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Biomedical subjects

A W Macfarlane

Publications and source records attributed to A W Macfarlane.

At least 19 recordsLinked to original sources
PubMed2006

Treatment of invasive squamous cell carcinoma with 5-percent imiquimod cream.

Skin cancer is a major problem in the elderly. Squamous cell carcinoma (SCC), the second most common skin cancer, typically occurs in this age group. Despite a number of modalities readily available for treatment (depending on the tumor site, and depth of invasion) there remains the problem of individuals with multiple lesions who may be unsuitable for existing treatments for SCC, particularly surgery. Consequently, the search for novel treatments continues. To our knowledge, there are only 6 published reports of invasive SCC treated with 5-percent imiquimod cream.

Aged, 80 and over↗
PubMed2005

Pyodermatitis-pyostomatitis vegetans complicated by methicillin-resistant Staphylococcus aureus infection.

Pyodermatitis-pyostomatitis vegetans (PPV), a rare disorder of the skin and oral mucosa, is considered a highly specific marker for inflammatory bowel disease, especially ulcerative colitis (UC). Oral lesions (pyostomatitis vegetans) are seen without skin involvement but rarely without gastrointestinal symptoms. Bowel symptoms may be minimal and precede the onset of other lesions by months or years. Dermatologically, PPV is characterized by annular, pustular lesions, which may precede or appear at the same time as the oral lesions. We report a case of PPV and UC in which presentation was confused by acneiform lesions and methicillin-resistant Staphylococcus aureus colonization. Management was complicated because of the patient's job commitments and need to travel, and the involvement of a number of different specialties at different locations.

Adult↗
PubMed1996

Cutaneous lesions in a case of acute megakaryoblastic leukaemia.

We describe the case of a 68-year-old woman who presented with asymptomatic skin nodules and symptoms of anaemia, and was found to have acute megakaryoblastic leukaemia with fibrosis, a condition now believed to correspond to the former diagnosis of acute myelofibrosis. There is only one previous report of skin lesions developing in this condition.

Aged↗
PubMed1991

A histopathological study of 643 cutaneous horns.

A retrospective study of 643 cutaneous horns examined in our department between 1970 and 1989 revealed that 38.9% were derived from malignant or premalignant epidermal lesions, and 61.1% from benign lesions. Four main features were associated with premalignant or malignant histopathological change at the base of a cutaneous horn (base pathology). These were: (i) age--the mean age of the patients whose cutaneous horns showed premalignant or malignant base pathology was 8.9 years greater than the mean age of the patients where base pathology was benign (P less than 0.0005); (ii) sex--males were more likely to develop a cutaneous horn with (pre)malignant base pathology (P less than 0.001); (iii) site--over 70% of all (pre)malignant lesions were found on the nose, pinnae, backs of hands, scalp, forearms and the face; a cutaneous horn found at these sites was 2.1 times more likely to have derived from a (pre)malignant base than from any other part of the body (P less than 0.0001); (iv) geometry of the lesion--lesions with a wide base or a low height-to-base ratio were significantly more likely to show (pre)malignant base pathology. Of those solar keratoses giving rise to cutaneous horns, 8.9% also showed histological evidence of change to squamous cell carcinoma (SCC); this figure was not significantly different from the 6.2% of solar keratoses without horns that showed SCC change during the same period (1970-89).

Age Factors↗
PubMed1991

Is erythrokeratoderma one disorder? A clinical and ultrastructural study of two siblings.

Two sisters with erythrokeratoderma are described. In the younger sister the clinical appearance corresponded to erythrokeratoderma variabilis (EKV), whereas in the older sister it corresponded to progressive symmetrical erythrokeratoderma (PSEK). Ultrastructural findings in both cases were identical. We suggest that EKV and PSEK are different manifestations of a single condition.

Child↗
PubMed1989

Trauma-induced bullous pemphigoid.

We describe three patients with bullous pemphigoid who presented with bullae at sites of trauma and with little spread of the condition outside such areas. The diagnosis was confirmed by histology and direct and/or indirect immunofluorescence; electron microscopy was performed in two cases to rule out the diagnosis of epidermolysis bullosa acquisita (EBA). Treatment was with either systemic steroids or ACTH in all three cases. Trauma-induced bullous pemphigoid should be included in the differential diagnosis of localized blistering eruptions.

Aged↗
PubMed1989

Delayed patch test reactions at days 7 and 9.

403 consecutive patients were examined on days 2, 4, 7, and 9 following application of patch tests. Late positive reactions, i.e., those which manifested after day 4, were seen in 29 patients (7.2%). The allergens which most commonly produced late positive reactions were neomycin (7), potassium dichromate (4), and cobalt (3). Paired patch test readings on days 4 and 7 were more reliable than those on days 2 and 4. If only 1 patch test reading were performed, a single reading on day 4 would have been most useful. The reading on day 9 proved to be of limited value. Of 11 patients who were retested after an interval of more than 6 months, 7 showed earlier eliciting reactions, which may have been due to active sensitization.

Dermatitis, Contact↗
PubMed1987

Scleromyxoedema--successful treatment with plasma exchange and immunosuppression.

A 34-year-old woman with scleromyxoedema failed to respond to initial treatment with cyclophosphamide or psoralen-UVA photochemotherapy (PUVA). She developed neurological symptoms which resolved after five 4 l plasma exchanges performed on successive days, together with pulse methylprednisolone therapy. Subsequent treatment was with oral prednisolone and cyclophosphamide. She had had no further episodes of neurological dysfunction 8 months after plasma exchange, and the appearance of the skin had improved almost to normal. The complications and difficulty in management of scleromyxoedema are discussed.

Adult↗
PubMed1986

Contact sensitivity to the amide anesthetics lidocaine, prilocaine, and mepivacaine. Case report and review of the literature.

Multiple sensitivities to amide local anesthetics occurred in a 70-year-old woman following dental treatment. Soft-tissue swelling of the cheek was the clinical presentation. Patch testing confirmed type IV hypersensitivity to lidocaine, prilocaine, mepivacaine, and dibucaine. We review the classification of local anesthetics and the literature relating to contact sensitivity to the amide group.

Aged↗