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Biomedical subjects

R B Amon

Publications and source records attributed to R B Amon.

12 recordsLinked to original sources

The glucagonoma syndrome. A distinctive cutaneous marker of systemic disease.

The glucagonoma syndrome is a rare clinical condition characterized by a distinctive cutaneous eruption associated with a glucagon-secreting islet cell neoplasm of the pancreas. A 19-year-old woman manifested typical features of this condition: a polymorphous skin eruption with characteristic distribution of lesions in perioral and paragenital regions; lesions in sites of cutaneous trauma; a skin biopsy that showed epidermal cleavage; glossitis; weight loss; mild anemia; abnormal glucose tolerance test results. Plasma glucagon levels, determined by radioimmunoassay, were approximately five times normal. Angiography indicated a pancreatic tumor with liver metastases. Islet cell origin was confirmed histologically. It is hoped that wider recognition of the distinctive clinical features of this syndrome will result in earlier detection and possible surgical cure of the underlying malignancy.

Adenoma, Islet Cell

Epidermal nevus and rhabdomyosarcoma.

A child with an epidermal nevus was diagnosed at the age of 15 months as having an embryonal rhabdomyosarcoma of the bladder. This child also had pigmentary abnormalities characteristic of the epidermal nevus syndrome. The question is again asked whether patients with epidermal nevi have an increased incidence of tumors. It is suggested that the thorough evaluation of these patients as recommended by Solomon should also include an alertness for the development of earlier-than-anticipated neoplasms.

Adult

Toxic epidermal necrolysis. Rapid differentiation between staphylococcal- and drug-induced disease.

Based on the difference in the level of epidermal split, staphylococcal-induced toxic epidermal necrolysis (TEN) can be rapidly differentiated from drug-induced TEN. The microscopic pathologic findings of the staphylococcal-induced disease shows epidermal cleavage high in the malpighian layer, while the nonstaphylococcal-induced disease shows a subepidermal split. Rapid differentiation is accomplished by histologically examining a frozen section of peeled skin obtained from a fresh lesion of TEN and by performing a Tzanck preparation on the denuded base. In order to illustrate these techniques, we present the cases of two adult patients with TEN; in one the disease was staphylococcal-induced while in the other it was drug-induced.

Diagnosis, Differential

Allergic contact dermatitis caused by idoxuridine. Patterns of cross reactivity with other pyrimidine analogues.

Idoxuridine has been used for many years in the treatment of herpex simplex infections of the eye. Use of the drug for herpes simplex infection of the skin is increasing. Ophthalmologists have noted occasional conjunctival and corneal irritant reactions, but no true delayed cutaneous hypersensitivity has been verified. We report four cases of allergic contact dermatitis from idoxuridine, sensitized by both eye and skin applications. Cross reactivity to brominated and chlorinated, but not fluorinated, pyrimidine analogues is noted. Extensive patch testing indicates the general relationship between the structure of pyrimidine compounds and their antigenic cross reactivity.

Adult