Search PubMed⌕ Search

Biomedical subjects

L Fry

Publications and source records attributed to L Fry.

At least 145 records · Page 8Linked to original sources
PubMed1981

Anti-gliadin antibodies and small intestinal mucosal damage in dermatitis herpetiformis.

Sera from forty-six patients with dermatitis herpetiformis (DH) were examined for anti-gliadin antibodies (AGA) by the enzyme linked immunosorbent assay (ELISA) test and by a simple new immunofluorescent (IF) test. AGA were present in fifteen out of thirty-two patients taking a normal diet, but in none of the fourteen taking a gluten-free diet (GFD). The presence of circulating AGA was related to the severity of the enteropathy. AGA were present in all ten patients with a flat mucosa and in four of six with a convoluted mucosa, but in only one out of thirty patients with normal morphology of the small intestine. However, in those patients taking a normal diet and with a normal morphology of the intestine there was evidence of gluten sensitivity compared to those taking a GFD, as the intraepithelial lymphocyte count (IELC) was significantly raised in the peri-nuclear and supra-nuclear positions. The study shows that the presence of AGA in the serum is a good indication of the degree of gluten sensitivity as expressed by severe mucosal damage in patients with DH.

Adolescent↗
PubMed1981

Hepatic injury in dermatitis herpetiformis.

Liver function tests were performed in 60 patients with dermatitis herpetiformis. Abnormalities of bilirubin or elevated liver enzyme levels were found in 17% of the patients. 13% had abnormal liver enzymes or elevated bilirubin levels not due to haemolysis. In 8% of patients bilirubin levels were elevated as a result of dapsone-induced haemolysis. The incidence of liver function abnormalities was higher (19%) in those on a normal diet than those on a gluten-free diet (9%). The abnormalities were not associated with the presence of immune complexes, anti-mitochondrial or anti-smooth muscle antibodies.

Dapsone↗
PubMed1980

A comparison of IgA positive and IgA negative dapsone responsive dermatoses.

A study of thirty-three patients with a clinical diagnosis of dermatitis herpetiformis (DH) referred to our DH clinic over the las 11 years is reported. Twenty-six were referred by other consultant dermatologists. The diagnosis had been made by the clinical features and response of the rash to dapsone. Seventeen patients were found to have IgA in the uninvolved skin (IgA positive) and in sixteen no IgA was found (IgA negative). The duration of the rash prior to referral to the DH clinic was 3 months to 19 years (mean 5.0 years) for the IgA negative patients and 2 months to 22 years (mean 5.2 years) for the IgA positive group. The length of follow-up was 3 months to 11 years (mean 5.0 years) for the IgA negative, and 2--11 years (mean 5.6 years) for the IgA positive group. During follow-up the rash cleared completely and required no treatment in seven of the sixteen IgA negative patients. Thirteen of these sixteen patients no longer required dapsone, but six patients were receiving alternative treatment. In the three patients still taking dapsone IgA has not been found on subsequent biopsy. Of the seventeen IgA positive patients only three were able to stop dapsone during follow-up and in these three the IgA was still detected in the skin. Small intestinal mucosa was abnormal in eight of eleven IgA positive patients, but was normal in all thirteen IgA negative patients in whom jejunal biopsies were performed. An alternative diagnosis to DH has subsequently been made in thirteen of the sixteen IgA negative patients. Although the significance of IgA in the skin in DH is not known it appears to be part of the disease process. Patients who have a rash suggestive of DH and which is dapsone responsive, but in whom IgA is not found in the uninvolved skin, usually turn out to have a dermatosis other than dermatitis herpetiformis. Referral to a unit with expertise in immunofluorescence techniques of skin biopsies would appear to be helpful.

Adolescent↗
PubMed1980

The potassium iodide patch test in the dermatitis herpetiformis in relation to treatment with a gluten-free diet and dapsone.

The potassium iodide patch test was studied in twenty-six patients with dermatitis herpetiformis. Histological assessment was found more sensitive than clinical. All of five patients with active disease and not on treatment had a positive test, whereas only two of six patients taking a gluten-free diet (GFD) and one of eight taking dapsone were positive. In another two patients taking a GFD, but in whom the diet had not been strict, the test was positive. All three patients in remission and both patients with the linear pattern of IgA (but with active disease) were negative. Immunofluorescence studies showed no difference in the presence, quantity, or distribution of immunoglobulin, complement or fibrinogen between the patch test site and uninvolved skin, or in the uninvolved skin between patients with and without active lesions.

Dapsone↗
PubMed1980

Quantitative studies on the reactions of psoriatic epidermis to treatment.

An image-analysing computer has been used to assess the changes in the length of the dermo-epidermal junction and in the epidermal area in histological sections from psoriatic plaques in groups of patients undergoing various treatment regimes. The changes in these two features closely parallel one another, and measurement of the length of the dermo-epidermal junction may be a relatively simple quantitative method of gauging the course of the disease. Topical fluocinolone acetonide produced a greater improvement than did dithranol or coal tar. Variation in the number of epidermal mitotic figures was not a reliable guide to improvement or otherwise in the psoriatic lesion and reappearance of the granular layer can occur independently of any decrease in mitosis.

Anthralin↗
PubMed1979

Comparison of immunoglobulin and complement deposition in multiple biopsies from the uninvolved skin in dermatitis herpetiformis.

The distribution of immunoglobulins and C3 component of complement (C3) in the skin of twenty-four patients with dermatitis herpetiformis was studied. Skin biopsies were taken from three sites, the extensor surface of the elbow, the flexor surface of the forearm and from the thigh. Twenty-two (90%) patients showed variation in deposits of immunoglobulins and C3 at the three sites. IgA was present in all patients, but differed in quantities deposited at the three sites in nineteen (80%) patients. Similar variation between sites was observed with IgG, IgM and C3. There was variation within three biopsies, IgA being absent from some sections and present in others. Three patients had a continuous pattern of IgA deposition. One had both continuous and papillary deposits within a single section. There was no difference in the incidence or quantity of immunoglobulin and C3 between the elbow, forearm and thigh. There was observed to be a diminution in quantity of IgA and incidence of C3 in patients taking a gluten-free diet. Deposition of IgA, IgM, IgG and C3 is not uniform throughout the skin and conclusions drawn from the quantity of immunoglobulin and C3 in a single biopsy may not be reliable.

Adult↗
PubMed1978

IgA and C3 complement in the uninvolved skin in dermatitis herpetiformis after gluten withdrawal.

IgA deposits in the skin in 53 patients with dermatitis herpetiformis (DH) have been studied in relation to treatment. In 19 patients the disorder was controlled by a gluten-freen diet (GFD) alone, in 13 patients by dapsone and GFD and in 18 by dapsone alone. In 3 patients the skin disorder became insignificant and required no treatment. Of the patients taking a GFD alone, six had been clear of skin lesions for 7 years, 5 for 3--5 years, and 8 for periods of 6 months--3 years. IgA deposits were found in all patients in an initial biopsy in a second biopsy after treatment for periods varying from 1 to 7 years. There was no difference in the quantity of IgA, as assessed by the amount of fluorescence, whether patients were controlled with a GFD alone, GFD and dapsone, dapsone alone, or in those in clinical remission. The C3 component of complement was present in the skin in 3 of the 19 patients (16%) controlled by a GFD alone, 6 of the 13 patients (46%) of those controlled by a GFD and dapsone, and in 12 of 18 (66%) of the patients taking dapsone alone, and in one of the patients in clinical remission.

Adult↗
PubMed1976

Multiple immune complexes and hypocomplementaemia in dermatitis herpetiformis and coeliac disease.

