bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxic epidermal necrolysis in patients receiving glucocorticosteroids.
Authors: Rzany B , Schmitt H , Schöpf E
Published: July 2023

Despite the lack of evidence of an immunologically mediated mechanism for Toxic Epidermal Necrolysis (TEN), glucocorticosteroids are frequently used for the treatment of patients afflicted with TEN. We investigated the data of 216 patients with TEN for therapy with glucocorticosteroids prior to the beginning of TEN. The data had been collected between 1984 and 1985 during the epidemiological study on severe skin reactions in West-Germany spanning the years 1981-85. 11/216 (5%) patients could be traced, who had been treated with glucocorticosteroids for at least a week prior to the first dermatological sign of TEN. Glucocorticosteroids had been administered predominantly for neurological or neurosurgical conditions. The period of treatment ranged from 1 week to several months. Doses ranging between 7.5 and 325 mg prednisolone/per day were found. There were no major differences between patients with or without steroid therapy with regard to sex, age and lethality. The observation of TEN in patients receiving therapy with glucocorticosteroids raises questions about the usefulness of treating patients with TEN with glucocorticosteroids.
Langerhans' cell histiocytosis in an adult.
Authors: Lindelöf B , Forslind B , Hilliges M , Johansson O , Aström L
Published: July 2023

A woman with typical skin lesions of histiocytosis X is reported. Electron microscopic and immunohistochemical investigations revealed a large number of markedly long Birbeck Langerhans' cell granulae. During treatment with Interferon alpha -2b, the patient developed infarctus cerebri and died.
Dose-response relationship between objective measures of histamine-induced weals and dose of terfenadine.
Authors: Shall L , Newcombe R G , Lush M , Marks R
Published: July 2023

Terfenadine is a safe non-sedative H1-receptor antagonist. This study aimed to quantify the relative reduction in weal and flare area, thickness and erythema at 4, 8, 12 and 24 h following a single but variable oral dose of terfenadine compared with pre-treatment measurements, in order to compare the dose-effect relationship and time course of the different dosages. In a double-blind randomized cross-over study, 12 healthy volunteers were given 60, 120 or 240 mg of terfenadine or placebo. Twenty micrograms of histamine acid phosphate was then injected intradermally at 4, 8, 12 and 24 h. The weal and flare areas were measured by planimetry, the thickness of the weal by an A-scan pulsed ultrasound device and the redness of both the weal and flare by an erythema-meter. A definite dose-response relationship was demonstrated between the weal and flare areas and the three active treatments. For the weal area, there was a significant difference between 60 mg and 240 mg of terfenadine at 4 h (p less than 0.01), at 8 and 12 h (p less than 0.05). For the flare area there was a similar significant difference at 4 h (p less than 0.01) and at 8 h (p less than 0.05). A dose-response relationship was demonstrated between weal erythema and 120 mg or 240 mg and 60 mg of terfenadine (p less than 0.05). There was a correlation between the plasma levels of the major metabolite and the initial dose of terfenadine, demonstrating their expected proportionality. This metabolite was also demonstrated in tissue fluid.
Reactions to intradermally injected substance P and topically applied mustard oil in atopic dermatitis patients.
Authors: Heyer G , Hornstein O P , Handwerker H O
Published: July 2023

Skin reactions and itch or burning pain sensations following intradermal injection of the neuropeptide substance P and topical application of the substance P releasing agent mustard oil were studied in 20 atopic dermatitis patients and 20 healthy controls. Changes in skin blood flow were measured with a Laser Doppler flowmeter. Areas of wheal and flare reactions were evaluated planimetrically. Simultaneous with Laser Doppler flowmeter measurements, subjective itch and burning pain ratings were verbally reported on a category partitioning scale at 10-second intervals. Substance P evoked dose-dependent wheal, flare, and itch reactions in both patients and controls. However, substance P doses of 10(-9) -10(-11) mol elicited smaller flares in patients than in the controls whereas the wheal sizes were similar in both groups. Substance P-induced itch ratings were lower in patients at a dose of 10(-10) mol, and the onset of itching was delayed at all substance P levels applied. Mustard oil elicited similar neurogenic inflammatory reactions in both groups, although pain sensations were significantly delayed in atopic dermatitis patients at two mustard oil concentrations, which is further indication of a desensitization of afferent nerve endings contributing to the neurogenic inflammatory reactions in the skin of these patients.
Topical cyclosporin induces hair growth in human split skin grafted onto nude mice.
Authors: Gilhar A , Etzioni A , Moscona R
Published: July 2023

