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G B Jemec

Publications and source records attributed to G B Jemec.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Arthritis and pustulosis palmoplantaris].

Pustulosis palmoplantaris (PPP) is a primary skin disease of unknown aetiology, clinically characterised by recurrent eruptions of sterile pustules on the palms and/or soles. About 15% of these patients have associating symptoms from the bones and joints, often localised to the anterior thorax wall where both osteolytic foci and arthritis can be seen. We present the case of a patient with the characteristic clinical picture of PPP and associating arthritis.

Adult↗
PubMed1996

Histology of hidradenitis suppurativa.

BACKGROUND: Hidradenitis suppurativa is traditionally classified as a disease of the apocrine gland. However, different histologic descriptions exist. OBJECTIVE: Our purpose was to describe prospectively the histopathologic characteristics of hidradenitis. METHODS: We systematically described and classified 60 consecutive biopsy specimens from patients with hidradenitis and compared them with 33 specimens from clinically noninvolved regional controls. RESULTS: A heterogeneous histologic picture was found. Apocrine glands were involved in a minority of the 60 specimens, 17 showed poral occlusion, 17 simple folliculitis without poral occlusion, 9 sinus tracts, 6 epithelial cyst, 5 abscess, 3 apocrinitis, 2 diffuse dermal inflammation, and 1 pyogenic granuloma and scarring. Secondary involvement of apocrine glands was found in 12% of all specimens, and secondary involvement of eccrine glands was found in 25%. Sinus tracts were found significantly more often in the presence of poral occlusion or epithelial cysts. Control specimens frequently revealed changes compatible with early stages of follicular involvement. Apocrine glands were observed significantly more often in the axillae than in the groin. CONCLUSION: The clinical picture of hidradenitis suppurativa covers a broad histologic spectrum. This may help explain the therapeutic problems posed by this disease. The disease appears to be predominantly follicular, and apocrine glands appear to be primarily involved in only a minority of axillary lesions.

Abscess↗
PubMed1996

The prevalence of hidradenitis suppurativa and its potential precursor lesions.

BACKGROUND: The morbidity of hidradenitis suppurativa can be considerable, but little is known about its epidemiology. OBJECTIVE: Our purpose was to describe the 1-year and point prevalences of hidradenitis suppurativa and its potential precursor lesions. METHODS: We obtained the histories and examined an unselected sample (599 persons) of the general population (1-year prevalence), and we performed physical examinations for a consecutive sample of 507 persons undergoing screening for sexually transmitted diseases (point prevalence). RESULTS: The point prevalence was 4.1% (95% confidence interval [CI] = 3.0-6.0) on the basis of objective findings. The 1-year prevalence of hidradenitis was 1.0% (CI = 0.4-2.2) on the basis of subject recollection only. The patients in the sample on which point prevalence is based were younger than those in the unselected sample of the general population (p < 0.001). Hidradenitis was significantly more common in women (p = 0.037), which may result from a female preponderance of genitofemoral lesions (odds ratio [OR] = 5.4; CI = 1.5 - 19.3). No sex difference was found in the prevalence of axillary lesions. CONCLUSION: Hidradenitis suppurativa is significantly more common than hitherto estimated. The female preponderance of patients is confirmed, except for patients with axillary lesions. Additional longitudinal studies are necessary to assess the importance of potential precursor lesions such as noninflamed nodules or comedones.

Adolescent↗
PubMed1996

Patient-physician consensus on quality of life in dermatology.

This study was undertaken in order to establish the correlation between physician-assessed and patient self-reported quality of life (QOL) when using a proposed Dermatology Life Quality Index (DLQI) in a random sample of 51 dermatological out-patients and in-patients. A substantial correlation was found between physician scores and DLQI (r 2 = 0.306, P < 0.001), suggesting that the DLQI can be used to assess QOL and general morbidity. Comparison of the observed and ideal patient-physician consensus suggests that patients with relatively benign or quiescent disease may over-estimate disease impact, while dermatological patients with more malign or aggressive disease may underestimate it compared with the physician estimate.

Adult↗
PubMed1996

Hidradenitis suppurativa--characteristics and consequences.

The general characteristics of patients with hidradenitis suppurativa have not been previously described in detail. Although rare complications of the disease have been described, little is known of the average impact of hidradenitis suppurativa. We have now aimed to describe the general characteristics of the disease and its impact on patients with an established diagnosis of hidradenitis (n = 68) and compare these with those of an unselected general population sample (n = 523). Pierced earlobes were more common in patients than in the controls (P < 0.02). Female patients were younger (P = 0.0002) and better educated (P < 0.0001), and fewer had been pregnant (P = 0.0006). The median number of treatments prior to referral was two, and an average of 2.7 work days/patient per year were lost due to hidradenitis. The self-reported health of patients was significantly inferior to that of the general population (P < 0.001), mainly because of soreness and restriction of movement. Low-grade hidradenitis suppurativa therefore has a considerable impact on the health of patients. Previously implied associations with the disease such as the use of cosmetics or oral contraceptives, menstrual cycle and body mass index (BMI) were not confirmed in our study, although they may influence the course pre-existing disease.

