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Biomedical subjects

M W Greaves

Publications and source records attributed to M W Greaves.

At least 127 records · Page 7Linked to original sources
PubMed1989

The effect of psoralen photochemotherapy (PUVA) on symptomatic dermographism.

A controlled trial of 4-weeks oral photochemotherapy (PUVA) on 14 patients with severe symptomatic dermatographism produced a clinically useful reduction in itching in five patients. In four of these patients itching had relapsed to pre-treatment levels within 3 months of finishing the PUVA course. A comparison of the weal and flare responses on exposed and covered (control) skin using a calibrated dermographometer showed no significant change in skin reactivity, even in the patients who experienced symptomatic relief. While PUVA may temporarily reduce itching in some patients with symptomatic dermographism, its use cannot generally be justified for treating this type of physical urticaria.

Adult↗
PubMed1989

A double-blind comparison of the efficacy of betamethasone dipropionate cream twice daily versus once daily in the treatment of steroid responsive dermatoses.

A total of 97 out-patients with steroid responsive dermatoses (63 eczema, 34 psoriasis) were recruited from two centres. They were randomly allocated in a double-blind manner to receive either betamethasone dipropionate cream twice daily or betamethasone dipropionate cream in the morning and base cream in the evening. The treatment period was 3 weeks. Eighty-five patients completed the study. There were no statistical differences between once daily application and twice daily for all of the parameters studied in both the eczema and psoriasis patients. Analysis of the diary card records, however, showed that symptomatic relief occurred more quickly in eczema patients receiving twice daily application of betamethasone dipropionate cream (P = 0.03). The use of betamethasone dipropionate cream once daily in conjunction with an emollient provides a regime which is as effective as a twice daily application of betamethasone dipropionate.

Administration, Topical↗
PubMed1989

A timed study of the histopathology, direct immunofluorescence and ultrastructural findings in idiopathic cold-contact urticaria over a 24-h period.

The histopathology, immunofluorescence and ultrastructure of skin in idiopathic cold-contact urticaria have been studied over the 24 h following the application of a cold stimulus sufficient to provoke a confluent weal on the anterior thigh. Biopsies were taken 10 min, 2 h and 24 h after ice removal. Considerable epidermal and dermal oedema was present. Type I and Type II mast-cell degranulation was noted but was not universal. Lymphatics and capillaries were dilated and endothelial cells showed an increase in micropinocytotic activity, without evident vasculitis. In two cases packed platelets were seen within vessel lumina. There was no change in the infiltrating dermal cell population and direct immunofluorescence was negative. The evidence suggests that idiopathic cold-contact urticaria is an exudative rather than an infiltrative process.

Adolescent↗
PubMed1989

Local increase in interleukin-1-like activity following UVB irradiation of human skin in vivo.

Using an in vivo skin chamber method, we demonstrated increased release of interleukin-1 (IL-1)-like activity at the site of irradiation with 3 times the minimal erythema dose of ultraviolet B (UVB). IL-1-like activity was estimated using the mouse thymocyte amplification assay. UVB-augmented release of IL-1-like activity peaked 1 h after irradiation and levels returned to baseline by 2 h. Release of IL-1-like activity from human skin after exposure to UV radiation may account for some of the local and systemic features of the sunburn response.

Adult↗
PubMed1988

Prostaglandin D2 and histamine release in cold urticaria unaccompanied by evidence of platelet activation.

Six patients with acquired primary cold urticaria and six normal control subjects were challenged with a 5-minute immersion of an arm in cold water, at 10 degrees C, to induce cold urticaria. Venous blood draining the arm was sampled before and at 5 and 20 minutes after challenge. Prostaglandin D2 levels in the serum increased significantly after cold challenge but did not correlate with the severity of the urticaria. Significant elevations in histamine after cold challenge tended to be higher in the patients with a low threshold to cold reaction. Two markers of platelet activation, platelet factor 4 and beta-thromboglobulin, remained at basal levels 5 minutes and 20 minutes after challenge.

Adult↗
PubMed1988

Delayed pressure urticaria. Clinical features, laboratory investigations, and response to therapy of 44 patients.

We studied 44 patients with delayed pressure urticaria. The mean age at onset of the disease was 33 years (range, 5 to 63 years) and the mean duration of disease was 9 years (range, 1 to 40 years). After pressure stimulus, the mean onset of whealing occurred in 3 1/2 hours, the mean peak swelling occurred after 10 hours, and the mean lesion duration was 36 hours. Two thirds of patients had generalized flulike symptoms. Sixty percent had disabling nonremitting delayed pressure urticaria. Sixty-two percent had coexistent chronic idiopathic urticaria, and 27% had angioedema. Delayed pressure urticaria was confirmed by pressure tests with either a calibrated dermographometer or suspended weights. More than 50% of patients tested also had delayed dermographism. A double-blind, controlled, crossover trial of indomethacin therapy in 14 patients revealed no significant subjective improvement or reduction in area of induced wheals. We conclude: (1) The diagnosis of delayed pressure urticaria can be easily made by dermographometer testing. (2) Delayed dermographism may be the same entity as delayed pressure urticaria induced by a different method of pressure application. (3) Systemic corticosteroids remain the only known effective treatment for disabling delayed pressure urticaria.

