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Biomedical subjects

R Friedman-Birnbaum

Publications and source records attributed to R Friedman-Birnbaum.

At least 19 recordsLinked to original sources

[Treatment of onychomycosis using 40% urea with 1% bifonazole].

The rate of success in treating onychomycosis with 40% urea ointment containing 1% bifonazole, with and without oral griseofulvin, was evaluated. Most patients had onychomycosis of the toes. 11 patients (group A: 5 men and 6 women, average age 48.5) were treated locally under occlusion with the ointment until dissolution of most of the nail, and then with 1% bifonazole cream for a total of 6 months. 11 others (group B: 3 men and 8 women, average age 42.5) received, in addition, griseofulvin 500 mg/day orally during that period. Treatment with the ointment alone did not give higher cure rates than the average of reported cure rates for griseofulvin alone. However, the results of treatment with 40% urea and 1% bifonazole ointment concomitantly with oral griseofulvin seemed superior to those of either of these agents alone, with full cure, partial cure and failure in group A of 22.2, 33.3 and 44.5%, respectively, and in group B, 45.4, 27.3 and 27.3%. This therapeutic experiment should be repeated in larger series of patients.

Administration, Oral

Malignant melanomas with histologic diameters less than 6 mm.

BACKGROUND: Malignant melanomas (MMs) with a small diameter (less than 6 mm) are rarely removed surgically; therefore there is a need for more data to characterize them. OBJECTIVE: The purpose of this study was to further elucidate the clinical and histopathologic features of small melanomas. METHODS: The greatest diameters of 112 consecutively submitted MMs were measured histologically. Those lesions with diameters of less than 6 mm were further studied clinically and histopathologically. RESULTS: Four MMs (3.5%) were found to have small histologic diameters. Their clinical features differed from the classic clinical ABCD's, although their histopathologic features resembled those of large MMs. Their depth of dermal invasion was relatively superficial, and their clinical outcome was favorable. CONCLUSION: Histopathologically, small MMs tend to resemble large MMs, but clinically they may require other diagnostic criteria. Because they tend to show a relatively superficial depth of invasion, their increased recognition and removal may have an impact on overall mortality from MM.

Adult

Influence of cumulative sun exposure on the prevalence of common acquired nevi.

BACKGROUND: Conflicting evidence exists on the relation between sun exposure and the number of common acquired nevi. The increase in the number of common acquired nevi until early adulthood and their greater concentration on sun-exposed areas suggested that the growth of common acquired nevi is promoted by UV radiation. Nevertheless, it was noticed that although solar exposure accumulates with age, the number of common acquired nevi decreases after the third decade. OBJECTIVE: Our purpose was to examine the relation between the prevalence of common acquired nevi and accumulative sun exposure. METHODS: The number of common acquired nevi on 128 patients with multiple solar keratoses (SK) was compared with their number on 82 control subjects. The existence of SK served as a biologic marker for long-term solar effects. RESULTS: On patients with SK we counted 1285 nevi (mean 10.0 nevi per person) and on control subjects, 1521 nevi (mean 18.5 nevi) (p = 0.0046; Kruskal-Wallis test). The finding that persons exhibiting signs of accumulating sun effects have fewer nevi was maintained irrespective to differences of gender, occupation, and complexion. CONCLUSION: Our data suggest that accumulating solar effects may contribute to the natural maturation and elimination of common acquired nevi in late adulthood.

Aged

A study of keratin expression in benign familial chronic pemphigus.

We studied keratin expression in the involved and uninvolved skin of six benign familial chronic pemphigus (BFCP) patients, using monoclonal antibodies specific for various keratin polypeptides and immunohistopathologic techniques. Normal and psoriatic (i.e., hyperproliferative) skin specimens served as controls. The uninvolved BFCP epidermis showed keratin profiles identical to that of normal epidermis. In the acantholytic epidermal segments of the involved BFCP skin, some of the lower suprabasal acantholytic cells failed to express keratin polypeptides 10 and 11 (Moll's catalog). This delay in expression of suprabasal keratins was not accompanied by an expression of hyperproliferative keratin polypeptide 16. Also, some of the lower suprabasal acantholytic cells of the involved BFCP epidermis retained staining by the antikeratin KS-1A3 antibody, which in the normal, psoriatic, and uninvolved epidermis was limited to the basal cell layer. Staining for keratin polypeptide 18 was negative in the epidermis of all four types of specimens. We believe that the delay in suprabasal keratin expression in the involved BFCP epidermis was more likely secondary to the acantholysis (i.e., "arrest of differentiation" due to acantholysis) rather than due to a primary defect in keratin expression.

Adult

Porokeratotic eccrine ostial and dermal duct nevus. An abnormally keratinizing epidermal invagination or a dilated, porokeratotically plugged acrosyringium and dermal duct?

