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Biomedical subjects

M Armenaka

Publications and source records attributed to M Armenaka.

16 recordsLinked to original sources
PubMed1998

Classic Kaposi's sarcoma in two young heterosexual men.

Classic Kaposi's sarcoma is primarily a skin disease of the lower extremities affecting predominantly elderly men of Mediterranean origin. We report classic Kaposi's sarcoma first presenting in the third decade in two heterosexual, HIV-negative, males of Greek origin from Albania. Ten years after onset, the disease became aggressive with unusual clinical features that included exophytic tumors, extensive lesions on the hands as well as the legs, and prominent leg edema. One of the patients also presented lesions on the face, trunk and palate, and bubonic lymphadenopathy. In both cases, CD4 counts were normal and HLA-DR5 was positive. Treatment included radiation therapy, subcutaneous interferon (alpha-2b) and combined chemotherapy (ABV). At follow up 1 and 2 years later, both patients remain in partial remission with significant improvement in clinical disease, on maintenance interferon.

Adult↗
PubMed1998

Contact allergens in patients with leg ulcers.

BACKGROUND: Contact dermatitis can complicate the treatment of leg ulcers and is an acquired phenomenon resulting from the use of topical medications. OBJECTIVE: To show the incidence of contact dermatitis reactions to topical medications applied to leg ulcers and to evidence changing trends in such reactions through comparison of two case series about 20 years apart. SUBJECTS AND METHODS: We studied two groups of patients with leg ulcers that were patch tested with contact allergens in 1973-1974 and in 1994-1995. RESULTS: One or more positive patch tests was present in 75% and 40% of the patients, respectively. A decrease in the incidence of positive reactions to neomycin, local anesthetics and parabens mix was seen in 1994-1995. The most important contact allergens in 1994-1995 were fragrance mix, colophony and the excipients wool alcohols and amerchol. Other relevant sensitizers were formaldehyde, neomycin and gentamycin. CONCLUSION: The changing trends in contact allergens over the last 20 years may be explained by changes in the components of topical agents used for treatment.

Allergens↗
PubMed1997

Study of persistence and loss of patch test reactions to dichromate and cobalt.

Hyposensitization is a poorly understood phenomenon that refers to the conversion from a positive to a negative (or less positive) patch test. We studied 180 cement workers with contact dermatitis, who originally had a total of 163 positive patch test reactions to potassium dichromate and 98 positive reactions to cobalt chloride. They were patch tested a 2nd time after 2-6 years. On the 2nd patch test to dichromate, 103 (63%) remained positive, while reactivity decreased in 33 (20%) and 27 (17%) had become non-reactive. Cobalt sensitivity persisted in 47%, diminished in 13%, and 40% of the patch tests became non-reactive. In 10 patients with persistent patch test reactions and 10 matched patients with diminished reactions or loss of reactivity, circulating T-cell responses to dichromate and cobalt were studied in vivo. Circulating T cells that proliferated only to specific contact allergens were isolated and in all patients they were primarily CD4+. However, in patients with persistent reactions, they were CD4+ CD45RA+ (suppressor - inducer cells). These differences support an immunologic basis for hyposensitization.

Adult↗
PubMed1996

Anaphylaxis induced by lentils.

BACKGROUND: The legume food family is large and includes peanut and soybean, two of the most frequent causes of food allergy. Literature on type I hypersensitivity to lentils, also a legume, is scarce. OBJECTIVE: To describe a child with repeated anaphylactic reactions related to lentils. METHODS: Skin prick tests with both commercial and cooked extracts and serum-specific IgE measured by CAP-RIA were used to identify specific IgE antibodies to various legumes. RESULTS: An 8-year-old girl suffered four episodes of anaphylaxis related to lentils from ages 3 to 7 years. The first three involved ingestion of cooked lentils and each time smaller amounts induced symptoms. The fourth episode occurred with inhalation exposure to cooking lentil soup. Subsequently, she presented with contact urticaria from raw chickpeas and an anaphylactic reaction after ingestion of cooked chickpeas. Prick tests showed strongly positive reactions to lentil and chickpea and weaker positive reactions to peanut, pea, soybean, and white bean. CAP-RIA was class 6 to lentil; class 5 to peanut, pea, and soybean; class 4 to white bean, and class 0 to green bean. CONCLUSION: Severe type I hypersensitivity to lentils occurred in this patient and was associated with clinically relevant hypersensitivity to chickpeas. Prick tests and CAP-RIA demonstrated multiple positive reactions to other legumes.

