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Biomedical subjects

I Bielsa

Publications and source records attributed to I Bielsa.

At least 19 recordsLinked to original sources
PubMed2001

Adverse granulomatous reaction after cosmetic dermal silicone injection.

BACKGROUND: Various alloplastic injectable implants have been developed for soft tissue augmentation without surgery, but different local or systemic adverse reactions have limited their use for cosmetic purposes. OBJECTIVE: To examine the problems associated with silicone injection. METHODS: Case report and literature review. RESULTS: We describe an adverse granulomatous reaction after the injection of liquid silicone for lip augmentation, causing facial disfigurement. Although the initial response to steroids was poor, after 3 years of follow-up the nodules have almost disappeared spontaneously. CONCLUSION: We advise that silicone injection be performed solely by trained physicians using medical-grade silicone or consider other injectable materials.

Cosmetic Techniques↗
PubMed2000

An immunohistopathologic study in cutaneous necrotizing vasculitis.

In order to investigate the importance of timing in the immunophenotypical characteristics of the inflammatory infiltrate and in the adhesion molecules expression in cutaneous necrotizing vasculitis (CNV) we carried on an immunohistopathologic study. An avidin-biotin-streptavidin peroxidase technique was performed on 21 lesional skin biopsy specimens obtained sequentially at 0 to 24, 72 and 120 hours from seven patients with a CNV presenting as palpable purpura. A panel of monoclonal antibodies specific for inflammatory cells (T lymphocytes, polymorphonuclear leukocytes, macrophages, dendritic cells) and different adhesion molecules (E-selectin, ICAM-1, VCAM-1, LFA-1, VLA-4) was used. Moreover, HECA-450 monoclonal antibody was used to identify cutaneous lymphocyte antigen (CLA) in the inflammatory infiltrate. In all cases, polymorphonuclear leukocytes predominated in the early phase of CNV and their number decreased significantly with time (p = 0.0001). The T lymphocytes were present from the beginning and their number remained stable or increased slightly in time (p = 0.1), thus becoming predominant in the perivascular infiltrate in older lesions. Macrophages were scattered on interstitium since the early phase and they showed a time-dependent increase (p = 0.0003). E-selectin (ELAM-1) expression was detected at the first biopsy and it decreased depending on the age of the evolving vasculitis (p = 0.0033). The expression of CLA decreased also with time in 5 of the 7 cases (p = 0.0001). Our study supports the existence of an unique histopathologic pattern in CNV, in which the inflammatory infiltrate varies with time at the expense of the number of polymorphonuclear cells and macrophages.

Antibodies, Monoclonal↗
PubMed1999

Keratotsis punctata of the palmar creases: report of two cases associated with ichthyosis vulgaris.

Two patients with keratosis punctata of the palmar creases are described. The association with ichthyosis vulgaris and other disorders of keratinization is discussed. In both cases, histopathology revealed a close relation between the keratotic plug and the sweat glands. The role of genetic factors and manual activity in the pathogenesis is discussed. Treatment with oral etretinate resulted in a good improvement in the first patient, but prolonged low-dose maintenance therapy was required to prevent recurrence.

Adult↗
PubMed1999

p53 immunohistochemical expression in early posttransplant-associated malignant and premalignant cutaneous lesions.

BACKGROUND: Current evidence suggests that p53 accumulation is critical to the development of skin cancer in the general population. It is possible, however, that the molecular steps involved in transplant-associated and non-transplant-associated skin carcinogenesis may differ. OBJECTIVE: Our purpose was to examine p53 expression in premalignant and malignant skin lesions from renal transplant recipients (RTRs) in their first 3 years of immunosuppression, as well as in equivalent lesions from immunocompetent normal individuals. METHODS: p53 expression was examined by routine immunohistochemical methods using the anti-p53 monoclonal antibody DO7. RESULTS: p53 immunoreactivity was more prevalent in dysplastic epidermal keratoses and cutaneous carcinomas from RTRs than in equivalent lesions from nontransplant controls. Statistical analysis revealed significant differences, however, only in premalignant skin lesions (p = 0.03). CONCLUSION: This study demonstrates that accumulation of p53 protein is frequently encountered in both premalignant and malignant skin lesions of RTRs, and that this may occur as an early step in transplant-associated skin carcinogenesis.

