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Thirty hours' evaluation of UVB-induced erythema by chromometry and microflowmetry.

BACKGROUND: Individual UVB photosensitivity is usually investigated by determining the minimal erythemal dose (MED). Nevertheless, factors such as room light intensity and subjective experience of the observer can influence the erythema perception and, therefore, the MED assessment. OBJECTIVE: To evaluate the relationship between the clinical and the chromometric and microflowmetric analyses of the UVB-induced erythema in 2 healthy volunteers. METHODS: A bank of 6 fluorescent mercury vapor tubes (Philips TL 12/20 W) was utilized as a source of UVB light. Three skin areas (4 cm2), from the dorsal region of each subject, were irradiated with 3 different UVB doses corresponding to: (1) MED; (2) 0.7 MED, and (3) 1.3 MED. RESULTS: (1) both microflowmetric and chromometric parameters reached a maximum peak 10-12 h after irradiation and maintained high values also 30 h after irradiation; (2) both microflowmetric and chromometric values were directly related to the UVB doses; (3) in some cases the microflowmetric values started to increase when the chromatic changes were still undetectable. CONCLUSION: These preliminary data confirm that the visual determination of MED performed 24 h after irradiation is a correct procedure. Nevertheless, the microflowmetric may precede the chromatic changes suggesting that vasodilatation follows irradiation without a latent period.

Adult↗

Erythema gyratum repens: another case of a rare disorder but no new insight into pathogenesis.

Erythema gyratum repens (EGR) is an uncommon but distinctive dermatosis characterized by marble-like swirls of erythema and a thin covering scale over the trunk, axillae and groins which has been associated with malignancy. Bronchial carcinoma has been the most frequent neoplasm associated. A case of EGR in a 50-year-old man with carcinoma of the lung is reported. The onset of dermatosis preceded the discovery of the neoplasm by 9 months. Oral corticosteroids induced the disappearance of the skin lesions. No recurrence was observed after discontinuation of the treatment. The patient died 1 year after the onset of dermatosis.

Carcinoma, Non-Small-Cell Lung↗

Taxol-induced acral erythema.

Chemotherapy-induced acral erythema is a peculiar localized cutaneous response to several chemotherapeutic agents, mostly antimetabolites. Taxol is a recently developed antineoplastic drug that acts on the mitotic spindle and does not interfere with nucleic acid synthesis. We describe the first case of taxol-induced acral erythema and report on additional data concerning the pathogenesis of this kind of toxic eruptions.

Adult↗

Measurement of actinic erythema in healthy subjects and in subjects with polymorphous light eruption using a tristimulus colorimeter.

BACKGROUND: The assessment of actinic erythema using a tristimulus colorimeter has only been reported from healthy volunteers but never from subjects with photodermatosis. OBJECTIVE: The aim of this study was to analyse the difference of chromometric measurements in patients with polymorphous light eruption versus healthy subjects. METHODS: Seventy-two subjects were subdivided according to two criteria: skin colour and clinical state. Measurements were done on a non-irradiated site and at the clinical minimal erythema dose site in the L*, a* and b* modes. RESULTS: The data submitted to two-way analysis of variance demonstrate the influence of skin colour and clinical state on the above parameters. CONCLUSION: Chromometric measurements of L* help to differentiate skin colour, whereas those of a* enable the discrimination of healthy subjects from those with photodermatosis.

Adult↗

'Flagellate' erythema in dermatomyositis.

We report a case presenting with 'flagellate' erythema which is a characteristic skin lesion of dermatomyositis seen in Japan. A possible pathological mechanism is proposed in comparison with the 'flagellate' erythema caused by bleomycin.

Bleomycin↗

Eruption resembling erythema gyratum repens in linear IgA dermatosis.

We report a case of linear IgA dermatosis associated with eruptions resembling erythema gyratum repens in a 62-year-old man. The patient revealed no clinical and laboratory evidence of an underlying malignancy. The presence of eruptions similar to erythema gyratum repens during the course of bullous dermatoses has been described in only eight reports.

Basement Membrane↗

Necrolytic migratory erythema without glucagonoma in a heroin-dependent patient.

We described a case of necrolytic migratory erythema without glucagonoma in a 33-year-old man. The patient had been heroin-dependent, HIV negative since the age of 23. He had no medical history of note and all the investigations revealed normal parameters. This is the first case of necrolytic migratory erythema without glucagonoma associated with heroin abuse.

Adult↗

Erythema multiforme-like eruption in association with severe headache following pyritinol.

A 46-year-old woman presented with an unusual erythema multiforme-like eruption and severe headache 10 days after treatment with pyritinol for cerebral concussion. Histopathologic findings were consistent with erythema multiforme. Skin lesions and headache cleared after withdrawal of the drug. According to neurological examination and magnetic resonance imaging of the brain, the headache may have resulted from a slight, pyritinol-induced vasculitis. Previous reports on severe pyritinol-induced side effects and possible pathogenetic mechanisms are reviewed. Since pyritinol cannot be considered as an essential drug for cerebral concussion, adverse effects as described here raise doubts as to its general use in the given indication.

Brain↗

Erythema chronicum migrans: evidence for cellular immune reaction in the skin lesion.

Skin biopsy specimens from 9 patients with erythema chronicum migrans (ECM) were studied immunohistochemically using a series of monoclonal antibodies. In biopsy specimens taken from the erythematous peripheral portion of ECM the perivascular infiltrates were composed predominantly of LEU-4+ T cells. LEU-3a + helper/inducer T cells were more numerous than LEU-2a + cytotoxic/suppressor T cells. Of particular interest was the high number of LEU-6+ Langerhans cells in the epidermis and dermis of specimens taken from the erythematous portion of ECM as well as from the noninflammatory skin outside the erythema. The presence of LEU-6+ Langerhans cells and T cells in the ECM lesions suggests that, apart from humoral factors, a cell-mediated immune response directed against Borrelia burgdorferi antigen is important as well in the pathogenesis of this disease.

Borrelia Infections↗

Erythema gyratum perstans: association with a familial neurologic disease.

Two members of the same family with erythema gyratum perstans and hypertrophic neuritis are reported. The dermatosis could be an expression of localization of neuritis to nerva vasorum with abnormal neurovascular response of cutaneous small vessels to normal stimuli with active erythema followed by cyanosis.

Adolescent↗

Necrolytic migratory erythema associated with an islet cell tumour of the pancreas.

A man of 59 is described with a characteristic skin eruption, necrolytic migratory erythema, associated with a malignant islet cell pancreatic tumour. There was no definite evidence that this was a glucagonoma although previous reports have suggested that the pancreatic tumour usually associated with necrolytic migratory erythema is always a glucagonoma. The relevant literature is reviewed.

Adenoma, Islet Cell↗

Suppression of ultraviolet erythema by topical corticosteroids.

The effect of three commercially available corticosteroid preparations on ultraviolet (UV) erythema reaction was studied in healthy volunteers. Four series of circles were marked on the skin of their backs. One half of the circle of each series received 0.01 ml of 0.05% betamethasone valerate, 0.1% triamcinolone acetonide and 0.01% hydrocortisone 17-butyrate dissolved in isopropyl alcohol or ethanol and was covered with impermeable plastic. 24 h later, the sites were irradiated with UV light from a Kromayer lamp during 2, 4, 8, 16 or 32 sec. The reactions were evaluated 24 h afterwards. The suppression effect of corticosteroids was expressed as the blanching score (0-3). In a second series of experiments, the reversed sequence was tested: irradiation with UV light was followed by the application of corticosteroids (betamethasone and hydrocortisone). In both series of experiments the blanching effect of the corticosteroids was found to decrease with increasing UV dose. Corticosteroids applied after irradiation were found to have stronger blanching effects. With UV doses of 1 minimum erythema dose (MED), mean blanching scores of 2.3-3.0 were registered, while with doses of 4 MED or more, only small effects were noticed. The three corticosteroid preparations showed comparable suppression effects.

Administration, Topical↗

Yersinia enterocolitica as a cause of erythema nodosum.

54 cases of erythema nodosum, seen in the Department of Dermatology at the St. Raphael University Hospital, Louvain, were reviewed for their possible aetiology. A search for Yersinia enterocolitica (Y.e.) agglutinins was performed in 21 patients of whom 8 had significant serum antibody titres. These cases are presented and discussed. Gastro-intestinal symptoms, preceding by 2 weeks the erythema nodosum, are strongly suggestive for an aetiologic link with Y.e. Our observations confirm and extend to this part of Europe, the experience of other, mainly Scandinavian, authors.

Adolescent↗

Enhanced prostaglandin synthesis after ultraviolet injury is mediated by endogenous histamine stimulation. A mechanism for irradiation erythema.

Acute ultraviolet light B (UVB) injury is associated with dermal mast cell histamine release. The possibility that histamine-stimulated prostaglandin (PG) synthesis could be a mechanism for irradiation erythema was therefore examined using human skin explants. Explants responded to UV irradiation (120 mJ/cm2) with a fivefold increase in synthesis of prostaglandins E2, F2 alpha and 6-keto PGF1 alpha. Incubating explants with the H1 antihistamines brompheniramine (50 microM) or pyrilamine (30 microM) inhibited PG release from irradiated explants 63 +/- 4.9% (mean +/- SEM) 6 h after UV exposure. Antihistamines did not affect PG synthesis in control explants. Irradiation increased the histamine concentration in explant conditioned medium only 50% over basal values, suggesting that irradiation enhanced histamine responsiveness. Explants were therefore incubated with exogenous histamine. In irradiated explants, PG synthesis was stimulated threefold by 3 microM histamine. Unirradiated explants' PG synthesis was unaffected by histamine. Enhanced histamine sensitivity was also examined in epidermal cell cultures. In irradiated cultures, histamine sensitivity was again markedly potentiated: as little as 1 microM histamine stimulated significant PGE2 release and the response to 10-30 microM histamine was increased six to eight times compared with that of unirradiated cultures. These studies demonstrate that endogenous histamine stimulates PG synthesis in human skin after UV injury by potentiation of histamine-induced prostaglandin release. Potentiated agonist responses induced by UV exposure may contribute to the effects of UVB irradiation injury and in particular to irradiation erythema.

Animals↗

Erythema multiforme and herpes simplex virus.

It has been suggested that herpes simplex virus (HSV) can trigger erythema multiforme (EM) at different times. One recent study showed HSV antigen in immune complexes of patients with EM. The purpose of our study was to assess a possible association between EM and HSV. Sixteen patients and 16 matched controls were studied using an enzyme-linked immunosorbent assay (ELISA) to measure antibody of the IgG, IgA, and IgM classes against HSV-1. From our study on patients with oral erythema multiforme, we found no evidence to correlate the occurrence and/or severity of EM and the HSV-1.

Adult↗

Erythema nodosum following typhoid vaccination.

Erythema nodosum has recently been recognised in association with salmonella infection (1). We report a case of classical erythema nodosum which developed following a typhoid vaccination.

Erythema Nodosum↗

Erythema ab igne in chronic pancreatic pain: a diagnostic sign.

Two patients with severe chronic pain of pancreatic origin are described. In both there was severe back pain and an area of erythema ab igne lay directly over the portion of the pancreas giving rise to the pain. In both patients therapy directed at these areas of diseased pancreas resulted in relief of symptoms. The presence of erythema ab igne on a patient's back at the level of T12-L2 should arouse suspicion of underlying pancreatic pathology, and this may be valuable in a disease with remarkably little to find on clinical examination. In one patient early obstruction of the pancreatic duct by pancreatic carcinoma caused distal chronic pancreatitis and back pain many months before the onset of obstructive jaundice.

Aged↗