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Biomedical subjects

W Ryman

Publications and source records attributed to W Ryman.

6 recordsLinked to original sources
PubMed2001

Understanding pyoderma gangrenosum: a review.

CONTEXT: Diagnosis and management of pyoderma gangrenosum, a chronic, ulcerative cutaneous inflammatory disease often associated with systemic disease, requires a multidisciplinary approach. No large-scale, controlled trials have been conducted and, as a consequence, the knowledge of this condition is largely based on anecdotal reports. OBJECTIVE: To investigate current understanding of the diagnosis and management of pyoderma gangrenosum. DESIGN: Critical review article. Two hundred eighty-six articles, limited to articles in English and pertaining to humans, were retrieved and reviewed from a MEDLINE search spanning the years 1960-2000. CONCLUSIONS: Diagnosis of pyoderma gangrenosum often requires consultation by multiple specialists in different fields of medicine. Treatment is individually tailored and depends on disease severity and the presence of associated disease. Local treatment is sufficient for mild disease, and the use of immunosuppressive agents is reserved for severe or refractory cases, with cyclosporin being the agent of choice. The long-term outcome for these patients has not been established.

Humans↗
PubMed2001

Giant congenital melanocytic naevus and symptomatic thoracic arachnoid cyst.

A 43-year-old female with multiple congenital naevi presented with a 5-year history of right upper quadrant pain. Magnetic resonance imaging demonstrated a large epidural thoracic arachnoid cyst. This case highlights the need to consider that the management of patients with giant congenital melanocytic naevus is variable depending on the age of the patient, the location of lesions and the presence of complications such as neurocutaneous melanosis. The value of magnetic resonance scanning as a screening device is discussed.

Adult↗
PubMed2001

Retrospective review of reconstructive methods of conchal bowl defects following mohs micrographic surgery.

BACKGROUND: Mohs micrographic surgery has consistently been demonstrated to be the most effective method for excision of potentially aggressive lesions of the conchal bowl. A variety of techniques are employed to reconstruct the conchal bowl following surgery. OBJECTIVE: To explore the type and frequency of reconstruction techniques used and the factors influencing the surgeons choice of reconstruction METHOD METHOD: Retrospective analysis of 272 patients with conchal bowl tumors. RESULTS: Split thickness skin grafting was the preferred method of reconstruction. The histopathology of the lesions and the size of the post-Mohs defect did not influence the choice of technique, except for lesions less than 1 cm in which healing by secondary intention was favored. CONCLUSION: Tumor size, type, and aggressiveness did not influence repair technique choice. Surgeon preference was therefore the principle factor dictating method of reconstructive technique following Mohs micrographic surgery.

Adult↗
PubMed1987

Autofluorescence of clofazimine in discoid lupus erythematosus.

A 70-year-old woman developed dark reddish blue pigmentation in scarred areas of discoid lupus erythematosus after taking clofazimine intermittently over a period of 10 years. Although light microscopy of routinely processed tissue failed to define the cause of the pigment, fluorescent microscopy showed vivid red deposits concentrated around larger vessels within the dermis. These deposits were shown to correspond to birefringent red clofazimine crystals on fresh frozen sections. Although the hyperpigmentation may clinically resemble melanin, biopsy specimens from our patient revealed a loss of melanin pigment in lesional skin, suggesting a primary role for clofazimine in producing the color changes observed.

Aged↗
PubMed1986

PUVA therapy for drug-resistant graft-versus-host disease.

Ultraviolet irradiation is known to diminish the functional capacity of cells of the immune system. We have used ultraviolet A irradiation in combination with psoralen (PUVA) to treat three patients with drug-resistant graft-versus-host disease (GVHD) of the skin or mouth. Each of the three patients had received an HLA-identical sibling bone marrow transplant for haematological malignancy or severe aplastic anaemia. One patient developed acute GVHD of skin and mouth and two patients developed chronic GVHD of the mouth, which did not respond to conventional immunosuppressive drugs including cyclosporin and methyl prednisolone (all three patients) and anti-thymocyte globulin (two patients). PUVA irradiation to the skin was given at a dose of 0.75-1.25 J (joules) daily for four days per week and that to the mouth at 0.75 J daily four days per week. Before each treatment, 8-methoxypsoralen (0.6 mg/kg) was given orally as a photosensitizer. Each patient improved considerably and in each case the dosage of conventional immunosuppression was reduced. No flare was noted in the two patients with chronic GVHD of the mouth at 1 month after the end of treatment. PUVA irradiation is a useful therapeutic adjunct in GVHD affecting skin and mouth and appears to confer a steroid or cyclosporin sparing effect.

Acute Disease↗