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Biomedical subjects

L Fry

Publications and source records attributed to L Fry.

At least 127 records · Page 7Linked to original sources
PubMed1983

Increased incidence of malignancy in dermatitis herpetiformis.

A retrospective study of 109 patients with dermatitis herpetiformis showed that malignant tumours had developed in seven patients, the expected incidence being 2.93, giving a relative risk of 2.38. In three of the seven patients the malignancy was a lymphoma, giving a relative risk of 100 for this tumour (expected incidence 0.03). In six of the seven patients who developed malignancies small-intestinal biopsy specimens were macroscopically abnormal, giving a relative risk of 4.22 in this group, which is similar to that reported in adult coeliac disease. Patients treated with a gluten-free diet appeared to have a reduced risk of developing malignancy compared with those taking a normal diet (relative risk with gluten-free diet 1.01 and with normal diet 3.09). A small subgroup of eight patients with linear IgA dermatitis herpetiformis were also studied: three developed malignant disease and in one the tumour was a lymphoma.

Dermatitis Herpetiformis↗
PubMed1983

Nerve conduction velocity, microscopic, and electron microscopy studies comparing repaired adult and baby monkey median nerves.

Three to three and a half years after repair of monkey nerves, comparison of total myelinated nerves, electron microscopic sections, and nerve conduction velocities delineated no significant difference between nerves sutured in adult life and those sutured in infancy. Extrapolating these results to the human clinical situation, central nervous system adaption in young patients could explain the better clinical results.

Age Factors↗
PubMed1983

Histology of linear IgA disease, dermatitis herpetiformis, and bullous pemphigoid.

The histologic appearances of cutaneous biopsy specimens from 30 patients with linear IgA disease with a continuous band of IgA along the basement membrane, four patients with a linear pattern of granular IgA along the basement membrane, 26 patients with dermatitis herpetiformis who had IgA in the papillary dermis, and 23 patients with bullous pemphigoid who had IgG and/or C3 along the basement membrane were compared. Those with linear and granular IgA and dermatitis herpetiformis differed from those with bullous pemphigoid in five respects. Multiple microabscesses and fibrin at tips of papillae and leukocytoclasis were less common in bullous pemphigoid, whereas a dense infiltrate of eosinophils in and below bullae and a linear infiltrate of eosinophils along the basement membrane were more common in bullous pemphigoid. Also, multilocular bullae and acantholysis were more common in dermatitis herpetiformis than in bullous pemphigoid. Linear IgA disease differed from dermatitis herpetiformis in two respects. Acantholysis and fibrin at the tips of papillae and leukocytoclasis were more common in dermatitis herpetiformis. The specimens from patients with granular IgA did not differ significantly from those with linear IgA or dermatitis herpetiformis. The appearances of biopsy specimens of patch tests with potassium iodide taken from 11 patients with dermatitis herpetiformis and linear or granular IgA disease were similar to those taken from spontaneous lesions.

Adult↗
PubMed1983

Pharmacokinetic observations on dapsone in dermatitis herpetiformis.

The pharmacokinetics of dapsone (DDS) and monoacetyldapsone (MADDS) following an oral dose of 150 mg DDS were studied in sixteen patients with dermatitis herpetiformis and seven normal subjects. No differences in DDS disposition were observed between the two groups. The maintenance dose of DDS for individual patients was not significantly correlated with jejunal biopsy morphology, DDS or MADDS half-lives, or the area under the plasma concentration-time curves for DDS or MADDS. DDS plasma protein binding was normal in patients and did not apparently determine the concentration of DDS in skin biopsies, for which the skin/plasma DDS concentration ratio was approximately unity. There was no undue representation of acetylator phenotype in the patient group and no correlation between maintenance dose and MADDS/DDS ratio was noted. The determinants of the maintenance DDS dose have not been found. This may relate to pharmacodynamic differences, but alternatively the concentration of oxidative metabolites rather than DDS or MADDS could be responsible for the therapeutic activity in dermatitis herpetiformis.

Adult↗
PubMed1983

Skin biopsies in relatives of patients with dermatitis herpetiformis.

Out of 109 patients with dermatitis herpetiformis (DH) only one was known to have a first-degree relative with the disease. This is in keeping with previous reports that the familial incidence of DH is low. Study of the family in which two siblings were affected showed both to have HLA-B9 whereas a third, unaffected sibling did not have this antigen. This finding supports the view that both genetic and environmental factors are involved in the pathogenesis of DH, 20 first-degree relatives of 10 other patients with DH had skin biopsies examined by immunofluorescence for the presence of IgA, but none proved positive.

Adolescent↗
PubMed1982

IgA in dermatitis-herpetiformis skin is dimeric.

