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Common Clinical Features (common + clinical_feature)
Selected AbstractsContact dermatitis in Korean dental techniciansCONTACT DERMATITIS, Issue 1 2001Jun Young Lee The high risk of occupational contact dermatitis in dental personnel are well accepted throughout the world. There are few reports concerning occupational skin disease in dental personnel in Korea. The purposes of this study were to investigate the frequency, characteristics and causative factors of contact dermatitis in Korean dental technicians. Recording of personal history, physical examination and patch tests with the Korean standard series and dental screening series were performed in 49 dental technicians. Most of the subjects were exposed to a variety of compounds, including acrylics, metals, plaster, alginate, etc. 22 (44.9%) subjects had contact dermatitis, present or past, and the site involved was the hand in all 22. The most common clinical feature of hand dermatitis was itching (77.3%); scaling, fissuring and erythema were other common clinical features. Metals, including potassium dichromate (24.5%), nickel sulfate (18.4%), mercury ammonium chloride (16.3%), cobalt chloride (12.2%) and palladium chloride (10.2%), showed high positive rates in patch test results of 49 dental technicians. 7 positive reactions to the various acrylics were found in 3 subjects. In our study, the frequency and clinical features of the contact dermatitis showed a similarity to other reports, though the patch test results were somewhat different; a higher patch-positive reaction to metals and a relatively lower patch-positive reaction to acrylics than the patch test results reported in Europe. [source] Clinical features and natural history of acquired cold urticaria in a tertiary referral hospital: a 10-year prospective studyJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 12 2008A Katsarou-Katsari Abstract Background, Acquired cold urticaria (ACU) represents a heterogeneous group of disorders that share a common clinical feature: the development of urticaria or angioedema after cold exposure. We present epidemiological and clinical data of subjects with ACU, natural progression and we examine possible parameters that could correlate with disease severity. Methods, During a 10-year period in all subjects with ACU, detailed record of personal history, laboratory testing, cold stimulation testing (CST), atopy assessment and disease severity took place. In a re-evaluation visit at the end of the surveillance period, ACU progression was assessed from patients in a subjective way. Results, Four thousand one hundred fifty-seven individuals with chronic urticaria were referred, and 352 (198 males, 154 females, 8.47% of patients with chronic urticaria) presented definite symptoms of physical urticarias, while 95 individuals (49 males, 46 females, 27% of patients with physical urticarias) were detected with ACU. Sixty-two participants were included in study analysis. Thirty-two patients (51.6%) were female; the mean age was 41.5 ± 15.6 years, while the mean age at disease onset was 32.5 ± 15.6 years; half were , 30 years old at disease onset. The mean duration of surveillance was 9.0 ± 6.9 years. During this time interval, 18 patients (29.0%) showed the same or even worse symptomatology, 26 patients reported some improvement (41.9%), while in 18 patients, symptoms resolved completely (29.0%); the mean time to resolution was 5.6 ± 3.5 years. Disease severity was the only variable statistically significantly related to disease progression (P = 0.004). Conclusions, Cold urticaria is a chronic persistent disorder with occasional severe clinical manifestations. [source] Contact dermatitis in Korean dental techniciansCONTACT DERMATITIS, Issue 1 2001Jun Young Lee The high risk of occupational contact dermatitis in dental personnel are well accepted throughout the world. There are few reports concerning occupational skin disease in dental personnel in Korea. The purposes of this study were to investigate the frequency, characteristics and causative factors of contact dermatitis in Korean dental technicians. Recording of personal history, physical examination and patch tests with the Korean standard series and dental screening series were performed in 49 dental technicians. Most of the subjects were exposed to a variety of compounds, including acrylics, metals, plaster, alginate, etc. 22 (44.9%) subjects had contact dermatitis, present or past, and the site involved was the hand in all 22. The most common clinical feature of hand dermatitis was itching (77.3%); scaling, fissuring and erythema were other common clinical features. Metals, including potassium dichromate (24.5%), nickel sulfate (18.4%), mercury ammonium chloride (16.3%), cobalt chloride (12.2%) and palladium chloride (10.2%), showed high positive rates in patch test results of 49 dental technicians. 