L a B U S E Formalin-Fixed Tissue Cannot Be Processed for Immunofluorescence
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Rapid Development of Perifolliculitis Following Mesotherapy
CASE LETTER Rapid Development of Perifolliculitis Following Mesotherapy Weihuang Vivian Ning, MD; Sameer Bashey, MD; Gene H. Kim, MD patient received mesotherapy with an unknown substance PRACTICE POINTS for cosmetic rejuvenation; the rash was localized only to the injection sites.copy She did not note any fever, chills, • Mesotherapy—the delivery of vitamins, chemicals, and plant extracts directly into the dermis via nausea, vomiting, diarrhea, headache, arthralgia, or upper injections—is a common procedure performed respiratory tract symptoms. She further denied starting in both medical and nonmedical settings for any new medications, herbal products, or topical therapies cosmetic rejuvenation. apart from the procedure she had received 2 weeks prior. • Complications can occur from mesotherapy treatment. Thenot patient was found to be in no acute distress and • Patients should be advised to seek medical care with vital signs were stable. Laboratory testing was remarkable US Food and Drug Administration–approved cosmetic for elevations in alanine aminotransferase (62 U/L [refer- techniques and substances only. ence range, 10–40 U/L]) and aspartate aminotransferase (72 U/L [reference range 10–30 U/L]). Moreover, she had Doan absolute neutrophil count of 0.5×103 cells/µL (refer- ence range 1.8–8.0×103 cells/µL). An electrolyte panel, To the Editor: creatinine level, and urinalysis were normal. Physical Mesotherapy, also known as intradermotherapy, is a examination revealed numerous 4- to 5-mm erythematous cosmetic procedure in which multiple -
Expert-Level Diagnosis of Nonpigmented Skin Cancer by Combined Convolutional Neural Networks
Supplementary Online Content Tschandl P, Rosendahl C, Akay BN, et al. Expert-level diagnosis of nonpigmented skin cancer by combined convolutional neural networks. JAMA Dermatol. Published online November 28, 2018. doi:10.1001/jamadermatol.2018.4378 eFigure. Sensitivities (Blue) and Specificities (Orange) at Different Threshold Cutoffs (Green) of the Combined Classifier Evaluated on the Validation Set eAppendix. Neural Network Training eTable 1. Complete List of Diagnoses and Their Frequencies Within the Test-Set eTable 2. Education of Users According to Their Experience Group eTable 3. Percent of Correct Prediction of the Malignancy Status for Specific Diagnoses of a CNN Using Either Close-up or Dermatoscopic Images This supplementary material has been provided by the authors to give readers additional information about their work. © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/25/2021 eFigure. Sensitivities (Blue) and Specificities (Orange) at Different Threshold Cutoffs (Green) of the Combined Classifier Evaluated on the Validation Set A threshold cut at 0.2 (black) is found for a minimum of 51.3% specificity. © 2018 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/25/2021 eAppendix. Neural Network Training We compared multiple architecture and training hyperparameter combinations in a grid-search fashion, and used only the single best performing network for dermoscopic and close-up images, based on validation accuracy, for further analyses. We trained four different CNN architectures (InceptionResNetV2, InceptionV3, Xception, ResNet50) and used model definitions and ImageNet pretrained weights as available in the Tensorflow (version 1.3.0)/ Keras (version 2.0.8) frameworks. -
New Approach in Combined Therapy of Perifolliculitis Capitis Abscedens Et Suffodiens
