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  • 1
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: In order to understand the kinematics which likely facilitated the speedy rupturing process of the 1999 Mw 7.6 Taiwan Chi-Chi earthquake, we examined exposed rocks in the Taiwan Slate belt, where the pressure and temperature conditions most resembled the hypocentre of the Chi-Chi earthquake, i.e. sub-greenschist facies. Field observations and composition analyses of the silicified vein-rich zones beneath the duplex structure suggest that impermeable slate layers may serve as cap rocks for confining deep-seated fluids. These fluids most likely come from the Taiwan metamorphic complex at deeper depths by the dehydration and decarbonation reactions (or partial melting). In addition, the gouge zone of a link fault above the detachment also indicates the presence of overpressured fluids during faulting. It is probable that episodic leakage of the confined fluid reservoirs may provide essential fluids for fault lubrication during earthquake ruptures.
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  • 2
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: Backstripping analysis has been carried out on nine outcrop sections of the Basque-Cantabrian Aptian and Albian of northern Spain which consist of shallow-water marine deposits up to 7000 m thick. It reveals four main pulses of common accelerated subsidence: I (Early Aptian), II (Early Albian), III (lower Late Albian), and IV (uppermost Late Albian) separated by tectonic quiescent intervals. Tectonic subsidence rates of 70 m Myr–1 for the Aptian and 101 m Myr–1 for the Albian were recorded (Sopuerta section). The calculated stretching factor referred to a pre-rift continental crust of 35 km is (βs=1.32) and represents approximately 8.5 km of crustal thinning. Points of change towards lesser subsidence rate in the curves are correlated with major unconformities in the sections, in the Basque-Cantabrian Basin and in Boreal Europe, suggesting geodynamic changes related with the opening of Bay of Biscay. Minor variations of spreading direction and intensity are proposed to explain the subsidence pulses.
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  • 3
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: The ability to deduce exhumation mechanisms from thermochronological data is hampered by the fact that assumptions on the thermal state of the lithosphere have to be made. Additional argumentation is generally required to discriminate between erosion-controlled and tectonically induced exhumation. This problem can be overcome by studying the spatial distribution of zircon and apatite (U-Th)/He and fission track data. In this work the variation of four different low temperature isotopic systems generating age trends along a sampling line is used to infer mechanisms of Quaternary exhumation in the Central High Himalayan Metamorphic Belt. Observed zircon age trends with southwards increasing cooling ages (from 0.5 to 1.7 Ma) are attributed to tectonically induced exhumation. The uniform apatite cooling ages clustered c. 0.5 Ma are attributed to erosion.
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  • 4
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: Metre-scale siliciclastic–carbonate cycles are the basic depositional motif of the lower Miocene Guadagnolo Formation outcropping in the central Apennines. The mechanisms which formed the mixed-lithology cycles are still a matter of debate. The mixed siliciclastic–carbonate system discussed in this paper provides a new case study to illustrate the role of orbital forcing in controlling the facies evolution and cyclic stacking of small-scale sequences deposited on the outer sector of a ramp. Two sections are discussed that display mixed siliciclastics and carbonates arranged in upward-shallowing cycles. Each cycle shows an upward decrease in the terrigenous input and a parallel increase in benthic fauna. Time-series analyses indicate the cyclic carbonate-terrigenous pattern to be largely controlled by orbital forcing in the Milankovitch frequency band. Coupling of climate change and sea-level fluctuations in tune with orbital cycles are proposed as driving mechanisms.
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  • 5
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: The Lomza orthoamphibolites in the crystalline basement of NE Poland, dated at 1802 ± 9 Ma by SHRIMP zircon U–Pb, are characterized by high incompatible and REE element contents. These features, the low Nb, and the position of the rock compositions on La–Y–Nb, Zr–Nb/Zr and Zr–Nb–Y tectonomagmatic discrimination diagrams, suggest that the metavolcanics formed in a subduction setting, possibly within a continental margin island arc. The likely extension of the belt of Paleoproterozoic mafic magmatism from Latvia and Lithuania into NE Poland provides convincing evidence for the existence of an active plate margin in that region at that time.
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  • 6
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: The biota of the 1.5 Ma period of the Middle Miocene Sarmatian of the Central Paratethys lack stenohaline components. This was the reason to interpret the Sarmatian stage as transitional between the marine Badenian and the lacustrine Pannonian stages. However, our new data indicate that brackish water conditions could not have prevailed. Sarmatian foraminifera, molluscs, serpulids, bryozoans, dasycladacean and corallinacean algae as well as diatoms clearly indicate normal marine conditions for the entire Sarmatian. During the Lower Sarmatian, however, a sea-level lowstand forced the development of many marginal marine environments. During the Late Sarmatian a highly productive carbonate factory of oolite shoals, mass-occurrences of thick-shelled molluscs and larger foraminifera, as well as marine cements clearly point to normal marine to hypersaline conditions. This trend is not restricted to the western margin of the Pannonian Basin System but can be observed in the entire Central and even Eastern Paratethys.
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  • 7
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: We discuss the implications of a lithospheric model of the Moroccan Atlas Mountains based on topography, heat flow, gravity and geoid anomalies, taking into account the regional geology. The NW African cratonic lithosphere, some 160–180 km thick, thins to c. 80 km beneath the Atlas fold-thrust belts, in contrast with the shortening regime prevailing there since the early Cenozoic. This fact explains several geological and geophysical features as high topography with modest tectonic shortening, the occurrence of alkaline magmatism contemporaneous to compression, the absence of large crustal roots to support elevation, the scarce development of foreland basins, and a marked geoid high. The modelled lithosphere thinning is related to a thermal upwelling constrained between the Iberia–Africa convergent plate boundary and the Saharan craton.
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  • 8
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: The Andes of northern Chile currently experience a phase of relief rejuvenation as indicated by valleys that are >1000 m dissected into pediplains. However, it has been unclear when this phase of relief enhancement started. This paper discusses the use of palaeomagnetic chronologies from four sections in the Taracapá-Region (northern Chile) to assess this age. The sections are located in distal and proximal positions. Sediment accumulation occurred between c. 22.5 and 8/7.5 Ma with a hiatus that possibly spans a time interval between c. 19.5 and 11 Ma. The magnetic polarity chronologies suggest a preferred age between 8.0 and 7.5 Ma for the time when relief growth started. In proximal positions, however, alternative correlations suggest an age of 8.5 Ma. In addition, the palaeomagnetic data reveal no rotation of the analysed strata, suggesting a minimum age of c. 22.5 Ma for the tectonic block rotation south of the Arica deflection.
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  • 9
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: The mechanism by which diamonds grow in Earth's mantle has been a subject of discussion for many years. Arguments have been advanced for growth from a melt, from a COH fluid, and in the solid state. The discovery of microdiamonds within ultra-high pressure terranes of continental collision settings re-energized this debate because of their very different but well-defined continental crust environment. We report here the discovery of filled nanometric fluid bubbles in diamonds from marble of the Kokchetav massif, Kazakhstan, and the serendipitous measurement of their contents due to bursting of a bubble very shortly after a measurement of chemical composition in the transmission electron microscope, thereby allowing immediate re-analysis with exactly the same settings of all parameters of the microscope. The chemical composition of the fluid is C, H, O, Cl, S, Ca, Fe and K. The direct observation and composition of a low-viscosity trapped fluid in microdiamond unambiguously establish their fluid growth medium.
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  • 10
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
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  • 11
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
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  • 12
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: Geometric analysis of nested Riedel structures was used to identify and quantify strain localization processes within faulted Navajo sandstone. The analysis shows systematic deviation from the basic Riedel geometry complying with the Mohr–Coulomb criterion. Using cross-cutting relations amongst deformation bands within the Riedel structures, and comparing the orientations of the deformation bands to theoretical strain calculations, we identify two coupling deformation mechanisms involved in the early stages of shear-zone evolution, namely, granular flow and discrete faulting. Both mechanisms localize during strain accumulation, and the granular flow facilitates considerable change in the initial geometry of the Riedel structures. The analysis demonstrates a systematic sequence, by which new Riedel structures form after a constant amount of shear strain takes place in the sandstone. Analysis further indicates that granular flow is the major deformation mechanism during early stages of shear-zone evolution and discrete faulting is the dominant mechanism during later deformation stages.
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  • 13
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: Svalbard is located in the north-west corner of the Barents Sea shelf and the Eurasian Plate, in a key area for interpreting Caledonian and older orogens in the Arctic region. Recent U–Pb dating in the Nordaustlandet Terrane of eastern Svalbard shows this terrane to consist of a Grenville-age basement, overlain by Neoproterozoic to early Palaeozoic platformal sediments, and intruded by Caledonian anatectic granites. Deformation, metamorphism and crustal anatectic magmatism occurred both during the Grenvillian (960–940 Ma) and Caledonian (450–410 Ma) orogenies. This evolution shows great similarities with that of eastern Greenland. In the classical model, eastern Svalbard is placed outboard of central east Greenland in pre-Caledonian time. Alternatively, it may have been located north-east of Greenland and transferred west and rotated anticlockwise during Caledonian continent–continent collision. In the Neoproterozoic, easternmost Svalbard may have been part of a wider area of Grenville-age crust, now fragmented and dispersed around the Arctic.
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  • 14
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Terra nova 17 (2005), S. 0 
    ISSN: 1365-3121
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Geosciences
    Notes: Understanding the formation and the development of salt structures is very important especially because they are of significant economical interest for hydrocarbon trapping and for long-term storage of radioactive waste and energy reserves. Generally, the activity of normal faults developed in extensional regimes is considered the most efficient mechanism for salt diapirs. The results of analogue models reported in this paper suggest a new triggering mechanism for the rise of salt structures during basin inversion. This mechanism relates the localization of ductile diapirs to early normal faults only after their inversion during later shortening. In this case, diapiric growth is related to the strong dip-slip reactivation component along the fault extruding the silicone-simulating salt upward. Some natural cases, in which the timing and the mechanism of diapiric growth is not clear, can be re-interpreted in the light of these analogue model results.
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  • 15
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 16
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 17
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 18
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Skin color is important to people in many societies. In this descriptive cross-sectional study, the causes of skin disorders in patients presenting for consultation over a period of 5 years were assessed and identified. A total of 4510 dyschromia cases were recorded, representing 9% of the total number of patients attending for consultations at the Dermatology Center of Abidjan over this period. Pigmentation disorders were more often found in female patients (53.56%; sex ratio female:male = 1.44) and were predominant in patients 20–30 years old (50%). All socio-professional categories were represented. However, students and service professionals (hairdressers, dressmakers, traders and switchboard operators) represented 50% of the patients with pigmentation disorders. Hyperchromia was common (48.49%) and was found in exposed areas of the skin. Most of the pigmentation disorders (60.94%) were of post-inflammation origin. Vitiligo was the most frequent etiology of systemic or endocrine dyschromia (92.63%). Among the hereditary pigmentation disorders, pigmented naevus was the most commonly found (41.5%). Dyschromic chemical eruptions appeared most frequently in the form of fixed pigmented erythema (84.55%). This study demonstrates that pigmentation disorders are still a frequent reason for consultation due to their distressing consequences.
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  • 19
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 20
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 21
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 22
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 23
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 24
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Lichen planus (LP) is classified as a papulosquamous disease. It has been associated with liver disease, particularly hepatitis C virus (HCV) infection, in several studies. Most of these reports, especially the larger series, were conducted in Europe and Japan.Objective  We conducted a case–control study in Kerman, Iran to explore the association between LP and HCV.Methods  The study included 66 patients with LP (as cases; mean age = 39.7 ± 15.8 years; 31 female, 35 male) and 140 volunteer blood donors (as controls; mean age = 29.5 ± 8.4 years; 43 females, 97 males). An enzyme-linked immunosorbent assay (ELISA) was used to determine the presence of anti-HCV antibodies in all subjects in both groups. To confirm positive diagnoses, a second generation recombinant immunoblot assay (RIBA II) test was performed.Results  Lichen planus lesions were most frequently located on the trunk and extremities, and the most common clinical type was generalized LP (48.5%). One of the patients with LP (1.5%) and three of the controls (2.1%) were HCV-Ab positive. No significant difference was observed in HCV-Ab positive between the two groups (OR = 0.7; 95% CI = 0.1–6.9).Conclusion  The findings indicate that an investigation for HCV infection should not necessarily be performed in all patients with LP. It is recommended that further studies should focus on larger groups in other regions of Iran to determine whether testing for HCV infection is necessary in patients with LP.
