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Biomedical subjects

S A Muller

Publications and source records attributed to S A Muller.

At least 73 records · Page 4Linked to original sources
PubMed1984

Treatment of parapsoriasis and mycosis fungoides: the role of psoralen and long-wave ultraviolet light A (PUVA).

Psoralen and long-wave ultraviolet light A (PUVA) was used to treat 12 patients with parapsoriasis and 19 patients with mycosis fungoides. Excellent results were obtained in all 12 patients with parapsoriasis: 8 patients had complete clearing, 3 had more than 80% improvement, and 1 had considerable improvement. The response to PUVA in patients with mycosis fungoides varied according to the stage of the disease. Of 10 patients with early disease (stage I or II), 7 had complete clearing and the 3 others had more than 80% improvement. The nine patients with more advanced disease generally did not respond well to PUVA, with the exception of one patient with stage IV disease and one with stage V disease. PUVA may be the treatment of choice for parapsoriasis and is highly effective in the early stages of mycosis fungoides.

Female↗
PubMed1984

Psoralens and ultraviolet A therapy of pityriasis lichenoides.

Three patients with long-standing pityriasis lichenoides, which was resistant to other forms of therapy, were successfully treated with PUVA (psoralens and ultraviolet light of wavelength A). One patient had complete clearing of all lesions, and the other two had marked improvement. PUVA is being used to treat increasing numbers of patients with pityriasis lichenoides, and the results have been very good.

Adult↗
PubMed1984

Olmsted syndrome--congenital palmoplantar and periorificial keratoderma.

We are reporting the third case of the Olmsted syndrome, an entity that has received little attention in the medical literature. The syndrome consists of congenital diffuse, sharply marginated keratoderma of the palms and soles, onychodystrophy , constrictions of digits, and periorificial keratoses. Our patient, in addition, had congenital universal alopecia, absence of a premolar tooth, leukokeratosis of oral tissue, and hyperlaxity of the joints. The differential diagnosis includes hidrotic ectodermal dysplasia of the Clouston type, pachyonychia congenita, acrodermatitis enteropathica, keratoma hereditarium mutilans of Vohwinkel , mal de Meleda , and other forms of palmoplantar keratodermas . This patient had originally been reported as having acrodermatitis enteropathica, a condition with which the Olmsted syndrome can easily be confused.

Adult↗
PubMed1984

Ecthyma gangrenosum: report of clinical, histopathologic, and bacteriologic aspects of eight cases.

The records of eight patients with ecthyma gangrenosum who were treated at the Mayo Clinic between 1970 and 1982 were reviewed. All patients had hematologic disease and had received immunosuppressive drugs. Patients with neutropenia that did not resolve by the end of a course of appropriate antibiotic treatment usually died. Solitary lesions of ecthyma gangrenosum were associated with a better prognosis than were multiple lesions. The typical skin findings of ecthyma gangrenosum usually occurred early and were often incorrectly diagnosed, resulting in time lost during which antibiotic therapy could have been instituted. For patients with ecthyma gangrenosum, a systematic procedure is important to establish the diagnosis early, so that appropriate systemic antibiotic therapy can be initiated.

Adult↗
PubMed1984

Pemphigus vulgaris: results of treatment with gold as a steroid-sparing agent in a series of thirteen patients.

Between 1974 and 1981, thirteen patients with pemphigus vulgaris were treated with prednisone supplemented by gold salts. Therapy resulted in excellent responses in eleven of the thirteen, with complete remission in seven. At a mean follow-up of 48.8 months, five patients still had complete remission and required no further treatment. Treatment of pemphigus vulgaris initially with prednisone followed by gold compounds is recommended as an important modality with relatively low morbidity and may permit lower effective doses of corticosteroids to be employed, occasionally even permitting their complete withdrawal.

Adult↗
PubMed1984

Pseudomonas aeruginosa infections of the skin.

Otitis externa, green nail syndrome, toe web infections, hot tub folliculitis, superinfections in chronic antibiotic-treated acne and infectious eczematoid dermatitis are examples of mild cutaneous infections due to Pseudomonas aeruginosa. These may occur in otherwise healthy persons. In persons with lowered resistance, more severe infections such as malignant otitis externa, blastomycosis-like pyoderma and necrotizing fasciitis are observed. Ecthyma gangrenosum, the pathognomonic skin sign of Pseudomonas septicemia, occurs in debilitated or terminally ill patients and must be treated immediately.

Acne Vulgaris↗
PubMed1984

Treatment of recurrent herpes simplex infections with L-lysine monohydrochloride.

In a prospective, randomized, double-blind, placebo-controlled, cross-over study of forty-one patients we found that oral ingestion of 1,248 mg a day of L-Lysine monohydrochloride shows evidence of decreasing the recurrence rate of herpes simplex attacks in nonimmunocompromised hosts. A dose of 624 mg a day was not effective. L-Lysine may also be capable of decreasing the severity of symptoms associated with recurrences. Neither dosage showed any evidence of shortening the healing time compared to placebo.

Administration, Oral↗
PubMed1983

The clinicopathologic spectrum of lymphomatoid papulosis: study of 31 cases.

