Mixed cryoglobulinemia and hepatitis C virus infection.
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Biomedical subjects
Publications and source records attributed to A S Pakula.
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Hepatitis C virus infection is a frequent cause of non-A, non-B hepatitis worldwide. Resultant morbidity is significant; chronic liver disease develops in 50% of infected persons. Since serologic testing has become available there have been several reports of cutaneous findings in association with hepatitis C virus infection, including vasculitis, cryoglobulinemia, urticaria, and lichen planus. We describe a patient with cryoglobulinemia, chronic cutaneous leukocytoclastic vasculitis, and hepatitis C virus infection. Hepatitis C virus infection should be included in the differential diagnosis of the causes of cryoglobulinemia and leukocytoclastic vasculitis.
Langerhans cell histiocytosis (LCH) is regarded as a disorder of histiocytic cell proliferation of the Langerhans type, probably resulting from altered immunoregulation. Cutaneous involvement is frequent and often appears as a scaling papular eruption that resembles seborrheic dermatitis; when limited to the scalp, scaling and erythema may also be confused with tinea capitis. We describe four patients who had LCH and documented dermatophyte infection versus colonization of the scalp. Fungal cultures should be considered in patients who have LCH with scalp involvement who do not respond to standard treatment; similarly, it may be appropriate to obtain a skin biopsy specimen from patients with recalcitrant tinea capitis to rule out the presence of underlying LCH.
Estimates are that 180,000 cases of breast cancer will be diagnosed in 1992. Breast conservation therapy is becoming the treatment of choice for many women. Physicians providing long-term care for these women must be aware of the cutaneous presentations of local metastatic or recurrent disease, including inflammatory, nodular, telangiectatic and scirrhous variants. In addition, radiation changes, as well as the development of a secondary malignancy at the site of previous radiation therapy, must be distinguished from metastatic breast lesions.
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Two unusual cases of intussusception in children less than a year old are presented. Each patient was brought to the author's attention because of altered level of activity, and both were found to be hypertensive. The hypertension resolved after the intussusception was reduced. Diagnosis of hypertension in children, when associated with gastrointestinal dysfunction, is discussed.