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Biomedical subjects

L G Millard

Publications and source records attributed to L G Millard.

At least 37 records · Page 2Linked to original sources
PubMed1986

Severe cutaneous reactions to captopril and enalapril; histological study and comparison with early mycosis fungoides.

A severe non-dose related skin eruption attributable to treatment with captopril was recently reported: this is distinct from the dose related rashes that have been widely described. Ultrastructural and immunohistochemical studies were carried out to determine in detail the histological features of this eruption: the histological appearances were similar to those found in early mycosis fungoides, so that this disease was erroneously diagnosed in one case. Unlike most other complications resulting from treatment with Captopril, an indistinguishable rash can result from treatment with enalapril, a newer angiotensin converting enzyme inhibitor.

Captopril↗
PubMed1984

Dermatological pathomimicry: a form of patient maladjustment.

Thirteen patients (eleven female, two male; aged 19-72 years) who mimicked their original dermatological disease by reproducing the original mechanisms of disease or by interfering with therapy were seen over a period of 5 years. Six patients had exacerbations of eczema, four drug reactions, and three non-healing leg ulcers. Exacerbations of dermatological disease were related to the patient's need for a sickness role. This maladjustment responded to positive directive psychotherapy rather than a superficial sympathetic approach which tended to reinforce the maladjustment. Eleven patients admitted their part in actively producing their disease, and the outcome was good. This clinical syndrome appears to be predominantly an opportunist reaction although one patient was depressed and one had early dementia. The syndrome should not be confused with dermatitis artefacta.

Adjustment Disorders↗
PubMed1979

Abnormal laboratory test results and their relationship to prognosis in discoid lupus erythematosus. A long-term follow-up study of 92 patients.

Investigation of 92 patients with discoid lupus erythematosus, manifested initially by localized cutaneous lesions only, showed abnormal laboratory test results for 57 patients (62%) on admission and for 62 patients (67.4%) on review 16 to 20 years later. Patients with discoid lesions confined to the head and neck (DLE) showed fewer laboratory abnormalities than those patients with disseminated lesions involving trunk and limbs (disseminated discoid lupus erythematosus [DDLE]). Systemic lupus erythematosus (SLE) eventually developed in six (6.5%) of the patients, and all had shown persistent multiple abnormal laboratory findings from the beginning. Complete remission occurred in 46.7%. A persistent positive antinuclear factor of either speckled or homogeneous pattern with a titer greater than 1:50, leukopenia, thrombocytopenia, or a false-positive Wassermann reaction indicated those patients who may progress to DDLE or SLE.

Antibodies, Antinuclear↗
PubMed1978

Chilblain lupus erythematosus (Hutchinson). A clinical and laboratory study of 17 patients.

Chilblain lupus erythematosus (LE) is a chronic unremitting form of LE ssen predominantly in women. It occurs commonly on the digits, calves and heels. Nasal lesions are rare. Chronic facial discoid LE usually appears before the chilblain form but, in most instances, resolves even though the chilblain lesions persists. Transformation to systemic LE occurs more often in those who develop both forms of cutaneous LE simultaneously and in the erythema multiforme syndrome. The chilblain lesions are the result of microvascular injury secondary to exposure to cold and possibly hyperviscosity from immunological abnormalities, Elevated serum gammaglobulins, positive latex factor and speckled pattern antinuclear factor are common. None of the usual treatments for cutaneous LE is effective for the chilblain lesions, probably because none is directed towards prevention and treatment of the microvascular stasis.

Adolescent↗
PubMed1977

Histocompatibility antigens in discoid and systemic lupus erythematosus.

A study of histocompatibility (HLA) antigens in 69 patients with discoid lupus erythematosus (DLE) showed an increased incidence of HLA-B7 and HLA-B8 related to the age at onset and sex of the patient. Young females and males aged 15-39 years at onset were associated with HLA-B7 and females aged over 40 years with HLA-B8. This supports previous studies concerning sex and age specific onset rates in DLE which suggests that there is more than one genotype in this disorder. Female patients with systemic lupus erythematosus (SLE) at all ages of onset showed a significant association with HLA-B8. Female patients, with onset 15-39 years, with either SLE or DLE which has transformed to SLE, show a significant increase in HLA-B8 compared with the females in the same age onset group who have the discoid disease. The presence of HLA-B8 in a young female with DLE may represent a risk factor for the development of the systemic disease.

Adolescent↗
PubMed1977

Chronic leg ulcers treated by the pinch graft method.

Forty-nine patients with chronic leg ulcers were treated by pinch grafting. The initial success of this procedure was high for both gravitational and arterio-sclerotic ulcers. Over half the grafted gravitational ulcers and 70% of grafted arteriosclerotic ulcers were intact after 2 years. Some grafts remained stable for 6 years. Arteritic ulcers did not respond as well; none of the grafted ulcers survived more than 6 months. Pinch grafting is still a simple, cheap and effective therapy offering prolonged graft stability as well as quicker healing to those patients who are not fit for more extensive surgery.

Adult↗
PubMed1977

A haemorrhagic bullous eruption of the hands caused by phenylbutazone: a report of 3 cases.

Three patients developed a haemorrhagic eruption on the hands after taking phenylbutazone. The reaction appeared within two weeks of taking the drug and is probably an allergic capillaritis. All patients showed generalised capillary fragility with a positive Hess test which became negative within a week of stopping the drug. A mechanism is suggested for the development and distribution of the blisters.

Adult↗