Prurigo in a patient with intestinal strongyloidiasis.
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Biomedical subjects
Publications and source records attributed to G Galbiati.
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BACKGROUND: Creeping eruption (CE), which is characteristic of tropical and subtropical regions, is being increasingly frequently observed in Italy. The presence on the beaches of stray animals infected by nematodes of the Ancylostoma species favors contact between human skin and the larva-infested soil. MATERIALS AND METHODS: Our experience with 56 patients (13 cryotherapy, one thiabendazole together with cryotherapy, six thiabendazole, two albendazole with cryotherapy, and 34 albendazole) is described. RESULTS: A prompt and definitive cure was achieved in all 56 patients. The therapeutic effectiveness of the various methods used is therefore equivalent. CONCLUSIONS: We believe that albendazole should be considered the first choice for treatment. It is extremely well tolerated and patient compliance is good.
BACKGROUND: Early detection of fungal infection is essential for beginning of prompt and specific therapy. In this study we describe a rapid and sensitive procedure to detect, by polymerase chain reaction (PCR) assays, a wide range of medically important opportunistic and pathogenic fungi in dermal specimens from dermatomycoses-affected patients. MATERIALS AND METHODS: Three primer pairs, amplifying fragments of the highly conserved gene coding for small ribosomal RNA (18S rDNA) and the adjacent internal transcribed spacer (ITS) rDNA, previously published by others, were probed on DNA from pure cultures of medically relevant human and animal fungal species. In order to evaluate the specificity of the assay, amplifications of control DNAs from other eukaryotes and prokaryotes were also carried out, and they gave negative results. RESULTS: These primer sets, in single amplification or double-rounded PCR assays, allowed specific amplification when applied to a wide number of fungal DNA from human and animal tissue specimens, including dermatophytes (genera Trichophyton, Microsporum), several yeast species (Candida, Saccharomyces, Cryptococcus, Malassezia) and moulds (Aspergillus, Penicillium). The PCR assay was able to detect as little as 10 pg of fungal DNA, corresponding to approximately 25 fungal genomes per sample specimen. A small-scale DNA extraction method was also developed. This simple, time-saving and sensitive procedure was successfully applied to 40 human and veterinary specimens, and the diagnosis was confirmed with cultural techniques, being shown to work even in the presence of other lesions or contaminating organisms. CONCLUSIONS: This method allows early recognition of fungal pathogen cells in clinical samples as an alternative tool to conventional detection techniques.
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A 68-year-old man had had for 3 years a severe onychodystrophy involving all fingers and toes which clinically mimicked nail lichen planus. The nail biopsy showed amyloid deposits in the superficial dermis of the nail matrix. Physical, pathological and laboratory examinations confirmed the diagnosis of primary systemic amyloidosis. At the time of the diagnosis the patient did not present any other cutaneous sign of systemic amyloidosis.
A case of cutaneous angiogenesis, probably induced by tumour angiogenic factors (TAF), is described. The patient, a 39-year-old female, affected by a vulvar squamous cell carcinoma, developed some erythematoangiomatous lesions on the lower abdominal quadrants, contiguously to the tumour. Histopathologically, the lesions were characterized by vascular neoformation in the superficial dermis and a slight lymphohistiocytic lesions resolved after the polychemotherapy which preceded enlarged vulvectomy. This supports the hypothesis of a close correlation between neoangiogenesis and TAF.
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A case of unilateral naevoid syringoma is reported. Syringoma is an adnexal benign neoplasia originating from the ducts of eccrine sweat glands. Localized (neck, anterior portion of the chest, genitalia, fingers) and generalized forms are known, but unilateral naevoid syringoma is quite uncommon. The existence of this variety can be explained with reference to the theory of "genetic mosaicism".
A case of a 70 year old man, affected by a solitary cutaneous metastasis of a clinically asymptomatic clear cell adenocarcinoma of the kidney is reported and some histopathological differential diagnoses are considered.
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Two different forms of granuloma annulare perforans are described. One form, which particularly affects young people, is characterized by small nodular lesions with central umbilication and a monomorphic clinical picture. These lesions can persist for many years, but spontaneous remission often occurs. The second form affects older patients. The clinical picture is polymorphic, consisting of dull red papules, umbilicated papules, pustular lesions and small atrophic scars. This form is resistant to a variety of therapies and does not heal spontaneously.
In an open non-comparative trial forty-three hospitalized patients with chronic psoriasis vulgaris were treated with 0.05% halometasone cream (without dressing) by day and 0.05% halometasone ointment (with occlusive dressing) at night. This combined regimen yielded good to very good results in 93.1% of the patients treated. The trial treatment was fairly well tolerated, did not have any systemic adverse effects and had to be discontinued in only one patient, due to severe pustular eruption at the site of application.
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Tinea pedis is a common and frequently recurring dermatophytic infection, which is extremely difficult to eradicate. The often inevitable persistence of predisposing conditions, especially maceration, suggests that application of powders containing antifungal medication to the affected area could be effective in preventive therapy against recurrence. For this study we used one of the most recent azole antifungal agents, fenticonazole. Thirty patients affected with tinea pedis were cured with topical antifungal treatment; both the diagnosis and the cure were confirmed by microscopic and cultural mycological analyses. The results of subsequent double blind antifungal versus placebo treatment (controlled with clinical and mycological tests over a period of 4 months and with a final statistic evaluation) confirmed the effectiveness of such therapy in reducing the frequency of tiresome relapses in such patients.
Trichophyton soudanense is an anthropophilic dermatophyte originating in Africa. Over the last 30 years sporadic cases have been reported in countries that had colonial relations with the endemic areas. In recent times, as a result of growing racial mixing linked to migratory movements, this strain has become increasingly integrated with the species most commonly responsible for dermatophytoses. This phenomenon has occurred, although only recently, in Italy too, where there has been a heavy influx of foreign immigrants over the last few years.