bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of systemic treatment with cholesterol-lowering drugs on the skin barrier function in humans.
Authors: Ramsing D , Agner E , Malinowski J , Meibom J , Agner T
Published: June 2023

The intercellular lipids of stratum corneum are predominantly formed by cholesterol, ceramides and free fatty acids. Cholesterol synthesis is inhibited by statins, cholesterol-lowering drugs (lovastatin, pravastatin, simvastatin). The present study was undertaken to examine the effect of these drugs on skin barrier function. Knowledge about the effect on epidermis of systemic inhibition of cholesterol synthesis may improve our understanding of the skin barrier function. Seventeen statin-treated subjects were compared to controls. All were patch-tested with sodium lauryl sulphate (SLS), and the skin was evaluated after 24 h and after 7 days by measurement of transepidermal water loss (TEWL), erythema and visual scoring. After 24 h as well as after one week erythema was significantly less pronounced in the statin-treated group than in controls (p < 0.001). No significant differences in TEWL were found between the groups at any time. The results imply a decreased bioavailability of SLS in the statin-treated group, while no evidence for an altered permeability barrier to water was found.
A simple method for measuring the amount of immunoglobulin A secreted onto the skin surface.
Authors: Imayama S , Shimozono Y , Urabe A , Hori Y
Published: June 2023

We developed a simple method for measuring the amount of the secretory form of immunoglobulin A (sIgA) present in sweat. A small disk (10 x 10 mm) made of cellulose membrane was attached to the skin surface for periods of 1 to 24 h. SIgA was absorbed to the membrane and accumulated during the period of application. Enzyme immunoassay using anti-sIgA and antisecretory component (SC) antibodies revealed distinct dots on the disk that corresponded to the eccrine excretory ducts. A densitograph was used to determine the number and density of the dots, thus obtaining the amount of sIgA excreted to the surface of the skin (per mm2). The amount of skin sIgA excreted differed inter-individually as well as intra-individually. That is, it varied according to the region of the skin, and its distribution roughly reflected that of the sweat ducts. SIgA excretion was maintained at a certain level, regardless of the increased sweating produced by either heat or exercise, which raised the output of sweat 3- to 15-fold. Immunohistochemical studies revealed that fewer glandular cells expressed SC in their cytoplasm as the amount of sIgA decreased. Such an independence of the excretion of sIgA from that of sweat may be necessary to the local immune defenses of the skin.
Influence of activation and differentiation of cells on the effectiveness of photodynamic therapy.
Authors: Schick E , Kaufmann R , Rück A , Hainzl A , Boehncke W H
Published: June 2023

Photodynamic therapy combines photosensitizers absorbing light in the red spectral region and irradiation with light of the corresponding wavelength. To analyse the influence of cell differentiation on susceptibility to photodynamic therapy, we compared the proliferation inhibition induced by photodynamic therapy on normal human keratinocytes, spontaneously transformed human keratinocyte cell line HaCat and on squamous cell carcinoma lines. Cells were irradiated with polychromatic methylene blue as well as the precursor of protoporphyrin, 5-aminolevulinic acid. When incubated with Photosan-3, normal human keratinocytes exhibited and ED50 about 10-fold lower than the other cell lines studied. When methylene blue and 5-aminolevulinic acid were used, photodynamic therapy had comparable effects on all cell types. Stimulation of normal human keratinocytes with either EGF-alpha or IFN-gamma resulted in an increase susceptibility to photodynamic therapy when 5-aminolevulinic acid was used. This effect was more pronounced in the case of EGF-alpha. Our experiments suggest that activation and differentiation are two important parameters determining susceptibility to photodynamic therapy.
Occurrence and clinical features of sensitization to Pityrosporum orbiculare and other allergens in children with atopic dermatitis.
Authors: Lindgren L , Wahlgren C F , Johansson S G , Wiklund I , Nordvall SL
Published: June 2023

One hundred and nineteen consecutive cases of children with atopic dermatitis aged 4-16 years (73 girls) from a pediatric dermatology outpatient clinic were included in a study of atopic sensitization. Structured interviews and clinical investigations were performed. IgE antibodies to common inhalant allergens, Pityrosporum orbiculare, Candida albicans, Tricophyton rubrum and Staphylococcus aureus were detected. Specific IgE antibodies frequently occurred to pollens, animal epithelia, C. albicans, house dust mites and moulds, whereas specific IgE antibodies to potential skin allergens were less prevalent. Twenty-six children (21.8%) had IgE antibodies to P. orbiculare, 14 (11.8%) to T. rubrum and 3 (2.5%) to S. aureus. Atopic dermatitis in children with one or several RAST positivities was worse, with a more chronic course, higher total eczema score, more frequent distribution in the head-neck-face regions and more itch compared to the children without serum detectable IgE antibodies. Severe itch disturbing nightly sleep was the only clinical feature that characterised P. orbiculare-positive cases. Allergy to P. orbiculare appears to be of little importance in early childhood atopic dermatitis but is likely to carry a poor prognosis.
An epidemic of tinea corporis caused by Trichophyton tonsurans among wrestlers in Sweden.
Authors: Hradil E , Hersle K , Nordin P , Faergemann J
Published: June 2023

