[Letter: Treatment of alopecia areata].
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Biomedical subjects
Publications and source records attributed to W N Meigel.
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Three young male patients with chewing pads are reported. Their tic-like habit of chewing on the dorsal aspects over the middle joints of fingers I-IV caused a pad-like thickening of soft tissue. These chewing pads are a variant of "false" knuckle pads. The importance of a medical history and dermatological inspection is stressed to avoid unnecessary diagnostic procedures. This harmless augmentation of soft tissue is commonly confused with rheumatoid disease of the fingers, sarcoidosis or pachydermoperiostosis. Patients should be informed of the true nature of their pads, as discontinuation of their chewing habit will resolve their problems.
A patient is reported, who tried to simulate a positive patch test reaction by scratching one of the patch-tests. When reading the results of patch-testing, the possibility of manipulation has to be considered, especially when dealing with compensation cases. Certain modifications of the test are proposed to avoid these problems.
Recent studies have established that connective tissue contains several chemically and genetically distinct collagens. Here we discuss the nature of these proteins, their occurrence in different tissues and their involvement in disease processes. Types I, II and II collagens show some similarities indicating a common origin. Morphological studies using antibodies against the various collagens indicate that the different collagens occur in different anatomical structures. Alterations in the distribution of these collagens are seen in tissues in certain disease states and may cause the loss of normal tissue function.
An infant is described with acrodermatitis enteropathica, who initially presented with severe and intractable watery diarrhea. Diagnosis was established at the age of eleven weeks. Serum-zinc concentrations were extremely low and urinary zinc excretion was diminished. Eleven days after oral zinc supplement (100 mg elemental zinc per day), the skin lesions had healed. The high therapeutic doses of zinc required for healing are suggestive that zinc malabsorption is an important pathogenetical factor of this disease.
Fibroblasts derived from skin biopsies of a patient with a congenital defect of connective tissue revealed a disturbance in collagen synthesis. The defect was found in the mechanism that controls the type of collagen synthesized. Biochemical data as well as evaluation of immunofluorescent micrographs using collagen type-specific antibodies, suggested that the fibroblasts of this patient synthesized type III collagen, at a time and rate which was not found in fibroblasts from an age-matched healthy individual.
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