Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Aug 2003
Case ReportsCutaneous nodular amyloidosis masquerading as a foot callus.
We report a unique case of a 69-year-old man who presented with a 1-year history of pink nodules and plaques limited to the anterior plantar surface of the right foot and a 30-year history of a callus on the right heel. Histologic examination findings of both areas showed deposits of amorphous, eosinophilic material and an infiltrate of plasma cells in the dermis. Congo red-stained deposits exhibited apple-green birefringence with polarized light. ⋯ The diagnosis of nodular primary localized cutaneous amyloidosis (PLCA) was made. Nodular PLCA isolated to pedal or strictly plantar surfaces is an unusual presentation of PLCA. The origin and the clinical and histopathologic features of nodular PLCA are reviewed.
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J. Am. Acad. Dermatol. · Aug 2003
The design of clinical trials in psoriasis: lessons for clinical practice.
Understanding the process by which drugs are approved gives clinicians a better understanding of the medications they prescribe and how these medications are best used to care for patients. The development of new drugs in the United States proceeds through a series of studies culminating in well-designed, large-scale human trials. ⋯ They also determine the labeling and marketing of products and guide (but do not fully determine) physicians' use of the drug. This article follows a hypothetical drug for use in psoriasis through the approval process, in order to illustrate the process and its implications for clinical practice.
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J. Am. Acad. Dermatol. · Aug 2003
Case ReportsCutaneous Strongyloides stercoralis infection: an unusual presentation.
Strongyloides stercoralis is a widespread, soil-transmitted, intestinal nematode common in tropical and subtropical countries. The parasite is unique in its capability to carry out its entire life cycle inside the human body. Human beings contract strongyloidiasis by penetration of filariform larvae into the skin or mucous membrane after contact with contaminated soil. ⋯ Chronic strongyloidiasis acquired in endemic areas may last decades and gives rise to various dermatologic lesions, the most characteristic of which is larva currens, a serpiginous, creeping urticarial eruption. In disseminated strongyloidiasis, the characteristic skin lesions are widespread petechiae and purpura. We present a case of disseminated strongyloidiasis with an unusual manifestation mimicking a drug rash and review the dermatologic manifestations of strongyloidiasis infestation.
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J. Am. Acad. Dermatol. · Aug 2003
Case ReportsFatal interstitial pulmonary fibrosis in anti-Jo-1-negative amyopathic dermatomyositis.
Amyopathic dermatomyositis (DM) describes a subpopulation with the cutaneous eruption of DM, but without muscle involvement. Interstitial pulmonary fibrosis is a recognized complication of DM, often correlated with antisynthetase enzymes, such as anti-Jo-1. We describe a case of fatal IPF in a patient with anti-Jo-1 antibody-negative amyopathic DM.