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Biomedical subjects

K H Neldner

Publications and source records attributed to K H Neldner.

At least 19 recordsLinked to original sources

Erythema gyratum repens: a paraneoplastic eruption.

Erythema gyratum reopens is a slowly expanding, mildly scaling dermatosis with a "wood-grain" pattern and is seen in patients with an underlying malignancy. To date only 49 cases have appeared in the literature, 41 of which (84%) were associated with a neoplasm, most commonly of the lung. Several patients also had pruritus, palmoplantar keratoderma, ichthyosis, vesiculobullous lesions, and/or eosinophilia. Histopathologic findings are nonspecific. The skin findings usually disappear with therapy for the underlying malignancy.

Diagnosis, Differential

Puncta pruritica.

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Back Pain

Double-blind randomized study of oral temafloxacin and cefadroxil in patients with mild to moderately severe bacterial skin infections.

A randomized, double-blind, multicenter study was conducted in 374 patients to evaluate the safety and efficacy of a 7-10-day regimen of oral temafloxacin (600 mg b.i.d.) or oral cefadroxil (500 mg b.i.d.) in the treatment of mild to moderate staphylococcal or streptococcal infection of the skin or skin structure. Specimens from the infected skin lesion were obtained for culture. A dermatologic assessment was made within 48 hours of starting therapy, 0-48 hours post-treatment, and once during the 5-9 days following the last dose of study drug. The most common diagnoses were abscess, superficial skin infection, cellulitis, and infection of the hair follicle/sweat gland. Clinical response rates exceeded 95% in both the temafloxacin and cefadroxil groups. A higher bacterial eradication rate was demonstrated in the temafloxacin-treated patients (91%) than in those receiving cefadroxil (84%). This was statistically significant in the subset of infections caused by Staphylococcus epidermidis (100% versus 81%, respectively; p = 0.032). Both regimens were well tolerated. These results indicate that temafloxacin is useful in the treatment of mild to moderate skin and skin structure infections caused by staphylococci or streptococci.

Adolescent

Hydroxyurea therapy.

Hydroxyurea's place in the scheme of psoriasis therapy has diminished in recent years. Some practitioners mistakenly believe that it is used only in desperate situations, is of little or no benefit in patients unresponsive to more conventional systemic therapies, and may predispose patients to the development of secondary malignancies. Moreover, a legitimate argument against the use of this drug may be made by physicians concerned about the proliferation of systemic therapies for what is a benign, albeit unsightly, eruption. However, hydroxyurea therapy is not without advantages. It is easily dosed, relatively inexpensive, and has few contraindications or subjective side effects. In addition, patients with common systemic disorders such as hyperlipidemia, mild renal insufficiency, and cardiopulmonary disease who may not be potential candidates for other medications may be managed with hydroxyurea.

Humans

Lichen planus.

Lichen planus, a papulosquamous disease, in its classical presentation is characterized by pruritic violaceous papules most commonly on the extremities of middle-aged adults. It may or may not be accompanied by oral and genital mucous membrane involvement. Its course is generally self-limited for a period of several months to years, but it may last indefinitely. There are many clinical variants described, ranging from lichenoid drug eruptions to association with other diseases such as diabetes mellitus, autoimmune disease, and the graft-versus-host reaction. The relationship of these, if any, to classical lichen planus is questionable. Multiple therapeutic options exist including corticosteroids, retinoids, griseofulvin, PUVA, and cyclosporine.

Humans

Multiple cutaneous granular cell tumors and neurofibromatosis in childhood. A case report and review of the literature.

Multiple cutaneous granular cell tumors have been previously reported in only 26 children or adolescents. An association of these tumors with neurofibromatosis has never been reported previously. We describe a 12-year-old black girl with multiple cutaneous granular cell tumors and neurofibromatosis. Although the histogenesis of these tumors is not completely clear, the findings of ultrastructural and immunohistochemical evaluation of our patient's tumors and the associated neurofibromatosis support a neural crest origin for granular cell tumors.

Child

Localized acquired cutaneous pseudoxanthoma elasticum.

Localized acquired cutaneous pseudoxanthoma elasticum is a new designation proposed for a nonheritable form of pseudoxanthoma elasticum (PXE), lacking the retinal and vascular stigmata associated with the inherited form of the disorder, but having skin lesions that are clinically, histologically, and ultrastructurally similar to those seen in the inherited type. A patient is presented with skin lesions confined to the chest and abdomen. Similar cases from the literature, some apparently idiopathic in multiparous black females and others with histories of cutaneous exposures to calcium salts, are grouped together as examples of the acquired form of PXE.

Adult

Acrodermatitis enteropathica.

Acrodermatisis enteropathical has had a remarkable hist orical course beginning only 35 years ago, first passing through a period of empiric management with the 8-hydroxyquinoline drugs and culminating with the discovery of a biochemical effect in zinc absorption. This accomplishment has not only resulted in the cure of a serious and often fatal disease, but has opened the way to an understanding of the vital role played by the trace element zinc in many previously unrecognized areas of human physiology.

Acrodermatitis

Neuropsychological findings with pseudoxanthoma elasticum.

It has been reported that the disease pseudoxanthoma elasticum (PXE) is associated with a high incidence of neurologic and psychiatric symptoms, which are possibly due to cerebrovascular ischemia. These reports are based mainly upon clinical observations made without reference to control group data. We have compared the results of 27 PXE patients with results of a control group on a battery of objective neuropsychological and personality tests. The PXE group showed only very mild deficits on extensive neuropsychological testing, a finding which argues against any marked involvement of cerebral vessels in these patients. Similarly, the personality test results did not reveal significant psychiatric disturbances which could be attributed to PXE. Possible reasons for the descrepancy with previous reports include the subjective data and much older PXE patients on which those reports are based. The need for systematic neuropsychological research with older PXE patients and control groups is suggested.

Adult