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D A Buckley

Publications and source records attributed to D A Buckley.

14 recordsLinked to original sources
PubMed1998

Persistent infection of the chin with an unusual skin pathogen (Streptococcus milleri): a sign of intraoral carcinoma.

Streptococcus milleri is a commensal of the oropharynx and gastrointestinal tract which is not generally associated with skin disease. We now report a patient who presented with a pustular mass of the chin with lower lip anaesthesia. He was initially thought to have sycosis barbae, but response to treatment was poor and lesional swabs repeatedly cultured S. milleri. After some delay, squamous cell carcinoma of the mouth, involving the mandible and overlying skin, was detected. We consider that the S. milleri either invaded through the tumour from the mouth or root canal or colonized the skin from saliva dribbled over the numb lower lip. Isolation of an unusual organism and numbness of the chin are features that should suggest the need for early radiography.

Aged↗
PubMed1998

The use of azathioprine in severe adult atopic eczema.

AIM: To evaluate the use of azathioprine in the treatment of severe adult atopic eczema and review the relevant literature. BACKGROUND: Effective treatment of severe adult atopic eczema may necessitate the use of agents such as systemic steroids, PUVA or cyclosporin, which are associated with significant morbidity. Azathioprine is an effective alternative which can induce disease remission and may be less toxic. METHODS: Ten patients treated with azathioprine 0.7-2.5 mg/kg per day for a minimum period of 12 months were evaluated in a retrospective follow-up study. RESULTS: Clearance or marked improvement was noted in eight patients; three of these later became refractory to the drug. Side-effects were few and were well-tolerated. One patient was found to have lymphoma 8 months after stopping treatment. CONCLUSION: Azathioprine is an effective and cheaper alternative to cyclosporin in the treatment of severe adult atopic eczema. Its long-term toxicity remains unclear.

Adult↗
PubMed1996

Vulvar lymphangiectasia due to recurrent cellulitis.

We describe a 42-year-old woman in whom extensive lymphangiectasia of the vulva developed after recurrent severe episodes of cellulitis, producing changes rather similar to those seen in lymphangioma circumscriptum. We suspect that an underlying lymphatic abnormality predisposed her to cellulitis, resulting in local lymphatic fibrosis and vulvar lymphangiectasia.

Adult↗
PubMed1996

Multiple keratoses and squamous carcinoma after PUVA treatment of vitiligo.

PUVA is known to be carcinogenic when used in the treatment of psoriasis. To date skin cancer has not been demonstrated after PUVA treatment of vitiligo. We report a patient in whom multiple squamous cell carcinomata and keratoses developed in vitiligo areas after a prolonged course of PUVA. PUVA therapy of vitiligo induces repigmentation of affected skin in some patients. An increased frequency of cutaneous neoplasms in depigmented areas is a potential hazard, as in these sites the photoprotective effect of melanin is lacking.

Carcinoma, Squamous Cell↗
PubMed1995

A comparison of twice-weekly MPD-PUVA and three times-weekly skin typing-PUVA regimens for the treatment of psoriasis.

The most frequent PUVA treatment regimen in current use is three times weekly, using skin typing to estimate the starting dose. Recently, it was suggested that twice-weekly treatment, using the minimal phototoxic dose (MPD) to calculate suberythemal starting doses of UVA, achieved similar clearance rates with fewer treatments and a lower cumulative UVA dose. We have carried out a trial on 83 patients, comparing twice-weekly MPD-PUVA with three times-weekly skin typing-PUVA, in order to test this hypothesis. Although clearance rates were comparable between the two regimens, there was no overall significant difference in the number of treatments or in the cumulative UVA doses at clearance. However, for patients with skin types I and II the cumulative UVA dose was significantly higher using the twice-weekly MPD regimen (70.0 J/cm2 vs. 55.8 J/cm2; P < 0.05). Our results do not confirm that there is a reduction in cumulative UVA dosage with twice-weekly MPD-PUVA.

Adult↗
PubMed1995

Cyclosporin-responsive hidradenitis suppurativa.

Hidradenitis suppurativa, a chronic inflammatory condition of the apocrine gland follicles, may rarely be complicated by pyoderma gangrenosum (PG). We report such a case, in which the immunosuppressant cyclosporin A (CyA) was given to treat PG and a dramatic improvement occurred in the patient's intractable perineal HS.

Cyclosporine↗
PubMedDate not supplied

Resolution of xanthomas in Alagille syndrome after liver transplantation.

Alagille syndrome (arteriohepatic dysplasia) is a genetic disorder with autosomal dominant transmission which has been localized to chromosome 20p. Cutaneous manifestations include jaundice, pruritus, and widespread xanthomata. We report a child with severe Alagille syndrome in whom orthotopic liver transplantation caused rapid resolution of disfiguring xanthomas.

Alagille Syndrome↗