Anaphylaxis↗
PubMed1995

Influence of the menstrual cycle on skin-prick test reactions to histamine, morphine and allergen.

The purpose of this study was to examine the possible influence of the phases of the menstrual cycle on dermal reactivity to skin-prick testing. We studied 15 atopic, menstruating women with seasonal rhinoconjunctivitis and/or asthma, with known sensitivity to olive and parietaria (mean age 25.2 years) and 15 non-atopic, healthy, female controls (mean age 24.7 years). Skin-prick tests with histamine, morphine, and in the atopic group with parietaria/and/or olive, were repeated three times during the same menstrual cycle, corresponding to bleeding (day 1-4), midcycle (day 12-16) and the late progesterone phase (day 24-28). None of the patients had received oral antihistamines or exogenous hormones for at least 1 month prior to testing. Results indicate a significant increase in weal-and-flare size to histamine, morphine, and parietaria on days 12-16 of the cycle, corresponding to ovulation and peak oestrogen levels. This was observed in both atopic and non-atopic women. Differences in skin reactivity to histamine and morphine between the groups were not significant. Therefore, in women, the phase of the menstrual cycle is another factor that may influence skin-test results.

Adult↗
PubMed1995

Familial cold urticaria: a father and daughter with typical clinical and laboratory features.

BACKGROUND: Familial cold urticaria is a rare, autosomally dominant disease of interest to physicians treating urticarial-type diseases. OBJECTIVE: To describe two patients, a father and daughter with the characteristics of this disease and review the features that differentiate it from other cold-induced syndromes. METHODS: Both patients underwent a cold room challenge, a lesional skin biopsy, and an ice-cube test, P-K test and extensive laboratory studies pre- and post-cold-room challenge. RESULTS: A careful history revealed winter outbreaks of erythematous, nonpruritic lesions occurring hours after cold air exposure since early childhood. Systemic symptoms included burning, chills, and arthralgias rather than the anaphylactic symptoms associated with acquired urticarias. Cold room challenge induced "non-urticarial" lesions after a delay of one-half to two hours. Lesional biopsy demonstrated polymorphonuclear infiltration with increased eosinophils. Ice-cube tests and P-K tests were negative, and laboratory studies were remarkable only for a rise in leukocytes and erythrocytic sedimentation rate after positive challenge. Abnormal serum proteins were not found. CONCLUSION: Familial cold urticaria is an inherited disease with distinct characteristics that distinguish it from acquired cold urticarias and other cold-induced syndromes. Most importantly, lesions occur with a delay after exposure to cold air and are not urticarial. Anaphylactic symptoms do not occur and abnormal serum proteins are not found.

Adult↗
PubMed1994

Serum immunoglobulins and IgG subclass levels in adults with chronic sinusitis: evidence for decreased IgG3 levels.

