Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “BLISTER”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed2004

Blistering diseases in the elderly: diagnosis and treatment.

This article discusses the major blistering diseases in the geriatric population. The diagnosis of both immune- and non-immune-mediated blistering disorders can be confirmed with the help of histologic and immunopathologic studies. Various serologic assays, which are more specific, also can be used to confirm the diagnosis of autoimmune blistering diseases. These techniques have facilitated the diagnosis and allowed the institution of early treatment. The treatment of blistering disorders has included both localized and systemic treatments. Localized treatment involves topical care including the following measures: the prevention of trauma; soaking of blisters in antiseptic (potassium permanganate or aluminum subacetate) solutions; topical and intralesional corticosteroids; and the prevention and early treatment of infections with local or systemic antibiotics. Conventional oral systemic therapies that have proved to be beneficial include systemic corticosteroids, anti-inflammatory agents, and immunosuppressive agents. Because the elderly are more prone to the side effects of these systemic agents, it is crucial that routine hematologic tests be done and monitored until the treatments have been discontinued. Recently, newer alternative treatment modalities have proved to be successful in patients who failed to respond or developed multiple side effects to the conventional oral systemic agents. In conclusion, as clinicians gain a greater understanding into the pathogenesis of these diseases, more specific molecular-targeted treatments will most likely become available.

Aged↗
PubMed2000

Increased tryptase and myeloperoxidase levels in blister fluids of patients with bullous pemphigoid: correlations with cytokines, adhesion molecules and anti-basement membrane zone antibodies.

Tryptase and myeloperoxidase respectively represent 2 specific markers of activated mast cells or neutrophils. Therefore, establishing the levels of these enzymes may be useful to quantify the cell involvement in the tissues or fluids of different origins and in different pathologies. The aim of this study was to analyse the levels of these 2 markers in both the sera and blister fluids of patients affected with bullous pemphigoid. These levels were then correlated to the concentrations of 19 cytokines and 2 soluble adhesion molecules determined in the same samples and also with the log (anti-basement membrane zone antibody) titres, evaluated in the patients' sera. For these purposes, 15 patients with bullous pemphigoid (10 males and 5 females; median age: 84 years, range 66-87; median disease duration: 0 years, range 0-3: median number of skin lesions: 17, range 14-30; median anti-basement membrane zone antibody titre: 1:320, range 0.0-1:2560) and 15 normal subjects (11 males and 4 females, median age: 81 years, range 59-86) were analysed by means of commercially available kits. Results showed that blister fluid myeloperoxidase and tryptase levels were increased as compared with the respective sera (P<0.01) and several correlations were observed with cytokines and adhesion molecules. In fact, significant correlations of blister fluid tryptase levels were observed with IL-3, IL-4, IL-5, IL-6, IL-7, IL-8, VEGF, RANTES and sICAM-1, while myeloperoxidase was correlated with IL-1beta, IL-13 and IL-15. The blister fluid tryptase levels were also significantly correlated with the anti-basement membrane zone antibody titres (R=0.53, P=0.05). In conclusion, these findings are in accord with an involvement of both mast cells and neutrophils in bullous pemphigoid and their recruitment may be mediated by different biological modulators. Our findings seem to indicate that the cytokine (IL-3, IFN-gamma and OSM) or adhesion molecule (sICAM-1) concentrations in blister fluid are logarithmically related to the anti-basement membrane zone antibody titers.

Aged↗
PubMed2004

Raman-scattering elucidation of the giant isotope effect in hydrogen-ion blistering of silicon.

In this work, we investigate the origin of a giant isotope effect discovered in the blistering of hydrogen-ion-implanted and annealed silicon. Si(001) samples were implanted or co-implanted with 5 keV of H and/or D ions to total fluences of 2 x 10(16) and 6 x 10(16) ion/cm(2). The lower fluence is sufficient for blistering by pure H, but the higher one is required for the maximum blister coverage whenever D is involved. On these samples, we carried out Raman-scattering investigations of the evolution of Si-H/D complexes upon a stepwise thermal annealing from 200 to 550 degrees C. We have identified the critical chemical transformations characterizing the hydrogen-deuterium-induced blistering of silicon. The puzzling dependence on ion mass appears to be mainly connected with the nature of the radiation damage. We have found that H is more efficient in "preparing the ground" for blistering by nucleating platelets parallel to the surface, essentially due to its ability to agglomerate in the multihydride monovacancy complexes that evolve into hydrogenated extended internal surfaces. By contrast, D is preferentially trapped in the surprisingly stable monodeuteride multivacancies.

