ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01606.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01607.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01608.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground. Recent data have supported an autoimmune etiology of vitiligo. Genetic factors also seem to play an important role in this disorder. The purpose of this study was to determine the presence and frequency of organ‐specific autoantibodies in vitiligo patients and their relatives.Methods. Twenty patients with vitiligo and two first or second degree relatives of each patient were interviewed and their sera analyzed for the presence of antithyroglobulin (ATg), antithyroid microsomal (ATM), antiparietal cell (APC), and antiadrenal (AAd) autoantibodies. The sera of 20 normal patients were used as control.Results. A significantly increased frequency of ATg, ATM, and APC antibodies was found in vitiligo patients when compared to normal controls. First and second degree relatives had significantly increased frequencies of ATg and ATM. A high incidence of autoimmune/endocrine diseases was found in the patients' relatives, including a 25% prevalence of vitiligo.Conclusions. These findings not only support an autoimmune etiology for vitiligo, but also highlight the strong genetic contribution to this pigmentary disorde

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01609.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground. Epidemiologic studies of alopecia areata (AA) are available from USA, Japan, and European countries, but there is a paucity of literature on AA from Asian countries, especially from the Indian subcontinent.Methods. In a prospective, hospital‐based study lasting for a decade (1983–1992), the epidemiology of AA was studied, including associated diseases and risk factors for development of severe AA. Simultaneously a similar study was carried out in age‐ and sex‐matched controls.Results. Eight hundred and eight patients (532 men, 276 women) and 572 age‐ and sex‐matched controls (370 men, 202 men) were studied. The incidence of AA was 0.7% of new dermatology outpatients. The majority of patients (712, 88%) were below 40 years of age, including 196 children<16 years of age (24%). Almost half (46%) of the women patients had onset of AA in childhood, compared to only 19% in men (P<0.001).Alopecia was total, universal, or extensive in 154 patients (19%). An onset in the first two decades was more often associated with severe alopecia (P<0.001), especially in men (P<0.01). Alopecia areata was recorded in family members of 70 patients (9%), being more frequent in the severe forms of AA (16%). Evidence of atopy was recorded in a total of 146 instances (18%). The frequency of atopy was the same in circumscribed alopecia (18.1%) and severe alopecia (18.2%). Nail changes were found in 162 patients (20%) and were more frequent in 76 (47%) with the severe form of AA (P<0.001). On 39 occasions (5%), autoimmune‐related diseases were detected: vitiligo in 15 (1.8%), thyroid disorders in 8 (1%), lichen planus in 6 (0.7%), collagen vascular diseases in 5 (0.6%), diabetes mellitus in 4 patients (0.4%), and pemphigus foliaceus in 1 (0.1%) patient. Patients with family members having vitiligo (recorded in 5.9% of patients), were more frequently affected with severe alopecia (P<0.001).Conclusions. Alopecia areata in North Indians showed a preponderance in men (M:F = 2:1) and the majority of persons with disease (88%) were below 40 years of age. Onset in childhood was more frequent in girls or women, but the incidence of severe alopecia was higher in boys or men with onset at an earlier age. Diseases associated with autoimmunity were seen in only 5% of patients. Atopy was found to be associated in 18% of patients, but its reported association with younger age of onset and severe alopecia was not confirmed. Presence of vitiligo in family members and onset before 20 years of age, especially in boys or men, were found to be risk factors for severe alopecia.Int J Dermatol

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01610.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractBackground. Alopecia areata (AA) is a noncicatricial alopecia with still unknown pathogenesis, but increasing evidence suggests that an immunologic process might be responsible for the disease.Materials and Methods. Nineteen patients with AA were studied with ten of them in the progressive phase of the disease and nine in the stabilized phase. Biopsies of both affected and unaffected skin were taken. For immunohistochemistry, monoclonal antibodies directed against CD3, CD4, CD8, CD10a, CD36, and HLA‐DR antigens, were used, as well as antibodies directed against adhesion molecules icam‐1, ELAM‐1 and LFA‐1. For electron microscopy (EM), specimens were fixed in glutaraldehyde‐sodium cacodylate buffer, post‐fixed in osmium tetroxide, and stained with uranyl acetate. For statistical analysis, sections from involved and uninvolved skin of each patient for each antibody, the sign test, Fisher's F‐test, and the Tukey‐Kramer test were used.Results.There was a rich infiltrate of CD4+ cells and CD1a+ cells, particularly in the perivascular zone of both unaffected and affected skin (here in the perivascular and in the peribulbar zone) in the progressive phase of AA. In the stabilized phase the infiltrate was scant, both in unaffected and affected skin and limited to the peribulbar area. Receptors of adhesion molecules (ICAM‐2, ELAM‐I, LFA‐1) were strongly expressed, mainly at the microvascular level in both unaffected and affected skin in the progressive phase, but were only weakly or not at all expressed in the stabilized phase, again in unaffected and affected skin. Ultrastructural data confirmed the immunohistochemical findings and showed close contacts between infiltrating lymphocytes and Langerhans'‐lineage cells mainly in the progressive phase.Conclusions.Our results suggest that: 1) an immunologic process, apparently carried out by CD4+ lymphocytes and by dendritic CD1a+ and CD36+ cells, may play a key role at least in the early phase of the disease involving primarily microvessels and later on the bulbar area; 2) the expression of adhesion molecule receptors is involved at the beginning of the disease by mediating the adherence of leukocytes to endothelial cells and subsequent traf

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01611.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A 28‐year‐old man was admitted to our institute because of acute urticaria appearing a few hours earlier. The patient stated that during sleep he had been bitten by a large number of “insects,” which had dropped from wooden ceiling beams under the roof of his room. The patient was living in the center of Milan in a very old house, where numerous pigeons had built their nests under the rooftop. The patient brought along with him some examples of these “insects,” which were later classified as pigeon ticks (Argas reflexus) (Figs. 1, 2). Dermatologic examination revealed the presence of numerous wheals and erythemato‐papular lesions on the neck and trunk. These lesions were of different shapes and sizes, bright red in color, and with a small central ulceration corresponding to the tick bite. In addition, there were numerous excoriated lesions due to scratching; the patient in fact complained of very intense pruritus. The general physical examination was within

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01612.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

A 68‐year‐old white woman was referred to us by her rheumatologist for possible participation in a clinical study of photopheresis for scleroderma. In February 1993, she noticed edema of her distal phalanges, Raynaud's phenomenon in both hands, flu‐like symptoms, fatigue, intermittent diarrhea, abdominal pain, tearing in both eyes, dyspnea on exertion, dysphagia, and odynophagia. Bilateral silicone‐gel breast implants had been placed 12 years before; 2 months before her present evaluation, they were removed and found to be ruptured.Physical examination revealed edema, limited to the fingers and hands bilaterally, and slight induration of the skin on the dorsum of both hands and distal forearms. The remainder of the physical examination was normal.According to our study protocol, a skin biopsy specimen from the dorsum of the right hand was taken, but all other laboratory investigations were refused. Histopathologic examination revealed multiple clear spaces of varying sizes in the dermis and multinucleated macrophages containing small refractile particles, characteristic of silicone granuloma (Figs. 1 and 2); however, the specimen showed no evidence of scleroderma. X‐ray energy dispersive analysis by scanning electron‐microscopy confirmed the presence of elemental silicon in the small refractile particles.The patient did not receive any treatment after her diagnosis and shortly thereafter, she was lost t

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01613.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01614.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

ISSN:0011-9059    

DOI:10.1111/j.1365-4362.1996.tb01615.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY