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Biomedical subjects

S L Moschella

Publications and source records attributed to S L Moschella.

At least 19 recordsLinked to original sources
PubMed1991

Vascular skin ulcers of limbs.

On clinical grounds, ulcers of the leg of vascular origin can fairly easily be separated into venous and arterial origins; 85% of ulcers of the leg are caused by venous insufficiency. The ulcers occur mainly around the medial malleolus, are covered by moist granulation tissue, and are surrounded by varying degrees of stasis dermatitis and brown hemosiderin pigmentation. The limb is usually edematous and improves with elevation. In contrast, arterial ulcers of the leg develop more distally on the toes or feet, severe pain is a prominent feature, and the dry crusted ulcers usually lack granulation tissue. Elevation of the leg aggravated the pain of ischemic ulcers, whereas dependency of the limb provides some relief. Both types of ulcers heal faster with occlusive dressings that furnish a moist wound environment. Patients with ulcers caused by venous insufficiency can have coexisting peripheral atherosclerosis. Compression elastic stockings used for venous insufficiency should not be so tight that they induce necrosis of the skin in patients with occult arterial disease.

Aged↗
PubMed1990

Mononuclear phagocytic and dendritic cell systems.

This review presents a classification scheme for disorders of the mononuclear phagocyte and dendritic cell systems. Previous classifications, based primarily on cytomorphology, are now obsolete. Electron microscopy, enzyme histochemistry, and, especially, immunocytochemistry have revealed the histiocyte identified by hematoxylin-and-eosin staining to be not one but several cell types. Currently, two broad groups of histiocytic cells are recognized, the monocyte-macrophage group and the dendritic cells. Dendritic cells are further subclassified as Langerhans cells, indeterminate cells, interdigitating cells, and dermal dendrocytes. Many disorders of the skin and other organs are characterized by proliferation of "histiocytic"-appearing cells. Some of these diseases clearly behave in a malignant fashion, whereas others follow a benign or variable course. At present, the proliferating cell type has been identified in only a few of these disorders by ultramicroscopy and cytochemical and immunocytochemical methods. Nevertheless, the pieces of the puzzle are beginning to fall into place. In general, those disorders that typically behave in a malignant fashion have been more extensively studied. The benign histiocytic disorders of children and adults are a heterogeneous group of diseases. Currently, some of these disorders are unclassified or classified with uncertainty. For example, how should severe histiocytosis with massive lymphadenopathy be classified? There is a proliferation of nonlymphoid mononuclear cells that are positive for S-100 protein and negative for CD1 and that exhibit lymphophagocytosis. Is this then a mononuclear phagocytic or dendritic cell disorder? Juvenile xanthogranuloma is a disorder of macrophages. Self-healing reticulohistiocytosis and solitary Langerhans cell histiocytoma are benign proliferative disorders of Langerhans cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Sarcoidosis. An updated review.

Sarcoidosis, a multisystem disease of unknown cause characterized by the formation of noncaseating granulomas, may involve any organ of the body, but the commonest sites of predilection are the lungs, lymph nodes, skin, and eyes. Sarcoidosis can be associated with polyclonal hyperglobulinemia, hypercalcemia, hypercalciuria, circulating immune complexes, cutaneous anergy, and in vitro depressed cell-mediated immunity. Recent studies of the cellular composition and cellular interactions of sarcoid-involved tissue have resulted in some insight into the pathophysiology of the disease. In early stages the predominance of activated T-helper cells in affected sites may account for many of the immunologic aberrations. The production of macrophage chemotactic substances by these cells may be the initial stimulus for the formation of the granuloma. The natural history of the disease is highly variable; the acute forms tend to resolve spontaneously, whereas the chronic forms rarely involute. Although multiple therapeutic modalities have been used and some have reportedly been effective, systemic corticosteroids remain the most effective available therapeutic agents.

Adrenal Cortex Hormones↗
PubMed1984

Neutrophilic eccrine hidradenitis: a distinctive rash associated with cytarabine therapy and acute leukemia.

Neutrophilic eccrine hidradenitis (NEH) is a recently described neutrophilic dermatosis associated with acute myelogenous leukemia (AML) and chemotherapy. This disorder is a distinct clinicopathologic entity separate from leukemid reactions and other neutrophilic dermatoses. We describe two cases in which plaques or nodules developed in the second week after initiation of induction chemotherapy for AML. The lesions regressed in 1 week and recurred in one case when induction chemotherapy was given a second time. Histologically, the findings were similar in each case. Neutrophils palisaded about and infiltrated the eccrine coil in which necrosis of secretory epithelium was present. Focal mucinous degeneration of the eccrine adipose tissue cuff was the only other significant alteration. No vasculitis was observed. Cultures and histologic preparations for pathogenic organisms were negative. Cytarabine was the chemotherapeutic agent used in all three cases. NEH most likely represents either an unusual response caused by cytarabine or a manifestation of AML. Recognition of NEH is important in order to exclude other neutrophilic dermatoses associated with AML, such as sepsis and leukemia cutis, which may appear clinically similar.

