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D M Elston

Publications and source records attributed to D M Elston.

At least 91 records · Page 5Linked to original sources
PubMed1997

Eosinophils in fibrous tracts and near hair bulbs: a helpful diagnostic feature of alopecia areata.

BACKGROUND: When biopsy specimens lack a "swarm of bees" peribulbar lymphoid infiltrate, the diagnosis of alopecia areata depends on the recognition of other histologic features of the disease. OBJECTIVE: Our objective was to determine the frequency of the presence of eosinophils in biopsy specimens of alopecia area'a in relation to the other major histologic features of the disease. METHODS: Biopsy specimens from 71 patients with alopecia areata were studied. RESULTS: Eosinophils were present in 38 of the 71 cases. A peribulbar lymphoid infiltrate was absent in 27 of the 71 cases. Eosinophils were present in 13 of these cases. Multiple catagen hairs and pigment casts (features which may lead to confusion with trichotillomania) were present in 39 cases. The presence of eosinophils was found to be a helpful diagnostic feature in cases with potential for misdiagnoses as trichotillomania. CONCLUSION: Eosinophils are common in all stages of alopecia areata, both within the peribulbar infiltrate and within fibrous tracts. A "swarm of bees" peribulbar infiltrate may be absent. The presence of eosinophils is a helpful diagnostic feature of alopecia areata.

Alopecia Areata↗
PubMed1997

Wrist dermatitis: contact allergy to neoprene in a keyboard wrist rest.

A case of allergic contact dermatitis to a keyboard wrist rest containing neoprene is reported. The patient, who had a history of sensitivity to rubber products, developed an acute vesicular reaction of the palmar aspects of her distal wrists, followed by eczematous patches of her extremities and face. Treatment with prednisone, a 3-week tapering dose (60, 40, 20 mg), cleared the dermatitis. The widespread uses of neoprene are discussed and suggest that neoprene will become a common source of contact dermatitis as the potential sources of exposure increase.

Adult↗
PubMed1997

Painful papulovesicles produced by the puss caterpillar.

A residential gardener complained of immediate stinging when a "fuzzy tan caterpillar" fell across his fingers. He presented with painful hemorrhagic papules on the dorsal aspect of his right hand. Lepidopterism from contact with Megalopyge opercularis is described.

Aged↗
PubMed1996

Bugs and bites.

Explore the source record for details and available documents.

Animals↗
PubMed1996

Acrospiroma: a case report and review.

Acrospiromas are cutaneous tumors of sweat duct differentiation. They usually present as slowly enlarging 1 to 2 cm nodules in middle-aged or older adults without site predilection. On histologic examination they are multilobular dermal masses composed of a biphasic cell population. Acrospiromas are benign, and treatment consists of surgical excision.

Acrospiroma↗
PubMed1995

Vertical and transverse sections of alopecia biopsy specimens: combining the two to maximize diagnostic yield.

BACKGROUND: Traditional vertical sections of scalp biopsy specimens contain few hair follicles. For this reason transverse sections of scalp biopsy specimens have been advocated. Both methods have advantages and disadvantages. We have developed a simple method that we believe offers the best of both methods. OBJECTIVE: Our purpose was to assess the impact of combining vertical and transverse sections of scalp biopsy specimens. METHODS: Two 4 mm punch biopsies are performed. One specimen is bisected vertically: half for hematoxylin-eosin (H-E) staining, half for direct immunofluorescence. The second specimen is bisected transversely and submitted for H-E. The three pieces of tissue for H-E staining are embedded in a single cassette. RESULTS: Because a biopsy specimen for direct immunofluorescence is commonly obtained in cases of alopecia, our method does not add a surgical procedure. All three pieces of tissue for H-E staining are embedded in a single paraffin block. Therefore the cost of histologic interpretation is not increased. Our diagnostic yield improved. Transverse sections were superior in cases of lupus erythematosus and lichen planopilaris with focal follicular involvement. Features of the follicular degeneration syndrome were also best demonstrated in transverse sections. Interface changes, lupus panniculitis, miniaturized hairs, and trichomalacia were better demonstrated in vertical sections. CONCLUSION: Our method exploits the advantages of both vertical and transverse sections and improves diagnostic yield without increasing cost.

Alopecia↗
PubMed1993

Epidermoid cyst of the scalp containing human papillomavirus.

