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Biomedical subjects

T Reunala

Publications and source records attributed to T Reunala.

At least 163 records · Page 9Linked to original sources
PubMed1988

Acne fulminans with bone lesions.

We present 5 young men who developed acne fulminans. During the acute, febrile illness, all had musculoskeletal symptoms, and X-ray and bone scan examinations revealed that 4 of the patients had osteolytic bone lesions. The disease was resistant to various antibiotics and one patient needed surgical trepanation of the sternum. No evidence of sepsis or bacterial osteomyelitis was found, as all bacteriological cultures proved negative and the tissue reaction was unspecific. The dermatopathogenetic origin of bone lesions in the present patients seems evident, but speculation that the etiology depends on immune mechanisms remains open.

Acne Vulgaris↗
PubMed1988

Contact urticaria from rubber gloves.

Surgical rubber (latex) gloves can cause contact urticaria and even more severe allergic symptoms; the frequency of this allergy may be as high as 3 per cent among hospital employees. Those at high risk are surgeons and instrument nurses, most of whom are atopics. Clinical history of immediate rubber-glove allergy can be misleading, but the diagnosis is easily confirmed by prick, use, and RAST tests. Sensitized persons manage well by using plastic undergloves or vinyl gloves.

Dermatitis, Contact↗
PubMed1988

Comparison of etretinate (Tigason) and parenteral gold in the treatment of psoriatic arthropathy.

Etretinate is a synthetic vitamin A derivate given orally for the treatment of severe skin psoriasis. This drug has been reported to be effective also in psoriatic arthropathy and in this study we compared the efficacy and side-effects of etretinate with those of parenteral gold. Sixteen out of 18 patients completed 6 months of therapy with etretinate (initial dose 0.7 mg/kg/day) whereas only 7/9 patients completed 6 months of therapy with parenteral gold. A statistically significant decrease in the joint index occurred in both groups. In the etretinate group, the musculoskeletal symptoms improved considerably in 12 (67%) patients completing the treatment, and at the end of therapy also the skin lesions had healed or improved markedly in most patients. In two patients the reasons for terminating etretinate treatment were hypertriglyceridaemia and epigastric pain. In the gold group, seven patients could not complete the treatment regimen due to the common toxic side-effects of gold. The results of this study confirm that both etretinate and parenteral gold are effective in treating psoriatic arthropathy, and show that etretinate treatment seems to cause fewer harmful side-effects than chrysotherapy with parenteral gold.

Adult↗
PubMed1987

Decreased monocyte production of interleukin-1 and impaired lymphocyte proliferation in atopic dermatitis.

We studied lymphocyte proliferation and subsets in ten atopic dermatitis (AD) patients and ten healthy controls. In addition, monocyte production of interleukin 1 (IL-1) was investigated. Mean numbers of total T cells, T-cells subsets, and B cells did not significantly differ between AD patients and controls even though the patients had slightly decreased amounts of suppressor T lymphocytes. Proliferative responses of AD patients to purified protein derivative of tuberculin (PPD), concanavalin A (ConA), or allogeneic cells did not significantly differ from those of healthy controls at optimal stimulant concentrations. In contrast, at suboptimal concentrations, AD patients showed a diminished response to all of these stimulants. Monocytes from AD patients elaborated clearly less IL-1 than those from healthy controls.

Adult↗
PubMed1987

Langerhans cell- and T-lymphocyte functions in patients with atopic dermatitis with disseminated cutaneous herpes simplex virus infection.

We studied whether Langerhans cell (LC)- and T-lymphocyte functions of atopic dermatitis (AD) patients are impaired. Our study groups consisted of 6 patients with AD with previous disseminated herpes simplex virus infection (AD + HSV), 8 patients with ordinary AD, and 5 healthy subjects. Suction blisters were performed on abdominal skin and LC isolated on the basis of their attachment to IgG-coated erythrocyte monolayers. Antigen-presenting function of purified LC was studied by measuring the proliferation of HSV-stimulated T cells. Langerhans cells were also used to stimulate T cells in autologous mixed cell reaction (AMCR). In addition, the production of epidermal cell thymocyte-activating factor (ETAF) by crude epidermal cells was measured. The HSV-induced T-cell proliferation in AD + HSV and AD patients was comparable with that of controls. The AMCR responses of patients with AD + HSV and AD were clearly diminished when compared with healthy controls. Patients with AD also produced significantly less ETAF than controls. Our results suggest that HSV antigen-presenting function of LC from patients with AD + HSV seems to be intact. Defective AMCR may reflect an abnormality in autoregulation and generation of effector cells and this together with decreased ETAF production may have pathogenetic significance in AD.

