Herbert Srolovitz

Malignant Transformation in Paget Disease of Bone

Background. The previously reported incidence of malignant transformation of Paget disease up to 5.5% and its dismal prognosis have prompted the clinical investigation of a large population with Paget disease.

Minocycline-induced Sweet's syndrome

This is the second reported case of minocycline-induced Sweets syndrome (and the first such case to appear in the American literature). The syndrome developed in a 32-year-old man 10 days after minocycline therapy for acne was begun and resolved rapidly after discontinuation of the medication and start of oral prednisone therapy.

Dermatomyositis presenting as panniculitis

A patient with dermatomyositis presenting initially as a nonspecific panniculitis, a rare event, is discussed .

The Temporal Bone in the Preauricular Pit, Cervical Fistula, Hearing Loss Syndrome

Histological study of the temporal bones of an infant with the preauricular pit, cervical fistula, hearing loss syndrome revealed abnormalities in the middle ear, the vestibular system, and the cochlea. There is a gross bilateral abnormality in the form and relationship of the middle ear spaces, the middle cranial fossa and the inner ear. The horizontal canal lacks ampulla and crista; the posterior canal terminates a short distance from the ampulla. The cochlear cavity is approximately four fifths of normal size. The modiolus of the cochlea shows minor abnormalities. Spiral ganglion cells and peripheral nerve fibers are present in all coils, but are below normal in population in the basal and apical coils. The stria vascularis is slightly deformed and partly atrophic in the upper apical coil. An occasional concretion is present in the base of the stria vascularis in the middle and apical coils.

Tongue, primary amyloidosis, and multiple myeloma

A case of macroglossia and resulting apertognathia because of primary amyloidosis in a 65-year-old man with multiple myeloma is described. In addition, a retrospective study of the oral manifestations of primary amyloidosis and multiple myeloma in the last 15 years is reported.

Eruptive vascular tumors associated with chronic graft-versus-host disease

We report the occurrence of benign angiomatous and mesenchymal tumors following chronic graft-versus-host disease. Our patient is a 23-year-old man who had undergone allogenic bone marrow transplantation for chronic myelogenous leukemia in 1978. Over the past 3 years he has developed poikiloderma and sclerodermatous tightening of the upper and lower extremities. From 1981 until the present time, violaceous to black friable tumors have erupted on the lower extremities. Histopathologic findings show an active mesenchymal and vascular tumorous response of variable-sized channels.

Pagetic arthritis: pathophysiology and management

A review of the records of 112 patients demonstrate modern concepts of pathogenesis and treatment of Pagets disease. Pain from Pagetic arthritis should initially be treated by medical treatment aimed at modulation of bone blood flow. Patients, even with impressive arthritic reactions, can respond dramatically. Pain persists in patients with end-stage destruction of articular cartilage and/or stress mi- crofractures. Patients with deformity without joint space loss may be candidates for osteotomy. Advanced cartilage destruction is treated by total arthroplasty and continuation of anti-Pagetic therapy after surgery, possibly to reduce the incidence of component loosening. Articular cartilage erosion and subchondral bone destruction are attributable to the disease process. Vascular invasion and joint surface collapse are associated with cartilage thinning and sequestration.

Fatal pulmonary toxicity following oral etoposide therapy

Oral etoposide has considerable activity in small cell lung cancer and the low risk of toxicity has resulted in the frequent prescription of this agent in elderly or infirmed patients. We describe a case of fatal pulmonary toxicity following the administration of oral etoposide. This is the first report of biopsy-proven pulmonary toxicity associated with this agent.

Dermatomyositis with Kaposi’s Sarcoma in a Patient without Human Immunodeficiency Virus-1 Infection

The first case of dermatomyositis complicating cutaneous and visceral Kaposi’s sarcoma is presented in a 75-year-old man without human immunodeficiency virus infection. Dermatomyositis preceded a definitive diagnosis of Kaposi’s sarcoma by six months, although in retrospect unrecognized lesions may have presented simultaneously. He was treated with prednisone and azathioprine, thus raising the possibility of the role of immunosuppression in promoting progression of the sarcoma. It is suggested that although the association between dermatomyositis and Kaposi’s sarcoma occurs rarely, dermatomyositis should be considered a paraneoplastic syndrome of Kaposi’s sarcoma. Further, the finding of cutaneous lesions of Kaposi’s sarcoma could predict gastrointestinal involvement when dermatomyositis and Kaposi’s sarcoma occur in the same patient.