ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00663.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractWe observed a 61‐year‐old woman, presenting with deeply infiltrating, erythemato‐cyanotic, sometimes ulcerated or crusted plaques and nodules, mainly located on the lower limbs. Similar lesions had been present for more than 4 years, with a typical evolution: fast growth, followed by ulceration and necrosis, resulting in hyperpigmented, atrophic patches. The patient had had Rx‐confirmed, symptomatic lung sarcoidosis for 5 years. Histological examination of skin lesions showed diffuse dermal and hypodermal lympho‐histiocytic infiltrate, mainly composed of pleomorphic cells. On immunohistochemistry, the infiltrate was mainly composed of CD2 ±, CD3 ±, CD45RO ±, CD4 ±, CD30 ±, CD25 ‐ T‐cells, with sparse CDla ± dendritic cells. The typical clinical evolution (relapsing, self‐regressing plaques and nodules), morpho‐immuno‐logical features of skin lesions, and strong expression of CD30 antigen by neoplastic T‐cells suggest the possible classification of this case as CD30 ± (Ki‐1 ±) cutaneous T‐cell lymphoma. The association with systemic sarcoidosis, together with a down‐regulated cell‐mediated immune response, suggests the possibility that this latter may be a common denominator i

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00664.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractErythropoietic protoporphyria (EPP) is characterized by increased red cell protoporphyrins, which are excreted solely in the bile. Since gallstones are thought to be more prevalent in EPP, all 17 patients in Northern Ireland known to have EPP had abdominal ultrasound scanning and tests of liver function. Asymptomatic gallstones were detected in one patient, an 11‐year‐old girl. Liver function was normal in all patie

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00665.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00666.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A 32‐year‐old woman presented with a patchy and ophiasis type of alopecia areata. She reported that at the age of 25 she had undergone plastic surgery for the same hair problem. In the occipital region, partial excision of bald areas and transplantation of punched grafts from unaffected areas of her scalp had been performed, but these grafts completely lost their hair shortly after transplantation. At the age of 30 she had developed, in addition, patchy alopecia areata in other areas of the scalp. The present observation of receptor site dominance of the area affected by alopecia areata suggests that the primary abnormality is situated in the affected tissue, and that the disease is caused by local spreading of a hitherto unknown fac

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00667.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractNineteen patients with extensive, therapy‐resistant psoriasis received combined treatment with etretinate plus hydroxyurea. The individual components were given at a reduced dosage and hydroxyurea was administered intermittently. During 12 weeks of treatment, complete remission or marked improvement was observed in 16 patients (84%). The combination of etretinate and hydroxyurea in the above‐mentioned regimen was both effective and well‐tole

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00668.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractInfection with beta‐haemolytic streptococci is accepted as one of the triggering factors leading to exacerbation of psoriasis. In a long‐term study lasting nine years (1982–1991) we investigated whether there is any evidence of dysfunction of humoral and cellular immune factors, and what part is played by microbial infection in this connection, with specific reference to streptococcal antigens. 110 patients with chronic psoriasis, either clinically inactive (stage 1) or active with eruptions (stage 2) and 70 healthy controls underwent the following immunologic investigations: streptococcal antibody titres, serum immunoglobulins IgM, IgA, IgG, total serum IgE, complement factors C3, C4, B and T cells, and subpopulations. The findings demonstrate that phases of inactivity are associated with a mechanism described as “Immunologic Regulation”‐activated antibacterial titres and unremarkable findings for humoral and cellular parameters. Eruptions of psoriasis are with phases of humoral and cellular deficiency; antibacterial titres are significantly elevated, serum IgM or IgA or IgG show deficient levels, C3 is activated, C4 is decreased, as are serum IgE and T4:T8 ratio. Shift in T‐cell subpopulations may depend on serum IgE concentration.The question for consideration is whether antigen‐eliminating inflammatory lesions present in immunodeficiency phases trigger the formation of circulating immune complexes. It seems probable that the pathogenicity of these immune complexes is controlled by serum factors and that they are involved in the initiation of keratinocyte hyp

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00669.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractHerpes simplex virus (HSV) infection is a common cause of genital ulceration. Primary presentation is usually with multiple, small, discrete, tender ulcers. We report an unusual case of chronic, giant ulceration of the vulva in a woman immunosuppressed by the human immunodeficiency virus (HIV). This was the first presentation of symptomatic disease. The diagnosis of HSV infection was made initially on histological examination of a punch biopsy from the ulcer and subsequently confirmed by viral isolation. The response to antiviral therapy with acyclovir was rapid. Other causes of genital ulceration are discussed and we highlight the diagnostic benefit of histological examination of a punch biopsy.

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00670.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractUrethritis in men may be divided into gonococcal or non‐gonococcal. These cannot be distinguished by symptoms and signs. Gram stain and culture remain the best methods for diagnosing uncomplicated lower genital tract gonorrhoea. Uncomplicated gonorrhoea responds to a single dose of a suitable antimicrobial, the choice of dose and drug depending on antimicrobial sensitivity. In non‐gonococcal urethritis, Chlamydia trachomatis may be identified in up to 58% of cases by cell culture or antigen identification methods, such as immunofluorescence or enzyme assay, with cell culture being the gold standard. Chlamydia responds to a minimum 6‐day course of a tetracycline or erythromycin, though longer courses are frequently prescribed. Resolution of symptoms, signs and evidence of urethritis may be a problem. Management of urethritis includes sexual partner notification, examination, investigation and treatment. Rapid accurate diagnosis and effective treatment are vital to prevent complications, to control spread, and to minimize the role of gonococci and chlamydia in the transmission of human immunodeficiency virus (HIV) infe

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00671.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

AbstractIdentification of human papilloma viruses (HPV) is of major clinical importance because certain types are strongly associated with neoplastic transformation, especially in the uterine cervix. These viruses are not reliably detected by serological tests or culture. The detection of viral capsid antigens by immunohistochemical techniques is of low sensitivity and cannot be used in typing of HPV. Molecular biology techniques based on nucleic acid hybridization are the most sensitive and specific for identification of HPV. Blot methods are applied on DNA extracted from cells or tissues. In the Southern blot technique, nucleic acid probes are bound with the electrophoresed DNA fragments whereas, in the dot blot test, the intact DNA is directly spotted onto filters and hybridized. Although the first method is considered the ‘gold standard’, the latter has a comparable sensitivity, is simpler and can also be used with non‐isotopic probes. In the filter in situ hybridization method, whole cells are denatured and hybridized on a membrane, and this results in high background and low specificity. In situ hybridization is applied directly to the cells and tissues and, although it is not as sensitive as blot methods, it permits comparison of pathological features and the retrospective study of archive material. Amplification of genomic sequences by polymerase chain reaction (PCR) makes possible their detection with non‐isotopic blot techniques. PCR, which is applicable on cells, fresh and fixed tissues, is an extremely valuable and sensitive technique for the identification of HPV in the clinical lab

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1992.tb00672.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY