摘要:

SummaryVitamin D and its analogues are effective in the treatment of psoriasis. The principal concern about the use of these agents is the possibility of adverse effects on systemic calcium homeostasis. We review the effects of vitamin D and its analogues on systemic calcium homeostasis and discuss the implications for patients with psoriasis.

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1002.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryWe have assessed the cutaneous signs in 73 patients with systemic lupus erythematosus (SLE), seen during a 5‐year period in an English hospital. Most previous information about the cutaneous manifestations of SLE has been obtained from studies performed in the U.S.A. We classified lesions as specific cutaneous and mucosal LE (acute, subacute and chronic) or non‐specific LE‐related, e.g. photosensitivity, urticaria, erythema, Raynaud's phenomenon or vasculitis. Acute cutaneous LE lesions included a butterfly rash with erythematous macules, telangiectasia or papulosquamous lesions, seen in 37 patients (51%) and facial oedema seen in four patients (5%). Five patients (7%) had psoriasiform subacute cutaneous LE, Chronic cutaneous LE was common: 18 patients (25%) had chronic discoid lesions (DLE) and, in 12 (15%), these had preceded systemic disease. One patient had facial lupus profundus. Ten patients (14%) had scarring alopecia secondary to DLE. Fifteen patients (20.5%) had chronic chilblain lupus. Twenty‐three patients (31.5%) had a history of mouth ulceration. Of these, 11 (15%) gave a history of ulcers at the onset of their disease. Three (4%) had erythema and superficial ulceration of the palate, not typical of aphthous ulcers, and three (4%) had chronic buccal plaques. Cheilitis due to DLE was seen in three (4%), episcleritis in three (4%), five (7%) had nasal disease, six (8%) bullous skin eruptions, one ‘the bullous eruption of SLE’, four bullae associated with cutaneous vasculitis, and one bullae associated with ultraviolet radiation. Forty‐six (63%) observed photosensitivity. A non‐scarring alopecia occurred in 29 (40%). Vascular phenomena were common: three patients (4%) had chronic palmar erythema. Raynaud's phenomenon occurred in 44 patients (60%), chronic urticaria, worsened by sun exposure, was noted by 32(44%) (in whom the lesions often lasted more than 36h), eight (11%) had cutaneous vasculitis and three (4%) livedo reticularis.Skin changes play a prominent part in SLE and may provide helpful diagnostic information. In this British population, chilblains and urticaria were particularly common. Lesions of subacute cutaneous LE were relatively unusual in this group of pa

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1004.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryA retrospective study of 487 patients with dermatitis herpetiformis showed that lymphoma developed in eight patients, the expected incidence being 0.21 (standardized registration ratio 3810). All lymphomas occurred in patients whose dermatitis herpetiformis had been controlled without a gluten‐free diet (GFD) or in those who had been treated with a GFD for less than 5 years. The results are suggestive of a protective role for a GFD against lymphoma in dermatitis herpetiformis and give further support for advising patients to adhere to a strict GFD for lif

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1005.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryThis study was undertaken to investigate human leucocyte antigen (HLA) associations with benign migratory glossitis and psoriasis in Brazilian patients and particularly to determine whether benign migratory glossitis is also associated with HLA‐Cw6, the classical association observed in psoriasis. The results showed a highly significant association of Cw6 with both psoriasis, and benign migratory glossitis, with this antigen being present in 59.1% of the patients with psoriasis, in 43.8% of the patients with benign migratory glossitis, and in only 12.6% of the controls. Other significant positive associations, although at a lower significance level, were with B13, both in psoriasis and in benign migratory glossitis, and with B17, only in psoriasis. To our knowledge, this is the first report on the association of Cw6 with benign migratory glossitis. We believe that this finding reinforces the concept of a pathogenetic relationship between benign migratory glossitis and psoriasi

