Biomedical subjects
K J Tomecki
Publications and source records attributed to K J Tomecki.
Diffuse dermal histiocytosis. A variant of generalized granuloma annulare.
A young man had asymptomatic, confluent, annular erythematous/violaceous plaques on the trunk and extremities. Pathology showed a moderately dense dermal infiltrate of spindle cells characterized as non-X histiocytes by immunohistology and ultrastructural analysis. We believe this is an unusual form of diffuse histiocytosis and should be classified as a variant of generalized granuloma annulare.
Tinea capitis in three adults.
Three cases of tinea capitis in healthy adults are presented. In light of the very low incidence (less than 1%) of tinea capitis in nonimmunocompromised adults and the possibility of contagion from asymptomatic dermatophyte carriers in the pediatric and adult populations, the necessity for heightened clinical suspicion and diagnostic tenacity in the evaluation of adults with scalp dermatitis and/or alopecia for possible tinea capitis is underscored.
Mucocutaneous presentations of Crohn's disease.
Crohn's disease is an idiopathic inflammatory process that predominantly affects the gastrointestinal tract. Numerous extraintestinal manifestations of Crohn's disease involving the skin and mucous membranes have been reported in patients with documented intestinal disease. We report here on two patients who presented with multiple manifestations of Crohn's disease before intestinal disease was diagnosed. We review the mucocutaneous manifestations of Crohn's disease with an emphasis on presentations that precede gastrointestinal involvement.
Case report and review of resolved fusariosis.
Erythematous macules, nonpalpable and palpable purpura, and flaccid pustules developed in a 59-year-old man with acute lymphocytic leukemia 8 days after reinduction chemotherapy with cytosine arabinoside and daunorubicin. Tissue and blood cultures grew Fusarium proliferatum, and a skin biopsy specimen revealed fungal vasculitis. Anemia and muscle weakness accompanied the disseminated infection, for which the patient received granulocyte transfusions and amphotericin B, ketoconazole, rifampin, and griseofulvin. Skin lesions and fungemia resolved with recovery of the bone marrow, and 51 days after the completion of his chemotherapy he returned home. If promptly recognized and aggressively treated, disseminated fusariosis is responsive to therapy. Infection with Fusarium species should be suspected in profoundly neutropenic patients in whom disseminated palpable purpura and myositis develop concomitantly.
Myelodysplastic syndrome and transient acantholytic dermatosis.
Focal acantholytic dyskeratosis consistent with the clinical and histological features of Darier's type of transient acantholytic dermatosis occurred in a man with myelodysplasia. Topical steroids and systemic antihistamines provided temporary and moderate relief from pruritus, but failed to control the dermatosis.
Systemic mycoses.
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Bullous systemic lupus erythematosus.
Two patients with bullous systemic lupus erythematosus are reported. In one, the disease appears to have been caused by hydralazine. The cutaneous lesions of bullous SLE have not been previously reported in drug-induced lupus.
Treatment of discoid lupus erythematosus.
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Drug therapy of fungal and parasitic diseases.
This article on therapy provides an updated review, including pharmacology, indications, doses, and side effects, of the major antifungal and antiparasitic drugs.
Epidermolysis bullosa simplex responding to isotretinoin.
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Linear IgA bullous dermatosis mimicking erythema multiforme in adult.
This report describes a 49-year-old woman with an erythema multiforme--like rash and direct immunofluorescence showing linear IgA deposits at the dermoepidermal junction. Light microscopy revealed features of bullous pemphigoid, dermatitis herpetiformis, and erythema multiforme; immunoelectron microscopy demonstrated IgA deposition beneath the lamina densa about anchoring fibrils. These data provide additional information about the variable clinical and histologic manifestations of the adult linear IgA bullous dermatosis and emphasize the diagnostic dilemmas of light microscopy, which are resolved by immunohistochemical methods.
Niacin or niacinamide? Nicotinic acid or nicotinamide? What is the difference?
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Serologic survey for markers of hepatitis B infection in dermatologists.
A serologic survey for markers of hepatitis B virus (HBV) infection was conducted in 593 dermatologists. Serologic evidence for previous infection was found in 15.4%, indicating that dermatologists are an at-risk population comparable to many other specialties of medicine. Dermatologists with a history of blood transfusion, tattoo, and homosexuality had an increased prevalence of serologic markers for HBV. The type of practice, extent of surgery, and glove-wearing practices did not correlate with HBV serologic markers.
Cocaine-related bullous disease.
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