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  • 25
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 26-year-old woman with no family history of dermatophytosis presented with pruritic erythema on the right palm (<link href="#f1">Fig. 1) in November 2002, 1 month after first noticing it. She had no lesions on the soles, toe webs, left palm, or nails. The erythema had been treated with topical steroids for 4 weeks, but had continued to expand. The erythema measured 42 mm × 36 mm, and was hyperemic and infiltrated unevenly. Its center showed no signs of healing, its periphery exhibited small vesicles, and its margin showed scales. On the scales, fungal hyphae and chains of arthroconidia were revealed by direct KOH test. The erythema was diagnosed as tinea manuum and was treated with topical terbinafine once daily. After several days of treatment, the erythema flared up and red papuloerythemas appeared on the back of both hands and on both forearms. Ten days after the first visit, the patient returned to our clinic for the treatment of newly developed eruptions. A trichophytin skin test produced an infiltrated erythema measuring 21 mm × 18 mm, confirming that the newly developed eruptions and exacerbated erythema on the right palm were due to a trichophytid reaction. Topical terbinafine was continued for the palm and fluocinolone acetonide ointment was applied on the newly developed eruptions on the arms from day 10 after the first visit. All the inflammatory eruptions subsided after 4 weeks of treatment and direct KOH test results were negative.<figure xml:id="f1">1<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2180:IJD_2180_f1"/>Clinical finding of erythema on the right palm. The scaly erythema exhibited fine vesiclesThe suspected cause of tinea manuum was the patient's pet female four-toed hedgehog (Atelerix albiventris) which she had kept for 4 years (<link href="#f2">Fig. 2). When she bought it from a local pet shop, it had desquamation on its body, but no lesions with loss of hair or quill and no dermatitis. The scaling decreased gradually with treatment given by a veterinarian.<figure xml:id="f2">2<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2180:IJD_2180_f2"/>The pet four-toed hedgehog. The species Atelerix albiventris is characterized by the four-toed rear legThree isolates of dermatophytes were obtained from the scale on the woman's palm (KMU 4455), scale removed from the hedgehog (KMU 4459-1), and a fallen-out quill (KMU 4459-2). KMU 4455 grew rapidly with an ivory-white and lightly powdery surface, and with concentric ripples at the periphery. The center of the colonies was fluffy and elevated slightly, with a yellow pigment beneath (<link href="#f3">Fig. 3). The strains from the hedgehog were morphologically similar to each other, and their colonies grew more slowly and had a more powdery texture than those of KMU 4455. KMU 4459-1 and KMU 4459-2 gave a positive urease test result, whereas KMU 4455 gave negative results even at day 7 of incubation. The microscopic findings of the three isolates were almost the same (<link href="#f4">Fig. 4). Numerous teardrop-shaped microconidia were produced along the sides of the rectangle of mycelium. Spherical microconidia clustered in some parts and some club-shaped, 2–6-roomed macroconidia were observed. There were some poorly developed macroconidia and some elongated microconidia which were so large that they were intermediate in size between normal microconidia and macroconidia. There was no spiral body.<figure xml:id="f3">3<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2180:IJD_2180_f3"/>Gross finding of KMU 4455 isolated from the palm. A rapidly growing colony with concentric rippling at the periphery<figure xml:id="f4">4<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2180:IJD_2180_f4"/>Microscopic findings of KMU 4455. Lactophenol cotton-blue staining. (a) Irregular-shaped, thin-walled macroconidia with intermediate-sized conidia (× 600). (b) Teardrop-shaped microconidia along the sides of the rectangle of mycelium (× 600)The isolates were mated with (+) and (–) tester strains of African and Americano-European races of Arthroderma benhamiae on sunflower seed agar plates. KMU 4455 produced gymnothecia with mature ascospores only when mated with the (+) strain of the African race, RV 30000 (<link href="#f5">Fig. 5), whilst KMU 4459-1 and KMU 4459-2 produced gymnothecia only when mated with the (–) strain of the African race, RV 30001.<figure xml:id="f5">5<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2180:IJD_2180_f5"/>Mating behavior on sunflower seed agar plates. (a) KMU 4455 was compatible only with RV 30000, a (+) tester strain of the African race of Arthroderma benhamiae (upper plate). (b) A high-power view of gymnothecia produced on the upper plateBased on the above findings, all three isolates were identified as Trichophyton mentagrophytes var. erinacei. To confirm that the isolates were not the African race of A. benhamiae, nucleotide sequence analysis of the internal transcribed spacer (ITS) regions of ribosomal DNA was performed. Total DNA was extracted from KMU 4455 and KMU 4459-1, the ITS regions were amplified using primers ITS1 and ITS4 (White TJ, Bruns T, Taylor J. Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. In: Innis MA, ed. PCR Protocols: A Guide to Methods and Applications. London: Academic Press, 1990: 315–322), and sequenced by a standard dye terminator method. A 591-base pair fragment of DNA was compared with that of T. mentagrophytes var. erinacei registered in a gene database, DDBJ. The DNA fragments of KMU 4455 (DDBJ accession number AB 100263) and KMU 4459-1 (DDBJ accession number AB 100264) were 100% homologous to those of T. mentagrophytes var. erinacei IFM 48154 (= <accessionId ref="info:ddbj-embl-genbank/RV28924">RV28924, DDBJ accession number AB 78899) (Takahashi Y, Haritani K, Sano A, et al. An isolate of A. benhamiae with T. mentagrophytes var. erinacei anamorph isolated from a four-toed hedgehog (Atelerix albiventris) in Japan. Jpn J Med Mycol 2002; 43: 249–255).
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  • 26
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 27
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 28
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 29
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 30
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 31
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 32
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 33
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 34
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 35
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Vitiligo is not uncommon in southern Saudi Arabia. The response of Saudi patients to PUVA therapy has not been previously assessed. The aim of this study was to evaluate this response.Methods  This is a retrospective study for the period of 1990–2001 in which 32 patients were included: Data were collected from the patients’ records, including: age, sex, age at onset of disease, type of vitiligo, cumulative dose, maintenance dose, total number of sessions, number of sessions to induce pigmentation, treatment duration, and response rate.Results  The overall response rate was 59.4%. The most sensitive sites were the face, trunk, arms, and legs, while the most resistant sites were the hands, feet, and perioroficial areas (perioral and periorbital). Acute complications occurred in 59.4%, while chronic complications occurred in 78.1%. Analysis of the factors that affect the response rate showed that age, sex, the disease duration, and the treatment duration did not affect the response rate, while the surface area and the number of sessions to induce pigmentation showed a positive relation.Conclusions  PUVA is still considered as the most appropriate and effective treatment for vitiligo. Saudi patients showed good response to treatment in general. Some sites such as the face, trunk, arms, and legs showed sensitivity to therapy, while hands, feet, and periorificial areas showed resistance to therapy. Generalized type was the best type to respond, followed by the periorificial type. Acral and segmental types were very resistant to therapy.
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  • 36
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Anticonvulsant hypersensitivity syndrome (AHS) is a rare and potentially fatal reaction characterized by the appearance of fever, skin rash and internal organ involvement.Phenytoin, phenobarbital and carbamazepine are the most frequent aromatic anticonvulsants causing the reaction. This syndrome occurs 1–8 weeks after the initial drug exposure but, even though glucocorticoids appear to be useful in severe cases, discontinuation of the drug has been found to be essential in the resolution of symptoms.
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  • 37
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  • 38
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
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  • 39
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The term “hidradenitis suppurativa” is firmly entrenched in the dermatological literature although it refers to a false pathogenetic concept. The term was historically coined based merely on the characteristic distribution of the apocrine glands and the anatomical coincidence with the disease process. At center stage is not a suppurative inflammation of the apocrine sweat glands but an occlusion of the hair follicles, comparable to acne vulgaris. Reviewing the literature on this subject, we were astonished to find that even articles that concluded that the entity represents a form of follicular occlusion still referred to it as hidradenitis suppurativa. The disorder shares histopathological and clinical aspects with acne vulgaris modified under the special circumstances of anatomical regions rich in apocrine glands. It is acne inversa because, in contrast to acne vulgaris, the disease involves intertriginous localizations and not the regions classically affected by acne. We suggest that the term “hidradenitis suppurativa” for this disease should (finally) be abandoned in favour of “acne inversa”.
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  • 40
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Ciclopirox is an antifungal agent and is effective against both Gram-positive and Gram-negative bacteria. These properties may give ciclopirox an advantage over other antifungal agents in the treatment of interdigital tinea pedis with secondary bacterial infection (dermatophytosis complex).Objective  To evaluate the efficacy of ciclopirox 0.77% gel in the treatment of tinea pedis interdigitalis with secondary bacterial infection in a prospective, randomized, double-blind, placebo-controlled clinical study.Subjects and methods  One hundred subjects were enrolled in this 8-week study (twice-daily ciclopirox, 40 subjects; once-daily ciclopirox, 40 subjects; twice-daily vehicle, 20 subjects). Mycologic sampling, bacterial swabs, and evaluations for symptoms and signs of tinea pedis were performed on a target webspace at baseline and at weeks 2, 4, and 8. Global evaluations were made by both investigator and subject at each visit.Results  Ciclopirox gel applied once or twice daily significantly reduced the signs and symptoms at week 8, compared with vehicle (P < 0.0036). The mycologic cure and complete cure rates were much higher for the ciclopirox regimens than for the vehicle regimen. Early reduction of bacterial counts was noted with the ciclopirox regimens. There was no significant difference in the adverse event rate between the ciclopirox groups and the placebo group.Conclusion  Ciclopirox 0.77% gel, applied once or twice daily, is effective and safe in the treatment of tinea pedis interdigitalis with concomitant bacterial infection (dermatophytosis complex).
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  • 41
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
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  • 42
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  • 43
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Pemphigus is a rare and chronic life-threatening disease. The clinical picture varies in reports from different regions of the world.Objective  To define the clinical forms of pemphigus in a large cohort of patients.Methods  Prospective analysis of 1209 patients diagnosed and followed at the Pemphigus Research Unit, Tehran University for Medical Sciences, from 1984 to 2003.Results   The mean age at onset was 42 years with a female to male ratio of 1.5/1. The most frequent form was pemphigus vulgaris. In pemphigus vulgaris, patients’ mucous membrane involvement alone was observed in 18%, skin involvement alone in 12%, and both in 70%. Pemphigus foliaceus was observed in 7% of the patients. Most complications were iatrogenic.Conclusion  In Iran, pemphigus vulgaris is the most frequent form of pemphigus. Females are more prone to the disease. The incidence of pemphigus in Tehran is approximately 1.6 per 100 000/year, and in Iran 1.0 per 100 000/year. The age of onset was lower than classically reported. Death occurred in 6.2% of the patients. In pemphigus vulgaris, the mucosal and skin form together had a worse prognosis than the other clinical forms.
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  • 44
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
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  • 45
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
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  • 46
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Several instruments are available for assessing impairment and disability associated with psoriasis. The first true psoriasis-specific quality of life (QoL) questionnaire suitable for use in clinical trials, the Psoriasis Index of Quality of Life (PSORIQoL), has recently been developed in the UK. The aim of the current study was to produce and validate a conceptually equivalent US version of the PSORIQoL with equally good psychometric properties.Methods  A lay translation panel was employed to ensure that the wording of the questionnaire was appropriate for a US population. Semi-structured interviews conducted with 37 patients tested the instrument's ease of completion, relevance and comprehensiveness. Finally, a test-retest validation mail survey was conducted with 72 patients to determine reliability, internal consistency and construct validity.Results  Few changes were necessary to the wording of the questionnaire. Interviewees found the questionnaire easy to complete (requiring an average of 4 min) and the content relevant and comprehensive. The adapted measure had comparable psychometric properties to the original, with a test-retest reliability coefficient of 0.90, indicating excellent reproducibility. Internal consistency and initial indications of construct validity were also good, with scores on the measure related as expected to perceived general health and severity of psoriasis and the presence of visible lesions.Conclusions  The US PSORIQoL is a practical, reliable and valid instrument for measuring the impact of psoriasis and its treatment on QoL in clinical trials and in routine practice. It remains necessary to establish the instrument's responsiveness to changes in QoL associated with effective interventions.
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  • 47
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Pigmented purpuric dermatosis comprises a group of vascular disorders of unknown etiology. Histologically, it is characterized by lymphocytic capillaritis in the papillary dermis. Although leukocytoclastic vasculitis confined to the skin is frequently reported with hepatitis C, lymphocytic vasculitis is rarely reported.Methods  Ten patients with pigmented purpuric dermatosis were studied clinically and histopathologically. Hepatitis profile was carried out in all of the patients to evaluate the possible relation.Results  Of the 10 patients, five tested positive for hepatitis C and two for hepatitis B antibodies.Conclusion  Hepatitis C and B virus may play a role in the pathogenesis of pigmented purpuric dermatosis. Further case–control studies are necessary to confirm this conclusion.
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  • 48
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 28-year-old man presented to our clinic for the evaluation of widespread black spots and cysts, in which recurrent infections could not be controlled by topical and systemic antimicrobials. He was first noted at birth to have a rudimentary toe on the right foot. By the age of 8 years, he had developed pitting on the neck and sole, many of which contained black dots. Over subsequent years, pigmented papules representing pigmented basal cell carcinomas (BCCs) also began to appear on the neck and chest. The patient gave a history of recurrent abscesses and cysts developing on the lesions after the age of 14 years. His personal history was negative for epileptiform attacks and congenital cataract. There was no parental consanguinity and no family history of any similar skin condition.Dermatologic examination revealed aggregated, linear, discrete, dilated, follicular orifices plugged with keratinous material on both sides of the neck, extending down to the upper chest. In some areas, these comedo-like pits were associated with erythematous papules, nodules, cysts, and scars. Some follicules had a rudimentary hair, and others no hair at all. In addition, there were multiple, small, black, glistening papules, characteristic of pigmented BCCs (<link href="#f1">Fig. 1). Interfollicular hypopigmentation was also observed. On the medial edge and sole of the right foot, there was a linear patch of pitting. There was also a skin-colored, soft, 2 cm pedunculated nodule arising from the medial aspect of the great toe, which was diagnosed as a rudimentary toe (<link href="#f2">Fig. 2). The rest of the physical examination was normal. The patient's general health was good.<figure xml:id="f1">1<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2055:IJD_2055_f1"/>Multiple, small, black, glistening papules on the upper chest typical of pigmented basal cell carcinoma<figure xml:id="f2">2<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2055:IJD_2055_f2"/>Linear patch of pitting on the medial edge and sole of the right foot and a skin-colored, soft, 2 cm, pedunculated nodule arising from the medial aspect of the great toe (rudimentary toe)Histopathologic examination of the skin lesions revealed dilated and invaginated keratin-filled follicular structures and well-defined, keratin-filled cysts. A peri-infundibular inflammatory infiltrate was also observed. Multiple BCCs were detected adjacent to nevus comedonicus (<link href="#f3">Fig. 3).<figure xml:id="f3">3<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2055:IJD_2055_f3"/>Nests of basal cell carcinoma adjacent to a lesion of nevus comedonicus (hematoxylin and eosin, × 10)The patient was treated with amoxicillin/clavulanic acid, plus daily applications of tretinoin gel 0.025% and benzoyl peroxide 5% with some improvement. Cryosurgery with liquid nitrogen was performed on the smaller BCCs. In addition, the larger BCCs and some persistent painful cysts were surgically removed. The patient remains under observation and is well.
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  • 49
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Much interest has been shown in the possibility of using digital images to aid in the more rapid diagnosis of patients with dermatologic disease. A study was undertaken to test the efficacy of the “teledermatology” screening of referrals, and thereby to triage the patients to appropriate care.Methods  A retrospective comparison of digital and “face-to-face” diagnoses by two consultant dermatologists was made. Eighty-four images from 75 patients seen in general dermatology clinics were studied. The clinical diagnosis and treatment plan of the patients seen in the clinic by one dermatologist were then compared with those suggested on digital image only, as seen by the other dermatologist.Results  The diagnostic correlation between the two observers was fair, with full agreement in 47 of 84 cases (56%) and partial agreement in a further 10 (12%). There was no agreement in 14 cases (16.7%); in a further 13 cases, the images and history were not sufficient to allow a diagnosis to be made. The image quality was considered to be poor in 18 cases, but in six of these a diagnosis was still attempted. It was recommended that 66 patients (88%) should be seen in the hospital setting. Thirty patients (40%) received treatment at their visit.Conclusions  Teledermatology is not likely to have a great impact on reducing waiting lists. It is possible that it may help to prioritize referrals from remote areas.
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  • 50
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Anetoderma is characterized by circumscribed oval macules with overlying wrinkled skin that is slightly depressed or bulges outwards. Skin biopsy shows a decrease of elastic dermal fibers. It may not be associated with an underlying disease (primary anetoderma) or may be related to many dermatoses (secondary anetoderma).We report a 7-year-old girl who presented at birth with yellowish brown papules on the upper trunk, neck and head, which within days evolved to yellowish orange papules. A skin biopsy was carried out and the presence of an histiocytic infiltrate with foam cells and Touton cells in the dermis that were CD68+, factor XIII+ and S-100−, confirmed the diagnosis of Juvenile Xanthogranuloma (JXG). After 4 years the lesions began to evolve to asymptomatic oval and round atrophic skin areas. Histopathologic evaluation showed decrease of elastic fibers in the dermis, diagnostic of anetoderma.The mechanisms of anetoderma are unknown. Although many different dermatoses have been associated with anetoderma we have only found two reported cases of anetoderma and JXG.
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  • 51
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  The possibility of treating skin carcinomas of the pinna with radiotherapy is somewhat under discussion and scarcely known. Therefore the aim of the study was to evaluate the effectiveness and safety of dermatologic radiotherapy in a series of patients affected by basal or squamous cell carcinoma of the pinna.Methods  A retrospective study was performed on 108 patients affected by 115 carcinomas of the pinna (99 basal cell carcinomas, 16 squamous cell carcinomas) without involvement of the external auditory canal. Radiotherapy was performed with kilovoltage techniques (55–120 kV) and the total doses administered ranged from 45 to 70 Gy (105 Gy in one case only), with different fractionations.Results  The mean follow-up was 28.80 months. Complete remission was obtained in 111 lesions (96.52%) and partial remission in one (0.87%), as evaluated 1 month after the end of radiotherapy. No response was observed in two lesions (1.74%). The response was not evaluable in one lesion (0.87%). During follow up a relapse was observed in 12 lesions (all basal cell carcinomas): nine central and three marginal to the irradiation field. The 5-year cure-rate from the end of radiotherapy was 78%. The cosmetic results were evaluated as good or acceptable in 88.28% of lesions. No complications nor sequelae to the treatment were observed.Conclusions  The results obtained confirm the possibility of treating epithelial skin neoplasms of the pinna with dermatologic radiotherapy, which can afford high-remission percentages without damaging cartilaginous tissue.
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  • 52
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Lichen scrofulosorum is considered a rare form of cutaneous tuberculosis. Current information is based on case reports and case series with a small number of patients.Methods  Thirty-nine patients with Lichen scrofulosorum were followed during the period January 1996 to December 2002. Clinical details (age, sex, duration of disease, associated tubercular lesions, extent and distribution of skin lesions), laboratory parameters (hemoglobin, total leucocytic counts, erythrocyte sedimentation rate, Mantoux test, presence of BCG scar), and response to antitubercular treatment were recorded and analyzed.Results  7.6% patients of all (511) patients with cutaneous tuberculosis had LS. 22 (56.4%) were males and 32 (84%) were below 15 years of age. Twenty-eight (72%) had an associated focus of tuberculosis elsewhere in the body; 13 (33%) had tubercular lymphadenopathy, while 11 (28%), three (8%) and six (15%) had pulmonary tuberculosis, intracranial tuberculosis and other forms of cutaneous tuberculosis, respectively. Six (15%) had tubercular focus at multiple sites. Eleven (28%) had no other identifiable focus of tuberculosis. Twenty-eight (72%) had evidence of receiving BCG vaccination. Trunk was the commonest (100%) affected site. The two groups with and without associated tubercular focus were not different with respect to age, sex, duration of disease, hemoglobin, total leukocyte count, erythrocyte sedimentation rate, Mantoux test positivity, and presence of BCG scar. Mycobacteria tuberculosis could not be detected either on acid fast bacilli (AFB) staining or on culture from biopsies of LS lesions. All patients (including those without evidence of tubercular focus) responded to antitubercular treatment, signifying an underlying occult tubercular focus as etiology.Conclusions  Lichen scrofulosorum is an uncommon but not rare cutaneous manifestation of tuberculosis. A high index of suspicion and awareness is required for diagnosis. Systemic tuberculosis is often associated with LS and a prior BCG inoculation does not protect against development of LS. Response to antitubercular treatment is good irrespective of the presence or absence of associated tubercular focus.
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  • 53
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  • 54
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  • 55
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Basaloid follicular hamartoma (BFH) is a unique benign follicular hamartoma characterized by variable clinical presentations, identical histologic features and possible associations with numerous disorders.Basaloid follicular hamartoma may be hereditary or acquired. Hereditary cases may be either generalized or unilateral nevoid. Although the generalized forms are usually associated with systemic manifestations, such as myasthenia gravis,2 it may occasionally present without internal disorders. On the other hand, the acquired forms of BFH may present in the form of localized or solitary forms.Herein we present four cases of BFH, one of them (first case) represents a unique form of the generalized variant of BFH, showing no associated internal disorders.
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  • 56
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    Oxford, UK : Blackwell Science Ltd
    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Aim  The Nordic Quality of Life Study was undertaken to assess the relationship between psoriasis and the quality of life in Nordic countries. The intention was also to determine whether there was a relationship between drinking, smoking, and the use of psychotherapeutic agents on the one hand, and psoriasis severity and quality of life on the other.Materials and methods  A questionnaire was mailed to 11,300 members of the Nordic Psoriasis Associations. Additional psoriasis patients were recruited by dermatologists (387) or admitted to dermatologic wards (385). These patients also underwent a physical examination, and their Psoriasis Area and Severity Index (PASI) was determined. The questionnaire included the Psoriasis Disability Index (PDI), Psoriasis Life Stress Inventory (PLSI), and additional questions on disease severity, treatment, and psoriasis arthritis. It also included questions regarding lifestyle issues, such as smoking, alcohol use, and the use of tranquilizers, antidepressants, and sleeping medications.Results  The response rate for members was 50.2%. Included in the evaluation were 6497 patients. Men drank significantly more beer and liquor than women. The number of beers per day had a weak correlation with the PDI. Wine consumption, however, showed a weak, but significant, negative correlation with both PDI and PLSI. Patients admitted to dermatologic wards smoked more cigarettes and drank less wine than the other two groups. Significant differences were found between countries with regard to total alcohol consumption and cigarette smoking. The number of cigarettes and the use of tranquilizers, sleeping medications, and antidepressants showed small, but significant, positive correlations with psoriasis quality of life measures.Conclusions  Cigarette smoking and the use of tranquilizers, sleeping medications, and antidepressants are statistically correlated with impaired psoriasis-related quality of life.
