Biomedical subjects

Adrian Lim

Publications and source records attributed to Adrian Lim.

6 recordsLinked to original sources

PubMed2005

Neonatal lupus erythematosus presenting as papules on the feet.

We describe a case of neonatal lupus erythematosus in a 4-week-old male baby presenting with nodules/papules on the plantar surface of both feet. Skin histology of the right foot papule was consistent with lupus erythematosus. Annular lesions more typical of this condition then appeared later and maternal antibodies were positive for speckled antinuclear antibodies (1:5120), anti-Ro/SSA and anti-La/SSB(+), rheumatoid factor 1380.0 IU/mL. The patient had no evidence of cardiac, haematological or hepatobilary involvement. Although the mother was asymptomatic, the maternal grandmother had recently been diagnosed with Sjögren's syndrome.

Administration, Topical↗

PubMed2005

Intravascular B-cell lymphoma diagnosed by skin biopsy.

A 58-year-old man presented with unexplained fever, constitutional symptoms, worsening respiratory failure and gross, generalized oedema. He was eventually diagnosed with intravascular B- cell lymphoma on a random skin biopsy. Examination of the skin showed patchy erythema and induration, with peau d'orange. Despite multiorgan failure requiring intensive care, he responded dramatically to multiagent chemotherapy (six cycles of cyclophosphamide, doxorubicin, vincristine and prednisone) and is currently in clinical remission.

Abdomen↗

PubMed2005

Multiple squamous cell carcinomas in a patient with mycosis fungoides.

A 51-year-old man with type IV skin presented for evaluation of a generalized rash associated with multiple ulcerated, nodular lesions on his legs. The nodular lesions occurred approximately 18 months after the initial onset of generalized rash, which had been diagnosed as plaque/patch stage mycosis fungoides. He continued to develop further nodular lesions on his trunk in the weeks following presentation. The nodular lesions were shown to be squamous-cell carcinoma on histopathology. He had received only topical hydrocortisone prior to the development of the second cutaneous malignancy and had no past exposure to carcinogens. His squamous cell carcinomas were treated with surgical excision and split-skin grafting. He received total skin electron-beam therapy to treat the mycosis fungoides. Second malignancy in mycosis fungoides is a recognized phenomenon and usually occurs after potentially carcinogenic therapy. This case demonstrates the occurrence of second malignancy in the absence of a precipitating factor, suggesting that there are innate, immune-mediated mechanisms in the development of cancer in patients with mycosis fungoides.

Acitretin↗

PubMed2004

Functional studies.

For the first time, functional studies with ultrasound have been made possible by the introduction of microbubble contrast agents. That they are confined to the circulation and that the small volume boluses that are effective are particular advantages when compared to iodinated and gadolinium-based agents. Classical indicator dilution calculations can be applied to the transit curves that can be measured as the contrast washes into and out of a region of interest. In addition, it is sometimes possible to measure the transit of the bolus through the supply artery and the draining vein, e.g. of a kidney and thus calculate the true transit time. Similar timing measurements have proved particularly useful for measuring the portosystemic shunts that are a feature of liver metastases and cirrhosis. A unique feature of microbubble contrast agents is their fragility when insonated at higher (but still permissible) powers. This can be used to create a negative bolus and the reperfusion of a slice of tissue can then be followed. From the exponential refill curve, features that relate to true tissue perfusion can be extracted.

Contrast Media↗

PubMed2003

Androgenetic alopecia in a postmenopausal woman as a result of ovarian hyperthecosis.

A 65-year-old woman presented with an 8-year history of progressive frontotemporal alopecia and hirsutism. She had elevated serum levels of testosterone, androstenedione and estradiol. Ultrasound and computed tomography imaging suggested a right ovarian mass, while bilateral ovarian venous sampling demonstrated increased testosterone levels originating from both ovarian veins. Histology obtained following bilateral oophorectomy demonstrated bilateral ovarian hyperthecosis. Six months after surgery, the patient remains well with no progression of the alopecia. Ovarian hyperthecosis is a rare cause of androgenetic alopecia in postmenopausal women. The role of hyperthecosis and its relationship to androgenetic alopecia is reviewed.

Aged↗

PubMed2002

Teledermatology: influence of zoning and education on a clinician's ability to observe peripheral lesions.

Teledermatology can benefit rural and remote communities, where specialist dermatological services may not be readily available. Regarding store-and- forward teledermatology, we hypothesized that the site of a lesion in an image (zoning) may influence a clinician's ability to observe target lesions, and that education on image viewing may improve use of this technology. We examined this by conducting both pre- and post-education studies. The education on image viewing consisted of a presentation on the outcome of the first study-survey on image viewing. The first study demonstrated that zoning influences a clinician's visual attention and that significant, concurrent lesions in the periphery may be missed. The second study demonstrated that brief education could produce a measurable change in observing peripheral lesions. These findings have medico-legal implications and suggest that further education in the use of such technology is necessary in order to optimize patient care and prevent potential errors.

Adult↗