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Biomedical subjects

L E Golitz

Publications and source records attributed to L E Golitz.

At least 55 records · Page 3Linked to original sources

Erythema multiforme: clinical, histopathologic, and immunologic study.

In a prospective study of erythema multiforme, forty-two cases were selected with the use of defined criteria. In thirty-three cases (79%), the erythema multiforme occurred following a lesion of recurrent herpes simplex; in four cases (10%), it was related to administration of a sulfonamide drug. Herpes-associated erythema multiforme (HEM) was largely recurrent erythema multiforme minor and was characterized histopathologically by inflammatory changes, such as spongiosis and exocytosis, and by focal liquefaction degeneration of the basal cell zone of the epidermis. Sulfa-associated erythema multiforme (SEM) was a nonrecurrent illness with widespread cutaneous and mucosal damage associated with prominent histologic necrosis of epidermal cells. The deposition of C3 and fibrin along the dermoepidermal junction and the deposition of IgM, C3, and fibrin around dermal blood vessels by immunofluorescence microscopy were similar in both groups. Although HEM and SEM may have somewhat different clinical and histologic features, there is significant overlap in the pattern of tissue damage.

Adolescent↗

Green foot.

Pseudomonas aeruginosa may infect the skin surface, nails, hair follicles, or deeper tissues. We report a 13-year-old male with an asymptomatic green discoloration of the toenails and sole of the right foot. Pseudomonas aeruginosa was cultured from the shoe, but not from the discolored skin. We suspect that constant wearing of occlusive, rubber-soled, basketball shoes associated with hyperhidrosis allowed colonization of his shoe with pseudomonas. This case is unique in that colonization resulted in a green color of the foot not associated with infection of the skin.

Adolescent↗

Bullous mastocytosis: diffuse cutaneous mastocytosis with extensive blisters mimicking scalded skin syndrome or erythema multiforme.

Bullous mastocytosis (diffuse cutaneous mastocytosis) is a rare form of mast cell disease that begins during the first month of life and causes extensive blisters that mimic scalded skin syndrome or bullous erythema multiforme. Discrete pigmented macules, papules, and nodules are absent and the characteristic leathery induration of skin may not develop until 6 months of age. Skin biopsy shows a subepidermal blister with mast cells at the base. The most serious complications are gastrointestinal hemorrhage and shock. The symptoms of bullous mastocytosis may be modified by a number of new therapeutic agents.

Burns↗

Clinical staging for cutaneous T-cell lymphoma.

The Mycosis Fungoides Cooperative Group has been following patients with cutaneous T-cell lymphoma, including mycosis fungoides and the Sézary syndrome variant. Previous analyses identified the extent of skin involvement and the number of sites of clinically enlarged lymph nodes as important prognostic variables. These two variables were used to classify 340 patients into four clinical stages. Repeat analysis based on additional followup data shows the usefulness of this clinical staging system for identifying patients with differing survival experience. An alternative grouping suggested by fitting a survival model to the data also has been studied. Staging systems based only on skin involvement and lymph nodes are recommended for general use because the information needed is readily available, requiring only physical examination.

Humans↗

Cutaneous leishmaniasis in an infant.

Cutaneous leishmaniasis (CL) in the United States is unusual. We report an infant who developed CL after returning from an endemic area. A skin biopsy yielded Leishmania organisms within 48 hours. The cutaneous lesions resolved with scarring after several months.

Humans↗

Scrotal calcinosis. Dystrophic calcification of epidermoid cysts.

Scrotal calcinosis, consisting of solitary or multiple circumscribed deposits of calcium within the dermis of the scrotum, has generally been assumed to be idiopathic. We have recently examined three patients in whom scrotal epidermoid cysts in varying stages of inflammation coexisted with scrotal calcinosis. Some cysts showed calcification of their keratin contents with little evidence of active inflammation. Other cysts showed rupture of their epithelial walls associated with the presence of keratin fibers, granulomatous inflammation, and calcium granules in the surrounding dermis. It seems that so-called idiopathic scrotal calcinosis may represent the end stage of dystrophic calcification associated with the inflammation of scrotal epidermoid cysts.