We report an epidermoid cyst of the scalp with light microscopic and immunohistochemical evidence of human papillomavirus (HPV) infection. Light microscopic features suggesting HPV infection included papillomatosis and hypergranulosis of the cyst lining with the presence of koilocytes. Much of the keratin within the cyst demonstrated parakeratosis. Immunoperoxidase labeling for HPV antigen was noted within koilocytes. Papillomavirus infection has been reported in plantar epidermoid cysts. To our knowledge, this is the first report of a papillomavirus-infected epidermoid cyst in a site other than plantar skin. Light microscopic features of our cases differed from those of the plantar cysts. Epidermoid cysts may be induced by the papillomavirus or the virus may merely infect pre-existing cysts.

Adult↗
PubMed1993

Schwannoma with sweat duct differentiation.

We report a schwannoma with well differentiated ducts resembling cutaneous sweat ducts. The tumor presented as a painless mass near the left knee of a 41-year-old female. The mass had been present for many years. Some increase in size had been noticed over the previous 2 to 3 yr. The bulk of the tumor was composed of spindle cells with the appearance of Antoni A and Antoni B tissue. Rare mitotic figures were noted. In several areas of the tumor, numerous well-differentiated ducts were present. Most resembled normal cutaneous sweat ducts. In some areas, cystic dilatation of the ducts was present. Focal areas demonstrated poorly formed ducts and single cells with prominent nuclei and ample cytoplasm. Well formed ducts, poorly formed ducts, and single cells marked with AE 1/3 (keratin) and epithelial membrane antigen. The spindle cell proliferation marked for S 100 protein and vimentin. Sweat duct differentiation has not been reported previously in either benign or malignant schwannoma. Light and electron microscopic features of this tumor are presented.

Adult↗
PubMed1993

Basal cell carcinoma with monster cells.

A case of basal cell carcinoma with "monster cells" is reported. Clinically, the lesion presented as a red nodule on the forearm of a 58-year-old male. The histologic picture was striking, with large, "monstrous" nuclei scattered throughout a well defined nodule. Basal cell carcinoma with monster cells appears to represent a histologic variant of nodular basal cell carcinoma. The prognostic significance of the monster cells remains to be established.

Basal Cell Carcinoma↗
PubMed1993

Aluminum tattoo: a phenomenon that can resemble parasitized histiocytes.

We present a study of aluminum tattoos that resulted from aluminum chloride cauterization of biopsy sites. The stippled macrophages were studied by light and electron microscopy and by means of X-ray energy spectroscopy (XES) analysis. The light microscopic appearance may be striking, and may mimic the appearance of parasitized histiocytes, although the particles are larger and vary in size and shape. The basophilic particles are electron dense by electron microscopy. XES analysis demonstrated distinct emission peaks corresponding to aluminum, calcium, and phosphorus. Only a minor chloride emission peak was identified. The particles may represent an inorganic precipitate or an organic compound in which aluminum, calcium, and phosphate form a complex with protein.

Aluminum↗
PubMed1993

Cutaneous and visceral granulomas in common variable immunodeficiency.

A middle-aged woman with common variable immunodeficiency noted a papular skin eruption that simulated Gottron's sign of dermatomyositis on the dorsal hands. Examination of a skin biopsy specimen demonstrated noninfectious granulomatous inflammation. The patient was subsequently found to have visceral granulomas when examined using laparotomy. Noninfectious granulomas of the viscera and integument have been previously reported in patients with several immunodeficiency syndromes, including common variable immunodeficiency.

Adult↗
PubMed1992

Bubble hair.

An unusual hair dystrophy was studied by means of light and electron microscopy. Hair fibers demonstrated a boomerang deformity containing small and large "bubbles". Electron microscopy revealed a loss of cortical cells and medulla at these sites. Cross-section images showed either a single large cavity or a reticulated, "swiss cheese-like" loss of cells. These two cases represent the second and third reported cases of bubble hair deformity. We present the second light and electron microscopic study of this disorder, including new electron microscopic findings. The cause of bubble hair deformity remains obscure. The involved tufts of wiry hair resolved with gentle hair care. This suggests that trauma to the hair shaft may play a role. It is likely that additional cases of bubble hair remain unrecognized. Investigation of other patients with localized tufts of wiry hair is likely to reveal additional cases.

Adult↗