ISSN:1018-8665    

DOI:10.1159/000246624

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Objective and Methods: We investigated the effects of several growth factors on [3H]thymidine incorporation and procollagen type I carboxyterminal propeptide (P1CP) production, which reflects type I collagen metabolism, in keloid and normal fibroblasts. Results: Six fibroblast cell strains, derived from keloid or normal skin, exhibited similar growth responses to platelet-derived growth factor, transforming growth factor β1 (TGF-β1), γ-interferon (γ-IFN) and histamine. In contrast, keloid fibroblasts showed significantly greater growth response to epidermal growth factor (EGF) than normal fibroblasts. PICP production was 4.4 times higher in 6 strains of keloid fibroblasts than in 6 controls. Treatment with γ-IFN (100 U/ml) decreased P1CP production in both groups; the effect was significantly greater in keloid fibroblasts. TGF-β1 treatment upregulated PICP production in both groups. Treatment with histamine increased P1CP production in keloid fibroblasts, although it did not change that in the controls. Conclusion: EGF and histamine may play some role in the development of ke

ISSN:1018-8665    

DOI:10.1159/000246625

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Multiple dermatofibromas (DFs) have been reported to develop in various disorders, especially in systemic lupus erythematosus (SLE). Objective: To investigate the role of mast cells in the formation of multiple DFs in association with autoimmune disorders, we quantified the number of mast cells. Methods: Three cases who developed multiple DFs with positive antinuclear antibodies are described; a 54-year-old woman with a 10-year history of SLE with 13 lesions, a 33-year-old woman with 11 lesions and a 46-year-old woman with SLE and Sjögren syndrome with 10 nodules. Distribution and number of mast cells were examined in the removed lesions of DFs. Results: In 2 cases, mast cells in the upper portion of the lesions were increased in number in comparison with the solitary DF, nevocellular nevus and normal skin. These 2 cases had early DFs from the onset; in the remaining case in which mast cell number was not increased, they were old or fading lesions. Conclusion: It is suggested that mast cells may play a role in induction and exacerbation of the fibrotic process of multiple DFs, and they are supposed to be a reactive hyperplasia in association with systemic autoimmune disorders

ISSN:1018-8665    

DOI:10.1159/000246626

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: ICAM-1 is known to be strongly expressed on keratinocytes in lesional atopic eczema correlating with the degree of inflammation. ELAM-1 was found to be expressed on dermal vascular endothelium in lesional atopic eczematous skin. Objective: The present study was performed to investigate whether elevated serum levels of soluble forms of these molecules are detectable in patients with severe atopic eczema and whether these parameters could be useful markers for disease activity. Methods: Serum levels of soluble ICAM-1 (sICAM-1) and ELAM-1 (sELAM-1) were measured by ELISA in 18 patients with severe atopic eczema before and after UVA1 therapy. Results: Before onset of treatment, serum sICAM-1 (565 + 99 ng/ml) and sELAM-1 (89.7 ± 29.9 ng/ml) levels were significantly (p < 0.001) elevated compared to 22 healthy control persons (296 ± 46 and 48.8 ± 22.7 ng/ml). After achievement of significant clinical improvement after 3 weeks of UVA1 therapy, there was neither a decrease in serum sICAM-1 nor in sELAM-1 levels. The posttherapeutic serum sICAM-1 and sELAM-1 values remained elevated (p < 0.001) above the normal range. Conclusion: Based on these data we suggest that (1) serum sICAM-1 and sELAM-1 are elevated in patients with severe atopic eczema, (2) sICAM-1 does not decrease together with reduction of ICAM-1-positive keratinocytes in atopic eczema following clinical improvement and might therefore be mainly of a different origin, i.e. leukocytes/endothelial cells, and that (3) sICAM-1 and sELAM-1 seem not to be suitable markers of actual disease activity in severe atopic ecze

