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Biomedical subjects

R A Marsden

Publications and source records attributed to R A Marsden.

At least 73 records · Page 4Linked to original sources
PubMed1981

Bullous pemphigoid: the frequency of mucosal involvement and concurrent malignancy related to indirect immunofluorescence findings.

A review of 124 cases of bullous pemphigoid was made and the clinical findings correlated with the results of indirect immunofluorescence. A circulating IgG basement membrane zone (BMZ) antibody was detected in the serum of eighty-nine (72%) of the patients. Antibody titres in these patients did not correlate with the extent of the disease or with the presence of mucous membrane lesions. Indeed, oral lesions were more common in the thirty-five sero-negative patients with 17% of such patients being affected compared to only 10% of those with positive indirect immunofluorescence findings. This difference, however, was not statistically significant. Concurrent malignant disease (i.e. malignancy occurring within 6 months of pemphigoid being diagnosed) occurred in eight of the seronegative group (23%) and in only four of the eighty-nine seropositive cases (4%); this difference was significant. The association of bullous pemphigoid and malignant disease still remains controversial, but those who believe that the relationship is coincidental must now explain why concurrent malignant disease is more common in patients who have bullous pemphigoid and negative indirect immunofluorescence findings.

Adult↗
PubMed1979

Comedo naevus of the palm--a sweat duct naevus?

A 9-year-old boy is described with keratotic pits on the left palm, present since birth, which clinically resembled those seen in comedo naevus. Histology and scanning electron microscopy of skin surface replicas showed the lesions to be large, abnormal sweat ducts. It is suggested that comedo naevi are not necessarily pilosebaceous in origin and that in our case the term sweat duct naevus may be more appropriate.

Child↗
PubMed1977

Herpetiform pemphigus induced by penicillamine.

A patient with arthritis is described who developed a dermatitis herpetiformis-like rash after 8 months of D-penicillamine therapy and which cleared soon after the drug was discontinued. The histopathological findings were compatible with a diagnosis of pemphigus, showing intra-epidermal vesicles and spongiosis but no acantholysis. Intercellular antibody was detected by indirect immunofluorescence at the onset of the eruption (titre 1 in 160) and also found in serum taken prior to penicillamine treatment (titre 1 in 20). It is now well known that D-penicillamine can induce pemphigus. The findings reported here suggest the possibility that the patient was predisposed to develop the eruption before the drug was given.

Arthritis, Rheumatoid↗
PubMed1977

Post-kala-azar dermal leishmaniasis.

Ten patients with post-kala-azar dermal leishmaniasis (2 females, 8 males-aged 17-47 years) are described. Two of them had macular lesions in which very few Leishman-Donovan bodies were seen and who responded well to treatment with stibophen. Five patients had both macular and nodular lesions, Leishman-Donovan bodies being present in nodules but not in macules. Treatment with stibophen caused partial regression of nodules. Nodular lesions were found in three patients, who did not have macules. They contained numerous Leishman-Donovan bodies and treatment produced only temporary improvement. The variable response to treatment with stibophen may have been due to differences in parasitic load. The difficulty in distinguishing this disease from leprosy is discussed.

Adolescent↗
PubMed1975

Effect on adrenal function of topically applied clobetasol propionate (Dermovate).

Thirty-nine patients (15 outpatients and 24 inpatients) with a variety of skin diseases affecting variable areas of the body surface were treated with clobetasol propionate ointment (Dermovate). Before and after treatment the adrenal response to an intramuscular injection of tetracosactrin was rested and additional 9 am plasma cortisol levels were measured at intervals during treatment. A satisfactory initial therapeutic response was achieved in almost all cases during the trial period. When more than 50 g of ointment a week was used a significant number of patients developed adrenal suppression. WHen less than 50 g per week was used any suppression tended to be transtion. These cysts may be the cause of this condition, producing abnormal amounts of ovarian steroids which modify the pituitary response. Futher studies are needed, however, to determine this possibility.

Adolescent↗