Adolescent↗
PubMed1988

Dermatopharmacology: drugs around the corner.

This article describes impending advances in drug treatment of skin diseases. We have included the following categories: (1) interesting new drugs for which there are reasonable prospects of eventual licensing for skin indications, (2) important novel compounds whose progress through licensing procedures, although incomplete at the time of writing, is advanced, and (3) new indications or improved regimens that have recently emerged for established drugs.

Azathioprine↗
PubMed1988

Actions of platelet activating factor (PAF) homologues and their combinations on neutrophil chemokinesis and cutaneous inflammatory responses in man.

The inflammatory actions of synthetic C16:0 and C18:0 platelet activating factor (PAF) homologues, both alone and in combination, have been compared in an in vitro human neutrophil chemokinesis assay and by intradermal injection in human skin. In the chemokinesis assay, the maximum distance moved by neutrophils in the presence of C18:0 PAF was significantly greater than that seen with the C16:0 compound. A mixture of C16:0 and C18:0 PAFs in a ratio of 1:9 appeared to be more active than in a ratio of 3:1. Intradermal injection of the C16:0 and C18:0 PAF homologues induced dose-dependent increases in weal volume and flare area responses which were not significantly different. Combination of these phospholipids in a ratio of 3:1 or 1:9 of C16:0:C18:0 did not significantly alter the dose response curves. Thus, changes in the chain length of the alkyl substituent of synthetic PAF homologues and combination of these homologues, in ratios found in vivo or formed by leukocytes in vitro, did not alter the cutaneous inflammatory responses to PAF in man. The C18:0 homologue was, however, more active as a human neutrophil chemoattractant in vitro.

Chemotaxis, Leukocyte↗
PubMed1988

The in vitro 5-lipoxygenase and cyclo-oxygenase inhibitor L-652,343 does not inhibit 5-lipoxygenase in vivo in human skin.

1 3-hydroxy-5-trifluoromethyl-N-[2-(2-thienyl)-2-phenyl-ethenyl]-benzo(B) thiophene-2-carboxamide (L-652,343) is a 5-lipoxygenase and cyclo-oxygenase inhibitor in vitro. 2 In psoriasis increased concentrations of arachidonic acid transformation products are found in the lesional skin which may be important in the pathogenesis of the disease. We have measured the effect of orally administered L-652,343 on the concentration of LTB4 and prostaglandins in the lesional skin. 3 Eight patients with stable chronic plaque psoriasis received 500 and 250 mg of L-652,343, 12 h apart. A chamber technique was used to collect skin exudate samples from abraded plaques before and at 4, 24 and 48 h after the first dose. Exudates were analysed for LTB4 by a neutrophil chemokinesis assay and for PGE2 and PGD2 by RIA. 4 PGE2 and PGD2 levels were significantly reduced at 4 and 24 h after the first dose of L-652,343 but LTB4 levels were not affected indicating inhibition of the cyclo-oxygenase pathway but not of the 5-lipoxygenase pathway. This shows the importance of confirming that the action of 5-lipoxygenase inhibiting drugs in vitro occurs in vivo.

Adult↗
PubMed1988

Pharmacological modulation of cold-induced pain in cutaneous leiomyomata.

In two patients with painful cutaneous leiomyomata, induction of pain by the application of an ice cube allowed assessment of a number of topical and systemic treatments aimed at reducing or preventing the pain. In one patient the alpha-adrenoceptor blocker, phenoxybenzamine alleviated cold-induced pain. In the second patient, topical 9% hyoscine hydrobromide (an anticholinergic agent) decreased pain induced by the ice cube, but was not helpful in reducing lesional pain due to cold weather.

Adult↗
PubMed1988

Combined cold urticaria and cholinergic urticaria--clinical characterization and laboratory findings.

Thirteen patients with both cold and cholinergic urticaria are reported. There was considerable variability, particularly in the cold urticaria which was of the common cold contact type in seven patients, of the generalized cold induced cholinergic type in two and in four patients the lesions induced by direct contact with ice were morphologically like cholinergic urticaria, but appeared despite prior application of an acetyl choline antagonist. The natural history, laboratory findings and the effects of therapy are discussed.

Adolescent↗
PubMed1988

Intestinal mucosal mast cells: enumeration in urticaria pigmentosa and systemic mastocytosis.

Endoscopic gastrointestinal mucosal biopsy specimens from one patient with systemic mastocytosis and five with urticaria pigmentosa (UP) were fixed with Carnoy's reagent and then stained for chloracetate esterase. The mast cell population densities were enumerated in the mucosa using cursor planimetry. Compared with controls, mast cell counts were increased in gastric and duodenal but not sigmoid mucosae. On a histological basis, systemic involvement would appear commoner in urticaria pigmentosa than is generally expected. Gastrointestinal symptoms did not relate to elevated mucosal mast cell counts.

Adult↗