Antibodies, Viral↗
PubMed1987

IgA anti-endomysial antibodies in dermatitis herpetiformis: correlation with jejunal morphology, gluten-free diet and anti-gliadin antibodies.

Circulating IgA-class anti-endomysium antibodies (EmA) can be detected by indirect immunofluorescence on monkey oesophagus sections. We found EmA in 22 (76%) of 29 patients with dermatitis herpetiformis (DH) on a normal, gluten-containing diet. The highest frequency (100%) of EmA was observed in patients with sub-total villous atrophy. IgA-class antigliadin antibodies (AGA) were found using an ELISA method in 59% of 29 DH patients and in 86% of those with sub-total villous atrophy. There was a significant correlation between EmA titres and AGA levels in individual patients. Gluten-free diet (GFD) treatment caused a rapid decrease in EmA titres; only three of the 12 patients still showed raised EmA after 6-12 months on a GFD and two of these three had failed to adhere to a strict diet. In contrast, no decrease in EmA titres occurred in four patients maintained on a normal diet, and two of the three patients with initially negative EmA developed positive titres when continuing on a normal diet. These results show that both IgA-class EmA and AGA are good indicators of jejunal damage in DH. The rapid fall of EmA titres after gluten withdrawal indicates that this test is also useful for monitoring a patient's adherence to a GFD.

Adolescent↗
PubMed1987

Parakeratotic horns in a patient with myeloma.

We describe a patient who in association with myeloma developed generalized keratotic horns. Light microscopy revealed parakeratotic plugs resembling those seen in Kyrle's disease. Electron microscopy showed distortion of keratinosomes and laminated bodies indicating a profound disturbance in keratinization. A strong C3 and weaker IgG and IgA immunofluorescence were seen in the areas of epidermal plugs and horns but no circulating epidermal antibodies were detected. All symptoms disappeared when therapy for myeloma was started favoring that they were of paraneoplastic origin.

Humans↗
PubMed1987

No evidence of hypersensitivity to dental restorative metals in oral lichen planus.

Twelve patients with oral lichen planus (OLP) suspected of dental restorative metal allergy were examined. All patients were patch tested with several metals including six different mercury compounds. One (8%) patient showed a positive patch test to two mercury compounds whereas no mercury allergy was found in a reference group of 17 patients suspected of dental restorative material allergy but without OLP lesions. The mercury allergic OLP patient was further tested on palatal mucosa but no reactions developed. Moreover, the energy dispersive X-ray microanalysis failed to show any contaminating metals in his OLP lesion. Mucosal biopsies were taken in close contact with amalgam fillings from nine OLP patients but these disclosed no evidence of lichenoid or dysplastic alterations. In OLP lesions, the immunofluorescence findings showed fibrinogen deposition, altered basement membrane and elastic fiber staining and intense Ulex europeaus I lectin fluorescence through all epithelial cell layers. Therefore, the present patch tests did not reveal increased frequency of mercury or other metal allergy in OLP patients and the mucosal biopsies failed to show any histologic or immunofluorescence alterations deviating from idiopathic OLP lesions.

Adult↗
PubMed1987

Light- and electron-microscopic findings in lichen sclerosus of the vulva during etretinate treatment.

Fifteen women with lichen sclerosus (LS) of the vulva were treated for 3 months with 0.6 mg/kg of etretinate. The clinical response was good in 11/15 of the patients and, in agreement with this, light microscopy showed decreasing atrophy and hyperkeratosis together with subsiding inflammatory changes. However, orcein staining demonstrated that even after etretinate treatment, elastic fibers were still absent in the upper dermis with only few fibers being detectable in some specimens. Conventional electron microscopy and immunoelectron microscopy were used to examine these changes more in detail. Antiserum to the microfibrillar part of the elastic fibers confirmed that only remnants of microfibrillar coat persisted in the upper dermis and that deeper in the dermis, elastic fibers were porous and fragmented. These findings demonstrate that despite the normalization of clinical and certain histological parameters during etretinate treatment, the initial elastic fiber damage persists both at the light- and electronmicroscopic levels.

Adult↗
PubMed1987

Isotretinoin treatment of rosacea.

Twenty patients with severe rosacea were treated with isotretinoin for 3-6 months. Six patients initially received 1.0 mg/kg and 14 patients 0.5 mg/kg of isotretinoin. The response was good or excellent in all patients and the papulopustular lesions in particular cleared promptly. Patients receiving 1.0 mg/kg of isotretinoin experienced more side-effects and the dose had to be lowered in five of the six patients. Seventeen of the 20 patients had no relapses during a follow-up of one year showing that isotretinoin has a long-lasting favourable effect in rosacea.

