摘要:

AbstractPG is a rare autoimmune bullous dermatosis of pregnancy that is characterised by linear deposition of C3, and occasionally IgG1along the BMZ of lesional, perilesional and clinically normal skin when examined by direct immunofluorescence. Frequently there is a circulating IgG1autoantibody (PG factor) directed against a BMZ antigen that avidly binds complement.The aberrant expression of MHC class II molecules in the placenta is important in triggering the immune response against a glycoprotein of 180 kDa found in the lamina lucida of the basement membrane of the amnion which cross reacts with that in the skin. The deposition of immune reagents in the placentae in PG has been implicated in the placental dysfunction and impaired foetal outcome which has been shown to occur in PG, Al present immunofluorescence is the key to differentiating PG from other clinically similar diseases.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00031.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractCandida Vulvovaginitis remains the subject of considerable research attention. Yeast species other thanCandida albicansare being incriminated with increasing frequency as causes of vaginitis in some recent publications, while analysis ofC. albicansstrain types by DNA fingerprinting has provided preliminary evidence that the fungus may be able to make minor adaptations of its genotype that facilitate vaginal colonization. The current perception ofC. albicansas a potentially virulent microbe relates several molecular factors to invasive processes. These include secretion of hydrolytic enzymes, in particular a proteolytic enzyme, and an inherent tendency to rapid phenotypic switching. Molecular biological experimentation with the genes determining secretion of enzymes should be able to demonstrate definitively the role played by such proteins in the pathogenetic process.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00032.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractIn this retrospective study on 141 HIV‐positive subjects, allergy was studied by a specific questionnaire and the Phadia‐Top‐Test, an in vitro screening test detecting specific IgE; both were correlated to the patient's history, clinical symptoms and the treatment used. Allergy was studied in reference to HIV‐negative controls and in relation to the clinical and biological subgroups of HIV patients.The application of the x2test demonstrated a high incidence of allergy and a specific relation to the HIV infection compared to the controls as well as in relation to the clinical stage of the infection. Atopy was not specifically related to the HIV infection despite the higher frequency found in the AIDS‐IKEL group.A significant number (21%) of patients with T4>300/μ1 considered immunocompetent presented clinical manifestations of AIDS‐IKEL and 100% of these patients were allergic. A significant number (19%) of patients with T4<300/μ1 considered immunodeficient were asymptomatic and 75% of them were allergic.Thus allergic symptoms may transiently be the only clinical manifestations in HIV infection and possibly a co‐factor for the evolution of the disease due to the immunomodulatory function of the mediators, the cytokines and the proteases released during al

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00033.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractObjectivesTo elucidate (1) the seasonal appearance ofMorsus insectifrom flea bites and (2)the prevalence of this disease in males and females.Material(1) 182 patients suspected of being bitten by fleas from dogs and/or cats and 9697 non‐patients complaining of ‘flea bites’ and (2) 514 non‐patients exposed to and bitten by (cat) fleas.Methods(1) Clinical examination of patients and microscopic investigation of fur samples from their pets and (2) inquiries about the sex and age of bitten vs non‐bitten members of the households.Results(1) Non‐patients are mainly affected by bird fleas from April to May and to cat fleas from August to October, as are patients, but examinations of fur gave insufficient verification in April‐May (expected) and in October (unexpected). (2) Children of both sexes (0–10 years) are equally bitten, but adult women are more often bitten (i.e., show Morsus insecti symptoms) than adult men.Conclusion(1) Examination of the patients' pets for signs of fleas is a useful diagnostic tool, but should be supplemented with knowledge of the seasonal appearance of flea bites. (2) It is necessary to elucidate whyMorsus insectifrom fleas preferentially appear in adult women. Some possible explanations are given, but non

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00034.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackgroundLimb activity meters are useful in correlation with subjective measurements for studying the antipruritic effects of drugs against current chloroquine itch among patients with malarial fever, in a tropical environment.ObjectiveTo prospectively monitor the palliative effects of drugs, without any presumptively significant antipuritic effects known, against moderate to severe chloroquine‐related pruritus among patients with malaria.MethodsUsing a standard ordinal (0–10) scale questionnaire and limb activity meters on all limbs, 60 subjects (50 malarial patients plus 10 healthy controls; both sexes; aged 16–32 years) were recruited for study. Forty patients and the 10 healthy unmedicated controls completed the study and were used for data analysis.ResultsDapsone (50 mg tablets, 8 hourly, orally) significantly reduced pruritus ordinal scores (below 2.5) and limb activity recordings to levels comparable with unmedicated controls by the second or third night of nocturnal monitoring the chloroquine itch among the patients. Clemastine or ketotifen (1 mg tablets, 8 hourly, orally) or prednisolone (5 mg tablets, 12 hourly, for 3 days, then tapered to 5 mg daily for another 2 days, orally), did not significantly exceed the placebo responsiveness to vitamin B‐comple.x tablets (one 8 hourly, orally, for 3 days).ConclusionDapsone. or sulphapyridine (500 mg tablets, 6 hourly, orally daily for 5 days in another recent investigation) have now emerged as potent symptomatic palliatives against chloroquine p

