Ralph J. Coskey

Porokeratotic eccrine duct and hair follicle nevus

A 30-year-old patient had a linear lesion involving the forearm and hand for 30 years. Histologic examination of this lesion revealed hyperkeratosis, hypergranulosis, and acanthosis. There also were funnel-shaped areas of epidermal depression containing parakeratotic columns which penetrated hair follicles and sweat ducts. The differential diagnosis of this lesion is discussed.

Letterer‐siwe disease in adults

Histiocytosis X (HX) is a rare disorder of histiocytic proliferation characterized by a broad spectrum of clinicopathologic disease. An unusual case of Letterer‐Siwe disease (LSD) or subacute disseminated HX in a 71‐year‐old woman is presented. The patient had a 3‐year history of splenomegaly before skin lesions developed. She presented to our clinic at 1.5 years later and the diagnosis of HX was made by skin biopsy. Topical nitrogen mustard (NM) therapy resulted in complete clearing of cutaneous lesions. Her condition was stable over the next 10 months. However, she subsequently suffered a rapid and fatal dissemination of her disease. Systemic treatment with prednisone, vinblastine sulphate, and suppressin A (SA) (a calf thymus derived hormone preparation that specifically induces suppressor T‐cells) was ineffective. Characteristic histopathologic, immunohistochemical, and electron microscopic findings of HX are illustrated. A review of the adult cases of LSD and treatment options for HX are presented and discussed.

Adverse effects of corticosteroids: I. Topical and intralesional

Abstract Topical corticosteroids may have adverse systemic effects and/or adverse local effects. Many of the adverse reactions seen with topical corticosteroids are related to their potency. Thus, side effects may frequently be avoided by using low-potency topical agents. Generally, fluorinated steroids are more potent than nonfluorinated steroids.

Contact dermatitis caused by diphenhydramine hydrochloride

Three cases of contact dermatitis caused by an ethanolamine antihistamine, diphenhydramine hydrochloride (Benadryl), are described. Patients who develop contact dermatitis from it should avoid its oral or parenteral administration because they may develop a localized or generalized flare of dermatitis. Dimenhydrinate (Dramamine), clemastine fumarate (Tavist), carbinoxamine maleate (Clistin-D), and doxylamine succinate (Decapryn) are also ethanolamine antihistamines. Since they may cross-react with diphenhydramine hydrochloride, they should be avoided in sensitive patients.

Dermatologic therapy: december 1985 to december 1986

I have reviewed the significant therapeutic changes reported in the English literature between December 1985 and December 1986. Readers should review the original articles in toto before attempting any new experimental or controversial therapy summarized.

Dermatologic therapy: 1993

This article reviews some therapeutic results reported in the English-language literature during 1993. Readers should review the original article in full before attempting any experimental or controversial therapy.

Dermatologic therapy: 1990

This article reviews significant therapeutic advances that have been reported in the English-language literature during 1990. Readers should review the original article in full before attempting any new experimental or controversial therapy.

Dermatologic therapy: December 1987 to December 1988

In this article I have reviewed the significant therapeutic advances that have been reported in the English-language literature from December 1987 to December 1988. Clinicians should read the original articles in toto before attempting any new experimental or controversial therapy.

Dermatologic therapy: December, 1979, through November, 1980

In this paper I have reviewed the literature on dermatologic therapy from December, 1979, through November, 1980. This information was presented to a forum at the 39th Annual Meeting of the American Academy of Dermatology in New York in December, 1980. Readers should review the original article in toto before attempting any new, experimental or controversial therapy summarized.