Prevalence of dermato-venereological diseases in a Norwegian Lapp population. Introduction.
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Adult↗
Biomedical subjects
E S Falk
Publications and source records attributed to E S Falk.
Prevalence of psoriasis in a Norwegian Lapp population.
The occurrence of psoriasis in a Norwegian Lapp population was estimated by reviewing medical records in the local health centre of Kautokeino. Altogether 40 cases of psoriasis were registered in the study population comprising 99.6% of the total population of 2,963 individuals. Thirty-five cases of psoriasis belonged to the Lappish population of 2,508 people, giving a prevalence of 1.4%, with no difference between males and females. Five cases of psoriasis were found in the non-Lappish population of 442 individuals which gives a prevalence of 1.1% with no sex differences. A peak prevalence among Lapps was observed in the age groups 20-39 years (2.7%), equal for both sexes and in females aged 50-59 years (3.2%), whereas a lower prevalence of 0.6% was found in the age group 40-49 years. A seronegative psoriatic arthritis was recorded in 6 of the 35 Lappish compared to none of the non-Lappish cases. A familial association was confirmed in 11 of the 35 Lappish cases, in none of the non-Lappish.
Adolescent↗
Systemic mastocytosis treated with histamine H1 and H2 receptor antagonists.
A case of systemic mastocytosis with skin characteristics of telangiectasia macularis eruptiva perstans is reported. Systemic involvement was confirmed as a combination of highly increased urinary excretion of methyl imidazole acetic acid (Melm AA) and increased amounts of mast cells in skin, liver and colon transversum. Treatment with cimetidine (H2 receptor antagonist) resulted in diarrhea, however, the addition of cyproheptadine (H1 receptor antagonist) was beneficial in amelioration of the cutaneous symptoms of mastocytosis. The excretion of Melm AA was unchanged during treatment. After 7 months of continuous cimetidine and cyproheptadine treatment no side effects were observed.
Biopsy↗
ELISA test for antimeningococcal IgG and IgM antibodies: application to epidemiology and diagnosis.
We have developed an enzyme-linked immunosorbent assay (ELISA) in order to quantitate antimeningococcal IgM and IgG serum antibodies. The B:15 meningococcal strain was used as coating antigen, and class specific antibodies were detected by using alkaline phosphatase labelled rabbit anti-human IgM or IgG as conjugate. The specific IgG activity was higher in sera from healthy meningococcal carriers than non-carriers, but the difference was not statistically significant. Antimeningococcal IgM serum antibodies were more frequent in carriers that in non-carriers. Acute sera from 34 patients with fulminant meningococcal disease contained less specific IgG and had a higher prevalence of IgM than healthy carriers and non-carriers. By combining measurement of antimeningococcal IgG and IgM antibodies in both acute and convalescent sera 15/18 meningococcal patients demonstrated an increase in either IgG and IgM antibodies during the hospital stay, giving a sensitivity of 83%. 8/118 individuals without meningococcal disease had detectable specific IgM antibodies in their serum, giving a clinical specificity of the test of 93%. We conclude that quantitation of specific IgG antimeningococcal antibodies by a whole bacteria ELISA test may be a useful test for the study of immunity against meningococcal disease in single individuals as well as in epidemiological studies. The combined use of the IgG and IgM tests is helpful in the diagnosis of meningococcal disease when blood or cerebrospinal fluid cultures are negative.
Antibodies, Bacterial↗
Lysozyme and IgA concentrations in serum and saliva from psoriatic patients.
Significantly lower lysozyme concentrations were found in saliva of 15 psoriatic patients compared with controls, whereas in serum, lysozyme activity, was significantly higher than in controls. The concentrations of IgA in serum of psoriatic patients were significantly higher than in controls, whereas in patients' saliva IgA concentrations were not significantly different from the controls. The findings indicate that lysozyme and IgA may be of significance in the pathophysiology of psoriasis.
Adult↗
[Mycosis fungoides. Clinical characteristics and treatment of 6 patients].
Mycosis fungoides is a low grade malignant cutaneous T-cell lymphoma. It is a rare disorder where diagnosis may be difficult to establish in early stages. Usually several years may pass between onset of disease and confirmation of the diagnosis, which should be confirmed histopathologically. Prognosis is difficult to predict and depends on whether mycosis fungoides is limited to the skin or has spread to lymph nodes or viscera. Based on the confirmation of six new cases of mycosis fungoides during the last 18 months by the Department of Dermatology, University Hospital of Tromsø, we discuss clinicopathological findings and alternative methods of treatment.
Aged↗
[Distance diagnosis of skin diseases].
During a period of eight weeks in late 1989, doctors in general practice in Kirkenes brought 27 dermatological patients to a studio at the local hospital. Video images were transmitted via a two-way telephone and video network, which enabled the patient and the doctor in Kirkenes to consult a specialist in dermatology in Tromsø. All the patients received written information before the consultation. Anamnestic information and clinical manifestations were presented from the studio at Kirkenes sykehus. The dermatologist diagnosed the disease and prescribed treatment from the studio at the hospital in Tromsø. The technical equipment satisfied our demands for remote diagnostics in dermatology. All the patients were positive to remote consultations.
Computer Communication Networks↗
Juvenile tinea capitis caused by Trichophyton violaceum. Hepatic reactions during ketoconazole treatment.
A 10-year-old boy with T. violaceum tinea capitis was given systemic ketoconazole therapy. After 4 weeks' treatment, liver enzymes had increased considerably. Ketoconazole treatment was stopped and 3 weeks later the values had returned to normal. Three weeks thereafter the patient was completely cured and no relapses have occurred.
Chemical and Drug Induced Liver Injury↗
[Malignant melanoma--a warning. How to reduce mortality?].
Incidence of malignant melanoma of the skin has risen rapidly during the last decades. Mortality rates are also rising, although not so much as incidence rates. There is strong evidence that exposure to sunlight is a major factor in the etiology of melanomas. There appears to be no direct cumulative dose-response relationship, except in the case of lentigo maligna melanoma. Episodes of sunburn among children and young individuals seem to be more important as an etiologic factor for melanoma than chronic exposure to the sun. Very high risk of melanoma exists in persons with dysplastic nevus syndrome. Persons with giant congenital nevi are also at increased risk. However, many melanomas arise de novo. It is our intention to reduce mortality by screening families at risk, by early detection and treatment of melanomas, and by education.
Dysplastic Nevus Syndrome↗
Lysozyme and IgA values in patients with atopic dermatitis.
Ten patients with atopic dermatitis had significantly depressed lysozyme levels in saliva, compared with controls, whereas no differences were found in lysozyme activity in serum of patients and controls. The concentrations of IgA in saliva of patients with atopic dermatitis were also significantly lower than in controls, whereas IgA in patients' serum was within normal levels.
Adolescent↗
A double-blind comparison of acitretin and etretinate in the treatment of severe psoriasis. Results of a Nordic multicentre study.
Acitretin, the free acid of etretinate, is less lipophilic and has a much shorter terminal half-life than the parent compound. The present double-blind, randomized study compared the therapeutic effectiveness and the tolerability of acitretin (n = 127) and etretinate (n = 41) in psoriasis. Patients were treated with 40 mg daily for the first 4 weeks and with an individually adjusted dose for the subsequent 8 weeks. The average daily doses of acitretin (0.54 mg/kg/day) and etretinate (0.65 mg/kg/day) were similar. The PASI (Psoriasis Area and Severity Index) scores improved in parallel in the 2 treatment groups. At the completion of the study, the PASI score improvement was 75.8% for acitretin and 70.8% for etretinate. Both acitretin and etretinate resulted in mucocutaneous side effects. Assessments of tolerability by investigators and patients showed a statistically significant difference in favour of etretinate. These results demonstrate that acitretin and etretinate have similar therapeutic effectiveness in psoriasis. Although the tolerance to acitretin was lower than to etretinate, acitretin offers the important advantage of a much shorter period of potential teratogenicity and is, therefore, to be preferred in women of childbearing potential.
Acitretin↗
Ultraviolet radiation at high latitudes and the risk of skin cancer.
Solar irradiance in the spectral region 280 to 800 nm was measured with a double monochromator at 2 locations in Norway, Tromsø (69.7 degrees N) and Longyearbyen (78.2 degrees N). During the observational (midnight sun) period in Longyearbyen, the maximum UVB irradiance recorded was less than 0.3 W/m2, and no radiation was detected for wavelengths below 300 nm. Such low levels are believed to be a consequence of the low solar elevation angle and the high ozone content of the Arctic ozone layer, which absorbs the incident UV light. With levels between 280 and 350 DU over the period of study, Tromsø and Longyearbyen recorded only one-ninth of the calculated UVB radiation at the equator. There is therefore a considerably higher risk of radiation damage to the skin in equatorial regions (controlling for skin type), a finding that agrees with the statistical evidence for a 7-8 times higher rate of skin cancer in the white population of equatorial countries.
Absorption↗
Genotypes and phenotypes of beta lactamase producing strains of Neisseria gonorrhoeae from African countries.
The phenotypes and genotypes of 26 beta lactamase (penicillinase) producing strains of Neisseria gonorrhoeae (PPNG) from African countries were investigated. Using the restriction enzyme technique nine different restriction enzyme patterns were found, two of them in 15 strains. Of the 26 strains, 16 belonged to serogroup WI (containing protein type IA) and 10 to serogroup WII/III (containing protein IB). Among the IA strains four different serovars were represented, whereas six serovars were found among the IB strains. Five different auxotypes were identified, of which proline requiring (found in 12 strains) and prototrophic (found in 10 strains) dominated. Twelve strains harboured a 4.4 megadalton as well as a 24.5 megadalton plasmid. A 3.2 megadalton plasmid was found in 14 strains, one of which also harboured a 24.5 megadalton plasmid. The 2.8 megadalton cryptic plasmid was present in all 26 strains. The MICs of doxycycline ranged from 0.25 to 2.0 mg/l; the MIC 50% for WI strains was 0.25 mg/l and for WII/WIII strains 1.0 mg/l. A total of 10 different combinations of restriction enzyme pattern, serovar, auxotype, and plasmid were seen in the 16 WI strains compared with eight such combinations in the 10 WII/WIII strains. As expected, the restriction enzyme technique and serological classification gave better differentiation than plasmid profiles and susceptibility to doxycycline. More relevantly, however, these techniques also compared favourably with auxotyping. When the different systems were combined, the sensitivity was greatly increased.
Africa↗
Genotypic and phenotypic markers in the differentiation of Neisseria gonorrhoeae strains.
Restriction enzyme (RE) patterns, using Hind III enzyme, were analysed on 101 urogenital strains of Neisseria gonorrhoeae. The strains were also analysed serologically, using monoclonal antibodies, and tested for nutritional requirements by auxotyping. In addition, testing susceptibility to doxycycline was performed by an agar-dilution method. The strains were distributed into 23 RE patterns, of which the five most common accounted for 67.3% of all isolates. The same strains were distributed into 17 serovars, of which the four most common accounted for 77.3% of all isolates. Eleven auxotypes were demonstrated, of which the four most common accounted for 85.1% of all isolates. When the methods were combined, 38 combinations of RE patterns and serovars, 25 combinations of RE patterns and auxotypes, and 31 combinations of serovars and auxotypes were seen. Combining all three methods, 40 combinations of RE patterns, serovars and auxotypes were found. Correlations were particularly seen between RE patterns and auxotypes. The strains were moderately sensitive to doxycycline, those with serological markers for WII/WIII being less sensitive than those with markers for WI.
Antibodies, Bacterial↗
Comparison between serological classification and auxotyping in the analysis of Neisseria gonorrhoeae infections.
Auxotyping and serological classification, using monoclonal antibodies, were performed on 730 gonococcal strains. These strains were isolated from 725 consecutive patients seen at the Venereal Outpatients Clinic at the Department of Dermatology, Södersjukhuset, Stockholm, during one year, up to April 1983. Strains from patients with repeated gonococcal infections were, besides auxotyping and serological classification, analysed with restriction endonuclease cleavage. The strains were distributed into 16 auxotypes, of which the eight most common accounted for 97.4% of all isolates. The same strains were distributed into 38 serovars, of which the eight most common accounted for 88.4% of all isolates. When the two methods were combined, 98 combinations of auxotypes and serovars were seen. The eight most common combinations included 60.0% of all strains. Correlations were found between auxotypes and serogroups as well as serovars. The serological classification gave a better resolution compared with auxotyping; however, when the two systems were combined the sensitivity was highly increased.
Antibodies, Monoclonal↗
UVB treatment of factitious urticaria.
Forty-three patients with factitious urticaria were treated with sub-erythematous doses of UVB 5 times weekly for 2-3 weeks. After an average of 13 treatments, 25 were free from symptoms, 14 improved and 4 were unchanged. The dermographism test was negative or considerably reduced after treatment. Most of the patients had permanent effects from the treatment, but 13 relapsed. As the effect of other treatment modalities in this disorder is unsatisfactory, the encouraging results documented in this clinical trial suggest that UVB therapy should be considered for patients with factitious urticaria.
Adolescent↗
[Multiresistant Haemophilus influenzae. Beta-lactamase producing, chloramphenicol and tetracycline resistant Haemophilus influenzae as a cause of septicemia].
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Chloramphenicol↗
An outbreak of group B meningococcal disease: tracing the causative strain of Neisseria meningitidis by DNA fingerprinting.
Following an outbreak of meningococcal disease in three schoolchildren in a small community in northern Norway, DNA fingerprinting, serotyping with monoclonal antibodies, serogrouping, and sulfonamide sensitivity testing were applied for characterization and tracing of the causative agent. The three case isolates were genomically indistinguishable, sulfonamide-resistant, serogroup B, serotype 15 meningococci. Throat specimens were collected from 552 healthy contacts, including all children below age 17 and their parents. Among the 36 carrier isolates (carrier rate, 6.5%) 13 showed DNA fingerprints identical, or almost identical, to the index pattern. All of these 13 isolates were sulfonamide resistant, 12 were of serotype 15, and 8 were of polysaccharide serogroup B (5 were nongroupable). These closely related isolates were almost exclusively recovered from schoolchildren of 2 of 15 small villages, one of which included the homes of two of the patients. The remaining 23 carrier isolates were nonresistant, non-type 15 meningococci of widely differing DNA restriction patterns. Our results confirm that DNA fingerprinting has potential as an efficient tool in practical meningococcal epidemiology.
Adolescent↗