Biomedical subjects
Publications and source records attributed to A Vélez.
Cutaneous graft-versus-host disease (GVHD) is the most common clinical setting for GVHD after bone marrow transplantation. Chronic cutaneous GVHD is categorized according to the type of skin lesions into lichenoid and sclerodermoid variants, but bullous scleroderma-like changes are exceptional. Recently, we studied a patient with these alterations. This is the second case described in the literature.
Report on the association of the psoriasis and vasculitis are a very infrequent in the literature. Such an association as been described in extensive psoriasis and arthropathy psoriasis. In this paper we described two cases in which psoriasis, vasculitis and nephropathy are present together. In both cases the association might be produced by methotrexate. In both cases methotrexate is possible uleashing.
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Poland's syndrome consists of unilateral congenital absence of the pectoralis major muscle with a variable degree of ipsilateral upper limb deformity. The aetiology of Poland's syndrome is unknown, although an inherited tendency to develop a compromised embryonic vascular supply in the affected areas has been suggested. The majority of reported cases are sporadic, and in only a few instances is there a familial incidence. We describe the occurrence of Poland's syndrome in two brothers who also had recessive X-linked ichthyosis. To the best of our knowledge this is the first report of such an association.
Hydroxyurea is a common cancer chemotherapy agent that inhibits ribonucleotide reductase, an enzyme essential to DNA synthesis. It is considered the drug of choice in the treatment of chronic myelogenous leukemia and essential thrombocythemia. The occurrence of leg ulcers have been described in 8.5% of patients receiving continuous treatment with hydroxyurea, but the cause of this complication is unknown. We report two additional patients and suggest that macroerythrocytosis, which occurs in almost all the patients taking hydroxyurea, may be a pathogenic factor. Macroerythrocytosis can be considered as an 'acquired' blood dyscrasia, and similar leg ulcers have long been known to occur with certain hereditary blood dyscrasias, such as sickle cell anemia, thalasemia, and spherocytosis.
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From a total of 20,004 patients seen during two years, we carried out a mycologic nail investigation (direct microscopy and repeated cultures). Ninety-three (43.2%) of the nails were judged to be infected by their clinical appearance. They fulfilled the laboratory criteria required to start antifungal treatment (isolation of the same fungus in culture on two consecutive occasions), but only in 64 cases (29.7%) was there a clinical and mycological recovery once antifungal treatment and follow up were completed. yeasts were isolated in two thirds of the cases of onychomycosis, mainly from fingernails. Candida albicans, C. parapsilosis or both were the most prevalent species. Dermatophytes were found in 18.8% of the samples, especially from toenails. Trichophyton rubrum was the predominant species. Non-dermatophytic filamentous fungi were cultured in 17.2%, Scopulariopsis brevicaulis being the most prevalent species. The highest prevalence of onychomycosis was found in patients between 50 and 70 years of age. Females were affected more frequently than males. Fingernails were affected more frequently than toenails. Proximal subungual onychomycosis, secondary to paronychia (PSOp), was the most prevalent clinical type, although primary distal and lateral subungual onychomycosis (DLSO) and total dystrophic onychomycosis (TDO) were also frequent. PSOp was only observed in fingernails, while DLSO was almost only seen in toenails and TDO in both fingernails and toenails. All the clinical types were more frequent in women except TDO, which showed a similar prevalence in both sexes.
Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon lesion that usually affects the tongue. The lesion is benign and self-limiting, develops rapidly and usually disappears after several weeks without treatment. Microscopically, it contains a diffuse polymorphous cell infiltrate composed mainly of eosinophils. The cause of EUOM is unknown, but the condition has been attributed to trauma. We now describe a case of EUOM on the lateral surface of the tongue with recurrence on its dorsal surface 3 years later. The occurrence of multiple lesions, whether at the same time or subsequently as reported here, makes a purely traumatic origin rather unlikely and suggests that there may be a predisposition of some patients to develop EUOM. Eosinophilic ulcer of the oral mucosa (EUOM) is an uncommon lesion that is very rarely reported in the dermatological literature. It usually affects the tongue and presents clinically as an ulcer with elevated and indurated borders. Recognition is important because it often mimicks tongue cancer; however, the lesion is benign and self-limiting, develops rapidly and usually disappears after several weeks without treatment. Usually the ulcer occurs in a single episode, but the possibility of recurrence at other sites has been poorly emphasized.
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One hundred and fourteen mentally retarded (MR) and non-mentally retarded (NMR) patients were divided into two groups and categorized according to the condition presented. Age, sex, and type of procedure performed were recorded for each patient. On the MR group 32% were over 17 years of age. On the NMR group 51% were under 6 years of age. The sex distribution was similar in both groups. Exodontia was the most frequently performed dental procedure. The MR group was composed of those who presented only mental retardation (42%), cerebral palsy (17%), epilepsy (15%), syndromes (7%), endocrinopathies (7%), hydrocephalus (5%) and other conditions (7%). The NMR group was composed of those who presented cardiopathy (7%), bottle syndrome (42%), hemotopathy (11%), maxillofacial disorders (24%) and other conditions (16%).
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We report the case of a non-HIV patient suffering from a metastatic renal adenocarcinoma who developed trichomegaly 3 months before death. The patient also developed generalized hypertrichosis of the terminal hair, a feature that has been previously described in malnutrition. Other cases of hypertrichosis, including ectopic hormone production, were excluded and the differential diagnosis with paraneoplastic acquired hypertrichosis lanuginosa is discussed. Although trichomegaly is usually considered as a cutaneous marker of AIDS, we suggest that both trichomegaly and hypertrichosis of the terminal hair were secondary to malnutrition.
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Five patients in the same family showed small keratotic plugs of the palmar creases. Transmission in lineage was consistent with an autosomal dominant pattern of inheritance. The syndrome was highly associated with ichthyosis vulgaris in several members of the family. The histopathology in two patients revealed a close relation between the plugs and the acrosyringium.