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Biomedical subjects

S J Brozena

Publications and source records attributed to S J Brozena.

14 recordsLinked to original sources
PubMed1994

Atypical beta 2-microglobulin amyloidosis following short-term hemodialysis.

A 47-year-old white female renal transplant recipient presented complaining of "wrinkles" that predominantly involved the palmar aspect of her fingers. Light-microscopic examination of biopsy material obtained from affected areas revealed deposits of amorphous, hyaline material in the reticular dermis that contrasted sharply with collagen and elastic fibers. Examination by transmission electron microscopy disclosed a mass of fibrils recognizable as amyloid, despite negative histochemical staining with both Congo red and crystal violet. Immunoperoxidase staining for beta 2-microglobulin was positive. Along with an elevated serum beta 2-microglobulin level, this finding supported the diagnosis of hemodialysis-induced amyloidosis (HIA). Unusual features of our case include lesion location, short duration of antecedent hemodialysis therapy, and negative staining for amyloid using conventional staining techniques.

Amyloidosis↗
PubMed1993

Attack of the scabies: what to do when an outbreak occurs.

Scabies remains a significant source of morbidity in nursing home residents because of its highly contagious nature. It is characterized by severe pruritus and papules, pustules, burrows, nodules, and occasionally urticarial lesions. Lesions are commonly found on the wrists, finger webs, antecubital fossae, axillae, areolae, periumbilical region, lower abdomen, genitals, and buttocks. Diagnosis is based on the history, physical examination, and demonstration of mites, eggs, or scybala on microscopic examination. Several topical scabicides are available, but permethrin cream appears to be less toxic and more effective in cases that are resistant to other agents. Successful management requires evaluation of individuals with close patient contact.

Cross Infection↗
PubMed1993

Nevus of Ota acquisita of late onset.

Nevus of Ota is a melanotic pigmentary disorder characterized by its distinctive cutaneous distribution involving skin innervated by the trigeminal nerve. Most cases are clinically manifest at birth or around puberty; however, acquired lesions in adults have been reported. We report a case of nevus of Ota acquisita that occurred in an eighty-one-year-old man.

Aged↗
PubMed1993

A case of kwashiorkor.

Kwashiorkor is part of the spectrum of protein-energy malnutrition. The condition results from a lack of nutritional protein coupled with carbohydrate excess. Protein malnutrition is much more common in the Third World; however, it is also the most common form of nutritional deficiency among hospitalized patients in the United States. Cutaneous clues to the diagnosis of protein deficiency include the "flag sign," hypochromotrichia, alopecia, "crazy pavement" dermatosis, pallor, and glossitis. Systemic manifestations include peripheral edema, liver disease, neurologic changes, diarrhea, weight loss, and hypoalbuminemia. We report here a case of profound kwashiorkor in a nonhospitalized patient who presented with multiple cutaneous and systemic findings indicative of protein malnutrition.

Adult↗
PubMed1992

Alkaptonuria and ochronosis: case report and review.

Alkaptonuria is a rare genetic disorder in which the enzyme homogentisic acid oxidase is deficient, resulting in the accumulation of homogentisic acid in various bodily tissues. This is a multisystem disorder with a characteristic blue-black discoloration of the skin and cartilage, which is termed ochronosis. Herein we report a profound case of ochronosis secondary to alkaptonuria. Furthermore, we review the clinical manifestations of alkaptonuria and discuss the spectrum of ochronosis, both endogenous and exogenous.

Aged↗
PubMed1992

Scabies: update on diagnosis and treatment.

Scabies, a pruritic, contagious skin disease, is endemic in our society. It is especially prevalent in schools and day care centers. Close physical contact, such as that of children playing, is required for transmission. During the past decade a new therapeutic agent has replaced standard therapy. Diagnosis, symptoms, possible complications and treatment options are discussed.

Humans↗
PubMed1990

Malignant melanoma: management guidelines.

The incidence of primary melanoma of the skin, once rare, has been increasing rapidly over the past few decades. Although it accounts for only 3% of all primary cutaneous malignancies, melanomas are responsible for two thirds of skin cancer-related deaths. Fortunately, early detection and surgical removal have resulted in a concomitant improvement in overall survival. Ongoing clinical trials are addressing various therapeutic alternatives, as well as whether any treatment modality will significantly increase response rates and survival in patients with advanced disease. These prospects are discussed, and current prognostic factors and available therapies reviewed.

Aged↗
PubMed1990

Pigmented skin lesions in the elderly: considerations in the differential diagnosis.

Malignant melanoma affects all age groups, but its highest age-specific incidence is in the elderly. Early diagnosis depends on the ability to identify potential precursor lesions and subtle changes in melanocytic nevi indicative of malignant degeneration. Familiarity with the clinical appearance of the common benign pigmented lesions is essential to minimize unnecessary biopsy procedures. Certain clues aid the differential diagnosis and enhance early recognition, which is presently the most effective means of reducing both the morbidity and mortality from this most ominous of skin cancers.

Adult↗
PubMed1988

Folliculitis decalvans--response to rifampin.

Folliculitis decalvans is a rare follicular inflammatory disease of the scalp. It is characterized by initial perifollicular inflammatory changes followed by peripheral extension and eventual circumscribed patches of cicatricial alopecia. The disease is known for its resistance to treatment, resulting in an unfavorable prognosis. The cause of the disease is unknown, although a bacterial etiology is postulated. We report a classic case that was temporized with various antibiotics and only subsequently resolved after ten weeks of therapy with rifampin. The patient has remained free of disease for more than one year. We present a brief review of the cicatricial alopecias and discuss rifampin therapy for this condition.

Adult↗
PubMed1988

Human adjuvant disease following augmentation mammoplasty.

Two patients are described in whom a progressive systemic sclerosis-like illness developed several years after silicone augmentation mammoplasty. Both had removal of breast implants, followed by marked-to-complete recovery from clinical abnormalities. This entity is increasingly recognized and has become known as human adjuvant disease.

Adult↗
PubMedDate not supplied

Epidemiology of malignant melanoma, worldwide incidence, and etiologic factors.

Malignant melanoma is increasing at an alarming rate, exceeding that of any other cancer in the United States today. Genetic susceptibility and exposure to ultraviolet radiation are thought to be the two most important risk factors for development of the neoplasm. While genetic factors cannot be altered, minimizing exposure to ultraviolet light, especially intermittent intense type, and photoprotective measures may significantly reduce the development of this ominous cutaneous malignancy.

Global Health↗
PubMedDate not supplied

Malignant melanoma: differential diagnosis of the pigmented lesion.

Familiarity with the clinical signs of malignant melanoma can result in earlier recognition and thus potentially decrease both patient morbidity and mortality. Unfortunately, several cutaneous tumors, both benign and malignant, have clinical similarities to this neoplasm, often making the correct diagnosis difficult. The purpose of this paper is to discuss the clinical characteristics of the different types of malignant melanoma and those lesions that mimic this ominous malignancy. Furthermore, diagnostic clues to help delineate between these various pigmented lesions are provided.

Diagnosis, Differential↗