Previously we observed that systemic CyA induces hair growth in an experimental model of human scalp skin graft transplanted onto nude mice. In the present study we investigated the role of topical CyA in the murine transplantation model, using human split-thickness skin grafts (HSTSG). Ten mice grafted with 1-mm-thick skin and another 10 mice grafted with 0.4-mm-thick skin were treated topically with CyA in olive oil. Ten other mice, treated with olive oil only, served as a control group. At the end of the study we observed hair growth only on the grafted skin of the CyA-treated group. Four out of 10 grafts showed hair growth in each of the groups. Quantitative analysis of transverse sections of cylindrical punch biopsy specimens of HSTSG before transplantation revealed anagen follicles, including small ones and telogen/catagen follicles, whereas specimens after skin transplantation showed terminal follicles mostly in the anagen phase. The present study provides further support to previous observations regarding the beneficial effect of CyA on hair growth.
Inflammatory linear verrucous epidermal naevus (ILVEN) versus linear psoriasis. A clinical, histological and immunohistochemical study.
Authors: De Jong E , Rulo H F , Van de Kerkhof P C
Published: July 2023

Inflammatory Linear Verrucous Epidermal Nevus (ILVEN) has been suggested to be a separate disease entity. However, the distinction from linear psoriasis has been discussed in the literature over recent decades. The aim of the present study was to investigate, in addition to the clinical and histological criteria, the immunohistochemical aspects of inflammation, epidermal proliferation and keratinization. From a clinical and histological point of view, ILVEN and psoriasis, according to the established criteria, have been proved to overlap. The immunohistochemical study suggests that the following procedures have an additional diagnostic impact: assessment of elastase-positive cells, assessment of keratin 16 and of keratin 10.
Topical salicylic acid interferes with UVB therapy for psoriasis.
Authors: Kristensen B , Kristensen O
Published: July 2023

Salicylic acid has been widely used in the topical treatment of psoriasis. Chemically it is closely related to paraaminobenzoic acid. Following in vitro studies indicating that salicylic acid might exhibit relevant UVB absorption, we found that salicylic acid had a clinically pronounced filter effect when applied prior to UVB exposure. The duration of photoprotection after application was more than 12 h, sometimes exceeding 24 h. In a prospective, randomized, double-blind, left-right comparison study in patients with psoriasis between emollients with and without salicylic acid, salicylic acid was shown to decrease the clearing rate significantly.
Immunocytochemical analysis of early focal cellular infiltrates in experimental oral contact hypersensitivity.
Authors: Warfvinge G , Larsson A
Published: July 2023

The cellular infiltrates of early contact hypersensitivity reactions to 2,4-dinitrofluorobenzene (DNFB) in rat oral mucosa were phenotypically characterized using serial frozen tissue sections and monoclonal antibodies. CD2+CD45RB- lymphocytes and ED1+RT1B/D+ monocytes/macrophages appeared in focal collections at the epithelium-connective tissue interface 2-6 h after challenge with DNFB. These foci also contained CD4+, CD5+, CD8+, TCR alpha beta+ cells. CD45RB+ "naive" T cells were difficult to detect at 2-6 h but appeared in significant numbers at 24 h post-challenge. At this stage, the number of all the other phenotypes also was increased. CD2+ cells were approximately twice as many as CD5+ or TCR alpha beta+ respectively, indicating that TCR gamma delta+ lymphocytes might be involved. An additional observation was the presence of increased numbers of CD2+ lymphocytes in the oral mucosa of sensitized but not challenged animals. Our findings indicate that the oral mucosa of skin DNFB pre-sensitized animals may be "contact hypersensitivity conditioned" by migration-prone memory T cells, and that these cells may rapidly interact with locally resident epithelial Langerhans' cells following antigen restimulation, creating the very initial antigen-specific part of experimental oral contact hypersensitivity.
Stigmata of atopic constitution in patients with atopic eczema or atopic respiratory disease.
Authors: Przybilla B , Ring J , Enders F , Winkelmann H
Published: July 2023

