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Biomedical subjects

J C Maize

Publications and source records attributed to J C Maize.

At least 19 recordsLinked to original sources
PubMed1992

A histopathologic comparison of Shulman's syndrome (diffuse fasciitis with eosinophilia) and the fasciitis associated with the eosinophilia-myalgia syndrome.

A comparison of the histopathologic features of Shulman's syndrome (diffuse fasciitis with eosinophilia) and the fasciitis associated with the eosinophilia-myalgia syndrome is presented. The study population consisted of eight biopsy specimens of seven patients with Shulman's syndrome and 11 specimens from 10 patients with eosinophilia-myalgia syndrome. Both groups exhibited inflammatory changes in the subcutaneous fat, septa, and fascia; cutaneous changes were more prominent in cases of eosinophilia-myalgia syndrome. Eosinophils and plasma cells were not consistently present in either condition; mast cells and factor XIIIa-positive cells were consistently present in the inflammatory infiltrates. Although there was overlap in the histopathologic findings, Shulman's syndrome tends to involve the subcutis alone and the eosinophilia-myalgia syndrome tends to be a pancutaneous-subcutaneous process.

Eosinophilia↗
PubMed1991

The histopathology of dysplastic nevi. Continued controversy.

The histopathologic criteria used in the diagnosis of dysplastic nevi have been a source of controversy, as has the clinical significance of these lesions. Several dermatopathologists noted for their work on dysplastic nevi were asked to contribute responses to questions regarding the architectural and cytological criteria used to classify a melanocytic nevus as dysplastic, the terminology used to describe these lesions, and the role of dysplastic nevi as precursors of melanoma. Although no consensus has been reached regarding the cytologic features required for diagnosis of dysplastic nevi, there is substantial agreement regarding the architectural features of these lesions.

Diagnosis, Differential↗
PubMed1991

Circumscribed storiform collagenoma (sclerosing fibroma).

In the past several years we have examined eight dermal nodules that have morphologic features identical to the nodules described in patients with Cowden's disease. The patients in this series had no other clinical manifestations of Cowden's disease. In an attempt to better define this distinctive entity, we subjected tissue sections to a battery of histochemical and immunohistochemical stains and examined tissue from one of the nodules ultrastructurally. Although we found similarities between these nodules and other common dermal fibrotic lesions, we believe that they are distinctive architecturally (they are sharply circumscribed and have a strikingly uniform storiform pattern) and immunohistochemically (with uniformly scattered factor 13a-positive cells). Because of the unique histologic features, we propose that the term "circumscribed storiform collagenoma" be applied to these nodules.

Adult↗
PubMed1991

Morsicatio buccarum et labiorum (excessive cheek and lip biting).

In some individuals habitual cheek and lip biting becomes a fixed neurosis. Pieces of oral mucosa are actually torn free from the surface, producing a distinctive clinical appearance termed morsicatio buccarum et labiorum. Sometimes it may be confused with other dermatological disorders involving the oral mucosa, and can lead to misdiagnosis. Most patients with this condition are unaware of their habit and will not aid in the diagnosis. We suggest that the histopathological features of this condition are distinctive, if not pathognomonic, and that an accurate diagnosis should be rendered if a biopsy sample is taken. Two cases are reported herein that were originally misdiagnosed as pemphigus, one of which resulted in complications of improper oral corticosteroid use.

Adult↗
PubMed1990

Scleroderma, fasciitis, and eosinophilia associated with the ingestion of tryptophan.