Cytarabine↗
PubMed1983

Leprosy today.

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Clofazimine↗
PubMed1982

Paget's disease of the male breast.

Paget's disease of the breast is a malignant lesion consisting of Paget cells in the epidermis and an underlying ductal carcinoma of the breast tissue. It is estimated that perhaps 3% of female breast carcinoma cases are Paget's disease. If one estimates male breast carcinoma to be approximately 1% of the rate in the female population, then Paget's disease in men is clearly a rare clinical event. Although Paget's disease has an epidermal component, little attention has been given to this entity in the dermatologic literature. We present a case report of this disease in an elderly male patient and comment on the clinical features which should alert the physician to the presence of the malignancy.

Aged↗
PubMed1980

Psoriasis.

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Animals↗
PubMed1979

Whole body surface electron irradiation in the treatment of mycosis fungoides. An evaluation of 200 patients.

The records of 200 patients with generalized cutaneous mycosis fungoides treated with whole body surface electron irradiation were reviewed. Type of skin lesion appeared to be the most important factor with respect to both survival and generalized skin disease-free interval. High-dose irradiation did not seem to influence prognosis significantly compared with a relatively conservative dose. The "cure" rate for the entire group was 7%. For a more homogeneous dose distribution, the eight-field technique is now used instead of the original four-field method. A new formula is proposed to standardize the reporting of doses.

Adolescent↗
PubMed1977

Chemotherapy used in dermatology.

Although systemic corticosteroids have been helpful in certain dermatologic conditions, their prolonged use may be cursed with serious side effects. Currently several dermatologic, immunologic, and proliferative disorders have been helped or controlled with cytotoxic and immunosuppressive drugs. A guideline for their use is advocated and described. The short- and long-term toxicity of these drugs is presented. The most frequently prescribed therapeutic programs for psoriasis, pemphigus and bullous pemphigoid lymphoma cutis, and metastatic melanoma are outlined and discussed. Lists of the most commonly used chemotherapeutic agents and of the diseases or conditions for which they have been or are used and of dosage and toxicities are given.

Adrenal Cortex Hormones↗
PubMed1976

Chemotherapy of psoriasis: ten years of experience.

The hunt for an effective, easier to administer, more acceptable therapeutic modality for extensive chronic psoriasis continues. The chemotherapy of psoriasis is reviewed in 246 patients from 1964 to 1974 treated with methotrexate, 92 patients from 1971 to 1974 with hydroxyurea, and 36 patients from 1972 to 1974 with azaribine. Currently, the available chemotherapy agents are the least palatable and desirable form of treatment. Methotrexate continues to be the most predictable, effective and least expensive. The use of photochemotherapy may prove to be more effective, less toxic, and more practical until a more specific and effective etiologically directed form of therapy becomes available.

Azauridine↗
PubMed1975

Cutaneous manifestations of internal malignancy.

Skin changes may result from metastases to skin or from chemicals or hormones that are secreted by the tumor, resulting in identifiable cutaneous syndromes, or may be inflammatory dermatoses, benign or malignant proliferative lesions, or nevoid states whose association is recognized but the mechanisms of which are unexplained.

Adenocarcinoma↗
PubMed1975

Double-blind controlled crossover high-dose study of Azaribine in psoriasis.

Azaribine used in high doses of 200 mg/kg a day is an effective agent in inducing temporary remissions in patients with severe psoriasis but potentially serious neurotoxicity may occur. Therapy should be initiated at lower doses of 125 mg/kg a day and advanced carefully only if clinical response does not ensue at the lower level.

Adult↗
PubMed1975

Hypersensitive and insensitive extremities. The dermatological aspects.

The importance of physically intact hands and feet is taken for granted and consequently not appreciated until they are functionally impaired by vascular or neural injury of disease. The pathogenesis and clinical manifestations of cutaneous lesions complicating hypersensitive and insensitive limbs are described. The current therapeutic approaches and measures for these conditions are presented. Protection and prophylaxis trauma for neurologically impaired parts are emphasized.

Female↗