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Abstract
In a series of 30 patients affected by severe anorexia nervosa (AN) we examined hair samples to detect the prevalence of acquired pili torti (APT). True APT were not detected but in two cases (6.6%) twisted hair was observed. The first case was a 24-year-old woman with secondary amenorrhoea for 9 years, whose body mass index (BMI) was 12.2 kg/m2. She also had severe skin xerosis and hypertrichosis. The second case was a 24-year-old woman with secondary amenorrhoea for 1 year, whose BMI was 11.3 kg/m2. She also had severe skin and lip xerosis, severe effluvium, cystic acne, acrocyanosis, perimylolysis (severe erosion of the dentition) and scars due to cigarette burns on her forearms. Reviewing the literature we noticed that the largest series of pili torti--congenital and acquired--were published by authors from countries such as Israel and Egypt. We therefore hypothesize that, under the same conditions, a genetic factor may predispose to this hair shaft defect.
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Affiliation(s)
- R Strumia
- Hospital University S. Anna, Unit of Dermatology, Ferrara, Italy.
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Bedani PL, Bergami M, Cavazzini PL, Strumia R, Morelli MC, Stabellini G, Gilli P. HBV-related cutaneous periarteritis nodosa in a patient 16 years after renal transplantation: efficacy of lamivudine. J Nephrol 2001; 14:428-30. [PMID: 11730280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Cutaneous periarteritis nodosa (PAN) is a clinical feature characterized by chronic, benign course; its pathogenesis is unknown. In patients submitted to renal transplantation cutaneous PAN is a rare complication. We report a case of cutaneous PAN associated with the reappearance of hepatitis B antigen 16 years after kidney transplantation. A 44-year-old man underwent successful renal transplantation in June 1980. In December 1996 he presented multiple painful erythematous subcutaneous nodules on both legs. Skin lesion biopsy showed the presence of cutaneous PAN. Six months later laboratory data demonstrated the presence of HbsAg. HBeAg, HBcAb and detectable HBV-DNA serum by polymerase-chain-reaction (PCR) assay. Anti-HBs and anti-HBe proved negative. In July 1998 the laboratory tests showed an important increase of HBV-DNA (5.1 billion by Branched DNA), and so lamivudine (100 mg/day) was introduced. HBV-DNA became undetectable by PCR after 3 months of therapy. Seven months later a new skin biopsy was performed. The typical signs of PAN were no longer evident. As HBV infecion was demonstrated six months after the clinical appearance of the PAN, in a patient who was believed to be immune to the virus, it is possible that, in the early stages, the hepatitis B antigen title was methodologically indeterminable, but sufficient to form circulating immune complexes responsible for vasculitis primer. Lamivudine therapy resulted efficacious in favouring the regression of cutaneous PAN, but its long-term efficacy requires further evaluation as regards potential selection of drug resistant hepatitis B virus (HBV) mutants during treatment.
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Affiliation(s)
- P L Bedani
- Division of Nephrology, Sant'Anna Hospital, Ferrara, Italy.
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Corazza M, Bertelli G, Altieri E, Strumia R. Mediterranean spotted fever: a case report. J Eur Acad Dermatol Venereol 1999; 13:229-30. [PMID: 10642065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
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Abstract
BACKGROUND Because of chronic immunosuppressive therapy, the skin of renal transplant recipients (RTR) is considered more liable to fungal infections. AIM The aim of the study was to analyze the prevalence of superficial dermatomycoses in a chronically immunosuppressed group of RTR who live in northern Italy and to verify the eventual relationship between the onset of mycoses, the immunosuppressive regimen and the interval of time elapsed after the transplantation. METHODS 73 RTR were submitted to a complete dermatological examination for fungal infection. Skin scrapings were taken from the upper back, from the 4th toe web of all patients and from any suspicious lesion. RESULTS 31 patients (42.5%) were affected by dermatomycosis. Pityriasis versicolor (PV) was present in 20 RTR (27.4%), fungal infection of the 4th toe web in 10 patients (13.7%) and onychomycosis in 9 RTR (12.3%). Trichophyton mentagrophytes was the most common dermatophyte. The prevalence of dermatomycoses was higher in the group of patients treated with azathioprine-cyclosporine-steroids and in those who had received their renal transplant in the previous 1-5 years. CONCLUSIONS PV was the most frequent dermatomycosis and showed a higher prevalence than in the normal population. The prevalence of fungal infection of the 4th toe web and onychomycosis was similar to that found in the immunocompetent population, but the length of interval after transplantation seemed to increase the probability of their occurrence and of mixed or simultaneous fungal infections in the same patient.
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Affiliation(s)
- A Virgili
- Dipartimento di Medicina Clinica e Sperimentale, Sezione di Dermatologia, Università degli Studi di Ferrara, Ferrara, Italia
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Bedani PL, Risichella IS, Strumia R, Cavazzini L, Gilli P, Calastrini C, Verzola A, Stabellini G. Kaposi's sarcoma in renal transplant recipients: pathogenetic relation between the reduced density of Langerhans cells and cyclosporin-A therapy. J Nephrol 1999; 12:193-6. [PMID: 10440518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Patients treated with immunosuppressive drugs can develop cancers. The authors present two cases of Kaposi's sarcoma in kidney transplant patients who had been treated with azathioprine, steroids and cyclosporin-A; during this treatment the Langerhans cells decreased and Kaposi's sarcoma appeared. Discontinuation or reduction of the dosage of cyclosporin-A led to complete regression of the illness, and the Langerhans cells reappeared. We suggest that cyclosporin-A damages the immunological function of the epidermal Langerhans cells, and that this is the primary factor in the development of Kaposi's sarcoma.
