Biomedical subjects
Publications and source records attributed to F Wojnarowska.
Two patients aged 8 and 34 years, with linear IgA dermatosis and systemic symptoms are described. Both presented with fever and sore throat 5 to 10 days before the onset of their rash and both developed severe arthralgia accompanying the skin eruption. The joint pains resolved when the skin eruption was treated.
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Chronic bullous dermatosis of childhood (CBDC) is an autoimmune, subepidermal bullous disease that, in the majority of patients, remits before the onset of puberty. The disease does not always pursue a benign course, however. We cared for a patient in whom the condition persisted well beyond puberty without clinical or immunologic remission.
The subclasses of the cutaneous IgA were studied in 8 patients with dermatitis herpetiformis and 4 with linear IgA disease. The cutaneous IgA in dermatitis herpetiformis consisted of both IgA1 and IgA2, although IgA1 predominated. This demonstrated that the IgA is polyclonal and may be both mucosal and blood derived. The IgA in linear IgA disease was exclusively IgA1, confirming previous work, and suggesting that mucosal IgA may not make a major contribution to the skin deposits.
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A case of pemphigoid is described which is complicated by ulcerative colitis and a cicatrizing nail dystrophy. A longitudinal nail biopsy revealed linear deposits of C3 and IgM at the basement membrane zone. The relevance of these findings is discussed.
In order to identify specific oestrogen-sensitive structures, normal human skin was examined for the binding of the ER D5 antibody which is associated with p29, a 29 kilodalton protein found in the cytoplasm of normal oestrogen-sensitive cells. Strong and specific staining was seen in the epidermis, with a gradient showing the most intense staining in the granular layer. Similar positive staining was seen in the hair follicles and sebaceous glands. Variable staining was seen in the eccrine glands and vessels. These findings demonstrate p29 to be present in these structures, and hence that oestrogens may exert a specific effect on these tissues.
The ultrastructural localization of the IgA deposits in the skin of 15 patients with linear IgA bullous dermatosis of adults (LAD), 13 with chronic bullous dermatosis of childhood (CBDC) and three with childhood cicatricial pemphigoid (CCP) were studied. The site of the antigen was determined using sera from two LAD, 13 CBDC and two CCP patients. In all 31 patients the IgA was located predominantly below the lamina lucida (sublamina densa). Similarly, the indirect immunoelectron microscopic studies demonstrated the antigen to be present at the same site, below the lamina densa. This suggests that in linear IgA bullous dermatosis the antibody reacts with the antigen in the sublamina densa region of the basement membrane zone.
Biopsies from suction blisters raised in three normal volunteers were used as substrate in the indirect immunofluorescence technique to determine the binding site of circulating IgA antibodies in serum from three patients with adult linear IgA disease (LAD), nine with chronic bullous disease of childhood (CBDC), three with childhood cicatricial pemphigoid (CCP), and four with bullous pemphigoid (BP). Direct immunofluorescence was done using suction blisters raised in two patients with LAD and one with CCP. The circulating IgA antibodies in LAD and CBDC bound mainly to the roof of the blister but also to the base, and in CCP they bound only to the base of the blister. The circulating IgG antibodies in BP bound to the roof and base of the blister. These results demonstrate that the antigens in the various linear IgA dermatoses are heterogenous and are localized at different sites. The LAD and CBDC antigens are present in the lamina lucida, and the antigen in CCP is associated with the basal lamina.
The use of cultured human epithelial cells as a substrate for the detection of antinuclear antibodies (ANAs) improves the sensitivity of detection above the standard substrates used. Standard antisera have been screened against a series of epithelial cell lines, including keratinocytes. Selected cells have then been used to detect ANAs in 78 patients with discoid lupus erythematosus.
Twelve benign acquired nevi were studied for the possible specific binding of the ER D5 monoclonal antibody. The ER D5 monoclonal antibody identifies the p29 protein, which is found in the cytoplasm of oestrogen-sensitive cells and which is present in a higher concentration than nuclear oestrogen receptors. No staining was seen in nevoid cells, and the results are taken to support the hypothesis that acquired nevi are not oestrogen-dependent tumours.
Musk ambrette, a contact and photocontact allergen, is a synthetic fragrance present in aftershave lotions and many toiletries. Thirty-four patients with contact and photocontact allergy to musk ambrette were studied. All had a facial eczema. Four distinctive clinical pictures were seen. These were plaques of eczema, jawline (mandibular) dermatitis, acute contact dermatitis and chronic actinic dermatitis. Twenty-six patients were light sensitive by history and 10 were diagnosed by clinical criteria as having chronic actinic dermatitis. Patch and photopatch testing to musk ambrette showed that seven patients had pure photocontact dermatitis to musk ambrette. Eight patients had contact dermatitis to musk ambrette but this was exacerbated by irradiation. Cross reaction with moskene occurred. Scrupulous avoidance of musk ambrette has resulted in clinical resolution in most patients.
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Reactive perforating collagenosis is an uncommon disorder and few accounts refer to ultrastructural features. This report includes a study by light and transmission electron microscopy of serially sectioned biopsies from early lesions in two patients. Immunohistological investigations utilizing antibodies to basement membrane, laminin, collagen and cytokeratin were also done. Collagen and elastin were demonstrated within the centre of the lesions and there was a defect in the basal lamina at the base of the lesion. The collagen, cytokeratin and the basal lamina in the lesions were antigenically similar to those in the surrounding normal skin. These results are compared with previous findings and discussed in the light of the current views on the pathogenesis of this disorder.