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Dirk M Elston

Publications and source records attributed to Dirk M Elston.

102 records · Page 6Linked to original sources
PubMed2002

Disseminated coccidioidomycosis discovered during routine skin cancer screening.

A 78-year-old white man presented for routine dermatologic examination. A 4x4-mm erythematous papule was noted on the left upper back. It was asymptomatic and previously unnoticed by the patient. The results of a shave biopsy revealed a large spherule with granular cytoplasm diagnostic of coccidioidomycosis. Chest x-ray revealed a 1.8-cm right upper lobe mass. The complement fixation antibody titer for cocci was 1:128. The patient was treated for disseminated coccidioidomycosis with oral fluconazole. The epidemiology, diagnosis, and management of coccidioidomycosis are discussed.

Aged↗
PubMed2002

Palmar petechiae in dermatitis herpetiformis: a case report and clinical review.

Palmar petechiae or purpura is an unusual finding in dermatitis herpetiformis (DH) that occurs in children but is only rarely reported in adults. We describe a 46-year-old man with DH who presented with the classic pruritic papulovesicular eruption and associated volar finger and palmar petechiae. We discuss recent advances in the pathogenesis and treatment of DH.

Anti-Infective Agents↗
PubMed2002

A case of bullous pemphigoid limited to psoriatic plaques.

Psoriasis occurs with increased incidence in patients with bullous pemphigoid (BP). In this article, we describe the seventh reported English literature case in which the bullous lesions were limited to psoriatic plaques, and we discuss the pathophysiologic mechanisms that might explain this phenomenon. Treatment with acitretin quickly cleared both psoriatic and bullous lesions, suggesting a direct link between the psoriatic inflammatory process and the evolution of bullous lesions.

Acitretin↗
PubMedDate not supplied

Rickettsial skin disease: uncommon presentations.

Rickettsioses occurring worldwide show a significant morbidity and mortality when not properly treated. Early diagnosis is mandatory for better outcome. Clinical symptoms and patient's history are essential, but uncommon presentation of these arthropod-borne diseases may be a challenge.

Anti-Bacterial Agents↗
PubMedDate not supplied

Fontana-positive grains in mycetoma caused by Microsporum canis.

We describe mycetoma caused by Microsporum canis occurring in a 9-year-old African-American girl. Pathologic evaluation showed a granulomatous dermatitis with numerous large fungal grains containing septate hyphae that were Fontana-Masson positive. Two cultures of pure grains grew M. canis. Mycetoma due to dermatophytes is very uncommon. The few instances reported have been pseudomycetoma (grains in the absence of sinus tracts). Our patient developed sinus tracts (true mycetoma). No prior reports were found of M. canis staining Fontana positive. Differentiation of dermatophyte-induced mycetoma from kerion is important because mycetomas require a combined approach including surgical debridement in addition to oral antifungal therapy.

Child↗
PubMedDate not supplied

Drugs used in the treatment of pediculosis.

Pediculosis is the result of infestation by one of two families of sucking lice. The Pediculidae include the agents of head and body lice. Pubic lice belong to the family Pthiridae. Pediculus humanus capitis (the head louse) and Pediculus humanus humanus (the body louse) look identical. The two differ by the slightly larger size of the average body louse, as well as where they reside and deposit their eggs. Head lice live in the scalp hair and deposit their ova on hair shafts. Body lice live in the seams of clothing and deposit their ova on fabric fibers, usually in the seams of the clothing. Although body lice are common vectors of disease, head lice have not been proven to act as disease vectors. This having been said, the two are so closely related that it is naive to believe that head lice will never be shown to spread disease.

Humans↗
PubMedDate not supplied

Optimal antibacterial treatment of uncomplicated skin and skin structure infections: applying a novel treatment algorithm.

Incision and drainage combined with antibiotic therapies form the backbone of managing uncomplicated skin and skin structure infections (uSSSIs). An algorithm has been developed to guide the treatment of uSSSIs in the primary care setting in situations where initial empiric therapy is appropriate. This includes instances when a culture is taken, but it is deemed appropriate to begin an antibiotic empirically pending the results of the culture. The panel that developed the algorithm was chaired by Dr. Richard Scher of Columbia University and included thought leaders in the fields of clinical dermatology, dermatologic surgery, infectious disease, pediatric infectious disease, podiatry, and HIV infection. The panel acknowledged that the initial choice of antibiotic is generally determined by tolerability, ease of administration, cost, and efficacy. The usual choices for initial empiric therapy include cephalosporins, penicillinase-resistant penicillins, and beta-lactam/beta-lactamase inhibitor combinations. Currently marketed cephalosporins, penicillinase-resistant penicillins, and beta-lactam/beta-lactamase inhibitor combinations lack activity against methicillin-resistant Staphylococcus aureus (MRSA), and the increasing prevalence of community-acquired MRSA (CA-MRSA) was a major consideration when designing the treatment algorithm. Many CA-MRSA skin infections present as abscess, and drainage is the most important component of therapy in this setting. When the history and physical exam suggest CA-MRSA infection, and there is no fluctuant collection of purulent material to be drained, a sulfa drug or tetracycline is generally the best choice for initial empiric therapy.

Algorithms↗