Biomedical subjects
Publications and source records attributed to H Zachariae.
Dermabrasion was carried out in 5 patients with severe Darier's disease. All patients improved significantly within the treated areas. In general, over 75% of the dermabraded skin remained free of disease for more than 2-1/2 years after surgery. It is suggested that skinplaning should include the entire papillary dermis in order to obtain the beneficial effect.
Seventy-five liver biopsies were performed in 30 psoriatics and 5 patients with mycosis fungoides undergoing treatment with photochemotherapy with 8-methoxypsoralen and UVA light. All patients had pre- and post-PUVA biopsies, the latter after one year. Five psoriatics had a further biopsy after 2 1/2 years of treatment. No statistically significant differences were found between biopsies taken before and after treatment.
The case is described of a 44-year-old man with acquired cutis laxa. The primary clinical manifestation was an erythema of the chest. Gradually there developed persistent circumscribed lesions in other areas of the skin, spreading into large erythematous plaques with loose skin. Slight restrictive ventilatory insufficiency, elongation of the vocal cord and diverticulosis of the colon were also found, indicating a chronic and widespread disorder. Skin biopsies showed diminution and degeneration of the elastic fibres. The light-microscopic features were subdivided in relation to the various skin manifestations. Ultrastructure of the skin showed various amounts of electron-dense, amorphous material and loosely bound microfibrils in and around elastic and collagen fibres as well as some microfibrils with knobs in the interfibrouer, were found normal. It is suggested that the first changes in the elastic fibres induced an inflammatory response and mild mucinous changes of the collagen fibres. Furthermore elastic fibres seemed to be replaced by newly formed collagen.
A report is given of the successful treatment with transfer factor as an additional therapeutic agent of a patient in the tumour stage of mycosis fungoides who had not responded to conventional treatment with nitrogen mustard, methotrexate, or grenz rays alone. Besides twelve injections of transfer factor, the patient received X-irradiation, 1 400 r (50 kV 1 mm Al) in all, to three tumours. The combined treatment induced sustained remissions. When that patient died from a coronary infarct 5 years after treatment began, autopsy showed no evidence of mycosis fungoides at all.
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Transfer factor therapy was applied in three patients with severe atopic dermatitis and given at regular intervals for 1 1/2 years. Clinically, slight improvements were seen, attacks of impetigo ceased and admissions to hospital were not necessary. However, IgE concentrations in serum remained constantly high in all cases and the absolute number of T and B lymphocytes was continuously subnormal despite treatment. The in vitro cellular reactivity to PPD as assayed by a leucocyte migration test was not significantly altered in the patients, although a slight increase was found early on in the therapy. Finally, a serum factor inhibiting leucocyte migration and appearing simultaneously with attacks of impetigo disappeared during treatment. In conclusion, no convincing effect of transfer factor therapy was encountered in immune parameters and no major alterations were found in the status of the patients' atopic dermatitis.
The patterns of drug resistance and the frequency of conjugative R plasmids in intestinal Escherichia coli from 88 patients treated for a skin disease (acne vulgaris) with low oral doses of tetracycline are reported. The proportion of patients with resistant bacteria was progressively greater in patients who received tetracycline for 1 week, 4 weeks, or longer (from 50 to 88%). No multiply drug-resistant bacteria were detected before treatment or after 1 week of treatment. After more than 4 weeks of treatment, multiply drug-resistant E. coli were isolated from about 50% of the patients. The origin and selection of R plasmid-determined multiple drug resistance are discussed.
HL-A typing was performed on 97 patients with pustular psoriasis. HLA-B27 was found increased for the combined three subgroups: localized psoriasis of palms and soles, acrodermatitis continua and generalized pustular psoriasis, who were associated with a high incidence of arthritis. These subgroups have this in common with Reiter's disease indicating a link between the entities. In persistent palmo-plantar pustulosis an increased incidence of HLA-Bw35 was found. HLA-B13, HLA-B17 and HLA-Bw37 which are found markedly increased in psoriasis vulgaris were in acrodermatitis continua, generalized pustular psoriasis and persistent palmo-plantar pustulosis either absent or not increased as compared with the control population. 7 of 30 patients with localized psoriasis of palms and soles had one of these antigens. Our findings confirm that psoriasis vulgaris and pustular psoriasis as such, seem to be different aetiological entities. Some patients with localized psoriasis of palms and soles may be true psoriatics which besides their psoriasis have a tendency to develop a pustular reaction in their palms and soles similar to persistent palmo-plantar pustulosis.
Eight accidental kidney biopsies in psoriatics were obtained together with 429 liver biopsies. None of the biopsies showed signs of renal damage. All patients had severe psoriasis, six had been treated with methotrexate for 1-2-6 years, receiving total dosages from 660 to 1757 g.
A total of 301 persons in a population unexposed to enzyme detergents (Rumania) were prick-tested with Alcalase, and RASTs were performed on their sera. The material consisted of three groups, one atopic, the second non atopic, and the third healthy. In the first two groups the percentage of positive prick-test reactions amounted to 6 and 5% respectively. Only one positive RAST was found (second group). In the third group no positive prick-tests were found and no positive RASTs. The majority of the positive prick-tests were considered non specific, and no correlation was found between results of prick-tests and RASTs in this material of non exposed individuals.
Thirty psoriatics were treated for 2 weeks on a double-blind controlled basis with desoximetasone (0.25%) and with hydrocortisone butyrate (0.1%). It was a randomised left-right comparative trial. Thirteen out of 27 patients preferred desoximetasone, 3 patients preferred hydrocortisone butyrate. There was also a significantly better effect of desoximetasone as judged by the observer after the second week of treatment.
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