摘要:

SummaryTopical vitamin D analogues offer a new, effective, more convenient and generally well‐tolerated option for the treatment of psoriasis. Only psoriasis vulgaris has been intensively studied, but other forms of the disease may also respond. Both calcitriol and calcipotriol have been shown to be effective in numerous clinical trials, and the latter has compared well with betamethasone valerate and shortcontact dithranol in controlled studies. Their mechanism of action is not yet fully understood and may prove complex. The most important effect may be a direct regulation of keratinocyte proliferation and differentiation. However, these compounds also have potent immunological properties, and may act by inhibition of cytokine production by keratinocytes or lymphocytes. Topical application of vitamin D analogues appears generally to be remarkably safe, but hypercalcaemia and hypercalciuria may develop if large quantities are use

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08035.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryDermatofibrosarcoma protuberans (DFSP) is a slow growing, locally invasive tumour whose differentiation from other fibrohistiocytic tumours sometimes poses serious diagnostic problems. We investigated CD34 expression immunohistologically in various fibrohistiocytic tumours including dermatofibroma, DFSP, malignant fibrous histiocytoma (MFH), infantile myofibromatosis, fibrosarcoma, hypertrophic scar and keloid. Among these, DFSP was unique in that tumour cells themselves expressed CD34, whereas in other tumours, CD34 expression was observed only on vascular endothelial cells amongst the tumour cells. Until now, there have been no reports of useful immunohistological markers for DFSP. CD34 expression by the tumour cells can be an extremely useful marker in establishing a definitive diagnosis of DFSP.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08036.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryWhen injected into human skin, endothelin‐1 produces intense vasoconstriction localized to the site of the injection, but this area of vasoconstriction is surrounded by vasodilatation which spreads several centimetres from the injection site. The vasodilatation induced by intradermal injection of endothelin‐1 (63 pmol) into human skin is prevented by local anaesthetic. Pretreatment of human skin with capsaicin also inhibits this response. Pretreatment of subjects with the selective histamine H1‐receptor antagonist cetirizine, 10 mg orally 4 h before intradermal injections, inhibited vasodilatation caused by the intradermal injection of histamine (750 pmol), endothelin‐1 (63 pmol), and carbachol (750 pmol). Endothelin‐l (0.3–10μm) and carbachol (1–30μm) failed to induce histamine release from rat peritoneal mast cells. We conclude that the vasodilatation caused by intradermal injection of endothelin‐1 into human skin is neurogenic and is probably mediated by neuropeptide‐containing primary afferent neurones. Because neither carbachol nor endothelin‐1 cause histamine release from mast cells, our data suggest that histamine release from mast cells at the effector end of the axon reflex is responsible for the carbachol‐ and endothelin‐induced vas

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08037.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryChromatographic assay ofn‐alkanes in skin showed detectable levels in normal controls and in patients with various forms of hereditary ichthyosis. Raisedn‐alkanes were found in some, but not all, patients with non‐bullous and bullous ichthyosiform erythroderma and in individual patients with lamellar ichthyosis, ichthyosis vulgaris and Netherton's syndrome.The finding of elevated scalen‐alkanes is neither consistent in ichthyosis, nor specific to any one type of ichthyosis, andn‐alkane assay is not helpful in distinguishing one type of hereditary ichthyosis from another. The source ofn‐alkanes in ichthyotic scale and their role, if any, in the pathogenesis of ichthyosis rem

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08038.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe intracellular inositol pathway is an important route for cell activation and relies on the stimulation of membrane‐bound phosphoinositide‐specific phospholipase C (PLC). Previously we have shown abnormalities of inositol metabolism in mononuclear cells (MNL) in atopic dermatitis (AD) using an indirect method. We now describe a direct method of measuring PLC activity in membrane and cytosol preparations of MNL in AD. We compare PLC activity in AD with that in normal controls and examine the effect of substrate concentration and nucleotide stimulation on the system. Our findings show increased membrane‐bound PLC activity in AD compared with normal controls. Nonspecific stimulation of AD PLC activity by nucleotides suggests that the enzyme of atopics is more sensitive to substrate‐driven activity than that of non