Circulating immune complexes have been detected in 100% of 59 patients with dermatitis herpetiformis (D.H.), and in 100% of 27 patients with coeliac disease (C.D.). Three methods for detecting immune complexes were employed: radiobioassay, which gave an incidence of 77% in D.H. and 81% in C.D.; C1q binding activity, with which the incidence was 83% and 96%, respectively; and precipitation with 4% polyethylene glycol (69% positivity in D.H., 100% in C.D.). The immune complexes in D.H. and C.D. were compared with those in sera from 23 patients with systemic lupus erythematosus (S.L.E.). Multiple complexes of differing properties were found in D.H. and C.D. but not in S.L.E. The varying nature of the complexes in D.H. and C.D. may account for the damage to different tissues (skin, small intestine, reticuloendothelial system). Low third component of complement was found in 49% and low C4 in 20% of D.H. patients. C3 hypocomplementaemia was found in 26% of patients with C.D.

Adult↗
PubMed1976

The ultrastructural changes in the skin in dermatitis herpetiformis after withdrawal of dapsone.

The development of skin lesions in patients with dermatitis herpetiformis after the withdrawal of their dapsone therapy was studied with the electron microscope. In control biopsies from patients prior to cessation of treatment, membrane-bound vacuoles were found beneath the basal lamina of the epidermis as previously described. After dapsone withdrawal, there was an apparent increase in the number of vacuoles and occasionally several vacuoles appeared to have coalesced forming an early blister. At this stage, the basal lamina and associated hemidesmosomes were normal although in places there were small discontinuities in the basal lamina. Where the reaction was more intense, vacuoles and cells, mainly eosinophils, were embedded in fibrin de posits. Above this, the basal lamina was usually disrupted with involvement of the basal epidermal cells. These results suggest that the vacuoles do play a part in the formation of the pathological lesion in dermatitis herpetiformis. In addition, the basal lamina is shown to be only secondarily involved. The nature of the vacuoles has still to be elucidated.

Biopsy↗
PubMed1976

A comparison of histocompatibility antigens in dermatitis herpetiformis and adult coeliac disease.

The incidence of histocompatibility antigens HL-A, 4a and 4b was studied in thirty-eight patients with dermatitis herpetiformis (DH) and thirty-six patients with adult coeliac disease (ACD). The 4b antigen was found in all the DH and ACD patients. HL-A 8 was found in 89% of patients with ACD--similar to the incidence reported in previous studies--and in 79% of patients with DH, a higher incidence than in previous studies which may be due to stricter criteria being used here to diagnose DH. There was no significant difference in the incidence of HL-A 8 between those patients with DH whose small intestinal biopsies appeared macroscopically abnormal and those with a normal macroscopic appearance. These findings suggest that patients with DH form a single disease group and do not support the concept previously postulated that there are two groups of patients with DH, one with an increased incidence of HL-A 8 antigen similar to that in ACD who have a gluten sensitive enteropathy (GSE), and another with a normal incidence of HL-A 8 antigen and without enteropathy.

Celiac Disease↗
PubMed1976

DNA synthesis and mitosis in uninvolved epidermis of persistent palmoplantar pustulosis.

Mitotic and DNA synthesizing cell counts have been performed in uninvolved epidermis of twenty-one patients with persistent palmoplantar pustulosis (PPP). There was no difference in mitotic counts and DNA synthesis in PPP compared with normal epidermis, but both were significantly lower than those found in the clinically uninvolved epidermis of patients with psoriasis.

Aged↗
PubMed1976

Clinical evaluation of clobetasone butyrate in the treatment of children with atopic eczema, and its effect on plasma corticosteroid levels.

Studies were carried out to assess the effectiveness of clobetasone butyrate in treating eczema and psoriasis, and to determine if the compound had any effect on plasma cortisol levels. In the first trial, 71 children with bilateral symmetrical atopic eczema lesions were treated twice daily for 1 week, on one side with 0.05% clobetasone butyrate cream or ointment and on the other with 0.0125% flurandrenolone cream or ointment. Lesions improved or healed in the majority of the patients. Treatment preference showed a trend in favour of clobetasone butyrate but the difference was not statistically significant. In a second open trial, 29 adults with eczema or psoriasis were treated twice daily with clobetasone butyrate for 1 week: lesions in 10 patients remained static, 12 improved, and 7 were cleared. Plasma corticosteroid levels remained within the normal range at the end of the treatment period.

Adolescent↗