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1006.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryThe occurrence of EG2‐positive (EG2+) eosinophils and IgE in biopsy specimens of duodenal mucosa and skin from 39 psoriasis patients was studied, with emphasis on the relation to serum eosinophil cationic protein (ECP), serum IgE and the presence or absence of serum IgA and IgG antigliadin antibodies. Psoriasis patients had significantly elevated serum levels of ECP even after exclusion of five of 37 sera which were Phadiatop positive. The elevated serum ECP was not associated with the presence of IgA or IgG antibodies to gliadin. After exclusion of Phadiatop positive sera the serum IgE values did not differ from those of a group of healthy blood donors.Patients with psoriasis had a pronounced increase of EG2+ cells in their duodenal stroma. Patients without antibodies to gliadin tended to have even more EG2+ cells than those with such antibodies and those with increased duodenal intraepithelial lymphocytes. IgE+ cells were present in most duodenal specimens, and in some specimens there were>100 IgE+ cells/section. The number of EG2+ cells was increased in lesional skin and, in some patients, also in non‐involved skin, but there was a more pronounced increase in EG2 reactivity in the duodenal than in the skin specimens. IgE reactivity was increased both in non‐involved and involved skin and was significantly related to the number of IgE‐positive cells in the duodenal stroma. The results of this study indicate that the gastrointestinal tract and the eosinophil granulocyte might be involved in psoriasis in a hitherto unkn

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1007.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryCalcipotriol and corticosteroids, two therapy modalities frequently prescribed in the treatment of psoriasis, are often used in combination. The aim of the present study was to determine whether the cell biological response pattern of concurrent use of calcipotriol and corticosteroids is different from calcipotriol monotherapy. Forty patients with chronic plaque psoriasis were divided at random in four parallel groups and treated for 8 weeks with: (1) calcipotriol cream (50 μg/g once daily); (2) calcipotriol cream twice daily; (3) calcipotriol and clobetasone 17‐butyrate (0.5 μg/g) creams; and (4) calcipotriol and betamethasone 17‐valerate (1 mg/g) creams. Before and after treatment keratotome biopsies were taken and single cell suspensions prepared for flow cytometric analysis. Flow cytometric multiparameter quantification of markers for proliferation (TO‐PRO‐3), differentiation (antikeratin 10) and inflammation (antivimentin) was used to evaluate all four therapy modalities.A statistically significant decrease of the percentage of basal cells in S‐ and G2M‐phase (proliferation)was obtained with all therapy modalities, except for calcipotriol monotherapy applied once daily. A significant reduction of the number of vimentin‐positive cells (non‐keratinocytes) was observed following combined treatment with calcipotriol and clobetasone butyrate. In contrast, monotherapy with calcipotriol had virtually no effect on the number of vimentin‐positive cells.It can be concluded that: (i) calcipotriol monotherapy, applied once daily was less antiproliferative compared with twice daily applications of calcipotriol or the combined treatment with corticosteroids and that (ii) the combination of calcipotriol and corticosteroids proved to have a marked effect on the percentage of non‐keratinocytes, in contrast to the modest e

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1008.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryCalcitriol (1α,25‐dihydroxyvitamin D3), applied topically in an ointment base, has been shown to be effective in the treatment of chronic plaque psoriasis. This open study was designed to assess the safety and tolerability of 3 μg/g calcitriol ointment applied twice daily over treatment periods of up to 78 weeks. In the 253 evaluable patients with chronic plaque psoriasis no clinically relevant changes were observed in the baseline/end‐point analyses of mean serum levels of total calcium, albumin‐adjusted total calcium, phosphorus and creatinine, and plasma calcitriol levels. Mean values of 24‐h urinary calcium, phosphorus, creatinine and hydroxyproline excretions, creatinine clearance and mean urinary calcium/creatinine ratio also did not show clinically relevant changes in the baseline/ end‐point analyses. The treatment was well tolerated, with no serious adverse events occurring during the course of the study. Eight patients withdrew from the study due to adverse events which, although not serious, were thought to be treatment‐related: in seven patients skin irritation reactions and in one case a transient asymptomatic slight hypercalcaemia was observed. In addition, assessments of global severity, global improvement and Psoriasis Area and Severity Index scores confirmed the therapeutic efficacy of twice daily 3 μg/g calcitriol ointment demonstrated in an earlier controlled study. In conclusion, this study demonstrated that twice daily application of 3 μg/g calcitriol ointment is safe and well‐tolerated in the treatment of chronic

