Mobilization of epidermal langerhans cells - reply from the authors
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Biomedical subjects
Publications and source records attributed to M Bhushan.
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The principle of patch testing is to identify individuals with a contact allergy of relevance to their disorder and to provide avoidance advice in an attempt to improve or resolve their condition. We aimed to define an optimum referral rate to a centralized contact dermatitis unit using a retrospective analysis of data relating to 10 consultants. The results showed no significant difference (P = 0.21) in the percentage of relevant positive individuals identified between the consultants. However, a linear relationship (r = 0.99) was seen between the number of relevant positive allergic reactions and the number referred by individual consultants. We propose that the minimal annual referral rate for patch testing from a predominately urban population in a developed country is one in 700 of the population.
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Neovascularization appears to play an early and important part in the evolution of psoriatic plaques. We studied the distribution and production of two known angiogenesis factors, endothelial cell stimulating angiogenesis factor (ESAF) and vascular endothelial growth factor (VEGF), in the skin of patients with chronic plaque psoriasis and normal control subjects. Our results showed that tissue levels of ESAF and VEGF were significantly elevated in involved as compared with normal control skin (P = 0.006 and P < 0. 0001, respectively). Tissue levels of ESAF and VEGF were also raised in involved skin as compared with uninvolved skin in patients with psoriasis (P = 0.001 and P < 0.0001, respectively). Tissue levels of ESAF and VEGF in plaques of psoriasis correlated closely with the clinical severity of psoriasis (r = 0.6 and r = 0.9, respectively). Serum levels of ESAF and VEGF were significantly raised in patients with psoriasis as compared with control subjects (P = 0.001 and P = 0.02, respectively). In vitro culture studies revealed that ESAF is produced by both keratinocytes and fibroblasts in approximately equal quantities in normal skin, whereas VEGF is secreted predominately by keratinocytes. A similar pattern is seen in both involved and uninvolved skin of patients with psoriasis. However, there is increased secretion of both factors in keratinocytes and fibroblasts from involved and uninvolved skin as compared with normal control skin (P < 0.001). The increased levels and secretion in plaques of psoriasis of two molecules, ESAF and VEGF, known to promote new blood vessel formation, suggest a pathogenetic role for them in this disease.
There has been controversy about the possible link between bullous pemphigoid and underlying malignancy. We report a case of bullous pemphigoid with marked figurate erythema which arose shortly before the clinical presentation of colonic carcinoma and cleared completely 1 week after its resection. We review the literature and conclude that patients who present with clinically atypical bullous pemphigoid may warrant investigation for underlying neoplasia.
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We report a patient with multiple glomus tumours and Coats' disease of the retina, an association not previously described. We discuss the possible pathogenesis of these conditions in view of the finding of elevated serum levels of basic fibroblast growth factor.
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