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Biomedical subjects

S A Muller

Publications and source records attributed to S A Muller.

At least 91 records · Page 5Linked to original sources
PubMed1981

Skin cancer in patients with psoriasis treated with coal tar. A 25-year follow-up study.

For many years, crude coal tar has been used for the treatment of psoriasis. The possible carcinogenic effect of crude coal tar and ultraviolet (UV) radiation (Goeckerman regimen), considered individually or in combination, has been of some concern to physicians. A 25-year follow-up study was completed on 280 patients with psoriasis who were hospitalized and treated with crude coal tar and UV radiation at the Mayo Clinic, Rochester, Minn, during the years 1950 through 1954. The results of this study suggest that the incidence of skin cancer is not appreciably increased above the expected incidence for the general population when patients are treated with coal tar ointments. It seems that the Goeckerman regimen (topical crude coal tar combined with UV radiation) can be used with minimal risk for skin cancer in the treatment of psoriasis.

Adult↗
PubMed1980

Incidence of skin cancers in patients with atopic dermatitis treated with coal tar. A 25-year follow-up study.

Coal tar ointments have been used for many years in the treatment of chronic eczematoid dermatitis. The possible carcinogenic effect of coal tar ointment and ultraviolet light (Goeckerman regimen), considered individually or in combination, has been of concern to physicians. A 25-year follow-up study was completed on 426 patients with atopic dermatitis and neurodermatitis who were hospitalized and treated with coal tar ointments and ultraviolet light at the Mayo Clinic from 1950 through 1954. These results were compared with those from a similar study that examined patients with psoriasis who also were treated with coal tar ointments and ultraviolet light. The results of this study suggest that the incidence of skin cancer is not significantly increased above the expected incidence for selected populations of the United States. This study offers reassurance about the relatively small risk of skin cancer developing in patients with atopic dermatitis and neurodermatitis treated with coal tar ointments and ultraviolet light (Goeckerman regimen).

Basal Cell Carcinoma↗
PubMed1980

Elastic tissue changes in skin following PUVA therapy.

Treatment of psoriasis with psoralens and high-intensity long-wave ultraviolet light (PUVA) produces changes in the ultrastructure of elastic tissue in skin. Early alterations consist of a loss of elastin followed by a breakdown of the microfibrils and subsequent fragmentation of the elastic fiber. Tissue examined 15 months after treatment was stopped still showed marked ultrastructural changes in the elastic fibers.

Elastic Tissue↗
PubMed1980

The coexistence of psoriasis and lupus erythematosus. An analysis of 27 cases.

From 1950 through 1975, 27 patients at the Mayo Clinic, Rochester, Minn, had coexistent psoriasis and lupus erythematosus (LE). Of the 27 patients, ten had systemic LE (SLE), 13 had discoid LE, and four had drug-induced LE or an SLE-like syndrome. The onset of psoriasis preceded LE in ten patients and was concomitant with it in six. Photosensitivity was noted in 23 patients. In 20 patients, the lesions of psoriasis and LE remained clinically distinct. Morphologic overlap and clinical interaction occurred in seven patients in whom the disorders were severe and complicated by a third disease. Generally, this latter group had extensive psoriasis, prominent photosensitivity, and a poor response to therapy.

Adolescent↗
PubMed1979

Melanocyte changes following PUVA therapy.

The effect of psoralens and long-wave ultraviolet light (PUVA) therapy on human melanocytes was studied at the ultrastructural level. The results demonstrate an increase in the number of melanocytes, a change in their location, and an increase in the size of the melanosomes. Significantly, some of the melanocytes extend in narrow columns deep into the dermis, limited by the basal lamina, while others are found free within the dermis. Other morphologic alterations in the melanocytes consist of abnormal mitochondria, a swollen and distorted endoplasmic reticulum, and large lysosomes. The aforementioned abnormalities were also present in PUVA-treated skin that was examined 15 months after the treatment had been stopped.

Furocoumarins↗
PubMed1979

Bilateral verrucous carcinoma of the feet.

A 51-year-old woman had had bilateral verrucous carcinoma of the feet for ten years. The tumors had been treated many times as extensive verruca vulgaris before a biopsy was performed and the true neoplastic nature of the lesion recognized. This case illustrates the necessity of performing biopsies on atypical or frequently unresponsive verrucous tumors.

Biopsy↗
PubMed1979

Porphyria cutanea tarda associated with lymphoma.

Three patients with porphyria cutanea tarda and lymphoma were seen at the Mayo Clinic. In one patient, the signs and symptoms of porphyria cutanea tarda and lymphoma occurred simultaneously, whereas in the other two, the porphyria was seen before the lymphoma occurred, three years before in one and one and a half years before in the other. Involvement of liver or marrow was not related to the development of porphyria cutanea tarda in any of the 3 patients. The porphyria cutanea tarda was not eased by radiotherapy or chemotherapy of the lymphoma, although it was probably less symptomatic after the patients were treated. While a relationship between porphyria cutanea tarda and lymphoma is speculative, confirmation will require a closer scrutiny of patients with these two diseases.

Aged↗
PubMed1978

Development of photosensitivity and an SLE-like syndrome in a patient with psoriasis.

