Biomedical subjects

Donald Rudikoff

Publications and source records attributed to Donald Rudikoff.

10 recordsLinked to original sources

PubMed2004

Idiopathic splinter hemorrhages.

Splinter hemorrhages are non-blanchable usually distal reddish-brown linear hemorrhages beneath the nails. Among a variety of etiologic factors reported, trauma is the most common cause. A 26-year-old Hispanic female presented with asymptomatic, extensive fingernail hemorrhages of two months duration. There was no history of physical trauma to the nails. Treatment with a topical antifungal medication for one month produced no improvement. The past medical history was noncontributory. Extensive laboratory testing revealed no underlying systemic disease. Three months after the initial presentation, 6 of 10 fingernails showed signs of resolution without treatment. We conclude that idiopathic atraumatic subungual splinter hemorrhages can occur in healthy individuals. Spontaneous resolution occurred in our patient.

Adult↗

PubMed2004

Frequency of culture-proven dermatophyte infection in patients with suspected tinea pedis.

BACKGROUND: This study examined the incidence of culture-proven tinea pedis in patients who presented with a foot rash clinically suspected to be tinea pedis. METHODS: Cultures were taken from 874 patients in 4 dermatology clinics across the country. The incidence of patients with positively cultured tinea pedis was compared with the total number of patients in the study. RESULTS: The surprisingly low percentage of patients correctly diagnosed with tinea pedis was determined to be 32%. The remaining 68% of patients either had a nonfungal foot dermatitis or tinea pedis with false-negative cultures. CONCLUSIONS: This study demonstrates the need for fungal cultures when patients present with scaling feet as well as the importance of a broad differential diagnosis to ensure timely and appropriate therapy.

Arthrodermataceae↗

PubMed2003

HIV-associated pruritus: etiology and management.

With the advent of highly active antiretroviral therapy (HAART), life-threatening opportunistic infection has become less common in patients with HIV infection and longevity has increased dramatically. With increased longevity, the problems of living with a chronic disease have become more prominent in this patient population. Disorders such as fat redistribution and metabolic abnormalities can result from antiviral medications and from HIV disease itself. Pruritus is one of the most common symptoms encountered in patients with HIV. The spectrum of skin diseases in such patients encompasses dermatoses of diverse etiologies; a few are peculiar to patients with HIV while others are not. Some of these conditions may cause severe and sometimes intractable pruritus that provokes scratching, picking, disfigurement, sleep loss, and significant psychological stress. Moreover, the expense of ongoing medical treatments can be daunting. Skin rash can sometimes be the initial presentation of HIV infection or serve as a harbinger of disease progression. Causes of pruritus include skin infections, infestations, papulosquamous disorders, photodermatitis, xerosis, drug reactions, and occasionally lymphoproliferative disorders. Drug eruptions are particularly common in patients who are HIV positive, presumably as a result of immune dysregulation, altered drug metabolism, and polypharmacy. Itching can also result from systemic diseases such as chronic renal failure, liver disease, or systemic lymphoma. Workup of pruritus should include a careful examination of the skin, hair, nails, and mucous membranes to establish a primary dermatologic diagnosis. If no dermatologic cause is found, a systemic cause or medication-related etiology should be sought. Idiopathic HIV pruritus is a diagnosis of exclusion and should only be considered when a specific diagnosis cannot be established. The management of HIV-associated pruritus should be directed at the underlying condition. Phototherapy has been found to be useful in the treatment of several HIV-associated dermatoses and idiopathic pruritus as well. Unfortunately, some of the treatments that have been suggested for patients with HIV are anecdotal or based on small uncontrolled studies. The last decade has seen a surge in the utilization of HAART which, to some degree, reconstitutes the immune system and ameliorates some dermatologic diseases. On the other hand, some skin diseases flare temporarily when HAART is started. Unless frank drug allergy is suspected, HAART does not need to be stopped.

AIDS-Related Opportunistic Infections↗

PubMed2002

The relationship between HIV infection and atopic dermatitis.

Patients with HIV infection exhibit a wide range of skin pathology, including bacterial, fungal, and viral infections, skin tumors, inflammatory and eczematous eruptions, and drug rashes. HIV-infected adults commonly develop a condition that strongly resembles atopic dermatitis and is sometimes called "atopic-like dermatitis"; moreover, atopic dermatitis and other atopic disorders have been described as common manifestations of pediatric HIV infection. Conditions such as sinusitis, asthma, and hyper-IgE syndrome, and laboratory abnormalities, eg, elevated IgE levels, eosinophilia, and possible Th1-Th2 imbalances, suggest a predilection for atopic disorders in these patients. It is of interest to examine the immune perturbations intrinsic to HIV infection, and their possible role in triggering atopic dermatitis, and to consider whether other abnormalities, such as xerosis, bacterial or viral superantigens, or epidermal barrier disruption with altered presentation of cutaneous aeroallergens, might play a significant role.

Adrenal Cortex Hormones↗

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