Primary squamous syringometaplasia with no underlying malignancy.
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Biomedical subjects
Publications and source records attributed to P Suvanprakorn.
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Twenty-nail dystrophy is a distinctive pattern of nail changes, in which all 20 nails are uniformly affected with excessive longitudinal ridging and loss of luster. Because of the rarity of this disorder, and controversy surrounding its cause and pathogenesis, we share our experience with five patients whose clinical diagnoses were consistent with 20-nail dystrophy. Histologically, all patients showed distinctive changes of spongiotic inflammation of the nail matrix. The cause and pathogenesis of these changes are still unknown. We suggest the concept that they represent a subgroup of endogenous eczema with a predilection for the nail matrix. A second, and less likely, hypothesis is that these lesions represent an autoimmunologic response to the nail matrix.
Idiopathic guttate hypomelanosis is a common skin disorder of unknown cause. Our studies have shown that significantly fewer dopa-positive melanocytes are in the white macules of idiopathic guttate hypomelanosis than in normal skin. By electron microscopy we observed that the melanocytes in the lesional skin were round and less dendritic with fewer melanosomes than in normal pigment cells. Lesions gently frozen with liquid nitrogen repigmented in 6 to 8 weeks. The number of dopa-positive melanocytes was significantly greater in the repigmented areas than in untreated lesions but less than in normal skin.
A case of papillary eccrine adenoma was studied by electron microscopy. Dilated ducts that contained granular eosinophilic material, often associated with intraluminal papillary projections were observed. The ductlike structures were composed of basal and luminal cells. Within the luminal cells there were intracytoplasmic cavities, but neither secretory granules nor glandular structure were observed. On the basis of our observations, papillary eccrine adenoma appears to differentiate toward ductal structures of the eccrine sweat apparatus.
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Patients with three types of leukoderma--vitiligo, idiopathic guttate hypomelanosis, and postinflammatory leukoderma--had successful repigmentation after transplantation of autologous melanocytes. The procedure was performed easily by producing blisters on normal skin and on depigmented lesions. Blisters were produced by suction or by freezing with liquid nitrogen. The roof of the blister from donor skin was grafted to the raw surface of the recipient site. Repigmentation was visible within 7 to 14 days. Direct immunofluorescence staining with bullous pemphigoid antibodies suggested that the separation of the epidermis from the dermis occurs within the lamina lucida. Histochemical studies confirmed the absence of dopa-positive cells in the areas of leukoderma prior to grafting. Melanocytes were present in the successful grafts.
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