Biomedical subjects
Publications and source records attributed to I McCrossin.
Most patients with HIV infection will develop an HIV-related lesion of the skin or mucous membranes before their progression to AIDS. As the skin is readily observed by patients and easily examined by doctors, skin disease presents a good opportunity for the early diagnosis of HIV infection.
Fifteen children with anogenital warts are presented. Twelve cases were referred for assessment of sexual abuse which was established in six cases, strongly suspected in one, and excluded in three. In two, the source was unclear. Papillomavirus typing was carried out by HPV DNA dot and Southern blot hybridization using mixed HPV 6/11, 16/18, and 2/3 DNA probes on 15 specimens from 12 of the children. Seven biopsy specimens were positive for HPV 6 or 11 and one hybridized with both HPV 6/11 and 16/18 mixed sets of probes. Two specimens were positive for HPV 2, and a further two hybridized with both HPV 18 and 2. Three wart specimens could not be typed with the available genital or skin probes. The viruses causing genital tract papillomata are the same for children and adults. The identification of HPV 16/18 raises the concern of potential oncogenicity and stresses the need for long-term assessment. The diagnosis of sexual abuse was made on history rather than examination, as only two cases showed additional physical signs of sexual abuse. It is advocated that the presence of anogenital warts alone be sufficient grounds to pursue the possibility of sexual abuse. Nonsexual transmission, although possible, is far less likely.
One hundred thirty-one patients with epidermal nevi are reviewed. The commonest site of involvement was the head and neck, and 13% of patients had widespread lesions. Ages of onset ranged from birth to 14 years. A spread beyond the original distribution was noted in 37% of patients. Many clinical patterns occurred, including eight cases of inflammatory linear verrucous epidermal nevus. A variety of other cutaneous abnormalities were found. Biopsies were performed in 41 cases. Three patients developed secondary tumors. One hundred nineteen of the patients were assessed for the presence of abnormalities in other organ systems. One or more abnormalities were demonstrated in 33% of patients, and in 5%, five or more abnormalities were detected. This study indicates that patients with epidermal nevi are at significant risk of having other abnormalities and warrant detailed initial assessment and close follow-up.
Skin biopsy specimens from four patients who had recurrent bouts of lesions conforming to the clinical description of acne necrotica were studied. The pathologic findings were dominated by lymphocytic inflammation around centrally placed follicles evolving to follicular necrosis that extended to the perifollicular epidermis and dermis. Early lesions showed the development of multiple individual necrotic keratinocytes within the follicular sheath and adjacent epidermis with lymphocytic exocytosis. Later lesions showed more intense necrosis and scale crust obscuring the central target but were still dominated by a peripheral lymphocytic infiltrate. The early pathologic findings of acne necrotica (varioliformis) are represented by a necrotizing lymphocytic folliculitis and differ from the pattern seen in association with nonspecific excoriations, acute bacterial folliculitis, classic comedogenic acne, or acnitis.
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The occurrence of pustular folliculitis in eight people after the use of health-spa whirlpools is described for the first time in Australia. The lesions were discovered ad identified during the peak season in two resorts in the Snowy Mountains area near Jindabyne, New South Wales. Pseudomonas aeruginosa, identified as serotype 0:6, was isolated from pus swabs of the lesions, water in the spa pools and pool filters.
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