Biomedical subjects
Publications and source records attributed to J R Pellegrini.
A middle-aged woman was admitted to the hospital with livedo reticularis of the extremities in addition to nonspecific symptoms and signs of hypothyroidism. The livedo reticularis disappeared with treatment of the hypothyroidism. Although livedo reticularis has been reported previously to be associated with thyroid disease, this association is rare. We review the literature and present the conditions associated with livedo reticularis.
It is established in the clinical literature that patients who develop specific types of malignancies are at an increased statistical risk for the development of a second primary malignancy. Previous studies have supported the theory that patients who develop primary cutaneous malignant melanoma (PCMM) have a greater risk for the development of a secondary primary noncutaneous malignancy (SPNM). Taken from the tumor registry of a community hospital, data for 504 consecutive patients (254 men and 250 women) with a diagnosis of PCMM were evaluated for the incidence of subsequent SPNM by comparing this series of patients to the general population of Connecticut. It was demonstrated that patients with PCMM had a significantly reduced incidence of SPNM (p = 0.002). Consideration should be given to possible biological and behavioral mechanisms which could explain the observed deficit.
This serious disorder of young adults is characterized by fever, hemolytic anemia, hemorrhagic signs, various neurologic abnormalities and renal dysfunction. Laboratory findings include a negative Coombs' test for hemolytic anemia, severe thrombocytopenia, and fragmented erythrocytes on the peripheral blood smear. Without treatment, mortality may exceed 80 percent. Early diagnosis and prompt therapy with high-dose corticosteroids and antiplatelet agents, as well as exchange plasmapheresis when indicated, bring about remission in 60 to 80 percent of patients.
Halo nevi may be associated with occult melanoma or may signify melanoma in a remote location. When a single halo nevus is present, the lesion should be biopsied to exclude melanoma. In addition, the patient's entire skin surface should be examined, and a careful ophthalmologic examination should be performed to exclude intraocular melanoma. Although the pathophysiologic relationship of halo nevus to melanoma is unclear, immunologic mechanisms have been postulated.
Polythelia (congenital supernumerary nipples) is a marker for more serious anomalies of the urinary and cardiovascular systems. It is associated with obstructive abnormalities of the kidney or the renal collecting system, renal agenesis, renal cell carcinoma, supernumerary kidneys, cardiac conduction disturbances and congenital heart disease.