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Biomedical subjects

Thomas N Helm

Publications and source records attributed to Thomas N Helm.

12 recordsLinked to original sources
PubMed2006

Alabaster skin after CO2 laser resurfacing: evidence for suppressed melanogenesis rather than just melanocyte destruction.

Hypopigmentation is a recognized side effect of CO2 laser resurfacing. Pigment abnormalities are a major side effect of facial laser procedures and can cause much emotional distress. We report a case of a patient who, after receiving laser treatment, developed persistent hypopigmentation that has defied a variety of treatment attempts. Results of histologic and immunohistochemical studies support the hypothesis that suppressed melanogenesis rather than just destruction of melanocytes is important in the etiology of the alabaster skin side effect.

Antigens, Neoplasm↗
PubMed2006

Biopsy may help identify early pyoderma faciale (rosacea fulminans).

Pyoderma faciale is an uncommon acute presentation of rosacea. Edema, nodules, and draining sinuses may occur. Women in their early 20s are typically affected, and severe scarring may result in untreated cases. We report the case of a woman in whom a biopsy helped establish an early diagnosis so that decisive intervention could be initiated and scarring avoided. The histologic features of pyoderma faciale only rarely have been described and are illustrated in this case.

Adult↗
PubMed2006

Erythema elevatum diutinum arising in the setting of dermatitis herpetiformis.

Dermatitis herpetiformis is an autoimmune blistering disease characterized by granular deposits of immunoglobulin A (IgA) in dermal papillae. Erythema elevatum diutinum is a chronic form of vasculitis associated with IgA paraproteinemia. We report a patient with dermatitis herpetiformis who developed characteristic erythema elevatum diutinum lesions on the elbows and knees despite sulfone therapy. We speculate that the different patterns of IgA deposition in the skin account for the clinical manifestation of these 2 uncommon disorders.

Dermatitis Herpetiformis↗
PubMed2004

Pemphigus, pregnancy, and plasmapheresis.

Pemphigus vulgaris (PV) is an autoimmune blistering disorder that usually occurs in the fifth and sixth decades of life but may occur at younger ages and during pregnancy. Circulating intercellular antibodies directed at desmosomal proteins may cross the placenta and place children at risk for neonatal pemphigus (NP). We describe the case of a pregnant woman with PV treated successfully with a combination of systemic corticosteroids and plasmapheresis. The possibility of PV should be considered in any pregnant woman with a worsening, widespread, mucocutaneous, blistering disease. Plasmapheresis offers a useful alternative to immunosuppressive therapy in the setting of pregnancy.

Adult↗
PubMed2002

A nonfatal case and 2 fatal cases of paraneoplastic pemphigus: can a complement indirect immunofluorescent test help to identify fatal "group A" paraneoplastic pemphigus cases?

We studied 3 recent cases of paraneoplastic pemphigus (PNP) in detail. Two patients died despite concerted management efforts. One patient received no treatment after the appearance of PNP and recovered completely from both PNP and lymphoma. Multiple serum studies of these 3 patients plus 9 other proven PNP cases revealed that 8 of 9 fatal PNP cases (referred to here as "group A") had distinctive cell surface antibodies detected by complement indirect immunofluorescent (CIIF) tests on monkey esophagus sections. By contrast, none of the sera from 3 patients with PNP who experienced long-term survival (referred to here as "group B") and none of 20 pemphigus vulgaris or 10 pemphigus foliaceus control sera revealed similar beaded cell surface CIIF reaction patterns, a difference that is statistically significant (P <.0001). Cell surface CIIF reaction patterns of group A PNP antibodies resemble the pattern of pemphigus antibody reactions in indirect immunofluorescent tests on the same substrate; however, the latter tend to be thinner and more linear, whereas the cell surface CIIF pattern tends to be more beaded, suggesting possible desmosomal reactions. We believe this test is useful in identifying an aggressive group A form of PNP.

Antibodies, Antinuclear↗
PubMed2002

Acquired cutis laxa associated with multiple myeloma.

Cutis laxa is an uncommon condition characterized by loose and redundant skin. Biopsy results are positive for a reduction in or an absence of elastic fibers in the dermis. Cutis laxa is acquired or congenital. The acquired form is either a generalized insidious form (type I) or a form associated with prior inflammation (type II). Cardiovascular, pulmonary, gastrointestinal, and urologic complications may occur. In the past, cutis laxa was associated with plasma cell dyscrasia. We report on a characteristic cause of cutis laxa to alert clinicians to this uncommon manifestation of multiple myeloma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Chilblain lupus erythematosus lesions precipitated by the cold.

Lupus erythematosus (LE) may exhibit a broad array of clinical presentations. Cutaneous manifestations include malar rash, discoid lesions, alopecia, and panniculitis. Cold-induced lesions are uncommon. To illustrate this unusual presentation, we describe a case of typical chilblain LE.

Abdomen↗