In the diagnosis of atopic eczema, minor physical markers (stigmata) frequently provide valuable clues. The prevalence of nine stigmata (dry skin, hyperlinearity of the palms or soles, infraorbital fold, white dermographism, facial pallor, orbital darkening, Hertoghe's sign, low hairline) was evaluated in 34 atopic eczema patients without atopic respiratory disease, in 16 patients with allergic rhinitis and/or asthma without atopic eczema, and in 23 controls without atopic respiratory or eczematous disease, and with negative results at prick testing with three common aeroallergens. Compared with controls, all features except Hertoghe's sign were significantly (p less than 0.01) more frequent in atopic eczema, and, except for Hertoghe's sign, dry skin and white dermographism, they were significantly (low hairline, p less than 0.05 others, p less than 0.01) more frequent also in respiratory disease. The prevalence of most stigmata did not differ significantly (p greater than 0.05) in cutaneous vs. respiratory atopic disease, only dry skin being more frequent in atopic eczema (p less than 0.05). Although not specific, most stigmata are characteristic markers not only of atopic eczema, but of atopy as such.
Reactivity of HMB-45 monoclonal antibody with sweat-gland tumours of the skin.
Authors: Kanitakis J , Hermier C , Chouvet B , Thivolet J
Published: July 2023

HMB-45, a monoclonal antibody claimed to be specific for malignant melanoma, has been observed to react with normal eccrine sweat glands and occasionally with normal mammary and bronchial epithelium. In this study we show that HMB-45 also decorates cells in approximately 15% of various sweatgland tumours of the skin. This finding, along with the reported reactivity on mammary carcinomas further outlines the lack of absolute specificity of HMB-45 for cells of the melanocytic lineage.
Eosinophilic cationic protein (ECP) in skin disorders.
Authors: Juhlin L , Venge P
Published: July 2023

Eosinophil cationic protein (ECP) is exclusively secreted only by the eosinophilic leukocyte. In this study the ECP concentration in the serum was measured in patients (n = 155) with various skin disorders and compared with the number of circulating eosinophils. The presence of activated eosinophils in the skin was also studied immunohistochemically using the monoclonal antibody EG-2, which recognizes both the eosinophil protein X (EPX/EDN) and ECP. EG-2 distinctly revealed these proteins in the eosinophils and their granules. Non-activated eosinophils were studied with the monoclonal antibody EG-1. In most cases this did not disclose any more eosinophils and often it was located more diffusely and not seldom on collagen fibers. Elevated serum ECP but normal numbers of circulating eosinophils were found in half of the patients with progressive plaque psoriasis and long-standing daily chronic urticaria. In patients with prurigo nodularis, papular erythematous eruptions, vasculitis, purpura and toxic drug reactions, Wells' syndrome, porphyria cutanea tarda and persistent light reaction the serum ECP was increased, although in some cases the number of circulating eosinophils was normal. In these disorders an increased number of activated eosinophils was found in the skin. Both serum ECP and the number of activated eosinophils normalized when the patients' condition improved. In atopic dermatitis the serum ECP and the number of activated eosinophils in the skin were increased only during exacerbation of the disease. High serum levels of ECP and activated eosinophils in the skin are frequent findings in many skin disorders in spite of often normal blood eosinophil counts.(ABSTRACT TRUNCATED AT 250 WORDS)
Common and dysplastic naevi as risk factors for cutaneous malignant melanoma in a Swedish population.
Authors: Augustsson A , Stierner U , Rosdahl I , Suurküla M
Published: July 2023

Common naevi, dysplastic naevi (DN) and other phenotypic features were evaluated as melanoma risk factors in a Swedish case-control study. One-hundred and twenty-one prevalent melanoma cases and 378 randomly selected controls participated. The mean total body naevus count was 115 in the cases and 67 in the controls. Fifty-six per cent of the cases and 18% of the controls had clinical DN. The corresponding figures for histologically diagnosed DN were 40% and 8% respectively. Clinical DN was as good as histologically diagnosed DN in identifying individuals at risk for melanoma. Subjects with sun-sensitive skin, greater than or equal to 150 naevi and presence of DN have 50 times higher melanoma risk than those without these characteristics.
Seborrheic dermatitis and daylight.
Authors: Maietta G , Rongioletti F , Rebora A
Published: July 2023

Patients with mood depression have been found to have a higher prevalence of seborrheic dermatitis (SD), possibly related to their tendency to live indoors. The prevalence of outpatients with SD has now been found to be directly related to the number of gloomy days in the area. Since UV light might not be the only reason for the well-known improvement in SD in summer, an explanation possibly related to melatonin is envisaged.
Epidermal and urethroid penile cyst.
Authors: Claudy A L , Dutoit M , Boucheron S
Published: July 2023