Serum immunoglobulin class and IgG subclasses were measured in 30 adult patients with chronic sinusitis documented by CT scans of the paranasal sinuses. Results were compared to 30 age-and-sex matched patients with chronic rhinitis who had normal sinus CT scans, and a matched group of asymptomatic, healthy subjects. None of the patients was taking oral corticosteroids and none had ever received allergen immunotherapy. IgA deficiency was present in 3% (2/60) of the patients with chronic rhinitis or sinusitis and IgG deficiency was seen in another two (3%). None of the normals had low IgA or IgG. Low levels of IgG1 or IgG3 were found in some patients in all three groups, while none had low IgG2 levels. Serum levels of IgG, IgA, IgM, IgG1, IgG2, and IgG4 were not significantly different between the groups. Mean serum IgG3 levels, however, were significantly lower in the chronic sinusitis group than the chronic rhinitis group (P < .003) or the normals (P < .0005). The incidence of below normal levels of IgG3 was also more frequent in chronic sinusitis than in chronic rhinitis (P < .04) or normals (P < .002). Patients in the chronic sinusitis group had a high incidence of asthma (57%) and atopy (45%) but there was no difference in immunoglobulin class or IgG subclass levels in matched asthmatics compared with nonasthmatic patients with chronic sinusitis. Atopic patients with chronic sinusitis had a higher frequency of IgG3 subclass deficiency than nonatopics (P = .04). Normalization of low immunoglobulin class or IgG subclass levels that coincided with clinical improvement was documented in two patients with sinusitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Anaphylaxis associated with a change in premarin dye formulation.

Coloring agents are frequently added to drugs, foods, and cosmetics. If approved by the FDA, these additives may be added or substituted without notifying physicians. A patient developed angioedema, wheezing, urticaria, and dizziness one hour after taking the first Premarin tablet from a new refill. She had previously tolerated Premarin daily for 7 months without any adverse reactions. The new tablets were noted to be a slightly different shade of maroon and subsequent investigation revealed that the dye formulation had been changed (FD&C red #3 and FD&C yellow #6 were changed to FD&C red #40 and D&C #27). Puncture skin testing with a suspended tablet from the new Premarin batch was positive but was negative to a different drug (dye-free). Premarin skin testing in two normal volunteers was negative. The patient has since tolerated transdermal estrogen without any adverse reactions. These findings suggest that an additive in the Premarin tablet, most likely one of the new dyes, and not the estrogen, was the cause of the anaphylaxis. Physicians need to be aware that inactive ingredients can be changed without warning and these new constituents may cause sudden and potentially very severe allergic reactions to previously tolerated medication.

Adult↗
PubMed1993

Sinusitis and atopy in human immunodeficiency virus infection.

Sinusitis is increased in patients with human immunodeficiency virus (HIV) infection. To determine the underlying mechanism(s), 37 HIV-positive patients were evaluated. HIV-negative controls included 21 with rhinosinusitis, 32 with atopy, and 16 without sinusitis. Twenty-two HIV-positive patients (59%) had sinusitis; 14 of them had AIDS. There was a significant association between sinusitis severity and stage of HIV infection (P < .05). IgE levels were higher in the HIV-positive patients, increased with disease progression, and were strongly correlated with sinusitis severity (P < .01). Of HIV-positive patients, 72% exhibited more than two positive skin tests compared with 24% of HIV-negative rhinosinusitis patients and 12.5% of controls (P < .05). Sinusitis is common in HIV-positive patients, especially those with AIDS. HIV causes an allergic diathesis with increased IgE levels and allergic reactivity. There is a significant correlation between IgE levels and sinusitis severity, suggesting sinusitis is part of this acquired atopic state.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Seasonal influence on patch test results in Greece.

Several studies have been reported on the suppressive effect of ultraviolet B (UVB), UVA sunlight and PUVA on contact dermatitis. However, studies that have tested the hypothesis that patch tests reactions have a seasonal variation due to the suppressive influence of sunlight, had found conflicting results. In order to clarify the influence of climate conditions in Athens, Greece (sunlight, temperature, latitude 38 degrees) on patch tests results, data from 5468 patch-tested patients (1978-1990) were analyzed for monthly, seasonal variation. In addition, 180 patients with a high degree of sun exposure due to occupation that were prospectively re-patch-tested in a different season (i.e. summer versus winter), with the same allergens and technique, were studied and analyzed statistically. Climate data was provided by the Hellenic National Meteorological Service. The results indicate that there is no significant influence on patch tests reactions in Athens, Greece. This may in part be due to the small differences in climate conditions that exist between summer and winter in Greece.

Allergens↗