Photosensitivity to musk ambrette in Spain.
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Biomedical subjects
Publications and source records attributed to G Serrano.
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A 36-year-old woman developed a photolocalized erythematous papulovesicular eruption while taking piroxicam. Histologic study revealed a superficial and deep spongiotic dermatitis. Phototesting with ultraviolet B (UVB) and ultraviolet A (UVA) was abnormal at the time the patient was seen and after oral challenge with the drug for 5 days. A modified lymphocyte transformation test was positive. The photosensitizing potential of the drug was evaluated in vivo and in vitro. In vivo studies consisted of phototesting twelve medical students before and after intake of piroxicam during 5 consecutive days. No lowering of the minimal erythema dose (MED) values or abnormal reactions to UV and visible light were observed in these students. In vitro studies by the Candida plate method and by photohemolysis showed negative results. Our studies suggest a systemic photoallergy mechanism requiring wavelengths in the UVA range for the reaction. This drug should be avoided in patients receiving photochemotherapy.
A case of eccrine epithelioma is presented. A 62-year-old woman was seen for with a lesion on the left forearm present for 36 years, and complicated by multiple recurrences. Histopathologically, it was composed of numerous small nests of basaloid cells, cystic and syringoid epithelial structures within the reticular dermis and invading the contiguous fat and muscle tissues. Tubular structures and cystic spaces contained PAS-positive, diastate-resistant, and alcian blue-positive material. Although the tumor was very aggressive locally, no metastasis had occurred throughout its long course.
A case of multicentric reticulohistiocytosis in a 49-year-old man associated with polymyositis is presented. The clinical features along with the light and electron microscopic studies are commented. Partial improvement of the skin lesions was achieved after treatment with azathioprine but the patient's general condition remained unchanged.
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Congenital lower lip pits are a rare developmental malformation of the lower lip. Clinically they present as bilateral depressions in the vermilion zone of the lower lip. It is important to be aware of this disorder because lower lip pits have also been reported in a variety of other congenital disorders and are associated with other malformations. Ten cases of this entity are presented. Nine of the 10 patients are members of two related families. The clinical and pathologic picture as well as some of the genetic and therapeutic aspects of this peculiar condition are discussed.
A 27-year-old woman and a 13-year-old girl diagnosed with juvenile dermatomyositis in childhood developed clinical findings of partial lipodystrophy 10 years after diagnosis. Exhaustive clinical and laboratory examinations showed an association with other abnormalities: hypertrichosis, steatohepatitis, and an abnormal insulin response to the glucose loading test in the first patient. Hypertrichosis, steatohepatitis, insulin-resistant diabetes mellitus, and acanthosis nigricans were observed in the second patient. Renal function was normal in both patients. Although a localized form of lipodystrophy has been reported associated with connective tissue disease (connective tissue lipoatrophy), the partial form has been infrequently described in association with juvenile dermatomyositis.
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