The authors describe a 74-year-old man who presented with a 2-cm nodule on the ventral face of the penis, showing histologically a cyst lined by both epidermal and urethroid epithelium. The authors discuss the various histological forms of raphe median cysts of the penis.
Episodic angioedema with eosinophilia: precursor lesions and relevance of histology. A case report.
Authors: Kühne U , Marsch W C
Published: July 2023

A 59-year-old patient suffered from persistent angioedema-like swellings and blood eosinophilia. The disease was preceded by an erythema multiforme-like exanthema and urticarial papules. Persistent eosinophilia with exclusion of its known causes and skin biopsy helped to establish the diagnosis of the benign variant of hypereosinophilic syndrome known as 'episodic angioedema with eosinophilia'. Corticosteroid therapy was successful. The therapeutic alternatives are discussed.
Indication for the identity of palmoplantar keratoderma type Unna-Thost with type Vörner. Thost's family revisited 110 years later.
Authors: Küster W , Becker A
Published: July 2023

Palmoplantar keratoderma (PPK) type Unna-Thost is known to be the most common form of a hereditary disorder of keratinization of palms and soles. The disease is clinically identical with PPK type Vörner which is histologically characterized by epidermolytic hyperkeratosis. By reinvestigation of the family originally seen by Thost in 1880, the features of epidermolytic hyperkeratosis were found histologically confirming the diagnosis PPK of Vörner. This proves the identity of PPK type Thost with PPK of Vörner. Because of the histological variability of epidermolytic hyperkeratosis, detailed light and electron microscopic studies are necessary in cases of diffuse types of PPK.
Group G streptococcal infections on a dermatological ward.
Authors: Nohlgård C , Björklind A , Hammar H
Published: July 2023

Groups A, B, C and G streptococci were cultured from 63 consecutive in-patients recruited between November 1987 and April 1988 and monitored until the end of July 1988. Chronic leg ulcers were present in 34 patients. Group G was found in 34 patients, 25 of whom had pyoderma and 3 had sepsis. Six of the patients had no signs of clinical infection, and treatment with antibiotics was therefore withheld. Recurrent phlegmon or erysipelas developed in 2 of 28 patients with clinical Group G infections. Erysipelas developed some 1-7 months later in 3 of the 6 patients who were not initially treated. No significant difference in severity or additional medical conditions was found between the patients with either Group G or Group A streptococci. In comparison, data on all streptococcal cultures at the Department indicated that Group G was isolated 2.6 times as often as Group A streptococci for the in-patients, compared with 1.1 for all patients seen. It is concluded that Group G streptococcal skin infections must be regarded with the same clinical vigilance as Group A infections.
Folliculitis decalvans. Long-lasting response to combined therapy with fusidic acid and zinc.
Authors: Abeck D , Korting H C , Braun-Falco O
Published: July 2023

In 3 patients, the diagnosis of folliculitis decalvans was based on clinical, histopathological and laboratory criteria. All patients responded to a combination therapy consisting of oral and topical fusidic acid and oral zinc sulphate. The follow-up period exceeded more than one year.
Hypertrichosis lanuginosa acquisita.
Authors: Bégány A , Nagy-Vezekényi K
Published: July 2023

Hypertrichosis lanuginosa acquisita was observed in a female patient with stage IV malignant melanoma and also diffuse melanosis of the skin. The patient died within 2 months after the appearance of HL.
Follow-up of men with genital papilloma virus infection. Psychosexual aspects.
Authors: Voog E , Löwhagen G B
Published: July 2023

Genital papilloma virus infection (GPVI) is in many patients a longlasting, relapsing disease for which no effective treatment is available. This fact and the association between the virus and cancer puts much stress on the afflicted patient. Of 41 men with GPVI interviewed, 17 (40%) reported a negative effect of the disease on their sexual life. Most distressing was the fear of transmitting the disease to their partner. After 18 months, 15 (37%) of the 41 men still exhibited signs of GPVI. In the care of patients with GPVI, more attention needs to be paid to the psychosexual effects of the disease.
Extraocular sebaceous carcinoma.
Authors: Tchornobay A M , Lévigne V , Favre J , Claudy A L
Published: July 2023

A 79-year-old man with no history of previous irradiation presented with a large ulcerated tumour of the cheek. The histological features favoured a true sebaceous carcinoma. Neither squamous nor basal differentiation were seen. Sudan stainings were positive. Tumour cells expressed suprabasal keratins and were negative for carcinoembryonic antigen, vimentin and S 100 protein. Extraocular sebaceous carcinomas occurring without previous irradiation are rare tumours which behave aggressively. Treatment regimens are discussed.
Delayed hypersensitivity reactions following allergic and irritant inflammation.
Authors: Hindsén M , Christensen O B
Published: July 2023