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  • 57
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    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  It is unknown how the quality of life (QOL) is affected in patients with pityriasis rosea (PR), and whether it is related to rash severity.Methods  We constructed a valid and reliable Cantonese version of the Dermatology Life Quality Index (DLQI). We recruited patients with PR, with atopic dermatitis and with acne vulgaris, and controls of the same sex and comparable age. We applied the DLQI and the Pityriasis Rosea Severity Score (PRSS) to the patients with PR, the DLQI and the SCORing Atopic Dermatitis Index (SCORAD) to the controls with atopic dermatitis, and the DLQI and the Leeds Acne Grading System (LAGS) to the controls with acne vulgaris.Results  Total DLQI scores of the 22 patients with PR (mean: 6.36, SD: 5.79) were significantly lower than those of the 22 controls with atopic dermatitis (mean: 12.00, SD: 5.38) (P = 0.021), but were insignificantly different from those of the 22 controls with acne vulgaris (mean: 6.86, SD: 4.53) (P = 0.57). Correlation between the total DLQI and PRSS scores was weak (γs = +0.19) and insignificant (P = 0.40). All six DLQI parameters were insignificantly correlated with the PRSS scores.In contrast, the total DLQI scores and most of the DLQI parameters were strongly correlated with the rash severity scores for the control subjects. Significantly more patients with PR have concerns regarding disease etiology and infectivity.Conclusions  The QOL of the patients with PR was significantly less affected than that for the patients with atopic dermatitis, but was insignificantly different from the patients with acne vulgaris. Unlike atopic dermatitis and acne vulgaris, the effects on the QOL in PR are insignificantly correlated with rash severity. These results bear important implications on clinical management.
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  • 58
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  • 59
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  • 60
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  • 61
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Very few studies have been conducted to assess the effect of corticosteroid application frequency to attain maximum benefit with minimum side-effects.Objectives  Compare the efficacy of twice-daily, once-daily and alternate-day applications of clobetasol propionate (0.05%) and compare whether an initial once-daily application followed by a subsequent alternate-day application is as effective as a once-daily application.Methods  The ability of corticosteroids to suppress histamine-induced wheals on human skin was used as a human bioassay model. Of the 26 subjects included, 21 completed the 1st phase. In the 2nd phase, 11 subjects were included and all completed the study.Four sites were chosen on the left forearm. Clobetasol propionate (0.05%) was applied twice daily, once daily, and on alternate days, and on the control site a color, texture and odour-matched vehicle was applied. Prick test with histamine was carried out after 10 days. In the 2nd phase, clobetasol propionate (0.05%) was applied once daily for 14 days and compared with the initial once daily for 7 days and the subsequent alternate-day application for 7 days. Prick test was carried out after 14 days.Results  The once-daily application of clobetasol propionate (0.05%) was as effective as the twice-daily application, but the alternate-day application was less effective than the once-daily application (P < 0.01). Also, the initial-daily and subsequent alternate-day applications were not as effective as the continuous once-daily application (P < 0.05).Conclusion  A once-daily application of clobetasol propionate (0.05%) is likely to provide the required therapeutic effect.
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  • 62
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  • 63
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Endemic pemphigus foliaceus (EPF) or fogo selvagem (FS) is an endemic autoimmune disease, characterized by flaccid bullae induced by IgG4 subclass antibodies. The authors demonstrate the epidemiological and clinical status of patients who have been followed at the University Hospital of Brasília (HUB) for more than 15 years.Methods  One hundred and ninety-six patients with FS took part in the project. In setting up this study a historical descriptive cohort of patients was put together. In order to collect data, the authors used a questionnaire where the patient indicated the sex, age at the onset, occupation, origin, clinical status, including scalp compromise, evolution, cofactors influencing clinical worsening and the treatment compliance. In order to minimize loss to follow up, the authors used the statistical method of incidence density (patients/years).Results  The disease occurred in 58.4% of the young patients in the 11–30-year age bracket, and 52% came from urban areas. These patients included students and teachers. Localized disease predominated as compared with the generalized presentation of this condition. Fifty-nine percent of the patients evolved to the recurrent form. Those patients with the evolutional form, in remission for more than 1 year (94%), had been followed for more than 5 years. Even patients with the less active forms of the disease had scalp lesions. Thus scalp lesions are not an indicator of bad prognosis.Conclusions  In the present study, the disease affected patients from a higher sociocultural class than previously described. Furthermore, in contrast to other reports, a substantial number of the patients lived in urban areas, although often spending some time in a rural setting for leisure or professional activities. This study suggests that the longer the follow up, the higher the likelihood that the disease would progress to a more controlled clinical presentation. Scalp lesions were not related to adverse prognosis. Sun, heat and infections act as triggering factors for the immunological imbalance, worsening the disease.
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  • 64
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The larval stages of the fly Cochliomyia hominivorax are responsible for myiasis, which primarily affects wounds. We report the case of a bed-ridden patient with dementia who developed right nasal myiasis during his stay at Cayenne Hospital. Progression was favorable, but the nasal pyramid was partially destroyed. In zones where this fly is endemic, particular attention should be given to hospitalized patients with wounds and consciousness problems.
