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At least 307 records · Page 17Linked to original sources
PubMed2006

Unusual palmoplantar blistering in the setting of hemodialysis: a case report and review of the dermatoses associated with hemodialysis.

We describe a 70-year-old White female on maintenance high-flux hemodialysis for chronic renal insufficiency with an abrupt onset of asymptomatic palmoplantar blisters. The lesions were tense, noninflamed and 0.2-1.0 cm in dimension. Concomitant photo-distributed blistering of the dorsal hands and forearms was not present. A cutaneous biopsy demonstrated nonspecific histological and direct immunofluorescent findings. Serum indirect immunofluorescence and tissue cultures for bacteria, fungi and viruses were negative. Fecal porphyrins were normal but an elevated plasma uroporphyrin level of 17.0 microg/dL (normal: < 1.0 microg/dL) was observed. The duration of each hemodialysis treatment, which the patient had continued to receive three times per week, was changed from 2 to 2.5 h. Within 2 weeks no new blisters occurred. Within 6 weeks complete clinical and biochemical remission was noted. During this time course no topical steroid or antifungal therapy was employed nor was the patient's oral medication regimen altered.

Aged↗
PubMed1996

Biochemical and antibacterial analysis of human wound and blister fluid.

Fluid from a post-operative wound, six leg ulcers and a large blister were collected and analysed by biochemical, microbiological and immunological techniques. The results were compared with those from sera. All samples were lyophilized and extracted twice with 60% aqueous acetonitrile containing 1% trifluoroacetic acid. The pooled supernatants were lyophilized, redissolved, and the fluid extracts were characterized by six techniques (the blister exudate only with three): reverse-phase HPLC, Edman degradation, mass spectrometry, Western blot analysis, inhibition zone assay on plates with Bacillus megaterium (anti-Bm activity) and zone clearing on plates with cell walls from Micrococcus luteus (a lysozyme assay). The material corresponding to HPLC peaks of the wound fluid extract was identified as: histone H2B fragments 1-11,1-15 and 1-16, intact thymosin beta-4, defensins HNP1, 2 and 3, lysozyme and the peptide antibiotic FALL-39 and its precursor(s). The HPLC-separated blister fluid was extremely rich in anti-Bm activity (mainly defensins) and lysozyme. It may also contain factors not identified before. The plate assays scored 50-fold differences in anti-Bm activities and more than 10-fold differences in lysozyme, factors which together with thymosin could be active in wound healing. It is concluded that analysis of wound fluid yields peptide and activity patterns with novel fragments of important peptides, and quantitative differences, that can be useful to understand molecular mechanisms of wound healing further.

Adult↗
PubMedDate not supplied

Angiotensin converting enzyme and substance P changes in blister fluid following afferent nerve stimulation in the rat.

We have examined the effect of electrical nerve stimulation on substance P and angiotensin converting enzyme activity in the interstitial fluid of rat skin using a blister model. Following sciatic nerve stimulation, blister fluid immunoreactive substance P (fmol/ml) was increased from 118 (unstimulated side, s.e.m. = 13, n = 15) to 197 (stimulated side, s.e.m. = 26, n = 15, P less than 0.0125, paired t-test, 14 d.f.). Angiotensin converting enzyme (ACE) activity (nmol HL/ml per h) was reduced in blister fluid from 26.5 (unstimulated side, s.e.m. = 2.4, n = 12) to 22.4 (stimulated side, s.e.m. = 1.4, P less than 0.05, paired t-test, 11 d.f.). Electrical stimulation of afferent nerves inhibits angiotensin converting enzyme activity in vivo. This may contribute to the process of neurogenic inflammation.

Animals↗
PubMed1990

Evaluation of the effect of azapropazone on neutrophil migration in anaesthetized swine using a multichamber blister suction technique.

1. The purpose of this study was to determine the in vivo inhibitory efficacy of azapropazone on neutrophil migration. The effects of azapropazone given at a dose of 100 mg kg-1 i.v. every 2 h on the neutrophil migration into skin inflammation sites (blister fluid) as well as into an autologous serum (+/- chemoattractant) placed above the blister surface (2nd chamber) were determined. 2. Azapropazone treatment schedule maintained blood levels at 70-100 micrograms ml-1 throughout the time course (360 min) of the experiment. 3. Azapropazone significantly inhibited (48 +/- 6%) neutrophil migration into the blister fluid (as evident from the decrease in myeloperoxidase activity). 4. Azapropazone significantly inhibited the neutrophil migration into the autologous serum either with (65 +/- 5%) or (35 +/- 6%) without the chemoattractant, formyl-methionyl-leucyl-phenylalanine (FMLP). The chemoattractant, FMLP, markedly increased neutrophil migration into the autologous serum by approximately 1.5 to 2 times the non-FMLP treated group. Azapropazone was more efficacious in inhibiting the neutrophil migration in the presence of FMLP than in its absence. 5. We conclude that azapropazone is an effective inhibitor of neutrophil migration into topically inflamed sites in anaesthetized swine.