An epidemic of tinea corporis due to Trichophyton tonsurans among wrestlers in Sweden is described. Totally 19 patients, 14 patients from Malmö and 5 from Gothenburg, were found. The suspected source of this epidemic was from a wrestlers' team from the USA visiting Sweden in April, 1993. All patients were treated orally with either griseofulvin, fluconazole or terbinafine, and all were cured. To prevent spreading, epidemiological tracing of secondary cases is important.
Hyperpigmentation due to calcipotriol (MC 903) plus heliotherapy in psoriatic patients. Three case reports.
Authors: Kokelj F , Lavaroni G , Perkan V , Plozzer C
Published: June 2023

Calcipotriol is a synthetic analogue of vitamin D, used in the treatment of psoriasis. Until now no specific sid-effects have been described after combined therapy with calcipotriol and UV. We describe 3 patients, who in the summer of 1993, after a combined treatment of calcipotriol and heliotherapy, developed hyperpigmentation in the site where the ointment had been applied. Hyperpigmentation healed spontaneously in less than 7 months. To the best of our knowledge there are no other reports of this side-effect due to calcipotriol. In our opinion the fact that the 3 patients presented the hyperpigmentation only on the treated lesions and that, in the past, they had not presented similar lesions after exposure to sunlight confirms the relationship between the hyperpigmentation and the combined treatment used.
The stimulatory effects of PDGF and TGF-beta 1 on dermal fibroblast attachment.
Authors: Ihn H , Kikuchi K , Soma Y , Sato S , Fujimoto M , Tamaki T , Igarashi A , Takehara K
Published: June 2023

We investigated the effects of various growth factors (platelet-derived growth factor (PDGF), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), transforming growth factor-alpha (TGF-alpha), transforming growth factor-beta 1 (TGF-beta 1), tumor necrosis factor-alpha (TNF-alpha), keratinocyte growth factor (KGF)) on fibroblast attachment to plastic plates. It is thought that cell attachment to plastic plates in vitro may represent the step between cell migration and proliferation in vivo during wound healing. Among the growth factors examined, only PDGF and TGF-beta 1 significantly increased fibroblast attachment to both uncoated and collagen-coated plates in a concentration-dependent manner. The addition of anti-PDGF antibody abolished the enhancing effect of PDGF but not that of TGF-beta 1, suggesting that the effect of TGF-beta 1 is not through the autocrine induction of PDGF-related activities secreted by the fibroblasts themselves. These data suggest that PDGF and TGF-beta 1 regulate fibroblast attachment to the suitable environment in the process of dermal wound healing in vivo.
High-frequency ultrasound for torture-inflicted skin lesions.
Authors: Gniadecka M , Danielsen L
Published: June 2023

Objectivity, reproducibility and non-invasiveness are required for a medico-legal evaluation of skin lesions in torture victims. In this report we describe the use of the high-frequency method for imaging of scars presumed to be inflicted by torturing. The extent of scarring and the size of the lesions could be determined precisely and objectively. We suggest that skin ultrasonography may be a useful supplementary method for evaluation of skin changes in torture victims.
Interruption of long-term methotrexate treatment in psoriasis. Evaluation of clinical course and laboratory parameters after discontinuation and reintroduction of weekly oral methotrexate.
Authors: Van Dooren-Greebe R J , Kuijpers A L , Termorshuizen F , Van de Kerkhof PC
Published: June 2023

The effects of interval treatment were evaluated in 10 psoriatic patients on long-term treatment with low-dose oral methotrexate (MTX). In all patients, the dosage of MTX had already been tapered off as much as possible. After interruption of MTX treatment, the clinical course and changes in laboratory parameters were evaluated. The mean MTX-free period was 17 weeks, and the mean reduction in cumulative MTX dose was 76 mg (p = 0.05). However, only 3 patients preferred interval treatment to a continuous schedule. During the first 3 weeks of discontinuation, a significant decrease in the serum transaminases was observed, indicating a direct toxic influence of MTX on the liver parenchym. We conclude that interruption of long-term MTX treatment leads to a substantial reduction of the cumulative MTX dose and reduces the hepatotoxic load of MTX. It is necessary to motivate patients on long-term MTX treatment for regular treatment interruptions to establish a further reduction in their cumulative MTX dose.
Objective assessment of the skin of children affected by atopic dermatitis: a study of pH, capacitance and TEWL in eczematous and clinically uninvolved skin.
Authors: Seidenari S , Giusti G
Published: June 2023

In order to obtain objective data on skin functions in subjects with atopic dermatitis (AD), according to the different phases of the disease, we evaluated the skin of children with AD instrumentally and compared it to that of healthy subjects of the same age group. One hundred patients, aged 3 to 12, and 21 healthy children were studied by means of measurements of pH, capacitance and transepidermal water loss (TEWL) at 8 different skin sites. At the moment of the investigation 55 children out of 100 presented skin lesions on at least one of the assessed skin areas, whereas 45 had been free from eczema for at least 1 month. Considering all skin sites together, significant differences were found between mean values of pH, capacitance and TEWL of eczematous skin, both in respect to those referring to apparently healthy skin in the same patients and in respect to the skin of control subjects. Moreover, TEWL, pH and capacitance values referring to uninvolved skin of AD patients significantly differed from those of healthy subjects. Finally, when values referring to patients with skin lesions and to patients without lesions were separately considered, significant differences concerning the parameters of uninvolved skin were observed. These data show that, in subjects with AD, skin functions undergo fluctuations according to the phase of the disease and support the hypothesis that the presence of active eczema determines an impairment of the barrier of uninvolved skin, even at sites far from active lesions.
The dynamics of the response of normal skin to single and multiple epicutaneous leukotriene B4 applications analysed by three-colour flow cytometry.
Authors: Glade C P , Botermans R J , Van Erp PE , Van de Kerkhof PC
Published: June 2023