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 39-year-old housewife sustained inadvertent trauma to the right index finger about 6 years ago, whilst stitching clothes. A couple of weeks later, the site of trauma became hard and gritty. Ever since, it has progressed slowly, without any appreciable outward sign. It was not associated with any discomfort/pain. Consequent on an opinion from a surgeon, it was decided to operate on the right index finger. During the operation, under local anesthesia, a hard and gritty material was removed. The material was subjected to histopathologic study. Several stitches were applied to the wound. It failed to respond to antimicrobial therapy over a 4-week period, prompting the patient to seek another opinion. Examination of the skin surface revealed a plaque with an irregular configuration on and around the distal interphalangeal joint of the right index finger. It was erythematous and pigmented. The top of the plaque was irregular and had alternating elevations and depressions (<link href="#f1">Fig. 1). Diascopy was negative for apple jelly nodule. A bacillus Calmette–Guérin (BCG) vaccination scar was identified on the left deltoid. There was no regional lymphadenopathy or systemic abnormality. Mantoux test with intradermal injection of 0.1 mL SPAN's tuberculin (purified protein derivative/5 tuberculin units/0.1 mL) (Span Diagnostic Ltd., Murat, India) was negative after 72 h. Investigations, including total and differential leukocyte count, erythrocyte sedimentation rate, serum biochemistry, and renal and liver function tests, were within the normal range, as was a chest X-ray.<figure xml:id="f1">1<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2019:IJD_2019_f1"/>Tuberculosis verrucosa cutis before (a) and after (b) antitubercular therapy (ATT)Hematoxylin and eosin-stained sections prepared from the biopsy taken from the lesion revealed noteworthy changes in the epidermis and the dermis. The former was marked by the presence of hyperkeratosis, acanthosis, and papillomatosis, whilst the latter contained tubercle granulomas. Each of the granulomas was well formed and consisted of large numbers of lymphocytes, histiocytes, and foreign body (Langerhans’) giant cells (<link href="#f2">Fig. 2). Caseation necrosis and acid-fast bacilli could not be demonstrated. The preceding revelations were fairly conducive to the diagnosis. Accordingly, antitubercular therapy (ATT), comprising 450 mg of rifampicin, 300 mg of isonicotinic acid hydrazide, and 800 mg of ethambutol, was recommended for oral administration each day for 60 days. The outcome of the treatment was satisfactory, resulting in perceptible regression of the skin lesion (<link href="#f1">Fig. 1b). The patient was advised to continue the treatment for another 30 days, after which 450 mg of rifampicin and 300 mg of isonicotinic acid hydrazide were to be continued for another 6 months.<figure xml:id="f2">2<mediaResource alt="image" href="urn:x-wiley:00119059:IJD2019:IJD_2019_f2"/>Tuberculosis verrucosa cutis depicting well-formed tubercle(s) comprising lymphocytes, histiocytes, neutrophils, and a few giant cells (hematoxylin and eosin, × 100)
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Isotretinoin is widely used in the treatment of severe, recalcitrant, nodular acne. Mucocutaneous side-effects are seen in the great majority of patients and some of them have elevations in their serum lipid and liver enzyme profiles. Recently, it has been shown that addition of vitamin E decreased the toxicity of high-dose retinoids.Objective  The purpose of this investigator-blinded, randomized study was to assess whether vitamin E would reduce the side-effects of isotretinoin in the treatment of acne vulgaris.Methods  Eighty two patients were randomly assigned to one of two treatment groups with isotretinoin (1 mg/kg/day) alone or combined with vitamin E (800 IU/day). The treatment duration was 16 weeks. Mucocutaneous side-effects such as facial erythema, facial dryness, cheilitis and serum lipid and liver enzyme profiles were assessed.Results  There was no difference in the incidence and severity of side-effects related to isotretinoin between the two treatment groups.Conclusion  Eight hundred IU/day vitamin E did not improve the side-effects of 1 mg/kg/day of isotretinoin in the treatment of acne vulgaris.
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Mycosis fungoides is rare in Hong Kong and oriental data on the disease are lacking.Methods  This is a multiclinic, 13-year, retrospective study to determine the clinicopathologic characteristics, treatment, and disease outcomes of 40 patients with mycosis fungoides/Sézary syndrome seen in the Social Hygiene Service, Hong Kong.Results  There were 27 males and 13 females with a mean age at diagnosis of 56.4 years. Based on figures in the Social Hygiene Service alone, the incidence in Hong Kong was estimated to be 0.044 per 100,000. Eighty-five per cent of patients presented with skin-limited disease, and pruritus was absent in 40% of patients. A mean of 1.48 biopsies was needed to establish the diagnosis, and only 58% of the mycosis fungoides skin biopsies were reported to be histologically diagnostic of the disease. Atypical lymphocytes, epidermotropism, interface changes, and Pautrier's microabscesses were the four most frequently encountered features that attained statistical significance. Sixty-nine per cent of patients were treated with psoralen–UVA as their initial therapy, and the complete response and relapse rates were 78.3% and 66.6%, respectively. Disease progression to more advanced stages was only seen in 15% of patients. The 5-year survival rates for the whole group and for stage IA and IB patients were 88.8% and 100%, respectively.Conclusion  Mycosis fungoides is rare amongst Hong Kong Chinese and the majority present with skin-limited nonprogressive disease.
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  • 75
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Rosacea is a common, chronic dermatosis that requires long-term therapy. Oral isotretinoin and topical and/or oral antibiotics are effective, but their usage may be limited due to side-effects.Objective  The goal of the study was to compare the efficacy of topical adapalene gel (0.1%) and topical metronidazole gel (0.75%) in the treatment of patients with papulopustular rosacea.Methods  This study included 55 patients with papulopustular rosacea. Diagnostic efforts were focused on clinical and histological features. Patients were randomly assigned to the adapalene (n = 30) and metronidazole (n = 25) groups. Sunlight protection factor 20 cream was used to protect all patients from sunlight. The characteristics and numbers of inflammatory papules, pustules, erythema and telangiectasia were scored at baseline and after 2, 4, 8 and 12 weeks. Side-effects were recorded at each visit.Results  Fifty patients, 27 in the adapalene group and 25 in the metronidzaole group, completed the study. Significant reductions in the total number of inflammatory lesions were found in the adapalene group compared with the metronidazole group. There was no significant difference in the scores of erythema and telangiectasia in the adapalene group. However, a significant reduction in erythema was seen in the metronidazole group.Conclusions  Adapalene gel is well tolerated and can be used as an alternative for topical treatment of papulopustular rosacea.
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    ISSN: 1365-4632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background  Certain moisturizers can improve skin barrier function in atopic dermatitis. The effect of topical nicotinamide on atopic dry skin is unknown. We examined the effect of topical nicotinamide on atopic dry skin and compared the results with the effect of white petrolatum in a left–right comparison study.Methods  Twenty-eight patients with atopic dermatitis, with symmetrical lesions of dry skin on both forearms, were enrolled, and were instructed to apply nicotinamide cream containing 2% nicotinamide on the left forearm and white petrolatum on the right forearm, twice daily over a 4- or 8-week treatment period. Transepidermal water loss and stratum corneum hydration were measured by instrumental devices. The amount of the stratum corneum exfoliated by tape stripping (desquamation index) was determined by an image analyzer.Results  Nicotinamide significantly decreased transepidermal water loss, but white petrolatum did not show any significant effect. Both nicotinamide and white petrolatum increased stratum corneum hydration, but nicotinamide was significantly more effective than white petrolatum. The desquamation index was positively correlated with stratum corneum hydration at baseline and gradually increased in the nicotinamide group, but not in the white petrolatum group.Conclusions  Nicotinamide cream is a more effective moisturizer than white petrolatum on atopic dry skin, and may be used as a treatment adjunct in atopic dermatitis.
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