Adult↗
PubMed1996

The bacteriology of hidradenitis suppurativa.

BACKGROUND: Bacteria have been suggested as a possible cause of hidradenitis. Different species have been found in several small studies, and particularly the presence of Streptococcus milleri has been linked to disease activity. OBJECTIVE: To investigate the possible role of bacteria in hidradenitis. METHODS: Cultures of active lesions and serological analysis of circulating IgG antibodies were studied in 41 patients. RESULTS: Bacteria were found in 49% (20/41) of all lesions: Staphylococcus aureus, 8; S. milleri, 1; Staphylococcus epidermidis, 11; Staphylococcus hominis, 1. Corynebacterium spp., Acinetobacter and Lactobacillus spp. were found once each and considered as contaminants. Patients in whom S. aureus was found had a shorter duration of disease (mean 1.7 vs. 9.7 years for sterile lesions). No other significant correlations were found between location of disease or antibody response and the bacterial species found. CONCLUSION: S. milleri appears to be an unusual pathogen, and bacteria are only found in approximately 50% of all active hidradenitis lesions. It is suggested that S. aureus may play a temporary role in the early phase of the disease, but additional longitudinal studies of cohorts of patients are needed to clarify this point.

Acinetobacter↗
PubMed1996

Decreased bone mineral density in patients with pustulosis palmaris et plantaris.

BACKGROUND: Focal skeletal changes in patients with pustulosis palmaris et plantaris (PPP) are known to occur in a minority of patients. It is unknown whether these changes are unique events or whether they merely represent more progressed cases. OBJECTIVE: The study was undertaken in order to investigate possible diffuse bone changes in patients with PPP. METHODS: Bone mineral density (BMD) and biochemical markers of bone turnover were studied in 18 female patients and 18 age-matched controls. RESULTS: A significant correlation was found between lower-forearm BMD and disease duration (< 0.05). With increasing age, patients had significantly lower values than controls for both forearm and spine BMD (p < 0.005); patients who had PPP for more than 2 years had significantly reduced forearm BMD (19.8%; 95% CI: 5.6-32.8%) and spine BMD (17.4%; 95% CI: 0.9-33.8%). No significant differences were observed in biochemical markers of bone turnover, physical activity or body mass index between patients and controls. The proportion of smokers among patients was four times higher than among controls (p < 0.0005). No significant dose effect was found between number of pack-years and BMD. CONCLUSION: Although we cannot exclude that prolonged use of topical steroids under occlusion is a confounding factor, the study suggests that PPP patients have decreased BMD due to primary pathogenic events, and that osteoporosis may be an additional problem for these patients.

Adult↗
PubMed1996

A case-control study of hidradenitis suppurativa in an STD population.

The prevalence of hidradenitis suppurativa has been found to be higher among patients attending an STD clinic than in an unselected general population sample. The aetiology of hidradenitis in unknown, but an association with chlamydial infections has been suggested for perineal lesions. Our aim was to describe the history of STD, STD risk factors and possible current STD in patients with hidradenitis. A case-control study comparing patients with hidradenitis (20) and controls (60) was therefore made in patients attending an STD clinic. Genital HPV infection was found to be more common in patients with hidradenitis (p = 0.036), but no differences were seen in the history of STD, STD risk behaviour or other current STD between the two groups studied. HPV infection appears to be the only STD which is more common in hidradenitis patients, but the biological significance of this finding is not clear. It is speculated that common predisposing factors may be responsible. We were unable to support the previously postulated association between Chlamydia trachomatis infection and hidradenitis.

Adult↗
PubMed1995

Nail abnormalities in nondermatologic patients: prevalence and possible role as diagnostic aids.

BACKGROUND: Nail changes have traditionally been used as diagnostic aids. Their usefulness in general and predictive value in particular, however, is not known. OBJECTIVE: Our purpose was to survey nail changes and to clarify the potential of nail abnormalities to diagnose nondermatologic diseases. METHODS: The fingernails of 567 patients admitted to general medical and surgical wards were examined. The point prevalence rates were calculated on the basis of a binomial distribution. The results were compared with the diagnosis with logistic regression analysis correcting for age and sex. RESULTS: The most common findings were absence of lunulae (22.9% [19.5% to 26.6%]), white nails or apparent leukonychia (11.8% [9.3% to 14.8%]), and red lunulae (5.1% [3.5% to 7.3%]). The following significant associations were noted: pulmonary disease and clubbing (odds ratio[OR] = 4.1, 95% confidence interval [CI] = 1.7 to 9.5), hematologic disease and brittle nails (OR = 4.6, 95% CI = 1.6 to 13.7), hematologic disease and Terry nails (OR = 8.7, 95% CI = 2.7 to 27.0), gastrointestinal disease and pincer nails (OR = 33.6, 95% CI = 3.7 to 307.3), and gastrointestinal disease and subjective complaints (OR = 2.7, 95% CI = 1.4 to 5.0). CONCLUSION: Several significant associations were identified, suggesting that nail abnormalities can be diagnostic clues in the diagnosis of chronic nondermatologic diseases. An association between pincer nails and gastrointestinal disease has not been previously described.