Delayed hypersensitivity retest reaction 3 and 6 weeks after induction of allergic and irritant inflammation, was studied in 13 females with known hypersensitivity to nickel. An increased retest reaction compared to controls was observed only in sites of earlier specific allergic inflammation. Also a general down-regulation of the degree of hypersensitivity was observed at retesting.
Effect of drugs on the early and late phase UV erythema.
Authors: Juhlin L , Shroot B
Published: July 2023

The inhibition of erythema by drugs applied topically after irradiation with 0.2-0.8 J of 313 nm has been studied in healthy volunteers. Indomethacin and piroxicam markedly inhibited the erythema at 6 to 24 h after irradiation but erythema reappeared at 45 h. The results reported suggest that the UVB response is biphasic with an early phase responsive to nonsteroid anti-inflammatory drugs and a late phase which is not responsive. No effect on the intensity of the erythema was seen with betamethasone chloroquine and cetirizine. Oral intake of aspirin before and/or after irradiation did not influence the UV response.
Zinc salts effects on granulocyte zinc concentration and chemotaxis in acne patients.
Authors: Dreno B , Trossaert M , Boiteau H L , Litoux P
Published: July 2023

To explore the mechanism by which zinc acts on cutaneous inflammatory lesions, we studied granulocyte zinc levels and in vitro polymorphonuclear leukocyte chemotaxis in 20 acne patients before and after 2 months of zinc therapy (200 mg/day zinc gluconate). The zinc level was assayed by flame absorption spectrophotometry and chemotaxis was performed by agarose assay. After 2 months of treatment, a significant decrease in granulocyte zinc level associated with inhibition of chemotaxis (r = 0.69) was observed in 16 patients. This suggests that zinc anti-inflammatory action is related to inhibition of polymorphonuclear leukocyte chemotaxis induced by a decreased granulocyte zinc level.
Can alopecia areata be triggered by emotional stress? An uncontrolled evaluation of 178 patients with extensive hair loss.
Authors: Van der Steen P , Boezeman J , Duller P , Happle R
Published: July 2023

One hundred and seventy-eight patients with severe alopecia areata were asked at interview whether they attributed their first attack of hair loss to an emotional trauma. Twelve patients (6.7%) reported a severely disturbing event during the 6 months preceding the first symptoms of their disease. No patient reported that episodes of hair loss coincided with stressful life events. Emotional triggers were not especially correlated with any particular type of alopecia areata. The present study does not therefore provide evidence of a significant role of emotional stress in the pathogenesis of alopecia areata.
The analgesic effect of EMLA cream on facial skin. Quantitative evaluation using argon laser stimulation.
Authors: Nielsen J C , Arendt-Nielsen L , Bjerring P , Svensson P
Published: July 2023

The hypoalgesic effect of EMLA cream (Eutectic Mixture of Local Anesthetics) applied for 5, 15, and 30 min on facial skin was evaluated. Hypoalgesia was assessed by changes in pain thresholds to brief argon laser stimuli 0, 2, 5, 10, 15, 20, 25, 30, 45, and 60 min after removal of EMLA cream. The local cutaneous vascular changes induced by EMLA cream was evaluated by Erythema Index determined by reflectance spectroscopy and by laser Doppler blood flowmetry. A large inter-individual variability in analgesic efficacy was observed. The volunteers could be divided into two groups, one group of 6 persons where EMLA induced analgesia or considerable hypoalgesia, and one group of 4 persons where EMLA had no or only slight hypoalgesic effect. This great variability should be considered when EMLA cream is used for facial application in the clinic. Differences in local blood flow probably contribute to the variability. Application of EMLA cream for 5 and 15 min did not change erythema of the skin, while 30 min of application caused minor blanching.
Subcorneal pustular dermatosis in a patient with Crohn's disease.
Authors: Delaporte E , Colombel J F , Nguyen-Mailfer C , Piette F , Cortot A , Bergoend H
Published: July 2023

A case of subcorneal pustular dermatosis (Sneddon-Wilkinson disease) is reported in a patient with a one-year history of Crohn's disease. Subcorneal pustular dermatosis has been described in association with monoclonal gammopathy, but to our knowledge it has not been associated with Crohn's disease. This new association reinforces the hypothesis of a possible common pathogenesis for neutrophilic dermatoses and inflammatory bowel diseases.
Hemolytic uremic syndrome in a patient with systemic sclerosis treated with cyclosporin A.
Authors: Zachariae H , Hansen H E , Olsen T S
Published: July 2023

