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PubMed1980

Eosinophil chemotactic factor (ECF) in blister fluid of dermatological diseases.

The occurrence of low molecular weight (less than 500 dalton) eosinophil chemotactic factor (ECF) was studied in the blister fluid of patients with various dermatological diseases by an in vitro chemotaxis method. After chromatographic separation of the test substance on a small Sephadex G 25 column, ECF was demonstrated in blisters of five patients with bullous pemphigoid, in three patients with systemic drug reactions and in one patient with blisters are contact with primula. ECF was not found in blisters of patients with epidermolysis bullosa and herpes gestationis or in DNCB-induced blisters. Fluid obtained from suction blisters was negative in normal controls and in unaffected skin of patients with atopic eczema, but contained ECF in eczematous areas. The demonstration of ECF in tissue fluid suggests that this factor plays a role in the local accumulation of eosinophils at sites of certain inflammatory reactions.

Blister↗
PubMed1982

Serum antibody to staphylococcal teichoic acid and alpha-haemolysin in dermatological patients.

Teichoic acid antibody (TAA) titres and antibody to alpha-haemolysin of Staphylococcus aureus (ASta) were measured in 274 dermatological patients and 200 normal controls. Positive ASta values (greater than or equal to 2.0 iu/ml) were common in patients with chronic pruritic dermatoses such as atopic dermatitis (44% ASta positive) and infective eczema (28% ASta positive), but patients with primary pyoderma were all ASTa negative. Positive TAA titres (greater than or equal to 1:4) were seen less frequently than positive ASta values, but still significantly more often in atopic dermatitis patients than in controls. Routine skin swabs were taken from all patients, but positive TAA or ASta tests correlated neither with growth of Staphylococcus aureus from skin lesions nor with signs of clinical infection. This study shows that the TAA test cannot be used as an indicator of septic staphylococcal infection in patients with atopic dermatitis.

Adolescent↗
PubMed1985

The prevalence of accentuated palmoplantar markings and keratosis pilaris in atopic dermatitis, autosomal dominant ichthyosis and control dermatological patients.

The prevalence of keratosis pilaris and accentuated palmoplantar marking was evaluated in 61 patients with atopic dermatitis, 35 patients with dominant ichthyosis vulgaris and 247 other dermatological cases taken as controls. Our data showed that (1) these features are of no diagnostic significance for atopic dermatitis and (2) they are significantly more frequent in patients with ichthyosis vulgaris without associated eczema than in those with atopic dermatitis. Consequently, they should be considered as part of the phenotype of ichthyosis vulgaris rather than attributed to a concomitant atopic dermatitis as suggested by some. These findings should be taken into account when evaluating atopic dermatitis or ichthyosis. To assess the frequency of scaling under winter weather conditions, 155 control subjects were also examined for evidence of visible desquamation and 25.8% showed slight but definite scaling.

Adolescent↗
PubMed1989

Thallium poisoning: a dermatological perspective.

The dermatological findings in five patients with thallium poisoning are described. Cutaneous involvement consisted mainly of an acneiform eruption, pellagra-like dyssebacea, crusted eczematous lesions and dry scaling of the distal parts of the extremities. Alopecia was not evident initially but later became apparent. The patients also had gastrointestinal and neurological symptoms and signs.

Alopecia↗
PubMed1991

Dermatology and the human gene map.

Chromosomal localization has been established for many genetic traits. Gene mapping may lead to the identification of disease genes, an understanding of pathogenesis, and the development of rational therapy, as well as facilitating antenatal diagnosis and genetic counselling. 'The new genetics' is therefore of great interest to the clinician. Unfortunately the complex technology and unfamiliar vocabulary of molecular biology often deter non-specialists from keeping abreast of these developments. This account explains the principles of gene mapping, discusses its relevance to dermatologists, and lists the established loci of dermatologically important genes.

Chromosome Aberrations↗
PubMed1995

PUVA treatment of alopecia areata partialis, totalis and universalis: audit of 10 years' experience at St John's Institute of Dermatology.

Our 10-year experience with PUVA treatment for alopecia areata, partialis, totalis and universalis was retrospectively reviewed using charts and follow-up questionnaires for 70 patients at St John's Institute of Dermatology. In all cases, several previous therapies were judged to be unsatisfactory prior to starting PUVA, and many cases were already deemed clinically refractory prior to referral for PUVA. If cases of vellus hair growth are excluded, and those who lost their PUVA-induced regrowth rapidly on follow-up, the effective success rate was at best 6.3% for alopecia areata partialis, 12.5% for alopecia areata totalis and 13.3% for alopecia areata universalis. We affirm that PUVA is generally not an effective treatment for alopecia areata.

