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The authors give their comments on the paper by A. A. Kalamkarian and V. A. Samsonov on the taxonomy of diffuse neurodermatitis and atopic dermatitis. They consider that the term "atopic disease" is more validated; discussing the wording of a detailed diagnosis, they come to the conclusion that the term "diffuse" should be used only as a characteristic of the process dissemination in neurodermatitis.
Basing on the WHO recommendations and on the statistical classification of diseases in the USSR (Section 691) on the use of the 'atopic dermatitis' term, the author thinks it desirable that age-associated features of the disease and clinical symptoms be taken into consideration and that the diagnosis be worded as 'atopic dermatitis' at the stage of childhood eczema or diffuse or local neurodermatitis; atopic neurodermatitis should also be considered as a rightful term.
Tissue from 134 patients with neurodermatitis and prurigo, pseudoepitheliomatous hyperplasia, pemphigus, and urticaria pigmentosa was examined qualitatively for epidermal mast cells. Epidermal mast cells were found in all of the diseases that were studied except dermatitis herpetiformis. Pemphigus vegetans and dermatitis vegetans were frequently associated with the presence of epidermal mast cells. In other pseudoepitheliomatous diseases, such as tuberculosis verrucosa cutis, blastomycosis, and bromoderma, epidermal mast cells were present in many cases. Four of eight patients with acral dermatitis with elevated IgE blood levels had intraepidermal mast cells; the number was much lower in patients with usual neurodermatitis and prurigo nodularis. Only two of ten cases of alopecia mucinosa showed epidermal mast cells. A single epidermal mast cell was found in ten cases of urticaria pigmentosa. Chronic inflammation associated with epidermal cell proliferation appeared to correlate with the presence of epidermal mast cell.
Fluocinolone acetonide cream is a new, potent topical corticosteroid. When used in conjunction with an occlusive plastic film dressing, herein described, it is highly effective in the treatment of psoriasis of the glabrous skin, pustular and paronychial psoriasis, neurodermatitis, and lichen planus. Psoriasis of the intertriginous areas responds to the local use of the fluocinolone cream alone. Relapses on cessation of treatment respond as a rule to retreatment.Indications, limitations, reactions and contraindications to this form of treatment are discussed.
A 68-year-old woman had a pigmented lentigo maligna lesion excised from her left arm. During a seven-year follow-up period, the excision site gradually evolved into a hypopigmented macule with irregular areas of mild erythema. The clinical impression was neurodermatitis, but a biopsy specimen revealed lentigo maligna without melanin pigmentation. To our knowledge, this is the first case of amelanotic lentigo maligna reported in the English literature in which the clinical presentation was dermatitis-like. Our experience suggests that biopsy should be done on all clinically changing sites of treated lentigo maligna, whether the changes are pigmented or not.
In order to explore the possibility of a mutually exclusive relationship between schizophrenia and certain psychosomatic disorders, 354 adult schizophrenic patients, both acute and chronic, were studied with regard to lifetime prevalence of peptic ulcer, bronchial asthma, neurodermatitis and rheumatoid arthritis. Significant evidence to support the hypothesis of mutual exclusivity was found only in the case of peptic ulcer in the overall sample. Prevalence was higher in younger, more acute patients than in older, chronic patients, but this finding was difficult to interpret. Parallel enquiry into the prevalence of schizophrenia and the same disorders among close family members of the patients yielded inconclusive results.