ISSN:1018-8665    

DOI:10.1159/000246627

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Xanthoma disseminatum (XD) is a rare mucocutaneous xanthoma nowadays classified as a benign non-Langerhans cell histiocytosis. Objective: We studied 7 cases of XD with a long follow-up and reviewed the literature in order to compare and discuss previous reports. Methods: We studied clinical manifestations, course, histopathologic, ultrastructural and immunohistochemical findings of 7 cases of XD followed for 1–20 years. Results: We report our findings and compare our cases with those described in the literature. Conclusions: XD and Langerhans cell histiocytosis were distinguished by clinical differences, as well as ultrastructural and immunohistochemical methods. Three clinical patterns of XD appeared to emerge in our group of patients and in the cases reviewed from the literatur

ISSN:1018-8665    

DOI:10.1159/000246628

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Recently a new standardized terminology in dermoscopy has been provided by a Consensus Meeting held by the Committee on Analytical Morphology of the Arbeitsgemeinschaft Dermatologische Forschung in Hamburg in order to be applied to further studies in this field. Objective: In this study on 159 pigmented skin tumors including 65 melanomas, the validity of various dermoscopic criteria proposed by the Consensus Meeting for detecting melanoma was evaluated. Methods: In each lesion, a detailed clinical and dermoscopic examination, photographic documentation of the clinical and dermoscopic appearance, surgical excision and histopathologic evaluation were performed. Statistical analyses including χ2 statistics, logistic regression analysis and CART (classification and regression tree) analysis were applied. Results: The diagnosis of melanoma using dermoscopy could be obtained easily, if combinations of the following criteria were observed: whitish veil, pigment network alterations (e.g. irregular pigment network, narrow pigment network, broad pigment network), irregular extensions, black dots and gray-blue areas. Interestingly, however, clinical and dermoscopic examination to detect melanomas yielded the same results, namely a sensitivity of 94%. The combined use of both methods led to an increase in the diagnostic sensitivity of 95%, whereas the combination of clinical and dermoscopic examination with logistic regression analysis of dermoscopic criteria enabled us to detect all 65 melanomas in our data set, thus providing a sensitivity of 100%. Furthermore, an algorithm for the classification of melanoma based on the evaluation of dermoscopic criteria has been constructed by CART analysis showing that the presence of a whitish veil in combination with a pigment network inevitably indicates melanoma. Conclusion: The validity of the various dermoscopic criteria set forth by the Consensus Meeting could be demonstrated as some criteria (e.g. whitish veil, irregular pigment network, irregular extensions) were observed with a significant higher frequency in melanomas

ISSN:1018-8665    

DOI:10.1159/000246629

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: The assessment of actinic erythema using a tristimulus colorimeter has only been reported from healthy volunteers but never from subjects with photodermatosis. Objective: The aim of this study was to analyse the difference of chromometric measurements in patients with polymorphous light eruption versus healthy subjects. Methods: Seventy-two subjects were subdivided according to two criteria: skin colour and clinical state. Measurements were done on a non-irradiated site and at the clinical minimal erythema dose site in the L*, a* and b* modes. Results: The data submitted to two-way analysis of variance demonstrate the influence of skin colour and clinical state on the above parameters. Conclusion: Chromometric measurements of L* help to differentiate skin colour, whereas those of a* enable the discrimination of healthy subjects from those with photodermatosis.

ISSN:1018-8665    

DOI:10.1159/000246630

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Arthritis is a frequent complication of pustular psoriasis. However, the mechanism of onset of this arthritis still remains unclear. Objectives: The present study was conducted to determine whether leukotriene (LT) B4 or LTC4 is one of the pro inflammatory mediators that possibly enhance exacerbation of the arthritis lesions. Methods: We investigated the condition of the arthritis and autopsy findings of two cases of generalized pustular psoriasis with the severe complication of aseptic purulent arthritis. We also measured the synovial fluid levels of LTB4 and LTC4 by radioimmunoassay. Results: The collected synovial fluid was purulent, but nonbacterial, and the synovium of the knee joint showed histopathologic evidence of polymorphonuclear leukocyte (PMN) invasion, edema and dilatation of small vessels showing similarity to a histologic reaction in the skin lesions. The immunoreactive (i-) LTB4 and i-LTC4 in the samples significantly exceeded the amount measured in osteoarthritis patients used as the controls. Conclusion: Thus, i-LTB4 and i-LTC4 appear to be generated in the arthritis lesions of pustular psoriasis, the former attracting PMNs to the joints and the latter causing exudation of synovial fluid.

ISSN:1018-8665    

DOI:10.1159/000246631

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: Species of fungi have specific characteristics in geographic distribution, and they have a predilection for certain body areas. Objective: To obtain information about the prevailing fungi and their pattern of infection in the Netherlands. Methods: An analysis was made of the results of mycological examinations carried out in subjects referred to the mycological laboratory of the Department of Dermatology, University Hospital Leiden, the Netherlands, in the period of 1972–1992. Results: The feet, extremities and groin were most commonly infected. The feet and extremities were mainly infected with dermato-phytes (Trichophyton rubrum), but in the groin Candida albicans accounted for 49.9% of the fungal infections. Onychomycosis ranked third in prevalence (17.3% of all fungal infections). The main etiologic agent in the toenails was T. rubrum, but in fingernails C. albicans seems to be at least as important as T. rubrum. On the trunk (mainly the chest, especially in women) and buttocks C. albicans was again the main etiologic agent for fungal infections. Dermato-phytes accounted for only 32.4% and 14.2% of the fungal infections on the buttock and trunk, respectively. On the buttock and trunk T. rubrum was the main etiologic agent as far as dermatophytes are concerned. On the trunk, Microsporum canis and M. ferrugineum were of some importance as well. The prevalence of tinea capitis was very low and accounted for only 0.7% of all fungal infections. Conclusion: Cutaneous candidosis accounted for 30.3% of all fungal infections and is therefore important. On the chest, buttocks, groin and fingernails, the prevalence of C. albicans is higher than that of dermatophyte

ISSN:1018-8665    

DOI:10.1159/000246632

出版商:S. Karger AG    

年代:1995

数据来源: Karger

摘要:

Background: The vitamin D3 derivative calcipotriol (Daivonex®) is an efficient topical treatment of psoriasis. When applied at a dose of about 25 g/week over a mean body surface of 16%, it is not associated with any detectable change in calcium metabolism. Objective: Our purposes were (i) to analyze the effects of calcipotriol on various parameters of calcium metabolism when applied on a large body surface and (ii) to evaluate the usefulness of an oral calcium tolerance test in monitoring psoriatic patients under topical calcipotriol. Methods: In group 1, 10 patients with psoriasis affecting 67.0 ± 2.7% of total body surface (range 55–80%) were treated with calcipotriol for 6.5 weeks (mean 383 g/month). In group 2, 19 patients with psoriasis involving 15% of body surface were treated with calcipotriol for 9 weeks (mean 105 g/month). In group 3, 7 patients without topical calcipotriol for at least 1 week were given 1.5 μg of oral calcitriol for 7 days. An extended survey of blood and urinary parameters of calcium metabolism was performed before and after 45 days of treatment (group 1). Since one of the actions of vitamin D is to stimulate intestinal calcium absorption, an oral calcium-loading test (groups 1, 2 and 3) was done in order to detect more subtle changes possibly induced by calcipotriol. Results: We did not detect any significant change in various parameters of calcium metabolism in group 1 (large body surface treated) patients. The urinary calcium responses to the oral calcium load were identical to controls in both group 1 (large body surface treated) and group 2 (limited body surface treated), whereas in group 3 (oral calcitriol therapy) an increased urinary calcium response to the calcium load was identified. Conclusions: No significant changes in calcium metabolism were detectable when calcipotriol was administered once a day over a large body surface with doses up to 100 g/week. The oral calcium tolerance test appears to be a cheap, simple and sensitive test to monitor patients exposed to high doses of calcipotriol as it detects increased intestinal calcium absorption induced by 1.5 μg of oral calci

ISSN:1018-8665    

DOI:10.1159/000246633

出版商:S. Karger AG    

年代:1995

数据来源: Karger