Family violence, child abuse, and anogenital warts.
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Adult↗
Biomedical subjects
S S Raimer
Publications and source records attributed to S S Raimer.
Grafting of leg ulcers with undifferentiated keratinocytes.
A procedure for transplanting cultured human keratinocytes has been developed and used successfully to treat patients with persistent leg ulcers. Shave excisions of donor skin of 1 cm2 or less were expanded in culture in 1 week to cover wounds as large as 90 cm2. The uniqueness of this system is the use of a biochemically modified surgical dressing that permits the transplantation of undifferentiated cells. Several hours after inoculation, trypsinized single cells become attached to the dressing and are ready for grafting. Seven of eight persistent stasis ulcers completely reepithelialized after application of the modified surgical dressing with undifferentiated keratinocytes.
Bandages↗
Omenn's syndrome and related combined immunodeficiency syndromes: diagnostic considerations in infants with persistent erythroderma and failure to thrive.
A 4-month-old male infant had a 2-month history of an exfoliative erythroderma and alopecia. Recurrent mucosal infections, diffuse lymphadenopathy, hepatosplenomegaly, lymphocytosis and eosinophilia, anemia, and failure to thrive later developed. Investigation revealed a combined immunodeficiency with T cells of an unusual phenotype in his peripheral blood, skin, and lymph nodes. Our patient's clinical manifestations most closely resemble Omenn's syndrome, a rare form of autosomal recessive combined immunodeficiency.
Alopecia↗
Treatment of necrolytic migratory erythema in glucagonoma syndrome.
The glucagonoma syndrome is characterized by elevated serum glucagon, a pancreatic alpha-cell tumor, anemia, hypoaminoacidemia, and necrolytic migratory erythema. Necrolytic migratory erythema may cause marked morbidity and is frequently misdiagnosed. A 42-year-old white woman with a 1 1/2-year history of refractory dermatitis (most severe on the lower extremities) had the glucagonoma syndrome. Her severe morbidity was markedly relieved with the administration of intravenous amino acids. This therapy was successful in controlling the necrolytic migratory erythema through recurrences after somatostatin (SMS 201-995), surgical debulking, and chemotherapy proved inadequate.
Adult↗
Cutis verticis gyrata.
When the scalp exhibits folds and furrows resembling gyri, it is termed cutis verticis gyrata. The possible etiologies may be categorized as primary essential, primary nonessential, and secondary cutis verticis gyrata. This is based on history, physical examination, and histologic criteria with or without laboratory examinations.
Adult↗
Stump the experts.
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Diagnosis, Differential↗
A new type of connective tissue nevus: isolated exophytic elastoma.
An unusual case of isolated exophytic elastic tissue nevi in the scrotal region of a 64-year-old man is described. The histological and ultrastructural findings were those of abundant abnormal elastic fibers and increased reticulin in the dermis. This hamartomatous lesion possesses clinical and histological features previously undescribed in connective tissue nevi.
Elastic Tissue↗
A surgical treatment for vitiligo: autologous cultured-epithelial grafts.
Medical treatment of vitiligo has been disappointing; therefore surgical treatments using autologous grafts have been tried. We investigated a new technique in which normally pigmented epidermal cells from a vitiligo patient were cultured on a collagen-coated membrane in MCDB-153, a media that supports melanocytes and keratinocytes. The cell/collagen-coated membrane was used to cover a superficially dermabraded vitiliginous area. Clinical repigmentation, though incomplete, was evident in three of four patients in 4 weeks. Immunofluorescence and electron microscopy were performed on the grafted areas (involved and uninvolved controls). These studies demonstrate the reappearance of melanocytes and melanosomes within the grafted area. All three patients who were successfully repigmented retained their pigment at 1 year follow-up. Further investigation of this promising treatment for vitiligo is warranted.
Adult↗
Histiocytic syndromes.
The histiocytic syndromes are currently divided into two major categories: Langerhans cell histiocytosis and non-Langerhans cell histiocytosis. The disease entities recognized under these categories are discussed. The discussion includes clinical features, histopathology, and treatment.
Histiocytic Sarcoma↗
Amniotic band syndrome.
