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At least 919 records · Page 51Linked to original sources
PubMed1998

Remember to consider dermatophyte infection when dealing with recalcitrant dermatoses.

BACKGROUND: Superficial fungal infections of the skin are among the most common infections encountered in medicine. The diagnosis is easily confirmed with simple office-based procedures. In certain clinical situations, the diagnosis can be elusive. METHODS: We analyzed clinical data on five patients who came in referral for treatment of a recalcitrant dermatosis. RESULTS: All patients had their diagnosis confirmed by a positive potassium hydroxide preparation from skin scrapings or by a skin biopsy positive for fungal elements. All showed clinical improvement and ultimate resolution of their skin lesions with topical and/or systemic antifungal therapy. CONCLUSIONS: Diagnosis can be complicated by previous use of corticosteroid-containing topical and/or systemic agents, a clinical history closely resembling that of a photosensitive disorder, and a lack of clinical-histopathologic correlation. Laboratory procedures and skin biopsy of an ambiguous appearing lesion can be diagnostic, but an accurate diagnosis is dependent on communication between the clinician and the pathologist. We recommend that office-based procedures be done early in treatment so that subsequent efforts can be directed toward providing appropriate therapies.

Adolescent↗
PubMed2001

Farm-related dermatoses in Iowa male farmers and wives of farmers: a cross-sectional analysis of the Iowa Farm Family Health and Hazard Surveillance Project.

Agricultural workers are exposed to a variety of hazards that increase their risk for dermatitis. Nevertheless, the prevalence, patterns, and risk factors for dermatitis have not been well characterized among farmers in the United States. We assessed the prevalence and risk factors for dermatitis among 382 male farmers and 256 wives of farmers in Iowa using a cross-sectional study design. From 1992 to 1994, we collected data on potential risk factors and dermatitis. The results showed that 9.6% of male farmers and 14.4% of wives of farmers reported dermatitis during the previous 12-month period. In multivariable models, a history of allergy (odds ratio [OR], 8.2; 95% confidence interval [CI], 2.0 to 33.3) was strongly associated with dermatitis among male farmers. Among wives of farmers, some college education (OR, 3.4; 95% CI, 1.1 to 9.9) and exposure to petroleum products (OR, 3.1; 95% CI, 1.3 to 7.0) were associated with dermatitis. These results can be used to form preventive efforts in controlling farmwork-related exposures.

Adult↗
PubMed1986

Contraction of collagen lattices by skin fibroblasts from dystrophic recessive epidermolysis bullosa and other dermatoses.

Skin fibroblasts incorporated into a lattice of hydrated collagen contract it to form a tissue-like structure. Fibroblasts from patients with skin diseases, including psoriasis, epidermolysis bullosa, and scleroderma, and from control subjects, all showed a similar ability to contract the lattice. The established skin epithelial cell line NCTC 2544, melanoma cells, and 3T6 mouse fibroblasts produced little contraction. Contraction required the presence of serum and was unaffected by the addition of fibronectin (10-20 micrograms/ml). Hyaluronic acid at 50-500 micrograms/ml had no effect, but contraction was inhibited at 1 mg/ml.

Cell Line↗
PubMed1988

A unique phospholipase A2 in human epidermis: its physiologic function and its level in certain dermatoses.

It is now well established that epidermis, like many other tissues, contains a phospholipase A2 that is responsible for the initiation of the arachidonic acid cascade. Here we report that human epidermis also contains a second, quite distinct enzyme of the phospholipase A2 group, which is unique in its extreme activity against phospholipids in true solution. It also differs from the classic cutaneous enzyme in that (a) its activity is not reduced by pretreatment of the skin with corticosteroids in vivo nor by treatment of the epidermal homogenate with alkaline phosphatase in vitro, and (b) its activity is reduced, rather than increased, in the lesions of inflammatory diseases such as psoriasis. The enzyme seems to occur mainly in fully differentiated keratinocytes, its level being low in the basal cell layer of epidermis and in keratinocytes cultured in vitro. On the basis of these observations, we suggest that this new phospholipase A2 is responsible for the degradation of phospholipids that accompanies the terminal keratinization process.

Alkaline Phosphatase↗
PubMed1993

Inhibition of neutrophil adherence to antibody by dapsone: a possible therapeutic mechanism of dapsone in the treatment of IgA dermatoses.

