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  • 1
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The clinieopathological features of eightpatients with cutaneous disease associated with HTLV-1 infection are reviewed. All were U. K. residents of West Indian extraction, and two are currently alive. Disease remained confined to the skin in two patients. Five patients with a cutaneous prodromal phase developed leukaemia after a medianduration of 124 months (3months-21years), and in one of these combination chemotherapy produced a sustained clinical remission for 20 months. Two patients developed cutaneous disease after remission of their leukaemia.Cutaneous lesions were heterogeneous and included localized papules, a generalized papulonodular eruption, diffuse and localized erythematous plaques, pompholy x-like lesions on the palms and soles, and tumours. The histology of the skin lesions was also variable, and consisted of aheavy dermal infiltrate with lymphocytes, histiocytes, plasmacells, eosinophils and cytologically atypical mono-nuclear cells. Epidermotropism was present in biopsies from five patients. Tumour cells with large, densely staining, pleomorphic nuclei, arranged in rows between collagen bundles, were present in the majority of cases. In one patient the infiltrate also consisted of epithelioid cells and muitinucleated giant cells. Six cases were classified histologically as pleomorphic T-cell lymphoma, and two as cerebriform or mycosis fungoides type.Molecular studies revealed a clonal T-cell population associated withmonoclonal integration of HTLV-1 provirus in tissue DNA from six patients. In two patients HTLV-1 integration was established retrospectively using enzymatic in vitro amplification of a specific HTLV-1 pol genesequence in DNA extracted from paraffin-embedded sections.This study indicates that the clinical and pathological features of HTLV-1-associated cutaneous disease are diverse. Patients may have disease confined to the skin for prolonged periods, either at presentation or following clinical relapse—cutaneous adult T-celll ymphoma. Molecular techniques allow distinction from other types of cutaneous T-cell lymphoma, and provide an opportunity for retrospective studies of archival material.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    British journal of dermatology 119 (1988), S. 0 
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1365-2133
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Five dark-skinned individuals presented with widespread well-demarcated hypopigmented lesions, biopsy of which revealed the histopathological features of mycosis fungoides. Ultrastructural studies showed focal invasion of the epidermis by mycosis cells with degenerative changes in adjacent melanocytes and keratinocytes. The majority of melanocytes exhibited swelling of cytoplasmic organelles and disordered melanogenesis with production of spherical incompletely melanized melanosomes. In addition disintegrating melanocytes were occasionally seen. Perifollicular repigmentation within hypopigmented areas occurred in two patients following clearing of the epidermal infiltrate with PUVA therapy. Mycosis fungoides may present with areas of cutaneous hypopigmentation.
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  • 4
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Fourteen patients with large cell lymphocytoma were studied. They presented with solitary or small numbers of grouped nodules on the trunk or head and neck region, which historically consisted of diffuse and nodular dermal aggregates of lymphoid cells. A proportion of these cells were large with clear cytoplasm and a varying degree of nuclear atypia. An infiltrate of small mature lymphocytes surrounded and extended between the zones of larger cells. Mitotic figures and pleomorphic cells were frequent and, on the basis of this histopathology, an initial diagnosis of cutaneous lymphoma had frequently been made. There were eight male and six female patients with a mean age at presentation of 40 years (range 14–71) who were followed up for a period of between 4 and 31 years (mean = 14·6). Thirteen of the 14 are alive and well, and there has been no evidence of systemic involvement in any of the patients; one patient died of chronic renal failure and pneumonia. Monoclonal antibody studies on paraffin sections showed the presence of lymphoid cells of B and T cell lineage in large cell lymphocytoma.We believe that these patients have a variety of cutaneous lymphocytic infiltrate, large cell lymphocytoma, which has characteristic clinical and histological features and is important to recognize because of its benign course.
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1365-2230
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Neurotrophic ulceration of the face is a rare but well recognized sequel to division of the trigeminal nerve. 1,2 Trauma is an important contributory factor and thought to be due in part to paraesthesiae, which encourages picking and scratching, with resultant chronic and persistent ulceration. 3 A case is described of an 82-year-old woman with severe trigeminal neurotrophic ulceration which improved substantially with pimozide, given for treatment of unrelated paranoid symptoms. The possible relevance of this to the established use of pimozide in delusional parasitosis is briefly discussed.
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  • 7
    ISSN: 1600-0536
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Two independent cases of suspected occupational allergic contact dermatitis from tobacco are reported to illustrate the difficulties inherent in the accurate diagnosis of this condition. An investigatory procedure is outlined whereby the comparatively rare cases of genuine contact sensitivity to tobacco can be distinguished from other commoner dermatoses.
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  • 8
    ISSN: 1573-9686
    Keywords: Coronary anatomy ; Finite element ; Network generation ; Mathematical model
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract A discrete anatomically accurate finite element model of the largest six generations of the coronary arterial network is developed. Using a previously developed anatomically accurate model of ventricular geometry the boundaries of the coronary mesh are defined from measured epicardial coronaries. Network topology is then generated stochastically from published anatomical data. Spatial information is added to this topological data using an avoidance algorithm accounting for global network geometry and optimal local branch angle properties. The generated vessel lengths, radii and connectivity are consistent with the published studies and a relativity even spatial distribution of vessels within the ventricular mesh is achieved. The local finite element coordinates of the coronary nodes within the ventricular mesh are calculated such that the coronary geometry can be recalculated within a deformed ventricular mesh. © 2000 Biomedical Engineering Society. PAC00: 8710+e, 8718Bb, 0270Dh
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  • 9
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Sézary syndrome is an uncommon variant of cutaneous T-cell lymphoma (CTCL) characterized by erythroderma, pruritus, adenopathy, and circulating atypical T-lymphocytes with cerebriform nuclei. The definition of Sézary syndrome can be further refined by including only patients with a circulating peripheral blood population of clonal T-cells. We have evaluated 79 skin biopsies from such a group of 41 erythrodermic patients with circulating Sézary cells and a clonal population of T-cells detected by T-cell receptor-figene rearrangement on Southern analysis of peripheral blood mononuclear cells. Histopathologic features consistent with chronic dermatitis were observed in 26/79 (33%) skin biopsy specimens, emphasizing that a non-specific histologic appearance is common. Evidence of CTCL was lacking in 11/41 patients on biopsy of their erythrodermic skin. The survival of these patients was not significantly different from 30/41 patients in whom skin biopsies revealed changes diagnostic of CTCL, such as a dermal lymphocytic band with atypical lymphocytes (18/79, 23%) or a mycosis fungoides-like infiltrate (30/79, 38%). This study confirms that non-specific cutaneous hlstopathologic findings are common in Sézary syndrome, even when a circulating T-cell clone is present. This stresses the need for peripheral blood genetic analysis and for multiple or repeat skin biopsies in erythrodermic patients when there is high clinical suspicion of CTCL.
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  • 10
    ISSN: 1600-0560
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report three patients with pemphigoid nodularis. Patients were females aged 76, 71 and 50 years, and all had features of billions pemphigoid together with prurigo-like lesions at some stage of their illness. In two eases, nodular lesions preceded the onset of blistering by some months. Blisters arose on normal skin and in one patient also at sites of prurigo lesions. Routine histology of bullous lesions revealed the presence of subepidermal blisters. Electron microscopy perlormed in two eases confirmed the level of split to be through the lamina lucicla. Direct immunoflourenscence in all eases was positive, with linear basement membrane zone deposition of IgG and G3. Circulating IgG anti-basement membrane antibody was also detected in all patients, and in two, immunoblotting revealed a single antigen of 220 kD.
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