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Affiliation(s)
- P L Bedani
- Division of Nephrology, S. Anna Hospital, Ferrara, Italy
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Strumia R, Roveggio C, Rotola A, Monini P, Cassai E. Keratoacanthomas: human papillomavirus and herpes simplex virus associated? J Eur Acad Dermatol Venereol 1997. [DOI: 10.1111/j.1468-3083.1997.tb00201.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Strumia R, Lombardi AR, Altieri E. The petrified ear--a manifestation of dystrophic calcification. Dermatology 1997; 194:371-3. [PMID: 9252764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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Affiliation(s)
- M Corazza
- Clinica Dermatologica, Università di Ferrara, Italy
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Nielsen I, Donati D, Strumia R, Zavarini G, Sartori S. Sweet's syndrome and malignancy: report of the first case associated with adenocarcinoma of the lung. Lung Cancer 1993; 10:95-9. [PMID: 8069609 DOI: 10.1016/0169-5002(93)90314-n] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Sweet's syndrome is a rare dermatosis characterized by fever, neutrophilia, raised painful erythematous plaques and a dense dermal infiltrate consisting of mature neutrophils. About 15% of published cases occurs in association with hematologic malignancies, so that the syndrome is considered a paraneoplastic phenomenon; conversely, the association with solid tumors is very rare (up to now seven cases). We report the first case of Sweet's syndrome associated with adenocarcinoma of the lung. The syndrome appeared when the tumor was in remission after five courses of chemotherapy, and remained the only sign of underlying malignancy for 2 months, when lung cancer relapsed.
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Affiliation(s)
- I Nielsen
- II Divisione Medica e Servizio di Oncologia, Arcispedale S. Anna, Ferrara, Italy
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Strumia R, Venturini D, Califano AL. Seasonality of presentation of keratoacanthoma. Int J Dermatol 1993; 32:691. [PMID: 8407104 DOI: 10.1111/j.1365-4362.1993.tb04032.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
The trunk and the limbs of an 82-year-old man were covered with large sheets of flat-topped erythematous papules arranged in a reticulate pattern which suddenly coalesced assuming erythroderma-like aspects. Body and positional folds were characteristically spared (deck chair sign). Mild eosinophilia was present. The histological and immunohistochemical examinations revealed an unspecific eczematous pattern. After systemic steroids and PUVA treatment the patient recovered from the dermatosis. Papuloerythroderma is a distinctive clinical entity, but it is not clear whether the dermatosis is the skin marker of systemic pathological conditions or a precursor of cutaneous lymphomas.
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Affiliation(s)
- V Bettoli
- Department of Dermatology, University of Ferrara, Italy
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Abstract
A complete examination of the skin was performed in 53 kidney transplant recipients. Cutaneous lesions were detected in almost all patients. Papillomavirus infections, premalignant and malignant lesions represent the greatest risk for these patients. Our study underlines the importance of a continuous observation to facilitate early diagnosis and treatment of these lesions.
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Affiliation(s)
- R Strumia
- Clinica Dermatologica, Università di Ferrara, Italia
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Strumia R. Prevalence of malignant tumors in patients with psoriasis. J Am Acad Dermatol 1991; 25:579. [PMID: 1918500 DOI: 10.1016/s0190-9622(08)80423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Strumia R, Bedetti A, Cavazzini L. [Staphylococcal scalded-skin syndrome in AIDS]. GIORN ITAL DERMAT V 1990; 125:461-4. [PMID: 2081625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Authors report a case of SSSS in a patient with AIDS. SSSS in adults is rare. Immunosuppression for several causes could predispose towards SSSS. The principal diagnostic differential to be made is from toxic drug induced epidermal necrolysis. Exfoliative cytology and histology can be useful in the diagnosis.
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Affiliation(s)
- R Strumia
- Clinica Dermatologica, Università di Ferrara
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Strumia R, Bettoli V, Marchetti F. [Cutaneous calcinosis with transepithelial elimination in porphyria cutanea tarda. Chemico-structural characterization]. GIORN ITAL DERMAT V 1990; 125:201-4. [PMID: 2253953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Authors describe a case of porphyria cutanea tarda with subcutaneous calcinosis which sustains transepidermal elimination at certain points. The structural and chemical characterization of this material revealed a kind of apatite similar to that of depositions present in calcified human aorta wall and human mitral valve.
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Affiliation(s)
- R Strumia
- Clinica Dermatologica, Università di Ferrara
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Strumia R. Ringworm of the chin. Alopecia mucinosa (follicular mucinosis). Arch Dermatol 1989; 125:288-9, 291-2. [PMID: 2783646 DOI: 10.1001/archderm.1989.01670140143030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Virgili A, Strumia R, Gelmi D. [Kyrle disease and transepithelial elimination]. GIORN ITAL DERMAT V 1987; 122:439-42. [PMID: 3679297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Abstract
The morphology and cultural characteristics of bacteria of the Simonsiella genus isolated from erosions of oral mucosa are reported here. Direct microscopic examination of smeared oral swabs and the consequent selection of suitable culturing procedures and media are compulsory for recovering Simonsiella microorganisms from clinical specimens in routine work.
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Medici M, Miotti A, Strumia R. [Gingival microangiopathy in insulin-dependent diabetics. Histological study]. Minerva Stomatol 1982; 31:215-9. [PMID: 7048056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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