An association between the ingestion tryptophan and a syndrome characterized by scleroderma-like skin abnormalities, fasciitis, and eosinophilia has recently been recognized in the United States. We report the clinical and histopathological findings in nine patients and the results of biochemical analyses of tryptophan metabolism in seven patients with this syndrome. Edema of the extremities, frequently accompanied by pruritus, paresthesia, and myalgia, developed in the nine patients (six women and three men; age range, 30 to 66 years) 1 to 18 months after the start of therapy with tryptophan (1.5 to 3.0 g daily) for insomnia, depression, or obesity. Five patients were taking drugs (benzodiazepines) known to inhibit hypothalamic-pituitary-adrenal function, and one had adrenal insufficiency. All had blood eosinophilia in the acute phase of their illness (mean eosinophil count [+/- SD], 3.62 +/- 2.87 X 10(9) cells per liter). All had histopathological changes in the dermis and subcutaneous tissue typical of scleroderma, and seven patients had eosinophils. The fascia was inflamed and fibrotic, and adjacent skeletal muscle often showed perifascicular inflammation. Tryptophan was discontinued in all patients, and eight received prednisone. The cutaneous symptoms improved, but only two patients had complete resolution of their illness. The patients had plasma levels of tryptophan before and after an oral dose of tryptophan that were similar to those in normal subjects. Plasma levels of L-kynurenine and quinolinic acid, which are metabolites of tryptophan, were significantly higher in four patients with active disease than in three patients studied after eosinophilia had resolved or in five normal subjects (P less than 0.001)--findings consistent with the activation of the enzyme indoleamine-2,3-dioxygenase. This illness resembles eosinophilic fasciitis and probably represents one aspect of the recently reported eosinophilia-myalgia syndrome. The development of the syndrome may result from a confluence of several factors, including the ingestion of tryptophan, exposure to agents that activate indoleamine-2,3-dioxygenase, and possibly, impaired function of the hypothalamic-pituitary-adrenal axis.

Adult↗
PubMed1990

Scleroderma following augmentation mammoplasty. Report of a case and review of the literature.

A 46-year-old woman developed localized scleroderma after surgical manipulation of her silicone gel-filled breast prostheses. She developed firm, shiny plaques on her legs that progressed to involve the thighs. Histopathologic examination of a deep-skin biopsy specimen confirmed the diagnosis of scleroderma. On surgical removal of the silicone implants, and their replacement with saline-filled implants, the scleroderma gradually resolved. Histopathologic examination of the removed implant capsules revealed evidence of silicone leakage. All new female patients with scleroderma should be questioned and examined regarding augmentation mammoplasty. Until prospective studies are completed on the possible association between scleroderma and silicone breast implants, it would seem prudent to use the saline-filled, elastomeric envelope-type breast implant for augmentation mammoplasty rather than the silicone gel-filled implant.

Breast↗
PubMed1990

Squamous syringometaplasia in lobular panniculitis and pyoderma gangrenosum.

Squamous metaplasia of eccrine sweat glands has been most frequently described in chronic cutaneous ulcerations with associated epidermal hyperplasia. We found examples of the process in skin biopsy specimens from five patients: three had associated lobular panniculitis and two had lesions of pyoderma gangrenosum. The metaplasia was located in the mid-to-deep reticular dermis in all five patients and extended into the superficial subcutis in one. Immunohistochemical stains for CEA and S-100 protein were used to accentuate the relationship of the metaplastic islands with eccrine ducts. It is postulated that necrosis of a portion of the eccrine duct is the stimulus for this process.

Adenoma↗
PubMed1990

Multiple rhabdomyomatous mesenchymal hamartomas of skin.

A case of multiple rhabdomyomatous mesenchymal hamartomas is presented. The patient is a black male infant, the product of an uncomplicated term gestation and delivery. At birth, there were numerous polyps distributed over the periorbital and periauricular areas bilaterally. Some appeared fingerlike with constrictions below their tips. Others were branched or globular in shape. These projections showed spontaneous and independent movement, particularly during feedings. On histopathologic examination, the polyps were covered by squamous epithelium and contained normal follicular units. Bundles of skeletal muscle were present in the reticular dermis, extending into the subcutis. Regular cross-striations were seen in these muscle fibers. In some specimens, the muscle bundles formed a solid, central core. Skeletal muscle histochemical stains confirmed the presence of both types 1 and 2 muscle fibers. Electron microscopy revealed a normal skeletal muscle banding pattern. This case is the first report of multiple rhabdomyomatous mesenchymal hamartomas of skin. Functional skeletal muscle with spontaneous movement is part of the clinical picture.

Diagnosis, Differential↗
PubMed1989

D-penicillamine-induced elastosis perforans serpiginosa in a child with juvenile rheumatoid arthritis. Report of a case and review of the literature.