Leukotriene B4 (LTB4) is a potent chemoattractant and a well-established stimulator of DNA-synthesis in keratinocytes. Previously, repeated applications of LTB4 have been reported to induce a topically defined tachyphylaxis with respect to the extravasation of polymorphonuclear neutrophils. The aim of the present study was to quantify epidermal proliferation (% basal keratinocytes in S- and G2M phase), epidermal keratinization (% keratin 10-positive keratinocytes) and the appearance of "non-keratinocytes", including melanocytes, Langerhans' cells and infiltrate cells (% vimentin-positive cells) in order to further elucidate the effect of chronic exposition of normal skin to LTB4. Using three-colour flow cytometry, we could reconfirm that the response to one single epicutaneous application of LTB4 was characterized by a marked increase of the percentage of basal keratinocytes in S- and G2M phase, and a marked increase of non-keratinocytes. Repeated applications of LTB4 induced a moderate increase of the percentage of cells in S- and G2M phase and a moderate increase of the percentage of keratin 10-positive keratinocytes. Remarkably, the percentage of non-keratinocytes had decreased following repeated applications of LTB4, compared to unchallenged normal skin. The present study suggests that chronic exposure of normal skin to LTB4 induces changes which differ markedly from the histological features of the chronic psoriatic lesion. Therefore, LTB4 is unlikely to be responsible for the perpetuation of the psoriatic plaque.
Quantitative description of echographic images of morphea plaques as assessed by computerized image analysis on 20 MHz B-scan recordings.
Authors: Seidenari S , Conti A , Pepe P , Giannetti A
Published: June 2023

In order to find image descriptors enabling the characterization of sclerotic skin of morphea plaques and their objective differentiation from normal skin, we studied 52 lesions in 35 patients affected by plaque type morphea. Echographic evaluations were carried out using a 20 MHz B-scanner, providing cross-sectional images of the skin. Images were processed by a program providing a numerical representation of the picture data, based on the following parameters, which were considered for 7 different amplitude intervals: 1) the extension of image areas marked by amplitude bands of interest, 2) the percentage of the image surface reflecting within a homogeneous amplitude band, 3) the number of objects composing the image, 4) the average object size, and 5) the "density" of the objects. For all parameters considered, marked differences between sclerotic skin and normal tissue were observable. When assessment is performed with amplitude bands covering the lower part of the scale, the image referring to sclerotic tissue appears relatively homogeneous with few, large objects within a thickened skin block, which occupy a more extended image surface in comparison to images of normal skin, characterized by spots, which are small and closely packed. On the contrary, binary images of morphea plaques transformed by intermediate to high amplitude intervals appear with fewer objects of approximately the same size or smaller, which are less compressed in respect to healthy skin images.
Prevalence and some clinical aspects of atopic dermatitis in the community of Sør-Varanger.
Authors: Dotterud L K , Kvammen B , Lund E , Falk E S
Published: June 2023

A study of the prevalence of atopic dermatitis among 7-12-year-old children was carried out in a rural community in Northern Norway close to the Russian border. Of the 424 children investigated, 37% had a past and/or present history of atopic dermatitis (cumulative incidence), whereas 23% were classified as having atopic dermatitis by clinical examination (point prevalence). A history of atopic dermatitis during the past year was reported by 26% of the children. Flexural lichenified dermatitis was present in 88%, and 12% of the children had facial and extensor involvement with or without hand dermatitis. Two thirds of the children showed mild and one third moderate symptoms
Urticarial vasculitis syndrome effectively treated with dapsone and pentoxifylline.
Authors: Nürnberg W , Grabbe J , Czarnetzki B M
Published: June 2023

Urticarial vasculitis is difficult to treat. We report here on a 40-year-old woman with a 16-year history of idiopathic hypocomplementemic urticarial vasculitis syndrome. Her disease had been resistant to treatment with H1- and H2-blockers, indomethacin, dapsone and interferon alpha but responded to > 25 mg/day prednisolone. Monotherapy with pentoxifylline was also of only minor benefit. Using a combination of dapsone (100 mg/day) and pentoxifylline (1,200 mg/day), we observed a gradual improvement resulting in a complete remission within 8 weeks. Complete control of symptoms could be maintained for 18 months without any serious side-effects. This type of treatment may be of benefit in other therapy-resistant cases of hypocomplementemic urticarial vasculitis syndrome, particularly in view of its excellent tolerance.
Protein-losing enteropathy in a child with junctional epidermolysis bullosa and pyloric atresia.
Authors: Meldgaard Lund A , Karlsmark T , Kobayasi T
Published: June 2023

We report on a newborn boy with junctional epidermolysis bullosa and pyloric atresia. Blisters were found on his skin at birth, especially in places exposed to pressure, and appeared later on his mucous membranes. Epidermolysis bullosa was confirmed by electron microscopy. Radiography revealed pyloric atresia, and a gastroduodenostomy was carried out at 7 days of age. A connective tissue septum was found between his ventricle and duodenum. The skin changes were mild, and the clinical course was determined by his protein-losing enteropathy. He died at 66 days of age from pseudomonas sepsis.
Remission of ordinary psoriasis following a short clearance course of cyclosporin.
Authors: Levell NJ , Shuster S , Munro CS , Friedmann PS
Published: June 2023

