Callused feet, thick nails, and white tongue. Pachyonychia congenita.
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Biomedical subjects
Publications and source records attributed to H A Oriba.
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A 26-year-old white woman had reticulate nonmelanocytic hyperpigmentation anomaly characterized by partially blanching red-brown papules and macules and a histologic picture of digitate epithelial budding proliferation with lightly pigmented rete ridges. Except for the classically described hyperpigmentation at the rete ridge tips, the patient has Dowling-Degos disease. This case of a reticulate nonmelanocytic hyperpigmentation anomaly is probably a variant of Dowling-Degos disease.
Malignant cylindroma may develop via malignant transformation of cylindroma in rare instances or may develop de novo in others. We present a case of malignant cylindroma located on the left parietal-occipital scalp that was treated twice by Mohs micrographic surgery in an attempt to excise the tumor completely and to minimize the excision of normal tissue. Our case is the sixteenth reported case of malignant cylindroma in the world literature.
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The skin barrier was evaluated as a function of transepidermal water loss (TEWL) and electrolyte loss. Combination electrodes for chloride and pH determinations and a potassium ion electrode were utilized. Delipidization of the skin did not impair the electrolyte barrier, but did damage the epidermal water barrier. Cellophane tape stripping of normal stratum corneum resulted in an increase in outward transepidermal potassium and chloride ion flux, an increase in skin surface pH, and an increase in TEWL. It appears that damage to the epidermal water barrier does not necessarily result in damage to the epidermal electrolyte barrier. We found the potassium electrode facile to use and believe that a combination potassium electrode would be useful for investigating and assessing the epidermal electrolyte barrier.
The kinetics of water desorption after water loading was evaluated by means of transepidermal water loss (TEWL) decay curves. The effects of delipidation and ageing on the desorption of the water biomolecule was investigated in the vulva and on the forearm. All decay constants were analysed by curve stripping analysis and found to fit a bi-exponential decay. There was no significant difference in decay constant when compared by site. However, the terminal decay constant differed significantly after delipidation in both vulva and on forearm (p less than 0.02, p less than 0.04, respectively) in premenopausal women. Significant differences were also noted at post-menopausal forearm and vulva sites after delipidation for the terminal decay constant (p less than 0.006, p less than 0.02, respectively). Delipidation probably alters bound water in the process of sorption. Differences in decay constant when compared between pre- and post-menopausal women were noted only at the vulva for beta 1 decay constant (p less than 0.05). beta 2 of the forearm was not affected by menopause. Data are also presented to support the notion that structural lipids of the stratum corneum may have a water-holding property.
Using noninvasive bioengineering skin technology, the vulvar skin has been partially characterized as having unique properties. The reduction in stratum corneum barrier function and the increase in basal blood flow in the vulvar skin may explain the high rate of percutaneous absorption and the increased reactivity to irritants. The vulvar microbial flora represents a unique combination of contaminants from the vagina and the perianal area and a resident flora that is typical for intertriginous skin, together with a high carrier rate of Staphylococcus aureus. The long-term goal of vulvar physiology is to understand better how this more specialized skin differs from less specialized areas in the hope of using this information clinically.
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We report a case of recalcitrant generalized cutaneous polydermatophyte and Candida infection in an AIDS patient who responded very poorly to topical, oral, and intravenous therapy. The patient died of respiratory arrest secondary to pneumonia 14 months after a cutaneous fungal infection developed and 12 months after AIDS was diagnosed. Extensive cutaneous fungal infections refractory to treatment may be a presenting sign of HIV infection.