ISSN:1018-8665    

DOI:10.1159/000247293

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:1018-8665    

DOI:10.1159/000247294

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Skin microcirculation is rather complex. The skin viability depends upon the nutritional circulation, which cannot be assessed by conventional macrocirculatory methods that evaluate total blood supply. The indisputable advantage of the microcirculatory methods is to provide information directly in diseased skin areas and assess the effectiveness of vasoactive drugs where they are supposed to act. Several techniques are available today to evaluate the skin microcirculation. Among them, capillaroscopy and transcutaneous measurement of the partial oxygen pressure are of special interest because they provide information which is directly useful in clinical practice. Other techniques remain experimental. In this paper, the main microcirculatory techniques are reviewed and their clinical implications discussed.

ISSN:1018-8665    

DOI:10.1159/000247295

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In the past, several authors described an association of cutaneous malignant melanoma (MM) with other neoplasms. As their results were not conclusive, we designed this study with the aim to determine whether the frequency and spectrum of coexisting neoplasms in patients with cutaneous MM are either a significant or a random event. Therefore, the histories of 623 patients with primary MM from our clinic have been evaluated by a direct questionnaire. Diagnosis of MM has been established by histologic examination after excisional biopsy. The male/female (M/F) ratio was 240/383, the mean age 52.5 years (range 14–93). The distribution of risk groups yielded 277 patients (M/F = 90/187) for low risk (Breslow < 0.75 mm trunk, 5.00 mm, respectively). 64 patients (10.3%) had associated primary carcinomas including 7 patients with 2 primary carcinomas compared to a control group (n = 313) with 12 carcinomas (3.8%). 50% of the carcinomas were diagnosed before the diagnosis of melanoma. The M/F ratio of this group was 25/39, the mean age at diagnosis of MM 62.7 years (range 28–91), the mean age at diagnosis of carcinoma 55.6 years (range 29–90). In the female group, breast cancer predominated (18/39), followed by uterus (7/39) and basal cell carcinoma (7/39); in the male group, basal cell carcinoma (10/25) was followed by prostate cancer (6/25). The frequency of breast cancer in the female group (n = 383) was 4.7% compared to a female control group (n = 171)

ISSN:1018-8665    

DOI:10.1159/000247296

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The L-tryptophan eosinophilic myalgia syndrome (EMS) clinically has some similarities with idiopathic eosinophilic fasciitis (EF). In order to study the pathology of both syndromes, we analyzed 21 biopsies of patients with EMS and 8 with idiopathic EF. In both diseases there is dermal and fascial mucin and dermal edema, but this was more common in EMS. EMS is also characterized by dilated lymphatics, dermal and septal sclerosis and macrophage-rich inflammation. Neural inflammation was seen in 4 of the cases with EMS and in none with idiopathic EF. In both syndromes, there are many histopathological similarities. The differences may be due to sampling and to sample size. The nerve lesions of EMS may result from the nature of lymphocyte-macrophage inflammation, or the effect of the eosinophil neurotoxin and may not be a primary event.

ISSN:1018-8665    

DOI:10.1159/000247297

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Background. Assessment methods for atopic dermatitis (AD) are not standardized, and therapeutic studies are difficult to interpret. Aims. To obtain a consensus on assessment methods in AD and to use a statistical method to develop a composite severity index.Methods. Consensus definitions were given for items used in the scoring system (extent, intensity, subjective) and illustrated for intensity items. Slides were reviewed to address within and between-observer variability by a group of 10 trained clinicians, and data were statistically evaluated with a two way analysis of variance. Two variants of an assessment system were compared in 88 patients at 5 different institutions. Data were analyzed using principal-component analysis. Results. For 5 intensity items studied (erythema, edema/papulation, oozing/crusts, excoriations, lichenification), within- and between-observer variability was good overall, except for edema/papulation which was difficult to assess with slides. In the series of 88 patients, principal-component analysis allowed to extract two unrelated components: the first one accounting for 33% of total variance was interpreted as a ‘severity’ component; the second one, accounting for 18% of variance, was interpreted as a ‘profile’ component distinguishing patients with mostly erythema and subjective symptoms and those with mostly lichenification and dryness and lower subjective symptoms. Of the two evaluation systems used, the one using the rule of nine to assess extent was found more workable than the one using a distribution × intensity product. A scoring index (SCORAD) combining extent, severity and subjective symptoms was mathematically derived from the first system and showed a normal distribution of the population studied. Conclusion. The final choice for the evaluation system was mostly made based on simplicity and easy routine use in outpatient clinics. Based on mathematical appreciation of weights of the items used in the assessment of AD, extent and subjective symptoms account for around 20% each of the total score, intensity items representing 60%. The so-designed composite index SCORAD needs to be further tested in clinica

