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2781. Foveal congenital hypertrophy of the retinal pigment epithelium in the setting of geographic atrophy from age-related macular degeneration. (Abstract)

of geographic atrophy and large-sized drusen were seen in the maculae of both eyes. Biomicroscopic examination of the right eye showed hyperpigmentation consistent with congenital hypertrophy of the retinal pigment epithelium through the center of the macula. No prior photographic documentation of the retina was available.This case suggests that foveal congenital hypertrophy of the retinal pigment epithelium may be seen in the setting of macular geographic atrophy. Although it is theoretically possible (...) that the hyperpigmentation is reactive rather than congenital, the pigmentation is typical for congenital hypertrophy and is unlike any reactive pigmentation in our experience or described in a MEDLINE search of features of age-related macular degeneration. The case suggests that a hypertrophic process of the retinal pigment epithelium may coexist within or immediately adjacent to the anatomic boundaries of an atrophic process such as geographic atrophy from age-related macular degeneration.

2003 American Journal of Ophthalmology

2782. Fundus autofluorescence and age-related macular degeneration. (Abstract)

patients was evaluated; 18 were in each group. The mean age was 75.4 years, and there was no difference in the mean ages among the groups (P = 0.16). There was no correlation of the autofluorescence measurements and the degree of nuclear sclerosis (P = 0.14). Patients with exudative AMD had more autofluorescence in the fellow eye than did eyes of patients without exudative AMD (P = 0.002). Patients in group 3 were more likely to have focal hyperpigmentation, particularly as imaged by infrared light (P (...) that corresponded, for the most part, with focal areas of hyperpigmentation best seen by infrared monochromatic fundus photography. Because the amount of fluorescence is directly related to the amount of lipofuscin, which in turn is related to the cumulative amount of oxidative damage, these findings suggest possible explanations for certain patterns of vessel growth seen in exudative AMD.

2003 Ophthalmology

2783. Stereotactic radiosurgery for patients with ACTH-producing pituitary adenomas after prior adrenalectomy. (Abstract)

Stereotactic radiosurgery for patients with ACTH-producing pituitary adenomas after prior adrenalectomy. To review the results of stereotactic radiosurgery for patients with adrenocorticotropic hormone (ACTH)-producing pituitary adenomas after bilateral adrenalectomy.Eleven patients with ACTH-producing pituitary adenomas after bilateral adrenalectomy underwent radiosurgery between 1990 and 1999. Nine patients had documented tumor growth, hyperpigmentation, and elevated ACTH levels (median 920

2002 Biology and Physics

2784. Accelerated partial breast irradiation using 3D conformal radiation therapy (3D-CRT). (Abstract)

localized hyperpigmentation and/or erythema was observed. No instances of symptomatic radiation pneumonitis have occurred.Accelerated partial-breast irradiation using 3D-CRT is technically feasible, and acute toxicity to date has been minimal. A CTV-to-PTV margin of 10 mm seems to provide coverage for most patients. However, more patients and additional studies will be needed to validate the accuracy of this margin, and longer follow-up will be needed to assess acute and chronic toxicity, tumor control

2003 Biology and Physics

2785. Urticarial vasculitis. (Abstract)

Urticarial vasculitis. Urticarial vasculitis is a clinico-pathologic entity typified by recurrent episodes of urticaria that have the histopathologic features of leukocytoclastic vasculitis. The cutaneous features may include painful, burning or pruritic skin lesions, the persistence of individual lesions greater than 24 hours, palpable purpura, pronounced central clearing of lesions, and residual hyperpigmentation following resolution. However, because clinical characteristics of urticarial

2002 Clinical Reviews in Allergy & Immunology

2786. Clinical, genetic, and functional characterization of adrenocorticotropin receptor mutations using a novel receptor assay. Full Text available with Trip Pro

mutations of MC2R lead to hereditary unresponsiveness to ACTH, also known as familial glucocorticoid deficiency (FGD). These patients are usually seen in early childhood with very low cortisol concentrations, normal mineralocorticoids, hyperpigmentation, and increased bodily growth. Several MC2R mutations have been reported in FGD, but assays of the activities of these mutants are cumbersome. We saw two patients with typical clinical findings of FGD. Genetic analysis showed that patient 1 was homozygous

2002 Journal of Clinical Endocrinology and Metabolism

2787. Neurosurgical treatment of Nelson's syndrome. Full Text available with Trip Pro

neurosurgery in all. Preoperatively, the median plasma ACTH level was 664 pmol/liter (range, 92-3665 pmol/liter); this fell to 29 pmol/liter (range, <2 to 1124 pmol/liter) postoperatively (P < 0.0005). Cutaneous hyperpigmentation was reduced in all and resolved in 11 patients. The pituitary tumor bulk was clearly reduced in 12 patients. There was no perioperative mortality. No patient developed a visual field defect attributable to surgery. New anterior pituitary hormone deficiency occurred in seven

2002 Journal of Clinical Endocrinology and Metabolism

2788. Pilot study of the effect of postoperative imiquimod 5% cream on the recurrence rate of excised keloids. (Abstract)

weeks. Patients were examined at weeks 4, 8, 16, and 24 for local erythema, edema, erosions, pigment alteration, and/or recurrence of keloids. Of the 11 keloids evaluated at 24 weeks, none (0%) recurred. Incidences of hyperpigmentation were 63.6%. Two cases of mild irritation and superficial erosion cleared with temporary discontinuation of imiquimod. Both patients completed the 8 weeks of topical therapy and the final 24-week assessment. At 24 weeks, the recurrence rate of excised keloids treated

2002 Journal of American Academy of Dermatology

2789. The inhibitory effect of glycolic acid and lactic acid on melanin synthesis in melanoma cells. (Abstract)

The inhibitory effect of glycolic acid and lactic acid on melanin synthesis in melanoma cells. Alpha-hydroxy acids (AHAs) such as glycolic acid (GA) and lactic acid (LA) have been reported to be effective in treating pigmentary lesions such as melasma, solar lentigines, and postinflammatory hyperpigmentation. The mechanism of this effect might be due to epidermal remodeling and accelerated desquamation, which would result in quick pigment dispersion. However, the direct effect of AHAs

2003 Experimental Dermatology

2790. Topical photodynamic therapy in disseminated superficial actinic porokeratosis. (Abstract)

the first treatment, the disorder cleared in the test area in one patient, but failed to respond in the other two patients. After subsequent treatment, the initial benefit seen in the first patient was not sustained, and no response was seen in the second patient, while the third patient was not retreated due to hyperpigmentation induced by the procedure. The results obtained in this small case series suggest that topical PDT is not a promising treatment for disseminated superficial actinic

2002 Clinical & Experimental Dermatology

2791. Tattoo ink darkening of a yellow tattoo after Q-switched laser treatment. (Abstract)

, hypopigmentation, hyperpigmentation, partial removal, infection, bleeding and tattoo ink darkening. The latter has been reported for flesh-toned and red tattoos. Such a complication has never been reported for the laser treatment of a yellow tattoo in the dermatological literature. We describe a case of tattoo ink darkening of a yellow tattoo after treatment with the 532 nm quality-switched Neodymium : Ytrrium-Aluminium Garnet laser to highlight clinicopathological features. The mechanism by which some tattoos

2002 Clinical & Experimental Dermatology

2792. The dermoscopic classification of atypical melanocytic naevi (Clark naevi) is useful to discriminate benign from malignant melanocytic lesions. (Abstract)

in melanomas, whereas eccentric peripheral hyperpigmented and multifocal hyper- or hypopigmented types were significantly more frequent in melanomas (P < 0.001).The dermoscopic classification of atypical naevi (Clark naevi) is useful to discriminate benign from malignant melanocytic lesions. The three-structure type and eccentric peripheral hyperpigmentation were significantly more frequently found in malignant than in benign melanocytic lesions. The knowledge of these two dermoscopic types should

2003 British Journal of Dermatology

2793. Increased procollagen alpha1(I) mRNA expression by dermal fibroblasts in melorheostosis. (Abstract)

left leg. Hyperpigmentation of the basal keratinocytes, thick-walled vessels in the reticular dermis, and proliferation of normal-appearing collagen around the hair follicles were observed histologically.

2003 British Journal of Dermatology

2794. Significance of extensive Mongolian spots in Hunter's syndrome. (Abstract)

spots in infants with Hunter's syndrome, and to clarify the relationship between the Mongolian spots and Hunter's syndrome clinically and histopathologically.Seven Japanese boys with Hunter's syndrome who had received HSCT at ages 4-11 years were observed. The cutaneous manifestations of Mongolian spots before HSCT were evaluated, and compared with those after HSCT. In two patients, the hyperpigmentation from the Mongolian spots was examined by light and electron microscopy.Pre-HSCT observation (...) clearly suggest that the hyperpigmentation is a long-lasting symptom. The recognition of the extensive Mongolian spots is essential as it may lead to early diagnosis in patients with a mild form of Hunter's syndrome.