Adolescent↗
PubMed1995

Treatment of basal cell carcinoma by dermatologists in the United Kingdom. British Association of Dermatologists Audit Subcommittee and the British Society for Dermatological Surgery.

Details of presentation and treatment were obtained prospectively by questionnaire for 1366 patients with basal cell carcinoma, first attending under the care of 166 consultant dermatologists in the U.K., during a 2-week period. One thousand five hundred and ninety-seven tumours were reported in these patients (median age 71 years). Most were situated on the head and neck, and their median size was 9 mm. Excision was the most common treatment used in 58% of tumours, curettage and cautery was used in 24%, cryotherapy in 8%, and radiotherapy in 8%. On average, one in four tumours were referred to other specialists for treatment (range 0-70%). Very few patients (2%) were referred to a combined dermatology/radiotherapy/plastic surgery clinic, calling into question its value and availability. There was considerable variation in practices between dermatologists, demonstrating a clear need for individual, local audit of the management of this common dermatological problem. The data collected in this study form a suitable measure with which local performance may be compared.

Adolescent↗
PubMed2000

Antibodies against human herpesvirus 8 in subjects with non-venereal dermatological conditions.

BACKGROUND: Human herpesvirus 8 (HHV8) is considered as the infectious cofactor involved in the pathogenesis of Kaposi's sarcoma (KS). Its seroprevalence and modes of transmission in the general population are still undetermined. OBJECTIVES: We aimed to estimate the prevalence of HHV8 infection in a population at low risk for sexually transmitted diseases. METHODS: We conducted a seroepidemiological survey on randomly selected individuals attending the dermatology department of a teaching hospital in Rome. Of 257 patients, 248 had their blood analysed for anti-HHV8 antibodies and 201 completed a standardized interview. Serological analysis was performed by an immunofluorescence assay able to detect antilytic antibodies. RESULTS: We found an overall seroprevalence of 15.7% (95% confidence interval, CI 11.4-20.9%), similar in men and women (15.1% vs. 16.3%) and higher at older ages. Seropositivity was not related to sexual habits, while it was significantly associated with a history of hepatitis (seroprevalence 34.6%, adjusted odds ratio, OR 4.08, 95% CI 1.52-11.00) and with a diagnosis of non-melanoma skin cancer (42.9%, OR 4.20, 95% CI 1.26-14.02) or atypical naevi (35.3%, OR 6.21, 95% CI 1.85-20.86). CONCLUSIONS: Our data suggest that a non-sexual mode of transmission of HHV8 infection is plausible in an Italian population at low risk for sexually transmitted diseases and that other factors, besides differences in prevalence of HHV8 infection, may be involved in the epidemiology of classical KS. The unexpectedly high seropositivity rates in subjects with non-melanoma skin cancer and atypical naevi should be viewed with caution and require confirmation.

Adult↗
PubMed2004

Topical photodynamic therapy in clinical dermatology.

The growing incidence of cutaneous malignancies each year necessitates the development of new and more effective methods for both the diagnosis and the treatment of cancerous lesions, while assuring better cosmetic results and improving patient satisfaction. With that in mind, the use of topical photodynamic therapy (PDT) has been explored in the treatment as well as the diagnosis of various cutaneous malignancies. Using the intrinsic cellular haem biosynthetic pathway and principles of photoillumination, topical PDT carries the goal of selectively targeting abnormal cells, while preserving the normal surrounding structures. This paper will discuss the various applications and data on the use of topical PDT in dermatology.

Adult↗
PubMed2004

Prevalence of foot diseases in outpatients attending the Institute of Dermatology, Bangkok, Thailand.

