[Dermatology in Vienna and the German Dermatologic Society. A historical perspective].
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Biomedical subjects
Publications and source records attributed to K Holubar.
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Ferdinand von Hebra was the first well-known Austrian dermatologist and he belonged to the so-called IInd Viennese School of Medicine in the 19th century, of which he was one of the most prominent members. Both his life and his oevre are outlined on the occasion of the 100th anniversary of his death (August 5, 1880). His monograph on scabies and his atlas on diseases of the skin are mentioned in particular.
Twenty-one patients with dermatitis herpetiformis were typed for HLA-ABC and -DR determinants. The incidence of HLA-AI, -B8 and -DR3 antigens was found to be significantly higher (P: = 10(-3), less than 10(-6) and less than 10(-6), respectively) among patients with dermatitis herpetiformis than among the normal population. HLA-DR3 was found in 85.7% of patients, HLA-B8 in 66.7% and HLA-AI in 61.9% only. These results indicate that HLA-DR3 is the antigen primarily associated in dermatitis herpetiformis and the latter antigens (HLA-AI and -B8) are present in increased incidence, probably due to the known linkage disequilibrium of these antigens with HLA-DR3.
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Polymorphonuclear leukocyte chemotaxis was investigated in 15 patients with dermatitis herpetiformis and was found not to be significantly increased when compared with the polymorphonuclear leukocyte chemotaxis of 15 normal healthy controls. These results indicate that accumulations of polymorphonuclear leukocytes found in the skin of patients with dermatitis herpetiformis are not due to an increased responsiveness of polymorphonuclear leukocytes to a chemotactic factor.
The functional activity of monocytes in human disease and the role of this particular cell type in host defense is a matter of current interest. Among several assays for monocyte function, an antibody-dependent cellular cytotoxicity microassay is regarded as a convenient test system in which monocytes of a Ficoll-Hypaque-separated mononuclear cell fraction act as effector cells and consequently lyse 51Cr-labeled, antibody-coated human erythrocytes. This assay was applied to a total of 35 individuals: 20 patients with Stage I melanoma and 15 healthy control subjects. All melanoma cases were treated by means of excision of the primary lesions and subsequent regional lymphadenectomy. Ten patients were selected at random and received additional adjuvant BCG immunotherapy for periods of 9.4 +/- 1.7 months. The mean percentage of 51Cr released in melanoma patients not receiving BCG was significantly lower (P less than 0.01%) than that in healthy control subjects. Monocyte numbers, as evaluated by means of nonspecific esterase staining, were not statistically significantly different.
Treatment with an oral aromatic all-trans retinoid (Ro 10-9359) resulted in clearing of the skin lesions in five patients with ichthyosis, four patients with Darier's disease and one patient with linear porokeratosis. No response to treatment was achieved in two patients with disseminated superficial actinic porokeratosis. Known side effects of retinoid treatment occurred in all patients in different intensity but disappeared when treatment was discontinued. Due to side effects (pruritus) treatment had to be discontinued only in one patient with Darier's disease and preexisting diabetes.
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It is well established that suprabasal acantholysis can be produced in tissue culture of normal human skin in the presence of pemphigus IgG autoantibody. In this study, bullous pemphigoid, herpes gestationis and linear dermatitis herpetiformis anti-basement membrane zone antibodies failed to produce dermoepidermal separation in a tissue culture model in spite of the presence of complement. The binding of the antibodies was demonstrated by immunofluorescence and immunoelectron microscopy; ultrastructurally, identical binding sites of anti-basement membrane zone antibodies could be demonstrated in vitro, as has been observed in vivo previously. Tissue culture is a suitable model for studying the binding sites of circulating anti-basement membrane zone antibodies but the functional activity (blister format;on) of these antibodies cannot be assessed thereby.
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Herpes gestationis is a rare blistering disease of pregnancy and the puerperium which is difficult to differentiate from other bullous eruptions of pregnancy by clinical and histopathological criteria only. Caracteristic immunopathological features permit the exact classification of this disease. This is a report on three typical cases of herpes gestationis. The clinical, histopathological and immunopathological findings of the disease as well as treatment and maternal and fetal risks are discussed.
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