Biomedical subjects
N H Cox
Publications and source records attributed to N H Cox.
Angioma serpiginosum: a simulator of purpura.
We describe two patients with angioma serpiginosum who had both undergone a variety of haematological tests for investigation of purpura, but in whom careful examination of the skin demonstrated abnormal blood vessels rather than extravasated blood. Recognition of vascular disorders which simulate purpura may avoid unnecessary investigations.
Emollients, salicylic acid, and ultraviolet erythema.
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Dermatomyositis. Disease associations and an evaluation of screening investigations for malignancy.
Fifty-three adult patients (19 men, 34 women) with dermatomyositis were studied. Two had dermatomyositis associated with benign disorders. Twenty-three (43%) had a malignancy; the risk of malignancy increased with age, but there was no sex difference. Seven malignancies were recurrences and 9 were diagnosed during investigation of dermatomyositis; these 16 were suspected clinically or from abnormal results of simple investigations. Extensive screening tests did not increase the number of malignancies diagnosed. In 7 patients, a diagnosis of malignancy was made more than 9 months after onset of dermatomyositis, although a relationship between malignancy and dermatomyositis was uncertain in two cases; the diagnosis of gynecological malignancy was missed in 2 patients despite appropriate investigations, 1 patient had poorly controlled dermatomyositis, and in 2 patients late diagnosis of malignancy was due to failure to reinvestigate relapse of previously stable dermatomyositis.
Sweet's syndrome associated with polycythemia rubra vera.
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Oral 8-methoxypsoralen as a cause of topical phototoxicity.
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A modified dosage schedule for increased efficiency in PUVA treatment.
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Unilateral naevoid basal-cell-carcinoma syndrome--an individually controlled study of fibroblast sensitivity to radiation.
A patient with unilateral naevoid basal-cell-carcinoma syndrome (NBCCS, Gorlin's syndrome) provided a unique opportunity to compare the radiation sensitivity of fibroblasts from the affected and unaffected sides of the same individual. Although the growth rate of the fibroblast strain established from the affected side was faster than that from the unaffected side there was no difference in X-ray, UV-B or UV-C radiation sensitivity between fibroblasts from the two sides. These results are discussed in the context of previous studies of radiation sensitivity in NBCCS.
A case of quadrantic capillaropathy.
A case of transient pigmented purpuric dermatosis in an unusual segmental distribution is presented, and possible aetiological factors discussed.
Increased collagen-linked fluorescence in skin of young patients with type I diabetes mellitus.
Our objective was to determine whether the fluorescence of skin collagen, which may reflect the accumulation of advanced glycosylation end products, is increased in young patients with type I (insulin-dependent) diabetes. Our study design was a cross-sectional case-control study in a referral-based diabetic clinic in an academic hospital. Study subjects comprised a convenience sample of 18 type I diabetic patients aged 17-30 yr and 8 age-matched healthy control subjects. The fluorescence of collagen was measured in skin biopsy material. Collagen-linked fluorescence (CLF) was increased in diabetic patients (mean 10.5 [range 5.8-15.8] U/mg) compared with control subjects (7.6 [5.6-10.1] U/mg, P less than 0.02). In diabetic patients, CLF was related to age (r = 0.581) and duration of diabetes (r = 0.697) but not concentration of glycosylated hemoglobin (r = 0.082). Partial correlation analysis demonstrated that duration of diabetes is the main factor determining the fluorescence of collagen in these patients. There was a relationship between CLF and presence of diabetic retinopathy after the data were adjusted for patient age and duration of diabetes (P = 0.023). Increased fluorescence of skin collagen can be detected in young type I diabetic patients and is primarily related to duration of diabetes.
Angiolymphoid hyperplasia with eosinophilia: an uncommon tumor of the external auditory canal.
We present a case of an 80-year-old woman with a six-month history of painless nodules in her external auditory canal. Biopsies of these nodules revealed ALHE. This type of lesion rarely has been reported in the otolaryngologic literature, despite the fact that the head and neck are sites of predilection. The potential of malignancy with this disorder is debatable, and the histologic features overlap with other benign and malignant vascular tumors. Thus, adequate local excision is recommended.
Terfenadine inhibits itch and wheal, but not abnormal erythema, in physical urticarias.
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Naevoid hypertrichosis--report of a patient with multiple lesions.
Naevoid hypertrichosis is an unusual congenital disorder consisting of a solitary circumscribed area of terminal hair growth which is not associated with any other systemic abnormalities. We describe a patient with multiple areas of circumscribed naevoid hypertrichosis on the trunk and limbs who also had lipodystrophy at some affected sites.
Transient post-inflammatory digitate keratoses.
We report details of two patients who had digitate keratoses as a transient phenomenon following inflammatory skin disorders. In one patient, keratoses arose from the epidermal surface, from invaginated pits in the epidermis, and from follicles. Apart from the short duration of the lesions, the clinical and histological features were similar to previously reported cases of digitate keratoses.
Compound allergy to a skin marker for patch testing: a chromatographic analysis.
We present details of a patient who was demonstrated to have contact allergy to a solution used to mark sites of application of patch tests, during investigation of allergy to gold and nickel. Negative results were obtained when patch testing was performed using the individual constituents of the marker solution (gentian violet, dihydroxyacetone and acetone). Chromatographic analysis of various combinations of these chemicals did not identify a chemical derivative which might have caused this reaction.
Cutaneous drug eruption caused by 8-methoxypsoralen.
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A comparison of the dose-response relationship for psoralen-UVA erythema and UVB erythema.
Twenty patients with psoriasis were phototested to determine their erythemal responses to UVB and psoralen-UVA (PUVA) (oral 8-methoxypsoralen). The smallest ultraviolet radiation doses to produce erythema (minimal erythema dose and minimal phototoxic dose, respectively) were recorded and dose-response curves were constructed for UVB (24 hours after irradiation) and PUVA (48 hours) using objective measurement. The choice of a 48-hour measurement was validated by phototesting an additional 11 subjects to determine the time course of PUVA erythema. No correlation was demonstrated between minimal erythema dose for UVB, minimal phototoxic dose for PUVA, and sun-reactive skin type. The mean slope of the dose-response curve for UVB erythema was four times steeper than that for PUVA. Psoralen-UVA erythema reached a broad maximum between 48 and 96 hours after irradiation. Using objective methods we have demonstrated that the commonly accepted view of a steep dose-response relationship for PUVA erythema is not valid.
Lichen planus associated with captopril: a further disorder demonstrating the 'tin-tack' sign.
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