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Biomedical subjects

D Burrows

Publications and source records attributed to D Burrows.

At least 55 records · Page 3Linked to original sources

Laryngo-onycho-cutaneous syndrome associated with familial benign hypercalcemia.

A Pakistani boy had chronic ulceration of the cheeks, generalized nail dystrophy, ulceration and hypergranulation of the nail beds, conjunctiva, and vocal cords, and dental enamel hypoplasia. These features are consistent with laryngo-onycho-cutaneous (LOCS) syndrome or Laryngeal and Ocular Granulation tissue in children from the Indian subContinent (LOGIC) syndrome. Both he and his elder brother had elevated levels of serum calcium consistent with familial benign hypercalcemia. Laryngo-onycho-cutaneous syndrome is a newly recognized condition and its association with familial benign hypercalcemia has not been previously reported.

Child, Preschool↗

Erythrodermic psoriasis. Report of a case associated with symptomatic hypophosphataemia.

We describe a patient with a long history of psoriasis who developed severe erythrodermic psoriasis associated with lethargy, muscular weakness and collapse. Serum biochemical screening at the time revealed severe hypophosphataemia, and when this was corrected by intravenous phosphate replacement her symptoms resolved and her psoriasis improved. Hypophosphataemia may therefore be another metabolic complication of erythrodermic psoriasis.

Dermatitis, Exfoliative↗

Allergic reactions to a hairdressers' series: results from 9 European centres. The European Environmental and Contact Dermatitis Research Group (EECDRG).

To obtain data on the frequency of sensitization among European hairdressers, the patch test results from 9 centres were evaluated. 8 allergens recommended by the ICDRG and EECDRG in the hairdressing series and PPD from the standard series were used to patch test 809 hairdressers and 104 clients suspected of contact sensitization. Among hairdressers, the mean frequencies of sensitization ranked as follows: GMT 19%, PPD 15%, APS 8%, PTD 8%, ONPPD 4% and PADH 4%. In contrast to GMT in acid permanent waves, the frequency of sensitization to AMT in alkaline permanent waves was only 4%. Frequencies of sensitization to pyrogallol and resorcinol were 0.8% and 0.6%, respectively. The frequencies of sensitization showed marked regional variations, particularly that to GMT, which was highest in Germany (51%), followed by Spain (22%) and London (19%). Clients of hairdressers showed a similar rank order of sensitization frequency, with the exception of APS, which was completely negative in this (small) series.

Beauty Culture↗

Allergic contact dermatitis from para-tertiary-butylphenol-formaldehyde resin (PTBP-F-R) in Northern Ireland.

Over the past 5 years, 2270 patients with suspected allergic contact dermatitis were patch tested in our clinic to the European standard series of allergens. 7 patients (0.3%) showed a positive reaction (> or = +) to PTBP-F-R. In 3 (42.9%) of these patients, the allergen was traced to adhesives but no allergen source was determined in the remainder (57.1%). On the basis of these findings, it is questionable whether PTBP-F-R alone should routinely be included in the European standard series.

Adult↗

Mercury allergy in a contact dermatitis clinic in Northern Ireland.

441 consecutive patients (294 female, 147 male) with suspected contact dermatitis were patch tested to the European standard series, mercury metal (1% pet), ammoniated mercury (1% pet.), and mercuric chloride (0.1% aq.). 14 patients (3.2%), 12 of whom were female, showed a positive response to 1 or more mercury compounds; none reacted to mercuric chloride alone. Primary sensitization was most likely due to either inoculation with vaccines containing merthiolate preservatives or amalgam dental restorations. Mercury allergy was of historical clinical relevance in only 2 patients, both women who developed gingivostomatitis following insertion of amalgam dental fillings. 1 of these women subsequently developed allergic contact dermatitis from contact lens solutions, shampoos and cosmetics which contained mercury preservatives. On the basis of these findings, we recommend patch testing with both metallic mercury and ammoniated mercury in patients with suspected mercury allergy.

Adult↗

Basal cell carcinoma occurring in association with dermatofibroma.

Two cases of basal cell carcinoma (BCC) occurring in association with long-standing dermatofibroma are reported. These lesions were asymptomatic, but both were characterized clinically by central ulceration. Histopathology of both cases revealed a BCC overlying a typical dermatofibroma. The association of these two tumours has rarely been reported and is controversial. It is disputed whether the changes of BCC overlying dermatofibromata are reactive or neoplastic.

Aged↗

Adenovirus 12 and dermatitis herpetiformis.

Previous studies have shown that A-gliadin, a major gluten-derived peptide known to activate the gluten-sensitive enteropathy (GSE) of coeliac disease (CD), and the non-structural E1B peptide produced during early lytic gastrointestinal infection with human adenovirus type 12 (AD12) share an identical twelve amino acid sequence. It is suggested that immunological cross reactivity between these two peptides may play an important role in the pathogenesis of CD. As a milder but histologically identical GSE is found in the majority of patients with dermatitis herpetiformis (DH), a condition also thought to be caused by dietary gluten, we postulated that AD12 may also be involved in the pathogenesis of DH. To test this we assayed sera from 40 patients with DH and 18 healthy controls for AD12-neutralizing antibodies as evidence of past viral exposure. Detectable AD12 antibodies (titre of 13 or higher) were found in only 15% (6/40) of DH patients, compared with 27.8% (5/18) controls (not significant). These findings do not support a causative role for AD12 in the pathogenesis of DH.