Elastosis perforans serpiginosa is a rare complication of D-penicillamine therapy. It has been reported to occur in Wilson's disease and cystinuria, usually after many years of high-dose therapy. We report a case of D-penicillamine-induced elastosis perforans serpiginosa with unique clinical features occurring in a 10-year-old child with juvenile rheumatoid arthritis who received only 71 gm of the drug over 9 months. The case is also unusual because of the short course and low cumulative dose of drug received and because of the calcification of elastic fibers. The calcification of elastic fibers suggests that this case may represent an unusual variant of elastosis perforans serpiginosa or an overlap with pseudoxanthoma elasticum. All reported cases of D-penicillamine-induced elastosis perforans serpiginosa are reviewed, and histopathologic and electron microscopic findings are presented. The theoretic mechanisms of action of D-penicillamine on elastic tissue synthesis and morphology are discussed.

Arthritis, Juvenile↗
PubMed1988

A new method for the comprehensive automatic morphologic image analysis of Langerhans cells.

Standard techniques used to study Langerhans cell (LC) populations are tedious and time-consuming. We developed a rapid and comprehensive method to evaluate LC using automatic digital image analysis. Human epidermal sheets were stained with OKT6 monoclonal antibody and evaluated on an IBAS 2000 computerized automatic digital image analysis system. The fields were imaged on a Photomicroscope I using a high-resolution monochrome video camera. Each field was digitized, normalized, and filtered. The LC were discriminated by density; each field was interactively edited to separate overlapping cells and to bridge small gaps in the dendrites. The discriminated binary image of the LC was measured for number of cells per field, total area of individual cells per field, and percent of the field occupied by LC. The cell bodies were then separately discriminated and subtracted from the thinned cell image to allow a separate measurement of number and length of dendrites per cell. Finally, the binary cell image in a reference section was dilated to occupy approximately the total field area. This degree of dilation was then applied to all subjects to give the "area of influence." This methodology provides a rapid and comprehensive tool for the evaluation of LC.

Autoanalysis↗
PubMed1988

Papillary eccrine adenoma. A light microscopic and immunohistochemical study.

The papillary eccrine adenoma is a rare benign sweat gland neoplasm characterized by a potentially locally aggressive clinical course. The light microscopic findings in two cases of this unusual neoplasm are discussed, with emphasis on the differential diagnosis of this tumor from other benign and malignant sweat gland neoplasms. Immunohistochemistry studies directed against various epithelial antigens were also performed. Immunoperoxidase stains positive for carcinoembryonic antigen, S-100 protein, and epithelial membrane antigen strongly support the hypothesis that this unusual neoplasm differentiates toward the eccrine secretory coil.

Antigens↗
PubMed1988

Mucosal melanosis.

The labial melanotic macule has an increased number of dendritic melanocytes along the basal layer. Numerous counterparts of the labial melanotic macule occur on the other mucosal and cutaneous surfaces. Most melanoacanthomas of the lip show a similar number of melanocytes along the junctional zone. Melanoacanthoma of the lip differs histologically from the labial melanotic macule by the presence of intraepithelial dendritic melanocytes. It also has histologic counterparts that occur on other oral mucosal surfaces. Primary acquired melanosis of the conjunctiva is biologically different from the other mucosal melanoses because it frequently progresses to malignant melanoma. All mucosal melanoses must be taken seriously by the physician, because it is usually not possible to exclude malignant melanoma on clinical inspection alone. A biopsy is always indicated. The labial melanotic macule and melanoacanthoma demonstrate histologic features strikingly different from those of melanoma. Although intraepithelial dendritic melanocytes are seen in melanoacanthoma, they are mostly present in the lower portions of the epithelium, and there is no full-thickness haphazard dispersion of atypical single and nested melanocytes. Along the basal layer in melanotic macules and melanoacanthomas of the lip, melanocytes are arranged as solitary units without a tendency to form abnormal nests or become confluent, in contrast to the picture in melanoma. Melanocytes in this zone show no pleomorphism, in contradistinction to the often bizarre, atypical melanocytes seen in melanoma.

Conjunctiva↗