726 Letters to the Editor New Approach in Combined Therapy of Perifolliculitis Capitis Abscedens et Suffodiens Felix Jacobs, Gisela Metzler, Jakub Kubiak, Martin Röcken and Martin Schaller Department of Dermatology, Eberhard Karls University, DE-72076 Tuebingen, Germany. E-mail: [email protected] Accepted March 14, 2011. Perifolliculitis capitis abscedens et suffodiens (PCAS) tract. In the upper dermis there was a suppurative inflam- is a rare scalp disease seen mostly in young males of mation with abscess material and hair shaft fragments being discharged via a draining sinus. Periodic acid-Schiff (PAS) Afro-American descent. The disease is characterized by staining for fungi, as well as immunohistochemical staining perifollicular pustules, suppurative nodules and fluctua- with anti-Mycobacterium bovis (BCG) and for T. pallidum was ting abscesses, as well as by intercommunicating sinus negative. Direct immunofluorescence of the perilesional scalp tracts on the scalp. We report here an elderly Caucasian skin was negative. woman who fulfilled the clinical and histological criteria Microbiological examinations failed to identify pathogenic organisms. for diagnosis of PCAS. Following the diagnosis of a PCAS, the patient was treated The patient was treated with initial prednisolone, with 10 mg acitretin and 30 mg prednisolone daily as an inpa- systemic acitretin, topical tacrolimus and oral zinc. tient. The prednisolone was reduced to 5 mg per day during the After 6 months, her condition was stable. course of treatment. Because of the decreased level of zinc, 100 mg zinc aspartate was given daily. In addition, topical gluco- corticoids and tacrolimus 0.1% were alternated. CASE REPOrt This regimen produced almost total healing within 11 days (Fig. -
Differential Diagnosis of the Scalp Hair Folliculitis
Acta Clin Croat 2011; 50:395-402 Review DIFFERENTIAL DIAGNOSIS OF THE SCALP HAIR FOLLICULITIS Liborija Lugović-Mihić1, Freja Barišić2, Vedrana Bulat1, Marija Buljan1, Mirna Šitum1, Lada Bradić1 and Josip Mihić3 1University Department of Dermatovenereology, 2University Department of Ophthalmology, Sestre milosrdnice University Hospital Center, Zagreb; 3Department of Neurosurgery, Dr Josip Benčević General Hospital, Slavonski Brod, Croatia SUMMARY – Scalp hair folliculitis is a relatively common condition in dermatological practice and a major diagnostic and therapeutic challenge due to the lack of exact guidelines. Generally, inflammatory diseases of the pilosebaceous follicle of the scalp most often manifest as folliculitis. There are numerous infective agents that may cause folliculitis, including bacteria, viruses and fungi, as well as many noninfective causes. Several noninfectious diseases may present as scalp hair folli- culitis, such as folliculitis decalvans capillitii, perifolliculitis capitis abscendens et suffodiens, erosive pustular dermatitis, lichen planopilaris, eosinophilic pustular folliculitis, etc. The classification of folliculitis is both confusing and controversial. There are many different forms of folliculitis and se- veral classifications. According to the considerable variability of histologic findings, there are three groups of folliculitis: infectious folliculitis, noninfectious folliculitis and perifolliculitis. The diagno- sis of folliculitis occasionally requires histologic confirmation and cannot be based -
Traction Folliculitis: an Underreported Entity
HIGHLIGHTING SKIN OF COLOR Traction Folliculitis: An Underreported Entity Gary N. Fox, MD; Julie M. Stausmire, MSN, CNS; Darius R. Mehregan, MD Traction folliculitis is a component of traction air and scalp diseases induced by traumatic alopecia syndrome and has received minimal hairstyling techniques, including the use of attention in primary source medical literature. Hchemical relaxers and permanent solutions, The popularity of hairstyles that produce hair hot combs, braids, hair extensions, and pomades, tend traction and the knowledge that early interven- to be underappreciated.1-4 The practice of these tech- tion improves prognosis amplify the importance niques and their sequelae are most common in black of recognizing this entity. Traction folliculitis individuals.1 We present an illustrative scenario of presents as perifollicular erythema and pustules trauma caused by hairstyling techniques in an infant on the scalp in areas where hairstyles produce and review the literature on traction folliculitis. We traction on the hair shaft. In addition to the trac- found no prior reports of traction folliculitis in infants tion, concurrent hair care practices may play a and no prior images of traction folliculitis in the facilitatory role in the development of traction primary source medical literature. folliculitis. Treatment involves immediate removal of traction on hair and temporary alteration of the Case Report facilitatory hair care practices. In more severe An 8-month-old black infant was brought in by his cases, topical or systemic antibacterial therapy mother for evaluation of “pus bumps” on the scalp and, occasionally, topical corticosteroid therapy of several weeks’ duration. The infant was otherwise may be necessary. -
