Ectopic cilia in a Caucasian girl with atopic eczema.
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Child↗
Biomedical subjects
J Ring
Publications and source records attributed to J Ring.
Congenital leukonychia totalis in two brothers.
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Adult↗
UVA1 irradiation is effective in treatment of chronic vesicular dyshidrotic hand eczema.
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Adult↗
Determination of histamine and leukotrienes from basophils in cell supernatants by high-performance liquid chromatography.
A reversed-phase high-performance liquid chromatographic method with gradient elution for the separation of the mediator substances histamine and the leukotrienes C4 (LTC4), D4 (LTD4), and E4 (LTE4) is described. The detection occurs fluorimetrically after automated precolumn derivatization with o-phthaldialdehyde. All components are chromatographically separable. Because of the different excitation and emission wavelengths, only the most important biological active mediators histamine and LTC4 are determinable in one parallel chromatographic run. The method is examined by linearity and precision tests and is applicable to biological sample matrices like cell supernatants of human basophils enriched by Percoll-density gradient centrifugation and stimulated for mediator release by anti-IgE. The established method is suitable to separate the mediators from other matrix components. The determination limit for histamine is 55.0 micrograms/L and that for LTC4 16.0 micrograms/L, referring to the reference solutions. Therefore, a fast, economical method for the common determination of the most important mediators histamine and LTC4 is established. This method is also suitable for high sample amounts in routine medical analysis.
Basophils↗
Isolation of cDNA clones coding for IgE autoantigens with serum IgE from atopic dermatitis patients.
Recently we demonstrated that a high percentage of atopic dermatitis (AD) patients displayed specific immunoglobulin E reactivity to human proteins. Here we show that IgE autoreactivity is found predominantly in AD patients with severe skin manifestations and reveal the molecular nature of four IgE autoantigens. An expression cDNA library constructed from a human epithelial cell line (A 431) was screened with serum IgE from two AD patients. DNA sequence analysis of three IgE-reactive clones identified the alpha-chain of the nascent polypeptide-associated complex, cytokeratin type II, and the BCL7B oncogen as atopy-related IgE autoantigens (ara). The fourth cDNA coded for an IgE autoantigen containing a typical calcium binding motif that occurred in histogenetically different cells and tissues (keratinocytes, muscle, brain). Recombinant Escherichia coli-expressed IgE autoantigens bound IgE from AD but not from patients with other immunologically mediated disorders (graft vs. host disease, systemic lupus erythematosus) and elicited immediate type skin reactions in AD patients. In serum samples collected from an AD patient over a period of 5 years, IgE anti-ara NAC antibody levels peaked during disease exacerbation. Our finding that ara BCL7B was detected in serum bound to IgE antibodies suggests that intracellular IgE autoantigens can become released after tissue damage and may occur as IgE immune complexes. Via binding to antigen presenting cells as well as to effector cells, IgE autoantigen immune complexes may contribute to exacerbation and/or perpetuation of severe atopic diseases even in the absence of exogenous allergens.
Amino Acid Sequence↗
Stromelysin-3: a potent marker for histopathologic differentiation between desmoplastic trichoepithelioma and morphealike basal cell carcinoma.
Histopathological differentiation between desmoplastic trichoepithelioma (DTE) and morphealike basal cell carcinoma (BCC) is a difficult problem because of their similar morphological features. The matrix metalloproteinase stromelysin-3 (ST-3), which is expressed as a specific fibroblastic factor especially surrounding carcinoma cells, was studied in these both conditions of wholly different clinical outcome. Using formalin-fixed paraffin-embedded tissues, we found positive immunoreactivity for ST-3 in fibroblastic cells surrounding morphealike BCC cells in 34 (68%) of 50 cases, whereas the epithelial tumor cells themselves were negative. In none of the 12 cases of DTE did we observe expression of ST-3 in fibroblasts. We conclude that the antibody against ST-3 protein is an immunohistochemical marker to distinguish morphealike BCC from DTE.
Biomarkers, Tumor↗
Safety and efficacy of intermittent therapy with itraconazole in finger- and toenail onychomycosis: a multicentre trial.
The efficacy and safety of intermittent itraconazole therapy were investigated in patients with onychomycosis. Patients were divided into two groups according to site and extent of infection. Group A comprised 635 patients with toenail onychomycosis (at least one nail with > or = 20% involvement; n = 560) or fingernail onychomycosis (at least one nail with > 75% involvement; n = 63) or both (n = 12). These patients received itraconazole 400 mg day-1 for 1 week per month for 3 months. Group B comprised 48 patients with fingernail onychomycosis (at least one nail with > or = 20% involvement but no nail with > 75% involvement) who received itraconazole 400 mg day-1 for 1 week per month for 2 months. Patients were followed for a further 18 weeks without treatment, and received another treatment cycle if not cured or markedly improved 6 weeks after the end of the last cycle. An additional cycle was administered to 76 patients with fingernail onychomycosis (group A, n = 43; group B, n = 28) and to 316 patients with toenail onychomycosis. Clinical response rates and mycological cure rates at study end point were 89.0% and 68.4% respectively for toenails, 91.4% and 85.3% respectively for group A fingernails and 84.4% and 77.1% respectively for group B fingernails. Most adverse events occurred infrequently; major changes in liver function tests were not noted. In conclusion, intermittent itraconazole therapy is highly effective and safe in patients with onychomycosis.