Skin-biopsy specimens from six patients with dermatitis herpetiformis (DH) were examined by means of indirect immunofluorescence with specific rabbit antisera for the presence of in-vivo J chain and secretory component in IgA deposits. The ability of IgA to bind purified secretory component was studied by means of indirect immunofluorescence with antisera to secretory component. Positive J-chain staining associated with IgA deposits was seen in cryostat sections of all seven DH skin-biopsy specimens. In-vivo secretory component was not detected, but on treatment of sections with a solution of purified secretory component, binding of the latter in the region of the IgA deposits was demonstrated in six of the seven DH skin-biopsy specimens. With double fluorochrome staining binding of secretory component was shown to be essentially coextensive with the IgA deposits. These findings suggest that the IgA deposited in DH skin originates from plasma cells in the small intestine.

Binding Sites, Antibody↗
PubMed1982

Linear IgA disease in adults.

A multi-centre study is described in which thirty-five adult patients with papillary IgA dermatitis herpetiformis (DH) were compared with forty-two patients with linear IgA deposits, of whom thirty-four had homogeneous-linear (HL) and eight had granular-linear (GL) IgA deposits. The three groups were similar with regard to age of onset, presence of circulating immune complexes and auto-antibodies, incidence of spontaneous remission, histology of lesional skin and response to dapsone. There was a female predominance in the HL group in contrast to the male predominance in the other two. It was not possible to diagnose the HL group clinically. Some patients had a rash typical of DH whilst others resembled pemphigoid. In the majority, however, no specific diagnosis could be made with confidence. The GL group clinically resembled the DH group. The incidence of positive potassium iodide patch tests was greater in the DH group than in the other two. An associated enteropathy was found in 24% of patients in the HL group, 30% of patients in the GL group and 85% of patients in the DH group. Fifty-six percent of HL patients had HLA-B8 compared with 50% in the GL group and 88% in the DH group. Patients with linear IgA deposits may not be a uniform group, but until they can be divided into specific subgroups (e.g. by ultrastructural localization of the deposit or by response to a gluten-free diet) we propose that the term adult linear IgA diseases should be used to distinguish these patients from those with papillary IgA deposits.

Adolescent↗
PubMed1982

Long term follow-up of dermatitis herpetiformis with and without dietary gluten withdrawal.

Seventy-eight patients with dermatitis herpetiformis have been followed up for periods ranging from 3 to 14 years (mean 7.4). Forty-two patients were treated with gluten-free diet (GFD) and thirty-six took a normal diet (ND). Thirty of the forty-two (71%) taking the GFD were able to discontinue drugs previously needed to control their rash compared with five (14%) of the thirty-six patients taking a ND. The mean time taken to reduce drug requirements for patients taking a GFD was 8 months (range 4-30), and for stopping drugs, 29 months (range 6-108). The incidence of macroscopic abnormality of the small intestine decreased from 69 to 15%, and the mean intra-epithelial lymphocyte count decreased significantly in those patients taking a GFD, whereas there was no significant change in patients taking a ND. The improvement in the skin and intestinal lesions was related to the strictness of the GFD.

Adolescent↗
PubMed1982

Ultrastructural localization of IgA deposits in adult linear IgA disease.

Two cases of adult linear IgA disease are reported. They demonstrate the two sites of deposition of IgA at an ultrastructural level: sub-basal lamina and lamina lucida. This finding supports the view that there are subgroups of this disease. Clinical presentation and histological appearance of lesional skin are misleading, and the immunofluorescent appearance is unhelpful in predicting the ultrastructural localization of the IgA deposit.

Aged↗
PubMed1981

Binding of wheat gliadin in vitro to reticulum in normal and dermatitis herpetiformis skin.

We have demonstrated by indirect immunofluorescence that wheat gliadin binds in vitro to reticulin-like fibrils present in cryostat sections of human skin, and rat liver, kidney and stomach. Gliadin was seen to bind to fibrils throughout the dermis of both normal and dermatitis herpetiformis skin, and this was particularly striking in the dermal papillae. Serum from 2 dermatitis herpetiformis patients who did not have antireticulin antibody gave reticulin staining when retested by immunofluorescence on cryostat sections of rat tissue pretreated with gliadin. Gliadin treated sections may prove useful in screening patients with gluten sensitive enteropathy for anti-gliadin antibody. Binding of gliadin to skin sites in dermatitis herpetiformis patients and subsequent deposition of antigliadin antibody at these sites may be involved in the development of skin lesions.

Animals↗
PubMed1981

Disodium cromoglycate in dermatitis herpetiformis.

Eleven patients with dermatitis herpetiformis, all requiring dapsone to control their rash and taking a normal diet, were given disodium cromoglycate (DSCG) 1.5-1.6 g daily. Eight out of the eleven patients continued to take DSCG for periods varying from 6-11 months, the other three patients chose to discontinue the DSCG before 6 months. Of the eight patients taking DSCG for at least 6 months, none was able to stop taking dapsone. In three of the eight, the dapsone requirements were unaltered, whilst in two it decreased and in three it increased. The mean daily dose of dapsone was 105 mg/day before DSCG and 141 mg/day after DSCG. In the eight patients who took DSCG for at least 6 months, intestinal biopsies were performed before and after this drug. The macroscopic appearance was unchanged in four, improved in two and worse in two. The mean interepithelial lymphocyte count was 346 before and 342 after DSG.

Adult↗