Anesthesia↗
PubMed2006

Suction blister epidermal grafting for management of eyelid vitiligo: special considerations.

BACKGROUND: Suction blister epidermal grafting is an established technique for the treatment of resistant and stable vitiligo especially over small and cosmetically important areas like the face. However, certain areas, such as lips and eyelids, require special considerations because of their anatomic peculiarities. PATIENTS AND METHODS: The current study was carried out on six patients of stable eyelid vitiligo, not responding to medical treatment. Suction blister was obtained from the thigh using the suction apparatus and the roof was grafted on to the dermabraded eyelid. Certain precautions were taken during the procedure, which will be highlighted in the current study. RESULTS: Response was excellent in all the patients in 3 to 6 months, with no complications. CONCLUSIONS: If carried out properly, suction blister technique is the procedure of choice for cosmetically important sites like eyelids.

Blister↗
PubMed1981

Suction skin blister, skin window, and skin chamber techniques to determine extravascular passage of cefotaxime in humans.

We report the results obtained in comparative study on the extravascular passage of cefotaxime, employing three different methods: suction skin blister, skin window, and skin chamber. Applying the skin blister method in two different ways, we also studied the influence that suction pressure and time lapse between blister formation and antibiotic injection had on the results obtained in order to standardize the method and establish repeatability of the results. Using the skin chamber method, we studied the influence that the different protein contents in the fluid used to fill the skin chamber had on extravascular concentrations.

Adolescent↗
PubMed1981

Comparison of ceftazidime and cefamandole pharmacokinetics and blister fluid concentrations.

Eight healthy male volunteers received 1 g of either ceftazidime or cefamandole as an intravenous infection. Serial blood samples were taken over the next 8 h. Urine samples were collected over 24 h. Levels of these antibiotics were measured in the fluid of blisters resulting from application of cantharides. The concentration of ceftazidime in serum at 0.25 h after intravenous injection was 83.3 micrograms/ml. The serum half-lives for the respective drugs were 1.8 and 0.8 h. The mean apparent volume of distribution of ceftazidime (13.6 liters) was greater than that of cefamandole (9.8 liters). Plasma clearance was 111 ml/min for ceftazidime and 216 ml/min for cefamandole. The maximum blister fluid concentration of ceftazidime was 45.9 micrograms/ml, and that of cefamandole was 22.1 micrograms/ml. The relative availability of each drug in blister fluid compared with serum was similar.

Adult↗
PubMed1990

Pharmacokinetics of cefpodoxime in plasma and skin blister fluid following oral dosing of cefpodoxime proxetil.

The single-dose and steady-state pharmacokinetics of cefpodoxime were assessed in plasma and skin blister fluid (SBF) after oral dosing of 200 mg (n = 8) and 400 mg (n = 8) of cefpodoxime proxetil (doses are expressed as cefpodoxime equivalents) in healthy subjects in an open-label, parallel-design study. Skin blisters were formed by air suction on the midvolar forearm by a previously validated method. After single-dose administration, serial plasma and SBF samples were collected over 24 h for measurement of cefpodoxime by microbiological assays. After a 1-week washout, subjects received the same doses of antibiotic every 12 h for 5 days, with plasma and SBF sampling on day 5. After 200 mg of cefpodoxime proxetil, average peak concentrations (Cmax) in plasma and SBF were 2.18 +/- 0.52 and 1.55 +/- 0.59 micrograms/ml, respectively, after a single dose and 2.33 +/- 0.74 and 1.56 +/- 0.55 micrograms/ml, respectively, at steady state. After 400 mg of cefpodoxime proxetil, Cmax in plasma and SBF averaged 4.16 +/- 1.04 and 2.94 +/- 0.71 micrograms/ml, respectively, following a single dose and 4.10 +/- 0.95 and 2.84 +/- 0.88 micrograms/ml, respectively, at steady state. Cmax occurred 1.1 to 1.6 h later in SBF than in plasma. There was no accumulation of cefpodoxime in plasma or SBF when dosing was done every 12 h. Cefpodoxime blister fluid penetration was estimated to be 67 to 101%, consistent with the relatively low serum protein binding of the drug. Cefpodoxime levels exceeding the MIC for 90% of many skin pathogens, such as Streptococcus species (<1 microgram/ml) or Staphylococcus species (2 to 4 micrograms/ml), were achieved in plasma and SBF following the 200- and/or 400-mg dosing regimens.

