摘要:

SummaryRecent studies have suggested that antibodies against the variable (V) regions of the T‐cell antigen receptor (TCR) may be used as markers for clonality and malignancy in T‐cell infiltrates. We have investigated this by examining biopsy samples from 45 patients with cutaneous T‐cell lymphomas (CTCL) for reactivity with seven antibodies against different V‐gene families on the TCR α/β heterodimer, i.e. ICI (VβSa), W112 (Vβ5b), OT145 (Vβ6a), 16G8 (Vβ8a), S511 (Vβ12a), Fl (Vα2a) and LC4 (αβVa). Serial biopsies were available in 13 patients and a total of 62 samples were studied. The neoplastic cells in five cases were positive for either Vβ5 (one case), Vβ6 (one case), Vβ8 (two cases) or Vβ12 (one case). In the remaining 40 cases, no staining was seen of the neoplastic cells. These findings indicate that while antibodies against the TCR V‐regions may be used as clonotypic markers for certain T‐cell neoplasms, there is as yet not a sufficient number of anti‐TCR V‐region antibodies available for the routine

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14764.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryThe demonstration of HLA‐DR on human acrosyringium has led to the suggestion that eccrine epithelium, through its interaction with certain molecules, might play an active role in epidermal immune responses. An immunohistochemical study was undertaken to identify the antigenic profile of acrosyringium in normal skin and following the intradermal administration of a T‐lymphocyte‐derived cytokine, interferon gamma (TFN‐γ). Acrosyringium in normal skin, in contrast to interappendageal epidermis, was found to lack CDla+Langerhans cells. However, antigens CD36 (OKM5) and Ll (MAC387) were uniquely expressed by keratinocytes immediately adjacent to the distal portion of acrosyringium. Constitutive expression of each class II MHC antigen, namely HLA‐DR, DP and DQ was observed on luminal acrosyringial cells. EBMl 1 antigen (CD68), a mononucler cell determinant, was similarly expressed on acrosyringial epithelium in normal skin. Following intradermal administration of IFN‐γ. Intercellular adhesion molecule‐1 (ICAM‐I) (CD54) was induced on acrosyringial epithelium and the expression of HLA‐DR was intensified. A range of other markers including CD3, CD4, CD8, CDl la, CDl l b and CDl5 were not expressed by acrosyringium either in normal skin or after administration of IFN‐γ.Expression of antigens associated with cell‐mediated immune mechanisms on acrosyringium is consistent with the hypothesis that it may have an immunological role in ep

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14765.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryIn a study of the comedolytic action of retinoids on the epidermal pseudocomedones of rhino mouse skin, the earliest changes and the sequence of events induced by the treatment were investigated. Rhino mice were treated topically with alltransretinoic acid and at various time intervals from day O to 3 weeks, histological and ultrastructural studies as well as quantification of mast cells were performed. The earliest changes occurred in the dermis after 2 days of treatment and were Characterized by degranulation of mast cells, clumping and association of Langerhans cells and lymphocytes. During the second week of treatment there was hyperplasia, hypergranulosis and an increase in the number of membrane coating granules with disorganization of the horny layer both of the epidermis and the follicular epithelium. These changes in the proliferation and the differentiation of keratinocytes resulted in a comedolytic effect. Associated with these epidermal changes there were changes in the dermis with an increased number of mast cells and a decreased number of Langerhans cells.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14766.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryThe pathogenesis of Hailey–Hailey disease and Darier's disease was investigated using immunocytological and explant‐tissue‐culture techniques. There was breakdown of the intercellular adhesions between keratinocytes in explants from clinically uninvolved skin of patients with Hailey–Hailey disease or Darier's disease. The major desmosomal components were present in the cultures and were expressed in a punctate peripheral pattern at cell‐cell contact sites, but there was diffuse staining of acantholytic cells. Plasminogen, which is expressed by basal keratinocytes in normal skin, was detected in association with suprabasal acantholytic cells in skin biopsies from these disea. Plasminogen was reversibly displaced from the cells by 6‐aminohexanoic acid, suggesting that binding is mediated by a reaction with the lysine receptor on the plasminogen molecule. Plasminogen was also detected in separating cells in explant cultures and there was cytoplasmic expression of the plasminogen activator urokinase by these cells.These abnormalities are not unique to either disease and do not account for the phenotypic differences between Darier's disease and Hailey–Hailey disease, but plasmin generation may have a role in perpetuating ce