ISSN:1018-8665    

DOI:10.1159/000247298

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

A series of 90 consecutive cases of toxic epidermal necrolysis (TEN) observed in a single center between 1985 and March 1991 was compared to a previous series from the same institution in order to look for changes in the characteristics of the patients and in the drug etiology. The most salient change was the high prevalence of human immunodeficiency virus (HIV) infection among patients with TEN (20/90). This high rate of HIV infection was linked to two other changes: higher number of male patients leading to an equilibrated sex ratio and an increased role of sulfonamides – mainly sulfadiazine – as etiologic age

ISSN:1018-8665    

DOI:10.1159/000247299

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

Human epidermal melanocytes were treated with all-trans-retinoic acid (RA) and examined for adhesion to bovine serum albumin-, fibronectin- and laminin-coated culture dishes. Control and treated cells were also examined for motility into micropore filters coated with the same proteins. Treatment of the cells with 3 × 10-6 M RA for 3-4 days resulted in inhibition of attachment to all three substrates. Decreased attachment was observed within 1.5 h. Inhibition of attachment was not due to toxicity because differences between control and treated cells disappeared by 18 h, when most of the cells (approximately 75%) were attached and spread on all three substrates. The same treatment that inhibited adhesion also reduced migration into the interstices of micropore filters coated with the same three proteins. In additional experiments, human and mouse melanoma cell lines were examined in place of normal melanocytes. RA treatment also blocked adhesion and motility of these cells. The malignant melanoma cells were less sensitive to RA than normal melanocytes in the adhesion assay but were equally sensitive in the motility assay. The ability of RA to inhibit melanocyte adhesion and motility as well as melanocyte growth could explain, in part, the capacity of retinoids to modulate melanocyte function in hyperpigmented skin lesions

ISSN:1018-8665    

DOI:10.1159/000247300

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The purpose of this study was to measure soluble CD 14 (sCD14) molecules in the skin and in serum of patients with psoriasis. CD 14 is a newly discovered cell surface marker on monocytes that is shed after cell activation. The following procedures were used: suction blisters were raised over the abdominal skin of 9 healthy control individuals and 8 patients with psoriasis. Serum of 17 healthy controls and 17 patients with psoriasis was collected. sCD14 was determined in suction blister fluid and serum by the ELISA technique. The clinical status of psoriasis was rated by the psoriasis area and severity index (PASI score). We found that sCD14 levels in suction blisters of healthy skin (1,050 ± 236 ng/ml, mean ± SE) were similar to those of nonlesional psoriatic skin (841 ± 113 ng/ml). By contrast, control serum contained 2,687 ± 167 ng/ml, but psoriatic serum 4,059 ± 388 ng/ml sCD14 (p = 0.001, Wilcoxon test). Linear regression analysis revealed that serum sCD14 levels and the PASI score of patients did not correlate. We conclude that there is an abnormal monocyte stimulation in blood but not in nonlesional skin in psoriasis that is independent from the clinical status expressed by the PASI s

ISSN:1018-8665    

DOI:10.1159/000247301

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The tandem scanning reflected light microscope invented by Petran and Hadravsky provides real time vision in the confocal mode. It performs nondestructive optical sectioning of biological material to a depth that depends on the transparency of the tissue. This real-time facility adds a fourth dimension (time) to the study of living specimens. In the present work, human skin was explored in vivo, at the cellular level to a depth of 150 μm. Two different anatomical sites were investigated: the back of the hand and the volar aspect of the forearm. The stratification of the horny layers, the nuclei of the living keratinocytes through the whole epidermis and the capillary loops within the superficial dermis constituted clear reference points. These permitted thickness measurements of the stratum corneum and epidermis to an accuracy of 1 μm. This method of exploration provides a new challenge for dermatologists and cosmetologist

ISSN:1018-8665    

DOI:10.1159/000247302

出版商:S. Karger AG    

年代:1993

数据来源: Karger