[Skin lesions in graft versus host disease].
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Biomedical subjects
Publications and source records attributed to S Haim.
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This is a report of a case with a chronic peculiar intractable pyoderma. The process started a year after splenectomy because of trauma. In the absence of an apparent other reason, we assume that a relationship exists between the operation and the skin disease.
The leucocyte migration inhibition (LIF) was investigated in 16 patients with Behçet's disease, 5 while in the active stage of the process, 3 both during relapse and remission, and 8 during remission of symptoms. In all patients skin tests with various antigens and with a needle prick and physiological saline were simultaneously performed. The results indicate a strong correlation between the activity of the disease, skin reactivity and the reactivity of LIF.
Eosinophilic fasciitis is an additional clinical entity to many others manifested by sclerodermic changes in the skin. A case with this process is reported. It presents vast cutaneous sclerodermic changes associated with eosinophilia, signs of muscular exertion, and a massive inflammatory infiltrate involving the lower part of the dermis, subcutaneous tissue and the muscle fascia. Prednisone therapy was followed by rapid and marked improvement.
A pronounced vitiliginous reaction developed at the sites of MER/BCG injections given as an adjuvant immunotherapy to a patient with malignant melanoma. To our knowledge, this is the third report on patients exhibiting vitiligo apparently induced by immunotherapy and the first in association with MER. This association may be a sign for an antimelanocytic effect and may offer a further confirmation for the autoimmune nature of vitiligo.
Current concepts incriminate a cell-mediated mechanism in the pathogenesis of mucocutaneous lesions of Behçet's disease. However, such a mechanism alone fails to explain various aspects of hyperreactivity response which is a unique feature manifested with lesions similar to those occurring spontaneously in the disease. 19 patients with active Behçet's disease have been investigated for possible mechanisms other than cell mediated which may be involved in the process. Beside cell-mediated mechanisms there were indications that polymorphonuclear leucocytes and mast cells may play part in the process. Further study of these two aspects may open a new approach in the understanding and possibly in the treatment of this disease.
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A patient with Behçet's disease developed the rare complications of pericarditis and, two months later, superior vena caval obstruction. The latter complication was investigated by angiography to exclude other causes. As a result of this investigation the caval obstruction was managed conservatively, the symptoms and signs improving spontaneously.
This is a report on two cases with pemphigus vulgaris effectively controlled by dapsone. In one, dapsone was added to the treatment after a failure of combined prednisone and methotrexate therapy to control the disease completely. It is suggested that dapsone may offer a means in an attempt to minimize adverse reactions met with during the long corticosteroid regimen required in pemphigus.
This is a report of 2 cases revealing photosensitivity in association with aminoaciduria. The first is a patient with psoriasis and the second, a patient with Ehlers-Danlos syndrome, mitis type. The display of the above combinations seems peculiar. The psoriatic lesions become confined mainly to the exposed surface and intermingled with those of photodermatitis forming lesions which are a mixture of the two processes. In the case with Ehlers-Danlos, the disease presented rupioid plaque-like erythematous oozing lesions which seem somewhat different from those of the photodermatosis yet known.
This is a report of three cases of associated tuberculous and neoplastic processes. The first is a case of lymphosarcoma complicated by cutaneous tuberculosis. The remaining two are cases of cutaneous tuberculosis complicated by squamouse cell carcinoma. Due to clinical similarity, the diagnosis of the secondary process in these cases was evoked by its failure to respond to treatment of the primary disease.
Histocompatibility antigens (HL-A) were studied in a family with Behçet's disease (BD). All who had symptoms or signs of BD had either HL-A B5 or BW35, or both. The increased number of families with BD recently reported supports the suggestion that positive family history may assist the diagnosis of BD.
Thirteen patients with localized granuloma annulare and 19 with the generalized form of the disease were typed for HLA antigens. The control group consisted of 70 matched apparently healthy subjects. No significant difference in the frequencies of the 26 tested antigens was revealed between patients with localized granuloma annulare and controls. Patients with the generalized form of the disease showed a highly significant increase in the frequency of HLA-Bw35 as compared with both controls and patients with the localized form of the disorder (P = 0.001 and 0.01 respectively). The results seem suggestive of a possible different pathogenesis of the two forms of the disease.