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Biomedical subjects

Sandra Marchese Johnson

Publications and source records attributed to Sandra Marchese Johnson.

14 recordsLinked to original sources
PubMed2005

Cutaneous warts: an evidence-based approach to therapy.

Cutaneous warts are a common presenting complaint in children and adolescents. Common, plantar, or flat warts are cutaneous manifestations of the human papillomavirus. The treatment of warts poses a therapeutic challenge for physicians. No single therapy has been proven effective at achieving complete remission in every patient. As a result, many different approaches to wart therapy exist. These approaches are discussed to demonstrate the evidence supporting common therapies and provide a guideline for physicians. Evidence supports the at-home use of topical salicylic acid and physician-administered cryotherapy. Intralesional immunotherapy for nongenital cutaneous warts may be an option for large or recalcitrant warts.

Administration, Topical↗
PubMed2004

Diltiazem-induced hyperpigmentation.

A healthy-appearing 66-year-old black woman presented with a 5-year history of facial hyperpigmentation that was unresponsive to topical sunscreen, hydroquinone, tretinoin, and azelaic acid. Her medications included extended-release diltiazem for hypertension for the past 7 years, rofecoxib for arthritis, and pantoprazole for esophagitis. On examination, the woman displayed hyperpigmented patches and papules involving most of her face. The punch biopsy findings from a hyperpigmented papule on the right temple revealed compact hyperkeratosis, follicular dilation, and dense inflammatory infiltrate along the dermal-epidermal junction with abundant dying keratinocytes. Her diltiazem therapy was discontinued, which led to gradual resolution of her hyperpigmentation.

Aged↗
PubMed2004

A double-blind comparative study of sodium sulfacetamide lotion 10% versus selenium sulfide lotion 2.5% in the treatment of pityriasis (tinea) versicolor.

Pityriasis (tinea) versicolor, which consists of hyperpigmented and hypopigmented scaly patches, is often difficult to treat. A double-blind comparative study between once-a-day sodium sulfacetamide lotion and selenium sulfide lotion was undertaken. Both treatments were safe and efficacious. Selenium sulfide was statistically more efficacious (76.2% vs 47.8%, P=.013).

Administration, Cutaneous↗
PubMed2004

Topical treatment for atopic dermatitis in the 21st century.

Atopic Dermatitis (AD) is a common cutaneous inflammatory disease. Recent estimates of prevalence in United States school children range from 10-20%. Topical treatment of AD is unsatisfactory. Now two new topical agents, tacrolimus and pimecrolimus, are revolutionizing the treatment of AD. Here we review AD as well as these breakthrough therapies.

Dermatitis, Atopic↗
PubMed2003

Seasonal effect upon excision of acquired melanocytic proliferations.

BACKGROUND: Acquired melanocytic proliferations (AMPs) are excised throughout the year. Questions exist concerning seasonal variation in these excisions. OBJECTIVE: To investigate whether AMPs are removed more often during the spring-summer seasons than in the fall-winter and whether the percentage of benign nevi, dysplastic nevi and melanoma varies according to season. DESIGN: Retrospective analysis of 4794 histologically confirmed biopsies of AMPs was performed. RESULTS: A total of 2802 of the 4794 lesions (58%) were removed during the spring-summer season. These results confirm that seasonal variation in removal of AMPs does occur, and that removal peaks during the warmer months. In addition, the increased numbers of removals were accounted for by increases in benign pigmented lesion removals. CONCLUSIONS: Many etiologic factors can be suggested for increased removal of AMPs during the warmer months. Reasons may include the cosmetic desires of the patient and clothing choices resulting in increased awareness of pigmented lesions. Increases in the number of skin cancer prevention programs offered by dermatologists in the spring also have a large impact on the awareness of the general population and potentially contribute to the seasonal variation.

Arkansas↗
PubMed2003

Necrolytic migratory erythema as the only presenting sign of a glucagonoma.

We describe a 39-year-old man with a 3-year history of a recalcitrant psoriasiform eruption that was accentuated in the intertriginous areas. Hsitopathology was consistent with psoriasis. A glucagon level was 744 pg/mL with the upper limit of normal being 130 pg/mL. Computed tomographic scan of the abdomen revealed a 5-cm mass in the tail of the pancreas. The tumor was removed and found to be a glucagonoma (pancreatic islet tumor). The clinical eruption resolved promptly with surgical excision. Neither the clinical eruption nor the tumor has recurred for 6 months. The course of disease confirms the diagnosis of necrolytic migratory erythema associated with a glucagonoma.

Adult↗
PubMed2003

Evidence-based review of management of nongenital cutaneous warts.

Human papillomavirus (HPV)-induced tumors of the skin are often varied in clinical presentation, ranging from benign warts to malignant neoplasms. This article reviews the natural history and recommended treatment of some of the common HPV-induced tumors, as well as reviews many of the clinical trials for future wart therapies. This review is not meant to serve as a guideline or to be all-inclusive. Almost invariably, HPV-associated diseases are difficult to treat. The treatment options employed by healthcare professionals are usually dependent on their prior experience or exposure during residency. Many wart treatments are based on anecdotal evidence rather than on carefully conducted clinical trials. A systematic review of the literature was performed using the 1966-April 2002 MEDLINE database, the 1967-2000 PubMed database (National Library of Medicine), and the Cochrane Database of Systematic Reviews. Randomized clinical trials, controlled clinical trials, and multicenter studies were reviewed. Articles were included in the evaluation if they were printed in English, reported on human subjects, and analyzed subjects who had cutaneous nongenital warts.

Evidence-Based Medicine↗
PubMed2003

Erythema gyratum repens in a case of resolving psoriasis.

Erythema gyratum repens (EGR) is a rare skin syndrome often associated with internal malignancies, and thus considered paraneoplastic. There are cases of erythema gyratum repens in the literature associated with other dermatoses without underlying malignancies. We present a case of resolving psoriasis which evolved into erythema gyratum repens when treated with acitretin.

Acitretin↗
PubMed2003

Minocycline-induced immune thrombocytopenia presenting as Schamberg's disease.

Minocycline hydrochloride, a synthetic tetracycline, is a systemic antibiotic that has received much attention over the past several years. Currently, minocycline is considered the most widely prescribed oral antibiotic in the management of acne. Minocycline has been associated with autoimmune events, hepatitis, lupus-like syndromes, serum sickness, vasculitis, Sweet's syndrome, and hyperpigmentation. We report a case of a patient who developed drug-induced immune thrombocytopenic purpura (DITP) after taking minocycline. The initial clinical presentation of nonpalpable, discrete nonblanching petechiae and cayenne pepper-like macules on his lower legs was diagnosed as pigmented purpuric dermatosis (Schamberg's disease). We report the first case of DITP with the clinical picture of Schamberg's disease associated with minocycline therapy.

Diagnosis, Differential↗
PubMed2003

Comparing therapy costs for physician treatment of warts.

To compare the cost of several common modalities used to treat non-genital warts in immunocompetent patients, we identified studies published in English using standard search strategies and evaluated the literature for the following common non-genital wart therapies: cryotherapy with liquid nitrogen, carbon dioxide and pulsed-dye laser therapy, topical squaric acid, intralesional bleomycin, intralesional interferon alpha injections, and intralesional immunotherapy with Candida antigens. Standard treatment algorithms, compiled by dermatologists experienced in the treatment of patients with moderate wart burdens, were utilized for cost-comparison analyses. Based on the cost analysis model, the least expensive treatment option for non-genital warts were carbon dioxide laser therapy (157 dollars) and Candida antigen injections (190 dollars). The other treatment modalities examined ranged from 495 dollars (bleomycin) to 1227 dollars (interferon alpha). Although treatment with the carbon dioxide laser therapy is the least expensive, pain and post-procedure complications limit the use of this modality.

Arkansas↗
PubMedDate not supplied

Immunotherapy for recalcitrant warts in children using intralesional mumps or Candida antigens.

Intralesional injection of mumps and Candida skin test antigens has been shown to be effective in the treatment of warts. Warts are generally difficult to treat in children. To determine the efficacy of intralesional skin test antigen injection for the treatment of resistant warts in children, we treated 47 pediatric patients with one or more warts with intralesional injection of mumps or Candida skin test antigen into one wart. Twenty-two patients (47%) with resistant warts experienced complete resolution of treated warts. An average of 3.78 treatments were necessary. An additional 34% of children had a greater than 25% improvement in their warts. Sixty-eight percent of subjects with more than one wart also noted at least partial resolution (greater than 25% resolution) of untreated warts at distant sites, with 34% experiencing complete resolution. We concluded that intralesional injection of skin test antigens is an effective therapy for children who have recalcitrant, nongenital, cutaneous warts.

Adolescent↗
PubMedDate not supplied

Venous thrombosis occurring after initiation of thalidomide for the treatment of cicatricial pemphigoid.

Thalidomide is increasingly being used for the treatment of a variety of dermatologic conditions. Some of the risks associated with thalidomide use, however, are still being uncovered. Increased incidence of venous thrombosis following thalidomide use has recently been reported in the treatment of diseases with disease-related thrombotic risks, such as malignancy and lupus with antiphospholipid antibody syndrome. We report a case of venous thrombosis resulting from thalidomide use in a patient with cicatricial pemphigoid, illustrating the potential concern for increased thrombosis following thalidomide use in the dermatology setting.

Axilla↗
PubMedDate not supplied

Intralesional immunotherapy for warts using a combination of skin test antigens: a safe and effective therapy.

Warts are a common dermatologic problem. There are many treatments available. Intralesional injection of a skin test antigen has been shown to be efficacious at eradicating all warts when only a part of one wart is injected. The aim of this study was to determine whether injection of the combination of Candida albicans, mumps, and Trichophyton skin test antigens was more efficacious than and as safe as single antigen injection. Seventy-one percent of subjects had resolution of their warts with the injection of the combination of skin test antigens in this open label single arm study.

Adult↗