The case is presented of a 48-year-old female suffering from diffuse cutaneous systemic sclerosis (diffuse scleroderma) since 8 years, who went into renal failure as part of hemolytic uremic syndrome following 3 weeks' treatment with 3.8 mg/kg cyclosporin A. Hemolytic uremic syndrome has previously been described in transplant patients receiving cyclosporin A. There are also four cases reported in the literature of renal failure developing in middle aged females with diffuse cutaneous systemic sclerosis after short-term use of low dosage cyclosporin A treatment. It is suggested, that it may be wise not to use cyclosporin A to this category of patients, in which it can not be ruled out, that even a low dose therapy may trigger the rapid onset of scleroderma renal crisis or as in our case provoke hemolytic uremic syndrome.
The increase in skin hydration after application of emollients with different amounts of lipids.
Authors: Lodén M
Published: July 2023

Emollients can increase the water content in the stratum corneum by delivery of their water to the skin, and by occlusion. These two mechanisms were studied using three preparations with different concentrations of lipids. The products were applied to the skin and then removed by cleaning the surface after 5 and 40 min. The increase in skin water loss following removal of product residue was considered as a release of excess water in the skin. Exposure of the skin to pure petrolatum for 5 min gave no increase in the water loss from the skin surface following removal of the product residue. A lipid rich cream (66% lipids) gave a significant increase, but the highest increase was found after removal of an ordinary cream (27% lipids). Release of water from the skin indicates that water in the creams had previously been absorbed into the skin. The occluding properties of the products were determined after 40 min of exposure. Petrolatum reduced the water loss by approximately 50% and the other products by 16%. The occlusion caused an increase of water in the skin, which resulted in a release of water following removal of the products. The release was related to the reduction of water loss. Thus petrolatum gave a higher release of water than the other emollients.
Pityriasis alba in a psoriatic location.
Authors: Wolf R , Wolf D , Trau H
Published: July 2023

Three patients with pityriasis alba whose lesions were confined to the knees only are reported. Such cases can be misdiagnosed as psoriasis. The key to the correct diagnosis lies in the physician's awareness of the existence of this variant of pityriasis alba.
The hairless mouse model for assaying the atrophogenicity of topical corticosteroids.
Authors: Woodbury R , Kligman A M
Published: July 2023

The daily application of corticosteroids for 18 days to the dorsal skin of hairless mice resulted in loss of volume of all the cutaneous compartments. The epidermis thinned, sebaceous glands regressed, dermal thickness was reduced, horn-filled cysts shrunk, subcutaneous fat disappeared, and regression of the muscular layer occurred. The magnitude of these changes correlated strongly with the accepted potency ranking of these agents by clinical efficacy. Thus, atrophogenicity predicts anti-inflammatory activity. This model furnishes a simple screening method for assaying corticosteroid activity and for optimizing proprietary formulations.
Localized proliferative effect of preadipocytes on cultured human epidermal keratinocytes.
Authors: Miyashita M , Baba S , Suzuki H
Published: July 2023

The effect of preadipocytes (ST 13) on cultured normal human epidermal keratinocytes (NHEK) was investigated. The growth of NHEK was accelerated with co-cultured ST 13 cells. This stimulative effect must have been localized around viable ST 13 cells, because neither the medium nor the surface conditioned by ST 13 or the ST 13 cell fragments showed any promotion of NHEK growth, and NHEK showed a compact, paving-like arrangement only when they were attached directly to ST 13 cells. It became clear that these compactly arranged keratinocytes have an active proliferative ability, since their nuclei showed a marked uptake of 5-bromodeoxyuridine (BrdU) and they were positively stained with anticytokeratin 37, a monoclonal antibody against the basal epidermis. Under electron microscopy, ST 13 preadipocytes were closely connected with NHEK. These results, together with those of previous reports, suggest that the localized proliferative effect of ST 13 cells on NHEK is due to cell-to-cell contact.
A dose-response study of irritant reactions to sodium lauryl sulphate in patients with seborrhoeic dermatitis and atopic eczema.
Authors: Cowley N C , Farr P M
Published: July 2023