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14767.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryThe blood flow rate in subcutaneous adipose tissue was measured on the lower legs of 11 patients with chronic lower‐leg venous insufficiency and ulceration and in eight age‐matched control subjects for 12–20 h, under ambulatory conditions, using the133Xe wash‐out technique with portable Cadmium telluride (CdTe(Cl)) detectors. In both groups, the change from an upright to a supine position at the beginning of the night period elicited an instantaneous increment in the blood flow rate of 30–40% with a decrease in the central and local postural sympathetic vasoconstrictor activity. After approximately 1 h of sleep, a considerable increase in blood flow rate was seen in both patient and control groups which persisted for nearly 100 min. In the patient group, the mean increase was 137% compared to a mean increase of 68% in the control group (P<0·01). The blood flow then returned to the same level as at the beginning of the night and remained stable until the subjects woke in the morning. The differences between this nocturnal hyperaemic phase and the adjacent phases were highly significant in both groups (P<0·0001 andP<0·005, respectively). The blood flow levels measured on the second day were of the same magnitude as those registered on the first day. The mean values of the wash‐out rate constants (k) of the two groups were of the same magnitude in all phases of subcutaneous blood flow level, except in the hyperaemic phase, where it was significantly higher in the patient group (P<0·01).The pattern of the nocturnal blood flow rate corresponded to that described previously in a younger healthy population, but with quantitative differences, which suggests that the abnormality occurs in the neural, humoral or metabolic factors involved in the nocturnal hype

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14768.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryPsoriasis can be triggered by haemolytic streptococcal infections. As M protein is a major pathogenic surface antigen in these streptococci, the cross‐reactivity between streptococcal M protein surface antigens and human epidermis was investigated. The conserved component common to the few M proteins investigated consists of an alpha‐helical ‘coiled‐coil’ configuration, similar to sub‐units of human keratin. The amino acid sequence of protein M6, one of the M proteins that has been fully sequenced, was compared with that of 4721 ubiquitous peptides, by computer‐assisted analysis using a protein‐sequence data bank. Of all human proteins in the data bank 50‐Da keratin type 1 showed the closest homology with protein M6. Further evaluation revealed that this homology mainly involved the heptapeptide repeat patterns, which form the alpha‐helical “coiled‐coil” structure, in both M6 and 50‐kDa keratin.Cryostat sections of normal, involved and uninvolved psoriatic skin were studied for cross‐reactivity with rabbit antisea raised against 10 different M proteins. All these antisera reacted with the stratum corneum of normal and psoriatic epidermis to a variable extent. Staining of keratinocyte cytoplasm was also observed, but this tended to be more prominent in lesional than in uninvolved and normal skin. Some of the M antisera also stained dendritic cells in the upper dermis as well as endothelium and smooth muscle. These cross‐reactivities might be relevant to the pathogenesis

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14769.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryPolymorphic light eruption (PLE) is a very common photosensitive disorder, the most important differential diagnosis of which is lupus erythematosus (LE). One‐hundred and forty‐two patients with PLE were screened for circulating antinuclear (ANA). Ro and La antibodies over a 2‐year period. Results were negative in 66 patients. Sixty‐two patients had low‐titre ANA of various patterns, ranging from trace to 1/80 without evidence of LE although one later developed subacute cutaneous LE. Fourteen had more significant findings, six with ANA ranging from 1/160 to 1/1280 but no anti‐Ro antibodies, four with ANA ranging from 1/160 to 1/1280 and also with anti‐Ro antibodies and four patients with anti‐Ro antibodies but low‐titre ANA, one of whom later developed discoid LE. Three of these 14 patients fulfilled the American Rheumatism Association criteria for the diagnosis of systemic LE, but it was not certain in any of the patients whether the PLE‐like rash represented cutaneous LE or coincidental PLE. However the overall 10% incidence of definite or possible LE in patients with suspected PLE suggests that all PLE patients should

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14770.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Summaryin order to investigate factors influencing the discomfort caused by the injection of different lignocaine preparations, a randomized, double‐blind comparison of paired injections was performed in 32 patients. In all subjects 2% plain lignocaine was found to be more painful than 0·5% plain lignocaine. Lignocaine with adrenaline 1:200,000 was found to be significantly more painful than plain lignocaine. The presence of sodium metabisulphite (the antioxidant in commercial adrenalized lignocaine) significantly increased the discomfort. Neutralization of acidic 0·5% lignocaine (pH 4·7) reduced the discomfort caused in 44% of patients, but this was not statistically signifi

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14771.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryForty‐five patients with cutaneous T‐cell lymphomas (CTCL), 32 with mycosis fungoides (MF) and 13 with Sézary syndrome (SS), were treated with interferon‐α2a (IFN‐α2a) (6–9 ± 10IU daily) for 3 months. Those responding to treatment were then treated with interferon‐α alone (6–9 ± 106IU three times weekly), and non‐responders received a combination of etretinate(0·5 mg/kg/day) and IFN‐α2a in similar concentrations. After 12 months of treatment, 28/ 45 patients (62–2%) were in complete or partial (>50%) remission. Of these. 17 (60±7%) were receiving IFN‐α alone and II the combined interferon–retinoid therapy. Of the patients with MF stage I and II,20/25 were responders (12 receiving IFN‐α alone and eight on combined therapy), whereas only 8/20 with Stage IV or SS responded to treatment (five receiving IFN‐α2a alone and three combined therapy). These results suggest that the association of etretinate with low‐dose recombinant IFN‐α2a is an effective means of treating epidermot

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14772.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

SummaryWe report a case of necrolytic migratory erythema without a glucagonoma and which responded to treatment with essential fatty acids and zinc.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1991.tb14773.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY