Combined short contact crude coal tar and dithranol therapy for psoriasis.
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Biomedical subjects
Publications and source records attributed to A Y Finlay.
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The expert system approach to computer diagnosis uses a non-algorithmic method to represent and manipulate an expert's knowledge and reasoning. This information, which may be provided by a dermatologist, is represented by rules in a logic-based computer language in order to provide interactive and explanatory features. The major advantages of using expert system techniques for computer-aided diagnosis in dermatology are that knowledge is made explicit, the heuristic nature of an expert's knowledge can be more easily captured and the more easily readable programs make modification easier. In the example described, the differential diagnosis of nine facial skin tumours was considered. The program, using the language 'micro-PROLOG' in an expert system shell 'APES', consists of 'rules' and 'facts' which define a relationship between patient and symptom, symptom and disease or disease and therapy. The 'strength' of each relationship is defined and 'key symptoms' identified. The system finally offers a diagnosis, an estimate of certainty and simple management advice.
A case is reported of a patient known to have ulcerative colitis who developed atypical lichen planus. This did not resolve when the patient discontinued sulphasalazine treatment but became more extensive within 48 h of an exacerbation of colitis. This case supports the view that there may be an association between ulcerative colitis and lichen planus.
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We report five patients in whom localised callosities were found on the dorsum of the feet. This was bilateral in four cases and was due to repetitive minor trauma associated with the sitting posture adopted by the patients. Three of the patients also had psoriasis vulgaris which was clinically dissimilar to the lesions we describe.
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A persistent eruption in light-exposed areas in two related carriers of X-linked chronic granulomatous disease is described. This eruption appears to be a separate entity, rather than a variant of cutaneous lupus erythematosus or Jessner's disease. Recognition may enable detection of carrier females prior to the birth of an affected son, so that genetic counselling and antenatal diagnosis can be instituted.
A photographic photometric method for objective measurement of fluorescence in skin is described. This method has been used to (a) improve the dansyl chloride method for determining stratum corneum turnover time by making assessments objective and quantitative, and (b) examine the barrier function of the stratum corneum by measuring the concentration of a fluorescent material at different levels within the stratum corneum at different times.
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Twenty patients with disabling disorders of keratinization were treated with Tigason (etretinate, Ro 10-9359), an oral aromatic retinoid, and the clinical responses and the effects on the skin were monitored. Most patients showed a considerable clinical improvement within 4 weeks. Side effects, such as cheilitis, were common but mostly transient or minor. In the skin there was a decrease in glucose-6-phosphate dehydrogenase activity within the granular cell layer of the epidermis, and an increase in mean epidermal thickness and mean corneocyte area. However, there was little apparent effect on epidermal proliferation or on histological and ultrastructural appearances. These findings suggest that the drug acts at a late stage of epidermal differentiation.
Fourteen patients with a clinical and histological diagnosis of necrobiosis lipoidica were treated in a double-blind control study with either an aspirin dipyridamole combination or a matching placebo for an 8-week period. None of the patients in the aspirin dipyridamole group showed a significant improvement.
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The non-eczematous but 'dry' skin of twelve patients with eczema has been studied and contrasted with skin from similar sites in control subjects of similar age and sex and with patients with autosomal dominant ichthyosis. The areas investigated were examined histologically and by techniques for assessment of the stratum corneum structure and function. The 'dry' skin sites demonstrated increased intracorneal cohesion, increased total epidermal thickness, patchy parakeratosis and in places slight hypergranulosis. It is concluded that the dry skin condition of patients with atopic eczema is not autosomal dominant ichthyosis and is probably eczematous in nature.