Dapsone is frequently effective in cutaneous diseases characterized by antibody deposition and accumulation of neutrophils. We hypothesized that this mechanism of action of dapsone may involve the inhibition of neutrophil adherence to antibody. The neutrophil adherence assay, which measures the binding of neutrophils to basement membrane zone-bound antibody on skin sections, was used to evaluate the effect of dapsone on neutrophil adherence to immunoglobulin A and immunoglobulin G. We evaluated the effect of dapsone on adherence of normal neutrophils to immunoglobulin A and immunoglobulin G from sera of linear immunoglobulin A bullous dermatosis and bullous pemphigoid patients, respectively. Linear immunoglobulin A bullous dermatosis or bullous pemphigoid antibody were bound to the basement membrane zone of normal skin sections as a substrate for the neutrophil adherence assay. Dapsone was added directly to the neutrophils or to the antibody source in concentrations of 0-50 micrograms/ml (pharmacologic range). Addition of dapsone to neutrophils produced an incremental inhibition of neutrophil adherence up to 75% at 50 micrograms/ml. Dapsone produced similar inhibition when added directly to the antibody itself, despite washing prior to usage in the neutrophil-adherence assay. Control specimens including irrelevant fractions of patient sera failed to demonstrate binding. Serum from a patient on dapsone therapy also showed inhibition of neutrophil adherence compared to the same patient on no therapy. We conclude that dapsone inhibits the adherence of neutrophils to basement membrane zone antibody in a dose-dependent manner. This may be related to an effect directly on antibody. This inhibition may contribute to the clinical efficacy of dapsone in antibody-mediated diseases.

Adult↗
PubMed1981

IgA-associated inhibition of polymorphonuclear leukocyte chemotaxis in neutrophilic dermatoses.

The chemotactic activity of normal human polymorphonuclear leukocytes (PMNs) confronted with heat inactivated sera from patients with psoriasis as well as various chronic proliferative diseases was determined using modified Boyden chambers. By the addition of phorbol myristate acetate (PMA) at a concentration of 1 ng/ml the chemoattractant activities of the sera were greatly potentiated. However, the chemotactic migration of normal PMNs was strongly inhibited by sera from patients with long standing and wide spread psoriasis, pyoderma gangrenosum, severe acne conglobata, Sweet syndrome, and some patients with chronic arthritis following rheumatoid fever. In acute guttate psoriasis and atopic dermatitis increased migratory activities were seen. The inhibition of chemotaxis correlated with increased serum IgA levels as determined by radial immuno diffusion. Column chromatography (Sephacryl S-300) revealed serum fractions of strong inhibitory potency at a molecular weight near 200,000 Dalton. These inhibitory fractions were seen in patients with long standing neutrophil related diseases and could not be detected in normal control sera. It appears that inhibition of PMN chemotaxis is a secondary phenomenon and may play an autoregulatory role in PMN related inflammation.

Adolescent↗
PubMed1990

Inherited mouse mutations as models of human adnexal, cornification, and papulosquamous dermatoses.

Nearly 100 mouse mutations have been described as causing some type of abnormality of the skin or hair. As only a few of these mutations have been studied in detail, they remain an untapped resource for furthering knowledge of basic cutaneous physiology and understanding the pathophysiology of analogous diseases in humans. Several diverse murine mutations are discussed. These include "asebia," a mildly hyperkeratotic disorder with sebaceous gland hypoplasia; "ichthyosis," an example of abnormal hair growth associated with hyperkeratosis; "rhino" and "hairless," two related examples of congenital follicular malformations; and "flaky skin", a potential animal model of eruptive psoriasis.

Animals↗
PubMed1986

Different in situ distribution patterns of dendritic cells having Langerhans (T6+) and interdigitating (RFD1+) cell immunophenotype in psoriasis, atopic dermatitis, and other inflammatory dermatoses.

Dendritic cells bearing Langerhans cell (OKT6+) or interdigitating cell (RFD1+) immunophenotype may be regularly detected within the dermis of chronic skin diseases characterized by a lymphohistiocytic (lymphoreticular) infiltrate. These 2 subsets of antigen-presenting cells within the dermis of lesions of exacerbating chronic plaque psoriasis, exacerbating nummular dermatitis (discoid eczema), atopic dermatitis, allergic contact dermatitis, pityriasis rosea, lichen ruber planus, and cutaneous lupus erythematosus were quantified using computer-assisted morphometry. The mean dendrite length per dermal dendritic cell was significantly higher for RFD1 than for OKT6 (74.4 +/- 0.98 microns vs 70.0 +/- 1.26 microns: p = 0.0023). The mean dendrite length per dermal dendritic cell was remarkably constant for each marker in the various diagnostic categories studied. Disease-specific patterns of total dendrite length and number (expressed per 100 infiltrating mononuclear cells) of these 2 dendritic cell types within the subepidermal infiltrates were obtained. Pityriasis rosea was characterized by its unique high percentage of OKT6+ Langerhans cells. Atopic dermatitis and psoriasis had relatively high percentages of both RFD1+ interdigitating cells and OKT6+ Langerhans cells. Nummular dermatitis had an intermediate number and total dendrite length for OKT6, but was relatively low in RFD1+ cells. Allergic contact dermatitis, lichen planus, and lupus erythematosus had low numbers and dendrite lengths for both dendritic cell subsets. It is suggested that pityriasis rosea is characterized by an abnormal migration pattern of Langerhans cells. Psoriasis and atopic dermatitis may be examples of diseases in which skin-localized antigen-presenting and T-cell-inducing events are continuously taking place. The other diseases may reflect inflammatory processes in which local antigen presentation is less relevant to the tissue reaction.

Antigen-Presenting Cells↗