A patient with acute necrotizing vasculitis is described in whom tests for circulating immune complexes were negative. The patient's serum injected intradermally produced lesions which closely resembled those occurring spontaneously. When the serum was fractionated, the skin-reactive fraction was found to be associated with IgG, but was of a higher molecular weight than normal IgG. Immunofluorescent studies showed that lesions induced by this active fraction contained IgG and complement in the epidermal basement membrane zone and within the small dermal vessels. We conclude that an immune complex of relatively low molecular weight is present in the active fractions, and capable of initiating the lesions of acute necrotizing vasculitis.

Antigen-Antibody Complex↗

PubMed1976

The treatment of psoriatic nail dystrophy with intradermal steroid injections.

Thirty-seven patients with psoriatic nail dystrophy were treated with intradermal nail-fold injections of either triamcinolone acetonide or triamcinolone hexacetonide, using the Port-O-Jet needleless injector. Mild nail-matrix changes showed a very good response to treatment, whilst nail-bed and/or hyponychial changes causing onycholysis and the more severe types of dystrophy usually showed little improvement. Although in occasional cases this may be a useful form of treatment, we would not recommend its general use in patients with psoriatic nail dystrophy.

Female↗

PubMed1974

Letter: Haemorrhage from varicose veins.

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Adrenal Cortex Hormones↗

PubMed1974

Painful piezogenic pedal papules.

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Biopsy↗

PubMed1974

Systemic nodular panniculitis with cardiac involvement.

A case of systemic nodular panniculitis is described in which the myocardium was found at necropsy to be extensively involved with focal interstitial carditis, identical histologically with nodules of panniculitis biopsied from the skin. This degree of myocardial involvement, which was not apparent during life and was not confined to pericardial or myocardial adipose tissue, has not previously been reported. The literature relating to nodular panniculitis is briefly reviewed and the concept of Weber-Christian disease critically re-appraised.

Adipose Tissue↗

PubMed1972