Administration, Oral↗
PubMed1996

Blistering skin diseases: models for studies on epidermal-dermal adhesion.

Blistering skin diseases represent a genetically and biologically heterogeneous group of pathologic conditions with attenuated epithelial adhesion in the skin or in mucosal surfaces. Investigations on genetic blistering disorders with ultrastructural analysis, determination of candidate genes, and isolation and characterization of the target proteins have had a major impact on our understanding of normal epithelial-mesenchymal interactions and epithelial cell adhesion in general. A higf1p4gree of molecular heterogeneity underlies the different pathological phenotypes, and certain genotype-phenotype correlations are starting to emerge. Accumulating data on the molecular basis of different blistering diseases have already disclosed ample new information on the physiological functions of many of the molecular components of the dermal-epidermal junction, and we expect a rapid expansion of knowledge on the field when genotype-phenotype correlations of more patients are discerned.

Blister↗
PubMed2006

Multiplex bead array assay for detection of 25 soluble cytokines in blister fluid of patients with complex regional pain syndrome type 1.

Inflammatory processes are known to be involved at least in the early phase of complex regional pain syndrome type 1 (CRPS1). Blister fluid obtained from the involved extremities displayed increased amounts of proinflammatory cytokines IL-6 and TNFalpha compared with the noninvolved extremities. The aim of this paper is to investigate the involvement of mediators by measurement of several other cytokines using new detection techniques that enable multiple cytokine measurement in small samples. The use of a multiplex-25 bead array cytokine assay and Luminex technology enabled simultaneous measurement of representative (1) proinflammatory cytokines such as GM-CSF, IL-1beta, IL-1RA, IL-6, IL-8, and TNF-alpha; (2) Th1/Th2 distinguishing cytokines IFN-gamma, IL-2, IL-2R, IL-4, IL-5, and IL-10; (3) nonspecific acting cytokines IFN-alpha, IL-7, IL-12p40/p70, IL-13, IL-15, and IL-17; and (4) chemokines eotaxin, IP-10, MCP-1, MIP-1alpha, MIP-1beta, MIG, and RANTES. Although minimal detection levels are significantly higher in the bead array system than those in common ELISA assays, in blister fluid, IL-1RA, IL-6, IL-8, TNF-alpha, IL-12p40/p70, MCP-1, and MIP-1beta were detectable and increased in CRPS1 affected extremities. Levels of IL-6 and TNF-alpha simultaneously measured by ELISA (Sanquin Compact kit) and by multiplex-25 bead array assay (Biosource) were highly correlated (r = 0.85, P < .001 for IL-6 and r = 0.88, P < .001 for TNF-alpha). Furthermore, IP-10 and eotaxin were detectable but diminished in CRPS1, whereas detectable amounts of IL-10 were similar in involved and noninvolved extremities. Multiplex bead array assays are useful systems to establish the involvement of cytokines in inflammatory processes by measurements in blister fluids of CRPS1. Ten representative cytokines were detectable. However, detection levels and amounts measured are at least 3 times higher in the multiplex-25 array assay than in the ELISA assays used simultaneously for the measurement of cytokines.

Adult↗
PubMed2001

CD8+ lymphocytes in the blister fluid of severe acute cutaneous graft-versus-host disease: further similarities with toxic epidermal necrolysis.

BACKGROUND: Graft-versus-host disease (GvHD) remains the major toxicity of allogeneic bone marrow transplantation (BMT). In the acute form of the disease, the differential diagnosis includes viral rash and drug eruptions. METHODS: We report two patients with chronic myeloid leukemia submitted to allogeneic BMT who developed a severe form of acute cutaneous GvHD, with clinical and histological pictures mimicking toxic epidermal necrolysis (TEN). RESULTS: We found a predominance of peripheral CD8+ T lymphocytes and, at the same time, studying the cellular profile of the blister fluid, just in the beginning of blister eruption, we also found a high proportion of CD8+ T lymphocytes, mainly CD8+CD57-. CONCLUSION: These data are in agreement with previous reports of the presence of CD8+ T cells in the blister fluid of patients with TEN, further emphasizing similar immunoinflammatory pathways in both diseases.

Acute Disease↗
PubMedDate not supplied

Hypericin levels in human serum and interstitial skin blister fluid after oral single-dose and steady-state administration of Hypericum perforatum extract (St. John's wort).