An unusual case of photosensitive psoriasis and systemic lupus erythematosus-related syndrome was characterized by erythroderma, chronic urticaria, angioneurotic edema, intermittent low-grade fever, and polyarthralgias. Investigation revealed no measurable total hemolytic complement and markedly diminished levels of C4, C2, and C3. Microscopic examination of three skin biopsy sections of sun-exposed skin showed psoriasis. Skin biopsy sections of sun-exposed psoriatic plaques and of non-sun-exposed, uninvolved skin (which were stained with fluorescein-tagged anti-IgG, anti-IgM, anti-IgA, and anti-C3) showed granular deposits of IgM and C3 at the dermal-epidermal junction in the sun-exposed plaques, and IgM alone in a granular pattern at the dermal-epidermal junction in uninvolved skin. Antibodies to single-stranded but not double-stranded DNA were detected in the patient's serum. In addition, serum immune complex-like material was detected by sucrose density-gradient ultracentrifugation, standard anticomplementary assays, and radioimmunoassays using both C1q and monoclonal rheumatoid factor.

Adult↗
PubMed1977

Keratinizing dermatoses. Combined data from four centers on short-term topical treatment with tretinoin.

In four medical centers, 40 patients with keratinizing dermatoses were treated with topical tretinoin (vitamin A acid) 0.1% cream and salicylic acid 2% cream in a short-term, double-blind study. Tretinoin was the more effective treatment for several of the keratinizing dermatoses with the exception of palmar-plantar hyperkeratosis, for which it was not effective in the concentration and method of application used. The most striking clinical responses occurred in patients with lamellar ichthyosis and ichthyosis vulgaris. Local adverse reactions-chiefly pruritus, erythema, burning, excoriation, and irritation-were not severe and could be controlled by modification of the treatment regimen.

Administration, Topical↗
PubMed1977

Surgical treatment of calcinosis cutis in the upper extremity.

Recent surgical experience with 11 cases of calcinosis cutis has given the authors an opportunity to define the role of surgery in the management of this condition. In scleroderma associated with dermatomyositis, when complications or disability arise from one or more areas of calcinosis, surgery may give significant palliation. Wound healing, although a potential problem, does not constitute a contraindication to operative treatment. Damage to deep structures usually is avoidable, but in some instances is a reasonable trade-off for the benefits obtained. Follow-up has confirmed that surgery is beneficial to patient comfort and function, even in the few patients in whom some calcinosis recurred.

Aged↗
PubMed1976

Herpes zoster. Case report of possible accidental inoculation.

A 30-year-old healthy male physician developed grouped, papulovesicular lesions along the dermatomes of T1 and T2 of the left side of his body. The onset occurred two days after he accidentally pricked his right index finger with a needle that had been used to aspirate the acute papulovesicular lesion of a patient with severe herpes zoster. The clinical appearance and dermatomal distribution, the subsequent clinical course, the skin biopsy findings, and the substantial increase in complement-fixing antibody titer to the varicella-zoster (V-Z) virus in the convalescent serum samples are strong evidence for herpes zoster. Although it is generally believed that person-to-person transmission of zoster is rare and that herpes zoster results from the reactivation of a latent varicella virus, the present case suggests that zoster can be acquired from exogenous infection with a V-Z virus, at least in certain circumstances.

Accidents↗
PubMed1976

Malignant atrophic papulosis (Degros disease). A report of two cases with clinical and histological studies.

Two women had malignant atrophic papulosis that affected the skin only. Immunologic studies showed normal amounts of serum immunoglobulins and complement and normal delayed hypersensitivity skin test results. Fibrinolysis autografts showed complete loss of fibrinolysis within the lesions but normal fibrinolysis in uninvolved skin. Histopathologic studies showed moderate inflammatory infiltration consisting of lymphocytes in addition to the typical cone-shaped regions of necrobiosis. Large amounts of mucin also were seen. Endovasculitis, thrombosis, and perivascular lymphocytic inflammation were noted in the subcutaneous arterioles of the lesions in only one of the patients. Enzyme histochemical studies showed oxidative enzymes, although in reduced amounts, in the epidermal and dermal cells of the affected skin. Electron microscopic studies of lesions showed paromyxovirus-like inclusions in endothelial cells and fibroblasts. The possibility of an unusual viral causation should be examined further.

Adult↗
PubMed1976

Atopic dermatitis and IgE. Relationship between changes in IgE levels and severity of disease.

At the Mayo Clinic, atopic dermatitis was evaluated in a series of 28 patients to determine whether, during the course of the disease, serum IgE levels fluctuated with changes in the severity of dermatitis. The study covered a 1- to 11/2-year follow-up period. Previously, it had been shown that, at initial examination, serum IgE levels were positively related to the extent of disease. Although notable fluctuations in serum IgE levels and in extent of dermatitis were seen in more than half of the cases, no relationship was found between the two factors during the period of study.

Dermatitis, Atopic↗
PubMed1975

The treatment of genetic disorders.

Dermatologists see many patients with disorders that have an important but variable genetic component. Conditions caused by multifactorial inheritance, which account for many patients seen in dermatologic practice, have a strong environmental component in their cause and are generally the most responsive to therapy. Treatment is also possible for many conditions of dermatologic importance that are caused by mutant genes of large effect. At this time, there is little chance of treating the patient in the sense of genetic engineering, but some understanding of the theoretic basis for laboratory manipulation of DNA is a prerequisite to understanding the possible potential of new forms of therapy.

Animals↗