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Biomedical subjects

J L Hawk

Publications and source records attributed to J L Hawk.

At least 145 records · Page 8Linked to original sources

Low-dose oral chloroquine in the treatment of porphyria cutanea tarda.

Seven patients with porphyria cutanea tarda received a total of ten courses of low-dose oral chloroquine therapy (125 mg chloroquine phosphate twice weekly). Patients were treated for a mean 14.9 months during which time all went into clinical and biochemical remission. Relapse occurred in four patients on a total of six occasions after a mean 17 months. In four patients there was no relapse after a mean 47.3 months. There were no adverse side-effects from the treatment. Low-dose oral chloroquine therapy appears to be a safe, effective and convenient treatment for porphyria cutanea tarda, although relapses may occur requiring further therapy.

Administration, Oral↗

Sunbeds.

Explore the source record for details and available documents.

Beds↗

Histologic changes associated with ultraviolet A--induced erythema in normal human skin.

We have examined the effects of a standardized, moderately erythemogenic dose of long-wave ultraviolet (UVA) radiation on normal human skin, with the use of an appropriately filtered solar simulator and sequential biopsy specimens processed as 1-micron Epon-embedded sections. Histologic changes were present immediately after irradiation and evolved slowly during the 48-hour study. The epidermis manifested slight intracellular and intercellular edema and progressive loss of Langerhans cells to approximately one-fifth control values. A dermal infiltrate of neutrophilic polymorphonuclear leukocytes was present in all postirradiation specimens and peaked at 3 hours. A perivascular lymphocytic infiltrate, moderate endothelial cell enlargement, mast cell hypogranulation, occasional massive venular dilation, and sparse red blood cell extravasation were also noted. Overall, our findings expand and quantify earlier impressions that, compared to UVB, UVA has a relatively greater histologic effect on the dermis than on the epidermis, depletes epidermal Langerhans cells, and recruits neutrophils into irradiated human skin.

Adult↗

Increased concentrations of arachidonic acid, prostaglandins E2, D2, and 6-oxo-F1 alpha, and histamine in human skin following UVA irradiation.

The buttock skin of clinically normal human subjects was subjected to approximately 2.5 minimal erythema doses of ultraviolet A irradiation. Deep red erythema developed during irradiation, faded slightly within the next few hours, increased to maximum intensity between 9-15 h, and decreased gradually thereafter although still persisting strongly at 48 h. Suction blister exudates were obtained at 0, 5, 9, 15, 24, and 48 h after irradiation as well as suction blister exudates from a contralateral control site and assayed for arachidonic acid, prostaglandins D2 and E2, and the prostacyclin breakdown product 6-oxo-prostaglandin F1 alpha by gas chromatography-mass spectrometry, and for histamine by radioenzyme assay. Increased concentrations of arachidonic acid and prostaglandins D2, E2, and 6-oxo-prostaglandin F1 alpha were found maximally between 5-9 h after irradiation, preceding the phase of maximal erythema. Elevations of histamine concentration occurred 9-15 h after irradiation, preceding and coinciding with the phase of maximal erythema. At 24 h, still at the height of the erythemal response, all values had returned to near control levels. Hence increased concentrations of arachidonic acid and its products from the cyclooxygenase pathway, and of histamine, accompany the early stages up to 24 h. A causal role in production of the erythema seems likely for these substances although other mediators are almost certainly involved.

6-Ketoprostaglandin F1 alpha↗

Thalidomide in actinic prurigo.

Fourteen patients suffering from actinic prurigo were treated with thalidomide. Eleven patients showed lasting improvement on the drug and three of these remained symptom-free after discontinuing therapy. No major side-effects were observed. Thalidomide is an effective drug in the treatment of actinic prurigo but it must be used with adequate contraception in women of child-bearing age.

Adolescent↗

Controlled therapeutic trials in polymorphic light eruption.

A series of controlled trials of treatments for polymorphic light eruption (PLE) with oral beta-carotene, ketoprofen and chloroquine, and topical benzimidazole sunscreen cream is described. Clinical features were recorded using diary cards filled out by the patients, and exposure to UVR was measured individually in all patients with film badges. Symptoms were found to be dependent on exposure. None of the treatments proved very effective, but beta-carotene seemed to give significant slight protection against irritation and erythema, though this was not confirmed in a repeat study using a higher dose. Chloroquine seemed to protect slightly against irritation. As the degree of improvement with chloroquine and beta carotene is quite small, equivalent to a protection factor of 2, it is arguable whether these treatments as used here are worthwhile and in the case of chloroquine, with its risk of adverse side effects, whether it is justifiable. Other treatment and dose regimes are possible and further trials seem worthwhile. Our studies have helped to define the special difficulties in collecting objective data in PLE and should improve the methods for assessing treatment in the photodermatoses.

Adult↗

Elevated blood histamine levels and mast cell degranulation in solar urticaria.

1 Ultraviolet radiation (UVR)-induced wealing was studied in four patients with solar urticaria, whose measured action spectra were within the range 300 to 700 nm. 2 Elevated histamine levels were found in blood draining wealed skin in all four patients. 3 Histological and electron microscopial studies of the irradiated skin showed evidence of mast cell degranulation. 4 These findings demonstrate an association between histamine release from mast cells and wealing in solar urticaria, and should encourage evaluation of drugs which suppress histamine release in this disorder.

Adult↗

Assessing the treatment of solar urticaria. The dose-response as a quantifying approach.

The weal and flare produced by monochromatic irradiation in solar urticaria may be treated as a classical dose-response. This has been used to investigate therapy with H1 and H2 antihistamines. The conventional H1 drug proved superior. But from the practical viewpoint, solar urticaria is difficult to suppress even with a relatively efficient H1 Antihistamine, chlorpheniramine; the mean protective factor in 5 patients was only 2, insufficient for satisfactory clinical management.

Adult↗

Skin surface glycerol levels in acne vulgaris.

Free glycerol would be expected from biochemical considerations to be an end product of lipolysis of sebum triglycerides. Glycerol was measured in skin surface washings of acne vulgaris patients, in acne vulgaris patients treated for at least 3 mo with oral tetracycline and in control subjects. Surface glycerol in untreated acne subjects was significantly less than that expected theoretically, whereas the amounts of such glycerol in treated acne patients and in control subjects closely approached the theoretically expected values. It is suggested that glycerol may be an in vivo substrate for Propionibacterium acnes.

Acne Vulgaris↗