Journal Article↗
PubMed1993

Demonstration of 72-kDa and 92-kDa forms of type IV collagenase in human skin: variable expression in various blistering diseases, induction during re-epithelialization, and decrease by topical glucocorticoids.

Type IV collagenases have been shown to play an important role in tumor metastasis and wound healing. In the present study, we have demonstrated the presence of 72-kDa and 92-kDa forms of type IV collagenase in human skin by biochemical and in situ hybridization techniques. In situ hybridization allowed us to localize the 72-kDa form mostly to fibroblasts and the 92-kDa form to the epidermis and endothelial cells. The presence of type IV collagenase was confirmed by Western blotting. Enzyme activity was assayed in spontaneous blisters (18 subjects) and suction-induced blisters (29 subjects) by the zymography method, and by using type IV collagen as the substrate. Thus, it was possible to detect both the 92-kDa and 72-kDa forms in spontaneous and induced blisters. An especially high level of the 92-kDa enzyme was found in a bullous pemphigoid patient. Type IV collagenases were studied during re-epithelialization of the blister, using the suction-blister model. There was a marked induction of the 92-kDa type that was confirmed to be in the regenerating, migratory, epithelium by in situ hybridization studies. These results indicate that 92-kDa type IV collagenase may play an essential role in the normal physiology and integrity of the skin and may be an important regulator of re-epithelialization. It was also shown that potent topical glucocorticoid down-regulated the 92-kDa type collagenase, suggesting that glucocorticoids may have a beneficial role in some skin diseases by decreasing type IV collagenase activity and, thus, reducing tissue destruction.

Administration, Topical↗
PubMed1984

Suction blisters of the skin: a compartment with physiological, interstitium-like properties.

In six young men without known skin disease we evaluated whether mild suction to the skin significantly alters the properties of the underlying capillaries or whether suction blisters can be regarded as an interstitium-like compartment with dynamic physiological properties. Instead of the usual technique where the tracer is administered intravenously prior to the suction, we postponed the administration of the tracer (99mTc-DTPA) to 15 min after the suction blisters had been formed on the abdominal skin. We found that the final slope of average interstitium 99mTc-DTPA was almost parallel to that of the final slope of 99mTc-DTPA in the blister fluid (r = 0.917). During the period 120-240 min after the injection where the final slopes could be defined, the ratio between the amount of 99mTc-DTPA present in the interstitium and the amount of 99mTc-DTPA present in a blister fluid volume equal to interstitial fluid volume was 1.3. It is concluded that suction blisters of the skin behave like a dynamic interstitium-like compartment.

Adult↗
PubMed1990

Blisters in the area pellucida, area opaca, and segmental plate of avian embryos.

This is a special communication in an area of special interest to all researchers using avian material. Avian embryos in the Northeast, representing four species (chicken, quail, duck, guinea hen), have been found to be drastically deficient in presomitic tissue (segmental plate tissue) between 45 and 60 h of incubation. These deficiencies first appear in the embryo as blisters, then, through tissue repair, they disappear and the embryos continue seemingly normal development. Similar blisters and excrescences appear in the area pellucida and area opaca between 20 and 30 h of incubation. Associated with these blisters and excrescences in very young embryos and blisters in segmental plates, but not necessarily the result of them, is a high incidence of congenital malformation during later development. These anomalies may be affecting the results obtained in avian research.

Animals↗
PubMed2000

Presence of interleukin 10 in the serum and blister fluid of patients with pemphigus vulgaris and pemphigoid.

