摘要:

Dermatofibromas are very common tumors of the skin, but little is known about their etiology and pathogenesis. Current concepts of disease pathogenesis are discussed, with special emphasis on an immunoreactive origin. There is recent evidence, that high numbers of cells with dendritic morphology and positive staining for factor XIIIa are concentrated at the periphery of the lesions. Furthermore, they express MHC class II molecules and costimulatory molecules such as B7-1 and B7-2 on their surface. Thus, there are similarities to professional antigen-presenting cells of the dendritic cell family, so-called dermal dendritic cells (DDCs), which have recently been identified in the human dermis. A concept is developed which explains DF as an abortive immunoreactive process, featuring DDCs as initiators of the disease.

ISSN:1018-8665    

DOI:10.1159/000246714

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Prurigo nodularis (PN) is a characteristic chronic dermatosis of unknown etiology showing severely pruritic nodules mainly on the extremities. Atopic diathesis has been implicated as a contributing factor. Objective: Our purpose was to analyze the role of environmental allergens from living organisms in the pathogenesis of PN, to report hypersensitivity against various environmental allergens and to relate this to atopic history in 31 PN patients. Methods: Positive and negative controls were studied including 52 patients with atopic dermatitis (AD) and 22 healthy controls. RAST, prick tests and scarification patch tests were performed on the patients and specimens from lesions of 8 patients were stained with anti-eosinophil cationic protein (ECP) antibody. Results: The 31 PN patients were divided into two groups, those with a past or present history of AD (PN + AD patients) and those without (PN-only patients). Twenty patients (65%) had PN + AD (median age at onset 19 years) and 11 (35%) had PN only (median age at onset 48 years). Analyses of serum IgE levels, RAST scores, prick test and scarification patch test results revealed that the PN + AD patients showed hypersensitive reactions to the environmental allergens in a pattern almost identical to that noted in AD without PN. In contrast, most of those with PN only did not show any hypersensitivity reactions to the environmental allergens. Histologically, many activated eosinophils, identified by monoclonal antibody to ECP, were observed only in the dermis of the PN + AD patients, in contrast to few eosinophils in the lesion of PN-only patients. Conclusions: These results indicate that there are two forms of PN: an atopic and a non-atopic one. The PN + AD group is closely associated with AD, being accompanied by cutaneous hypersensitivity to various environmental allergens (a pattern similar to that displayed by AD patients) and has a younger age of onset, whereas the PN-only group, which showed a much older age of onset, does not show any such hypersensitive reactions against these allergens.

ISSN:1018-8665    

DOI:10.1159/000246715

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Lupus erythematosus (LE) is a multi-organ-system disease, the characteristics of which are reflected in the 1982 American Rheumatism Association (ARA) criteria for systemic lupus erythematosus (SLE). From a dermatological point of view, only the presence of LE-specific histopathology is necessary and sufficient for the diagnosis of LE. The association between the type of LE-specific skin lesion and the severity of extracutaneous manifestations of LE has not yet been investigated systematically. Objective: The aim of this study was to evaluate, according to the type of LE skin lesions, the prevalence of the 1982 criteria for SLE. Methods: We selected 191 patients whose skin lesions were histologically diagnosed as LE specific. Patients were classified on the basis of skin disease, and their clinical and laboratory data were analyzed. Results: Of 191 patients, 130 (68%) exhibited only one type of LE-specific skin lesion (monomorphic), 55 (29%) had two types (bimorphic) and the remaining 6 (3%) displayed three types (trimorphic). Nineteen of 22 (86%) patients who presented discoid lupus skin lesions above the neck without other eruptions were classified in the cutaneous-limited LE spectrum. Of 116 patients with acute lupus skin lesions (malar rash), 83 (72%) clearly fulfilled the 1982 ARA criteria for SLE. In skin lesions of LE profundus, chilblain lupus, subacute lupus (annular-polycyclic erythema and the papulosquamous variant), there were no significant correlations between the type of eruption and the severity of extracutaneous manifestations. Conclusion: Patients with acute lupus skin lesions could usually be classified as suffering from SLE, whereas monomorphic patients with localized discoid lesions rarely exhibited extracutaneous manifestations. This tendency was less distinct in bimorphic patients. Almost all patients with subacute skin lesions were bimorphic or trimorphic, which might be due to genetic or racial differences between Japanese and other populations.

ISSN:1018-8665    

DOI:10.1159/000246716

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: There is at present little published information on the current indications for isotretinoin as a treatment of acne vulgaris. Objectives: To investigate the factors which influence our current prescribing of isotretinoin: acne severity, response to previous therapy, scarring and psychological effect. Methods: Data on the factors influencing treatment of 200 patients with isotretinoin between January 1993 and May 1994 were examined. Results: 41% of patients were prescribed isotretinoin for partial response to previous therapy, 26% for partial therapy and scarring and 17% for partial response to treatment and psychological disturbance. Only 16 patients received isotretinoin for severe acne. Conclusion: Patients who show only partial response to conventional antibiotic therapy should be prescribed isotretinoin in order to minimize scarring and significant psychological disturbance, independently of the severity of the acne.

