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R F Palestine

Publications and source records attributed to R F Palestine.

9 recordsLinked to original sources
PubMed1983

Late-onset chronic mucocutaneous and ocular candidiasis and malignant thymoma.

Late-onset chronic mucocutaneous candidiasis (CMCC) is part of a spectrum of candidal infections. It usually develops during or after the fourth decade of life and is often associated with an underlying neoplasm, especially thymoma. A 56-year-old man with late-onset CMCC and thymoma had several unusual features. His malignant thymoma seemed to be more widespread than the thymomas of previously described patients. Ocular infection was present in addition to extensive involvement of the skin, nails, and oral mucosa. To our knowledge, this is the first report of ocular involvement in this syndrome. We also believe that this is the first patient with thymoma-associated late-onset CMCC to be treated effectively with ketoconazole.

Candidiasis↗
PubMed1983

Chronic mucocutaneous candidiasis and keratitis associated with malignant thymoma.

Chronic mucocutaneous candidiasis is a rare skin condition that may be associated with immunologic defects, failure of the endocrine system, or a neoplasm, especially thymoma. Ocular findings are rare. Our patients, a middle-aged man, had chronic mucocutaneous candidiasis in conjunction with an aggressive malignant thymoma. He was initially seen with recurrent Candida keratitis and subsequently had Candida esophagitis and a polymicrobial lung abscess. The skin, nail, mucous membrane, and conjunctival involvement responded to oral ketoconazole therapy. This syndrome consists of at least five groups, and various pathogenetic mechanisms and therapeutic agents have been proposed.

Candidiasis↗
PubMed1982

Diagnosis and treatment of mycetoma.

A mycetoma is a chronic granulomatous infection of the skin and subcutaneous tissue from which grains of the causative organism are eliminated through sinus tracts. In a patient with a suspected mycetoma, evaluation should include (1) elicitation of a history of trauma, (2) determination of the presence of the clinical triad of swelling, sinus tracts, and extrusion of grains, (3) roentgenographic examination, (4) examination of the grains, (5) histopathologic study, and (6) culture. Identification of the causative organism is important for guiding therapy; etiologic agents include actinomycetes, eumycetes, eubacteria, and dermatophytes. Whereas surgical treatment is still usually required for eumycetomas, various chemotherapeutic agents have shown promising results in the other types of mycetoma.

Actinomycetales↗
PubMed1982

Verruciform xanthoma in an epithelial nevus.

Verruciform xanthoma is an unusual lesion that was initially reported in 1971. Clinically, it is a verrucous, vascular, epithelial plaque or papillomatous growth commonly found on oral or mucosal tissues. Histologically, it is characterized by a verruciform epithelium with abundant parakeratosis and by foam cells occupying the vascularized dermal papillae. This is the second extramucosal verruciform xanthoma reported. Our patient had several unique features. She is the youngest patient described to date, her lesion is the largest reported, and the lesion occurred in an epithelial nevus-type eruption of a phocomelic extremity. Light and electron microscopic studies disclosed abnormal keratinization, mast cell proliferation, and the previously described foam cells. We believe that the verruciform xanthoma in our patient represents part of a reaction to the epithelial nevus occurring in association with a developmental anomaly.

Abnormalities, Multiple↗
PubMed1981

Epidermolysis bullosa acquisita: a heterogeneous disease.

The question of whether epidermolysis bullosa acquisita (EBA) is a distinct entity prompted a review of the Mayo Clinic experience. Twelve patients with this diagnosis were seen from 1955 through 1979, and their records were reviewed. Particular attention was directed to immunofluorescence microscopy (IF), which had been performed in seven patients. Direct IF was positive in seven patients, and indirect IF was positive in four patients. Although many cases of EBA may remain distinct, we believe that the morphologic appearance known as EBA may represent a final common pathway of disease expression in a heterogeneous group of patients with a variety of more specific diseases and that trauma serves as a localizing factor. Our findings indicate that cicatricial pemphigoid probably is the most common specific diagnosis but that all cases of EBA are not represented by this diagnosis. Furthermore, we conclude that when IF is performed, exclusion of other bullous diseases, which is a key criterion for the diagnosis of EBA, is more difficult than previously recognized.

Adolescent↗
PubMed1980

Skin manifestations of pentazocine abuse.

Seventeen patients who had cutaneous complications following pentazocine injections are presented. The mean age was 50 years; total daily pentazocine dose ranged from 60 to 2,400 mg; evidence of psychiatric illness was present in 94%, and previous drug or alcohol abuse was noted in 65%. Fifty-three percent of our series of patients had a medical or paramedical background. Eighteen percent had diabetes mellitus, and 65% had a personal or family history (or both) of diabetes. A hypothesis is presented for this association. Characteristic histologic findings included fibrosis of the dermis and panniculus, with vascular alterations, fat necrosis with granulomatous inflammation, and vascular thrombosis with occasional endarteritis. We emphasize that medical and paramedical personnel and patients with a personal or family history of diabetes should be added to the group of patients considered to be at special risk for cutaneous complications of pentazocine injections.

Adult↗
PubMed1980

Inflammatory changes in verruca vulgaris.

Forty-one (8%) of 500 randomly selected biopsy specimens in verruca vulgaris showed evidence of inflammation. The inflammation was lymphocytic and lichenoid in 21 specimens and was associated with papillary hemorrhage and infarction in 23. Clinical review indicated that patients of all ages were represented but that there was a predominance of verrucae of the extremities in older patients. The data suggest the possibility of a distinct solitary acral verruca in the elderly.

Female↗