Porokeratotic eccrine ostial and dermal duct nevus (PEODDN) has been said to represent a widely dilated, keratin-plugged acrosyringium and dermal duct. We have observed in a case of congenital PEODDN a normal-appearing, acrosyringium-like duct that traverses vertically the entire length of the parakeratotic column. Also, in its lower course, it stained positively for carcinoembryonic antigen, while the inner borders of the invagination from which the parakeratotic column arose stained negatively. This leads us to suggest that the epithelial structure in PEODDN is an abnormally keratinizing epidermal invagination through which an acrosyringium-like duct traverses, rather than an abnormally dilated, parakeratotically plugged acrosyringium and dermal duct.

Adult

Neutral lipid storage disease with ichthyosis: serum apolipoprotein levels and cholesterol metabolism in monocyte-derived macrophages.

Neutral lipid storage disease with ichthyosis (NLSDI) is an inherited metabolic disorder characterized by accumulation of neutral lipids, in a wide variety of cells, by a still unknown mechanism. Previous studies have shown normal cholesterol content in NLSDI granulocytes, fibroblasts and skin cells. Monocyte-derived macrophages possess an additional pathway of cholesterol uptake, which is not shared by these cells and which is not regulated by intracellular cholesterol levels. This pathway is thought to play a rôle in the process of atherosclerosis. Three NLSDI patients were studied. The serum levels of triglycerides, cholesterol, high-density lipoprotein cholesterol, and apolipoproteins A-I and B were within normal limits in all three patients. The intracellular levels of free and esterified cholesterol were measured in the monocyte-derived macrophages of one patient and found to be normal, while the triglyceride concentrations were twice as high as normal. The cholesterol esterification rates, which serve as a sensitive indicator of intracellular changes in cholesteryl ester levels, were normal in the monocyte-derived macrophages of all three patients. These findings provide further evidence that cholesterol metabolism is not disturbed in NLSDI, and it may be inferred that in this respect these patients are not at increased risk for atherosclerosis.

Adult

Classic Kaposi's sarcoma: T-lymphocyte subsets, T4/T8 ratio, and NK cell activity.

Lymphocyte function as expressed by T-lymphocyte subsets and natural killer cell activity was evaluated in a group of Israeli patients with classic Kaposi's sarcoma. T-cell subsets were examined in 28 patients, 14 with lesions limited to the lower extremities and 14 with diffuse cutaneous or systemic involvement. CD4 and CD8 lymphocytes and CD4/CD8 ratio were in the normal range in all patients, and mean values of the entire group were similar to a control group. However, CD8 was in the upper limits of the normal range in some patients with diffuse cutaneous or systemic involvement. This factor led to a significantly decreased CD4/CD8 ratio in that group as compared with the group of patients with the disease limited to the lower extremities. Mean values of natural killer cell activity in three effector/target cell ratios were significantly decreased in 13 of the patients with Kaposi's sarcoma with lesions limited to the lower extremities and in all of the patients with normal T-cell subsets and CD4/CD8 ratios.

Adult

A comparative immunohistochemical study of adenoid cystic carcinoma of the skin and salivary glands.

We performed an immunohistochemical study that compared a primary adenoid cystic carcinoma (ACC) of the skin with two salivary gland ACC. All three tumors stained positively and in identical fashion for epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), broad-spectrum keratins, and low-molecular-weight keratins. Both EMA and CEA were localized to the luminal surfaces and the secreted contents of the tubular structures and the ductlike structures of the cribriform formations. The staining reactions for both types of keratin were more intense in the cells lining the tubular structures and the ductlike structures of the cribriform formations. One of the two salivary ACCs stained positively for S-100 protein; the other was positive for vimentin. The cutaneous ACC was negative for both antigens. Leu-7 antigen was not detected in either type of ACC. These results show that primary cutaneous ACC and salivary ACC have similar immunohistochemical staining patterns for a number of antigens. We believe this similarity is due to the fact that these antigens are shared by the sweat glands and salivary glands, which are considered to be the respective sites of origin for these two types of tumors.

Adult

Seborrheic skin and acne vulgaris as protective factors against the development of basal cell epithelioma.

This study was conducted in order to evaluate a possible protective role of seborrheic complexion and a history of acne on the development of basal cell epithelioma (BCE). For this purpose, 77 patients with this tumor were examined and asked to fill out a questionnaire. The questionnaire included demographic data and questions about skin type, eye and hair colors, sun exposure habits and a past history of acne. The nature, number and location of tumors, the texture of skin and acne scars were noted by a physician. A group of 93 age-, sex- and skin-color-matched patients served as controls. The results show a clear relationship between seborrheic features and a lower risk of developing BCE, after controlling for solar exposure using the Mantel-Haenszel summary measure. The same trend was found in patients with a history of acne. Whether ultraviolet light absorption by sebum, an anticancer activity of Propionibacterium acnes or other factors play a protective role against the development of BCE is as yet unclear.

Acne Vulgaris

Interferon in the treatment of AIDS-associated Kaposi's sarcoma: the American experience.

This report is intended to summarize the use of Interferon in the treatment of Kaposi's sarcoma (KS) associated with AIDS. The review is basically focused on the trials in the United States, which resulted in approval by the Food & Drug Administration (FDA) of the use of recombinant interferon alpha for the treatment of Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome

Anticardiolipin antibodies in Behçet's disease.

Twenty-six patients with Behçet's disease were studied for serum levels of anticardiolipin (ACL) antibody isotypes IgG and IgM. The frequency of elevated levels of ACL antibody isotype IgM was found to be significantly increased in these patients. This increased frequency, however, did not correlate statistically with a thrombotic tendency, colchicine intake, antinuclear antibodies, or a positive VDRL test.

Adult

An immunofluorescence study of primary anetoderma.

Primary anetoderma (PA) has occasionally been described in association with lupus erythematosus (LE). The present study was performed to elucidate a possible causal link between PA and LE by the use of direct and indirect immunofluorescence (IF) methods. Two patients with PA were studied. Biopsy specimens were obtained from early inflammatory and atrophic anetoderma lesions and from the exposed and unexposed uninvolved skin of each patient. The pattern of immune deposits observed in one patient was indistinguishable from that which is often seen in systemic LE, and in the other patient from that which may be observed in chronic cutaneous LE. The direct IF study also showed fibrillar immune deposits in the dermis that resembled elastic fibres morphologically. The indirect IF study, however, failed to demonstrate anti-elastic fibre antibodies in the patients' sera. The results of this study and a review of the literature suggest that some cases of PA have direct IF findings similar to those of either chronic cutaneous or systemic LE. However, these findings, along with the serological findings, are insufficient to establish a diagnosis of LE in most of these PA cases.

Adult

Adult xanthogranulomatosis associated with abnormal plasma apolipoprotein levels.

A case of adult xanthogranulomatosis was investigated in depth for lipid abnormalities. The xanthogranulomatous lesion was shown to be composed primarily of cholesterol esters and triglycerides. Fasting plasma lipid levels and lipoprotein concentrations were within normal limits. Plasma lipoprotein electrophoresis and immunoelectrophoresis demonstrated normal high-density lipoprotein (HDL) and low-density lipoprotein mobilities. Polyacrylamide-gel isoelectric-focusing electrophoresis revealed increased levels of very-low-density apolipoprotein (apo) E, especially apo E-III. In the HDL fraction, apo-C-III and apo-E levels were both found to be slightly elevated. These findings might imply a causal relationship between the abnormal plasma apolipoprotein levels and the xanthogranulomatous disease.

Adult

Decreased natural killer cell function in patients with classical Kaposi's sarcoma.

Natural killer (NK) cell activity of peripheral blood lymphocytes was evaluated in a group of 13 patients with classical Kaposi's sarcoma (KS). All patients had a normal T4/T8 ratio, and the disease was confined to the skin of the lower extremities. A group of 5 healthy subjects served as controls. NK cell function was significantly decreased in patients as compared to controls. Our result is similar to that found in another group of patients with AIDS-related KS with lymphadenopathy and an abnormal T4/T8 ratio. This suggests that decreased NK cell function is not a result of a progressive process and might be directly involved in the development of KS.

Aged

Kaposi's sarcoma: retrospective study of 67 cases with the classical form.

The records of 67 Israeli patients with classical Kaposi's sarcoma treated at Rambam Medical Center were analyzed retrospectively for clinical and laboratory data. As expected, all except 1 patient were of Jewish origin. There was a male predominance with a ratio of 2.2:1. The age of onset was mostly during the 5th to 7th decades of life. The course of the disease was usually slow and indolent. As has been already noted, we found a higher frequency of diabetes mellitus (16.4%). Although a high frequency of second primary malignancy was seen in our patients, this was less so than that described in an American series, 15% as compared to 37%, respectively. The most frequent second malignancy was that of the lymphoreticular system. No serologic evidence for an association with types of herpes virus infection has been found. No alterations in humoral and cellular immunity were demonstrated. These data show similar clinical findings with those described in other series, besides the lower frequency of a second primary malignancy. Some discordance with that described before concerning the relationship with cytomegalovirus infection and T cells subsets was also noted.

Adult

Sensitivity and specificity of pathergy test results in Israeli patients with Behçet's disease.

Hyperreactivity of the skin to intracutaneous injection or needle prick (the pathergy test) is a unique feature of Behçet's disease. This phenomenon has been demonstrated to be highly sensitive and even specific in patients with Behçet's disease from Turkey, Japan, and Israel. A lack of positive reaction to this test has been reported in British and American patients. To evaluate the specificity of the pathergy test's results in Israeli patients with Behçet's disease, we compared their prevalence in these patients to that in a group of patients with other diseases associated with vasculitis. Forty-six Jewish and Arab Israeli patients with Behçet's disease, during a period of peak activity of their disease, and forty-six patients with other diseases associated with vasculitis, were studied for the hyperreactivity phenomenon. A positive reaction was observed in forty-five of forty-six patients with Behçet's disease, while the test gave negative results in all those with other diseases. Our study indicates, therefore, that the results of the pathergy test are highly sensitive and specific for Behçet's disease in Israeli patients.

Adolescent