The susceptibility of the skin of patients with seborrhoeic dermatitis to surfactant irritation was investigated and compared to that of a group of normal subjects and patients with a history of atopic eczema. Responses to six concentrations of sodium lauryl sulphate (SLS), applied to forearm skin, were assessed clinically and measured by laser Doppler flowmetry. Analysis of dose-response curves showed statistically significant increased susceptibility to SLS-induced irritation in patients with seborrhoeic dermatitis and atopic eczema compared with normal subjects. Increased susceptibility to chemical irritation may be important in the pathogenesis of seborrhoeic dermatitis.
Cyclosporin A responsive chronic severe vesicular hand eczema.
Authors: Petersen C S , Menné T
Published: July 2023

A patient with an otherwise recalcitrant chronic vesicular hand eczema responded with a dramatical improvement within 2 weeks of cyclosporin A (CsA) therapy 5.0 mg/kg daily. The patient was still free of eczema in spite of reducing the CsA dose to 2.5 mg/kg daily. CsA therapy was finally stopped due to a moderate increase in blood pressure, resulting in rapid recurrence of the hand eczema. The case report clearly demonstrates that oral CsA should be considered in patients with severe hand eczema that cannot be controlled on conventional immunosuppressive treatments.
Efficacy and skeletal side effects of two years' acitretin treatment.
Authors: Mørk N J , Kolbenstvedt A , Austad J
Published: July 2023

In this prospective study, 51 patients suffering from psoriasis and ichthyosis were treated with acitretin for 2 years. The average dose was 0.5 mg/kg/day. We have evaluated the efficacy and side effects, focusing on skeletal side effects. X-ray examinations were done before treatment and after 1 and 2 years. Forty-five patients completed the study. Acitretin had a good clinical effect, with 75% improvement in 35 of the patients. Apart from the well-known side effects affecting the mucous membranes, one patient developed biopsy- proven toxic hepatitis. In 2 patients we observed unusual skeletal calcifications located in the forearms and in the hip. These were considered to be caused by the drug. In this study, which included patients up to 71 years, only radiographs of the pelvis and the forearms were of value as routine follow-up films.
Birthmarks in 4346 Finnish newborns.
Authors: Karvonen S L , Vaajalahti P , Marenk M , Janas M , Kuokkanen K
Published: July 2023

We examined all babies born live (4346) at two Finnish hospitals in the course of one year to determine the frequency of birthmarks, specially pigmented lesions, among Finnish newborns. All birthmarks excluding common salmon patches on the forehead and neck were recorded and photographed at birth. The babies were re-examined at the age of three months. Various birthmarks were recorded for 241 of 4346 babies, i.e. for 5.5% of all newborns. Ninety-one (2.1%) infants had congenital pigmented skin lesions, 167 (3.8%) had various vascular lesions and 21 (0.5%) had other birthmarks. The frequency of congenital melanocytic naevi was 1.5%. Most of the naevi were less than 20 mm in diameter. Only one child had a giant naevus. The frequency of congenital naevi in our study was the same or somewhat higher than previously described (1-8) but fewer other pigmented skin lesions were found than in previous studies perhaps due to racial differences.
Allogeneic cultured keratinocytes in the treatment of leg ulcers. A pilot study.
Authors: Marcusson J A , Lindgren C , Berghard A , Toftgård R
Published: July 2023

Forty-two patients (10 males and 32 females) with 52 chronic leg ulcers were treated with sheets of cultured allogeneic keratinocytes. Sixty-five % of the ulcers healed completely and the healing rate differed between various diagnostic groups. The best results were obtained in patients with venous ulcers and wounds with mixed etiology, whereas less improvement was observed with ischaemic ulcers. Rheumatic ulcers also responded well in combination with oral corticosteroids. The overall impression was that the grafting procedure markedly enhanced wound healing.
Suction blister fluid histamine in fixed drug eruption.
Authors: Alanko K , Stubb S , Salo O P , Reitamo S
Published: July 2023

The histamine concentration was measured from suction blister fluid obtained from normal and lesional skin of 8 patients with fixed drug eruption (FDE) caused by phenazone salicylate and from that of 2 healthy control subjects. In blister fluid samples obtained before peroral challenge with phenazone salicylate, the histamine concentrations were below 5 nmol/l both in uninvolved skin and in sites of previous FDE lesion (sample 0). After challenge, samples were taken from the incipient reaction that was visible after an average of 155 min. Histamine levels were significantly elevated in the blister fluid of 2 out of 8 FDE lesions (200 and 640 nmol/l) but in none of the uninvolved skin (sample 1). Two hours later (sample 2) the histamine levels were elevated in both uninvolved (mean 51.4 nmol/l) and lesional skin (mean 168 nmol/l). After 24 h (sample 3) the corresponding mean value was 25.4 nmol/l for uninvolved skin and 108 nmol/l for lesional skin. The histamine values in the blister fluid from FDE lesions in samples 2 and 3 were significantly higher (p less than 0.05) than those in the control blisters of uninvolved skin. An elevation of histamine levels comparable to that in the uninvolved skin of FDE patients was seen in the 2 healthy control subjects studied. The present study provides direct evidence of early release of histamine from mast cells or basophils in FDE and suggests that histamine is one of the mediators of clinical symptoms of FDE.
Cross-reactivity to palladium and nickel studied in the guinea pig.
Authors: Wahlberg J E , Boman A S
Published: July 2023