Antibodies, Monoclonal↗
PubMed1998

Hereditary hypotrichosis simplex.

Hypotrichosis is a relatively common feature of a number of complex hereditary syndromes. However, the isolated variant, called hereditary hypotrichosis simplex (HHS), is especially uncommon. We present a Spanish family with 8 of 19 persons covering 4 generations affected by HHS. No associated ectodermal or other defects were noted. The pedigree was compatible with an autosomal dominant inheritance with variable penetrance.

Child↗
PubMed1997

Low-grade mucoepidermoid carcinoma on the vermilion border of the lip.

We report a case of primary cutaneous carcinoma with mucoepidermoid features located on the vermilion border of the lower lip, at a distance from both salivary glands and cutaneous adnexal structures. The clinical appearance of the present case, which is similar to that of conventional cutaneous squamous cell carcinoma, as well as the existence of surrounding areas of actinic cheilitis favors the hypothesis of a phenomenon of mucinous metaplastic change in a squamous cell carcinoma. We consider that, independently of their origin, tumors having mucin-secreting and squamous differentiation ought to be named according to the same criteria generally used for other organs, namely, "low grade mucoepidermoid carcinoma" would designate tumors with bland mucin-secreting cells and well-differentiated squamous component, and "high grade mucoepidermoid carcinoma" would indicate their less well differentiated counterpart. We propose to reserve the term "adenosquamous carcinoma" for aggressive tumors with high-grade glandular and squamous elements, marked nuclear atypia, frequent mitoses, and extensive necrosis.

Carcinoembryonic Antigen↗
PubMed1997

Sequential combined therapy with thalidomide and narrow-band (TL01) UVB in the treatment of prurigo nodularis.

BACKGROUND: Prurigo nodularis (PN) is a chronic disease of which treatment choices are limited. Among them, thalidomide and phototherapy have been used with satisfactory results. Unfortunately, the possibility of side effects limits their use. OBJECTIVE: To evaluate the efficacy of a sequential combined treatment with thalidomide and ultraviolet B (UVB) therapy in order to minimize side effects and, thus, making possible a long-term treatment. METHODS: A prospective open trial combining thalidomide as initial therapy followed by narrow-band UVB (TL01) irradiation until complete or almost complete remission of the disease was achieved. RESULTS: An excellent response was obtained after an average of 12 weeks of thalidomide therapy and 32 UVB courses. CONCLUSIONS: Sequential combined therapy with thalidomide and narrow-band UVB therapy could improve the management of prurigo nodularis with minimal side effects, although it should probably be reserved to men and women over 50 years of age.

Administration, Oral↗
PubMed1995

Epidermal dysplasia and neoplasia in kidney transplant recipients.

BACKGROUND: Established data confirm an increased incidence of skin cancer, mainly squamous cell carcinoma (SCC), in long-term kidney transplant recipients (KTRs). OBJECTIVE: Our purpose was to investigate prospectively the type and frequency of neoplastic and preneoplastic skin lesions in KTRs during the first 3 years of immunosuppression, as well as the influence of potential risk factors. METHODS: Eighty-one consecutive KTRs were examined every 6 months during the first 3 years after transplantation. All survival analyses were performed with the EGRET statistical software package. RESULTS: After a median follow-up of 34 months, 25 skin cancers developed in 12 patients; the basal cell carcinoma (BCC)/SCC ratio was 3.1:1. The cumulative risk of skin cancer developing after 3 years of graft survival was 18.1%. Only age at the time of transplantation (p = 0.005) and occupational sun exposure (p = 0.048) had statistical significance as risk factors. CONCLUSION: In carefully supervised KTRs, a high incidence of cutaneous malignancy, mainly BCC, exists in the early posttransplant period. Sun exposure and the patient's age at the time of transplantation seem to be the most important risk factors.

Adult↗
PubMed1994

Erythroderma due to thalidomide: report of two cases.

Cutaneous reactions to thalidomide therapy are reported infrequently. We report two new cases. Both patients suffered from chronic renal insufficiency and were on thalidomide therapy because of prurigo nodularis. The cutaneous reaction consisted of a severe erythematous rash progressing to erythroderma, associated with peripheral eosinophilia. In both cases rapid resolution occurred after withdrawal of thalidomide. We emphasize the possibility of a severe cutaneous hypersensitivity reaction due to thalidomide and speculate about the role played by the renal insufficiency present in both cases.

Adult↗
PubMed1994

[Cholesterol embolism].

Two patients with advanced atherosclerotic vascular disease developed multiple cholesterol emboli. In both patients the clinical presentation included livedo reticularis of the lower part of the body and purple toes with small areas of distal necrosis and ulceration. The predisposing factors are operative vascular procedures and the use of anticoagulants respectively. Biopsy of skin lesions revealed characteristic cholesterol clefts within atheromatous debris filling small, deep arterial lumen. Multiple cholesterol emboli should be suspected in presence of cutaneous lesions and confirmed histologically in the appropriate clinical setting.

Aged↗
PubMed1994

Histopathologic findings in cutaneous lupus erythematosus.

BACKGROUND AND DESIGN: The possible distinction between different types of cutaneous lupus erythematosus (CLE) based on histologic features has been largely debated. This study describes the histopathologic features of three distinct subsets of CLE: chronic, annular-subacute, and papulosquamous-subacute. Biopsy specimens from 92 patients with CLE were examined without the clinical diagnosis being known by the examiners. Of them, 36 clinically demonstrated chronic CLE; 32, annular-subacute CLE; and 24, papulosquamous-subacute CLE. RESULTS: In chronic CLE, the dermal changes (basement membrane thickening, dermal colloid bodies, pilosebaceous atrophy, and periappendageal infiltrate) were more frequent, while in annular-subacute CLE, a more severe vacuolation of the basal layer and a greater number of epidermal colloid bodies were seen. In addition, pilosebaceous atrophy and more severe epidermal damage were almost exclusive to chronic CLE and annular-subacute CLE, respectively. CONCLUSIONS: Although some histologic differences between chronic and annular-subacute CLE exist, histopathologic diagnosis of the CLE subsets can only be accurately established when pilosebaceous atrophy or necrosis of all epidermal layers is observed.

Diagnosis, Differential↗
PubMed1991

Immunogenetic findings in cutaneous lupus erythematosus.

The serologic features and histocompatibility antigen associations of 93 patients with cutaneous lupus erythematosus are reported. Of them, 37 had chronic cutaneous lupus erythematosus and 56 had subacute cutaneous lupus erythematosus. Subacute cutaneous lupus erythematosus with an annular pattern occurred in 32 patients; 24 had a papulosquamous morphology. Sixty percent of patients with annular subacute cutaneous lupus erythematosus had anti-Ro antibodies. The incidence of this antibody in the other two groups was lower. In addition, patients with annular skin lesions had significant antigen association with HLA-B8 (37.5%; relative risk, 4.6) and HLA-DR3 (59.4%; relative risk, 4.3). There were no significant differences among chronic cutaneous lupus erythematosus and subacute cutaneous lupus erythematosus of the papulosquamous type and the control population for any HLA loci. Thus only patients with annular skin lesions represent a homogeneous subgroup in which there is a striking concordance of anti-Ro antibodies and the HLA-B8 and HLA-DR3 phenotypes.

Acute Disease↗