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1009.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryCalcipotriol (Dovonex) ointment has been shown to be an effective, well tolerated, and acceptable treatment for psoriasis vulgaris in adults. This open study was conducted in 16 U.K. centres to assess the safety and efficacy of calcipotriol ointment in treating psoriasis vulgaris in children. Following a 2‐week washout, patients were treated with calcipotriol ointment, 50 μg/g twice daily, for up to 8 weeks. A blood sample was taken on entry and a second‘on treatment’ sample was taken after either 2 or 8 weeks treatment. Sixty‐six children (26 boys, 40 girls, age range from 3 to 14 years) entered and 58 completed the study. There was a statistically significant reduction in the mean (±SD) Psoriasis Area and Severity Index (PASI) from 6.1 ± 3.5 at the start of treatment to 2.7 ± 1.9 at the end of treatment (P<0.001). Marked improvement or clearance of psoriasis at the end of treatment occurred in 65% of patients as assessed by the investigator and 62% as assessed by the patient. Cosmetic acceptability of calcipotriol ointment was found to be good or excellent in 79% of patients. Eight patients withdrew from the study (four defaulted, two unacceptable responses, two adverse events). Adverse events were reported by 16 patients; the most common being local irritation (seven patients). There was no significant change in the mean serum ionized calcium from baseline to 2 or 8weeks treatment. Similarly, there were no consistent or clinically important changes in haematological, or other biochemical parameters, measured during the study period. Calcipotriol ointment has been shown to be an effective, well tolerated, and acceptable treatment for psoriasis vulgaris

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1010.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryProteoglycans are macromolecules displaying structural roles as well as regulatory functions in the maintenance of the extracellular matrix. Biglycan/PG‐I and decorin/PG‐II are two small proteoglycans that are structurally related but differ considerably in their localizationin vivoand behaviourin vitro. Decorin and, to a minor extent, biglycan, can be located at the surface of type I collagen fibrils and have been shown to influence collagen fibrillogenesis. However, the physiological role of biglycan in the dermis is not known. Biopsies obtained from keloids were bisected and processed for total RNA extraction and immunohistochemistry. Northern blot analysis of total RNA obtained from keloids with high growth tendencyin vivoshowed a marked induction of biglycan and collagen α1(I) mRNA expression in comparison with total RNA obtained from normal skin or keloids with little growth tendency. In contrast, decorin mRNA expression remained largely unaltered. Studying these biopsies by immunohistochemistry, decorin expression in the dermis was unaltered comparing normal and keloid tissue, whereas a markedly increased staining for biglycan was observed in the keloid tissue, which was most pronounced in the nodular formations, and was a characteristie feature of keloids. The altered expression of biglycan in keloid tissue might be involved in the abnormal regulation of extracellular matrix deposition either through the binding of growth factors or by influencing the three‐dimensional organization of collagen fibres or associated mol

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1011.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

SummaryHMB‐45 is a monoclonal antibody specific for melanoma cells and premature developing melanocytes. We examined the expression and specific subcellular binding sites of HMB‐45 in various types of melanocytes including epidermal melanocytes from fetuses and infants with or without tyrosinase‐negative oculocutaneous albinism (type IA), melanin‐producing and non‐producing melanoma cell lines (G361 and MeWo), andin vivomelanoma cells (melanotic and amelanotic malignant melanoma). Subcellular HMB‐45 binding was examined by using post‐embedding immunogold electron microscopy with rapid freezing and freeze substitution fixation methods without the use of chemical fixatives to preserve the intracytoplasmic delicate antigen property of HMB‐45. HMB‐45 antigen was detected not only inin vivomelanoma cells and normal fetal melanocytes, but also in melanocytes in the other conditions. Post‐embedding immunogold electron microscopy revealed that HMB‐45 antigen was exclusively localized to stages I and III melanosomes in the melanocytes from fetuses and infants. In tyrosinase‐negative oculocutaneous albinism, only stages I and II melanosomes were detected in the cytoplasm, but both stages of melanosomes were HMB‐45 positive.We conclude that HMB‐45 appears mainly on the immature melanosomes during melanogenesisin both neoplastic and non‐neoplastic melanocytes regardless of their tyrosinase activity, but the intracytoplasmic localization of HMB‐45 antigen is different b

ISSN:0007-0963    

DOI:10.1046/j.1365-2133.1996.d01-1012.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY