Systemic amyloidosis with an underlying lymphoproliferative disorder. Report of a case in which nail involvement was a presenting feature.
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Biomedical subjects
Publications and source records attributed to J D Wilkinson.
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A 3-year study of patch test reactions to the Standard European Battery has been carried out in two adjacent areas of S. E. England with the same climatic and cultural background. The source of materials and method of testing were identical; both observers had worked together in the same Contact Dermatitis department and the interpretation of reactions can therefore be considered to be consistent. The main differences between the two areas lay in the pattern of employment and of local medicament prescribing. The first only is examined here. One area was dominated by the automobile industry, the other by the furniture industry, with important subsidiary rubber, foam and electronics factories. The pattern that emerges shows that patch test reactions to the Standard European Battery were more likely to be related to environmental allergens and medicament usage than to industrial hazards. Chrome dermatitis was less common than elsewhere in Europe but nickel sensitivity showed the same pattern. Rubber chemical sensitivity reflected industrial, as well as domestic usage. Colophony and formaldehyde appeared to have less industrial significance than we expected. Special additional industrial allergens are not considered here but were of particular importance in the furniture industry. Although the numbers analysed were relatively small, we believe that they reflect the pattern to be expected in areas of relatively low industrial risk in Great Britain at the present time.
Topical methoxsalen photochemotherapy has been assessed in 22 patients suffering from recalcitrant palmoplantar pustulosis or psoriasis predominantly involving the hands and feet. Although 20 out of 22 patients improved and good results were obtained in exactly half of those treated, only 4 patients were classified as being "clear" or "minimally involved" at the end of 12 weeks. Two patients have shown no improvement at all. Minor local side effects were relatively common and included symptomatic erythema, blistering and local pigmentation. The histological findings in post PUVA treated skin are discussed and the pros and cons of topical photochemotherapy in this group of diseases is reviewed.
Three members of a farming family and their local postman contracted orf. One of those affected had had no direct contact with infected sheep. Two of the family developed a widespread papulo-vesicular eruption of the skin and mucosae with pyrexia, malaise and lymphadenopathy lasting 4-5 weeks. The eruption did not resemble erythema multiforme or the toxic erythemas usually associated with this infection.
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There is increasing evidence that oxidative stress plays a role in the pathogenesis of acute irritant contact dermatitis. As part of on-going studies into the effect of irritant chemicals on the anti-oxidant enzyme systems in the skin, we have examined the changing levels of two classes of glutathione S-transferase in patch test reactions to dithranol and sodium lauryl sulphate, using quantitative immunocytochemistry. Although no changes were evident after 6 hrs, significant reductions in the density of staining for glutathione S-transferase alpha were seen with both irritants after 48 hrs and 96 hrs. Glutathione S-transferase pi levels were reduced to a lesser degree, reaching significance for dithranol at the 96 hrs time point only, and for sodium lauryl sulphate at 48 hrs only. The results support the hypothesis that oxidative stress plays a role in chemically-induced inflammation, not only in the case of irritants such as dithranol which are known to directly generate reactive oxygen species, but also with chemicals not generally associated with free radical generation.
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Oxidative stress is known to be implicated in the inflammation induced by the anti-psoriatic irritant, dithranol. In this study, we wished to investigate whether this is reflected in the levels of the antioxidant enzyme, Cu,Zn-superoxide dismutase, as detected by quantitative immunocytochemistry, and whether similar changes also occur following exposure to an irritant not normally associated with reactive oxygen species generation, namely sodium lauryl sulphate. Analysis of biopsies from patch test sites revealed that significant reductions in the epidermal levels of Cu,Zn-superoxide dismutase were induced by both dithranol and sodium lauryl sulphate, although the time course of diminished activity was different for each irritant. Our findings suggest that oxidative stress plays a general role in the pathophysiology of acute irritant contact dermatitis.