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Biomedical subjects

J P Callen

Publications and source records attributed to J P Callen.

At least 91 records · Page 5Linked to original sources
PubMed1994

Treatment of cutaneous lesions in patients with lupus erythematosus.

After proper classification of cutaneous lesions in LE patients and extensive evaluation, we can begin to approach effective therapy. Patients with CLE (DLE or SCLE) generally have a favorable prognosis and can be managed with safe yet effective therapy. Sunscreens are the most important topical therapy. Intralesional corticosteroids are an effective local adjunctive therapy, useful in bringing lesions under control. Systemic therapy with antimalarials, either used singly or in combination, is usually effective. When "standard" therapy fails, azathioprine, retinoids, or occasionally dapsone may be effective.

Adrenal Cortex Hormones↗
PubMed1994

Dermatomyositis occurring during psoralen A (PUVA) therapy.

Dermatomyositis (DM) developed in a 35-year-old woman after 2 months of psoralen ultraviolet-A (PUVA) therapy for presumed psoriasis. Her disease was characterized by symmetrical proximal muscle weakness and cutaneous lesions compatible with DM. In addition, laboratory abnormalities included a positive antinuclear antibody, and elevated levels of creatine kinase and aldolase. This is the first report of DM developing during PUVA therapy.

Adult↗
PubMed1993

Chlorambucil. An effective corticosteroid-sparing agent for patients with recalcitrant dermatomyositis.

OBJECTIVE: To investigate the effectiveness of oral chlorambucil treatment in patients with dermatomyositis (DM) that is recalcitrant to treatment with prednisone and/or immunosuppressive agents. METHODS: Five patients with recalcitrant DM were treated with oral chlorambucil, 4 mg/day, after discontinuation of the other immunosuppressive agent (azathioprine or methotrexate). Three patients were treated with a combination of prednisone and chlorambucil, and 2 with chlorambucil alone. RESULTS: Beneficial effects were noted within 4-6 weeks in all 5 patients, and corticosteroids were eventually discontinued in 4. Currently, only 1 patient is still receiving therapy; the other 4 have stopped chlorambucil after 13-30 months of treatment, and their disease remains in remission. Minimal chlorambucil toxicity was noted, consisting of leukopenia in 2 patients. CONCLUSION: Our findings suggest that chlorambucil is an effective, corticosteroid-sparing agent for the control of DM.

Administration, Oral↗
PubMed1993

Unilateral emboli in a patient with thrombotic thrombocytopenic purpura.

Thrombotic thrombocytopenic purpura is a rare disease most commonly associated with microangiopathic hemolytic anemia, thrombocytopenia, fever, neurologic disorders, and renal dysfunction. We describe a patient with a history of thrombotic thrombocytopenic purpura that had been quiescent for 4 months; he had a 3-week history of painful purpuric lesions on the left hand only. He also had mottling and a livedoid purpura of the distal fingertips, splinter hemorrhages of the left fingernails, and a decreased radial pulse. Findings of a biopsy specimen revealed multiple capillary and small vessel thromboses. Contrast aortography demonstrated a pseudoaneurysm of the proximal descending thoracic aorta with stenosis of the left subclavian artery at its origin and an associated thrombus.

Adult↗
PubMed1993

Cutaneous vasculitis and other neutrophilic dermatoses.

During 1991 and 1992 there was an abundance of articles dealing with vasculitis and its cutaneous manifestations, as well as with the perhaps related disorders known as neutrophilic dermatoses. This brief review will deal with some of the more controversial areas. The specific issues discussed are those relating to the "new" American College of Rheumatology classification system and its application to patients who have skin lesions of vasculitis, the recently associated diseases, and the newer therapies for vasculitis. In addition, recent publications regarding acute neutrophilic dermatosis (Sweet's syndrome) and pyoderma gangrenosum are briefly discussed.

Humans↗
PubMed1993

Ultraviolet recall associated with etoposide and cyclophosphamide therapy.

Ultraviolet recall (UR) or sunburn reactivation is an infrequently reported phenomenon. It is characterized by an erythematous eruption in the distribution of previous ultraviolet-induced sunburn. The timing of the eruption correlates well with the speculation that it is induced by the administration of a chemotherapeutic agent(s). The case of a young man who developed UR after treatment with etoposide (VP16) and cyclophosphamide is reported.

