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Biomedical subjects

W F Bergfeld

Publications and source records attributed to W F Bergfeld.

At least 109 records · Page 6Linked to original sources
PubMed1989

Oral melanoacanthoma with prominent spongiotic intraepithelial vesicles.

Oral melanoacanthoma is a rarely-reported, benign pigmented lesion of oral mucosa. Spongiosis was only recently mentioned as a light-microscopical finding occasionally seen in oral melanoacanthoma, and the formation of spongiotic intraepithelial vesicles to our knowledge has never been reported. The authors discuss a case of a 34-year-old, black woman who acutely developed extensive hyperpigmented oral lesions which on the biopsy showed both intraepithelial dendritic melanocytes and severe spongiosis forming intraepithelial vesicles. These lesions resolved spontaneously in a few months which led the authors to believe that the term melanoacanthoma, implying that it is a tumor, is a misnomer. This report supports findings of other investigators who consider oral melanoacanthoma to be a mucositis with unusual proliferation of dendritic melanocytes in the epidermis.

Adult↗
PubMed1989

Treatment of chronic idiopathic urticaria with astemizole.

Astemizole is a new, long-acting H1 receptor antagonist that has proven effective in controlling the signs and symptoms of chronic idiopathic urticaria, without the sedative and anticholinergic side effects that typify use of many antihistamines. In an eight-week open study of 20 patients, astemizole significantly decreased the signs and symptoms of urticaria, as well as the severity of urticaria by anatomic location. Five patients reported complete clearing. Modest weight gain while on chronic therapy appears to be a significant side effect.

Adolescent↗
PubMed1989

Alopecia: histologic changes.

The major types of alopecia that can be diagnosed histologically are androgenic alopecia, alopecia areata, trichotillomania, inflammatory scarring alopecias, pseudopelade, and anagen and telogen effluviums. Important to recognize are the common histologic features in chronic alopecias, which include follicular plugging, decreased numbers of hair follicles, frequent increased fibrous tracts, and superficial changes of actinic damage. Specific helpful changes to be observed are (1) the presence of actinically damaged skin that would reveal a chronic alopecic condition, (2) the presence and site of the dermal inflammation, (3) whether there is a decrease in the numbers of hair follicles and the presence of a reversal of the anagen/telogen ratio, (4) miniaturization of the hair follicle, (5) evidence of involution, and (6) the presence of scarring as demonstrated with elastic fiber stains. By assessing these histologic changes, the dermatopathologist can make a reasonably specific diagnosis of alopecia.

Acute Disease↗
PubMed1988

Pyoderma gangrenosum: a review.

Pyoderma gangrenosum is a poorly understood disease characterized by exacerbations and remissions of morphologically unique skin ulcers. It frequently is thought to be the cutaneous manifestation of an underlying systemic disease. In this review of pyoderma gangrenosum, the characteristics of the disease are described and a differential diagnosis is formulated. Associations with systemic diseases are made through a review of the literature. The pathophysiology of pyoderma gangrenosum and probable causes are considered, and special consideration is given to the immunologic mechanisms that may be operative in the disease. Finally the currently available therapeutic alternatives are reviewed.

Colitis, Ulcerative↗
PubMed1988

Common and uncommon dermatologic diseases related to sports activities.

The athlete is exposed to a whole spectrum of skin diseases that may or may not be unique to the particular sport or activity. Although the athlete is usually a healthy young adult and sports-related skin diseases are often minor, it is important for these disorders to be recognized by physicians, nurses, coaches, and trainers. Prevention, early diagnosis, and treatment will enable the athlete to resume participation as early as medically possible.

Dermatitis, Contact↗
PubMed1987

Linear IgA bullous dermatosis mimicking erythema multiforme in adult.

This report describes a 49-year-old woman with an erythema multiforme--like rash and direct immunofluorescence showing linear IgA deposits at the dermoepidermal junction. Light microscopy revealed features of bullous pemphigoid, dermatitis herpetiformis, and erythema multiforme; immunoelectron microscopy demonstrated IgA deposition beneath the lamina densa about anchoring fibrils. These data provide additional information about the variable clinical and histologic manifestations of the adult linear IgA bullous dermatosis and emphasize the diagnostic dilemmas of light microscopy, which are resolved by immunohistochemical methods.

Dapsone↗
PubMed1987

Minocycline-related cutaneous hyperpigmentation as demonstrated by light microscopy, electron microscopy and X-ray energy spectroscopy.

A 70-year-old patient with a chronic cutaneous ulcer treated by minocycline hydrochloride developed hyperpigmentation of the forearms. Biopsy material was studied by light microscopy, electron microscopy and X-ray energy spectroscopy. Granular gold-brown pigment was found in dermal histiocytes and eccrine myoepithelial cells, which gave positive reaction with Prussian blue and Fontana-Masson stains. Electron microscopy revealed intracytoplasmic granules of dark, homogeneous material and small fine particles. X-ray energy spectroscopy showed iron and other elements in smaller amounts. The different types of minocycline-related hyperpigmentation and the possible pathomechanism are discussed with special regard to the importance of the diagnostic methods.

Aged↗
PubMed1987

Identification of foreign metallic substances inducing hyperpigmentation of skin: light microscopy, electron microscopy and x-ray energy spectroscopic examination.

Identification of foreign metallic substances that induce hyperpigmentation is now possible with the use of x-ray energy spectroscopy (XES), an ultrastructure, nondestructive technique that allows the correlation of the presence of foreign substances with localized tissue and cellular histological changes. This new analytic technique will be an innovative adjunctive technique in the practice of diagnostic pathology and dermatopathology. It is certain that further evaluation of hyperpigmentation will allow for better identification of possible etiological causes, especially in the evaluation of cutaneous hyperpigmentation secondary to metal toxicity.

Adult↗
PubMed1987

Androgenic alopecia.

Androgenic alopecia is a common and perplexing clinical problem in the female patient. In the past medical literature has offered little assistance in understanding or evaluating the balding woman. Recent advances in technology have better enabled the physician to evaluate and treat females with androgenic alopecia. This article presents the current evaluation and possible treatment modalities of androgenic alopecia.

Alopecia↗
PubMed1987

Hirsutism.

The androgen status of a hirsute woman can be diagnosed today by new techniques for measuring circulating androgens. Unfortunately, a battery of expensive tests is required to make this assessment. Two specific basic screening tests, DHEA-S and total free testosterone determinations, should be done. If the patient is interested in and can afford it, further testing can be done; it includes 17-hydroxyprogesterone, prolactin, compound S (serum 11-deoxycortisol) and cortisol measurements and a dexamethasone suppression test. Elevations of androgens, whereas elevations of testosterone can be due to ovarian or adrenal secretion. Establishing the site of androgen hypersecretion allows one to be more selective regarding the antiandrogen therapy. When excess androgen secretion is primarily adrenal in origin, adrenal suppression is effective with the use of such drugs as dexamethasone. If the excess androgen is primarily of ovarian origin, cyclic estrogens, for example, Demulen or Premarin with Provera, would be helpful. The evaluation of a hirsute patient takes time, interest, and knowledge of specific androgen-dependent cutaneous syndromes involving multiple possible enzymatic defects in the conversion of cholesterol to testosterone or intercellular pathways of androgen metabolism. If the dermatologist is not interested in or lacks the knowledge for such an evaluation, the patient is best referred to an interested endocrinologist.

Female↗
PubMed1987

Perforating granuloma annulare in a patient with acquired immunodeficiency syndrome. Immunohistologic evaluation of the cellular infiltrate.

The inflammatory infiltrate found in the lesions of perforating granuloma annulare in a patient with acquired immunodeficiency syndrome was analyzed. Double labeling with fluorescent antibody tags fluorescein isothiocyanate-Leu 4 (peripheral T cells) and phycoerythrin-Leu 2a (cytotoxic/suppressor) revealed the infiltrate to consist predominantly of cytotoxic/suppressor T cells. This finding is a reflection of the patient's altered immune status and calls into question the role of specific T-cell subsets in the pathogenesis of granuloma annulare.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Cutaneous signs of internal malignancy. A pictorial essay.

The skin is a window of internal malignancies and other diseases. The cutaneous signs of internal malignancy can be divided into four major groups: (1) hypersensitivity or toxic reactions, (2) infections, (3) metabolic disorders, and (4) tumors. A diagnosis of the many signs of systemic malignancy is made by inspection, history taking, and skin biopsy. Hypersensitivity reactions or nonspecific cutaneous changes in middle-aged or elderly patients should arouse suspicion of internal malignancy. Likewise, sudden onset of a cutaneous tumor in an elderly patient should alert the attentive observer to the possibility of cancer.

Aged↗