Ruth F Walters

New York University

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Exogenous ochronosis.

PubMed (2008)

Joseph F. Merola S. Meehan Ruth F Walters Lance Brown

A 55-year-old woman with melasma develops biopsy-proved exogenous ochronosis in the setting of prolonged topical hydroquinone use. A limited number of similar reports exist in the US literature and are the basis for an FDA call to review hydroquinone-based products. This case underscores the difficult therapeutic dilemma which this diagnosis presents to dermatologists.

Ochronosis

Melasma

Hydroquinone

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Citations (1)

Epidermodysplasia verruciformis in the setting of HIV infection

Dermatology Online Journal (2008)

Peter Chen Hideko Kamino Ruth F Walters Karla Rosenman Miriam Keltz Pomeranz

A 56-year-old man with human immunodeficiency virus infection presented with pink-to-hypopigmented, thin, flat-topped papules coalescent to plaques on the trunk and extremities for five years. The histopathologic findings were consistent with flat warts resembling epidermodysplasia verruciformis. Typically an inherited condition, this entity has also been observed in the setting of immunosuppression; the risk of developing non-melanoma skin cancers is of concern. Treatment options vary considerably, but often the lesions will recur upon cessation of therapy.

Epidermodysplasia verruciformis

Immunosuppression

10.5070/d38wf0515g

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Citations (9)

Iconography : Acral lymphomatoid papulosis

Molly Yancovitz Ruth F Walters Hideko Kamino Lance Brown

Lymphomatoid papulosis

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Glomangioma.

PubMed (2010)

Marie Léger Utpal Patel Rajni Mandal Ruth F Walters Kathleen Cook

A 22-year-old man presented with a 9-year history of multiple blue nodules on the medial aspect of his right arm. A biopsy specimen showed a cystic space with a cuboidal cellular lining that stained positive for α-smooth-muscle actin; these findings were consistent with multiple glomangiomas. We review the clinical and histopathologic characteristics of this rare entity.

Clinical history

Cuboidal Cell

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Citations (5)

DOES INTRA-DISCAL ELECTROTHERMAL THERAPY (IDET)DENERVATE AND REPAIR EXPERIMENTALLY-INDUCED POSTERO-LATERAL ANNULAR TEARS IN AN ANIMAL MODEL?

Orthopaedic Proceedings (2005)

B J C Freeman Ruth F Walters Moore R.J Robert D. Fraser

Objectives: Posterolateral annular lesions were experimentally induced and allowed to mature for 12 weeks in the intervertebral discs of sheep. IDET was performed in an attempt to denervate and repair the annular lesion. The histological and immunohistochemical effects of IDET were studied.Summary of Background Data: IDET continues to be used as a minimally-invasive treatment for chronic discogenic low back pain, with success rates reported in up to 70% of cases. The mechanism of action by which IDET exerts its effect is poorly understood. Proposed mechanisms include the contraction of collagen and the coagulation of annular nociceptors. An ovine model was used firstly to induce a posterolateral annular lesion, secondly to assess the innervation of such a lesion, and thirdly to assess the effect of IDET on this innervation.Methods: Posterolateral annular incisions were made in 40 lumbar discs of 20 sheep. Twelve weeks were allowed for each annular lesion to mature. IDET was then performed in the disc with...

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Massive Localized Lymphedema: A Soft Tissue Process that May Present to Dermatologists

American Journal of Dermatopathology (2010)

Nadia S Wang Ruth F Walters Simon Warren

Massive localized lymphedema (MLL) is a clinically and histologically distinct entity seen in morbidly obese patients. We describe two obese patients with MLL in the lower abdomen and suprapubic area. Biopsies showed characteristic histologic features of an expanded dermis with lymphangiectases, fibrotic septae and focal fat necrosis. One patient had long-standing hypothyroidism, an association previously reported. This disease is frequently complicated by recurrent cellulitis and may be amenable to surgery. Patients with MLL may present to dermatologists, and this disease has characteristic histopathologic findings that may mimic liposarcoma to the unaware dermatopathologist.

Fat necrosis

10.1097/dad.0b013e3181bede0a

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Citations (16)

Radiation-Induced Sarcoma After High-Dose Thoracic Radiation Therapy in Non–Small-Cell Lung Cancer

Journal of Clinical Oncology (2007)

Thomas E. Stinchcombe Ruth F Walters Amir H. Khandani Mark A. Socinksi

10.1200/jco.2006.10.3267

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Citations (9)

Cutaneous umbilical endometriosis

Dermatology Online Journal (2008)

Arnold Lee Hien Tran Ruth F Walters Herman Yee Karla Rosenman

A 35-year-old woman presented with a four-month history of a tender umbilical nodule that bleeds during her menstrual period. Physical examination showed a hyperpigmented umbilical nodule. A biopsy specimen showed fibrotic dermis with increased numbers of blood vessels and scattered glandular structures with areas of hemosiderin deposition consistent with a diagnosis of endometriosis. Cutaneous umbilical endometriosis is rare, with an estimated incidence of 0.5 to 1.0 percent. Although anti-gonadotropin medications, such as danazol, have been used for symptomatic control, but surgical excision is the treatment of choice owing to the possibility of malignant degeneration of cutaneous endometriosis.

Nodule (geology)

Danazol

10.5070/d34jr4n5zg

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Citations (24)

Invasive squamous-cell carcinoma and arsenical keratoses

Dermatology Online Journal (2008)

Sarina B. Elmariah Robert Anolik Ruth F Walters Karla Rosenman Miriam Keltz Pomeranz

A 42-year-old man presented with a six-month history of a slowly-enlarging ulcer on his right sole, a 30-year history of altered pigmentation of the trunk and extremities, and hyperkeratotic papules of the palms and soles. Histopathologic examination showed an invasive squamous-cell carcinoma of the right sole and hyperkeratosis with keratinocyte atypia of the left finger and left lateral foot. The clinical and histopathologic findings are consistent with chronic arsenicism, which most commonly occurs in the setting of drinking contaminated water or after occupational exposure. Evaluation should include a physical examination, basic laboratory work-up, and measurement of a 24-hour urine arsenic concentration. Vigilant surveillance for the development of cutaneous malignancies is required. Oral retinoids may be helpful in reducing hyperkeratosis secondary to chronic arsenicism.

Atypia

Keratosis

Actinic Keratoses

Dyskeratosis

10.5070/d36d71r5d9

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Citations (7)

Topical drug-induced subacute cutaneous lupus erythematosus isolated to the hands

Lupus Science & Medicine (2017)

Sarika Ramachandran Jonathan S. Leventhal Loren Franco Adnan Mir Ruth F Walters

Subacute cutaneous lupus erythematosus (SCLE) is a well-defined subtype of lupus erythematosus, characterised by photosensitivity, annular and/or psoriasiform lesions, variable systemic involvement and presence of circulating SSA/anti-Ro antibodies. SCLE may be idiopathic or drug-induced. Both the idiopathic and drug-induced forms of SCLE are analogous in their clinical, serological and histological features. Drug-induced SCLE has been reported with various oral agents, but to our knowledge this is the first reported case due to a topical medication. A 34-year-old female foot masseuse presented with a 2-month history of scaly, erythematous lesions isolated to the dorsal hands and interdigital spaces. She had used topical terbinafine, a topical antifungal cream, to her clients’ feet for a number of years. ANA and anti-SSA/Ro antibodies were positive. Physical examination, serology and histopathology were consistent with SCLE. We propose that our patient's unique presentation of SCLE may be explained by a prolonged occupational exposure to topical terbinafine as a foot masseuse. While oral terbinafine is a drug known to cause drug-induced SCLE, to our knowledge, this is the first topically induced form of the disease.

10.1136/lupus-2017-000207

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Citations (8)