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08039.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe α6β4 integrin is associated ultrastructurally with the hemidesmosomes of the basal keratinocytes and with the bullous pemphigoid antigen (BPA), suggesting an important role in adhesion of epidermal cells to the basement membrane. Using an immunofluorescence technique with chainspecific monoclonal antibodies to the α and β subunits we have investigated the distribution of the α6β4 integrin in normal skin (n=3) and in BP skin (uninvolved, perilesional and lesional) [n=11]). The findings have been compared with other types of subepidermal blisters and with normal skin split by chemical means (n=2) and by suction (n=2). The distribution of α6β4 integrin was compared with that of bullous pemphigoid antigen (BPA) and with other basement membrane zone (BMZ) macromolecules, laminin, collagen type IV, collagen type VII and the BM600 antigen. In uninvolved, perilesional and early pre‐blistered lesional BP skin the distribution of both the α6 and β4 integrin subunits, BPA laminin, collagen types IV and VII and the BM600 antigen was identical to normal skin, i.e. a linear band in the BMZ. Within BP blisters, both α6 and β4 integrin subunits and BPA were absent, except in two blisters in which the integrin expression was retained in the blister roof, despite loss of BPA. The other BMZ components were expressed on the blister floor. These findings distinguished BP from linear IgA disease (patchy retention of α6β4 integrin expression along the blister roof and floor, with BPA expressed in the roof), and from blisters of the dermolytic type (recessive dystrophic epidermolysis bullosa and eosinophilic cellulites) in which all the BMZ components, including α6β4 integrin and BPA were expressed along the blister roof. In artificially split skin, α6β4 integrin and BPA were expressed along the roof of the split, whereas the other BMZ components were expressed along the floor. We conclude that although there is no widespread abnormality of α6β4 integrin expression in uninvolved BP skin, nor in early pre‐blistered lesions, loss of expression of both α6β4 integrin and BPA is a feature of most fully developed BP blisters, and is specific for BP compared with other types of subepidermal blisters. Disruption of the hemidesmosomerelated antigens appears be a prerequisite for

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08040.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryIt has been suggested that patients with homogeneous linear IgA deposits at the basement membrane zone constitute a distinct bullous disorder called linear IgA dermatosis (LAD) of adults or children. The results of the present ultrastructural immunogold study in two patients with LAD suggest that LAD is not a single disease entity. LAD in a 10‐year‐old girl was found to be ultrastructurally similar to an IgA‐type pemphigoid. IgA was detected in the uppermost lamina lucida underlying the basal cell plasma membrane. In a second patient, an 86‐year‐old man, IgA deposits were present within the lamina densa and the anchoring plaques. The distribution of IgA in this patient was ultrastructurally identical with that of IgG in epidermolysis bullosa acquisita skin and with that of the non‐collagenous globular terminus of collagen VII within the basement membrane zone of normal skin. By using the immunogold technique, we could distinguish two distinct types of LAD according to the IgA binding sites in the diseased skin. We suggest that different labelling patterns may correspond to different clinic

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08041.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryA solution of silver nitrate in methanol was used to assess the demonstration of the true surgical excision margin at histology of 100 skin excisions for basal cell carcinoma. In 15% of cases the true margin was not presented and deeper sections were required. The findings highlight the need for routine marking of excision specimens of neoplastic skin lesions to prevent incorrect diagnosis of incomplete excision based on a false resection margin.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08042.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryWe report the use of dynamic hepatic scintigraphy in the assessment of the hepatic status of psoriatic patients before and during methotrexate therapy. Eighty‐seven paired dynamic scans and percutaneous liver biopsies were performed in 63 patients. The liver biopsies were graded according to Warinet al.1with fibrosis of grade 2 or worse being a strong indication for withdrawal of methotrexate. The sensitivity of dynamic hepatic scintigraphy in detecting fibrosis of grade 2 or worse was 83.3% and the specificity was 81.5%. The predictive value of a normal scan for fibrosis of grade 0–1 was high (98.5%) although the predictive value of an abnormal scan for fibrosis of grade 2 or worse was low (25%). Dynamic hepatic scintigraphy may therefore offer a means to reduce the number of liver biopsies necessary in patients receiving methotrexate for psoria

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08043.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

SummaryThe prevalence, pattern of inheritance, and phenotype of Darier's disease was examined in a cross‐sectional study of cases in north‐east England. Seventy‐five cases, representing a local prevalence of at least 1: 36,000, were identified and examined. Forty‐two cases were known to dermatologists, and 33 were identified in the course of the study; 60 were adults (above the age of 20) and 15 were children. In nine families, 66 of 136 adults with an affected parent were known to be affected, indicating complete penetrance of an autosomal dominant gene. Eighteen individuals gave no family history, but seven of these were found to be members of affected kindreds and five obligate carriers examined all proved to have evidence of the disease. In other ‘new’ cases, including several whose parents were examined and confirmed to be normal, no relationship to other cases was found. These cases probably represent new mutations or non‐paternity rather than incomplete penetrance.All but one adult case had the typical rash, but it was milder in women; 16/18 adults who had not presented to dermatologists were female. Diagnostics nail lesions were found in 59 (99%), palmar pits and keratoses in 57 (95%), and acrokeratosis verruciformis in 44 (73%). In 15 young cases (aged 5–18) with one or more diagnostic features, the rash was found in only four (27%), nail lesions in nine (60%), palmar pits in eight (53%), and acrokeratoses in ten (67%). The minor lesions were often subtle but were more consistent early evidence of disease than the rash, and even in the absence of a rash gene penetrance may be complete b

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1992.tb08044.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY