Current comments on cutaneous allergy. Management of antibiotic allergies.
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Biomedical subjects
Publications and source records attributed to M J Fellner.
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A retrospective study of patients with pemphigus vulgaris, drug eruptions, psoriasis, and normal controls was undertaken in an attempt to determine whether a significant difference in drug exposure and/or drug allergy existed between the various groups. A statistically significant difference in drug exposure was found between pemphigus vulgaris and drug eruption patients, as compared with psoriatics and normal patients. Representative case reports and some possible mechanisms for the induction or exacerbation of pemphigus patients is described and discussed.
A 39-year-old man developed allergic hypersensitivity to lidocaine hydrochloride and showed urticarial dermographism. Although hypersensitivity reactions to local anesthetics are rare and are usually due to esters of procaine, reaction to the amides of lidocaine can occur. A review of the literature for the past decade revealed only four reported cases of allergic hypersensitivity to lidocaine hydrochloride.
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Keratoacanthomas have been associated with multiple carcinomas, discoid lupus erythematosus, and multiple sebaceous gland tumors with colonic and gastric carcinoma. Steatocystoma multiplex has been associated with ichthyosis and koilonychia, pachyonychia congenita, multiple hairs and acrokeratosis verruciformis of Hopf, hypertrophic lichen planus, hypohidrosis, hypothyroidism, hidradenitis suppurativa, and hypotrichosis. We report a case of multiple keratoacanthoma associated with steatocystoma multiplex and rheumatoid arthritis.
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The skin of 41 patients including 16 blacks, 15 Caucasians, and 10 Hispanics, was observed using a fluorescent microscope. Three patterns of autofluorescence were observed: intercellular, cytoplasmic, and a combination of intercellular and cytoplasmic. The hair of 75 subjects, including 18 Negroes and 55 Caucasians, was observed. Two patterns were found: medullar and at the cortex. Skin form black patients was associated with the cytoplasmic pattern of autofluorescence. Compared to lighter skin, black skin was also significantly associated with increased intensity of autofluorescence, indicating that autofluorescence of the epidermis parallels the clinical degree of pigmentation. In the hair of 75 subjects, similar results were obtained: Negro hair exhibited more fluorescence than Caucasian hair, and darker hair (brown to black) exhibited more fluorescence than lighter hair (blond). This may be related to melanin and it breakdown products.
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A case of prostatic adenocarcinoma associated with extensive cutaneous metastases and malignant acanthosis nigricans is reported. Pertinent literature is reviewed. The pathogenesis of the possible mechanism of the development of cutaneous metastases in this as well as other related cases is discussed.
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Previous reports showed that cyclophosphamide used late in the treatment of patients with pemphigus vulgaris reduced the complications due to steroids. In this study, cyclophosphamide was used in the initial treatment of five patients with pemphigus vulgaris in combination with prednisone to avoid side-effects of prednisone. Two patients had no prior treatment with steroids for pemphigus. Results indicate that initial combined program may be a highly effective treatment method for pemphigus vulgaris. Followup from one to four years after treatment shows all five patients in remission; four require no medication.