Biomedical subjects

Eve J Lowenstein

Publications and source records attributed to Eve J Lowenstein.

6 recordsLinked to original sources

PubMed2006

Recurrent injection site reactions from interferon beta 1-b.

Recombinant human interferon beta-1b is an immune-modulatory drug used for a variety of conditions including multiple sclerosis (MS). Skin reactions to therapeutic use of injectable interferon beta-lb are relatively common, including injection site reactions and exacerbation of underlying skin disease. Injection site reactions are seen much more frequently in females. We discuss a case of prolonged susceptibility to injection site reaction with over a decade of use of interferon beta 1-b for MS. Given the prevalence of such reactions, the dermatologist should be aware of the phenomenon and that it frequently does not necessitate discontinuation of therapy.

Aged↗

PubMed2004

Turner's syndrome in dermatology.

Turner's syndrome (TS) is a common genetic disorder of girls and women, for which the defining clinical triad is short stature, impaired sexual development, and infertility. Although classically known as monosomy X, genetic heterogeneity is frequent in TS, with mosaicism conferring a survival advantage. Several genetic loci have been implicated in TS including the short stature homeobox gene. TS effects many organs, with cutaneous stigmata providing critical clues for early detection of TS. The presence of lymphedema and its cutaneous sequelae are predictive of other systemic disorders, such as cardiac disease. Although an increased number of benign nevi have been reported in TS, the decreased melanoma rate in this population suggests some protective factor is active. Keloids were thought to be prevalent in TS, but recent data suggest otherwise. Autoimmune diseases are common in TS, with a possible increased prevalence of alopecia areata and vitiligo. The following review discusses new insights into the genetics and pathogenesis of this complex disorder, summarizes the major systemic effects, and reviews skin manifestations of TS and their implications.

Female↗

PubMed2002

Isotretinoin made S.M.A.R.T. and simple.

With the introduction of oral isotretinoin 20 years ago, an incredible triumph was achieved in the treatment of acne vulgaris. Much has been learned of the pathogenesis of acne and the mechanism by which isotretinoin affects acne. The teratogenicity of isotretinoin has cast a shadow on this effective drug with recent concern about the regulation of its use. The S.M.A.R.T. program has been implemented to address this concern. Alleged depressive mood effects of isotretinoin have resulted in further controversy. The efficacy of and indications for isotretinoin use are discussed here, with elaboration on the reported side effects. Given its established risks, treatment with isotretinoin may become severely curtailed if caution is not exercised.

Acne Vulgaris↗

PubMedDate not supplied

Diagnosis and management of the dermatologic manifestations of the polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a complex phenotypic spectrum of primarily hyperandrogenic signs and symptoms. PCOS is the most common endocrine disturbance to affect women of reproductive years. Although patients affected are often very disturbed by the cutaneous manifestations, including acne, hirsutism, alopecia, obesity, and acanthosis nigricans, the clinical manifestations of PCOS ramify far beyond the skin. PCOS frequently causes menstrual abnormalities and infertility. Insulin resistance is both pathogenic and a cause of numerous serious health consequences. The accurate diagnosis and recognition of cutaneous hyperandrogenism in PCOS are discussed. The differential diagnosis is reviewed. The work-up and approach to evaluation of patients with PCOS is presented. Although no uniform treatment approach for the management of the cutaneous manifestations of PCOS has been agreed upon, the data on various treatment options and the author's treatment approach to these patients are presented.

Diagnosis, Differential↗

PubMedDate not supplied

Case study: delicate skin cutting: management beyond the skin and implications of superficial habitual self-mutilation.

A 16-year-old girl accompanied by her mother was noted to have several thin, well healed brown lines on the distal third of her left flexural forearm (Figure). She admits to having recently made these marks by skin cutting. She feels depressed and at times feels life "is not worth living." She denies alcohol or substance abuse or true suicidal ideation, plan, or intent. Her mother describes her as previously well adjusted and a good student who has become erratic and moody in the past 6 months, with worsening school performance. Her father had a history of depression and alcoholism and died 3 years ago. She is undergoing psychotherapy and pharmacotherapy with sertraline with good results. She has not cut her skin in 3 months. Her mood and behavior have improved.

Adolescent↗

PubMedDate not supplied

Delayed type hypersensitivity to benzoyl peroxide.

Benzoyl peroxide (BP) has been a standard and effective topical treatment for acne vulgaris for the past 35 years. Previous studies and case reports have documented benzoyl peroxide to be a strong irritant and a weak allergen, with many cases of tolerance induced with repeat use of this irritant. While less common, numerous cases of BP-induced allergic contact dermatitis (delayed type hypersensitivity reaction) have been reported in the literature. We report here an individual with an incipient edematous reaction to topical BP used for acne therapy. This under-recognized presentation is discussed in the context of published literature on BP-induced hypersensitivity and irritation.

Acne Vulgaris↗