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Biomedical subjects

R K Winkelmann

Publications and source records attributed to R K Winkelmann.

At least 343 records · Page 19Linked to original sources
PubMed1976

Pathogenesis and staging of scleroderma.

Scleroderma is reviewed as a complex disease of vascular, connective-tissue, and inflammatory reactions. If the scleroderma syndromes related to occupational, immunologic, inflammatory, metabolic, and genetic factors are recognized, then true progressive systemic scleroderma (PSS) appears to be a disease of vascular fibrosis with secondary inflammatory phases. The primary pathology appears to be a fibromucinous change of the vascular endothelium. The vessels also demonstrate altered reactivity to cold and to serotonin. Biopsy of the skin of the inflammatory or mesenchymal scleroderma may reveal (by positive direct immunofluorescence) deposition of globulins at the basement membrane zone. Evaluation of scleroderma is discussed and a system of clinical staging of PSS is proposed which relates the organ involvement to the prognosis.

Calcinosis↗
PubMed1976

T and B lymphocytes in contact and atopic dermatitis.

The pattern of distribution of T and B lymphocytes was investigated in a group of patients with contact, atopic, and mixed dermatitis by means of immunofluorescence and T-cell rosette tests. A significant increase (P less than .001) in B lymphocytes with surface IgD but without changes in the lymphocytes bearing other immunoglobulins or C3 and T cells was noted in patients with contact dermatitis when compared with a control group. A significant increase (P less than .001) in B lymphocytes carrying IgE and a significant decrease (P less than .001) in the total numbers of T cells were noted in patients with atopic dermatitis, and a significant increase in B lymphocytes positive for IgD (P less than .001) and IgE (P less than .003) with a decrease in the number of lymphocytes bearing IgG were the most important changes observed in patients with mixed contact and atopic dermatitis.

Adolescent↗
PubMed1976

Treatment of Kaposi sarcoma with vinblastine.

Five cases of Kaposi sarcoma with vinblastine sulfate treatment were compared with 18 cases reported in the literature. Our experience with a low-dosage schedule emphasizes that toxicity is not necessary for a favorable result. Vinblastine seems to be an effective treatment for Kaposi sarcoma and, in selected cases, may supplement radiation therapy or be used alone.

Adult↗
PubMed1976

Benign papular acantholytic dermatosis.

Seven male patients, aged 41 to 63, had benign papular acantholytic dermatosis. The patients complained of firm, intensely pruritic, 1- to 3-mm, reddish-brown or flesh-colored papules. The lesions were usually found on the upper part of the torso or on the neck. At least five of the seven patients reported that sunlight initiated or exacerbated the condition. The mean duration of the disorder exceeded two years. Histologically, the predominant lesion in all seven cases was acantholysis. Dyskeratosis was not a characteristic finding, being absent in five of the seven cases and minimally present in two. We will compare the features of benign papular acantholytic dermatosis with those of other papular acantholytic disorders.

Acantholysis↗
PubMed1976

Coexistence of benign familial pemphigus and psoriasis vulgaris.

The treatment of psoriasis vulgaris in a 67-year-old woman was complicated by the presence of an acantholytic diathesis. The clinical and histologic evidence showed that the patient had an atypical phenotype of familial benign chronic pemphigus (FBCP) as well as psoriasis. Consideration of the possible effects of psoriasis and FBCP on each other may help explain some of the typical features noted in this patient.

Aged↗
PubMed1975

Granulomatous panniculitis in erythema nodosum.

A group of ten patients with granulomatous panniculitis was studied; five had erythema induratum of the tuberculous or the nontuberculous type and five had erythema nodosum. In both groups, histiocytic giant cells and lymphocytic inflammation of the fat were seen microscopically. Massive caseation was seen in the patients who had erythema induratum, but this was not a distinguishing feature between the tuberculous and the nontuberculous type. The clinical history in all instances was a reliable guide to diagnosis. No specific cause was found, and treatment was not specific. tin granulomatous panniculitis, the clinical pattern of disease is confusing in view of the histologic findings, and the diagnosis can be made with confidence only if the clinical findings are carefully correlated to the course of the disease.

Adult↗
PubMed1975

IgE in human eccrine sweat.

By the use of a sensitive and specific double antibody radioimmunoassay, immunoglobulin E was demonstrated in sweat from 6 of 11 healthy volunteers; the concentrations of IgE ranged from 1 to 3.9 ng/ml of sweat. Six of seven patients with dermatitis and elevated levels of serum IgE also had high IgE levels in sweat; the highest IgE value in sweat was 75.5 ng/ml and was noted in a patient with atopic dermatitis. Thus, all the main immunoglobulin classes can be demonstrated in eccrine sweat.

Adult↗
PubMed1975

New observations in the histopathology of erythema nodosum.

Erythema nodosum presents variable clinical and histologic patterns of response in the vessels, septa, and fat lobules of the subcutaneous tissue. Acute or chronic phlebitis with hemorrhage may be commonly observed; acute panniculitis is observed in foci, but at time it may be the principal histologic feature; lymphocytic infiltration of fat lobules is often found, and lymphoid nodules are not infrequent; rarely, chronic granulomatous lesions involve septa or fat lobules; and proliferative lipocyte response may be observed. Because these variable histologic patterns may be coexistent, excision biopsy and multiple sections are necessary to recognize them. The variable histologic features correlate with the different clinical forms: acute nodular, chronic nodular, migrating plaque lesion, cellulitis, and the rate suppurative form. This variety of panniculus response in erythema nodosum can be explained on the basis of host-tissue response to a delayed hypersensitivity reaction to an antigenic stimulus.

Adipose Tissue↗
PubMed1975

Dermal-epidermal deposition of complement components and properdin in systemic lupus erythematosus.

Skin lesions and clinically normal skin of thirteen patients with systemic lupus erythematosus (SLE) were examined, by the use of immunofluorescent techniques, to determine the presence of CIq, C3, C3 proactivator (C3PA), properdin, immunoglobulins (IgG, IgA, and IgM), and fibrin. IgM deposition was present in all thirteen skin lesions and in eleven normal areas tested, whereas IgG deposition occurred in eleven of the lesions but in only six normal areas. IgA was the least frequently encountered immunoglobulin. CIq deposition occurred in all thirteen skin lesions, and C3 deposition was present in twelve. Seven of nine and eight of eleven clinically normal areas demonstrated CIq and C3 deposition, respectively. Although less intense that CIq and C3 deposition, properdin deposition occurred in eight of the thirteen skin lesions tested but in only two of nine normal areas. C3PA deposition was of greater intensity than was properdin, but was seen in only five lesions and three clinically normal areas. Seven skin lesions and two normal areas also demonstrated fibrin deposition. Although alternate pathway activation is apparent, our findings suggest that the classical pathway (CI to C9) is the primary complement pathway involved in SLE skin.

Adult↗
PubMed1975

Peripheral blood lymphocyte distribution in scleroderma.

Determination in peripheral blood T and B lymphocytes performed in progressive systemic scleroderma (8 patients); dermatomyositis (5 patients); and inflammatory or mesenchymal scleroderma ('mixed' connective tissue disease) (5 patients) demonstrated a marked increase in peripheral B cells with T cell depression in patients with mesenchymal scleroderma. Patients with progressive systemic scleroderma and dermatomyositis demonstrated also a peripheral T depression, but no consistent changes in B cell population were found. The clear relationship between a B lymphocyte increase and elevated immunoglobulins, antinuclear and antiribonucleoprotein antibody and positive direct immunofluorescence of skin (basal membrane and blood vessels) defines inflammatory or mesenchymal scleroderma in which a disturbance in humoral immunity is involved. B lymphocyte determination can help to measure these changes in immunoreactivity.

Adult↗
PubMed1975

Livedo vasculitis (the vasculitis of atrophie blanche). Immunohistopathologic study.

Hyalinizing segmental vasculitis or livedo vasculitis (atrophie blanche) is a clinical entity with a distinctive immunohistopathologic morphology that can be distinguished from other forms of cutaneous vasculitis by histologic and direct immunofluorescent studies. Our studies showed that immunoglobulins and complement components (C-1g, C-3, and properdin) were localized in diseased vessel walls, suggesting an immune pathogenesis.

Atrophy↗
PubMed1975

[In vitro cellular immunity in lymphoproliferative skin diseases. Inhibitory factor of macrophages].

27 patients affected of lymphoproliferative processes, 9 with different non-granulomatous dermatosis and 40 controls are studied by the authors. The technique David & David is used to determine the inhibition of the migration of macrophages in capillary tubes, adding to the culture medium the serum of the patient. They find MIF-like activity in the serum of three patients affected by the sezary syndrome. All sutdied cases of cutaneous lymphoma, non granulomatous dermatosis and healthy controls are negative.

Animals↗