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Biomedical subjects

A V Benedetto

Publications and source records attributed to A V Benedetto.

At least 19 recordsLinked to original sources

Relapsing cutaneous polyarteritis nodosa associated with streptococcal infections.

BACKGROUND: Polyarteritis nodosa is an aggressive, often fatal form of vasculitis associated with multi-organ involvement. Cutaneous polyarteritis nodosa is purported to be a more benign form of this disorder with involvement limited to the skin. METHODS: The identification of a female patient from childhood to adulthood documenting repeated episodes of cutaneous polyarteritis nodosa following bouts of recurrent streptococcal pharyngitis. RESULTS: Repeated bouts of streptococcal pharyngitis at ages 11, 28, and 33 years were followed by episodes of cutaneous polyarteritis nodosa, documented by histopathologic skin changes and clinical presentation, and confirmed by therapeutic management. CONCLUSIONS: Various infectious and non-infectious conditions have been linked both to the initiation and relapse of this disease. We describe a patient with recurrent episodes of cutaneous polyarteritis nodosa spanning a period of over 20 years with each episode appearing to be linked to a prior streptococcal infection.

Child

Intralesional electrodesiccation of syringomas.

BACKGROUND: Syringomas are common, benign adnexal tumors. In the periorbital area, they pose a cosmetic dilemma for both patients and physicians alike. Many different therapeutic modalities potentially can cause scarring, and recurrences are common. OBJECTIVE: To develop a treatment method that minimizes scarring and subsequent recurrences. METHOD: Each syringoma is treated with short bursts of high frequency low voltage electrodesiccation delivered with a fine needle electrode that is inserted into the center of the syringoma, as deeply as the reticular dermis. RESULTS: Twelve patients treated over a 4-year period showed no permanent adverse effects postoperatively and no recurrences. CONCLUSIONS: Intralesional electrodesiccation is a safe, nonscarring and, reliable method that can be used to eradicate periorbital syringomas.

Adult

Syringomas: new approach to an old technique.

BACKGROUND: Syringomas are common, benign periorbital adnexal tumors that pose a cosmetic dilemma for both patients and physicians alike. Many therapeutic modalities can potentially cause scarring and recurrences are common. The objective was to develop a treatment method that minimizes scarring and subsequent recurrences. METHODS: Each syringoma is treated with short bursts of low voltage electrodesiccation, delivered with an epilating needle that is inserted deeply into the skin at the level of the reticular dermis. RESULTS: A patient treated by intralesional electrodesiccation of her long-standing periorbital syringomas remains lesion-free for over 24 months after therapy. CONCLUSIONS: Intralesional electrodesiccation is a safe, nonscarring and reliable method that can be used to eradicate periorbital syringomas.

Adult

Exuberant keloidal formation.

Keloids are disfiguring deformities that occur after trauma or wounding of the skin, most commonly among blacks. The case presented here is unusual because of the number of keloids and the massive size of one. The patient underwent full surgical excision together with intraoperative and postoperative steroid injections with good cosmetic results. Various causes of keloids are reviewed as are the histopathologic differences between hypertrophic scars and keloids. Alternative surgical and nonsurgical treatment techniques are examined.

Adult

Dermabrasion: therapy and prophylaxis of the photoaged face.

BACKGROUND: For many years dermabrasion has been used for the treatment of photoaged facial skin. However, there is a paucity of correlative studies that document the beneficial histopathologic effects of dermabrasion with clinical changes. Moreover, long-term follow-up and comparative studies that document these therapeutic results are lacking. OBJECTIVE: Our purpose was to study patients with photoaged facial skin by comparing the preoperative and postoperative clinical and histopathologic changes that occur as a result of surgical dermabrasion of aged and photodamaged facial skin. METHODS: Twelve patients 40 years of age and older with significant photoaging and dermatoheliosis were treated with full-face dermabrasion. Predermabrasion biopsy specimens were compared with matched postdermabrasion biopsy specimens taken at various time intervals from 6 months to 8 years after dermabrasion. RESULTS: Microscopic normalization of the actinically damaged epidermis and papillary dermis was manifested clinically by the replacement of dermatoheliosis with supple, smooth-textured facial skin that remained clinically evident well beyond 8 years after dermabrasion. In addition, the necessity for the continued treatment of premalignant and malignant lesions was virtually eliminated during the 8-year postdermabrasion period. CONCLUSION: Not only is dermabrasion a beneficial therapeutic option for aged and photo-damaged skin, but it also is a valid means of prophylaxis against neoplastic changes.

Adult

Multiple cutaneous reticulohistiocytomas (reticulohistiocytic granulomas).

Multiple cutaneous reticulohistiocytomas (reticulohistiocytic granulomas) represent a unique pattern in the spectrum of the reticulohistiocytoses. Seven cases have been reported in the English-language literature. A case of multiple cutaneous reticulohistiocytomas observed for 5 years is presented. The spectrum of the reticulohistiocytoses is reviewed, and the distinct clinical patterns of the disease are compared.

Female

Necrotizing sialometaplasia masquerading as residual cancer of the lip.

Necrotizing sialometaplasia is a benign disorder that histologically can mimic carcinoma. It is thought to develop as a result of ischemia or adjacent tissue injury. A patient is described who underwent a Mohs' micrographical fresh-tissue excision of one-third of the upper lip for basal cell carcinoma. By the time she was ready for reconstruction, a marked eczematous reaction developed to a polymyxin neomycin preparation (Neosporin ointment) at the wound edges. Reexcision of the wound margins before a flap reconstruction revealed necrotizing sialometaplasia on histopathological examination. This incidental finding fortunately was not mistaken for residual tumor. To prevent over-diagnosis and over-treatment of presumed malignancies, an awareness of necrotizing sialometaplasia is essential for all surgeons operating on mucosal surfaces in the head and neck.

Aged

Acanthoma fissuratum. Histopathology and review of the literature.

A review of the literature and report of a case describing perhaps the youngest and first black patient recorded in whom bilateral lesions of acanthoma fissuratum developed and were successfully treated with intralesional corticosteroids is presented herein. Awareness of the clinical characteristics of this benign process can prevent potentially costly and needless diagnostic and therapeutic procedures.

Adolescent

Porphyria cutanea tarda in three generations of a single family.

We examined conjugal and blood relatives of one kindred for evidence of porphyria cutanea tarda. The disease was identified in eight family members in three generations. Four were classified as having overt porphyria cutanea tarda because of four criteria: photo-enhanced dermatosis; excessive urinary excretion of uroporphyrins; characteristic thin-layer chromatographic pattern of urinary porphyrins; and decreased activity of erythrocyte uroporphyrinogen decarboxylase. Two patients with excessive excretion of uroporphyrins or characteristic chromatograms, or both, and decreased uroporphyrinogen decarboxylase activity were classified as having subclinical porphyria cutanea tarda, and two with decreased uroporphyrinogen decarboxylase activity only were classified as having latent porphyria cutanea tarda. This study provides further evidence that prophyria cutanea tarda can be a familial disease inherited in an autosomal dominant fashion. We propose a reclassification of porphria cutanea tarda as an overt, subclinical or latent disorder.

Adult