(12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr
USOO7359748B1 (12) United States Patent (10) Patent No.: US 7,359,748 B1 Drugge (45) Date of Patent: Apr. 15, 2008 (54) APPARATUS FOR TOTAL IMMERSION 6,339,216 B1* 1/2002 Wake ..................... 250,214. A PHOTOGRAPHY 6,397,091 B2 * 5/2002 Diab et al. .................. 600,323 6,556,858 B1 * 4/2003 Zeman ............. ... 600,473 (76) Inventor: Rhett Drugge, 50 Glenbrook Rd., Suite 6,597,941 B2. T/2003 Fontenot et al. ............ 600/473 1C, Stamford, NH (US) 06902-2914 7,092,014 B1 8/2006 Li et al. .................. 348.218.1 (*) Notice: Subject to any disclaimer, the term of this k cited. by examiner patent is extended or adjusted under 35 Primary Examiner Daniel Robinson U.S.C. 154(b) by 802 days. (74) Attorney, Agent, or Firm—McCarter & English, LLP (21) Appl. No.: 09/625,712 (57) ABSTRACT (22) Filed: Jul. 26, 2000 Total Immersion Photography (TIP) is disclosed, preferably for the use of screening for various medical and cosmetic (51) Int. Cl. conditions. TIP, in a preferred embodiment, comprises an A6 IB 6/00 (2006.01) enclosed structure that may be sized in accordance with an (52) U.S. Cl. ....................................... 600/476; 600/477 entire person, or individual body parts. Disposed therein are (58) Field of Classification Search ................ 600/476, a plurality of imaging means which may gather a variety of 600/162,407, 477, 478,479, 480; A61 B 6/00 information, e.g., chemical, light, temperature, etc. In a See application file for complete search history. preferred embodiment, a computer and plurality of USB (56) References Cited hubs are used to remotely operate and control digital cam eras. -
Histopathologic Evaluation of Acneiform Eruptions: Practical Algorithmic Proposal for Acne Lesions 141
Provisional chapter Chapter 10 Histopathologic Evaluation of Acneiform Eruptions: HistopathologicPractical Algorithmic Evaluation Proposal of Acneiformfor Acne Lesions Eruptions: Practical Algorithmic Proposal for Acne Lesions Murat Alper and Fatma Aksoy Khurami Murat Alper and Fatma Aksoy Khurami Additional information is available at the end of the chapter Additional information is available at the end of the chapter http://dx.doi.org/10.5772/65494 Abstract Acneiform lesions are encountered in different chapters in various dermatology and der- matopathology textbooks. The most common titles used for these disorders are diseases of the hair, diseases of cutaneous appendages, folliculitis, acne, and inflammatory lesions of dermis and epidermis. In this chapter, first of all we will discuss folliculitis, and then acne vulgaris that is a kind of folliculitis will be described. After acne vulgaris, other acneiform eruptions and demodicosis will be studied. At the end, simple algorithmic schemes by assembling clinical, pathological, and microbiological data will be shared. Keywords: acneiform lesions, algorithm, histopathologic evaluation 1. Introduction 1.1. Histology of pilar unit Pilar unit is a structure generally made up of three subunits which are hair follicle, seba- ceous gland, and arrector pili muscle. Hair follicle is divided in to three parts: infundibulum, isthmus, and inferior part. Infundibulum extends between entrance of sebaceous gland duct to the follicular orifice in epidermis. Isthmus: extends between entrance of sebaceous duct to hair follicle and insertion of arrector pili muscle. The basal part of hair follicle is called the inferior segment or inferior part. Histologic structure and function of hair follicle is very intriguing. Demodex folliculorum mites, Staphylococcus epidermis, and yeast of pityrosporum can be seen and can be a normal component of pilosebaceous unit. -
Drug-Induced Acneform Eruptions: Definitions and Causes Saira Momin, DO; Aaron Peterson, DO; James Q