2003 British Journal of Dermatology

2795. Dowling-Degos disease associated with squamous cell carcinomas on the dappled pigmentation. (Abstract)

and back, a finger-like fibroma in the right popliteal fossa, dystrophic fingernails, and a large number of seborrhoeic keratosis-like lesions predominantly on the flexural areas. Another unique clinical feature was the lack of vellus hair on the whole body surface. In addition to thin branching and elongation of rete ridges with basal hyperpigmentation, immature hair follicles surrounded by fibrosis and a lace-like pattern of the hair follicle epithelia were observed histologically. These epithelial

2002 British Journal of Dermatology

2796. Pigmentary mosaicism with mosaic chromosome 5p tetrasomy. (Abstract)

Pigmentary mosaicism with mosaic chromosome 5p tetrasomy. Pigmentary mosaicism with mosaic chromosome 5p tetrasomy is described. A 5-year-old girl had phylloid hyperpigmentation segregated in the midline, and neurological deficits. Chromosome analysis performed on blood lymphocytes was normal, whereas skin fibroblasts from affected skin areas revealed chromosomal mosaicism.

2003 British Journal of Dermatology

2797. Efficacy of pulsed dye laser treatment of port wine stain malformations of the lower limb. (Abstract)

and postinflammatory hyperpigmentation has been reported to be a significant problem.To review retrospectively patients who attended for PDL treatment of PWS affecting the lower limb and assess the efficacy and adverse effects with particular reference to skin site.A retrospective review was carried out of patients attending the Leeds Dermatology Laser Centre for treatment of a PWS on the lower limb with a 585-nm PDL.A total of 52 sites in 39 patients were treated: 17 on the thigh, 31 on the lower leg and four (...) on the foot. The mean number of sessions per patient was 14, with an excellent outcome in seven treatment sites (13.5%), good in 13 (25%), moderate in 21 (40.4%) and poor outcome in 11 (21.1%). Patients were generally pleased with their results with a mean improvement of 7 on a scale of 0-10. Perifollicular persistence of the PWS was observed in six sites (11.5%). Adverse effects occurred in 36 patients (92.3%), most commonly hyperpigmentation (87%). Six patients (15.4%) developed atrophic scarring

2003 British Journal of Dermatology

2798. A natural canine homologue of alopecia areata in humans. (Abstract)

, immunohistochemistry for lymphocyte markers, indirect immunofluorescence and immunoblotting analysis of circulating serum IgG, selective immunoprecipitation of HF proteins by serum IgG, and passive transfer of purified canine IgG into naïve C57BL/10 mice.Clinical signs including alopecia, skin hyperpigmentation and leucotrichia usually developed during adulthood and were first seen on the face, followed by the forehead, ears and legs. Spontaneous remission of alopecia occurred in 60% of dogs and regrowing hair

2003 British Journal of Dermatology

2799. Delayed full-thickness skin grafts revisited. (Abstract)

of 70 patients, seen over a 5-year period, who had their Mohs surgical defects repaired with a FTSG or who were scheduled for a delayed FTSG, were reviewed, along with their accompanying photographs (when available). The outcome of immediate and delayed FTSG was compared in terms of (1) graft loss, (2) epidermal sloughing, (3) thickening and/or irregularity, (4) contour correction, (5) hypopigmentation/hyperpigmentation, (6) persistent erythema, and (7) need for surgical revision.Twenty-seven

2003 Dermatologic Surgery

2800. 532-nm Nd:YAG and 595-nm pulsed dye laser treatment of leg telangiectasia using ultralong pulse duration. (Abstract)

more than 75% improvement after single treatment with a 532-nm Nd:YAG laser. Similarly, 2 of 10 subjects had less than 25%, 2 had 25% to 50%, and 6 had 50% to 75% improvement with the 595-nm PDL. Hyperpigmentation occurred in one subject treated with the 532-nm Nd:YAG laser and two subjects treated with the 595-nm PDL. No blistering, crusting, hypopigmentation, or scarring were observed.Both lasers using ultralong pulse width improved leg telangiectasias after a single treatment with minimal

2003 Dermatologic Surgery

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