Two thousand patients who visited the outpatient department at the Institute of Dermatology, Bangkok, were assessed for the presence of foot diseases by questionnaire and physical examination. Abnormalities were detected in 741 individuals (37.1%). Nonfungal conditions were more prevalent (31.4%), mainly consisting of eczema (254 cases, 12.7%) and psoriasis (176 cases, 8.8%). Fungal disease was observed in 119 cases (6.0%). There were 76 cases (3.8%) with tinea pedis and 33 cases (1.7%) with onychomycosis. The identified organisms causing tinea pedis were 57.9% nondermatophyte moulds, 36.8% dermatophytes, and 2.6%Candida spp. The corresponding organisms causing onychomycosis were 51.6% nondermatophyte moulds, 36.3% dermatophytes, and 6.0%Candida spp. Among nondermatophytes, Scytalidium dimidiatum was the leading pathogen while Trichophyton rubrum and T. mentagrophytes were the predominant dermatophytes identified. Diabetes mellitus, peripheral vascular disease and activities related to foot trauma were noted to be predisposing factors for onychomycosis. Footwear, particularly sandals and cut shoes, was the only factor relevant to individuals with tinea pedis (P < or = 0.05). In contrast with other published data on fungal foot infections, this study disclosed a higher prevalence of nondermatophyte organisms, predominantly S. dimidiatum, as the major cause of tinea pedis and onychomycosis. An increase in awareness is necessary to identify such cases, prevent misdiagnosis and initiate appropriate treatment.

Adolescent↗
PubMed2004

Cyclosporin A: a new drug in the field of canine dermatology.

In the last few years, there has been growing interest in the use of cyclosporin to treat canine skin diseases. Cyclosporin exhibits potent immunomodulating properties that reflect its ability to block the transcription of cytokines genes in activated T lymphocytes. Cyclosporin also inhibits a number of immune allergic reactions that occur after activation of mast cells, Langerhans cells, eosinophils and keratinocytes. In randomized controlled trials, cyclosporin has proven to be as effective as glucocorticoids for treatment of canine atopic dermatitis at the inducing dosage of 5 mg kg(-1). The drug has also proven beneficial for the treatment of perianal fistulas in dogs. Other potential applications are suggested from small pilot open trials using dogs affected with various immune-mediated dermatological diseases. The pharmacokinetic properties of cyclosporin are very similar in dogs and man, but its safety margin is much wider in dogs. Therefore, routine cyclosporin blood level monitoring does not appear necessary. Although in man renal impairment and hypertension are often seen, even at low doses, these effects are not observed in dogs. Adverse reactions consist mainly of transient emesis and diarrhoea occurring during the first days of treatment. Other adverse reactions, such as gingival hyperplasia, verruciform lesions and hypertrichosis, appear to be dose-dependent, and occur rarely at therapeutic doses. An increased susceptibility to infections has not been reported in dogs receiving this drug.

Administration, Oral↗
PubMed2006

Comparison of clinical history and dermatologic findings in 29 dogs with severe eosinophilic dermatitis: a retrospective analysis.

The medical records and histopathological sections of 29 dogs diagnosed with a unique eosinophilic dermatitis resembling Wells' syndrome were reviewed in an attempt to elucidate the pathogenesis of this syndrome. The medical records were reviewed for information on dermatological lesion appearance, systemic signs in other organ systems, clinical analyte abnormalities, and drug therapy. Histological sections of dogs with moderate to severe eosinophilic dermatitis without folliculitis and furunculosis were reviewed and evaluated for the presence of collagen flame figures. Three categories of patients were found. Category 1 consisted of 17 dogs treated for vomiting and/or diarrhoea (often haematochezia or haematemesis) prior (mean: 4.6 days) to the onset of skin lesions. Fourteen category 1 dogs had erythematous lesions (macules, papules or plaques) that were most pronounced on the abdomen. Sixteen of the 17 dogs received multiple classes of drugs, and 59% were hypoalbuminemic. Category 2 consisted of five dogs that had skin lesions and gastrointestinal signs at presentation and four of these dogs were hypoalbuminemic. Category 3 included seven dogs without enteric illness. A positive drug score was found in six category 1 dogs and one each from categories 2 and 3. Eighteen cases had eosinophilic dermatitis without flame figures, seven cases had early flame figures and four had well-developed flame figures. These changes did not correlate with the categories of clinical presentation. More than 50% of the dogs developed eosinophilic dermatitis following treatment for severe gastrointestinal disease. The authors propose that this represents a unique syndrome that may have causal drug association.

Animals↗
PubMed1976

Clofazimine in dermatology.

In dermatology, patients with nodosum leprosum and discoid lupus erythematosus are benefited by clofazimine therapy. Its use in other autoimmune diseases has to be considered. Patients with lupus pernio may respond to this regime, but further prolonged trials will have to be undertaken.