REVIEW Drug-Induced Acneform Eruptions: Definitions and Causes Saira Momin, DO; Aaron Peterson, DO; James Q. Del Rosso, DO Several drugs are capable of producing eruptions that may simulate acne vulgaris, clinically, histologi- cally, or both. These include corticosteroids, epidermal growth factor receptor inhibitors, cyclosporine, anabolic steroids, danazol, anticonvulsants, amineptine, lithium, isotretinoin, antituberculosis drugs, quinidine, azathioprine, infliximab, and testosterone. In some cases, the eruption is clinically and his- tologically similar to acne vulgaris; in other cases, the eruption is clinically suggestive of acne vulgaris without histologic information, and in still others, despite some clinical resemblance, histology is not consistent with acne vulgaris.COS DERM rugs are a relatively common cause of involvement; and clearing of lesions when the drug eruptions that may resemble acne clini- is discontinued.1 cally, histologically,Do or both.Not With acne Copy vulgaris, the primary lesion is com- CORTICOSTEROIDS edonal, secondary to ductal hypercor- It has been well documented that high levels of systemic Dnification, with inflammation leading to formation of corticosteroid exposure may induce or exacerbate acne, papules and pustules. In drug-induced acne eruptions, as evidenced by common occurrence in patients with the initial lesion has been reported to be inflammatory Cushing disease.2 Systemic corticosteroid therapy, and, with comedones occurring secondarily. In some cases in some cases, exposure to inhaled or topical corticoste- where biopsies were obtained, the earliest histologic roids are recognized to induce monomorphic acneform observation is spongiosis, followed by lymphocytic and lesions.2-4 Corticosteroid-induced acne consists predomi- neutrophilic infiltrate. Important clues to drug-induced nantly of inflammatory papules and pustules that are acne are unusual lesion distribution; monomorphic small and uniform in size (monomorphic), with few or lesions; occurrence beyond the usual age distribution no comedones. -
Redalyc.Report of a Patient with Acne Conglobata and Perifolliculitis
Colombia Médica ISSN: 0120-8322 [email protected] Universidad del Valle Colombia CÁRDENAS, MÓNICA LORENA; LÓPEZ, FRANCISCO; MORENO, LUIS HERNANDO Report of a patient with acne conglobata and perifolliculitis capitis abscedens et suffodiens Colombia Médica, vol. 42, núm. 2, abril-junio, 2011, pp. 224-227 Universidad del Valle Cali, Colombia Disponible en: http://www.redalyc.org/articulo.oa?id=28318450013 Cómo citar el artículo Número completo Sistema de Información Científica Más información del artículo Red de Revistas Científicas de América Latina, el Caribe, España y Portugal Página de la revista en redalyc.org Proyecto académico sin fines de lucro, desarrollado bajo la iniciativa de acceso abierto Colombia Médica Vol. 42 Nº 2, 2011 (Abril-Junio) Report of a patient with acne conglobata and perifolliculitis capitis abscedens et suffodiens MÓNICA LORENA CÁRDENAS, MD1, FRANCISCO LÓPEZ, MD1, LUIS HERNANDO MORENO, MD2 SUMMARY Perifoliculitis capitis abscedens et suffodiens, dissecting folliculitis, dissecting cellulitis, or Hoffman disease is a rare, inflammatory and chronic condition, which affects the scalp of young black men, mainly characterized by the appearance of nodules and abscesses that drain purulent material with fistulas and pathways, leading ultimately to scarring alopecia. At present, this condition is defined as a primary disorder of follicular keratinization, being part of the triad or tetrad of follicular occlusion. One third of the cases are associated with acne conglobata as a primary event. Management, frustrating for many years, is promising with the successful use of isotretinoin and a combination of medications that intervene each of its physiopathological principles. Keywords: Perifolliculitis capitis abscedens et suffodiens; Acné conglobata; Dissecting cellulitis of scalp. -
Dermatopathology: We've Only Just
