weber syndrome. In neurofibromatosis type 1, these include optic glioma, astrocytoma, and plexiform neurofibroma, and "unidentified bright objects" that are seen only with MRI. Bilateral acoustic neuromas are the hallmark of neurofibromatosis type 2. Subependymal nodules and cortical and white matter tubers are characteristic of tuberous sclerosis. Manifestations of Sturge-Weber syndrome include leptomeningeal angiomatosis, hemiatrophy, cortical calcification, and patchy parenchymal gliosis and demyelination. CONCLUSIONS: MRI, especially with gadolinium enhancement, appears to be more sensitive than CT in the detection of neurofibromatosis, tuberous sclerosis, and Sturge-Weber syndrome. MRI may be the imaging method of choice for following certain patients or screening family members.

Brain Diseases↗
PubMed1991

Sun protection in childhood.

There is compelling evidence that childhood is a particularly vulnerable time for the photocarcinogenic effects of sun exposure on the skin. Studies indicate that excessive sun exposure during the first 10-20 years of life greatly increases the risk of skin cancer. Nonmelanoma skin cancer (basal cell and squamous cell carcinoma) has been associated with cumulative sun exposure, whereas melanoma has been associated with short, intense sun exposure or blistering sunburn. Under normal circumstances, children receive three times the annual sun exposure of adults; most of one's lifetime sun exposure occurs in childhood. Depletion of the earth's protective ozone layer adds to the photodamage problem. It is clear that sun protection is most vital in the early years. Those with fair skin are at highest risk. Photoprotective measures including sunscreen, clothing, and sun avoidance in childhood may significantly reduce the occurrence of melanoma and other skin cancer in later life. Regular use of sunscreen with a sun protection factor of 15 during the first 18 years of life could reduce the lifetime incidence of nonmelanoma skin cancer by 78%. Pediatricians can play a major role in educating parents and children.

Child↗
PubMed1987

Lichen myxedematosus. An unusual case with rapid progression and possible internal involvement.

Lichen myxedematosus (papular mucinosis) is a slowly progressive mucinous disorder that is thought by many to have no internal organ involvement. We report a case of lichen myxedematosus (lichenoid plaque type) that is remarkable for the sudden and rapid nature of the infiltrative process with both cutaneous and possibly systemic manifestations. The cutaneous abnormalities were successfully treated with cyclophosphamide and intralesional steroids. The fact that our patient's systemic signs and symptoms also responded to therapy supports the concept of internal involvement in lichen myxedematosus.

Aged↗
PubMed1987

Blastomycosis in a patient with psoriasis: treatment with ketoconazole.

Slowly enlarging verrucous skin lesions occurred in a 42-year-old man with psoriasis after he received systemic steroid treatment. Examination of skin biopsy specimens established the diagnosis of blastomycosis. Extensive evaluation revealed no other organ system involvement. The lesions of blastomycosis responded well to ketoconazole therapy; the psoriasis was unaffected. This report reviews the natural history of blastomycosis, speculates on the patient's immune status at the time of infection, and comments on the use of ketoconazole in the treatment of blastomycosis and psoriasis.

Adult↗
PubMed1986

The cutaneous mucinoses.

The cutaneous mucinoses are a group of connective tissue disorders characterized by the deposition of mucin, either focally or diffusely, in the interstices of the dermis. The diseases may be a primary (metabolic) or secondary (catabolic) process. Systemic abnormalities are seen with most of these disorders. This review discusses the primary mucinoses in which the predominant dermal mucin is hyaluronic acid. Current therapy and proposed mechanisms for the mucinoses are considered.

Age Factors↗
PubMed1986

Nodular primary localized cutaneous amyloidosis: immunohistochemical evaluation and treatment with the carbon dioxide laser.

Nodular primary localized cutaneous amyloidosis is an uncommon disorder for which there is no consistently satisfactory treatment. The amyloid fibrils are thought to have an immunoglobulin light chain derivation and systemic involvement must be excluded in all cases. We report a patient with a large scalp lesion of nodular primary localized cutaneous amyloidosis whose immunohistochemical evaluation revealed lambda light chain deposits and who thus far has no apparent systemic involvement. The lesion was treated by the carbon dioxide (CO2) laser with excellent cosmetic results and minimal morbidity.

Adult↗
PubMed1986

Pityriasis lichenoides in children: therapeutic response to erythromycin.

Fifteen of twenty-two children with pityriasis lichenoides were treated with oral erythromycin. Eleven (73%) had a remission, usually within 2 months. Two others showed partial improvement, and two were unimproved. Seven of the children who experienced a remission were off erythromycin and free of lesions after 2 to 5 months of therapy. A trial of erythromycin as described herein should be considered in children with pityriasis lichenoides before other, possibly more toxic, measures are instituted.

Adolescent↗
PubMed1985

Facial and scalp lipomas: case reports and study of prevalence.

Lipomas of the face and scalp are reportedly rare, comprising less than 2% of lipomas. Three such cases have recently been diagnosed in our clinic. Among 110 lipomas in our files, a total of 16 (14.5%) involved the face and scalp. The clinician rarely considered lipoma as the primary preoperative diagnosis. Often mistaken clinically for epidermal cysts, face and scalp lipomas appear more common than the literature would indicate.

Adolescent↗
PubMed1985

Pretibial myxedema.

Pretibial myxedema is a localized dermopathy seen in patients with past or present hyperthyroidism. Massive intradermal deposition of mucin (acid mucopolysaccharide) produces the classic indurated nodules or plaques on the anterior lower legs. Most patients have elevated levels of LATS in their serum; however, this appears to be a marker for the disease, rather than a cause. Mild pretibial myxedema requires no treatment. Topical, intralesional or systemic steroids may be useful in severe cases.

Female↗
PubMed1984

Pityriasis rosea.

Pityriasis rosea is a common, self-limited, scaling disorder of unknown etiology, seen predominantly in young adults. The lesions, typically found on the trunk and proximal extremities, are ovoid, salmon-colored and symmetric. A "herald patch" appears in 70 percent of cases. Variants appear frequently. Papular, urticarial, vesicular or hemorrhagic lesions may be seen. Management with antipruritic lotions, emollients or antihistamines may be necessary to relieve itching.

Adolescent↗