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Biomedical subjects

J M Hanifin

Publications and source records attributed to J M Hanifin.

159 records · Page 9Linked to original sources
PubMed1977

Staphylococcal infections in patients with atopic dermatitis.

Cutaneous staphylococcal infections appear to be relatively infrequent in atopic dermatitis even though patients have broken skin heavily colonized with staphylococcal organsism. We found superficial staphylococcal pustules on the skin of 22 patients with atopic dermatitis. Such lesions were more commonly found with severe exacerbations of atopic dermatitis. They appeared on unbroken skin independent of hair follicles and were associated with considerable pruritus. Such lesions were rapidly removed by excoriation and frequently were overlooked by patients and physicians. Most lesions appeared when polymorphonuclear leukocyte chemotaxis was depressed. Ineffective chemotaxis combined with high-colonization density and inadequate stratum corneum barrier during exacerbations of atopic dermatitis may lead to mild staphylococcal infections. These infections appear to have no systemic effects but possibly the considerable associated pruritus could worsen the atopic dermatitis. Occasional patients may require intermittent or continuous antibiotic therapy.

Adult↗
PubMed1976

Immunodeficiencies in severe atopic dermatitis. Depressed chemotaxis and lymphocyte transformation.

Various reports have indicated assorted immune defects in atopic dermatitis, but the prevalence and degree of the defects remain unclear. We assessed various immunological factors in 14 patients with atopic dermatitis to determine whether immunodeficiencies were present consistently and were reflected by the patients' clinical characteristics. A high incidence of cutaneous infection was noted. Cutaneous delayed-hypersensitivity testing showed anergy in eight (67%) patients. Only the seven patients with the most severe condition showed altered leukocyte function, as determined by polymorphonuclear and mononuclear leukocyte chemotaxis and by lymphocyte responsiveness to phytohemaglutinin. All three cell types where shown to be simultaneously dysfunctional during severe atopic flares. Chemotactic studies during clinical remissions disclosed notable improvement in cell migration. Serum IgE levels were elevated in each patient, but did not correlate with the degree of cutaneous anergy or altered leukocyte function.

Adult↗
PubMed1975

Allergic contact dermatitis caused by idoxuridine. Patterns of cross reactivity with other pyrimidine analogues.

Idoxuridine has been used for many years in the treatment of herpex simplex infections of the eye. Use of the drug for herpes simplex infection of the skin is increasing. Ophthalmologists have noted occasional conjunctival and corneal irritant reactions, but no true delayed cutaneous hypersensitivity has been verified. We report four cases of allergic contact dermatitis from idoxuridine, sensitized by both eye and skin applications. Cross reactivity to brominated and chlorinated, but not fluorinated, pyrimidine analogues is noted. Extensive patch testing indicates the general relationship between the structure of pyrimidine compounds and their antigenic cross reactivity.

Adult↗
PubMed1970

Human monocytes and macrophages. Interaction with antigen and lymphocytes.

PPD-sensitized monocytes and macrophages from tuberculin-positive subjects are both capable of inducing blastogenic transformation of autologous lymphocytes. Incorporation of thymidine-(3)H and morphological transformation were always greater in lymphocyte cultures containing macrophages than in those containing monocytes. More lymphocytes entered the first detectable S phase in cultures containing macrophages. Lymphocyte DNA synthesis occurred as early as 40 hr of culture and always in cells in contact with mononuclear phagocytes. By 120-144 hr, many transformed lymphocytes were free in suspension; at the same time, the "immunological cluster" had increased greatly in size and contained transformed and untransformed lymphocytes. The greater effectiveness of macrophages at induction of lymphocyte transformation may be related to the efficiency of this cell type at trapping antigen and its effectiveness at making contact with and binding lymphocytes.

Culture Techniques↗
PubMedDate not supplied

Atopic dermatitis.

AD is a complex, multifactorial, cutaneous manifestation of the atopic diathesis. Observations from bone marrow transplantation cases have shown transmission of the disease from atopic donors [30] and indicate that the basic defect is carried in immune and inflammatory cells which infiltrate skin lesions. Mast cells appear to be important in the initiation of inflammatory events and eosinophils may have an important role in perpetuating the response. New evidence suggests that IL-4 may be a crucial factor controlling mast cells as well as IgE production in allergic disease. The significance of the Fc&RII/CD23 in regulating IgE synthesis and its role in Langerhans' cell/antigen interactions in atopic dermatitis represents an intriguing area in need of further study.

Antigens, Differentiation, B-Lymphocyte↗
PubMedDate not supplied

Oral therapy with ketoconazole for dermatophyte infections unresponsive to griseofulvin.

Oral ketoconazole therapy was evaluated with 21 patients who had recalcitrant dermatophytosis. During an 18-week period, all patients, including three with organisms resistant to griseofulvin in vitro, showed impressive clinical improvement. The four patients without nail involvement became mycologically negative earlier than those with onychomycosis. The latter group showed progressive clearing of the nails, but only three were mycologically clear after 18 weeks. Adverse reactions to ketoconazole were negligible, and no patients required discontinuance of the drug. Ketoconazole appears to be a safe, effective drug for oral therapy of dermatophytoses in humans.

Adult↗
PubMedDate not supplied

Herpes simplex virus shedding in genital secretions.

Nine women and eight men with a history of genital herpes had cultures taken for 60 consecutive days to assess the frequency and duration of viral shedding in the absence of symptoms. Daily self-obtained specimens (cervical-vaginal swabs from women and urethral swabs from men) were submitted for viral isolation. Five of 972 samples were found to contain infectious virus; two of the positive specimens correlated with overt disease. The other three positive cultures, two from the same individual, were not clearly associated with a genital infection. Thus, the overall frequency of asymptomatic viral shedding was 0.31% and occurred in two of 17 individuals. It is concluded that prolonged continuous sampling may be necessary to assess the risk of asymptomatic shedding. Infectious virus was not present in the genital secretions of most individuals (15 of 17) in the absence of a lesion, even when cultured on a daily basis for 60 days.

Adult↗
PubMedDate not supplied

Recognizing and managing clinical problems in atopic dermatitis.

Atopic dermatitis is a pruritic, inflammatory cutaneous disorder found most frequently among patients with a personal or family history of atopic disease. A primary defect is found in bone marrow cells. The most consistent abnormality relates to the overproduction of IgE. Pharmacophysiologic abnormalities include abnormal vascular responses, abnormal sweating responses, and a reduced threshold for itch. In addition, seven of 12 patients with pure atopic dermatitis with no respiratory disease have an abnormal methacholine inhalation test. There is an abnormal response of leukocyte cyclic AMP to a variety of adenylate cyclase stimulants. Characteristic histological findings are interepidermal edema, called spongiosis, which is consistent with a composite of late-phase and delayed hypersensitivity. The brittle stratum corneum can be treated with hydration, a commonly neglected aspect of management. An overlooked complication is herpes simplex infection of the eye. Overall management includes stress control, treating allergenic trigger factors, topical steroids, systemic antibiotics, antihistamines, ultraviolet light, and hospitalization in severe cases.

Adrenal Cortex Hormones↗