Adolescent↗
PubMed1995

The influence of sex hormones on UVB induced erythema in man.

Clinical and experimental evidence suggests that sex hormones can modify the inflammatory response in a number of diseases. In a pilot study the influence of sex hormones on UV-induced inflammation, testing was done with oestradiol-17beta, testosterone and progesterone, as a double-blind vehicle-controlled study in 47 healthy volunteers. Inflammation was graded using laser-doppler velocimetry. Oestradiol (5 mg/100 g) was found to increase the inflammatory response significantly when compared with placebo or testosterone treated areas (P < 0.03). These findings support previous experimental and epidemiological observations of an increased inflammation following oestrogenic stimulation, and suggest that non-lymphocyte-mediated mechanisms may be involved as well.

Administration, Topical↗
PubMed1994

Pyoderma gangrenosum complicated by necrotizing fasciitis.

Necrotizing fasciitis is a potentially life-threatening infection that may resemble extensive pyoderma gangrenosum. The treatment of the two diseases is, however, different, and differentiating them is therefore essential. A case is presented in which necrotizing fasciitis appeared as a complication of pyoderma gangrenosum. The successful treatment is described, and the differential diagnosis of the two entities is presented. The need for early and aggressive treatment of necrotizing fasciitis is stressed.

Aged↗
PubMed1993

The influence of water, glycerin, paraffin oil and ethanol on skin mechanics.

Moisturizers and emollients do not only smooth the skin but also make it more supple. To clarify this effect, the short-term influence of tap water, paraffin oil, ethanol and glycerin on skin mechanics was studied. These substances are all common ingredients in moisturizers and emollients. Significant changes were seen already after 10 min of application. The distensibility and hysteresis (creep phenomenon) showed the most pronounced changes. Water and paraffin oil application caused significant (p < 0.03) increases after 10 min of application. The changes persisted for at least 10 min following paraffin oil application, while they disappeared sooner following water application. Application of ethanol had a negative effect on distensibility (p < 0.03). Glycerin appears to have a slow onset of action, but with the changes continuing even after application was stopped. The changes induced by glycerin appear to be similar to those induced by water and paraffin oil. The study shows that some of the most common ingredients in moisturizers and emollients are capable of inducing significant changes in the mechanical properties of human skin in vivo even after a 10-min application, suggesting that the outermost layers of the epidermis play an important role in skin mechanics.

Adult↗
PubMed1992

Scaling, dry skin and gender. A bioengineering study of dry skin.

Dry skin and scaling was studied in a group of 72 healthy volunteers by using subjective self-assessment and by clinical assessment by a dermatologist, as well as application of noninvasive bioengineering techniques to measure scaling and epidermal hydration. The study revealed that 67% of the volunteers had subjective complaints, while only 5.6% had definite clinical signs of dry skin at the time of examination. Subjective complaints were more common in women than in men (p < 0.001), though neither clinical nor objective measurements showed any sex difference, which suggests that other factors may play a role in the way men and women perceive dry skin. Subjective and clinical scores were correlated (p < 0.02), though neither was significantly correlated to objective measurements. Grading of skin scaling on D-squame tapes correlated with densitometry of the tapes (p < 0.001), as did the electrical capacitance (p < 0.001). Both clinical and objective methods can identify dry skin. However, the study showed that in healthy persons a number of irrational factors play a role in the use of moisturizers, and while these factors cannot be measured, they must be taken into account. Healthy, but dry skin is a vaguely defined clinical entity, which may explain the generally poor correlation between the two methods. This underlines the need for several methods to be used simultaneously in order to elicit complementary information.

Adult↗
PubMed1991

Circulating androgens in male patients suffering from systemic scleroderma.

The excretion of collagen metabolites and circulating androgens was measured in ten males suffering from progressive systemic sclerosis. Significantly higher levels of sex hormone-binding globulin, total testosterone and dihydrotestosterone (DHT) (P less than 0.01), and total oestradiol (P less than 0.05), were found in patients when compared with age-matched controls. Urinary excretion of hydroxyproline in patients was found to correlate significantly with total testosterone (P = 0.035), with DHT (P = 0.005) and dehydroepiandrosterone-sulphate (DHEAS) (P = 0.034). Similarly the hydroxyproline peptide fraction was found to correlate significantly with total testosterone (P = 0.037), with DHT (P = 0.005) and with DHEAS (P = 0.008). Hydroxylysine peptide in the urine correlated significantly with free testosterone (P = 0.035) and DHT (P = 0.040). Oestrogens did not correlate with urinary excretion of collagen metabolites. These findings suggest that androgens may play a role in the pathogenesis of scleroderma in male patients.

Adult↗