We set out to show that the assumption is incorrect that continuous treatment with cyclosporin is necessary in psoriasis, as this tenet forms a basis for current recommended treatment regimens. Sixty patients with mild to moderate plaque psoriasis were allocated at random to treatment with oral cyclosporin 5 mg/kg/day (30 patients) or topical dithranol and ultraviolet B therapy (30 patients) for up to 16 weeks until clear (median time 6 weeks cyclosporin and 8 dithranol), and the times to relapse compared. The patients were seen monthly for up to 8 months, and the severity and the extent of psoriasis were assessed. Relapse, defined as return of psoriasis to 50% of the area at the start of the trial or patient demand for further treatment, was not significantly different between the groups (hazard ratio 1.11, 95% CI 0.55-2.32). No patients suffered a rebound of severe disease and none relapsed in the first 8 weeks after stopping treatment. The relapse rate was higher following cyclosporin from 8 to 28 weeks after treatment and following dithranol from 28 to 34 weeks. The patients with arthritis had a higher median joint severity score at relapse than prior to treatment with cyclosporin. At the end of 8 months, 5 patients treated with dithranol and 8 patients with cyclosporin remained clear, 75% and 67% having relapsed. We conclude that rapid relapse does not occur after clearance of mild to moderate plaque psoriasis with cyclosporin and the relapse rate was no different from dithranol treatment.
Human papilloma virus infection among women attending an STD clinic correlated to reason for attending, presence of clinical signs, concomitant infections and abnormal cytology.
Authors: Voog E , Bolmstedt A , Olofsson S , Ryd W , Löwhagen G B
Published: June 2023

The purpose of this study was to demonstrate the prevalence of cervical human papilloma virus (HPV) infection correlated to reason for attending an STD clinic, presence of clinical signs of HPV infection, concomitant infection and abnormal cytology. Samples from the cervical canals of 588 consecutive women attending the STD clinic, Department of Dermato-Venereology, Sahlgrenska Hospital, Gothenburg, were taken with a Cytobrush for detection of HPV DNA with the dot blot/Southern-blot technique. Visible condylomata, i.e. filiform or papular condylomata, were registered. Acetic acid test and colposcopy were not routinely performed. Cytological examination was performed as well as isolation of Chlamydia trachomatis on Mc Coy's cells and culture on Sabouraud agar for Candida albicans. The prevalence of HPV DNA was 8% (48/588). In the group of 233 women attending because of concern about HPV infection, 94 (40%) had visible signs of HPV infection and 30 (13%) were positive for HPV DNA in the cervix. In 355 women attending for other reasons, such as discharge, pruritus or STD check-up, 4 (1%) had visible signs of HPV infection and 18 (5%) were HPV DNA positive. Of 98 women with visible signs of vulvar/vaginal HPV infection, 33 (34%) were HPV-positive in the cervix with a commercial Southern-blot test. Of 490 patients without visible signs of HPV infection, 15 (3%) were HPV-positive in the cervix. In the group of HPV-positive women a positive culture for Candida was demonstrated in 26% (11/43), Compared to 16% (79/504) of the HPV-negative women.(ABSTRACT TRUNCATED AT 250 WORDS)
Role of adhesion molecules in the development of pustular lesions in patients with pustulosis palmaris et plantaris.
Authors: Yokochi K , Tamada Y , Takama H , Ikeya T , Ohashi M.
Published: June 2023

The expression of adhesion molecules and the ligands on endothelial cells and infiltrating inflammatory cells in lesional skin specimens from patients with pustulosis palmaris et plantaris was studied. Intercellular adhesion molecule-1 and E-selectin were expressed on endothelial cells of microvessels in the papillary dermis. Intercellular adhesion molecule-1 was also expressed focally on keratinocytes in the epidermis of the lesional skin. On the other hand, lymphocyte function-associated antigen-1, Mac-1 and sialyl Lewis(x) were expressed on infiltrating inflammatory cells. Further, flow cytometric analysis demonstrated that circulating leukocytes in peripheral blood from patients with pustulosis palmaris et plantaris expressed the ligands of adhesion molecules. It is therefore suggested that the expression of adhesion molecules and the ligands on circulating leukocytes, endothelial cells, infiltrating inflammatory cells and keratinocytes might be closely related to the formation of pustular lesions in patients with pustulosis palmaris et plantaris.
Clinical aspects of the use of gamma linolenic acid in systemic sclerosis.
Authors: Stainforth JM , Layton AM , Goodfield MJ.
Published: June 2023

Systemic sclerosis is a multi system disorder, for which there is no satisfactory treatment. Theoretically, dietary supplementation with essential fatty acids may lead to an increase in their derivatives, the vasoactive prostaglandins, which benefit the acute and chronic ischaemic lesions of this disease. We assessed the value of concentrated essential fatty acids in patients with systemic sclerosis, concentrating particularly on vascular symptoms and objective tests of vascular reactivity. Twenty-five patients with systemic sclerosis were randomised to receive concentrated essential fatty acids or placebo, for 6 months in a double-blind parallel group study. There was no significant difference between the active and placebo groups in terms of maximum blood flow after warming, minimum blood flow after cooling or the recovery time after cooling. There were no significant differences between the groups in the other parameters measured. Dietary essential fatty acids have no role in the treatment of vascular symptoms in established systemic sclerosis.
Sexually transmitted diseases and risk of HIV infection.
Authors: Parazzini F , D'Oro LC , Naldi L , Bianchi C , Chatenoud L , Ricci E , Cainelli T , Pansera B , Mezzanotte C , Tessari GP , Locatelli A.
Published: June 2023