Interleukin 10 (IL-10) is an immunoregulatory cytokine produced by T lymphocytes and macrophages. Recently, it has been suggested that IL-10 may be involved in the pathogenesis of various inflammatory and autoimmune diseases. Using an ELISA we investigated the presence of IL-10 in the serum and blister fluid of pemphigus vulgaris (PV) patients with active disease and those in prolonged clinical remission compared with normal controls. Sera from patients with bullous pemphigoid (BP), ocular cicatricial pemphigoid (OCP), oral pemphigoid (OP) and blister fluid from five patients with BP were also studied. Increased levels of IL-10 were detected in the sera of 87.5% of patients with active PV and were statistically significant (P=0.0003) when compared with levels in normal human serum. Lower levels of IL-10 were detected in 12.5% PV patients in remission and were statistically significant (P=0.0001) when compared with levels in patients with active disease. Levels of IL-10 were detected in sera of 4.6% (1 of 24) of the normal controls. The levels of IL-10 were approximately four times higher in blister fluids than levels in the serum in the same PV patients. This difference was highly statistically significant (P=0.0008). A correlation was observed between serum levels of IL-10 and titres of pemphigus autoantibodies and with disease severity. Elevated level of IL-10 was detected in the blister fluid from five BP patients. Levels of IL-10 in the sera of patients with BP, OCP and OP were not significantly increased. These preliminary data suggest that IL-10 in concert with other cytokines may play an important role in the pathogenesis of PV and BP.

Autoantibodies↗
PubMed1978

Suction blister fluid as a model for interstitial fluid in rats.

1. Suction blisters on the skin of rats, obtained with a negative pressure of 150 mm Hg, show a close similarity to human suction blisters, based on histological, electrolyte and protein findings. 2. Pharmacokinetic experiments with inulin and antipyrine have proved that the movement of these low protein binding drugs between blister fluid and serum follows the laws of diffusion. 3. The investigations suggest that blister fluid resembles interstitial fluid and can therefore serve as a model for the estimation of drug concentrations in interstitial fluid.

Animals↗
PubMed1982

Determination of 8-methoxypsoralen levels in plasma and skin suction blister fluid by a new sensitive fluorodensitometric method.

An improved fluorodensitometric assay for the determination of 8-methoxypsoralen (8-MOP) in plasma is described. Because of its low limit of detection (below 1 ng/spot) this method is suitable to determine the drug in skin suction blister fluid, too. The standard deviation of the procedure is 6.4% or less. Plasma and skin blister fluid levels of 8-MOP are determined 2 h following oral administration of 40-60 mg 8-MOP. They range from 0-239 ng/ml and 0-163 ng/ml, respectively. A rather close correlation (r = 0.91) between these two parameters could be observed. Thus, in cases with relatively high plasma levels sufficient skin levels can be predicted. If further investigations would prove, however, that a distinct concentration threshold required for therapeutic success exists--and recent experiments with fibroblast cultures imply that--skin blister fluid level determinations would seem highly desirable when plasma levels let us expect skin levels in the critical range. In general determination of 8-MOP skin blister fluid levels can be looked upon as a model for the evaluation of drug skin levels after systemic application in man.

Adult↗
PubMed1985

Human plasma and skin blister fluid levels of griseofulvin after its repeated administration.

Griseofulvin was administered orally to 6 healthy volunteers for 6 days. The subjects received 500 mg of a microsize formulation and 330 mg of an ultramicrosize formulation, according to a cross-over design. The drug was determined in plasma, suction blister fluid (SBF) and cantharides blister fluid (CBF) following the last dose. Urinary excretion of the main metabolites 6-demethylgriseofulvin (6-DMG) and its glucuronic acid conjugate was also measured. The pharmacokinetic parameters were compared with those obtained from a recent single dose experiment. On repeated administration, the bioavailability of griseofulvin was significantly lower from the microsize formulation; the urinary recovery of total 6-DMG was 33.8% versus 53.6% on administration of the ultramicrosize material. Bioavailability was reduced as compared to ingestion of a single dose. The reduction was more prominent following the microsize (36%) than the ultramicrosize (17%) formulation. Penetration into skin blister fluid was not altered as compared to the single dose experiment. Relative areas under the blister fluid-time curves amounted to 51% (SBF) and 80% (CBF) of the area under the plasma level-time curve. The concentration of unbound griseofulvin in these body fluids was identical throughout the entire dosage interval. Unbound griseofulvin levels were low in comparison with the minimum inhibitory concentrations for strains of trichophyton and microsporum.

Blister↗
PubMed1985

Human plasma and skin blister fluid levels of griseofulvin following a single oral dose.

