摘要:

SummaryLasers have many applications in dermatology. Recent developments in laser technology have produced significant therapeutic advances in several areas. The introduction of pulsed tunable dye lasers has considerably improved the treatment of vascular lesions, particularly port wine stain malformations in children. A wider range of continuous‐wave and quasi‐continuous‐wave lasers have also become available for treating vascular lesions, and their use in conjunction with automated delivery systems has improved results whilst reducing adverse effects. Increasing interest in treatment of pigmented lesions and tattoos has led to investigation of a range of high‐power short‐pulse lasers, and early results look very promising. However, further work is needed in all these areas to determine which lesions respond best to each laser system, and which treatment techniques ar

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03302.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03355.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThe plasma of patients with overt variegate porphyria contains porphyrin with a fluorescence emission maximum at about 626 nm, which is diagnostic for the condition. We have evaluated qualitative fluorescence emission scanning of saline‐diluted plasma as a method for the identification of asymptomatic carriers of the gene for variegate porphyria. Plasma from 36 unrelated patients with variegate porphyria. 136 of their asymptomatic first‐ and second‐degree relatives aged 15 years or over, and 322 normal subjects was scanned. An emission maximum between 621 and 627 nm was observed in the 36 patients with variegate porphyria and 54 of their relatives, but not in any normal subject, nor in 56 patients with other types of porphyria. For the detection of asymptomatic adult carriers of the gene for variegate porphyria. fluorescence emission scanning of plasma appears to be 100% specific, with a sensitivity of 86% (95% confidence interval 71–98%). In contrast, the sensitivity of faecal porphyrin analysis as a test for adult gene carriers was 36%. These results suggest that fluorescence emission scanning of plasma should replace faecal porphyrin analysis as the test of first choice for this

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03303.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThe administration or oral activated charcoal to two patients with congenital erythropoietic porphyria has previously been reported to result in a marked reduction in plasma and urinary porphyrin concentrations and in one case, clinical remission. We describe an additional case in which the use of charcoal was associated with an apparent exacerbation of the biochemical activity of the disease following an initial period of remission. This result is unexpected, and currently unexplained. We conclude that charcoal therapy in porphyria may not be without risk, and should be used with caution.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03304.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03356.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryThe behaviour of cutaneous disease in systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE), under the influence of various hormonal states, was studied in 68 patients. In 28 pregnancies, cutaneous disease was essentially unchanged. In a total of 57 patients whose lupus erythematosus (LE) had been diagnosed prior to the menopause, 20% described a premenstrual cutaneous exacerbation. Only three patients had taken an oestrogen‐containing contraceptive. The duration of oral contraceptive treatment before the onset of lupus varied: 1 month in a patient presenting with the acute malar rash of SLE, 2 months in a patient who presented with annular weals and later developed systemic features, and 12 months in a patient who developed generalized DLE. Thirty‐three patients were menopausal at the time of the study; 4% had noticed a perimenopausal cutaneous flare. There was no deterioration in the skin of the five patients on hormone replacement ther

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03305.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryIn this study we investigated the activity of the vellus hair follicle in acne. Hair growth and sebum excretion in vellus hair follicles were measured on the forehead and back of men, and on the forehead, cheek, and back of women with acne. Hair growth was assessed by computerized image analysis (phototrichogram), and sebum excretion by computer analysis using Sebutape®.In patients with acne, marked differences were revealed when results were compared with recent data from healthy persons. In particular, the mean growth rate of vellus hairs was higher, whereas the percentage of anagen hairs was lower, and the duration of the anagen phase shorter in patients with acne than in healthy individuals. Hair growth and sebum excretion depended significantly (P0.01), (ii) for vellus hair length (P<0.05), and (iii) for the duration of the anagen phase (P<0.01).The present study demonstrates that the activity of the vellus hair follicle is influenced by acne, and vice versa, and therefore its role in the aetiopathogenesis of acne should be reconsidered

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03306.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryUltraviolet radiation (UVR) is known to suppress some cell‐mediated immune responses to antigens encountered during or soon after exposure. Phototherapy is widely used in psoriasis, and this study was undertaken to monitor changes in a range of immunological parameters during standard courses of treatment, with the aim of ascertaining whether such modulations contribute to the effectiveness of therapy. The responses of 17 patients with psoriasis undergoing UVB therapy, and four receiving PUVA therapy, were compared with 15 patients receiving coal tar treatment and four normal subjects undergoing UVB irradiation. In each case, samples were taken before starting therapy, after 4 weeks of therapy, and 4 weeks after completion of treatment. Serum immunoglobulin isotypes and complement components were within normal ranges in most of the psoriasis patients, and remained unchanged throughout therapy. Similarly, percentages of subsets of peripheral blood monnnuclear cells (PBMC) were normal, and were unaltered by treatment. Patients who were already infected with herpes simplex virus (HSV), as demonstrated by a positive lymphoproliferation testin vitro, were monitored for asymptomatic HSV shedding and HSV recrudescences during therapy. There was little evidence that phototherapy caused reactivation of the virus. No significant alteration in lymphoproliferative response to HSV and to the mitogen concanavalin A was observed during therapy. Epidermal cells and blood adherent cells were used to present HSV to PBMC, depleted of adherent cells and enriched for T cells, in a lymphoproliferative assay. The functional antigen‐presenting ability of adherent cells remained unchanged throughout therapy, whereas that of epidermal cells was suppressed during UVB irradiation and recovered, in most instances, after UVB therapy had been completed. The epidermis of patients with psoriasis contained about three times the quantity of urocanic acid (UCA) of normal subjects, whereas the UCA concentration in suction blister fluid did not differ between the two groups. During UVB irradiation, the percentage ofcis‐UCA rose in both the epidermis and suction blister fluid of all subjects, and it remained elevated in the blister fluid after therapy had finished. Tumour necrosis factor‐α was measured in suction blister fluid, and its concentration did not alter consistently as a result of therapy. Whether any of the immunological parameters measured, and the changes noted, contribute to the effectiveness of phototherapy in the treatment of psoriasis remains u

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03307.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03357.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

SummaryA detailed case‐control study was carried out on 24 PUVA‐treated patients with squamous cell cancer of the skin, and on an accurately matched control population of 96 PUVA‐treated patients. Possible co‐carcinogens, such as prior therapy with tar, ultraviolet‐B, ionizing radiation, methotrexate and arsenic, were investigated. The only statistically significant association to emerge was that of prior therapy with methotrexate: relative risk 3.5; 95% confidence interval 1.2–9.9. Our data suggest that prior therapy with methotrexate might be a risk factor for skin cancer in PUVA‐tre

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1993.tb03308.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY