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[Clinical significance of infection with cag A and vac A positive Helicobacter pylori strains].

Clinical relevance of infection with different Helicobacter pylori strains was reviewed in this paper. Helicobacter pylori (H. pylori) infection plays a role in pathogenesis of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma and MALT lymphoma. Extragastric manifestations of H. pylori infection most probably include acne rosacea and chronic urticaria, while the importance of H. pylori infection for pathogenesis of growth retardation in children, iron deficiency anemia, coronary heart disease, stroke and idiopathic thrombocytopenic purpura remains vague. The expression of two H. pylori proteins, cytotoxin associated protein (cag A) and vacuolization cytotoxin (vac A) is considered to be related with pathogenicity of the bacterium. It is clear that presence of cag A+ strains is important for development of peptic ulcer; nevertheless, it is also protective against esophageal reflux disease. On the other hand, cag A+ strains are common in gastric adenocarcinoma and MALT lymphoma patients, but it seems that certain subtypes of vac A cytotoxin are more important risk factors. Infection with cag A+ strains is more common in patients with acne rosacea, stroke and coronary heart disease.

Antigens, Bacterial↗

Work with video display terminals among office employees. V. Dermatologic factors.

According to some reports, mainly from Norway, work with a video display terminal (VDT) has been suspected to cause skin rashes. In conjunction with an epidemiologic study of some 550 office employees, 74 persons, who complained of skin symptoms, were examined by occupational dermatologists. The objective was to see whether the findings from earlier reports could be confirmed, whether any type of rash could be suspected to depend on VDT work, and whether positive findings might be explained by means of physical data. Many different diagnoses were made, but no case demonstrated the clinical picture described among VDT operators from Norway. Subjects with seborrheic dermatitis, acne, and rosacea were overrepresented in the exposed group. Whether this occurrence was due to physical factors, psychological factors, or pure chance is still unclear. This study and observations from our clinic imply that a relationship might exist between VDT work and aggravation of seborrheic dermatitis, acne, and rosacea and probably poikiloderma of Civatte.

Adult↗

[Helicobacter pylori and skin diseases--a (still) intact myth?].

Helicobacter pylori plays a key role in the aetiology of peptic ulcer, gastric cancer and gastric MALT-lymphoma. Based on a number of reports, a possible relationship of Helicobacter pylori infection to a variety of different dermatoses has been suggested, including urticaria, rosacea, acne-rosacea, atopic dermatitis, alopecia areata, Sjögren's syndrome, Schönlein-Henoch purpura, and Sweet syndrome. Larger case-control studies, however, do not confirm this relationship. Therefore, Helicobacter pylori eradication therapy cannot be generally recommended in these dermatoses.

Helicobacter Infections↗

Ectropion secondary to bolus injection of 5-fluorouracil.

BACKGROUND: 5-fluorouracil (5-FU) targets rapidly dividing cancer cell populations. In turn, it may cause inflammation in such rapidly dividing tissues as the corneal epithelium, conjunctiva, and tear duct. Inflammation may be exacerbated by pre-existing dermatologic conditions. This case report describes a rare combination of facial dermatologic toxicity and ectropion. CASE REPORT: A 76-year-old man came to us in October 1998 with symptoms of foreign body sensation, epiphora, and difficulty removing his contact lenses. His medical history was significant for 5-FU bolus injections for intestinal cancer since May 1998. Examination revealed facial erythema and eczema, ectropion, blepharitis, chemosis, lid teleangectasia, and contact lens-related corneal edema. Differential diagnoses included ocular rosacea with cicatrizing conjunctivitis and 5-FU-induced ectropion. He was treated and monitored over the subsequent several months. As of December 1998, only mild ectropion persisted. DISCUSSION: Patients with 5-FU-induced ectropion experience tender, red, scaled lids, making contact lens wear difficult. Therefore, contact lens wear should be discontinued to prevent further complications. This patient's ectropion and facial eczema may have been confounded by ocular rosacea. Exacerbation of 5-FU dermatologic toxicities in patients with preexisting conditions suggests the importance of aggressive ocular prophylaxis, using frequent ocular lubrication and topical steroid preparations with concurrent medical management of pre-existing dermatologic conditions. CONCLUSION: This case illustrates a potential link between dermatologic and ocular 5-FU toxicities. Further research and better communication among health care professionals are needed to determine if prophylaxis can reduce adverse ocular events.

Aged↗

Combination therapy in clinical and cosmetic dermatology: the marriage of device and drug.

The first generations of lasers used in clinical and cosmetic dermatology achieved their effects by means of epidermal and dermal ablation. While effective in removing some of the stigmata of photodamage including pigmentary changes and rhytides, vascular abnormalities associated with such conditions as melasma and rosacea, were not sufficiently effective. The new generation of laser and non-laser light devices (eg, intense pulsed light or IPL) offer excellent results in the management of clinical and cosmetic conditions, including significant changes in improvement in vascular conditions such as rosacea and actinic damage and stimulating dermal collagen production, without significant injury to the epidermis. The combination of light therapies and topical agents adds to the efficacy of these procedures, particularly in post-procedural maintenance. Light-based therapies have been an important addition to the anti-acne armamentarium as they are effective and do not add to the increasing bacterial resistance problem.

Acne Vulgaris↗

[Sugar transport, metabolism, accumulation and their regulation in fruits].

Photosynthates transported into fruits are mainly in the form of sucrose in most fruit tree species; but sorbitol takes the place of sucrose in woody Rosaceae plants. The transport of sugars across the plasma membrane from apoplastic space into cells is mediated by sugar transporters. The fact that gene expression of sugar transporters is upregulated just before and during sugar accumulation suggests the participation of sugar transporters in sugar accumulation of fruit. The sucrose-metabolizing enzymes participate in four futile cycles that involve sugar transport between cytosol, vacuole, amyloplast and apoplast. The increase in SS (sucrose synthase) and SPS (sucrose phosphate synthase) activities and mRNA levels during maturation parallels the increase in sugar accumulation indicates that the sucrose-metabolizing enzymes have important roles on sugar accumulation in fruits. The prerequisite for rapid accumulation of sugar in fruit is restriction of hexose catabolism and promotion of its synthesis. In woody Rosaceae plants, the fact that sucrose metabolism is also quite active in fruit suggests that sorbitol and sucrose probably play similar roles in fruit development. Sugars as signal molecules regulate the expression of genes involved in sugar transport and metabolism. Sugar transport, metabolism and accumulation are also regulated by natural environmental factors and cultural practices. The increase in sugar content of tomato fruit in acid invertase gene antisense-inhibited plants provides promising prospect of genetic engineering as a potential effective technique in regulation of sugar accumulation in fruits. Thus, the sugar content of fruit is determined by both intrinsic and extrinsic factors. The future research works will be focused on elucidating the mechanism of sugar signal and other intrinsic signals as well as extrinsic signals including nutrients, plant hormones and physical factors on sugar transport, metabolism and accumulation and the interrelationship among them.

Biological Transport↗

Acneiform eruption due to "megadose" vitamins B6 and B12.

Medications and other exogenous factors are known to be capable of exacerbating acne or precipitating acneiform eruptions. This case illustrates an eruption resembling acne rosacea that was temporally associated with daily ingestion of high-dose B vitamin supplement. The eruption failed to respond to the usual treatment regimens for rosacea, but promptly improved when use of the vitamin supplement was discontinued.

Acne Vulgaris↗

Rhinophyma's fibrous variant. Histopathology and immunohistochemistry.

Rhinophyma may present with either of two distinct histopathologic appearances. The most common shows histopathologic features of rosacea. The second pattern shows telangiectasia, diffuse dermal fibrosis with abundant mucin, and a virtual absence of pilosebaceous structures. These histopathologic features of the lesser-known fibrous variant of rhinophyma mimic those of fibrous papule of the nose. We report an unusual case that histopathologically resembled the second variant. Immunohistochemically, the dermal fibroblasts in this case showed intense staining with Factor XIIIa in a pattern similar to that demonstrated in fibrous papules. S-100 protein failed to stain these dermal fibroblasts. The presence of Factor XIIIa+ dermal fibroblasts may portend the evolution of fibrosis in rosacea and other inflammatory dermatoses.

Aged↗

Rhinophyma--unusual expression of simple-type keratins and S100A in sebocytes and abundance of VIP receptor-positive dermal cells.

Rhinophyma represents a severe variant of rosacea, a common mid-facial erythematous dermatosis. Increased blood flow and pooling in skin are thought to be involved in its pathogenesis. Since neuropeptides and their receptors are responsible for local blood flow regulation, immunolocalization for the vasoactive intestinal peptide (VIP)-receptor(R) was performed in slice biopsies taken from five patients with glandular rhinophyma. Additional immunostainings included intermediate filaments (keratin, vimentin) and neuroglandular antigen (NGA). In contrast to controls, rhinophyma disclosed not only a more dense distribution of VIP-R positive cells within the endothelium but immunoreactive perivascular large cells. The immature sebocytes stained positive with monoclonal antibody Cam5.2 against glandular antigens and polyclonal anti-S100A. Elastotic connective tissue in the dermis showed a strong immunoreactivity for vimentin and NGA. From these results we suggest that, (a) ligands of the VIP-R may contribute to vascular and dermal alterations in rosacea and (b) immature sebocytes show an unusual antigen expression of S100A and glandular keratin.

Aged↗

A NEW LOTION FOR THE TREATMENT OF ACNE VULGARIS.

A therapeutic assessment of a new lotion containing methylprednisolone, neomycin, colloidal sulfur and aluminum chlorhydroxide complex (Neo-Medrol Acne Lotion) was carried out on 187 patients suffering from acne vulgaris.Of the 187 patients, 165 showed excellent or good response. Following enthusiastic acceptance of the lotion by the patients in the initial study, a second random study with an additional 134 subjects was undertaken to compare the active lotion with the lotion base alone.The active lotion was superior to the placebo lotion in this study, at a statistically significant level. The overall findings suggest that this lotion is an efficient preparation for the control of acne vulgaris (early and late types) and it also showed promise in the treatment of a few cases of acne rosacea and seborrheic dermatitis facialis.

Acne Vulgaris↗

Haber's syndrome. Report of a new family.

Three Japanese brothers had the rosacea-like facies and multiple intraepidermal epitheliomas that characterize Haber's syndrome. They also had xerosis of the lower extremities. The facial lesions were dry, warm, erythematous, and indurated, with enlarged follicular orifices and telangiectasia. One patient had disturbing "burning" of the face, which was relieved by short courses of steroid therapy that were given for systemic effects.

Adult↗

Topically administered clindamycin in the treatment of acne vulgaris and other dermatologic disorders.

Clindamycin is a macrolide antibiotic that has been used orally and topically in the treatment of acne vulgaris. Unfortunately, oral administration is associated with pseudomembranous colitis in up to 10% of patients; consequently, it is no longer a generally accepted form of acne therapy. Topical application is an effective, safer alternative. Topical formulations may be extemporaneously prepared or purchased as a pre-mixed hydroalcoholic solution. Adverse effects associated with topical preparations are few and mostly minor. Topical clindamycin is also used in the treatment of erythrasma, rosacea, periorificial facial dermatitis, and folliculitis.

Acne Vulgaris↗

Two new dammarane triterpenoids from Kageneckia angustifolia D. Don.

Two new dammarane triterpenoids, 20R,21-epoxydammar-24-ene-3,23-dione and 20R,21-epoxy-3beta-hydroxydammar-24-ene-23-one have been isolated from the aerial parts of Kageneckia angustifolia D. Don, Rosaceae, along with the previously reported triterpenoids oleanolic acid and 3beta-(beta-D-glucosyloxy)-16alpha,23alpha-epoxycucurbita-5,24-dien-11-one and the phenolic prunasin. The structures of these compounds were established by MS, 1D- and 2D-NMR experiments, and the structure of the new compounds were confirmed by X-ray diffraction analysis.

Carbon Isotopes↗

Novel isoforms of Pru av 1 with diverging immunoglobulin E binding properties identified by a synergistic combination of molecular biology and proteomics.

Birch pollen-related food allergies are mainly associated to Bet v 1. Little is known about isoforms of Bet v 1 homologous in fruit of the Rosaceae family. We attempted to identify novel isoforms of Pru av 1, the major cherry allergen, at the cDNA and the protein level by a combination of molecular biology and proteomic tools. A cDNA library was screened with patients immunoglobulin E (IgE) and a specific hybridization probe. Edman sequencing, mass spectrometry (MS), and MS/MS were performed after detecting Pru av 1 on 2-D maps by immunoblotting using patients IgE and a monoclonal antibody. Partial amino acid sequences were completed with a polymerase chain reaction (PCR) strategy. The IgE-binding properties of the Pru av 1 spots were analyzed by 2-D blot inhibition. cDNA library analysis revealed a novel Pru av 1 isoform. MS and N-terminal sequencing confirmed the cDNA sequences at the protein level. A series of spots were confirmed as the already known Pru av 1. One spot, exclusively detected with patients sera, was identified as the novel isoform. A partial amino acid sequence detected with MS/MS was completed by PCR-cloning. The 2-D blot inhibition revealed epitope differences between the novel isoform and the previously published Pru av 1. Our data demonstrate that a synergistic combination of molecular biology and proteomics represents a powerful tool for reliable and comprehensive identification of allergen isoforms and variants. The newly identified isoform showed diverging IgE-binding properties and may be relevant for the diagnosis or therapy of cherry allergy.

Allergens↗

Gallic acid is partially responsible for the antiangiogenic activities of Rubus leaf extract.

An aqueous extract of leaves from Rubus suavissimus S. Lee (Rosaceae) or sweet leaf tea was tested for antiangiogenic activity in a human tissue-based fibrin-thrombin clot angiogenesis assay. Further fractionation of this crude extract was performed and the antiangiogenic effect of individual fractions was assessed. The extract was also tested for its oral bioavailability by using the serum of normal rats gavaged with the extract in the assay. At a 0.1% w/v concentration, the extract inhibited initiation of the angiogenic response and subsequent neovessel growth from samples that had already initiated an angiogenic response. Two subfractions of the extract showed significant inhibition of angiogenesis at 0.1% w/w. Gallic acid was elucidated as one of the active angiogenesis inhibitors in one fraction. A 1 mm concentration of gallic acid totally inhibited angiogenesis. In the form of leaf extract, a one-tenth concentration produced the same total inhibition as pure gallic acid. The 10-fold difference in potency suggests the presence of other active compounds contributing to the overall antiangiogenic effect of the extract. The oral absorption of this extract was tested by using serum from rats given the extract orally (gavage) in the angiogenesis assay system. The serum of rats orally administered the sweet leaf tea extract at doses of 0.1% w/w and 0.3% w/w did not significantly inhibit angiogenesis. However, the serum of rats injected intraperitoneally at a dose of 0.1% w/w caused a 41% inhibition of angiogenesis compared with saline injected controls. These preliminary results warrant further bioassay directed identification of other responsible compounds.

Absorption↗

Action of Rubus coreanus extract on systemic and local anaphylaxis.

The effect was investigated of the aqueous extract of Rubus coreanus Miq. (Rosaceae) fruits (RCAE) on systemic and local anaphylaxis. RCAE (0.01-1 g/kg) dose-dependently inhibited systemic anaphylaxis induced by compound 48/80 in mice. RCAE (1 g/kg) also significantly inhibited local anaphylaxis activated by anti-DNP IgE. Pretreatment with RCAE at the same concentration before systemic anaphylaxis reduced the plasma histamine levels in a dose-dependent manner. RCAE (0.001-1 mg/mL) dose-dependently inhibited the histamine release from rat peritoneal mast cells (RPMC) activated by compound 48/80 or anti-DNP IgE. The level of cAMP in RPMC, when RCAE was added, significantly increased, compared with that of the normal control. Moreover, RCAE (0.01-1 mg/mL) had a significant inhibitory effect on anti-DNP IgE-induced tumour necrosis factor-alpha production from RPMC. These results indicate that RCAE may possess antianaphylactic action.

Anaphylaxis↗

Cytokines and tear function in ocular surface disease.

In summary, tear EGF levels correlate most strongly with tear production in normals, and it is likely that some form of homeostatic mechanism exists to provide a constant supply to the ocular surface. Commercial ELISA kits appear to measure EGF in tears with good consistency and may be useful in the future to improve comparability of data from different studies. In addition, in ocular rosacea, which mimics keratoconjunctivitis sicca in a number of respects, there is a differential increase in the level of the inflammatory cytokine IL-1 alpha in the tear fluid. Much of this elevation appears to be the result of reduced tear turnover, which may form an important positive feedback mechanism encouraging tear stagnation and the perpetuation of ocular surface inflammation.

Adult↗