The treatment of chronic psoriasis a two-centre comparative study.
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Biomedical subjects
Publications and source records attributed to D M Williamson.
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A patient with herpes gestationis has persisted with clinically active disease for 8 years post-partum. She also had Graves' disease, alopecia totalis and ulcerative colitis. The case demonstrates the close overlap between herpes gestationis and bullous pemphigoid.
Nine patients with hereditary angio-oedema (H.A.E.) with a deficiency of C1 esterase inhibitor (C1 INH), have been treated with low dose attenuated androgenic drugs, with complete control of their disease. The C1 esterase inhibitor and C4 levels became normal in only one patient. It is concluded that H.A.E. can be controlled in the absence of correction of the reduced levels of C1 INH and C4. The mode of action of these drugs appears to be more complex than is generally realized.
A small uncontrolled pilot study was carried out in 6 patients with ischaemic leg ulceration in which pain was severe to assess the effectiveness of thymoxamine in the relief of pain and on the rate of healing. Patients were treated for 3 days with intravenous injections of 0.1 mg thymoxamine/kg body weight and then with oral 40 mg thymoxamine 4-times daily for a further month. The results showed that there appeared to be a definite improvement in pain during intravenous therapy and this was maintained to a large extent, although not so definite, on oral therapy. No enhanced rate of healing, however, was evident.
A previously undescribed short-lived non-puritic reticulate erythema has been noted in several members of unrelated families with hereditary angio-oedema. The eruption which may be widespread can last from 1 to 4 days and usually immediately precedes an overt attack of hereditary angio-oedema although this is not invariable, and swellings may occur in areas not previously involved by the erythema. Histology including immunohistology probably shows no specific changes.
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Pigmented neurofibroma is a rare tumour of the dermis. The clinical features and histology of a lesion occurring in a female of 69 years are described in this report. This entity was first described by Willis in 1959 in three patients with pigmented dermal tumours which showed a plexiform structure and the presence of pseudo-Meissnerian bodies.
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Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by the presence of multiple gas containing thin walled cysts in the intestinal wall and mesentery. It is sometimes associated with chronic obstructive pulmonary disease, but has been described most often in patients with gastrointestinal disorders including duodenal and gastric ulceration, small bowel obstruction, regional enteritis and gastrointestinal malignancy. Its association in the patient described below with severe systemic sclerosis is of particular interest. There have been occasional previous reports of this association which should be considered in any patient with systemic sclerosis who develops abdominal symptoms suggestive of acute or sub-acute intestinal obstruction, not readily explicable by other causes.
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Fifty-one patients with acne vulgaris were included in a double-blind trial to assess the therapeutic effect of 250 mg. tetracycline hydrochloride twice daily for three months. The results, assessed clinically and photographically, showed that tetracycline hydrochloride had a statistically significant beneficial effect. Hence, since it is cheap and rarely has side-effects in healthy young adults, its use is suggested, as well as local therapy, in the more severe forms of acne.
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