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Biomedical subjects

L Juhlin

Publications and source records attributed to L Juhlin.

At least 73 records · Page 4Linked to original sources
PubMed1989

Episodic erythema gyratum repens with ichthyosis and palmoplantar hyperkeratosis without signs of internal malignancy.

Two patients with typical lesions of erythema gyratum repens, peripheral ichthyosis, palmoplantar hyperkeratosis and nail changes are described. A non-specific erythrodermic eruption of several weeks' duration had preceded the typical lesions. No signs of internal malignancy were found and the typical gyrate lesions disappeared within some weeks with full restitution of all skin lesions within 6-8 months.

Aged↗
PubMed1989

Carpal tunnel syndrome (CTS) and exposure to vibration, repetitive wrist movements, and heavy manual work: a case-referent study.

Possible connections between carpal tunnel syndrome (CTS) and exposure to vibrating handheld tools, repetitive wrist movements, and heavy manual work were examined in a case-referent study. The cases were 38 men operated on for CTS between 1974 and 1980. For each case, two referents were drawn from among other surgical cases (hospital referents) and two further referents from the population register and telephone directory, respectively (population referents). Thirty four of 38 cases (89%) and 143 of 152 referents (94%) were interviewed by telephone. An increased prevalence of obesity, rheumatoid disease, diabetes, or thyroid disease was observed among the cases but most did not suffer from any of these disorders. CTS was significantly correlated with exposure to vibration from handheld tools and to repetitive wrist movements but showed a weaker correlation with work producing a heavy load on the wrist. A cause-effect relation between CTS and exposures to handheld vibrating tools and to work causing repetitive movements of the wrist seems probable. Some differences between hospital and population referents indicate that a case-referent study of this type could be biased by inappropriate selection of referents.

Adult↗
PubMed1989

Absorption of lidocaine and prilocaine after application of a eutectic mixture of local anesthetics (EMLA) on normal and diseased skin.

A eutectic mixture of 5% lidocaine and prilocaine was applied under occlusion for 1 or 2 hours on 25-100 cm2 areas of normal and diseased skin, and the absorption was followed by measuring the concentrations of the drugs in the draining vein and the general circulation at different time intervals after the application. The analgesic and vascular effects in the skin were also recorded. When the mixture was applied on normal skin the absorption was more rapid from the face than from the forearm. The absorption from diseased skin was faster than that from normal skin, with higher plasma concentrations, and a more rapid but shorter anesthetic effect was noted. With the doses used the plasma levels in the general circulation were 100 times lower than those associated with toxicity. The drug concentrations in the draining vein were highest after treatment of diseased skin and were 2-90 times higher than in the general circulation. The plasma concentrations of lidocaine and prilocaine ran parallel to each other, but the prilocaine level was 10-50% lower than that of lidocaine in the draining vein and 200-300% lower in the general circulation.

Anesthetics, Local↗
PubMed1989

Immunohistochemical reactivity of monoclonal antibodies generated after immunization of mice with cells from a psoriatic lesion.

Monoclonal antibodies were produced by immunizing mice with dispersed epidermal cells from a psoriatic plaque. We obtained 128 growing hybridoma clones. The immunohistochemical reactivity of the antibodies produced by these hybridomas was primarily screened on sections of skin biopsies from psoriatic plaques. Supernatants with positive staining were then tested on other dermatoses and human organs. Six supernatants stained infiltrating dermal cells and the whole epidermis in psoriatic lesions, but showed no reaction with sections from normal skin, ichthyosis, or acutely inflamed skin. With these antibodies, positive staining was also seen in some areas of the normal-appearing skin of patients with increasingly active psoriasis as well as after treatment in recently clinically healed lesions. A different and more heterogenous staining of epidermis with no or fewer infiltrating cells was seen in longstanding inflammatory disorders such as chronic eczema, neurodermatitis, lichen planus, discoid lupus erythematosus and mycosis fungoides. Scattered staining with these antibodies was in addition seen on infiltrating macrophage-like cells present also in other organs than skin and in some of the organs also other types of cells were stained, such as neck mucosal cells of the stomach, parts of duodenal mucosal cells, certain secretory cells in parotid gland, lung bronchiole and Hassall's bodies on the thymus. The cross-reactivity of antibodies to psoriatic lesions with other organs is of interest, since psoriasis might involve various tissues. Our findings support the idea that there exist unique cell surface antigens in psoriatic skin which might help elicit an immune reaction and/or be targets for such local immune reactions.

Adult↗
PubMed1989

Hyperpigmented acral papular mucinosis, systemic lupus erythematosus and universal alopecia.

A 42-year-old man presented with systemic lupus erythematosus, universal alopecia and non-pruritic hyperpigmented papular mucinosis. The latter was most evident on acral areas. In hyperpigmented areas of the face the immunofluorescence showed deposits as in LE and with alcian blue and colloidal iron an abundance of mucin was demonstrated in the dermis. A lesion on the back showed only papular mucinosis. Fifteen cases of LE and papular mucinosis reported in the literature are reviewed. Our patient differs with respect to the marked pigmentation of his lesions, their localization and the association with universal alopecia.

Adult↗
PubMed1989

Longitudinal melanonychia after healing of lichen planus.

A patient with progressive longitudinal ridging, diffuse pigmentation and narrowing of the finger nails as the only signs of lichen planus was treated with intramuscular injections of triamcinolone for 2 years. Her nails healed, with the appearance of normal proximal nails after 6 months. After one year, longitudinal bands of melanonychia appeared on the thumbs and still persist.

Female↗
PubMed1989

Treatment of psoriasis and other dermatoses with a single application of a corticosteroid left under a hydrocolloid occlusive dressing for one week.

Lotions of five different corticosteroids were applied on 3 X 4 cm areas of large infiltrated chronic psoriatic plaque in eight patients, and left occluded with a hydrocolloid dressing (Actiderm) for one week. Area treated with clobetasol, betamethasone and triamcinolone were clinically healed within one week in four patients, but slight residual erythema was observed in the other four. Hydrocortisone-treated areas showed better improvement than the non-steroid-treated control area, where infiltration and erythema remained unchanged. In 44 patients with psoriasis, lichen planus, chronic lichenified eczema, discoid lupus erythematosus and necrobiosis lipoidica, treatment with betamethasone applied 1-3 times under Actiderm once a week healed the lesions. The skin-coloured Actiderm is easy to apply and wear and does not loosen when taking a shower or hot bath.

Adolescent↗
PubMed1989

Expression of CD36 (OKM5) antigen on epidermal cells in normal and diseased skin.

The expression of the CD36 (OKM5) antigen was studied with the PAP technique on sections of skin from healthy subjects and of normal and diseased skin from patients with various skin diseases. In specimens from healthy subjects the antigen was found on vascular and perivascular structures and in some cases it was seen on cells of the acrosyringium. A net-like pattern of CD36 was observed in the upper part of the stratum spinosum in skin lesions of patients with psoriasis, lichen planus, pityriasis rosea, morbilliform drug reactions, necrobiosis lipoidica, lichen amyloidosus, Darier's disease and ichthyosis vulgaris. Expression of CD36 was also seen in the nonlesional skin just below the granular layer in 3 of 5 patients with factitial urticaria with immediate dermographism, but not in delayed dermographism or chronic urticaria. In ichthyosis vulgaris CD36 was also expressed in dendritic cells of the basal layer and in a patient with a graft versus host reaction it was recognized both on scattered keratinocytes and on dendritic cells in the epidermis. The role of the expression of the CD36 antigen in the skin is unknown. The activated cells might possibly serve as antigen-presenting cells and/or have a modulatory influence on an inflammatory reaction.

Antibodies, Monoclonal↗
PubMed1989

Detection of transferrin and C3d receptors in the skin of patients with various dermatoses.

The localization of transferrin and C3d receptors in various skin lesions and normal appearing skin have been studied on sections with the PAP technique. The transferrin receptor was recognized in the lower epidermis from psoriatic plaques. Here it was more evident than in other inflammatory or hyperproliferative disorders where it was mainly detected on the basal cells. In healthy skin or lesions of lichen planus, scleroderma and ichthyosis the transferrin receptor was not detected in the epidermis. The C3d receptor was in normal skin found on the basement membrane and on elastic fibres in the papillary dermis. The basement membrane was strongly marked in pemphigoid but was not seen in lichen planus and Ehlers-Danlos syndrome. In patients with urticaria factitia, contact dematitis, psoriasis and Darier's disease the suprabasal cells also expressed C3d whereas in other dermatoses the epidermis was negative. Colloid bodies in lichen planus and GVH reactions expressed both the transferrin receptor and C3d.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1988

Treatment of chronic urticaria with cetirizine dihydrochloride a non-sedating antihistamine.

The efficacy of cetirizine dihydrochloride, a new H1-antagonist with minimal sedative or anticholinergic side effects was evaluated in 30 patients with chronic idiopathic urticaria. In the first part of the study, cetirizine 10 mg and placebo were compared in a double-blind cross-over trial. In the second part, patients who did not respond adequately in the first part were randomized, still double-blind, to receive 10 mg cetirizine either once daily or twice daily. In the first part, treatment was discontinued by 17 patients on placebo and two patients on cetirizine because of lack of efficacy. Cetirizine dihydrochloride was found significantly to reduce occurrence of weals, erythema and pruritus compared with placebo (P less than 0.001). Twenty-six of the patients improved on cetirizine and two on placebo. Mild sedation was noted by two patients on cetirizine and by one on placebo.

Adolescent↗
PubMed1988

Total absence of eosinophils in a patient with chronic urticaria and vitiligo.