We have analyzed the association between sexually transmitted diseases (STD) and HIV infection, using data from a cross-sectional survey of subjects attending STD clinics in Northern Italy conducted since 1988. A total of 1,711 subjects (1,259 males, 452 females), who had referred themselves to three STD clinics in Northern Italy for suspected STD or STD treatment, were included for the study. Out of these, 145 subjects (113 males and 32 females) were HIV-positive. A total of 58 HIV-positive and 368 HIV-negative subjects reported a history of STD
Sporadic unilateral intra-areolar polythelia. Report of an additional case and review of the literature.
Authors: Urbani CE , Betti R.
Published: June 2023

No abstract available
Chloroquine-induced vitiligo. A case report and review of the literature.
Authors: Selvaag E.
Published: June 2023

No abstract available
Cutaneous leishmaniasis. an old disease with a new face.
Authors: Kibbi AG , Hassouna L , Rubeiz NG.
Published: June 2023

No abstract available
Growth factor mRNA levels in alopecia areata before and after treatment with the contact allergen diphenylcyclopropenone.
Authors: Hoffmann R , Wenzel E , Huth A , Van der Steen P , Schäufele M , König A , Happle R.
Published: June 2023

The early immune response in alopecia areata is characterized by a Th1 T helper cell cytokine pattern and an aberrant expression of ICAM-1 and HLA-DR molecules on lesional hair bulbs. A counteracting cytokine pattern induced by a therapeutic contact dermatitis is supposed to mediate the hair regrowth. In addition to cytokines, growth factors have been shown to influence immune responses, and we therefore investigated the expression levels for a panel of growth factors in untreated versus alopecia areata after treatment with the contact sensitizer diphenylcyclopropenone. Using semiquantitative reverse transcriptase polymerase chain reaction we detected a striking overexpression of transforming growth factor beta 1 mRNA in successfully treated patients. This cytokine has been shown to be a potent immune response modifier, which can suppress Th1 immune responses. The way in which topical immunotherapy induces hair regrowth in alopecia areata is unknown, but a lesional increased expression of transforming growth factor beta 1 may be a possible mechanism.
Skin ultrastructure after calcipotriol treatment: a transmission electron microscopic and freeze-fracture study on psoriatic patients.
Authors: Cavicchini S , Brezzi A , Gasparini G , Caputo R.
Published: June 2023

Electron microscopic details in psoriatic skin during calcipotriol application are reported. Ten psoriatic patients (PASI score 3-14) were punch-biopsied on typical lesions before treatment and 2, 4 and 8 weeks after it. Two patients dropped out after 1 month because of lack of clinical response. Skin blocks were processed routinely for transmission electron microscopy and freeze-fracture techniques. The first modifications were the disappearance of fine intercellular granular material and the restoration of the granular layer. After 4 weeks desmosomes appeared in greater amounts than at baseline. Horny layer lipid vacuoles and remnants of nuclei as well as multilayering of the basal lamina were only focally observed. Dilatation of dermal capillaries was still seen even after 8 weeks. Freeze-fracture confirmed the data about the desmosomes and revealed a marked decrease of the gap junctions. Calcipotriol basically seems to act similarly to other antipsoriatic agents, though faster. The persistence of microvasculature dilatation could imply the need for long-term therapy.
Cell adhesion molecule expression in cutaneous lesions of dermatomyositis.
Authors: Hausmann G , Mascaró Jr JM , Herrero C , Cid MC , Palou J , Mascaró JM.
Published: June 2023

Chronic inflammation seems to play a major role in skin and muscle cell damage in dermatomyositis. Adhesion molecules and their ligands are fundamental in regulating inflammation. We have carried out an immunohistochemical analysis of different activation-inducible adhesion markers in 15 biopsy specimens from dermatomyositis skin lesions. Consistent findings were the increased expression of intercellular adhesion molecule-1 (ICAM-1) on endothelial cells, inflammatory cells and focally grouped keratinocytes in contact with subepidermal inflammatory infiltrates. Immunoreactivity for vascular cell adhesion molecule-1 (VCAM-1) was predominant on endothelial cells of the upper reticular dermis and dermal stellate-shaped cells. E-selectin (endothelial leukocyte adhesion molecule-1) immunoreactivity was less extensive, detected mostly on segments of vessels of the papillary dermis and upper reticular dermis, and sometimes independent of inflammation. This pattern of adhesion molecule expression is similar to that described in other immunemediated dermatoses. The up-regulation of the adhesion molecules appears to play a role in the development and perpetuation of dermatomyositis skin lesions.
Cavity foot ulcers in diabetic patients: a comparative study of cadexomer iodine ointment and standard treatment. An economic analysis alongside a clinical trial.
Authors: Apelqvist J , Ragnarson Tennvall
Published: June 2023

Diabetic foot ulcers with exposure of tendon, muscle, or bone imply a high probability for deep infections and amputations. Delayed healing times are often described. The aim of this study was to compare the clinical effect and economic cost of cadexomer iodine with standard treatment in diabetic feet with cavity ulcers. Patients with deep, exudative foot ulcers were included in a 12-week open, randomised, comparative study. When ulcers stopped exudating, vaseline gauze was used in both groups until the end of the study. Costs were estimated for dressing material, staff and transportation. Clinically relevant improvement was seen in 12 patients treated with cadexomer iodine and in 13 patients treated with standard treatment. The average weekly cost was SEK 903 and SEK 1,421, respectively, of which the major part was costs for staff and transportation related to frequency of dressing changes. Treatment with cadexomer iodine ointment (Iodosorb) showed no clinical difference compared to topical treatment consisting of gentamicin solution, streptodornase/streptokinase, or dry saline gauze but was associated with considerably lower weekly treatment costs.
Treatment of ischaemic digital ulcers and prevention of gangrene with intravenous iloprost in systemic sclerosis.
Authors: Zachariae H , Halkier-Sørensen L , Bjerring P , Heickendorff L.
Published: June 2023

