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Ronald P Rapini

Publications and source records attributed to Ronald P Rapini.

10 recordsLinked to original sources
PubMed2006

Epidermolysis bullosa acquisita occurring in 2 patients with hepatitis C.

We report 2 patients with documented chronic hepatitis C infection and epidermolysis bullosa acquisita (EBA). Both patients clinically represent classic EBA, exhibiting skin fragility and blistering occurring both spontaneously and secondary to trauma, which heal with milia and scar formation. EBA often is a disease of altered immune status and debility. Further work is necessary to show whether hepatitis C plays a causative role in EBA in these 2 patients and in general.

Adult↗
PubMed2003

Herpetic whitlow during isotretinoin therapy.

Isotretinoin is an extremely valuable drug that is occasionally associated with well-known mucocutaneous side-effects, including cheilitis, retinoid dermatitis, palmoplantar desquamation, and photosensitivity. Paronychia has been reported rarely: only two prior cases of herpes simplex infections associated with isotretinoin have been previously reported. We present the first known case of herpetic paronychia occurring in an atopic patient while on isotretinoin therapy for acne.

Acne Vulgaris↗
PubMed2003

Four cases of dermatomycosis: superficial cutaneous infection by Alternaria or Bipolaris.

Invasive dermal infections in immunosuppressed patients by a wide variety of opportunistic fungi are well described in the literature; however, superficial infections (dermatomycosis) are more rarely described. We report 4 cases of dermatomycosis by Alternaria or Bipolaris species. All but one of the patients had predisposing conditions including topical corticosteroid use, atopic or seborrheic dermatitis, and nail dystrophy. All 4 patients were otherwise immunocompetent. These cases represent some of the very few reports of Bipolaris in a primary stratum corneum infection and the first report of Bipolaris in an otherwise healthy person. We also describe what may be the first report of Bipolaris onychomycosis. All of our patients responded to topical or oral imidazole antifungal therapy. We discuss the significance of Alternaria and Bipolaris as contaminants or irrelevant organisms grown in some cultures of skin scrapings.

Administration, Oral↗
PubMed2002

CD4+ T lymphocytopenia with disseminated HPV.

BACKGROUND: There have been several reports of HIV-negative patients with chronic idiopathic CD4+ T lymphocytopenia, the diagnostic criteria for which are: depressed numbers of circulating T lymphocytes (less than 300/ micro l or less than 20%) on more than one occasion; no laboratory evidence of HIV-1 or HIV-2 infection; and the absence of any defined immunodeficiency or therapy associated with depressed levels of CD4+ T lymphocytes. METHODS: We report a patient with disseminated human papillomavirus infection associated with idiopathic CD4+ T-cell lymphocytopenia. A 50-year-old woman presented to the dermatology clinic with a 10-year history of widespread verrucae involving the skin and the cervix. RESULTS: Biopsy from the arm revealed a common wart. PCR analysis performed from the paraffin-embedded block was strongly positive for HPV type 2. Other HPV types (including EV-associated HPV 5, 8, 14, 15, 17) were not found. Further laboratory work up revealed T-cell lymphocytopenia, with an absolute CD4 count of 21. HIV tests were repeatedly negative. She was treated with interferon A 8 million units SQ three times per week with partial improvement. The patient underwent a hysterectomy for cervical dysplasia and a vulvectomy for vulvar intraepithelial neoplasia. She developed small-cell lung carcinoma and died. CONCLUSIONS: The diagnosis of idiopathic CD4+ T-cell lymphocytopenia should be considered in any patient with widespread viral, fungal, or mycobacterial infection whose HIV test is negative, and appropriate evaluation of the absolute CD4+ counts should be performed.

Carcinoma, Small Cell↗
PubMed2002

Epidermolytic hyperkeratosis associated with melanocytic nevi: a report of 53 cases.

Epidermolytic hyperkeratosis (EH) is a unique histopathologic alteration of the skin characterized by hyperkeratosis with perinuclear vacuolization of keratinocytes primarily in the stratum granulosum and the stratum malpighii. It is seen as an incidental finding in a variety of conditions, benign and malignant, as well as sporadic and familial. Recently, it has been reported that EH may be associated with dysplastic nevi (nevus with architectural disorder [NAD]). Cases of melanocytic nevi with epidermolytic hyperkeratosis were retrieved from the files of a referral dermatopathology laboratory over a 6-year period. We present a series of 53 cases of EH in both ordinary nevi and NAD. Epidermolytic hyperkeratosis identified in association with NAD accounted for 46 cases or 86.8% of the total lesions while ordinary nevi represented 7 or 13.2% of total cases. Our study confirms that the incidence of EH is higher in association with dysplastic nevi than in ordinary melanocytic nevi and may serve as a marker for NAD, but with lower sensitivity and only moderate specificity.

Adolescent↗
PubMed2002

Osteomas of the skin revisited: a clinicopathologic review of 74 cases.

Cutaneous ossification is an unusual event that may be primary or secondary to either inflammatory or neoplastic processes. It is classified as primary when it occurs in the absence of a demonstrable preexisting lesion. Secondary lesions have been most commonly reported occurring with pilomatricoma, basal cell carcinoma, acne vulgaris, and melanocytic nevi (nevus of Nanta). Histologically, the osteomas are composed of well-formed bony spicules with prominent cement lines and calcification. They may demonstrate osteoblasts, osteoclasts, and osteocytes and occasionally may even demonstrate bone marrow elements. We searched the files of a reference dermatopathology laboratory to identify cases of either primary or secondary cutaneous ossification. We present a series of 74 cases of primary and secondary cutaneous ossification. Most cases were secondary in nature. Lesions were more common on the head and neck and in whites. Lesions were also more commonly identified in female patients. In addition, included in our series are 19 cases of nevus of Nanta. To our knowledge, this represents the largest series of such cases in the English literature. Cutaneous ossification is seen both in primary and, more commonly, in secondary conditions involving the skin. Benign neoplasms, especially melanocytic nevi, represent the most common cause of secondary osteoma formation. Women are more commonly affected than men, but the reason for this is unclear. The exact reason why osteoma formation occurs is unclear and requires further study.

Adult↗
PubMedDate not supplied

Relapsing polychondritis.

Relapsing polychondritis is a rare disease most commonly presenting as inflammation of the cartilage of the ears and nose. Auricular chondritis, with red ears resembling infectious cellulitis, is the most common initial finding. Antibodies to type II collagen in cartilage are found, and the earlobes are classically spared. Chronic disease may result in a flabby, droopy ear, cauliflower ear, or saddle nose deformity. Acute involvement of the tracheal cartilage may cause collapse of the airway with obstruction and pulmonary infections. Arthritis may be oligoarticular or polyarticular, most often involving the costochondral junctions. Other manifestations include audiovestibular damage; heart valve disease; and neurologic, ocular, and renal disease. Corticosteroids remain the major treatment. Other therapies include nonsteroidal anti-inflammatory drugs, dapsone, colchicine, azathioprine, methotrexate, cyclophosphamide, hydroxychloroquine, cyclosporine, and infliximab.

Anti-Inflammatory Agents, Non-Steroidal↗