Griseofulvin and 6-demethylgriseofulvin (6-DMG) in plasma, suction blister fluid (SBF) and cantharides blister fluid (CBF) and urinary excretion of 6-DMG, were evaluated following administration of single oral doses of an ultramicrosize and a microsize formulation of griseofulvin to 6 healthy volunteers. The bioavailability of griseofulvin was higher following the ultramicrosize formulation when 64% of the dose was recovered (via metabolites) versus 52% after the microsize preparation. Penetration into skin blister fluid was delayed as compared to plasma levels; the peak concentration in plasma was observed at 3-4 h, whereas griseofulvin in CBF increased up to 6 h. The terminal half-live was calculated from plasma levels to 9.3 h. The half-lives calculated from SBF and CBF concentrations were 9.2 and 9.8 h, respectively, (n = 5). In plasma 84% of griseofulvin was bound to proteins, predominantly to albumin; binding in SBF and CBF was 72 and 82%, respectively. 3 h after drug administration the free concentration in plasma significantly exceeded the free concentrations in SBF and CBF. Distribution equilibrium between plasma and skin blister fluid was observed after 27 h. Thus, during chronic administration, the plasma griseofulvin level should reflect its concentration in the target organ.

Administration, Oral↗
PubMed1982

Comparison of skin blisters and implanted cotton threads for the evaluation of antibiotic tissue concentrations.

The skin blister technique and a new technique using subcutaneously implanted cotton threads for the evaluation of antibiotic tissue concentrations were compared. Six volunteers received 2 g ampicillin and, after at least one week, 1 g of cloxacillin intravenously. Samples of serum, blister fluid and thread fluid were analysed by an agar well diffusion technique. The half-life of ampicillin and cloxacillin was prolonged in blister fluid compared to serum and thread fluid. Our conclusions are that the thread technique might reflect the kinetics of antibiotics in extracellular fluid where the penetration mostly depends on serum protein binding of the drug. The blister technique on the other hand might resemble the conditions in different subcutaneously implanted cages, fibrin clots and even abscesses where factors such as time and volume of the extracellular compartments also strongly influence the distribution of antibiotics.

Adult↗
PubMed2003

Immunocytochemical and freeze-fracture characterization of the Caenorhabditis elegans DR 847 bli-1(n361) mutant which produces abnormal cuticle blisters.

The bli-1 gene of Caenorhabditis elegans has previously been described as a mutation which disrupts the structure of the adult-stage cuticle, causing the formation of fluid-filled blisters. We investigated the blistering phenotype exhibited of n361 allele through immunocytochemical and freeze-fracture techniques. In the course of the blistering process several fine changes occurred, including a high-electron-density granulous material filling the intermediate layer, alterations in strut structure, and finally the total disappearance of the fibrous and basal layers. A polyclonal antibody against a synthetic 18-amino-acid peptide of the 3A3-collagen sequence labeled all the cuticular regions of the N(2) strain of the nematode C. elegans except for the intermediate layer. Similarly, no reaction was observed in the intermediate layer of the mutant strain DR 847 bli-1 (n361), which was filled by the granulous and electron-dense material. Replicas of quick-frozen, freeze-fracture, deep-etched, and rotatory-shadowed adult forms of the mutant DR 847 bli-1 (n361) of C. elegans revealed an increased number of the filamentous structures filling the intermediate layer in older nematodes, and also a gradual destruction and disappearance of the fibrous and basal layers. Based on these results, we postulated that the blistering phenotype is due to an altered function of bli-1 gene, which is probably enzymatic.

Animals↗
PubMed2002

Coma blisters, peripheral neuropathy, and amitriptyline overdose: a brief report.

BACKGROUND: Coma blisters are most commonly associated with barbiturate and benzodiazepine overdose; however, they have also been described in association with many other substances, including amitriptyline. OBJECTIVE: To review the literature on the clinical manifestations of coma blisters in the setting of amitriptyline overdose. METHODS: Case report and literature review. RESULTS: Coma blisters in association with amitriptyline overdose have rarely been documented in the literature. Of the few reported cases, peripheral neuropathy has been present two (including our case report) out of four times. CONCLUSION: Amitriptyline is known to impair endothelial cell tight junction integrity. Thus, individuals with amitriptyline overdose may be predisposed to microvascular damage during the compression imposed from a comatose state. This may help to explain the tendency for patients to present with the interesting triad of coma, blisters, and neuropathy.

