Biomedical subjects
Publications and source records attributed to K J Tomecki.
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.
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This article on therapy provides an updated review, including pharmacology, indications, doses, and side effects, of the major antifungal and antiparasitic drugs.
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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.
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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.
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Of 9,375 inpatients consecutively discharged from a major university hospital during a six-month period, 2,912 (31%) had a serologic test for syphilis (STS) before or during hospitalization. Seventy-five patients (2.6%) had reactive serology, and further testing confirmed the diagnosis of syphilis in at least 56 patients (75%). Forty-seven (84%) of the 56 patients were aged 40 or more, and 32 (57%) were women; seven (12.5%) had a spinal tap. A history of venereal disease was recorded for only 20 patients (36%), and 16 had a positive history of venereal disease or exposure. Forty-three percent of patients with reactive serology, including those with a biologic false-positive reaction, had proper management, including treatment when indicated. Only 16 (28%) of the 56 patients with syphilis had evidence of adequate therapy either before, during, or after hospitalization. We conclude that STS is frequently omitted in the evaluation of hospitalized persons, and that even with evidence of positive serology, the diagnosis, proper interpretation, and therapy are often ignored.
Chronic blistering dermatosis of childhood (CBDC) in a 1-year-old black girl responded to the administration of sulfapyridine. CBDC is a rare blistering skin disease characterized by the presence of tense bullae and the linear deposition of IgA at the dermal-epidermal junction of lesional and perilesional skin. The disease may resemble bullous impetigo, bullous erythema multiforme, dermatitis herpetiformis, or pemphigus. The treatment involves the use of either dapsone or sulfapyridine.
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