A 71-year-old woman with chronic urticaria and vitiligo is reported who lacked eosinophil and basophil leukocytes in her blood, bone-marrow and skin. No IgE was detectable in serum. She had a low level of serum eosinophil cationic protein (ECP) which could indicate that some eosinophils had been formed but rapidly destroyed. There was, however, no ECP release when the patient's serum was mixed with heterologous eosinophils. Staining for eosinophilic proteins in white blood cells by monoclonal antibodies revealed no storage or secreted forms of ECP. The source of ECP in our patient therefore remains unknown.

Aged↗
PubMed1988

Low dosage alpha-interferon treatment in patients with advanced cutaneous T-cell lymphoma.

Treatment with high dose (10-50 x 10(6) IU/m2 three times a week) of alpha-interferon (alpha-IFN) has been shown to induce remissions in about 50% of patients with cutaneous T-cell lymphoma. The optimal alpha-IFN dose, however, is not known. 4 patients with advanced cutaneous T-cell lymphoma were therefore treated with alpha-IFN in low doses of 2-4 x 10(6) IU/m2 three times a wk. 1 complete, 1 partial and 1 minor remission were observed. Skin biopsies before and during treatment were taken from 2 of the patients and showed improvement. Low doses of alpha-IFN can thus induce remission in patients with cutaneous T-cell lymphoma.

Adult↗
PubMed1987

Delayed-onset synergism between leukotriene B4 and prostaglandin E2 in human skin.

The time-course of cutaneous inflammatory responses to LTB4 and PGE2 both alone and in combination has been studied in 10 healthy volunteers. LTB4 induced a transient wheal and flare response in some subjects, maximal at 15 minutes and succeeded by an erythematous, indurated lesion at 2-4 hours. PGE2 elicited a wheal and erythema response which resolved within 1-2 hours. Combination of LTB4 and PGE2 produced acute wheal and erythema responses which did not differ significantly from the summation of responses to the individual constituents of the mixture or from responses to a two-fold increase in the concentration of either component. Wheal and erythema responses persisted, however, with significant potentiation of responses 4 hours after injection. As both leukotrienes and prostaglandins are generated in acute allergic reactions, the effects of these mediators in combination could contribute to persisting and late-onset responses to allergen, in both the skin and lung. In particular, sustained responses to the combination of LTB4 and PGE2 might be important in the pathogenesis of inflammatory skin diseases such as psoriasis.

Adult↗
PubMed1987

Inhibiting effect of cetirizine on histamine-induced and 48/80-induced wheals and flares, experimental dermographism, and cold-induced urticaria.

A single oral dose of cetirizine, 10 mg, a new H1 antagonist with minimal sedative effects and devoid of anticholinergic activities, was administered to eight healthy subjects. It markedly inhibited the wheal and flare induced 4 hours later by intracutaneously injected histamine and compound 48/80. Dermographism was produced by different pressures (100 to 500 gm/15 mm2) in 10 patients with factitial urticaria. Four hours after 10 mg of cetirizine, the whealing was absent in eight patients and markedly reduced in the other two subjects. In 12 patients with cold urticaria, wheals were induced by 30 seconds to 12 minutes application of an ice cube. Four hours after 10 mg of cetirizine, the urticarial reaction had disappeared in five patients and was decreased in the other patients. No itching was experienced in any of the patients after cetirizine, but the tested areas had an erythema lasting for 20 to 60 minutes.

Adult↗
PubMed1987

Drug-induced photo-onycholysis. Three subtypes identified in a study of 15 cases.

We have studied 15 patients with photo-onycholysis induced by tetracyclines, psoralens, or fluoroquinolones. Three distinct clinical subtypes of onycholysis were seen. Type I showed a half-moon-shaped separation that was concave distally. Type II had a circular notch opened distally and shaped as if the distal nail plate had acted as a convex lens. In type III the changes were located in the central part of the nail bed with no connection to the margins. Ultraviolet (UV) irradiation of normal fingernails with various wavelengths showed that 3% to 20% of the irradiation could penetrate the nail. The different patterns of photodamage might be caused by the nail acting as a lens. Less protection by lack of melanin and absence of sebum and stratum granulosum may favor penetration of UV irradiation and explain why the skin was not always affected.

Adult↗
PubMed1987

A syndrome with painful lipomas, familial dysarthria, abnormal eye-movements and clumsiness.

A syndrome of dysarthria, clumsiness and abnormal ocular movements are described in a man and his 3 children. His father, who died when our patient was born, also had the same speech abnormality. Our patient also had multiple painful lipomas suggesting a probable diagnosis of adipositas dolorosa Dercum. Although he looked muscular he complained of muscular weakness and fatigue. Oral treatment with a local anesthetic, mexiletin, inhibited the pain in the lipomas. Analysis of the speech disorder in our patient and his children revealed disturbances in the coordination of jaws, larynx and tongue with a poor control of pitch and volume and impaired intelligibility. The poor fine coordination of hands, clumsiness when walking, dysarthria and disturbance of eye-movements could be due to a familial malformation in the pons or cerebellum. Computer tomography and X-ray of head were normal but the grooves on the surface of the cerebellum were more marked than usual.

Adult↗