7 positive reactions to the various acrylics were found in 3 subjects. In our study, the frequency and clinical features of the contact dermatitis showed a similarity to other reports, though the patch test results were somewhat different; a higher patch-positive reaction to metals and a relatively lower patch-positive reaction to acrylics than the patch test results reported in Europe. [source] Analysis of fumarate hydratase mutations in a population-based series of early onset uterine leiomyosarcoma patientsINTERNATIONAL JOURNAL OF CANCER, Issue 2 2006Sanna K. Ylisaukko-oja Abstract Germline mutations in fumarate hydratase (FH) gene at 1q43 predispose to hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome. In HLRCC, the most common clinical features are leiomyomas of the skin and uterus, and in a subset of the families, renal cell cancer (RCC) and uterine leiomyosarcoma (ULMS) occur frequently at young age. This study was conducted to evaluate the possible contribution of FH mutations in a population-based series of early onset (,45 years) ULMSs. Eighty-one cases were identified through the national cancer registry, and samples from 67 cases (83%) were available for FH mutation screening and analysis of allelic imbalance (AI) at the FH locus. Seventeen percent of tumors showed AI. In the mutation analysis, a novel missense mutation K424R was found. The mutation was also found from the patient's normal tissue. To study whether this variant has functional consequences, FH enzyme activity assay was performed in a cell model. The activity of the mutated protein was significantly reduced as compared to wild type (p = 0.009). This study shows that FH germline mutations can occur in seemingly nonsyndromic cases of ULMS (1/67, 1.5%). It appears that on the population level hereditary FH defects do play a role in pathogenesis of sporadic early onset ULMSs, albeit rarely. © 2006 Wiley-Liss, Inc. [source] Patterns of skin manifestations and their relationships with CD4 counts among HIV/AIDS patients in CameroonINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2006Mbuagbaw Josephine Background, Skin manifestations are common clinical features among HIV/AIDS-positive patients. Their frequencies, patterns and associated factors have been shown to vary from region to region. The present study is aimed at documenting skin manifestations and their relationships with CD4 cell counts among HIV/AIDS patients in Cameroon. Methods, This study lasted for 16 months (from September 2001 to December 2002). After informed consent, data on skin disorders, HIV status, CD4 and viral load were obtained by physical examination and laboratory methods. Results, Of the 384 subjects studied, 236 (61.5%) were females and 148 (38.5%) were males. Up to 264 (68.8%) patients presented with at least one type of skin problem. Generalized prurigo, oral candidiasis, herpes zoster, and vaginal candidiasis were the most common skin problems. Mean CD4 cell count (128 ± 85 cells/mm3) and mean viral load (79,433 copies/mL) in patients with herpes zoster were higher (P < 0.001). Patients with oral candidiasis and vaginal candidiasis had significantly lower (109 ± 127 cells/mm3, P < 0.02) and higher (131 ± 85 cells/mm3, P < 0.05) mean CD4 cell counts, respectively. Prurigo was associated with higher mean viral load (31,623 ± 20 copies/mL, P < 0.04). Viral lesions were associated with high mean CD4 cell count (123 ± 83 cells/mm3, P < 0.001). Kaposi's sarcoma and parasitic lesions (crusted scabies) were both, respectively, associated with lower mean CD4 cell counts [(78 ± 66 cells/mm3, P < 0.001) (6 ± 0 cells/mm3, P < 0.04)]. Conclusion, We conclude, first that skin problems are common in HIV-infected individuals in Cameroon and that patients with advanced stages of these problems have relatively very low mean CD4 cell counts. Second, that mucocutaneous disorders like vaginal candidiasis and herpes zoster occur early in HIV infection while Kaposi's sarcoma is common in advanced HIV infection. [source] Possible coexistence of SLE and sarcoidosis in a Chinese female patientINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 1 2003K. K. Lee Abstract Systemic lupus erythematosus (SLE) and sarcoidosis, both being multisystem disorders, share some common clinical features. However, while SLE is not an uncommon disease in the Chinese population, sarcoidosis is distinctly rare in the Chinese. We report a Chinese female patient whose presenting features tend to suggest a lupus-like illness. However, eventually, the diagnosis of sarcoidosis was documented, based on the histological findings of her lymph node biopsy. The possible coexistence of SLE and sarcoidosis is discussed. [source] PL1 Subepithelial bullous diseases , topic overviewORAL DISEASES, Issue 2006M Mravak-Stipeti Subepithelial bullous diseases comprise the group of mucocutaneous autoimmune blistering diseases characterized by subepithelial separation and the deposition of immunoglobulin and complement against several antigens along the basement membrane zone (BMZ). This result in spectrum of diseases that affect skin, oral mucosa, and other mucosal membranes and include bullous pemphigoid (BP), mucous membrane (cicatricial) pemphigoid (MMP), linear IgA disease (LAD), and chronic bullous dermatosis of childhood (CBDC). The most common clinical features are oral erosions, desquamative gingivitis and conjunctival fibrosis, as well as skin lesions, predominantly in older female population. The heterogeneity of clinical presentation and diversity of target autoantigens have contributed to difficulties in characterizing this condition immunologically. In addition to the clinical presentation and a subepithelial vesicle or bullae on routine histologic analysis, the diagnosis is based on direct and indirect immunofluorescence studies. The nature of the disease is determined by the target antigens in the epithelium and BMZ such as antigen 180 (BP180), antigen 230 (BP230), laminin 5, and beta 4 integrin. Circulating IgG and IgA antibodies bind to different epitopes of BP180. The use of salt-split skin substrate enables differentiation between epidermal and dermal 'binders'. Since the antigen and the antibody titer appear to have direct relationships with the disease severity, and a combination of clinical finding and antibody titer provides valuable prognostic data, these