Herein we review the Mayo Clinic experience with thirty-one cases of lymphomatoid papulosis seen since 1965. All patients had chronic, recurrent, and self-healing erythematous papulonodular lesions, which often became pustular, ulcerated, and resolved with scarring. The clinical features often corresponded to those seen in Mucha-Habermann disease; however, the predominant histopathologic feature was an infiltrate composed primarily of atypical lymphoid cells suggestive of malignant lymphoma. In six patients, a lymphoproliferative disorder was eventually diagnosed. There were two cases of mycosis fungoides (stage I), one case of nodular sclerosing Hodgkin's disease, and three cases of malignant lymphoma--one diffuse mixed large and small cell type with features of T-immunoblastic type, one diffuse large cell type, and one follicular small cleaved cell type. The clinical course of the lymphomatoid papulosis was unaffected by chemotherapy for the lymphoproliferative disorder. Our data indicate that, with sufficient duration of follow-up, malignant lymphoma may develop in some patients with lymphomatoid papulosis.

Adolescent↗
PubMed1983

Eosinophilic spongiosis: a clinicopathologic review of seventy-one cases.

Eosinophilic spongiosis has a distinctive but not diagnostic histologic pattern of the epidermis. This pattern may be seen in a wide variety of clinical disorders. We have observed it most commonly in bullous pemphigoid, particularly the urticarial stage. In most biopsy specimens that show eosinophilic spongiosis, additional definable histologic criteria allow a specific clinical diagnosis to be made. Rarely, clinical correlation and immunofluorescent data may be needed for a precise diagnosis. The location of eosinophilic spongiosis within the epidermis is generally not helpful in making a definite diagnosis. The peripheral eosinophilia, found in 61% and 46% of our pemphigoid and pemphigus cases, respectively, may be an important laboratory parameter in the evolution of this distinctive histologic pattern. Eosinophilic spongiosis occurs in early pemphigus lesions. However, its presence does not necessarily herald pemphigus, as a similar histologic pattern can be seen in pemphigoid and other disorders.

Adolescent↗
PubMed1983

Treatment of cystic acne with 13-cis-retinoic acid.

13-cis-Retinoic acid (Accutane) is an effective new agent for the treatment of severe cystic acne. The most encouraging feature associated with use of this drug is the persistence of remissions even after administration has been discontinued. The cutaneous side effects are mild to moderate and are usually well tolerated. Careful monitoring of the serum lipids is necessary. In 4 of our 10 patients, the levels of triglycerides became elevated. Of these four patients, three had lowering of the high-density lipoprotein fraction. In three of our most severely affected patients, nonhealing erosions with heaped-up granulation tissue developed at the sites of large acne cysts, which healed promptly after therapy was completed. For the present, we emphasize that use of Accutane should be reserved for severe acne that is unresponsive to conventional treatment; in such cases, careful clinical and laboratory monitoring is imperative.

Acne Vulgaris↗
PubMed1983

Subcorneal pustular dermatosis and pustular psoriasis. A clinicopathologic correlation.

The relationship between subcorneal pustular dermatosis (SCPD) and pustular psoriasis is discussed on the basis of a study of 23 patients with SCPD seen at the Mayo Clinic, Rochester, Minn, since 1956. In seven of the 23 patients, pustular psoriasis subsequently developed, and in three other patients there was associated psoriasis vulgaris. It was impossible to make a histopathologic distinction between SCPD and some cases of pustular psoriasis. The response to therapy with sulfones was erratic, if not ineffective. Our data suggest that disease identical to SCPD is, in many instances, strongly associated biologically, clinically, and histopathologically with psoriasis, and that continued observation of the clinical course may further substantiate this relationship in many cases.

Adult↗
PubMed1982

Kerion of the glabrous skin.

Five patients had kerion celsi on the glabrous skin. Four of these were farmers, and one was a veterinarian. The lesions occurred on the distal part of the forearm of four patients and in the breast area of one patient, most occurring during the spring months. Several of the lesions were misdiagnosed as bacterial infections or nondermatophytic fungal infections and were treated as such. Our report calls attention to this atypical form of localized inflammatory infection caused by tinea.

Adult↗
PubMed1981

Immunofluorescence in psoriasis: a clinical study of sixty patients.

Direct immunofluorescent microscopy was positive on skin biopsy specimens in thirty-one of sixty patients with various forms of psoriasis. Patients with positive immunofluorescence were classified into five main clinical subgroups: (1) psoriasis vulgaris with decreased tolerance to sunlight or ultraviolet light B (eight patients), (2) psoriatic arthritis (seven patients), (3) guttate psoriasis (five patients), (4) pustular psoriasis (four patients), and (5) "uncomplicated" psoriasis vulgaris (seven patients). Various patterns of deposition of immunoglobulins, complement, and fibrin were seen in the five subgroups, the most consistent being granular C3 at the basement membrane zone in specimens from five of the seven patients with guttate psoriasis. Direct immunofluorescent microscopy was usually negative in psoriasis vulgaris, but positive results may be anticipated in special forms of psoriasis.

Biopsy↗