Autoimmune Diseases↗
PubMed1985

The dermatology of Kauai, Hawaii, 1981-1982.

The distribution of skin disease within a population can be used as the basis for research as well as planning for the delivery of health services. In this prospective study, the cutaneous diagnoses and demographic data on all patients seen in the only dermatology clinic on Kauai, Hawaii, were recorded from March 1981 to February 1982. Kauai is relatively unique in that the population is comprised of four racial groups with roughly equal representation; these groups live under similar conditions. A total of 3,277 patients were seen and 4,106 diagnoses were made. Three hundred twenty-four separate diagnoses were rendered: acne vulgaris, contact dermatitis, verrucae, and dermatophytosis were the most common. Various diseases were not equally divided among the racial groups. These data are compared to similar previous studies.

Adolescent↗
PubMed1995

Co-morbidity between dermatologic diseases and psychiatric disorders in Papua New Guinea.

BACKGROUND: Neurodermatitis (now subdivided into lichen simplex chronicus and atopic dermatitis) was included among the psychosomatic disorders. Psychologic causes have been suggested for many skin conditions, such as urticaria, lichen simplex chronicus, atopic dermatitis, psoriasis, alopecia areata, and pruritus. The evidence for psychologic causation is neither strong nor convincing; however, psychiatric disorders are common among people with established skin diseases. Recent investigators have published data reporting co-morbidity between certain psychiatric disorders and skin diseases. The objective of the research was a prospective clinical study of 132 consecutive patients, who attended the dermatologic outpatient clinic of the Port Moresby General Hospital during 1992. METHODS: The instrument for the study is the "Harding Self-Rating Questionnaire (SRQ) that has been demonstrated to work well as a gross screening instrument in the Urban Primary Health Care Clinic setting. The questionnaire was administered to 132 outpatients by one of the investigators (HM). Those patients who scored above the cut-off point of seven were referred to the second investigator (FYAJ) for examination of their mental state. RESULTS: The results of the study showed all 132 patients were adults, aged between 16 and 75 years. There were 67/132 (50.75%) men and 65/132 (49.24%) women patients. The psychiatric diagnoses for the women patients were: normal variation 17/65, anxiety neurosis 11/65, and neurotic depression 37/65. For the men patients, the psychiatric diagnoses were: normal variation 21/67, anxiety neurosis 15/67, and neurotic depression 30/67. One man with psoriasis also presented with clinical features of schizophrenic psychosis. CONCLUSIONS: The results of the study support the hypothesis, that there is a co-morbidity between some psychiatric disorders and some skin diseases.

Adolescent↗
PubMed2004

Tinea capitis in a dermatology center in the city of Fortaleza, Brazil: the role of Trichophyton tonsurans.

BACKGROUND: Over a 3-year period (March 1999 to March 2002), 944 patients with scalp lesions attended a dermatology reference center in the city of Fortaleza, Ceará, Brazil. Clinical specimens were examined at the Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza-CE, Brazil, to detect patients with tinea capitis. METHODS: Specimens were obtained from pus, scales, and hairs from suspected lesions of tinea capitis. Mycologic analyses were conducted by direct microscopy and by fungal culture on Sabouraud dextrose agar, with or without chloramphenicol and Mycosel agar. The culture tubes were incubated at 28 degrees C and examined daily for 1 month. RESULTS: Fungi were seen in 438 (46.4%) of the 944 clinical specimens. The percentage of positive direct microscopic examinations of the clinical specimens was 83.7%. Of those patients with tinea capitis, 157 (35.8%) were males and 281 (64.2%; P < 0.001) were females. The distribution of dermatophyte species in males, from 136 positive cultures, was Trichophyton tonsurans (54.41%), Microsporum canis (38.97%), T. rubrum (4.41%), T. mentagrophytes var. mentagrophytes (1.47%), and M. gypseum (0.74%). On the other hand, only three species, from 251 positive cultures, were present in females: T. tonsurans (80.08%), M. canis (17.53%), and T. rubrum (2.39%). There was a high proportion of positive results in children under 10 years of age (n = 309). No significant difference was detected in the seasonal distribution of tinea capitis. CONCLUSIONS: Our data show that T. tonsurans is the main etiologic agent of tinea capitis, and is more likely to be found in females and in the prepubertal population.

Adolescent↗

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