Adult↗
PubMed1991

Skin suction blister wound exposed to u.v. irradiation: a burn wound model for use in humans.

The effects of exposing blister wounds to u.v. irradiation were assessed in 14 male volunteers, on whose forearms blister wounds (diameter 5 mm, suction set at 200 mmHg below atmospheric for 2 h 15 min, blister roof cut at base), and irradiated blister wounds (as above, in addition u.v. irradiation given selectively for 30 min from a distance of 10 cm), were produced. In non-u.v.-irradiated wounds, flow cessation, assessed by video microscopy (n = 6), was observed in a small proportion of the papillary loop vessels. The oedema adjacent to the wound was poorly developed. Laser Doppler linear scans (n = 8) demonstrated a pronounced hyperaemia in the wound bed and also in the adjacent skin, the reaction subsiding over a few days. The exudation rate, determined by weighing the hydrocolloid dressings applied to the wound, was maximal on day 1 and then rapidly decreased. Epithelialization, assessed evaporimetrically as the time taken for reinstatement of the epidermal water barrier, was complete in 5.1 days. In the u.v.-irradiated wounds the blood flow had ceased in all the papillary loop vessels by day 1, and increased oedema, exudation and hyperaemia at the wound edges were observed. Epithelialization was not significantly retarded by the irradiation injury. After 6 months, slight discolouration of the skin was occasionally observed, but no cosmetically disturbing scars. This benign and standardized wound model in humans--based on a combination of a mechanical suction injury and a superficial radiation burn--may prove to be useful, for instance when studying the effects of burns treatment.

Adult↗
PubMed2005

The problem of subepidermal blisters in neoformed integuments.

The present paper is a review of articles on the onset of subepidermal blisters in neoformed integuments. Considering the discrepancy between the literature data and our clinical experience concerning spontaneous onset of subepidermal blisters in neoformed integuments, we decided to conduct an extensive review of the literature. The main finding arising from it was the lack of characterization of the neoformed integument where the blisters were formed. These were normally referred to only by clinical descriptions such as "spontaneously healed burn", "grafted site", "donor site", "epidermal graft". Anatomical and clinical pathology aspects such as the formation mechanism of these integuments and the respective tissues that comprise them were not considered. We concluded that by adopting more precise criteria to classify neoformed integuments we would realize that split thickness grafts are not susceptible to blister formation.

Blister↗
PubMed2004

[Acquired lymphangiectasias or mammary dermolytic blisters with spontaneous resolution].

INTRODUCTION: Spontaneous occurrence of hemorrhagic blisters on the lower side of the breasts is an unusual clinical presentation of acquired lymphangiectasia. CASE REPORT: A 64 Year-old and a 85 Year-old woman had developed recurrent bleeding blisters in the sub-mammary region for several Months. Histological, immunohistochemical and electron microscopic examination revealed a subpapillary dermal bullous dehiscence, parallel to the epidermis, which was connected to lymphangiectasias of the superficial dermis. Their extreme dilatation and rupture were probably responsible for the clinical inflammatory and bleeding aspect of the lesions, which have not recurred after 1 and 3 Years, respectively. DISCUSSION: The presence of subpapillary inflammatory lymphangiectasias might be responsible for recurrent dermal blister formation. The reason for the presence of these hemorrhagic lymphangiectasias, restricted to the sub-mammary location and their spontaneous regression after several flare-ups, remain unclear. The unusual clinical presentation of the lesions observed in these two women constitutes a differential diagnosis of acquired dermolytic blisters.

Aged↗
PubMed1985

Cutaneous blisters and carbon monoxide poisoning.

We present the cases of three patients with skin blisters following carbon monoxide (CO) poisoning. Their blisters appeared to be related to the severity of the poisoning (HbCO levels of more than 40%). Two of the three patients died despite aggressive initial 100% surface oxygen followed by hyperbaric oxygen therapy. The pathophysiology of this type of blister remains unresolved. It could result from pressure necrosis alone or from a combination of pressure necrosis and direct CO inhibition of tissue oxidative enzymes. Although skin involvement as a result of CO poisoning is less frequently reported today than in the past (perhaps because of misidentified burns or because of more aggressive resuscitation and treatment protocols), the physician should recognize that such blisters may signal severe CO poisoning.

Adolescent↗