Biomedical subjects
Publications and source records attributed to B K Fisher.
Granuloma inguinale (GI) is a sexually transmitted disease seldom seen in the United States and Canada. We are reporting three cases recently seen in Toronto, Ontario, two in immigrants, and one in a native born Canadian who had an intimate relationship with a foreign visitor. The basic features of the disease are discussed.
A 78-year-old man presented simultaneously with subacute cutaneous lupus erythematosus (SCLE) and Sweet syndrome (neutrophilic dermatosis). He was subsequently investigated for and found to have Sjögren syndrome. We believe that the simultaneous occurrence of the above cutaneous manifestations are very suggestive of and should prompt investigation for Sjögren syndrome.
We report the first case of acral localized acquired cutis laxa. The skin laxity was preceded by swelling of the fingers and toes and by the appearance of papular urticaria. Dapsone therapy was effective in controlling the swelling. Examination of skin biopsy specimens showed fragmentation and almost total loss of elastic fibers in the areas of cutis laxa. Electron microscopy showed no abnormalities in elastic structure and function in unaffected skin. In addition, electron microscopic examination of an urticarial lesion showed a neutrophilic dermatosis with polymorphonuclear leukocytes attached to the surface of either normal elastic fibers or fibers showing early degenerative changes. These findings suggest that there is no primary defect in the elastic fibers and that the polymorphonuclear leukocytes play a significant role in the destruction of the elastic fibers and the subsequent development of cutis laxa in this case.
A case of tuberculous skin ulcer is reported. The biopsy specimen did not reveal acid-fast bacteria but cultures grew Mycobacterium tuberculosis. A high index of suspicion is needed to diagnose mycobacterial ulcers correctly. The classification of the cutaneous tuberculoses is discussed.
Squamous cell carcinoma developed in the meningomyelocele of a 25-year-old man. This is the third such case reported. The possibility of malignant disease arising in this congenital defect must be taken into account when treatment is being considered.
A 49-year-old man was found to have a rare, mutilating basal cell epithelioma of the face. Conventional early therapy with surgery and radiotherapy did not halt the progress of the disease in a hospital environment. The patient died 12 years later.
We report here on the first epidemic of Microsporum canis infection in Israel. All 78 cases were diagnosed in the port city of Eilat between August, 1975 and May 1976. The epidemic has apparently been controlled with Griseofulvin therapy and public health measures.
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Bullous skin lesions that indicate sweat gland necrosis have been known to occur in drug-induced coma resulting from barbiturates and in carbon monoxide poisoning. To our knowledge, this is the first cases in which diazepam is implicated in causing bullous lesions over pressure points, and the first case showing on biopsy specimen eccrine sweat gland and sweat duct necrosis. Penile and oral lesions are being described here for the first time to our knowledge. The following mechanisms could be responsible for the skin lesions: hypoxia, local pressure, hyperthermia with excessive sweating, and a specific toxic effect on the eccrine gland. With the increasing use of the benzodiazepines, such lesions could be seen more frequently in the future.
A case of basal cell epithelioma of the vulva is reported. Basal cell epitheliomata of the vulva are less rare than commonly thought. They are easily misdiagnosed and the proper treatment may thus be delayed.
A case of dermatitis artefacta is reported. The lesions were shown to contain silver and were probably caused by a silver nitrate caustic stick. The patient never admitted to having produced these lesions.
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A car mechanic sustained a deep partial thickness burn of the wrist when his metal watch strap short circuited the battery of a car upon which he was working.
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