Twelve patients with systemic sclerosis were treated with intravenous infusions of the prostacyclin-stable analogue iloprost 0.5-2.0 ng/kg/min for 6 h from 8 to 13 days. Imminent gangrene was stopped in 2 patients and followed by healing. In 4 of 6 patients iloprost led to complete healing of ischaemic ulcers and in the remaining 2 patients to partial healing. One patient with severe Raynaud's phenomenon discontinued the study after 3 days due to severe headache. The 2 remaining patients with Raynaud's phenomenon as an indication improved, while no improvement was recorded in a patient with vasculitis of the lower leg. Side-effects such as headache, nausea and flushing were the reason that only 5 patients reached the maximum infusion rate. No statistical differences were recorded in digital bloodflow before and after the study or in plasma endothelin in the 9 patients investigated. Three of the 6 patients with healing ulcers, however, showed a pronounced decrease in plasma endothelin. Iloprost appears useful as a treatment of imminent gangrene and ischaemic ulcers in systemic sclerosis. This reparatory capacity could also be of a more general importance in therapy of this disease.
Acute multifocal skin necrosis: synergism between invasive streptococcal infection and cocaine-induced tissue ischaemia?
Authors: Hoeger PH , Haupt G , Hoelzle E.
Published: June 2023

A 30-year-old pregnant woman with full thickness skin necrosis following parenteral abuse of cocaine and heroine is described. Three lesions occurred simultaneously on the trunk and right knee subsequent to an abscess on the left thigh from which S. pyogenes group A and S. aureus were isolated. Histology revealed necrotic subcutaneous tissue with obliterated vessels and a mixed inflammatory infiltrate. The sequence of events suggests a synergism between the effects of bacterial proteases and cocaine-induced impairment of soft tissue perfusion. In the present case, this synergism may have been further enhanced by decreased cocaine tolerance during pregnancy.
Elevated levels of circulating intercellular adhesion molecule-3 (cICAM-3) in Psoriasis.
Authors: Griffiths CE , Boffa MJ , Gallatin WM , Martin S.
Published: June 2023

Intercellular adhesion molecule (ICAM)-3 is important in regulating leukocyte function and T-lymphocyte-antigen presenting cell interactions. Soluble, circulating forms of ICAM-3 and ICAM-1 (cICAM-3, cICAM-1) exist in serum, and levels are elevated in a variety of autoimmune diseases. Two types of soluble circulating tumour necrosis factor receptor (cTNF-R1, cTNF-R2) are found in the sera of healthy people. cTNF-R1 binds TNF-alpha and is important in regulating TNF-alpha-mediated inflammation. Psoriasis is a T-lymphocyte-mediated disease, characterized by cutaneous expression of ICAM-1, ICAM-3 and TNF-alpha. As it is unknown whether cICAM-3 is increased in sera of patients with psoriasis, we measured serum levels of cICAM-3 and compared them to levels of cICAM-1, cTNF-R1 and clinical severity of psoriasis. Sera was taken from 112 healthy controls and 32 patients with psoriasis. Clinical severity of psoriasis was assessed using the psoriasis area severity index (PASI). cICAM-1, cICAM-3 and cTNF-R1 in serum were quantitated using a dual antibody, solid phase ELISA, Levels of cICAM-3, cICAM-1 and cTNF-R1 were significantly increased in sera of patients with psoriasis as compared with controls, and these elevated levels correlated with clinical severity of psoriasis as assessed by the PASI. Also, there were good correlations between serum levels of cICAM-3, cICAM-1 and cTNF-R1 in psoriasis. These results demonstrate, for the first time, that circulating levels of cICAM-3 are increased in psoriasis and that these levels correlate both with disease severity and with elevated levels of cICAM-1 and cTNF-R1. The exact physiologic roles of circulating, soluble adhesion molecules and cTNF-R1 are unknown, but it is hypothesised that elevation of their circulating levels, as observed in psoriasis, may play a role in modulating the inflammatory reactions occurring in this disease.
Cell-mediated immunity of patients who have had basal cell carcinomas.
Authors: Czarnecki D , Mar A , Kulinskaya E.
Published: June 2023

The cell-mediated immunity of patients who had basal cell carcinomas (BCCs) removed was studied by measuring cuntaneous delayed hypersensitivity reactions to recall antigens (Multitest CMI, Pasteur-Merieux), and by measuring lymphocyte counts and subsets. One group of patients had multiple BCCs (3 or more) removed and were considered to have a high risk of new BCC formation. The other group consisted of patients who had one BCC and had not developed another within 5 years
Increased collagen propeptides in the skin of a scleredema patient but no change in re-epithelialisation rate.
Authors: Haapasaari KM , Kallioinen M , Tasanen K , Risteli J , Palatsi R , Oikarinen A.
Published: June 2023