ISSN:1018-8665    

DOI:10.1159/000246717

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Lymphomatoid papulosis is a rare cutaneous lymphoproliferative disorder with nodular, papulonecrotic or plaque-like lesions. Although it is clinically benign, the histology shows large, atypical lymphoid cells that display antigenic markers of activated T-helper lymphocytes and express CD30. There is a close relationship to Hodgkin’s disease and to Ki-1-positive anaplastic large-cell lymphoma of the skin. For therapy, various modalities such as PUVA, steroids and acyclovir have been used. We report on a patient with a 10-year history of disease. Treatment with interferon alfa-2a, 3 MU 3 times/week for 4 weeks, and etretinate, 50 mg/day for 5 months, was initially successful, but lesions further relapsed 5 months after cessation of the therap

ISSN:1018-8665    

DOI:10.1159/000246718

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Two patients with Sjögren-Larsson syndrome were treated with calcipotriol in ointment and the ointment base only for 12 weeks, using a double-blind bilaterally paired comparative study. Unilateral improvement was observed in both patients in favour of the calcipotriol-treated side. The present case is the first demonstration of a substantial clinical effect of calcipotriol in the Sjögren-Larsson syndrom

ISSN:1018-8665    

DOI:10.1159/000246719

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Flutrimazole is a new imidazole derivate. Its antifungal activity has been demonstrated in in vivo and in vitro studies to be comparable to that of clotrimazole and higher than bifonazole. Aim: To compare the efficacy and tolerability of flutrimazole cream 1% with a reference drug, bifonazole, in the treatment of dermatomycoses, eligible for topical treatment exclusively. Methods: A multicentre, double-blind, ramdomized, parallel-group clinical trial was conducted. Patients with clinically and mycologically (KHO and/or culture) diagnosed fungal infection of the skin were included in this study and were randomized into two treatment groups: 1 % flutrimazole or 1 % bifonazole, applied to the affected area (target lesion) once a day. The principal criterion of efficacy, ‘cure’, was based on clinical and mycological assessment. Results: Four hundred and forty-nine patients were included in the study (228 flutrimazole, 221 bifonazole). ‘Intention-to-treat’ analysis of the data showed a difference between the treatments in terms of the rate of cure (clinical and mycological) after 4 weeks: 73% in the flutrimazole group and 65% in the bifonazole group (p = 0.05). From a safety point of view, flutrimazole and bifonazole were well tolerated, and the overall incidence of adverse effects (mainly mild local effects like irritation or burning sensation) was 5%. Conclusions: One percent flutrimazole applied topically once a day in the treatment of fungal infections of the skin presents a better efficacy than bifonazole and a good toler

ISSN:1018-8665    

DOI:10.1159/000246720

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Optical profilometry after nail shadowing is introduced as a new technique to quantify nail surface alterations. Objective evaluations can be performed in vivo as well as on nail clippings and silicone rubber replicas. Trachyonychia, pittings, grooves and any other type of onychodystrophy are conveniently defined by 3 profilometric parameters: the mean roughness, the mean depth of roughness and the number of peaks or crests.

ISSN:1018-8665    

DOI:10.1159/000246721

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

We identified genes involved in the normal response to acute UV damage, as they were modulated in cultured newborn keratinocytes by a single sublethal UV dose, appropriately filtered to mimic solar radiation. Their gene products encode proteins involved in the regulation of cell growth (proto-oncogenes c-myc and c-fos), a gene inducible by growth arrest and DNA damage (GADD153), the cytokine interleukin (IL) lα and β and finally a differentiation-associated small proline-rich gene (SPR2). Because chronically sun-exposed skin is known to have altered immune responsiveness and a statistical predisposition to skin cancer, we then examined UV induction of these genes in cultured keratinocytes derived from habitually sun-exposed adult skin, and for the older donors in paired cultures derived from sun-protected site of the same donors. Aging alone increased the baseline expression of two differentiation-associated genes (SPR2 and IL-1 receptor antagonist) in cultures from sun-protected skin. In contrast, photoaging increased the UV inducibility of c-fos but decreased the baseline expression of the differentiation-associated genes IL-1 receptor antagonist and SPR

ISSN:1018-8665    

DOI:10.1159/000246722

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Multiple dermatofibromas (DFs) may occur in association with altered immunity, including systemic lupus erythematosus and iatrogenic immunosuppression. We report a case of multiple eruptive DFs which occurred in a patient positive for human immunodeficiency virus (HIV). The association of eruptive DFs and HIV infection has not been previously reported. The mechanism for the development of DFs in the setting of immune disturbance remains unclear. In the setting of HIV infection, DFs may clinically mimic Kaposi’s sarcom

ISSN:1018-8665    

DOI:10.1159/000246723

出版商:S. Karger AG    

年代:1995

数据来源: Karger