Adult↗
Photoallergic contact dermatitis due to combined UVB (4-methylbenzylidene camphor/octyl methoxycinnamate) and UVA (benzophenone-3/butyl methoxydibenzoylmethane) absorber sensitization.
In a 71-year-old male Caucasian patient with persistent eczema on light-exposed skin, photocontact allergy was demonstrated to the UV filter substances 4-methylbenzylidene camphor (UVB), octyl methoxycinnamate (UVB), benzophenone-3 (UVA) and butyl methoxydibenzoylmethane (UVA) present in sunscreen products used by the patient over several years. A significantly reduced UVB sensitivity of 25 mJ/cm2 in this patient (normal minimal erythema dose in our laboratory = 70-130 mJ/cm2) was considered an early indication of a persistent light reaction. Topical anti-inflammatory treatment over 2 weeks together with consequent application of a sunscreen containing Mexoryl SX/titanium dioxide led to complete remission. Taking into account the widespread use of the above UV filter substances not only in sun protection products, but also in cosmetics such as antiaging lotions and day care products, the possible risk of allergy to these chemicals has to be taken seriously. The substitution of known photocontact sensitizers in UV filters by photostable compounds and detailed product information are the basis of preventive strategies.
Aged↗
Congenital lower lip pits--a very rare syndrome? Report of two cases and review of the literature.
A 43-year-old white man and his 12-year-old daughter both displayed congenital lower lip pits. Since Van der Woude's description of this syndrome more than forty years ago, little attention has been given to this uncommon anomaly, probably due to variable expressivity, incomplete penetrance, and recognition of its clinical stigmata. We describe two family members with Van der Woude's syndrome and review its clinical aspects, differential diagnosis, and treatment.
Adult↗
Expression of cathepsins in dermal fibrous tumors: an immunohistochemical study.
Cathepsins are lysosomal proteases that are distributed in many normal tissues and are primarily responsible for intracellular catabolism and turnover. The increased level of cathepsins in tumors together with their ability to degrade extracellular matrix proteins has led to the hypothesis that they are involved in the process of invasion and metastasis. We studied immunohistochemically the expression of cathepsins B, pro-D and pro-L in 8 cases of dermatofibrosarcoma protuberans (DFS), five cases of atypical fibroxanthoma (AFX) and twenty cases of dermatofibroma (DF). Expression of cathepsins B and pro-D could be detected in 5 of the 8 cases (62.5%) of DFS, whereas cathepsin pro-L was found in 4 (50%) cases. All AFX expressed cathepsin pro-L, whereas cathepsins B and pro-D were observed in 4 out of 5 cases. None of the malignant tumors showed a recurrence or metastasis after a period of four years. We found no expression of cathepsins in DF. In the epidermis and appendages, an expression of cathepsins pro-D, pro-L and B was seen. We conclude that cathepsins may be markers of increased metabolism rather than specific markers of malignancy.
Adolescent↗
Phototoxicity to tetrazepam - A new adverse reaction.
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Aged↗
Airborne particulate matter modulates the production of reactive oxygen species in human polymorphonuclear granulocytes.
Causal relationships between airborne particles (especially particulate matter < 10 microm in diameter) and increases in prevalences and symptoms of respiratory diseases have been postulated in many epidemiologic studies. Polymorphonuclear leukocytes (PMN) in the nasal or bronchial epithelium can be exposed to particulate matter (PM) and may upon exposure produce reactive oxygen species (ROS). Release of ROS can result in cellular and tissue damage and initiate or exacerbate inflammation. To elucidate the effect of PM on inflammatory reactions, we exposed human PMN to PM extracts. PM were collected with high volume samplers in two cities, Dusseldorf and Duisburg, in Germany and reflect sites with high traffic and industrial emissions respectively. The collected particles were extracted using water and then dichloromethane, resulting in an aqueous and an organic extract. The production of ROS was determined using luminol-enhanced chemiluminescence (LCL) of resting and zymosan-stimulated PMN. The present study shows that extracts of PM alone significantly stimulated the production and release of ROS in resting PMN. The effects of the PM extracts were inhibited by superoxide dismutase (SOD), catalase and sodium azide (NaN3). Zymosan-induced LCL was, however, diminished by coincubation with PM extracts. The chemical composition is important when considering the effects of particles. Our study shows that only organic substances adsorbed to particles stimulate LCL. SOZ-induced LCL is inhibited by both types of extracts, but aqueous extracts have a stronger inhibitory effect. It is at present unclear which substances are responsible for these effects.
Air Pollutants↗
Palpable migratory arciform erythema. Clinical morphology, histopathology, immunohistochemistry, and response to treatment.
BACKGROUND: Palpable migratory arciform erythema is clinically characterized by sharply circumscribed, infiltrated erythematous patches that tend to spread irregularly, resulting in arciform morphologic features. The histopathologic features are characterized by a patchy inflammatory perivascular and periadnexal T-lymphocytic infiltrate throughout the dermis. The disease runs a chronic course and is rarely described in the literature. OBSERVATION: Three middle-aged patients of both sexes had palpable migratory arciform erythema with 1, several, or multiple lesions on the trunk. There was a dense perivascular and periadnexal, predominantly lymphocytic infiltrate of the reticular dermis without any interstitial distribution of inflammatory cells. Absence of mucin deposits and plasma cells was a striking feature. The immunohistochemical profile showed an infiltrate dominated by T cells of polyclonal origin. In addition, polyclonal B cells and histiocytes were present in small numbers. In all 3 cases, oral antibacterial treatment resulted in a complete (2 patients) or temporary (1 patient) resolution of skin lesions. CONCLUSIONS: Palpable migratory arciform erythema shows distinctive differences in clinical and pathological features and treatment in contrast to other diseases with cutaneous lymphocytic infiltrates, including lymphocytic infiltration of Jessner and Kanof. Therefore, it is likely a distinct disease entity.
Adult↗
[Perianal ergotismus gangraenosus].
Ergotamine-containing drugs are widely used in the treatment of acute migraine attacks. Among others, spastic vasoconstrictions are one of the possible side effects usually affecting the lower extremities and sometimes leading to gangrene. The case of a 75 year old woman is presented who was suffering from migraine-attacks since adolescence. Due to longterm use of ergotamine containing suppositories she developed perianal ulcers. After withdrawal of the drug the ulcers healed up entirely. The spectrum of ergotamine-induced side-effects and possible intervention strategies are discussed.
Aged↗
[Reversible increase in photosensitivity to UV-B caused by St. John's wort extract].
A 61-year-old woman with depression developed recurring elevated itching erythematous lesions in light-exposed areas after taking St. John's Wort-extract for three years. Routine patchtesting did not reveal any relevant reactions and photopatch testing was negative. Using a systemic oral photoprovocation test with St. John's Wort, we were able to demonstrate a decrease of the MED-UVB which was reversible after withdrawal of the medication.
Antidepressive Agents↗
[Treatment of atopic eczema in childhood].
Adjuvant basic therapy plays a central role in the therapeutic approach to atopic eczema in childhood. It involves the regular use of emollients and oil baths according to the clinical picture. Emollients containing urea may cause problems when used in younger children due to their stinging effect. Glucocorticosteroids still form the mainstay of anti-inflammatory therapy and are superior to other topical drugs with anti-inflammatory effects. Antihistamines preferably of the sedative type can be used successfully during periods of exacerbation. Systemic use of antibiotics is essential in cases of impetiginized atopic eczema. In cases of bacterial-triggered eczema, the topical use of antibiotics in cases of limited or antiseptics in generalized disease may be helpful.
Administration, Topical↗
[Allergy and atopic eczema: on the value of the "atopy patch test"].
The role of allergic reactions in eliciting and maintaining atopic eczema (AE) is still controversial. In a subgroup of patients with atopic eczema, exacerbations of itching and eczematous skin lesions have been described after contract with aeroallergens. To investigate this observation, an epicutaneous patch test with IgE-inducing allergens (atopy patch test, APT) has been proposed, which results in eczematous skin reactions in 30-70% of AE patients. Usage of allergen concentrations exceeding 5000 PNU/g in petrolatum allows testing on clinically uninvolved skin without potentially irritating epidermal tape stripping. The clinical relevance of positive APT reactions is suggested by comparison of APT with skin prick test, specific IgE, patient's history and eczema pattern. Patients with an eczema pattern with preferred localization of skin lesions in air-exposed areas, a predictive history and raised specific IgE (depending on allergen) were shown to have the highest rate of positive APT. Future controlled studies with allergen avoidance and reexposition may focus on this patient group.
Allergens↗
[The Eppendorf Pruritus Questionnaire].
In dermatological practice, itch is the leading symptom of many skin diseases with a variety of psychophysiological aspects. However, a complete inventory for the qualitative evaluation of these central nervous factors is missing, whereas in pain research, the McGill Pain Questionnaire is well established for this purpose. Thus, therapeutic effects of antipruritic agents are only incompletely described by visual analog scales or parameters of skin physiology. Here, a questionnaire modified in analogy to the McGill pain questionnaire is presented, developed in cooperation between dermatologists and neurophysiologists.
Diagnosis, Differential↗