Scleredema is a rare disease, affecting the skin connective tissue with increased amounts of collagen and glycosaminoglycans. In the present study, the collagen synthesis and re-epithelialisation rate were measured from a 64-year-old male patient, who rapidly developed extensive tightening of the skin, without any underlying disease. The skin was thickened at several sites when measured with ultrasound, and the histology revealed accumulation of glycosaminoglycans and collagen bundles. The collagen synthesis rate was measured from suction blisters induced on two different sites of the skin before the treatment and three times later up to 6 months after the treatment with a systemic steroid was started. The aminoterminal propeptide of type I collagen (PINP) was increased manifold in the affected skin when compared with the controls, indicating active collagen deposition in vivo. Systemic steroid medication with high doses (over 20 mg/d) decreased both the type I and the type III collagen propeptide levels. The time schedule of the decreases in the propeptides in the thickened, affected skin and in the clinically normal-looking skin varied, and especially in the thickened skin in the abdomen the decrease in PINP was noted only after 3 months of prednisolone therapy. When the prednisolone dose was only 10 mg daily, the propeptides were again up-regulated, perhaps reflecting the natural course of the disease. The re-epithelialisation rates at two different sites of the patient were similar to those in the controls, suggesting that even massive fibrosis with active deposition of collagen does not alter the basal rate of re-epithelialisation in the skin. In conclusion, collagen synthesis is markedly elevated in scleredema, leading to fibrosis of the skin. A recently developed method utilizing assays of collagen propeptides from suction blister fluid allows monitoring of the collagen synthesis and detection of changes in the collagen synthesis during the treatment of fibrotic disorders.
Phototoxicity of non-steroidal anti-inflammatory drugs: in vitro studies with visible light.
Authors: Becker L , Eberlein-König B , Przybilla B.
Published: June 2023

Photosensitivity reactions due to non-steroidal anti-inflammatory drugs (NSAID) are well-known side-effects of these agents and are usually attributed to ultraviolet (UV) radiation. Eight NSAID (carprofen, diclofenac, ibuprofen, ketoprofen, naproxen, piroxicam, phenylbutazone, tiaprofenic acid) were assessed in a photohemolysis test for phototoxic effects in the visible light range. For the studies an experimental visible light lamp was used, emitting 5% UVA at most. To control for UVA-induced effects, additional samples were exposed to appropriate UVA doses from an UVA source and as well to the visible light lamp while being covered by a GG 400 or GG 420 filter. Photo-induced hemolysis was found after exposure to the visible light lamp with carprofen, ketoprofen, naproxen, piroxicam, phenylbutazone or tiaprofenic acid
Cutaneous reactions after treatment with 2-chlorodeoxyadenosine.
Authors: Meunier P , Castaigne S , Bastie JN , Chosidow O , Aractingi S.
Published: June 2023

2-chlorodeoxyadenosine (2-CdA) is a new purine analogue which has shown great efficacy in the treatment of hairy cell leukemia. Only one case of cutaneous reaction after this treatment has previously been reported. The data from 33 patients treated with 2-CdA were retrospectively reviewed. Seven of these (21%) developed a disseminated eruption during the month following 2-CdA. One had toxic epidermal necrolysis. A reaction to the associated antibiotic therapy seemed "likely" or "very likely" in 5 out of the 7 cases. The incidence of adverse drug reactions may be increased after 2-CdA, and the role of CD4+ lymphocytopenia in these reactions is discussed.
A novel dithranol formulation (Micanol): the effects of monotherapy and UVB combination therapy on epidermal differentiation, proliferation and cutaneous inflammation in psoriasis vulgaris.
Authors: Van der Vleuten CJ , Gerritsen MJ , De Jong EM , Elbers M , De Jongh GJ , Van de Kerkhof PC.
Published: June 2023

Micanol, in which dithranol is micro-encapsulated in crystalline monoglycerides, is easy to wash off and staining and irritation are inconspicuous. These features make it appropriate to use in an out-patient setting. In this study the immunohistochemical effects of this new dithranol formulation were studied and compared with UVB and the combination of these therapies in skin biopsies of 8 patients with psoriasis. Markers for epidermal differentiation, proliferation and cutaneous inflammation were assessed. The present study suggests that Micanol predominantly had diminishing effects on inflammation markers, hardly affecting the epidermis. UVB had a broad spectrum of reductions. It is feasible that the combination resulted in various synergistic effects. Previous studies, however, revealed a relative persistence of the inflammatory infiltrate with more effects on epidermal processes following dithranol treatment. Based on the present study and on previous studies, it is hypothesised that Micanol delivers the active substance more directly in the dermal infiltrate, leaving the epidermis relatively unaffected. This might explain the low irritancy of Micanol treatment.
Enhanced release of interleukin-8 from human epidermal keratinocytes in response to stimulation with trichophytin in vitro.
Authors: Koga T , Ishizaki H , Matsumoto T , Toshitani S.
Published: June 2023

No abstract available.
Negative patch test reactions to sweat in atopic dermatitis.
Authors: Adachi J , Endo K , Fukuzumi T , Kojima M , Aoki T.
Published: June 2023

No abstract available.
Early onset (< 40 years age) psoriasis is comorbid with greater psychopathology than late onset psoriasis: a study of 137 patients.
Authors: Gupta MA , Gupta AK , Watteel GN.
Published: June 2023

Early onset (< age 40 years) psoriasis has been reported to be more readily triggered by environmental factors such as stress, in contrast to late onset (> or = age 40 years) psoriasis. We examined whether certain psychopathologic factors differentiated the psoriasis patient with early onset versus late onset disease. One hundred and thirty-seven psoriasis inpatients completed a battery of psychosocial questionnaires. Logistics regression analysis, using the psychologic measures, age and TBSA affected as independent variables, revealed that higher Anger-in (Anger Expression Scale) scores significantly (p < 0.05) increased the odds or probability of having early versus late onset psoriasis. Psoriasis with onset prior to age 40 is comorbid with greater difficulties with assertion and expression of anger, a personality trait that may adversely affect the patient's capacity to cope with stress.
Two-point discrimination of itch in patients with atopic dermatitis and healthy subjects.
Authors: Wahlgren CF , Ekblom A.
Published: June 2023

The ability to perceive two pruritic stimuli as separate depending on the distance between them (two-point discrimination of itch) was determined in a single-blind study of 20 patients with atopic dermatitis and 20 healthy subjects. Itch was induced with pairs of histamine injections (0.1 micrograms each) given on the upper arm, either along its axis (longitudinally within a dermatome) or at right angles to it (transversally involving more than one dermatome). The interinjection distances were varied in 3-cm steps until the shortest distance at which the two itching stimuli could be perceived as separate was found. Pairs consisting of one injection of histamine (0.1 micrograms) and one of saline served as controls. The two-point discrimination of itch was significantly better in the atopic dermatitis patients than in the healthy controls, both longitudinally (atopic dermatitis: median 12 cm, range 3-21 cm
A possible role of interleukin-8 in the induction of psoriasis-like lesions in Torre-Muir syndrome.
Authors: Yamamoto T , Katayama I , Nishioka K.
Published: June 2023

No abstract available.
Lateral edge nail involvement indicates poor prognosis for treating onychomycosis with the new systemic antifungals.
Authors: Baran R , De Doncker P.
Published: June 2023

No abstract available.
Milker's nodule--a report of 15 cases in the county of North Jutland.
Authors: Hansen SK , Mertz H , Krogdahl A , Veien NK.
Published: June 2023

No abstract available.
Flow-cytometric investigation of epidermal cell characteristics in monogenic disorders of keratinization and their modulation by topical calcipotriol treatment.
Authors: Lucker GP , Steijen PM , Suykerbuyk EJ , Kragballe K , Brandrup F , Van de Kerkhof PC.
Published: June 2023

A flow-cytometric study was performed in monogenic disorders of keratinization, to assess DNA distribution as well as the expression of keratins and involucrin. In addition, the changes in expression of these markers under influence of calcipotriol treatment were investigated. Proliferation, measured by the percentage of epidermal cells in SG2M-phase of the cell cycle, was increased in Darier's disease, lamellar ichthyosis, congenital bullous ichthyotic erythroderma of Brocq and the Comel-Netherton syndrome, whereas normal proliferation was found in autosomal dominant ichthyosis vulgaris, X-linked recessive ichthyosis, keratosis pilaris, ichthyosis bullosa of Siemens and the Sjögren-Larsson syndrome. Keratin 6 was enhanced in erythrodermic lamellar ichthyosis, congenital bullous ichthyotic erythroderma of Brocq and the Comel-Netherton syndrome, showing also reduction of keratin 10. Involucrin was only slightly reduced in erythrodermic lamellar ichthyosis, congenital bullous ichthyotic erythroderma of Brocq and the Comel-Netherton syndrome, compared to the pronounced reduction in all other skin disorders studied. Calcipotriol was found to enhance differentiation in Darier's disease, erythrodermic lamellar ichthyosis, and congenital bullous ichthyotic erythroderma of Brocq. Only Darier's disease did not show clinical improvement. In conclusion, flow cytometry provides a useful method for quantification of epidermal cell characteristics in monogenic disorders of keratinization. Further studies need to be performed to establish its usefulness as a diagnostic and prognostic tool.
Fine mapping of the locus for nevoid basal cell carcinoma syndrome on chromosome 9q.
Authors: Undén AB , Ståhle-Bäckdahl M , Holmberg E , Larsson C , Toftgård R.
Published: June 2023

The nevoid basal cell carcinoma syndrome is an autosomal dominant disorder, characterized by predisposition to multiple early basal cell carcinomas of the skin and several other tumours as well as frequent occurrence of developmental anomalies. The gene has previously been mapped to chromosome 9q22 and is believed to function as a tumour suppressor. We have applied linkage and haplotype analysis to four Swedish nevoid basal cell carcinoma syndrome families to refine the localization of the nevoid basal cell carcinoma syndrome gene. Information from critical recombinants localizes the gene proximal of marker D9S287, which in combination with analysis of loss of heterozygosity in a hereditary cardiac fibroma has allowed us to define a minimal candidate region of 1Mb or less for the nevoid basal cell carcinoma gene flanked by the markers D9S280 and D9S287 in the 9q22.3 area.
Technical advances in prenatal diagnosis of tyrosinase-negative oculocutaneous albinism.
Authors: Shimizu H.
Published: June 2023

Technical advances in the prenatal diagnosis of tyrosinase-negative oculocutaneous albinism, the most severe subtype of this disease, are reviewed. Ultrastructural examination of hair bulb melanocytes in fetal skin during the second trimester of pregnancy was the first successful method for the prenatal diagnosis of oculocutaneous albinism. Subsequent introduction of the electron microscopic DOPA reaction test in fetal skin provided safer, more practical, and reliable information for diagnosing tyrosinase-negative oculocutaneous albinism prenatally. The recent elucidation of the specific gene mutation of tyrosinase in the affected individuals now allows the DNA-based prenatal diagnosis of tyrosinase-negative oculocutaneous albinism in the first trimester of pregnancy.