Biomedical subjects
C T Kennedy
Publications and source records attributed to C T Kennedy.
Hypercalcaemia and sarcoidosis in infancy.
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Masson's pseudoangiosarcoma.
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Does EMLA reduce the discomfort associated with local-anaesthetic infiltration?
The effectiveness of EMLA cream in relieving the discomfort associated with percutaneous infiltration of lignocaine was assessed in a double-blind, placebo-controlled study. Patients undergoing minor skin surgery were divided into two groups, according to the number of lesions requiring surgery. The first group had a single lesion and were randomized to apply either EMLA or placebo cream 1 h prior to infiltration, whilst the second group received EMLA to one and placebo to the other of two lesions treated at the same clinic attendance. In neither group was there a clinically useful reduction of discomfort, probably due to inadequate dermal anaesthesia, and we would not, therefore, recommend the routine use of EMLA for this purpose. The most recent evidence suggests that a 2-h application time may give more effective dermal anaesthesia, but this would probably limit its use to occasional problematical cases.
Temporal association between Der pI exposure, immediate hypersensitivity and clinical severity of eczema.
Uncontrolled studies of avoidance of house dust mite (Dermatophagoides pteronyssinus) by atopic subjects have reported clinical improvement in the severity of eczema. The aim of the present study was to examine the temporal relationship between environmental exposure to the major mite allergen (Der pI) and clinical disease severity in children with chronic atopic eczema. Twelve children were identified as being house dust mite-sensitive on the basis of skin prick test and RAST to Der pI. They were examined on two occasions with a median interval of 63 days. Clinical severity of eczema improved in nine children and deteriorated in two children during this period. Der pI concentration in dust from mattresses changed significantly in only three subjects and there was no correlation between changes in clinical severity and changes in environmental Der pI exposure. Change in RAST against Der pI did correlate positively with change in Der pI exposure (rho = 0.56, P less than 0.05) but these changes were not associated significantly with changes in eczema severity or skin test response to Der pI. It is concluded that the observed changes in clinical severity were unlikely to be due to immediate hypersensitivity responses to natural variations in Der pI concentrations in the personal environments of these subjects.
Contact dermatitis from tioconazole.
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Treatment of itching in atopic eczema with antihistamines with a low sedative profile.
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Agranulocytosis caused by dapsone therapy for granuloma annulare.
Dapsone has been suggested as a useful drug in the treatment of granuloma annulare; however, adverse reactions include a potentially life-threatening agranulocytosis. We report the case of a 50-year-old woman in whom agranulocytosis and septicemia developed after 7 weeks of therapy with dapsone for granuloma annulare. Full recovery followed cessation of this drug, but caution is advised in prescribing dapsone for relatively benign skin conditions.
Cutaneous reaction to diltiazem resulting in an exacerbation of angina.
A 77-year-old woman developed a widespread erythematous rash after treatment with the calcium antagonist, diltiazem, which resulted in an exacerbation of the angina for which the drug was originally described. Drugs which may give widespread cutaneous side-effects should be used with caution in patients with compromised cardiac function.
Mepacrine pigmentation in systemic lupus erythematosus. New data from an ultrastructural, biochemical and analytical electron microscopic investigation.
A case of mepacrine pigmentation occurring in a patient with systemic lupus erythematosus has been investigated by fluorescent light microscopy, gas--liquid chromatography and analytical electron microscopy. There is strong evidence for the presence of mepacrine itself within the typical granules, which have been shown by electron microscopy to be membrane bound and intracellular. Analytical electron microscopy also showed that the granules contain large quantities of iron and smaller quantities of sulphur.