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00035.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackgroundAllergic contact dermatitis is sometimes difficult to treat because the patients are unable to effect prevention. Contact dermatitis can then become chronic and progressive, posing serious therapeutic problems.Patients and MethodFifteen patients with severe allergic contact dermatitis were treated with cyclosporin A (CyA). All patients were polysensitized and unable to avoid with haptens for socioeconomic reasons. The drug was given orally at a dose of 5 mg/kg/day for 4 weeks followed by 3 mg/kg/day for a further 2 months. In three patients the treatment was continued for a further period of 60 days at 2 mg/kg/day.ResultsAll patients responded well to the therapy and no side effects were observed. The manifestations of acute inflammation improved rapidly, whereas the signs of chronic reaction took longer to regress. At the end of treatment some subjects remained without lesions for up 6 months while others relapsed with mild forms. The recurrent dermatitis responded to a further cycle of CyA. Patch test reactions were only slightly modified after 30 days of treatment.ConclusionOur results qualify CyA as a new drug for the treatment of allergic contact dermatitis. It cannot be regarded as the elective treatment but it can be extremely useful in chronic and severe cases.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00036.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackgroundOver the 1980s several education campaigns for prevention and early diagnosis of cutaneous melanoma have been reported from various parts of the world.AimTo improve incidence and prognosis of cutaneous melanoma in 1985 we started, in our area, an information and health education campaign aimed at identifying precursors of melanoma (congenital melanocytic nevi), suspicious lesions (changing moles) and subjects with increased risk of melanoma.MethodPrecursors and suspicious lesions were promptly removed, and high‐risk persons entered the follow‐up program.ResultAs a general effect of these activities the percentage of thin melanomas diagnosed in our division after 1985 increased from 25 to 37.ConclusionWe believe that education campaigns and screening of a targeted population, particularly of subjects presenting increased risk of melanoma, may be helpful in the early diagnosis of melan

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00037.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackgroundAlopecia is a common side‐effect of cancer chemotherapy. Although this complication has been known for many decades, little progress has been made in its prevention or treatment. Previously, we made the following observations: (a) treatment of 8‐day‐old rats with 1‐0‐n‐arabinofuranosylcytosine (ara‐C), doxorubicin, and cyclophosphamide (CYC) produced either total body alopecia (ara‐C and CYC) or alopecia confined to the head and proximal part of the neck (doxorubicin); (b) Imuvert, a biological response modifier, and interleukin‐1 protected against alopecia‐induced by ara‐C; and (c) neither Imuvert or interleukin‐1 protected against CYC‐induced alopecia.ObjectiveExperiments were designed to test for agents to protect against CYC‐induced alopecia.MethodsAgents were tested in the 8‐day‐old rats as a model for chemotherapy‐induced alopecia.ResultsMesna andS‐2‐(3‐aminopropylamino)‐ethylphospnorothioic acid (WR‐2721) did not offer any protection against chemotherapy‐induced alopecia.N‐Acetylcysterine offered very good protection against alopecia induced by CYC but not that produced by ara‐C in the newborn rate animal model.ConclusionN‐Acetylcysteine may prove to be important in the prevention of CYC‐induced alopecia

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00038.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractAimsTo establish the skin changes found in epileptics, and to relate these changes to drug therapy.BackgroundSkin changes in epileptics, although welt acknowledged, have been subjected to few recent large‐scale surveys. Newer anti‐epileptic drugs, in addition to the older therapies, including phenytoin, phenobarbitone and primidone, are now popular. In an effort to update our knowledge of skin changes in epileptics, a study of 200 patients in a long‐term epilepsy hospital was performed.MethodsThe study included taking a history, recording drug therapy and examining the skin of 200 patients.ResultsPatients ranged in age from 21 to over 70. 60% were men and 40% women. Their epilepsy was mostly well controlled, varying in length from less than 10 to greater than 40 years. 57.5% had post traumatic scars. 32.5% had gum hypertrophy, only half having dental caries. Dupuytren's contracture occurred in 24.5%. Seborrheic dermatitis was seen in 15%. 12.5% had coarse facial features and 11.5% had acne. 57.5% of women had facial hirsutes. 17.5% of all patients had sacral hirsutes, which is an unique feature in this group of patients. These clinical findings were correlated with drugs taken at the time, the age of the patients and length of epilepsy. 52% were on carbamazepine, 48% on phenytoin and 42% on primidone or phenobarbitone, singly or in combination.ConclusionsA number of skin conditions are more common among epileptics. Phenytoin and phenobarbitone are linked to gingival hypertrophy, palmar fibromatosis, hypertrichosis, coarse fades and acne. Carbamazepine, too, may be implicated in gum hypertrophy, palmar fibromatosis, hypertrichosis, more specifically sacral hirsutes, seborrheic dermatitis, acne and coarse f

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00039.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackgroundEfforts are being made to find a non‐fluorinated topical corticosteroid with higher anti‐inflammatory activity for use in chronic dermatoses.Patients and methodsIn a third‐party blind evaluation study we compared Mometasone cream, 0.1% once a day, with Clobetasone cream, 0.05% twice daily, in 60 children with atopic dermatitis treated for 3 weeks. At each visit carried out at days 0, 7, 14. 21 we evaluated signs and symptoms, therapeutic response and skin atrophy. Further visits were carried out at days 2, 3, 4 to evaluate the onset of action. During the first and last visit we also carried out laboratory tests including blood cortisol.ResultsMometasone was more effective and rapid in reducing signs and symptoms than Clobetasone. The difference between the two drugs was statistically significant (P<0.05) from the fourth day of treatment for pruritus, and from days 7 and 14 for induration and eythema, respectively. At the end of the study 50% of the patients treated with Mometasone showed no symptoms vs 6.7% of those treated with Clobetasone. Topical and systemic tolerability were very good and laboratory tests were not significantly affected by either drug.ConclusionsMonometasone cream seems to represent an interesting therapeutic approach to chronic dermatoses, i.e., atopic derma

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00040.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY