PubMed Health⌕ Search

Biomedical subjects

A Rebora

Publications and source records attributed to A Rebora.

At least 19 recordsLinked to original sources
PubMed2006

A distinctive erythematous macular exanthem of the adult: a new entity?

BACKGROUND: Delineating a new exanthem is difficult. Atypical or modified types of already known conditions can easily be mistaken for new entities. OBJECTIVES: To report 29 cases of an acute, self-limiting exanthem never described before. METHODS: Clinical description, serology, polymerase chain reaction (PCR) and other laboratory investigations. RESULTS: The eruption starts with bright pink-red slightly oedematous macules symmetrically arranged on the trunk. The lesions tend to coalesce, and spread to the limbs on which they may acquire a marginated annular appearance. The lesions invariably spare the face (including oral mucous membranes), palms and soles. The eruption is pruritic and lasts 20-30 days, clearing spontaneously. The disease has a predilection for men aged 17-56 years and occurs mostly between spring and summer. Serological tests, PCR assays and investigations for bacteria, parasites or viruses were consistently negative. CONCLUSIONS: The clinical picture does not recall any of the classical exanthems or their atypical forms.

Acute Disease↗
PubMed2005

Scar sarcoidosis after hyaluronic acid injection.

A 54-year-old woman presented with a 5-month history of tender nodules in both nasolabial folds that had developed 4 months after the injection of hyaluronic acid (HA) (Restylane) for wrinkles. The patient was treated with 1.5 mg/day betamethasone for 6 days and her lesions disappeared within 1 week. About 8 days after stopping therapy, however, new nodules developed at the same site, on previously healthy buttocks, and on old scars. On examination, nodules of about 0.5-1 cm in size were palpable at the nasolabial folds, and red nodules were present on the buttocks (Fig. 1) and on two old scars. Laboratory tests disclosed an increased protein C reaction (7.9 mg/L; normal value, < 5 mg/L) and acetyl-converting enzyme test (14.5 U/L; normal value, < 9 U/L). A chest X-ray was normal. Lung function tests showed a decreased lung CO diffusion, and chest axial tomography disclosed fibrosis, increased parenchyma density, and calcifications, findings suggestive of a diagnosis of lung sarcoidosis. An X-ray of the hands showed some bone cysts. Interestingly, two granulomatous lesions were observed at the sites of venipuncture. Histology of a gluteal lesion biopsy showed a deep granuloma with epithelioid and Langhans cells in the absence of necrobiosis. Sarcoidosis was diagnosed and the patient was given 50 mg/day prednisone with clear clinical improvement of cutaneous lesions in about 6 months. Decreased parenchyma density was also observed by chest axial tomography.

Adjuvants, Immunologic↗
PubMed2005

Interobserver reproducibility of histological features in cutaneous malignant melanoma.

AIMS: To assess the interobserver reproducibility of certain histological features proposed for the diagnosis of melanoma. METHODS: In a series of melanomas, 13 histological parameters were analysed: dimension > 6 mm, asymmetry, poor circumscription, irregular confluent nests, single melanocytes predominating, absence of maturation, suprabasal melanocytes, asymmetrical melanin, melanin in deep cells, cytological atypia, mitoses, dermal lymphocytic infiltrate, and necrosis. RESULTS: The agreement (reproducibility) between the nine observers was excellent (kappa > 0.75) for 10 of the 13 examined features (dimension > 6 mm, poor circumscription, irregular confluent nests, single melanocytes predominating, absence of maturation, suprabasal melanocytes, asymmetrical melanin, melanin in deep cells, mitoses, and necrosis). The agreement for asymmetry was very close to excellence (kappa = 0.74), and that for cytological atypia (kappa = 0.65) and dermal lymphocytic infiltrate (kappa = 0.47) was slightly lower, but in the fair to good agreement range. The kappa values obtained by comparison with the majority diagnosis were generally high (> or = 0.85); the mean value of kappa was lower (0.70) for only one parameter (dermal lymphocytic infiltrate). CONCLUSIONS: The parameters investigated showed an overall good reproducibility.

Humans↗
PubMed2005

Kenogen in female androgenetic alopecia. A longitudinal study.

BACKGROUND: Kenogen indicates the physiological interval of the hair cycle in which the hair follicle remains empty after the telogen hair has been extruded and before a new anagen hair emerges. Kenogen frequency and duration are greater in men and women with androgenetic alopecia (AGA). OBJECTIVE: To study the relationship of kenogen with female AGA. METHODS: A woman with AGA, studied 14 years before, was re-examined for 2 years by the phototrichogram technique. Kenogen was identified when telogen lasted 3 months and shedding left the follicle empty. RESULTS: Kenogen lasted 1-5 months, the longest duration affecting cycles of vellus hairs, and involved more hair follicles (16 vs. 8%) than in the first observation. Cycles of vellus hairs increased in number from 4 to 13%, and cycles with a normal succession of phases decreased from 60 to 32%. CONCLUSIONS: The number of kenogen phases increased in parallel with vellus hairs and the diminished number of normal hair cycles, features that mark AGA aggravation. Kenogen seems to be related also to the progression of female AGA.

Alopecia↗
PubMed2004

Melanocytic nevi of the breast: a histologic case-control study.

BACKGROUND: Melanocytic nevi in the genital, acral, and flexural sites often display clinical and histologic features that may simulate melanoma. We verified whether this is the case also for nevi of the breast. METHODS: Eleven dermatopathologists, from nine Italian Institutions, collected the specimens of melanocytic lesions from the breast and other body sites, excluding the acral, genital, and flexural areas, as controls. Cases and controls were matched for sex and age. All nevi were observed 'blindly' and simultaneously by all participants. For each lesion, 10 histological parameters were analyzed: asymmetry, absence of lateral demarcation of melanocytes, lentiginous proliferation, nested and dyshesive pattern, intraepidermal melanocytes above the basal layer, involvement of the hair follicle, absence of maturation of dermal melanocytes, melanocytic atypia, fibroplasia of the papillary dermis, and lymphocytic dermal infiltrate. Each parameter was scored 2 when present and 1 when absent or not valuable. A total score was calculated for each lesion. Results were statistically analyzed by the chi-square test and the Mann-Whitney U-test. RESULTS: One hundred and one nevi came from the breast area and 97 from elsewhere. Breast nevi exhibited significantly more atypical features than nevi from other sites. In particular, breast nevi with intraepidermal melanocytes, melanocytic atypia, and dermal fibroplasia were significantly more numerous. We did not find any sexual difference. CONCLUSIONS: To avoid undue concerns, dermatopathologists should be aware that melanocytic nevi of the breast may show a high degree of atypical features.

Adolescent↗
PubMed2002

Human herpes virus-like particles in pityriasis rosea lesions: an electron microscopy study.

BACKGROUND: In a previous study we detected virions with electron microscopy features of human herpes viruses in the supernatant of cocultured mononuclear cells from patients with acute pityriasis rosea. Because of their morphology and of polymerase chain reaction studies, we ascribed them to human herpes virus 7. OBJECTIVE: To find such virions in the lesional skin of pityriasis rosea patients. METHODS: Skin specimens from lesions of 21 patients with acute pityriasis rosea were examined by elecron microscopy. RESULTS: In 15 (71%) patients, human herpes virus particles in various stages of morphogenesis were detected. Mature enveloped virions appeared as typical human herpes virus virions, measuring about 160-200 nm in diameter and containing an electrodense cylindrical core, a capsid, an envelope with typical spikes and a very distinct tegument layer between the capsid and the envelope. They were very similar to those we reported in the supernatant of co-cultured circulating mononuclear cells from patients with pityriasis rosea. CONCLUSION: Our results confirm our previous findings and provides further evidence of a viral etiology for pityriasis rosea.

Herpesvirus 7, Human↗
PubMed2002

Atypical exanthems: morphology and laboratory investigations may lead to an aetiological diagnosis in about 70% of cases.

BACKGROUND: Besides the six classical exanthems, other exanthems may occur, differing in morphology and causative agent (atypical exanthems). Their aetiological diagnosis is difficult but crucial for both the patient and community concerning issues such as time off school, immunizations, and risks for pregnant women and immunocompromised patients. OBJECTIVES: To investigate whether morphology, associated symptoms and laboratory results can help to determine the aetiology of atypical exanthems. METHODS: We studied 112 consecutive out-patients attending two university dermatology departments. Peripheral blood mononuclear cells (PBMC) and throat, rectal and vaginal swabs were studied to identify viral and bacterial growth. Nested polymerase chain reaction was performed on PBMC and plasma using specific primers for herpesviruses. Serology for common viruses was investigated. RESULTS: We classified the exanthems into seven morphological patterns: macular erythema (32 patients), papular erythema (eight), maculopapular erythema (42), maculopapular erythema with petechiae (seven), erythema with vesiculation (11), erythema with pustules (five) and urticaria (seven). On the basis of morphology, in concert with the associated symptoms and laboratory results, we found a causal relationship in 76 patients (68%): 25 cases due to drugs, 32 to viruses, 16 to bacteria and three to parasites. A good correspondence between morphology and aetiology was found. The erythematous-vesicular pattern was exclusive to viral infections and was often accompanied by enanthema. The erythemato-pustular and papular patterns were found only in drug-related cases and in some undiagnosed cases. In contrast, the macular and maculopapular patterns were almost evenly distributed among the various aetiologies, although their colour was duskier in the drug-related exanthems. Severe pruritus was associated with drug-related exanthems. CONCLUSIONS: This is the largest series of consecutive patients with atypical exanthems reported. Their morphology and their association with pruritus or constitutional symptoms proved to be important diagnostic clues.

Adolescent↗
PubMed2002

Antidouble-stranded DNA isotypes in lupus erythematosus patients with prevalent cutaneous presentation.

BACKGROUND: Antidouble-stranded DNA antibodies (anti-dsDNA Ab), in particular of the IgG isotype, are usually considered a marker of systemic lupus erythematosus and often correlate with the disease activity. OBJECTIVES: To determine IgG, IgA and IgM anti-dsDNA Ab in a group of 330 patients with lupus erythematosus and prevalent cutaneous lesions. METHODS: The titre of anti-dsDNA Ab was determined by enzyme-linked immunosorbent assay, and disease activity was assessed by means of the systemic lupus activity measure. RESULTS: One hundred and six patients had anti-dsDNA Ab. Thirty-nine patients had antibodies of all three isotypes of immunoglobulins, 17 had IgG + IgM, five IgG + IgA, and two IgA + IgM. Forty-three patients had a single isotype of anti-dsDNA Ab. Patients with systemic disease and higher disease activity had antibodies of all three isotypes of immunoglobulins or of IgG isotype. Remarkably, anti-dsDNA Ab of the IgA isotype, alone or associated with IgM, marked dermatological patients with low disease activity, but often with disquieting clinical and/or laboratory alterations. CONCLUSIONS: These results indicate a correlation between disease activity and both frequency and isotype of anti-dsDNA Ab.

Adult↗
PubMed2002

Multiple eruptive dermatofibromas in patients with systemic lupus erythematosus treated with prednisone.

Solitary dermatofibromas are a common occurrence, especially on the lower limbs of young women, while multiple dermatofibromas (MDF) are rare, accounting for less than 0.3% of all dermatofibromas and may suddenly develop in immunosuppressed patients. We report a patient with systemic lupus erythematosus (SLE) who developed MDF while she was taking oral prednisone. A 46-year-old woman presented in 1989 complaining of photosensitivity, arthralgias, fatigue, malaise and dyspepsia. The patient denied fever, Raynaud's phenomenon, oral ulcer and hair loss. On examination she presented a typical SLE malar rash. Erythrocyte sedimentation rate (ESR) was elevated (54 mm/h). Speckle patterned IgG/IgM antinuclear antibodies were present at 1/1280 titer. Antibodies anti Ro/SSA were detected by counterimmunelectrophoresis up to 1/8 titer. Other laboratory findings were negative or within normal limits. Systemic lupus erythematosus was diagnosed and the patient given 50 mg/day prednisone. After a few months, both clinical symptoms and immunologic parameters improved. Eighteen months later, prednisone was replaced by 500 mg/day hydroxychloroquine. In 1994, she presented again with malar rash, arthralgias and facial hyperpigmentation. Prednisone 15 mg/day was reintroduced and hydroxychloroquine stopped being a possible cause of the facial hyperpigmented macules. In 1996, while she was taking 5 mg/day prednisone, several nodules developed on her limbs within a few months. On examination we observed 16 firm, slightly elevated 3-15-mm wide brown nodules on her arms, legs and trunk. A biopsy specimen of a lesion of the trunk revealed an epidermal seborrheic-keratosis-like hyperplasia with dermal fibrosis and fibroblastic proliferation (Fig. 1). Dermatofibroma was diagnosed.

Anti-Inflammatory Agents↗
PubMed2002

Dermatomyositis in 132 patients with different clinical subtypes: cutaneous signs, constitutional symptoms and circulating antibodies.

We retrospectively studied 132 patients with dermatomyositis; 84 had idiopathic, 30 paraneoplastic, 5 juvenile and 13 amyopathic forms of the disease. The commonest features were macular erythema, heliotropic erythema and Gottron's papules. Flagellate erythema occurred in 5% of patients with idiopathic dermatomyositis and correlated with the disease activity. Necrotic lesions were also found in this group of patients but did not always signal malignancy. The prevalence of malignancy was high (23%). Raynaud's phenomenon occurred in 10.6% of patients, also in those with malignancy. Dysphagia, interstitial lung disease and arthralgias affected 20%, 8% and 40% of patients, respectively. Anti-Jo-1 antibodies were found in 5% of patients with idiopathic dermatomyositis and low titre ANA in 1/3 of patients. ANA did not correlate with the disease activity. We confirmed the data from the literature, but no cutaneous sign, constitutional symptom or circulating antibody was found marking a particular subtype of the disease.

Adolescent↗