The amniotic band syndrome (ABS) refers to the infrequent occurrence of congenital deformities presumably due to fetal entanglement in strands of ruptured amniotic sac. The most commonly associated anomalies include amputations, constriction bands, syndactyly, craniofacial defects, club feet, and cleft lip. We present a typical case and short literature review of ABS. The infant reported also had a connective tissue nevus and a cutaneous striated muscle hamartoma.
Abdominal Injuries↗
Recurrent subepidermal calcified nodule of the nose.
A form of idiopathic calcinosis cutis, subepidermal calcified nodule (SCN), recurred twice on the nasal ala of a healthy 6-year-old girl whose serum calcium and phosphorus levels were within normal limits. Basophilic granular material and numerous mast cells were present in the superficial dermis. The pathogenesis of SCN is uncertain, but the clinical and histologic features of this lesion are distinctive.
Biopsy↗
Rhabdomyosarcoma presenting as a cutaneous nodule.
Two patients with rhabdomyosarcoma presented clinically with dermal nodules on the face. The first patient was a 12-month-old girl with a 2 X 3-cm-diameter red nodule on her left cheek that had begun as a small red papule when she was 3 months old and had progressively increased in size. The second patient was a 19-year-old girl who presented with an enlarging mass on her right cheek that had begun as a pea-sized nodule three months previously. In both cases, biopsies revealed a rhabdomyosarcoma in the underlying soft tissue with extension into the overlying dermis. Rhabdomyosarcoma presenting as a dermal nodule is rare. It usually presents as an asymptomatic papule without distinctive clinical features and therefore may result in delayed diagnosis unless a biopsy is performed.
Adult↗
Cutaneous manifestations of acrodynia (pink disease).
A 14-month-old girl who presented with multiple systemic complaints was found to have gingivitis, peeling of her palms and soles, and a peculiar acral eruption. A diagnosis of acrodynia, or pink disease, was confirmed by elevated levels of mercury in the urine. The many cutaneous manifestations of this once common disease are discussed.
Acrodynia↗
Diet and atopic dermatitis.
Prevention or modification of the onset of atopic dermatitis has been difficult to document through prolonged breast feeding or delayed introduction of solid foods. Dietary management of established atopic dermatitis is not routinely indicated for the majority of patients. Dietary management of atopic dermatitis should not be continued indefinitely. Gradual reintroduction of the offending food(s) is often appropriate. The foods most commonly avoided in the management of atopic dermatitis are cow's milk, wheat, eggs, and nuts. Severe or prolonged dietary restrictions should not be instituted without full consideration of their impact on the patient's general health.
Age Factors↗
Solar elastotic bands of the forearm: an unusual clinical presentation of actinic elastosis.
Actinic damage of dermal tissues produces several distinct clinical patterns. Three patients are described as having discrete, soft, cordlike bands on the forearms that extend from dorsal areas of actinic damage and senile purpura to greatest prominence in flexural regions with less solar damage. Histochemical analyses and light and electron microscopy studies of the plaques showed changes consistent with solar elastosis. The clinical variants of actinic elastosis and the possible origins of the abnormal elastic fibrils found in the dermis of chronically sun-damaged skin are discussed. Solar elastotic bands are an unusual form of actinic degeneration.
Aged↗
Striated muscle hamartoma: description of two cases.
We saw two newborn infants with striated muscle hamartoma. One patient had numerous associated congenital anomalies. The clinical appearance of both lesions was that of a soft fibroma. Histologically, striated muscle fibers and nerve bundles were seen in the central core and also at the periphery of the lesion, below the epidermis. A marked number of sebaceous glands, vellus hair follicles, and eccrine glands were also present. We propose the term striated muscle hamartoma, which points out the most remarkable feature of these lesions.
Hamartoma↗
Suppressor-cytotoxic T-lymphocyte panniculitis.
A 3 1/2-year-old girl had fever and nonsuppurative panniculitis. Biopsies revealed lobular lymphocytic panniculitis. An extensive evaluation of the patient for infectious and other systemic diseases yielded negative results. Although the number of peripheral T lymphocytes was normal, suppressor-cytotoxic (OKT8) lymphocytes predominated in the subcutis of the lesions. Suppressor-cytotoxic T-lymphocyte panniculitis may represent a unique type of panniculitis.
Adipose Tissue↗