Biomedical subjects
J Fransson
Publications and source records attributed to J Fransson.
Palmoplantar lesions in psoriatic patients and their relation to inverse psoriasis, tinea infection and contact allergy.
One hundred and seven psoriatics with palmoplantar involvement were clinically examined. They were selected from 921 patients filed in 1976 with the diagnosis psoriasis. Fifty per cent of the patients with palmoplantar psoriasis had flexural changes. The frequency of palmar involvement in patients with inverse psoriasis compared to patients with psoriasis vulgaris was increased 5.3 times. Pustulosis palmoplantaris (PPP) in addition to psoriasis was diagnosed in 18 patients (17%). A dermatophyte infection was observed in 1 of 48 patients examined for tinea infection. Positive patch tests were obtained in 8 of 47 patients, 7 of whom had more than one test reaction. The result gives no evidence of tinea infection and contact allergy as important factors in maintaining palmoplantar psoriasis.
Correlation between quantitative in vivo and in vitro responses in nickel-allergic patients.
Forty-three nickel-allergic patients (40 females and 3 males) participated in this study which was designed to elucidate the correlation between quantitative in vivo and in vitro responses. All were patch-tested with various concentrations of nickel-sulphate serial-diluted in water. The lowest concentration eliciting a cutaneous reaction (indicating the severity of the allergy) was recorded for each individual and compared with the in vitro lymphocyte response, using the lymphocyte transformation test. The best correlation coefficients obtained were 0.42 and 0.46, tested for linear and logarithmic correlation respectively. However, there were individuals who showed a weak cutaneous response and high lymphocyte reactivity. The converse situation was also found, however, indicating that other mechanisms than those mediated via lymphocytes may be of significance in the patch test response.
EMLA cream provides rapid pain relief for the curettage of molluscum contagiosum in children with atopic dermatitis without causing serious application-site reactions.
Twenty-nine children with atopic dermatitis, 4 to 9 years of age, were included in an open study of the analgesic efficacy and the application-site reactions produced by EMLA cream 5% at a maximum dose of 10 g applied for 30 minutes under occlusion prior to the curettage of molluscum contagiosum. Molluscum areas with and without eczema were treated. The overall magnitude of pain was assessed first by the child and then by the physician on a four-step verbal rating scale immediately after completion of the curettage. Prior to the surgical treatment, the application site was examined for local skin reactions. Eighty-three percent of the children rated the pain from the surgical procedure as none or mild, while the physicians rated the pain as none or mild in 86% of the children. The application-site reactions were pallor, redness, and edema. These reactions were transient and required no clinical attention. Their incidence or severity did not differ significantly between areas with and without eczema. In conclusion, EMLA cream 5% applied for 30 minutes under an occlusive dressing provides effective local analgesia without serious application-site reactions for the curettage of molluscum contagiosum in children with atopic dermatitis.
Tumour necrosis factor-alpha does not influence proliferation and differentiation of healthy and psoriatic keratinocytes in a skin-equivalent model.
Tumour necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of psoriasis. Its effect on keratinocytes from healthy and psoriatic skin was investigated. The keratinocytes were co-cultured with healthy and psoriatic fibroblasts in skin equivalents and grown in a serum-free medium for 15 days. TNF-alpha was added, or not, on day 12. The expression of differentiation and proliferation markers was investigated with immunohistochemistry. The epidermal growth rate was assessed by the percentage of Ki-67-positive nuclei in the basal layers of the outgrowths, which were all multilayered and orthokeratotic. The expression of the epidermal growth factor receptor, cytokeratin 16, involucrin and filaggrin displayed a hyperproliferative, regenerative pattern. No statistically significant differences in growth rate were found between the groups. These findings indicate a lack of effect of TNF-alpha on proliferation and differentiation in healthy and psoriatic keratinocytes. Further studies are warranted to elucidate the pathophysiological role of TNF-alpha in psoriasis.
Blood dehydroepiandrosterone sulphate (DHEAS) levels in pemphigoid/pemphigus and psoriasis.
Serum dehydroepiandrosterone sulphate (DHEAS) levels and diagnostic autoantibody titers were measured in patients with pemphigoid/pemphigus [n = 46/4; 21 men and 29 women, 42 to 93 years of age (mean 79)]. Twenty-four patients were either on peroral Prednisolone (n = 11), or topical treatment with betamethasone (n = 13), and the other 26 were either receiving non-steroidal drugs or were untreated. Their DHEAS levels were compared to those of 20 patients with psoriasis, and to 23 patients with secondary osteoarthritis (OA). Assessing the patients by group, the mean DHEAS level was markedly lower in the pemphigoid/pemphigus than in the psoriasis and OA patients (geometric mean 600 vs. 2130 and 2100 nmol/l, respectively; p < 0.001). This difference was independent of steroid treatment. No correlation was found between the DHEAS levels and antibody titers. The low levels found in pemphigoid/pemphigus are concordant with those reported for systemic lupus erythematosus, rheumatoid arthritis and polymyalgia rheumatica/giant cell arteritis. DHEAS deficiency is a permanent feature in these autoimmune diseases, and may contribute to their etiology and/or pathophysiology.