Paul K. Shitabata, M.D. Dermatopathology Institute Pa#erns Epidermis Dermis/Vessels/Hair Follicles Fat/Vessels Epidermal Reac1on Pa#erns Orthokeratosis Hyperkeratosis Spongiosis Modify by Inflammatory Cell type Parakeratosis Acanthosis Spongiosis Parakeratosis Acanthosis Hyperkeratosis Orthokeratosis Hyperkeratosis Acanthosis Epidermal/Dermal Reac1on Pa#erns Superficial perivascular Superficial and deep perivascular Nodular and diffuse Intraepidermal vesicular and pustular Subepidermal vesicular No Epidermal Changes Perivascular Intestitial Superficial/Deep Epidermal Changes Spongiotic Epidermal Changes Ballooning Interface Psoriasiform/Lichenoid Lichenoid/Interface Spongiotic Psoriasiform Psoriasiform Lichenoid Superficial Perivascular No Epidermal Changes Tinea versicolor Dermatophytosis Erythrasma Pitted keratolysis Vitiligo Schamberg's disease Viral exanthems Drug eruption (one type) Urticaria, late Erythema figuratum, superficial Superficial Perivascular/Inters11al No Epidermal Changes Schamberg's disease PUPPP Dermatitis herpetiformis Linear IgA dermatosis Dermatitis herpetiformis-like drug eruptions Acute discoid lupus erythematosus/SLE Leukocytoclastic vasculitis Erythema marginatum Superficial Perivascular/Inters11al No Epidermal Changes Bullous pemphigoid/Herpes gestationis, urticarial Pemphigus vulgaris, urticarial Arthropod PUPPP Urticaria Postinflammatory pigmentary alteration Macular amyloidosis Urticaria pigmentosa Brachioradial pruritis Superficial Perivascular Psoriasiform Psoriasis Allergic contact dermatitis Nummular -
Mallory Prelims 27/1/05 1:16 Pm Page I
Mallory Prelims 27/1/05 1:16 pm Page i Illustrated Manual of Pediatric Dermatology Mallory Prelims 27/1/05 1:16 pm Page ii Mallory Prelims 27/1/05 1:16 pm Page iii Illustrated Manual of Pediatric Dermatology Diagnosis and Management Susan Bayliss Mallory MD Professor of Internal Medicine/Division of Dermatology and Department of Pediatrics Washington University School of Medicine Director, Pediatric Dermatology St. Louis Children’s Hospital St. Louis, Missouri, USA Alanna Bree MD St. Louis University Director, Pediatric Dermatology Cardinal Glennon Children’s Hospital St. Louis, Missouri, USA Peggy Chern MD Department of Internal Medicine/Division of Dermatology and Department of Pediatrics Washington University School of Medicine St. Louis, Missouri, USA Mallory Prelims 27/1/05 1:16 pm Page iv © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park Abingdon, Oxon OX14 4RN, UK Tel: +44 (0) 20 7017 6000 Fax: +44 (0) 20 7017 6699 Website: www.tandf.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. -
An Overview of Zinc and Its Importance in Dermatology- Part II
Global Dermatology Review Article ISSN: 2056-7863 An overview of zinc and its importance in dermatology- Part II: The association of zinc with some dermatologic disorders Nooshin Bagherani1* and Bruce R Smoller2 1Dermatologist at Dr. Nooshin Bagheran’s office, Taha Physicians’ building, Iran 2Department of Dermatology, University of Rochester, School of Medicine and Dentistry, USA Abstract Zinc is an essential trace element important for a large number of structural proteins, enzymatic processes and transcription factors. It plays main roles in the cell- mediated immunity, bone formation, tissue growth, brain function, growth of the fetus and child. It also has roles in pathogenesis of some dermatological disorders. Zinc can be used as effective agent for treatment of some skin and hair disorders, but generally, it seems that with the exception of states relating to zinc deficiency, there is very little evidence to support the efficacy of zinc as a first-line treatment for most of dermatological conditions. Herein, we collected and summarized the appropriate manuscripts and papers regarding the importance of zinc in some of the most important dermatological disorders. Introduction In a study on humans and mice with Zn deficiency, Kawamura et al. revealed that allergic contact dermatitis was diminished, whereas In human beings, zinc (Zn) constitutes less than 0.005% of total irritant contact dermatitis was more severe and prolonged than that body weight, and is present in all types of cells [1]. It is an essential in controls. They also proved that epidermal Langerhans cells, which trace element important for a large number of structural proteins, play a protective role against the ATP-mediated inflammatory signals, enzymatic processes and transcription factors [2].