Biomedical subjects
C Moss
Publications and source records attributed to C Moss.
"Isolated" radial ray defect may be due to Rothmund-Thomson syndrome.
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Duplicate reporting of patients with Rothmund-Thomson syndrome.
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Genetic control of sebum excretion and acne--a twin study.
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Compound allergy to a skin marker for patch testing: a chromatographic analysis.
We present details of a patient who was demonstrated to have contact allergy to a solution used to mark sites of application of patch tests, during investigation of allergy to gold and nickel. Negative results were obtained when patch testing was performed using the individual constituents of the marker solution (gentian violet, dihydroxyacetone and acetone). Chromatographic analysis of various combinations of these chemicals did not identify a chemical derivative which might have caused this reaction.
Antigenic stimulation during ultraviolet therapy in man does not result in immunological tolerance.
People receiving therapy with either 8-methoxypsoralen plus long wavelength ultraviolet radiation (PUVA) or medium wavelength ultraviolet radiation (UVB) have been studied to see whether their unresponsiveness to the contact sensitizer dinitrochlorobenzene (DNCB) is a form of immunological tolerance. It was confirmed that both PUVA and UVB therapy impair sensitization by DNCB:4/13 PUVA-treated and 9/29 UVB-treated psoriatic subjects became sensitized by a dose of DNCB which sensitizes 100% of untreated patients. Subjects unsuccessfully sensitized during PUVA therapy could subsequently be sensitized perfectly normally. Subjects unsuccessfully sensitized during UVB therapy showed slight impairment of subsequent sensitization which was not statistically significant, and which was probably a persistent effect of UVB exposure. In conclusion, the temporary unresponsiveness seen in human subjects exposed to antigens during PUVA or UVB therapy is not due to immunological tolerance.
Thrombocytopenia in systemic lupus erythematosus responsive to dapsone.
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Cutaneous reactions to aluminium in vaccines: an avoidable problem.
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Recovery of cutaneous immune responsiveness after PUVA therapy.
We studied sensitization to dinitrochlorobenzene (DNCB) in psoriatic patients before, during and 2, 4, and 6 weeks after a course of photochemotherapy (PUVA). The inhibition of sensitivity observed during PUVA was completely reversed after 6 weeks. Thus the PUVA-mediated inhibition of cutaneous immune responsiveness is of short duration. However, whether there are long-term sequelae remains to be established.
Haemangiectatic hypotrophy associated with Perthe's disease.
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Genetic counselling in hypomelanosis of Ito: case report and review.
A 27-year-old male with hypomelanosis of Ito (HI) is reported. One of his two children had a postaxial ray defect of one leg but neither had cutaneous features of HI. Somatic mosaicism for a gene defect lethal to ectodermal derivatives offers the best explanation for HI in males, with consequent negligible recurrence risk. The limb defect is considered coincidental. The excess of girls with HI could be due to a female cohort with incontinentia pigmenti (IP) which may be indistinguishable: counselling of females must therefore take account of possible X-linked inheritance.
Allergy to non-toxoid constituents of vaccines and implications for patch testing.
We report 3 patients with persistent symptoms at vaccination sites. All were allergic to aluminium and one to thiomersal and neomycin too. Aluminium allergy causes false positive patch test reactions and we propose methods of patch testing patients with symptoms at vaccination sites in order to avoid this problem. The practical relevance of allergy to non-toxoid constituents of vaccines is discussed.
Anhidrotic and achromians lesions in incontinentia pigmenti.
Three women subsequently shown to have incontinentia pigmenti (IP) presented with white hairless streaks on the limbs as the predominant cutaneous abnormality. Seven other patients with IP diagnosed in infancy were reviewed to establish the frequency of this sign. It was found in all of them, and in the otherwise unaffected mother of three affected girls. A focal absence of sweating in these lesions is reported here for the first time. There are other similarities with anhidrotic ectodermal dysplasia, suggesting a genetic overlap between these two X-linked conditions.
Comparison of cadexomer iodine and dextranomer for chronic venous ulcers.
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The effect of altering area of application and dose per unit area on sensitization by DNCB.
We have investigated the contributions of dose per unit area and area of application to the degree of sensitivity induced by dinitrochlorobenzene (DNCB). Subjects sensitized with 35.4 micrograms/cm2 showed equal sensitization whether the total dose was 250 micrograms applied to 7.1 cm2 or 62.5 micrograms applied to 1.8 cm2. Three groups of subjects were sensitized with 16.4 micrograms/cm2 applied as 56 micrograms on 3.5 cm2, 116 micrograms on 7.1 cm2 or 232 micrograms on 14.2 cm2. Although the total dose changed by a factor of four, the proportions of subjects sensitized were comparable (66, 50 and 55% respectively), and their degrees of reactivity were similar. This contrasts with previous findings that when the area of sensitization was fixed and the concentration was increased over a similar range, highly significant increases in the proportion of sensitized subjects and degree of reactivity occurred.
The nature of mycosis fungoides.
Thirty-four patients with a clinical diagnosis of plaque stage mycosis fungoides, poikiloderma atrophicans vasculare (poikiloderma) and parapsoriasis en plaques (parapsoriasis) were investigated for evidence of extracutaneous disease using a biochemical screen, blood films, bone marrow examination, chest radiograph, abdominal ultrasound, isotope liver scan, liver biopsy and lymphangiography. Skin biopsies were also taken from these patients and, in order to rule out non-specific histological change, from 29 controls with inflammatory skin disease; the slides were examined blind by two independent observers for evidence of mycosis fungoides or poikiloderma and graded accordingly. Both observers were able to differentiate significantly histological grades of mycosis fungoides corresponding to the clinical diagnosis although exact histological grades only corresponded on 35 per cent of slides. Features graded as classical or probable mycosis fungoides were found in between 22 and 67 per cent of patients with parapsoriasis and between 67 and 100 per cent of those with poikiloderma. We found no evidence of extracutaneous disease in any of our patients. Lymphangiograms were abnormal in 30 of 31 examinations but the changes were non-specific and did not correspond to disease type, duration or extent. Four patients had apparently unrelated co-existing disease including chronic lymphatic leukaemia in two, a monoclonal gammopathy and autoimmune haemolytic anaemia. This study shows that in its early stages mycosis fungoides is predominantly if not primarily a cutaneous disease. The findings also suggest that parapsoriasis and poikiloderma are part of the same disorder as mycosis fungoides or evolve into it. Aggressive treatment to prevent progression to mycosis fungoides plaque and tumour stage should therefore be tried. The findings support the idea that mycosis fungoides is a reactive rather than a neoplastic disorder.
Visual acuity screening of children 6 months to 3 years of age.
The operant preferential looking (OPL) procedure allows a behavioral estimate of visual acuity to be obtained from children 6 mo to 3 yr of age. In clinical settings, there is often too little time available to obtain an acuity estimate with the standard OPL procedure. The goal of this study was to identify specific spatial frequencies, termed diagnostic grating frequencies, that could enable the OPL technique to be used as a screening procedure under conditions where completion of acuity estimation was not possible. One hundred eighty presumptively normal children, 6, 12, 18, 24, 30, and 36 mo of age, were each tested with up to 20 trials of a potential diagnostic grating frequency to determine the highest spatial frequency grating that could be resolved by 90% of children at each age. For all ages except 18 mo, there existed a spatial frequency that produced uniformly high OPL performance within the age group; this spatial frequency was separated by one-half to one octave from a higher spatial frequency that more than 30% of children at that age failed to detect. These results suggest that at all ages except 18 mo, it should be possible to use the OPL procedure as a vision screening tool by testing individual children with the diagnostic grating frequency appropriate for their age.
Susceptibility and amplification of sensitivity in contact dermatitis.
We have examined the hypothesis that people who develop contact allergies to environmental substances do so because they have heightened susceptibility. Analysis of data from 2200 consecutive patients tested with the 20 commonest antigens in a patch-test clinic showed that more people developed multiple contact allergies than would be predicted from the frequency of single allergies; the excess was too great to be explained by chance and increased with number and rarity of the combinations of sensitizers. The possibility that this was due to enhanced individual susceptibility to sensitization rather than concomitant exposure to several sensitizers was confirmed by showing that patients with multiple allergies are more readily sensitized experimentally, and to a greater degree than normal, by dinitrochlorobenzene (DNCB), an unrelated antigen. The defect involves induction rather than expression of sensitivity. Amplification of the response to DNCB is proportional to susceptibility (calculated from the ratio of observed prevalence of multiple allergies to that predicted from the prevalence of single allergies) throughout the range from normal subjects, through those with a single sensitivity, to those with rare, multiple allergies. Therefore, we conclude that individual susceptibility is an important factor in the development of contact dermatitis, and occurs by a non-antigen-specific amplification of immune sensitization.