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Biomedical subjects

R S Rogers

Publications and source records attributed to R S Rogers.

At least 19 recordsLinked to original sources
PubMed1992

Common lesions of the oral mucosa. A guide to diseases of the lips, cheeks, tongue, and gingivae.

Canker sores and cold sores are common, relatively banal diseases of the oral mucosa and lips, occurring most often in young persons. Some otherwise healthy patients may have a more severe variant, such as major aphthous ulcers, recurring lesions of aphthous stomatitis, or acute herpetic gingivostomatitis. Other patients may present with severe recurrent herpes simplex labialis or chronic oral candidiasis, and in these patients an immunodeficiency state must be considered.

Cheek↗
PubMed1992

Orofacial manifestations of Melkersson-Rosenthal syndrome. A study of 42 patients and review of 220 cases from the literature.

We investigated orofacial manifestations in 42 patients with Melkersson-Rosenthal syndrome who were examined at our institution between 1965 and 1990. Patient histories and histologic and clinical findings were reviewed in detail. These data were compared with the oral findings in 220 cases that were reported in the literature between 1965 and 1990. There were 28 females in our study. The age at onset of signs and symptoms varied widely with a mean of 33.8 years. Most frequent initial signs were labial edema, facial swelling, and Bell's palsy. During the course of the disease, 75% of all patients had labial swelling, 50% had facial edema, and 33% had Bell's palsy. Swelling, erythema, or painful erosions that affected the gingiva, buccal mucosa, palate, or tongue were common intraoral symptoms. A comparison with patients reported in the literature revealed a similar frequency of extraoral symptoms but more prevalent intraoral symptoms in our patients.

Adolescent↗
PubMed1992

Oral lesions in systemic lupus erythematosus. Do ulcerative lesions represent a necrotizing vasculitis?

BACKGROUND: It has been suggested that oral lesions in patients with systemic lupus erythematosus (SLE) may be grouped clinically as erythema, discoid lesions, or oral ulcerations. Oral ulcerations have been said to foretell a severe systemic disease flare and the proposal that oral ulcers represent a mucosal vasculitis has been suggested to explain this hypothesis. OBJECTIVE: Our objective was to test the hypothesis that oral ulcers in patients with SLE result from vasculitis. METHODS: We studied 10 patients with American College of Rheumatology (ACR) criteria for a diagnosis of SLE who had oral lesions of lupus (six prospectively and four retrospectively) clinically and by routine and immunofluorescence microscopy. Biopsy specimens were reviewed in a single-blinded fashion. RESULTS: In our patients, no oral lesion, regardless of morphology, demonstrated vasculitis histologically. All lesions demonstrated an interface mucositis. CONCLUSION: Our data strongly contradict the hypothesis that leukocytoclastic vasculitis explains a possible unproven correlation between oral ulceration and disease flares in patients with SLE.

Adult↗
PubMed1991

Cicatricial pemphigoid.

Cicatricial pemphigoid is a subepidermal blistering disease that involves the mucous membranes and the skin. The oral cavity and the eye are most frequently involved. The clinical course is of long duration, and often there is significant scarring that can have devastating sequelae. The majority of the patients are elderly. The disease is characterized by the in vivo deposition of an anti-basement membrane zone antibody. The anti-basement membrane zone antibody cannot be detected in the circulation by routine laboratory techniques. The pathogenesis is poorly understood, and the cause is not known. Cicatricial pemphigoid may remain localized to the oral cavity or the eye or the skin (Brunsting-Perry variety), or it may be generalized. It rarely occurs in children, and it may be drug induced. Efforts must be made to differentiate cicatricial pemphigoid from bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA bullous disease, and other vesiculobullous disease. Early recognition and treatment can improve the prognosis and avoid surgical intervention. Topical therapy is beneficial and expedites healing. Intralesional corticosteroids are effective and can help reduce the dose of systemic steroids. Most patients require systemic corticosteroid therapy. Dapsone is also useful in treating cicatricial pemphigoid, especially in patients in whom systemic steroids are ineffective or in whom they have to be discontinued because of side effects. Immunosuppressive agents (azathioprine or cyclosphosphamide) are indicated in patients with progressive disease. Occasionally both drugs may be needed.

Humans↗
PubMed1991

Multiple pilomatricomas and myotonic dystrophy.

Multiple pilomatricomas are rare. However, among patients with myotonic dystrophy, the occurrence is higher. The authors report a patient, to their knowledge the 11th case of multiple pilomatricomas associated with myotonic dystrophy, to emphasize that these tumors may be associated with the disease.

Adult↗
PubMed1990

Evaluation of ammonium lactate in the treatment of seborrheic keratoses.

A double-blind, paired comparison study was used to evaluate treatment effects of 12% ammonium lactate lotion (Lac-Hydrin) against its vehicle on seborrheic keratoses. Fifty-eight volunteer patients, 37 to 82 years of age, were studied for 16 weeks. The patients had a minimum of two seborrheic keratoses at least 10 cm apart. They applied the medication twice daily. The lesions were evaluated for height, surface characteristics, color, and length with the use of 7X calibrated loupe, a template, skin replicas, and scanning electron microscopy. Lac-Hydrin 12% lotion significantly reduced the height (elevation) of seborrheic keratoses, and two seborrheic keratoses cleared completely; however, there was no statistically significant difference in the length, color, and surface characteristics between the study group and the control group. Skin replicas and scanning electron microscopy can be used to evaluate lesion surface characteristics, dimensions, and therapeutic effects.

Dermatitis, Seborrheic↗
PubMed1990

Woolly hair nevus.

Woolly hair nevus is a rare, nongenetically determined condition in which unruly and tightly curled hair is localized on one or several areas of the scalp. We report the first case of woolly hair nevus with onset during adolescence. Marked improvement was evident 5 years after onset. Light microscopic examination of a biopsy specimen from the scalp showed a curved hair follicle. Scanning electron microscopic examination revealed slight fluting and marked flattening of the hair shafts. A discussion of these results and a comparison with those of the previously reported cases suggest that woolly hair nevus correlates with a variety of structural changes in the hair.

Adolescent↗
PubMed1990

Behçet's disease.

Explore the source record for details and available documents.

Behcet Syndrome↗
PubMed1989

Clinical correlations of linear IgA deposition at the cutaneous basement membrane zone.

To determine the specificity of linear IgA deposition at the cutaneous basement membrane zone for primary bullous disease, we reviewed the results of all direct immunofluorescence studies of skin biopsy specimens taken from patients seen at Mayo Clinic during the period 1982 through 1986. Of 4642 specimens submitted for direct immunofluorescence during this 5-year period, 44 from 42 patients showed linear IgA deposition at the basement membrane zone, with or without other immunoglobulins. Of these 42 patients, 36 (86%) had primary subepidermal bullous disease. Of the 36, 20 had linear IgA without IgG at the basement membrane zone (10 with clinical adult linear IgA bullous dermatosis, 2 with chronic bullous disease of childhood, and 8 with cicatricial pemphigoid). Sixteen had linear IgA and IgG at the basement membrane zone (10 with clinical cicatricial pemphigoid, 5 with bullous pemphigoid, and 1 with epidermolysis bullosa acquisita). There was a high frequency of mucosal involvement (67% of the 36 patients) and a somewhat higher frequency of ocular involvement in patients with cicatricial pemphigoid who had linear IgA without IgG at the basement membrane zone (6 of 8) than in those who had both immunoglobulins at the basement membrane zone (4 of 10). These results show that the direct immunofluorescence finding of linear IgA deposition at the basement membrane zone correlates with primary subepidermal bullous disease in a high percentage of patients but reflects a heterogeneous group of blistering disorders.

Adolescent↗
PubMed1989

Comparative efficacy of 12% ammonium lactate lotion and 5% lactic acid lotion in the treatment of moderate to severe xerosis.

This double-blind study was designed to evaluate treatment results and time effects of 12% ammonium lactate and 5% lactic acid lotion for moderate to severe xerosis. Results showed 12% ammonium lactate lotion was significantly more effective than 5% lactic acid lotion in reducing the severity of xerosis in both the 3-week, twice-a-day treatment period and the following 3-week, no-treatment (regression) period.

Adult↗
PubMed1989

Melkersson-Rosenthal syndrome: a review of 36 patients.

The Melkersson-Rosenthal syndrome is an uncommon condition of uncertain pathogenesis and cause. The classic triad of signs includes recurrent orofacial edema, recurrent facial nerve palsy, and lingua plicata. We retrospectively reviewed the medical records of 36 patients (24 women and 12 men) with elements of the Melkersson-Rosenthal syndrome. The complete triad was present in 9 (25%) patients. Orofacial involvement was the dominant feature; it occurred in all 36 patients and was the presenting sign in 15 (42%). Lingua plicata occurred in 18 (50%) patients, and peripheral facial paralysis was present in 17 (47%). Fourteen biopsy specimens were obtained, all from the orofacial region. Eight specimens revealed the classic pathologic picture of granulomatous cheilitis. No etiologic agent was identified in any of the patients. Diagnosis is difficult when all features of the triad are not present. A conservative treatment approach is recommended.

Adolescent↗
PubMed1989

Erythema nodosum-like lesions in Behçet's syndrome: a histopathologic study of 30 cases.

Thirty patients who fulfilled the criteria for complete and incomplete types of Behçet's syndrome were studied to determine the histopathologic changes of erythema nodosum-like lesions. Lymphocytic vasculitis was observed in 12 (40%) of the cases, but it was only focal in areas of severe lymphocytic inflammation and only mild in degree. No diffuse vasculitis was seen. It is our opinion that the observed lymphocytic vasculitis is only secondary to moderate or severe lymphocytic inflammation. Twelve cases (40%) revealed septal panniculitis, 10 cases (33%) demonstrated lobular panniculitis with moderate to marked inflammation and fat cell necrosis, and 8 cases (27%) showed mild and nonspecific inflammation in the panniculus. Therefore, there is a spectrum of histopathologic changes of erythema nodosum-like lesions in Behçet's syndrome, similar to that of erythema nodosum secondary to other systemic disorders.

Adolescent↗
PubMed1988

Cellular autoimmunity in psoriasis and lichen planus.

The objective of this investigation was to determine whether specific cellular recognition of the epidermis is associated with the human skin diseases, psoriasis and lichen planus. Epidermal cells (EC) obtained from biopsies of involved and uninvolved skin of patients with these diseases were used as stimulators and targets for autologous peripheral blood mononuclear cells (PBMC) in assays of three conventional manifestations of cellular immunity: lymphocyte transformation, leukocyte migration-inhibition and cell-mediated cytotoxicity. Parallel tests were conducted with autologous PBMC as stimulators to ascertain the tissue specificity of the reactions evoked by autologous EC. Similar assays were conducted with EC and PBMC from a large group of normal subjects, and the results were compared to those of the dermatology patients by rigorous statistical analyses. No evidence of lymphocyte-mediated cytotoxicity towards autologous EC was obtained with any of the subject groups, but autologous EC, and to a lesser extent PBMC, of the psoriasis patients, but not of the other two groups, evoked significant lymphocyte transformation. These results were obtained only with patients on Goeckerman therapy, raising the possibility that they were a manifestation of the treatment (topical coal-tar and ultraviolet light irradiation) rather than of the disease, although reasons are presented why this is unlikely. Clearer evidence of disease-associated autoimmunity was obtained in the leukocyte migration-inhibition assays, where autologous EC, and to a lesser extent, PBMC, of the psoriasis patients in general, not just those on Goeckerman therapy, and not those of the lichen planus patients or of the normal subjects, stimulated the release of a leukocyte migration-inhibition factor. These results support the concept of a central role for T-cell mediated autoimmunity in the pathogenesis of psoriasis.

Adult↗
PubMed1988

Pernicious anemia with associated glossodynia.

Glossitis and glossodynia are commonly seen by the dental practitioner. The awareness that these symptoms in conjunction with other oral signs indicate pernicious anemia is important for the clinician. Correct diagnosis can be made, and neurological complications avoided. Two case reports are presented and typical oral and systemic features of pernicious anemia are discussed.

Adult↗
PubMed1988

Dapsone therapy of cicatricial pemphigoid.

Dapsone and the related sulfapyridine have been valuable therapeutic agents in many inflammatory disease states although the exact mechanism of action remains unclear. In patients with mild CP or the localized (gingival or ocular) variants, dapsone has been shown to be a relatively safe, first drug of choice in therapy before commencing treatment with systemic corticosteroids and/or immunosuppressive agents. In patients with extensive, severe, or rapidly progressive CP, initial therapy with corticosteroids in a dose of 1 to 2 mg/kg/d of prednisone plus immunosuppressive agents such as azathioprine or cyclophosphamide in a dose of 2 to 3 mg/kg/d are recommended.

Dapsone↗