Adult↗
PubMed1993

Urinary retention associated with herpes zoster infection.

BACKGROUND: Herpes zoster infection particularly involving the sacral dermatomes has been associated with bladder and bowel dysfunction, most commonly urinary retention. CASE REPORTS: We report two patients who developed acute urinary retention, one of whom also had constipation, within days of herpes zoster skin lesions of the S2-S4 dermatomes. CONCLUSIONS: Herpes zoster is a reversible cause of neurogenic bladder and bowel dysfunction and should be considered in a patient that presents with acute urinary retention and/or constipation. Sensory abnormalities and flaccid detrusor paralysis are most likely involved in the pathogenesis.

Aged↗
PubMed1992

Cutaneous leukocytoclastic vasculitis associated with active Wegener's granulomatosis.

BACKGROUND: Cutaneous manifestations are common in Wegener's granulomatosis and may occur at any time during the illness. OBJECTIVE: Our purpose was to describe the relation of the appearance of cutaneous leukocytoclastic vasculitis to activity and other manifestations of Wegener's granulomatosis. METHODS: Three patients with Wegener's granulomatosis who had recent onset of skin lesions are reported. Data regarding the relation of their cutaneous disease to their systemic disease was collected. RESULTS AND CONCLUSION: In each case, onset of the skin lesions of biopsy-proven cutaneous leukocytoclastic vasculitis was associated with activation of the systemic features of Wegener's granulomatosis.

Adult↗
PubMed1992

Human papillomavirus type 11 in multiple squamous cell carcinomas in a patient with subacute cutaneous lupus erythematosus.

Squamous cell carcinoma (SCC) is a rare complication of cutaneous lupus erythematosus (LE). Aside from the documented role of ultraviolet light, SCC may arise in areas of chronic scarring, such as in lesions of discoid LE. Iatrogenic immunosuppression associated with organ transplantation also results in a predisposition to SCC, often with multiple tumors. A role for certain human papillomaviruses (HPV) in the development of squamous cell carcinoma has been documented; specifically, HPV types 5 and 8 are detected in SCCs in patients with epidermodysplasia verruciformis and in recipients of organ transplants. HPV-11 is generally found in benign genital condylomata or laryngeal papillomas, but has not yet been associated with malignancy. We describe a patient with non-scarring cutaneous LE who was treated with azathioprine and prednisone and developed multiple SCCs. HPV-11 DNA and the target oncogenes neu and Ki-ras were detected in tumor tissue with the polymerase chain reaction. The HPV may have been involved in tumor induction and the azathioprine may have been involved in tumor promotion.

Acute Disease↗
PubMed1992

Oral lesions in systemic lupus erythematosus. Do ulcerative lesions represent a necrotizing vasculitis?

BACKGROUND: It has been suggested that oral lesions in patients with systemic lupus erythematosus (SLE) may be grouped clinically as erythema, discoid lesions, or oral ulcerations. Oral ulcerations have been said to foretell a severe systemic disease flare and the proposal that oral ulcers represent a mucosal vasculitis has been suggested to explain this hypothesis. OBJECTIVE: Our objective was to test the hypothesis that oral ulcers in patients with SLE result from vasculitis. METHODS: We studied 10 patients with American College of Rheumatology (ACR) criteria for a diagnosis of SLE who had oral lesions of lupus (six prospectively and four retrospectively) clinically and by routine and immunofluorescence microscopy. Biopsy specimens were reviewed in a single-blinded fashion. RESULTS: In our patients, no oral lesion, regardless of morphology, demonstrated vasculitis histologically. All lesions demonstrated an interface mucositis. CONCLUSION: Our data strongly contradict the hypothesis that leukocytoclastic vasculitis explains a possible unproven correlation between oral ulceration and disease flares in patients with SLE.

Adult↗
PubMed1992

Oculocutaneous manifestations observed in multisystem disorders.

Patients with multisystem disorders frequently present with or eventually manifest cutaneous disease. Many of these patients will also manifest ocular changes. In these disorders, the dermatologist or ophthalmologist may act as primary provider or consultant. Thus, familiarity with these conditions will enable the specialist to provide better care for these patients. This article reviews the oculocutaneous manifestations of sarcoidosis, Behçet's disease, Reiter's syndrome, and Sjögren's syndrome.

Arthritis, Reactive↗