Adenoviridae Infections↗

Dynamic hepatic scintigraphy in the screening of psoriatic patients for methotrexate-induced hepatotoxicity.

We report the use of dynamic hepatic scintigraphy in the assessment of the hepatic status of psoriatic patients before and during methotrexate therapy. Eighty-seven paired dynamic scans and percutaneous liver biopsies were performed in 63 patients. The liver biopsies were graded according to Warin et al. with fibrosis of grade 2 or worse being a strong indication for withdrawal of methotrexate. The sensitivity of dynamic hepatic scintigraphy in detecting fibrosis of grade 2 or worse was 83.3% and the specificity was 81.5%. The predictive value of a normal scan for fibrosis of grade 0-1 was high (98.5%) although the predictive value of an abnormal scan for fibrosis of grade 2 or worse was low (25%). Dynamic hepatic scintigraphy may therefore offer a means to reduce the number of liver biopsies necessary in patients receiving methotrexate for psoriasis.

Adult↗

Erythropoietic protoporphyria, transfusion therapy and liver disease.

A 28-year-old man who had suffered from erythropoietic protoporphyria since infancy was referred because of worsening photosensitivity. Conventional therapy with beta-carotene, terfenadine and topical sunscreens was ineffective or not tolerated, and he was treated with transfusions of washed packed cells. Unexpectedly, his photosensitivity deteriorated further, his whole blood protoporphyrin levels doubled and he developed abnormal liver function tests. This is the first report of such an adverse response to blood transfusion therapy for erythropoietic protoporphyria and may have been related to subclinical hepatitis or the increased iron load associated with blood transfusion.

Adult↗

Patch testing with pure palladium metal in patients with sensitivity to palladium chloride.

During a 15-month period, 536 patients being investigated for suspected contact dermatitis were patch tested with the European standard series and palladium chloride 1% pet. 13 patients (2.4%) had a positive allergic response to palladium chloride and all 13 were also allergic to nickel. 12 of these 13 patients consented to further patch testing with discs of pure palladium metal foil, and none reacted. We have shown previously that palladium chloride patch test material contains traces of nickel, and propose an explanation for these results in terms of the additive effect of allergens when tested in combination.

Adult↗

Keratinocyte expression of class II MHC antigens in long-lasting allergic patch test reactions.

The keratinocyte expression of class II MHC antigens HLA-DR, DP and DQ was studied in 20 long-lasting allergic patch test reactions and 17 normal allergic patch tests reactions. No significant difference in the expression of these antigens in the 2 groups was detected. No 1 allergen was responsible for the majority of long-lasting allergic patch test reactions. The immunological mechanisms which may contribute to long-lasting allergic patch test reactions are discussed with reference to HLA-DR keratinocytes.

Adult↗

Subcorneal pustular dermatosis and IgA paraproteinaemia: response to both etretinate and PUVA.

A non-insulin dependent male diabetic is reported with subcorneal pustular dermatosis associated with intraepidermal IgA deposits and a benign IgA paraproteinaemia. Treatment with dapsone and etretinate was reasonably effective, but etretinate had to be discontinued due to the development of diffuse idiopathic skeletal hyperostosis. His subcorneal pustular dermatosis subsequently flared and was troublesome for 2 years until he was commenced on PUVA, with excellent response.

Aged↗

Minocycline-induced pigmentation occurring in two sisters.

Two sisters are described who developed facial pigmentation while on minocycline therapy for acne vulgaris. It is suggested that the possible mechanisms for this relatively uncommon complication occurring in these two patients may be due to either a genetically acquired alteration in metabolic handling of minocycline or to the ethinyloestradiol component of Dianette, which they were also receiving as treatment for their acne vulgaris. It is concluded that patients on minocycline should be regularly screened for signs of hyperpigmentation, especially if they are on other drugs which are known to accentuate pigmentation of skin.

Acne Vulgaris↗

Reduced frequency of nickel allergy upon oral nickel contact at an early age.

From animal studies we know that oral administration of T-dependent antigens before sensitization effectively induces systemic immune unresponsiveness. Such 'oral tolerance' is persistent, dose-dependent, antigen-specific and presumably T suppressor cell-mediated. Oral tolerance induction could be an effective way to prevent undesired T cell-mediated immune functions, such as playing a role in allograft reaction, autoimmune and allergic diseases. In the present study allergic contact hypersensitivity (ACH) to nickel, currently presenting the most frequent contact allergy in man, was chosen to establish the feasibility of oral prevention of undesired T cell-mediated immunity in man. Potentially tolerizing (oral nickel contacts via orthodontic braces) as well as sensitizing (ear piercing) events were studied retrospectively in 2176 patients attending nine European patch test clinics. Patients were interviewed by means of a confidential questionnaire. The results show that ear piercing strongly favoured development of nickel ACH. More importantly, patients having had oral contacts with nickel-releasing appliances (dental braces) at an early age, but only if prior to ear piercing, showed a reduced frequency of nickel hypersensitivity. Frequencies of other hypersensitivities, in particular to fragrance, were not affected. These results support our view that induction of specific systemic immunologic tolerance by timely oral administration of antigens is feasible in man.

Adolescent↗