Marvin J Rapaport

Fifty-four patients with problems following “medical grade” silicone injections into the face and legs were seen from 1974 until 1995. Complications consisted of chronic cellulitis, nodules, foreign body reactions, and movement of material to near and distant parts of the body. These difficulties usually demonstrated themselves many years after injection. It is suggested that problems occur despite good technique, good material, and small amounts injected. Because the side effects are ...

A 20-year-old woman was seen with the associated disorders of pellagra and anorexia nervosa, both of which had been present for approximately six months. Treatment with niacin induced resolution of the pellagra skin changes.

A patient with histiocytosis X had nonhealing mouth lesions. Evaluation revealed diabetes insipidus and numerous bony lesions. Electron microscopy of the mouth lesions and lymph nodes did not indicate Langerhans cells, which have frequently been described as occurring in histiocytosis X. A survey of 59 patients examined during a 20-year period at UCLA reported the presence of oral lesions in 42% of the cases and confirmed the occurrence of a wide range of clinical patterns and variations ...

Hypersensitivity, manifested by generalized nummular eczematous and papular dermatitis, and presumably by contact urticaria, developed in a 47-year-old man after four years of using oral and topical aloe. Patch tests for aloe were positive in this patient.

In the article by Taylor et al,1 there looms a dilemma of which patch tests we are to believe. The report discusses patches where erythema, irritation, and positive results in the nature of 1+'s are seen in various patients who at some time in the past had used doxepin hydrochloride cream. There were no adequate controls. In addition, the article cursorily mentions the Draize-Shelanski-Jordan repeat-insult patch test.This Draize-Shelanski-Jordan test2 is the standard test for seeking out ...

To the Editor.— Injectable collagen has been used in California for approximately five years and, in 1981, gained Food and Drug Administration approval to be used nationally.Collagen implant (Zyderm), a highly purified bovine dermal collagen, contains a small amount of xylocaine and has been used for the augmentation of certain dermal defects. Depressed surgical scars, acne pits and scars, atrophy, and aging lines have been treated in a "building-up" procedure. Several thousand patients ...

It appears that benefit from collagen injections accrued to a large percentage of patients who responded to our questionnaire. It is interesting that 70% did not forward any information. Of those who reported benefit, the benefit lasted less than a year and was, in fact, within the 6-month range. Still, a large percentage of those responding were enthusiastic about further injections to correct their wrinkling.

Quinazaline yellow SS (DC Yellow 11), a quinoline chemical, has elicited interest because of a potential for sensitization.1-4 This is a Food and Drug Administrationapproved dye that is widely used in cosmetics. However, DC Yellow 10, a closely related quinoline chemical, is more widely used in cosmetics and topical preparations, and there has been some concern about possible cross-sensitization between these two drugs.Recently, Noster and Hausen5 reported one case of occupational ...

To the Editor.— Circulating antibodies against the intercellular cement of the epidermis are pathognomic for pemphigus and its clinical variants.1 They have been described in other diseases, eg, toxic epidermal necrolysis, drug eruption, superficial fungal infection, lepromatous leprosy, myasthenia gravis, and thermal burns.2 Recently, a patient with bullous mycosis fungoides and a patient with bullous impetigo have been described in whom such antibodies were found.3 We report herein a ...

To the Editor.— I found the answer to the question concerning skin tumor specimen template1 to be inappropriate and overly critical.First, the comment that the "principles... stated [by three cited authors] are still valid for the practice of surgery regardless of specialization" might be questioned by someone who is not an abdominal surgeon but who has had surgical training.Second, the question was never answered. Dr Field, who is a specialist in dermatologic surgery, asked whether skin ...