12 results on '"Quimby SR"'
Search Results
2. Pseudosclerodermatous panniculitis after irradiation: an unusual complication of megavoltage treatment of breast carcinoma.
- Author
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Winkelmann RK, Grado GL, Quimby SR, and Connolly SM
- Subjects
- Aged, Biopsy, Breast Neoplasms diagnostic imaging, Breast Neoplasms therapy, Combined Modality Therapy, Diagnosis, Differential, Female, Hospitals, Group Practice, Humans, Inflammation, Lymphocytes, Macrophages, Middle Aged, Minnesota, Panniculitis etiology, Panniculitis pathology, Radiography, Radiotherapy Dosage, Radiotherapy, High-Energy methods, Breast Neoplasms radiotherapy, Panniculitis diagnosis, Radiotherapy, High-Energy adverse effects
- Abstract
An unusual edematous and indurated erythema developed in four patients with breast carcinoma 1 to 6 months after conservative surgical treatment and irradiation. The radiation therapy consisted of megavoltage x-ray photon with or without either electron beam or iridium-192 interstitial boost. Several tissue biopsy specimens revealed pronounced lymphocytic dermal and fat inflammation in conjunction with focal areas of plasma cells. The connective tissue bundles were enlarged and hyalinized. Macrophages and isolated giant cells were noted in the dermis. One biopsy specimen showed elastic tissue in giant cell cytoplasm. No mucin, fibrin, formation of cysts, or calcification was present. Lipophages and hyaline connective tissue replaced some fat lobules. The radiation-induced changes of dilated and hyalinized blood vessels, endothelial cell hyperplasia, fibrosis associated with involution of epidermal appendages, and fibroblasts were present. This combination of radiation-related and inflammatory pathologic changes is unusual and emphasizes the remarkable qualities of this rare reaction. The clinical differential diagnoses of recurrent carcinoma, cellulitis, and connective tissue disease can be excluded by reviewing the pathologic characteristics.
- Published
- 1993
- Full Text
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3. Clinicopathologic spectrum of specific cutaneous lesions of disseminated coccidioidomycosis.
- Author
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Quimby SR, Connolly SM, Winkelmann RK, and Smilack JD
- Subjects
- Adolescent, Adult, Aged, Coccidioides isolation & purification, Coccidioidomycosis microbiology, Dermatomycoses microbiology, Female, Humans, Male, Skin microbiology, Skin pathology, Coccidioidomycosis pathology, Dermatomycoses pathology
- Abstract
Background: Disseminated coccidioidomycosis merits greater attention because the number of persons living and traveling in endemic areas is increasing., Objective: Our purpose was to study the clinical and histopathologic findings in patients with specific cutaneous disseminated coccidioidomycosis., Methods: In six patients with specific skin lesions of disseminated coccidioidomycosis, the diagnosis was confirmed by identification of the organism in tissue or by positive results of tissue culturing., Results: Clinical lesions included solitary granulomatous plaques in two patients and multiple papular, nodular, or pustular lesions in four patients, two of whom also had subcutaneous abscesses. Identifying organisms directly in tissue was possible in only 8 of 17 biopsy specimens and in five of six patients. The histopathologic features showed various degrees of three primary patterns: (1) abscess formation with necrosis, (2) epithelial hyperplasia and granuloma formation with microabscesses, and (3) vascular and perivascular proliferative and inflammatory cell reactions at times suggesting vasculitis. Tissue eosinophilia, present in all patients, was striking in two (eosinophilic abscess formation) and notable in another (vascular inflammation with eosinophilia)., Conclusion: Cutaneous manifestations of disseminated coccidioidomycosis may be more common and varied than usually recognized.
- Published
- 1992
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4. Histopathologic features of the L-tryptophan-related eosinophilia-myalgia (fasciitis) syndrome.
- Author
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Winkelmann RK, Connolly SM, Quimby SR, Griffing WL, and Lie JT
- Subjects
- Collagen analysis, Edema pathology, Elastic Tissue metabolism, Elastic Tissue pathology, Eosinophilia chemically induced, Eosinophilia metabolism, Fascia pathology, Fasciitis chemically induced, Fasciitis metabolism, Fluorescent Antibody Technique, Glycosaminoglycans analysis, Humans, Hyalin chemistry, Immunoglobulins analysis, Muscles pathology, Muscular Diseases chemically induced, Muscular Diseases metabolism, Scleroderma, Localized pathology, Sclerosis pathology, Skin Diseases pathology, Syndrome, Eosinophilia pathology, Fasciitis pathology, Muscular Diseases pathology, Tryptophan adverse effects
- Abstract
Study of 18 biopsy specimens in 11 patients with L-tryptophan-related eosinophiliamyalgia (fasciitis) syndrome showed hyaline sclerodermoid changes. Dermal scleroderma was found in eight of nine punch biopsy specimens and eight of nine excisional biopsy specimens. Fascial scleroderma was found in eight excisional biopsy specimens. One specimen obtained by excision had no fascia present. Eleven biopsy specimens showed edema of the dermis, and 13 showed dilated lymphatic structures; thus, the clinical picture of edematous sclerosis was confirmed. Mucinous fasciitis was present in five excisional biopsy specimens, in conjunction with a large number of macrophages in four. Dermal mucinosis was present in 11 biopsy specimens. Lymphocytic and macrophage inflammation was minimal in 14 biopsy specimens and pronounced in only 4. Plasma cells were present in eight cases. Eosinophils were present in substantial numbers in three biopsy specimens and only occasionally in four. Eosinophilic spongiosis was observed in one patient. Lymphocytic inflammation was noted around a single muscle spindle and around large nerve trunks in three patients. No relationship was established between these pathologic features and the duration or dose of tryptophan, prednisone treatment, or duration of symptoms. Pathologic features of the L-tryptophan syndrome consist of hyaline sclerodermoid collagen in the dermis, the septa, and the fascia. Edema, focal mucinosis, and macrophage inflammation may be features that identify this event.
- Published
- 1991
- Full Text
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5. Scleroderma and L-tryptophan: a possible explanation of the eosinophilia-myalgia syndrome.
- Author
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Connolly SM, Quimby SR, Griffing WL, and Winkelmann RK
- Subjects
- Adult, Aged, Eosinophilia pathology, Fasciitis pathology, Female, Humans, Kynurenine urine, Middle Aged, Myositis pathology, Prednisone administration & dosage, Prednisone therapeutic use, Scleroderma, Systemic pathology, Skin pathology, Syndrome, Tryptophan administration & dosage, Tryptophan metabolism, Eosinophilia chemically induced, Scleroderma, Systemic chemically induced, Tryptophan adverse effects
- Abstract
Scleroderma developed in six women who were taking L-tryptophan. Fasciitis and morphea were most common, but one patient had pleural effusion, hypertension, and signs of cardiac and kidney failure. In five patients the biopsy findings were characteristic of scleroderma; the sixth patient had Crohn's disease and developed fasciitis; her biopsy specimen showed inflammatory arteritis. All patients' conditions improved after cessation of their L-tryptophan intake, initiation of corticosteroid therapy, or both. These findings confirm previous data that show altered tryptophan-kynurenine metabolism in some patients with scleroderma and fasciitis, particularly with tryptophan loading.
- Published
- 1990
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6. Plaquelike cutaneous mucinosis: its relationship to reticular erythematous mucinosis.
- Author
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Quimby SR and Perry HO
- Subjects
- Adult, Diagnosis, Differential, Erythema diagnosis, Erythema pathology, Female, Humans, Male, Middle Aged, Myxedema diagnosis, Myxedema pathology, Sex Factors, Syndrome, Mucins analysis, Mucins metabolism, Skin Diseases diagnosis
- Abstract
Nine patients with plaquelike cutaneous mucinosis, including the three described originally in 1960, are presented. The clinical manifestations of asymptomatic persistent, erythematous, infiltrated papules, either isolated or coalescing into plaques, in the midline of the back or chest are suggestive of the diagnosis. The dermal histopathologic findings of perivascular and periappendageal round cell infiltrates and mucin (acid mucopolysaccharides) on special stains confirm the diagnosis. This syndrome is more common among women, may be aggravated by exposure to ultraviolet light, and may subside spontaneously after long periods. We believe the condition of these patients is identical to that described as reticular erythematous mucinosis syndrome.
- Published
- 1982
- Full Text
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7. Histopathologic features of superficial granulomatous pyoderma.
- Author
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Winkelmann RK, Wilson-Jones E, Gibson LE, and Quimby SR
- Subjects
- Diagnosis, Differential, Humans, Pyoderma classification, Abscess pathology, Granuloma pathology, Pyoderma pathology, Skin Diseases pathology
- Abstract
Study of the histopathologic pattern of 28 cases of superficial granulomatous pyoderma demonstrated an ulcerative, verrucous pyoderma of the superficial dermis. Focal abscesses in the subepidermis or dermis were juxtaposed with granuloma formation and plasma cell inflammation. Hemorrhage and granulation tissue were present. The clinical lesions are indolent, and this feature is confirmed by chronic inflammatory elements, including sinus tract formation and focal fibrosis. Superficial granulomatous pyoderma must be added to the histologic differential diagnosis of the vegetative and ulcerative granulomas: blastomycosis, tuberculosis verrucosa cutis, and bromoderma.
- Published
- 1989
- Full Text
- View/download PDF
8. Herpes gestationis.
- Author
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Quimby SR, Xenias SJ, and Perry HO
- Subjects
- Adolescent, Complement C3 analysis, Female, Humans, Infant, Newborn, Male, Pemphigoid Gestationis drug therapy, Pemphigoid Gestationis pathology, Postpartum Period, Prednisone therapeutic use, Pregnancy, Pemphigoid Gestationis diagnosis, Pregnancy Complications diagnosis, Skin Diseases, Vesiculobullous diagnosis
- Abstract
Herpes gestationis is a rare, pruritic, blistering disease of the skin that occurs in pregnancy and the puerperium. Its recognition by those caring for the pregnant patient is important in determining appropriate care for the patient and in alerting the physician to possible effects on fetal outcome. Understanding of this disease has been rapidly expanding, and these advances are reviewed here through the use of an illustrative case report and a review of the literature. The evidence for significant risk of fetal morbidity and mortality, the potential indicators in patients who are at high risk, and the treatment approaches are stressed.