investigations should be carried out routinely. Clinicians should recognize clinical spectrum of SBD, the histopathologic and immunopathologic characteristics, the differential diagnosis, the treatment, and the natural history of the disease. Involvement of oral medicine specialists, dermatologists, ophthalmologists, otolaryngologists and gastroenterologists contribute to early diagnosis and will aid in providing SBD patients with the highest quality of care. [source] Waldenstrom's macroglobulinemia presenting with spinal cord compression: A case reportAMERICAN JOURNAL OF HEMATOLOGY, Issue 12 2006Hani Al-Halabi Abstract Waldenstrom's macroglobulinemia (WM) is a rare lymphoplasmacytic lymphoma characterized by a wide range of clinical presentations related to direct tumor infiltration and the production of IgM. Most commonly it presents with cytopenia, hepatosplenomegaly, lymphadenopathy, constitutional symptoms, and hyperviscosity syndrome. We report a case of WM in an 81-year-old man who initially presented with severe back pain. The patient had no peripheral lymphadenopathy or hepatosplenomegaly and his peripheral blood smear was normal. MRI of the spine revealed an epidural mass causing spinal cord compression at T9. Surgical decompression was performed and pathological analysis of the mass revealed a lymphoproliferative B-cell process. The diagnosis of WM was established after cytomorphologic and immunohistochemical analysis of the patient's bone marrow revealed the presence of a lymphoid/lymphoplasmacytoid-like bone marrow infiltrate along with an elevated serum IgM level. The patient responded both clinically and serologically to local radiotherapy. This case is unusual because the patient lacked all common clinical features of WM. This is the first reported case of epidural spinal cord compression as the initial manifestation of WM, adding to the spectrum of clinical presentations seen in this disease. Am. J. Hematol., 2006. © 2006 Wiley-Liss, Inc. [source] Autoinflammatory syndromes with a dermatological perspectiveTHE JOURNAL OF DERMATOLOGY, Issue 9 2007Nobuo KANAZAWA ABSTRACT The term autoinflammatory syndromes describes a distinct group of systemic inflammatory diseases apparently different from infectious, autoimmune, allergic and immunodeficient ones. Originally, it was almost synonymous with clinically defined hereditary periodic fever syndromes, including familial Mediterranean fever, hyper immunoglobulin D syndrome with periodic fever and tumor necrosis factor receptor-associated periodic syndrome. Similar but distinct periodic fever syndromes accompanied by urticarial rash, familial cold autoinflammatory syndrome, Muckle,Wells syndrome and chronic infantile neurological cutaneous articular syndrome, have all been reportedly associated with CIAS1 mutations and are collectively called cryopyrin-associated periodic syndromes. Consequently, the concept of autoinflammatory syndromes has been spread to contain other systemic inflammatory diseases: rare hereditary diseases with or without periodic fevers, such as pyogenic sterile arthritis, pyoderma gangrenosum and acne syndrome, Blau syndrome and chronic recurrent multifocal osteomyelitis, and the more common collagen disease-like diseases, such as Behcet's disease, Crohn's disease, sarcoidosis and psoriatic arthritis. These diseases are all caused by or associated with mutations of genes regulating innate immunity and have common clinical features accompanied with activation of neutrophils and/or monocytes/macrophages. In this review, major autoinflammatory syndromes are summarized and the pathophysiology of related skin disorders is discussed in association with dysregulated innate immune signaling. [source] Evidence for a pathogenetic role of interleukin-18 in cutaneous lupus erythematosusARTHRITIS & RHEUMATISM, Issue 10 2008Dong Wang Objective Cutaneous manifestations are the most common clinical features of lupus erythematosus (LE). The aim of this study was to analyze differences in the inflammatory response of keratinocytes from patients with cutaneous LE (CLE) compared with healthy controls. Methods Keratinocytes from LE patients and controls were cultured from epidermal stem cells of the hair follicle of anagen head hairs. Functional responses of keratinocytes to cytokine stimulation were determined by flow cytometry and enzyme-linked immunosorbent assay. Biopsy samples of lesional skin were analyzed by immunohistochemistry. Results Keratinocytes from CLE patients expressed higher levels of IL-18 receptor on their cell surface in response to tumor necrosis factor , (TNF,) or interferon-, stimulation. In response to IL-18 stimulation, these cells produced large amounts of TNF,. Of note, in the presence of IL-18, CLE keratinocytes failed to express IL-12. IL-12 has previously been shown to protect keratinocytes from ultraviolet irradiation,induced apoptosis. Keratinocytes from LE patients were more prone to die upon exposure to IL-18, and this increased apoptosis was abrogated by blockade of endogenously produced TNF, as well as by the addition of exogenous IL-12. IL-18 was highly expressed in biopsy samples of lesional skin from CLE patients. Conclusion Our results demonstrate an intrinsic difference in the inflammatory response of keratinocytes and indicate an autocrine feedback loop involving TNF,, IL-18, and IL-12 family members. Our results suggest that IL-18 may occupy an important position in the cytokine hierarchy in CLE, indicating the potential benefit of a local agent that blocks IL-18 activity in the treatment of the manifestations of CLE. 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