The photodynamically active plant pigment hypericin, a characteristic metabolite of Hypericum perforatum (St. John's wort), is widely used as an antidepressant. When administered orally, phototoxic symptoms may limit the therapeutic use of hypericin-containing drugs. Here we describe the high-performance liquid chromatographic (HPLC) detection of hypericin and semiquantitative detection of pseudohypericin in human serum and skin blister fluid after oral single-dose (1 x 6 tablets) or steady-state (3 x 1 tablet/day, for 7 days) administration of the Hypericum extract LI 160 in healthy volunteers (n = 12). Serum levels of hypericin and pseudohypericin were always significantly higher than skin levels (p </= 0.01). After oral single-dose administration of Hypericum extract the mean serum level of total hypericin (hypericin + pseudohypericin) was 43 ng/ml and the mean skin blister fluid level was 5.3 ng/ml. After steady-state administration the mean serum level of total hypericin was 12.5 ng/ml and the mean skin blister fluid level was 2.8 ng/ml. These skin levels are far below hypericin skin levels that are estimated to be phototoxic (>100 ng/ml).

Adult↗
PubMed1991

Citropten and bergapten suction blister fluid concentrations after solar product application in man.

Citropten (5,7-dimethoxycoumarin) and bergapten (5-methoxypsoralen) are present in bergamot oil which is used as a cosmetic tanning product. The aim of this study was to quantify, using HPLC, the amount of citropten and bergapten in the skin after the application of suntan products (emulsion and oil formulations). A suction blister technique, performed on the volar aspect of the forearm, permitted the collection of these two molecules. The blister fluid concentrations were 37 and 51 ng/ml (emulsion) and 26 and 23 ng/ml (oil), respectively, for citropten and bergapten. Our results show that the suction blister technique could be used for comparing transepidermal penetration of several compounds in vivo in man.

5-Methoxypsoralen↗
PubMed1985

Pharmacokinetics of brodimoprim in serum and skin blister fluid.

Following 400 mg brodimoprim given orally to 8 volunteers, the peaks of the mean concentration curves were 3.2 +/- 1.0 mg/l in serum and 1.0 +/- 0.2 mg/l (+/- SEM) in skin blister fluid. The terminal half-lives were 25.9 +/- 2.2 h and 42.2 +/- 6.5 h in serum and blister fluid, respectively. The area under the concentration-versus-time curve for blister fluid was 73% of serum value, and the mean recovery of bioactive drug in urine during 24 h was 3.4%. Considering the minimal inhibitory concentrations of potential target organisms and the slow elimination, the results suggest that brodimoprim may be useful in the treatment of infections, and that dosage once a day may be sufficient.

Administration, Oral↗
PubMed1986

Human pharmacokinetics and skin blister levels of sulfonamides and dihydrofolate reductase inhibitors.

The penetration into suction skin blisters and pharmacokinetics of 4 sulfonamides (sulfacarbamide, sulfadimidine, sulfadiazine, sulfamethoxazole) and two dihydrofolate reductase inhibitors (methioprim, trimethoprim) have been compared in healthy volunteers. The concentrations were monitored after the first dose and for the subsequent 4 days when approximate steady state conditions could be assumed to have been established. The serum or plasma half-life of the agents in the above order was 3.1, 6.3, 13.9, 12.1, 9.3, and 12.0 h. The respective areas under the serum curves were 97.1, 607.8, 942.6, 1423.1, 128.1 and 175.4 mg/l per dose of 1.0 g. With the sulfonamides, there was a distinct correlation between serum protein binding and pKa and the ability of the compounds to penetrate into blister fluid as shown by the 12-hour ratios between areas under the concentration curves in blister fluid relative to serum.

Adult↗
PubMed1993

Soluble CD14 monocyte antigen in suction blister fluid and serum of patients with psoriasis.

The purpose of this study was to measure soluble CD14 (sCD14) molecules in the skin and in serum of patients with psoriasis. CD14 is a newly discovered cell surface marker on monocytes that is shed after cell activation. The following procedures were used: suction blisters were raised over the abdominal skin of 9 healthy control individuals and 8 patients with psoriasis. Serum of 17 healthy controls and 17 patients with psoriasis was collected. sCD14 was determined in suction blister fluid and serum by the ELISA technique. The clinical status of psoriasis was rated by the psoriasis area and severity index (PASI score). We found that sCD14 levels in suction blisters of healthy skin (1,050 +/- 236 ng/ml, mean +/- SE) were similar to those of nonlesional psoriatic skin (841 +/- 113 ng/ml). By contrast, control serum contained 2,687 +/- 167 ng/ml, but psoriatic serum 4,059 +/- 388 ng/ml sCD14 (p = 0.001, Wilcoxon test). Linear-regression analysis revealed that serum sCD14 levels and the PASI score of patients did not correlate. We conclude that there is an abnormal monocyte stimulation in blood but not in nonlesional skin in psoriasis that is independent from the clinical status expressed by the PASI score.

Adolescent↗