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At least 955 records · Page 53Linked to original sources
PubMed1977

Oriented fibrin crystallization: A phenomenon of hypersensitivity to bacteria in psoriasis, vasculitis and other dermatoses.

Heparinized blood from patients with a variety of dermatological problems was incubated with killed bacteria, bacterial extracts or Gram-negative bacterial endotoxin. Within 18-24 h asteroid bodies consisting of an amorphous centre with fine radiating needle crystals were seen. These bodies, not found in the blood of healthy volunteers, were most consistently observed in blood from patients with psoriasis, vasculitis and bacterial infections. Immunofluorescent studies disclosed the asteroid formations to be crystals of fibrin radiating presumably from a central platelet aggregate. The failure to demonstrate IgG, A, M or D suggests that the phenomenon results from the bacterial activation of complement by a non-immune yet specific pathway which in turn involves white cells, platelet aggregation and release of procoagulants.

Antigens, Bacterial↗
PubMed1980

A comparison of IgA positive and IgA negative dapsone responsive dermatoses.

A study of thirty-three patients with a clinical diagnosis of dermatitis herpetiformis (DH) referred to our DH clinic over the las 11 years is reported. Twenty-six were referred by other consultant dermatologists. The diagnosis had been made by the clinical features and response of the rash to dapsone. Seventeen patients were found to have IgA in the uninvolved skin (IgA positive) and in sixteen no IgA was found (IgA negative). The duration of the rash prior to referral to the DH clinic was 3 months to 19 years (mean 5.0 years) for the IgA negative patients and 2 months to 22 years (mean 5.2 years) for the IgA positive group. The length of follow-up was 3 months to 11 years (mean 5.0 years) for the IgA negative, and 2--11 years (mean 5.6 years) for the IgA positive group. During follow-up the rash cleared completely and required no treatment in seven of the sixteen IgA negative patients. Thirteen of these sixteen patients no longer required dapsone, but six patients were receiving alternative treatment. In the three patients still taking dapsone IgA has not been found on subsequent biopsy. Of the seventeen IgA positive patients only three were able to stop dapsone during follow-up and in these three the IgA was still detected in the skin. Small intestinal mucosa was abnormal in eight of eleven IgA positive patients, but was normal in all thirteen IgA negative patients in whom jejunal biopsies were performed. An alternative diagnosis to DH has subsequently been made in thirteen of the sixteen IgA negative patients. Although the significance of IgA in the skin in DH is not known it appears to be part of the disease process. Patients who have a rash suggestive of DH and which is dapsone responsive, but in whom IgA is not found in the uninvolved skin, usually turn out to have a dermatosis other than dermatitis herpetiformis. Referral to a unit with expertise in immunofluorescence techniques of skin biopsies would appear to be helpful.

Adolescent↗
PubMed1989

Dermatoses in five related female carriers of X-linked chronic granulomatous disease.

Eight female members of a family with X-linked chronic granulomatous disease were identified. Five were shown to be carriers of the disease gene. Each of these female carriers of the gene had a history of skin eruptions. The identification of the carrier state is important as genetic counselling should be offered and the prenatal diagnosis of this disorder is possible.

Adult↗
PubMed1992

Allergic contact dermatitis and vulvar dermatoses.

Vulval itch and discomfort are often intractable symptoms and the response to standard therapy can be unsatisfactory. There is some evidence that vulvar sensitivity to irritants is higher than that of forearm skin, but the incidence of relevant allergic contact sensitivity amongst this patient population is unknown. The patch-test data over a 5-year period of 135 patients with persistent vulval symptoms were reviewed and 63 patients had positive results. Of these, 39 had positive results considered to be relevant to their clinical condition. Medicaments and their constituents were responsible for most of these reactions and more than half the patients had multiple allergies.

Adolescent↗
PubMed1992

A prospective immunofluorescence study of 111 cases of pruritic dermatoses of pregnancy: IgM anti-basement membrane zone antibodies as a novel finding.

Since 1981, all pregnant women presenting to our department with a pruritic dermatosis have been investigated by histological and immunopathological techniques. We recruited 111 patients and performed skin histology in 77, 109 direct immunofluorescence tests (DIF), 74 indirect immunofluorescence tests (IIF) and 15 Western blots (WB). We identified: (i) five typical cases of pemphigoid gestationis (PG) (4.5%), corresponding to an incidence of 1/7000 pregnancies. (ii) Five cases without PG but showing circulating anti-BMZ antibodies of IgM type. With the exception of one case, clinical features were homogeneous--occurrence of erythematous papular and/or urticarial lesions on the trunk, and less often, on the limbs between the 32nd and 38th week of pregnancy. Rapid clearance of lesions within a few days was the rule. Whenever performed, DIF was negative and IIF showed circulating anti-BMZ antibodies of IgM type. Western blot studies were negative in these five cases. (iii) One hundred and one cases with negative immunofluorescence tests, considered to be suffering from polymorphic eruption of pregnancy. Our results show the value of systematic immunopathological investigations in pregnant women presenting with a pruritic dermatosis, and raise the possibility of a new entity, as defined by circulating anti-BMZ antibodies of IgM type.

Adult↗
PubMed1994

Increased concentration of beta-endorphin in sera of patients with psoriasis and other inflammatory dermatoses.

Serum beta-endorphin was quantified by radioimmunoassay in 71 patients with psoriasis vulgaris, other chronic inflammatory skin diseases with T-cell infiltrates [atopic dermatitis (n = 25), and systemic sclerosis (n = 34)], and 100 healthy subjects. The neuropeptide was found to be markedly (P < 0.001) increased in patients with psoriasis (14.4 pg/ml), atopic dermatitis (9.2 pg/ml) and systemic sclerosis (9.8 pg/ml) compared with normal controls (6.1 pg/ml). The highest values of beta-endorphin were found in patients with actively spreading plaque psoriasis (17.3 pg/ml), whereas lesion-free patients showed a reduction in neuropeptide concentration (10.2 pg/ml). The levels were much higher in patients with widespread psoriatic lesions (> 60% body surface; 16.2 pg/ml), which lasted longer than 3 months (15.8 pg/ml), whereas neither the presence of stress nor itching correlated with the serum peptide concentration. Our data suggest that beta-endorphin is produced in psoriatic lesions by inflammatory cells, rather than the increased levels being the result of activation of the pituitary-adrenal axis by chronic stress. The generation of neuropeptide in psoriatic lesions and its antinociceptive effect on the peripheral sensory nerves might explain why pruritus is a relatively rare phenomenon in psoriasis.

Acute Disease↗
PubMed1996

A new microemulsion formulation of cyclosporin (Neoral) is effective in the treatment of cyclosporin-resistant dermatoses.

Cyclosporin is a highly effective treatment for severe psoriasis and atopic dermatitis. However, both inter- and intrapatient gastrointestinal absorption of the conventional formulation of cyclosporin (Sandimmun) are very variable, ranging from 20 to 50%. Variations in bioavailability may explain isolated resistance to therapy. Neoral is a novel microemulsion formulation of cyclosporin which has been developed to enhance and standardize its absorption. We report the first experience with Neoral in patients with psoriasis and atopic dermatitis refractory to Sandimmun.

Adult↗