Adult↗
PubMed1987

Stereospecific inhibition of human epidermal cell interleukin-1 secretion and HLA-DR expression by cis-urocanic acid.

UV radiation is known to photoisomerize trans-urocanic acid (trans-UCA) into a stable isomer, cis-urocanic acid (cis-UCA). To study the possible immunomodulatory effects of cis-UCA, the two isomers were added separately to different in vitro assays employing human epidermal cell suspensions or purified human peripheral T lymphocytes, supplemented with epidermal cells. Cis-UCA but not trans-UCA suppressed interleukin-1 (IL-1) production by epidermal cell suspensions in a dose-dependent fashion and diminished the number of HLA-DR positive epidermal cells to 61% of control values. An inhibitory effect on epidermal cell accessory function could be demonstrated with both isomers of UCA, but only if UVB-irradiated epidermis was used as a source for the epidermal cells. Taken together, the findings of our study lend indirect support to the concept of cis-UCA as a possible mediator of UV-radiation-induced immunosuppression.

Adjuvants, Immunologic↗
PubMed1987

Dermatitis herpetiformis and celiac disease associated with Addison's disease.

We treated two patients with dermatitis herpetiformis and Addison's disease, and one patient with celiac disease without the rash, but with Addison's disease and juvenile diabetes. In two of the patients, the concomitant diseases also included a thyroid disease. The predisposing factors to the multiple endocrine disorders in these patients with gluten-sensitive skin and/or small intestinal disease remained unknown. Two of the three patients had HLA-B8, none was known to have affected relatives, and the Addison's disease appeared before, at the same time, or after the patients contracted dermatitis herpetiformis or celiac disease.

Addison Disease↗
PubMed1986

Enrichment of human epidermal Langerhans cells by attachment to erythrocyte monolayers.

The present investigation introduces a method for purification of human epidermal Langerhans cells (LC). The method is based on the attachment of LC to IgG-coated sheep erythrocyte monolayers via their Fc receptors. To optimize the enrichment assay, several variables were tested. The best results were obtained when epidermal cells were centrifuged against erythrocyte monolayers; the purification procedure was performed at 4 degrees C in the presence of 5% fetal calf serum, using about 6 X 10(6) epidermal cells per erythrocyte plate (diameter 5 cm). The average purity of the recovered LC was 80.9% and LC-depleted fractions contained an average of 0.5% DR-positive cells. LC were able to enhance significantly leukoagglutinin- and purified protein derivative-induced T lymphocyte proliferation and leukocyte migration inhibitory factor production.

Animals↗
PubMed1986

Proteolytic enzymes in blister fluids from patients with dermatitis herpetiformis.

Proteolytic enzymes may be involved in blister formation in dermatitis herpetiformis (DH). We have examined collagenase, gelatinase and elastase-like enzyme activities in fluids collected from spontaneous blisters and from suction blisters raised on developing DH-lesions induced by application of potassium iodide. Control suction blisters were raised on unaffected DH-skin and on healthy volunteers. High enzyme activities were found in spontaneous blisters, and suction blister fluids obtained from developing lesions showed increased levels of gelatinase and elastase-like enzymes. Inhibitor studies revealed that a part of the elastase-like enzyme activity might be derived from inflammatory cells. Gel filtration chromatography disclosed two separate elastase-like enzymes which, as they had high molecular weights, could be either enzyme-inhibitor complexes or aggregates.

Blister↗
PubMed1986

Human epidermal Langerhans cells and peripheral blood monocytes. Accessory cell function, autoactivating and alloactivating capacity and ETAF/IL-1 production.

We compared the functional capacities of human epidermal Langerhans cells (LC) and peripheral blood monocytes. Epidermal sheets were obtained by a suction blister device. After enzymatic treatment LC were enriched by attaching them to IgG-located erythrocyte monolayers. On a per cell basis, LC were several times more efficient accessory cells than monocytes in augmenting nickel-and tuberculin (PPD)-induced T-cell proliferation. In mixed cell cultures LC stimulated both autologous and allogeneic T cells, whereas monocytes stimulated only allogeneic cells. In addition, LC were significantly more potent allogeneic stimulators than monocytes. Although monocytes were weaker accessory cells and allogeneic stimulators than LC, they induced higher interleukin 1 (IL-1) activities than LC-enriched or LC-depleted cells. These results indicate that there are functional differences between LC and monocytes and that antigen presentation and mediator secretion are not correlated.

Antigen-Presenting Cells↗