Adult↗

Median raphe canals of the penis.

Developmental abnormalities of the male genitalia can result in epithelial-lined canals or cysts which occur along the ventral median raphe from the glans penis to the anus. Although usually asymptomatic, secondary infection may produce swelling, tenderness and a purulent discharge. The canals are lined by stratified squamous epithelium which does not communicate with the urethra. Surgical excision is the treatment of choice.

Adult↗

Nevoid basal cell carcinoma syndrome. Multiple basal cell carcinomas of the palms after radiation therapy.

A patient with the nevoid basal cell carcinoma syndrome had been treated with radiation therapy to the hands at 5 years of age. Multiple basal cell carcinomas of the palms and dorsa of the hands developed when the patient was 28 years of age. It is proposed that the radiation therapy induced tumors in palmar pits that seem to represent a forme fruste of basal cell carcinoma. Radiation therapy should be avoided in individuals with the nevoid basal cell carcinoma syndrome.

Adult↗

Ciliated plantar cyst.

A 33-year-old woman had a solitary cyst of the right sole. The cyst was lined by ciliated columnar epithelium that varied in thickness from a single layer to pseudostratified layers. We suggest that the cyst may represent a developmental anomaly that resulted in the abnormal localization of cells with the potential for ciliogenesis.

Adult↗

Erythropoietic protoporphyria with hepatic cirrhosis.

Cholestatic jaundice and rapidly deteriorating hepatic function developed in a 19-year-old man with a lifelong history of photosensitivity. Laboratory studies revealed the characteristic increased erythrocyte and fecal protoporphyrin levels of erythropoietic protoporphyria. Progressive hepatic failure was treated by orthotopic liver transplantation six months after the first clinical indication of hepatic dysfunction. Characteristic light microscopic, fluorescence microscopic, and electron microscopic findings of erythropoietic protoporphyria were present in skin and liver. Four weeks after liver transplantation, the patient died of disseminated candidiasis. At autopsy, the donor liver had no microscopic evidence of protoporphyrin accumulation, although tissue protoporphyrin levels were mildly elevated.

Adult↗

Defective monocyte chemotaxis in mycosis fungoides: lack of essential helper lymphocytes.

The effect of lymphocytes on monocytes chemotaxis in vitro was studied using lymphocyte fractions prepared by glass bead column separation and mononuclear cell fractions prepared by Ficoll-Hypaque separation. The diminished monocyte chemotaxis in ten patients with mycosis fungoides was corrected in vitro by the addition of normal lymphocytes. This helper effect was not mediated by soluble factors. Lymphocytes from mycosis fungoides patients did not inhibit chemotaxis by monocytes from mycosis fungoides patients did not inhibit chemotaxis by monocytes from normal donors. No cell directed chemotactic inhibitor, differences in LDCF production in vitro or differences in circulating chemattractants were found. These data support the conclusion that the abnormal monocyte chemotaxis seen in mycosis fungoides is due to lack of essential helper lymphocyte function and represents an abnormal mononuclear cell interaction which may be important in the establishment of the mononuclear cell infiltrate in mycosis fungoides.

Adult↗

Status report of 376 mycosis fungoides patients at 4 years: Mycosis Fungoides Cooperative Group.

The frequency and prognostic importance of various characteristics of patients registered by the Mycosis Fungoides Cooperative Group between November 1974 and December 1977 are reported. Variables which were considered include demographic and historical factors, symptoms, extent of disease, and other physical findings. A staging system which is based on the extent of skin involvement and the number of nodal sites clinically involved is described. Finally, a description of therapeutic results to date for patients randomized into Mycosis Fungoides Cooperative Group protocols is presented.

Adult↗

Median raphe cysts of the penis.

The occurrence of a ventral cystic lesion of the penis should alert the clinician to the diagnosis of a median raphe cyst. The lesions, which are most common near the glans penis, may occur anywhere from the urethral meatus to the anus. Cysts of the median raphe represent defects in the embryologic development of the genitalia and are usually lined by entodermal epithelium. Surgical excision is the treatment of choice.

Adult↗