Behavior change professionals have developed treatment programs for a wide variety of health care problems affecting adolescents. Although a substantial data base of experimentally tested techniques exists for obesity, smoking prevention, and dysmenorrhea, much work remains in other areas. For example, the case studies reported on neurodermatitis and the survey work in teenage alcohol abuse must give way to systematic interventions employing group experimental designs. In addition, behavioral procedures should be compared to other treatments. Also, component analysis should be performed when multiple treatment strategies are used. Finally, strategies aimed at increasing the generalization of treatment, such as from classrooms to different community settings in substance abuse prevention programs and maintenance of treatment effects over long follow-up periods, are necessary. Only in this way will the efficacy of behavioral interventions for specific health problems be established. The leading causes of mortality among adolescents are due to accidents. Of the total number of deaths due to accidents, approximately 50% are attributed to motor vehicle accidents (National Safety Council, 1977). Many of these accidents are due to negligence, substance abuse, and, in general, immature behavior (Bakwin & Bakwin, 1972). In spite of a slow but consistent trend toward lower accidental deaths over time (National Safety Council, 1977), there still is a need for interventions designed to decrease risk-taking behavior, substance abuse, and carelessness in adolescents. Again, behavior change professionals might follow the example set by researchers who have begun to develop successful strategies for decreasing onset of cigarette smoking. These interventions and research methods, designed for use in schools, may provide a promising approach for addressing other kinds of prevention problems. It also seems appropriate to categorize cigarette smoking not only as a risk factor in the development of cardiovascular disease (Kuller, 1976), but also as a member of the risk-taking behaviors. Thus, procedures used to prevent cigarette smoking might also be adapted to prevent other kinds of risk-taking behaviors among adolescents. The work of McAlister et al. (1980), in preventing alcohol abuse as well as cigarette smoking by use of the same or similar procedures, is a case in point. Use of a procedure designed to train competency in refusing peer pressure has clear implications for reducing other risk-taking behaviors, such as reckless driving, drug abuse, and swimming and boating accidents.(ABSTRACT TRUNCATED AT 400 WORDS)
Using the paper-radioimmunosorbens test (PRIST) normal values were obtained from 200 non-allergic children. The IgE level was aged-dependent, in part with significant differences between various age groups. These normal values were compared with those in children with seborrhoeic dermitis, constitutional neurodermatitis, parasitoses, urticaria, Quincke oedema, Schönlein-Henoch purpura, pityriasis rosea, multiform exudative erythema, erythema nodosum and infantile papular acrodermatitis. Half-life of IgE in neonates was 16.2 hours.
BACKGROUND: Tobacco smoke, containing more than 4800 chemical substances with a large number of mutagenic and carcinogenic compounds, is the most important indoor pollution. Aim of the study was to analyse the relationship between exposure of children (2-15 years) to environmental tobacco smoke (ETS) with the amount of respiratory diseases, the occurrence of atopic diseases and the risk for genotoxic damage. PATIENTS AND METHODS: Within the last 1.5 years 216 children were included in the study. Smoking habits of the family, environmental settings, housing, nutrition, social and economic factors were assessed by a detailed questionnaire. Two different effect markers were used to assess molecular and genetic damage. Biochemical effect of ETS was quantified by 4-aminobiphenyl-hemoglobin (4-ABP-Hb) adducts and the genotoxic damage was determined by chromosomal damage as seen in the micro nucleus test in lymphocytes. RESULTS: Chronic rhinosinusitis and allergic rhinitis are accumulated in the ETS-exposed children. In the ETS-group atopic diseases (allergic rhinitis, extrinsic asthma or neurodermatitis) were significantly more frequent (39.5 %, p = 0.01) than in the non-exposed group (23 %). In addition the genetic predisposition was significantly decreased in the ETS-group (20.8 %, p = 0.048) compared to the non-exposed group (45 %). Until now, blood samples of 63 individuals were analysed for Hb adducts and 92 for micro nuclei. Hemoglobin adducts of 4-ABP, a human carcinogenic aromatic amine, were significantly elevated in children with smoking parents (mean: 82.2pg/g Hb, p = 0.003) compared to children with non-smoking parents (mean: 60.6 pg/g Hb). ETS-exposed children showed significantly higher micro nucleus frequencies (mean ETS: 8.0/1000 binucleate (BN) cells, p = 0.001) than non-ETS exposed children (mean: 6.2/1000 BN cells). CONCLUSION: Our data underline the thesis, that ETS plays an important role for the development of atopic diseases. The significantly increased effect markers of tobacco smoke in exposed children give evidence, that ETS causes elevated molecular and genotoxic damage in children.
We describe the clinico-pathologic features of 44 patients with a peculiar pretibial pruritic papular dermatitis (PPPD). Clinically, PPPD consists of discrete, roundish, extremely pruritic papules with a smooth surface caused by the delicate and persistent rubbing of pretibial skin. Histologically, PPPD showed minimal compact orthokeratosis, flattening of the rete ridges, a superficial and mid-dermal perivascular and interstitial infiltrate of lymphocytes, histiocytes, eosinophils and multinucleated fibroblasts, and thickened collagen bundles in haphazard array in the superficial dermis. The clinical picture of PPPD closely resembled that of lichen simplex chronicus/circumscribed neurodermatitis or lichen amyloidosus. Histologically, the absence of uneven psoriasiform epidermal hyperplasia, marked compact orthokeratosis, hypergranulosis, and coarse bundles of collagen arranged in vertical streaks in the papillary dermis distinguished PPPD from lichen simplex chronicus, whereas the lack of amyloid deposits in the dermal papillae differentiated PPPD from lichen amyloidosus. We suggest that PPPD is an unusual morphologic expression of gentle and chronic rubbing of pretibial skin with distinctive histopathologic features.
Those who dye their hair frequently manifest allergic contact dermatitis (ACD) from p-phenylenediamine (PPD)-containing hair dye. PPD is known to be the most frequent sensitizer in hair dye, but there has been no documentation of this sensitizer having a role in chronic dermatologic conditions. Our department experienced a case of a 62-year-old woman with lichen simplex chronicus (LSC), who complained of aggravation after hair dyeing and made such an association. We conducted a prospective and retrospective study to further evaluate the clinical associations between the two. In our prospective study, patch testing was performed in selected patients who regularly carried out hair dyeing and also had clinical manifestations of LSC. Also a retrospective examination was conducted in cases where patch testing had been performed with PPD in the past for suspected ACD and further selected cases with concurrent LSC and/or other neurodermatitis. 11 and 14 patients in our prospective and retrospective study, respectively, presented with both LSC and positive findings to PPD. 5 (45.5%) and 4 (28.6%) patients in our prospective and retrospective study showed clinical relevance from clinical improvement after stopping use and rechallenge. We report several cases of patients diagnosed as having LSC and/or prurigo nodularis who showed clinical improvement after discontinuing the use of hair dye. The suggestion can therefore be made that hair dye could be a possible aetiologic agent causing LSC in those using hair dyes.
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.
The use of corticosteroids systemically in dermatology has benefited patients with pemphigus and systemic lupus erythematosus in that they now have a better chance to carry on a productive life. These hormones, used cautiously, can alleviate some of the tremendous suffering during the explosive exacerbations and acute crises of atopic and neurodermatitis. Corticosteroids are useful in the widespread and acute contact dermatitis and drug eruptions; they are contraindicated in the treatment of ordinary psoriasis. Every attempt should be made by history-taking, clinical examination and necessary laboratory studies to reach an accurate diagnosis before corticosteroids are used. If use of them is indicated, then total patient care is required to avoid complications, and a very careful follow-up is mandatory.
The most common dermatoese encountered in the adolescent-acne, seborrhea, neurodermatitis, contact dermatitis, warts pyodermas, fungal infections and venereal disease-are discussed. Specific treatments are described, and proprietary preparations are indicated.
Hepatic mitochondrial respiration was recorded by polarography in various metabolic states using relevant substrates and inhibitors in rat male experiments in vivo and in vitro. The above measurements were made following electrophoresis of parmidine and phencarol in 50% dimexide solution. Parmidine from dimexide solution proved indifferent to mitochondrial energy apparatus, while phencarol could inhibit NADH-dehydrogenase link of the respiratory chain and arrest dimexide inhibition of succinate oxidase system. The findings provided a basis for therapeutic procedures which were tested in 105 patients. The immediate response of coronary and neurodermatitis patients appeared satisfactory.
Atopic dermatitis (a. D.) is a chronically relapsing inflammatory disease of the skin caused by a genetically transmitted hypersensitivity to environmental substances. Its pathogenesis is complex and multifactorial: heredity of atopic constitution, disturbances of humoral (hyperimmunoglobulinemia-E) and cellular (defect of suppressor-T-cells) immunity, abnormal vascular reactions and abnormal skin functions. A. D. shows different forms in different age groups: Eczema infantum in infancy, Eczema flexurarum in childhood and Neurodermatitis disseminata and pruriginosa while and after puberty. Typically for all forms is a pruritus and the status neurodermiticus. The healing of a. D. is spontaneously possible at any time, but not predictable for a special case.
For the purpose of improving disturbances of the immunosystem 188 plasmaphereses were carried out in 64 patients. This reports deals with the results of 85 therapeutic plasmaphereses in 39 patients with rheumatoid arthritis, diabetes mellitus, and neurodermatitis or pregnant women with rhesus antibodies for diminishing antibody titres. The Soviet equipment of the type RK-0.5, PF-0.5 and FK-3.5 as well as the US devices Aminco and IBM were used. A decrease of the serum protein content from 9-13% appeared immediately after plasmaphereses with 1.3 l of plasma withdrawal per week and an average substitution of 40% of the protein loss by using a 5% solution of albumin. A continual control of this parameter is necessary.
Structural changes in the blood mononuclear glycocalyx has been revealed in children suffering from neurodermatitis. These shifts correlated with the cellular ability to respond to mitogenic stimulation. Treatment by UV-irradiated blood autotransfusions normalized the structure and function of mononuclears whereas routine therapy has been ineffective.