- Published
- 1982
9. Necrobiosis lipoidica diabeticorum: platelet survival and response to platelet inhibitors.
- Author
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Quimby SR, Muller SA, Schroeter AL, Fuster V, and Kazmier FJ
- Subjects
- Adult, Drug Administration Schedule, Drug Therapy, Combination, Humans, Middle Aged, Necrobiosis Lipoidica blood, Skin pathology, Aspirin administration & dosage, Blood Platelets drug effects, Cell Survival drug effects, Dipyridamole administration & dosage, Necrobiosis Lipoidica drug therapy
- Abstract
Results of an open trial of platelet inhibitor treatment for necrobiosis lipoidica diabeticorum suggest the possible importance of abnormal platelet function in this disease. In ten female patients with necrobiosis lipoidica diabeticorum (six who were diabetic and four who were not) platelet survival times were measured before and after treatment with aspirin and dipyridamole. Pretreatment platelet survival time was considerably shortened in 50 percent of the diabetic and nondiabetic patients. Platelet-inhibitor treatment prolonged platelet survival time toward normal in most of these patients. The clinical response to treatment varied from healing to no noticeable effect.
- Published
- 1989
10. Superficial granulomatous pyoderma: clinicopathologic spectrum.
- Author
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Quimby SR, Gibson LE, and Winkelmann RK
- Subjects
- Adult, Aged, Follow-Up Studies, Granuloma drug therapy, Granuloma pathology, Humans, Male, Middle Aged, Pyoderma drug therapy, Pyoderma pathology, Granuloma complications, Pyoderma complications
- Abstract
Superficial granulomatous pyoderma is a form of pyoderma gangrenosum characterized by superficial ulceration and a chronic course. Histopathologic examination shows a granulomatous response. We report two new cases of superficial granulomatous pyoderma in detail and briefly review the clinical data of five previous cases included in a recent series. These lesions typically begin as single furunculoid papules that most commonly occur on the trunk and that may arise at sites of surgical treatment or other pathergic stimuli. The lesions progress to superficial ulcers with a relatively clean base and vegetative borders. Tetracycline, minocycline, sulfapyridine, dapsone, and intralesionally administered corticosteroids have been effective anti-inflammatory agents, producing healing and allowing avoidance of the use of systemic corticosteroids in the management of most patients with superficial granulomatous pyoderma.
- Published
- 1989
- Full Text
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11. Livedo reticularis and cerebrovascular accidents.
- Author
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Quimby SR and Perry HO
- Subjects
- Adult, Diagnosis, Differential, Endarteritis complications, Female, Humans, Lupus Erythematosus, Systemic diagnosis, Male, Middle Aged, Polyarteritis Nodosa diagnosis, Skin pathology, Skin Diseases diagnosis, Skin Diseases pathology, Vasculitis diagnosis, Vasculitis pathology, Cerebrovascular Disorders complications, Skin Diseases complications, Vasculitis complications
- Abstract
Livedo reticularis is a clinical pattern of cutaneous vascular involvement that can be seen in association with many diseases. The association of livedo reticularis and cerebrovascular accidents has been reported rarely in the past. We report on a 52-year-old woman with marked generalized livedo reticularis and cerebrovascular accidents who exhibited endarteritis obliterans without other pathologic changes on histologic examination of the skin. This constellation of findings suggest a primary vasculopathy with rather extensive involvement which merits our attention and further study.
- Published
- 1980
- Full Text
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12. The cutaneous immunopathology of necrobiosis lipoidica diabeticorum.
- Author
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Quimby SR, Muller SA, and Schroeter AL
- Subjects
- Adult, Biopsy, Child, Diabetic Angiopathies immunology, Female, Fluorescent Antibody Technique, Humans, Necrobiosis Lipoidica immunology, Skin immunology, Diabetic Angiopathies pathology, Necrobiosis Lipoidica pathology, Skin pathology
- Abstract
Twelve female patients with necrobiosis lipoidica diabeticorum (six with diabetes and six without) had a 5-mm punch biopsy of the skin lesion performed. The tissue was processed for dermatopathologic examination in 12 cases and for direct immunofluorescence in 11. Vasculopathy with inflammation and thickening of vessel walls, at times leading to occlusion, was found in lesional skin in all 12 cases. Vessels contained deposits of immunoreactants in the involved skin in 11 cases. This included IgM in six, C3 in nine, fibrin in ten, IgG in one, and IgA in two. Vessels contained deposits of immunoreactants in uninvolved skin in seven patients (C3 in four, IgM in three, fibrin in three, C4 in one, and IgA in one), three of whom had type I diabetes.
- Published
- 1988
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