In recent years there have been several reports on concomitant patch test reactions to palladium and nickel, which belong to the same group in the periodic table. Exposure to palladium mainly takes place via dental alloys and jewelry. However, the clinical relevance of simultaneous reactivity to these metals is unknown. To elucidate the question of cross-reactivity, guinea pigs were induced with palladium or nickel and simultaneously challenged with palladium and nickel. Animals sensitized to palladium according to the guinea pig maximization test method (GPMT) or to a new method by van Hoogstraten & Scheper (H&S) reacted to palladium as well as to nickel. On the other hand, animals sensitized to nickel according to H&S reacted to nickel but not to palladium. The GPMT shows that palladium is a more potent sensitizer than nickel: could palladium be the primary sensitizer in humans?
Effects of systemic isotretinoin on serum markers of collagen synthesis and degradation.
Authors: Autio P , Risteli J , Palatsi R , Väänänen K , Vuori J , Risteli L , Oikarinen A
Published: July 2023

In the present investigation, collagen synthesis and degradation were studied by measuring the carboxyterminal propeptide of type I procollagen (PICP), the aminoterminal propeptide of type III procollagen (PIIINP) and a type I collagen/specific degradation peptide (ICTP) in the sera of 43 male patients, treated for acne with isotretinoin or with tetracycline. The values were compared with those observed in 24 acne patients without treatment and in healthy controls. The treatment with isotretinoin did not seem to affect these parameters in a cross/sectional setting, whereas tetracycline treatment was associated with slightly decreased levels of ICTP. Since there were marked variations in the PICP, PIIINP and ICTP levels between individual subjects, a follow/up study, including male and female patients, others than in the first part of the study, was conducted. Two other biochemical markers of bone metabolism, osteocalcin, reflecting osteoblastic activity, and tartrate/resistant acid phosphatase (TRAP), reflecting osteoclastic activity, were also analyzed. In females, all these parameters were lower than in males. In addition, the changes in females were more pronounced in particular, PIIINP and TRAP were significantly increased in females during retinoid treatment (p < 0.05 and p < 0.01, respectively). Importantly, no increase was found in the synthesis of type I collagen during retinoid treatment, suggesting that the commonly used retinoid dosages do not stimulate the synthesis of type I collagen in vivo.
Skin, adipose tissue and plasma levels of acitretin with rare occurrence of esterified acitretin during long/term treatment.
Authors: Meyer E , De Bersaques J , Lambert W E , De Leenheer A P , Kint A H
Published: July 2023

In a previous study acitretin and its 13/cis/metabolite were monitored in the plasma and epidermis of healthy volunteers. They were given 50 mg of trans/acitretin daily. No drug accumulation was observed in the skin, nor in the plasma. The purpose of the present study was to extend the data from non/psoriatic to psoriatic (n = 11) subjects, treated for at least 1 month with 25 mg acitretin. Plasma, skin biopsies and subcutaneous fat samples were analysed using HPLC. Trough levels of acitretin in skin were below the quantification limit, increasing to 28 +// 16 ng/g within 5 h after dosing. Fat tissue levels exceeded those of skin, with values of 98 +// 71 ng/g within 5 h after drug intake. In 2 patients, additional samples were taken 3 days post/therapy. Here, concentrations were below the quantification limit in adipose tissue, confirming that acitretin is not stored in subcutaneous fat. Esterification of acitretin into etretinate was observed in 2 subjects. This observation illustrates the recently described new metabolic pathway for acitretin. On both occasions, the unexpected ethylester metabolite was extensively stored in fat tissue.
Antibodies to retrovirus proteins in scleroderma.
Authors: Haustein U F , Pustowoit B , Krusche U , Herrmann K
Published: July 2023

In 8 out of 29 patients with scleroderma we found antibodies to HIV retroviral proteins in the Western blot analysis. The sera reacted only to one or two of the following bands: p 18, p 24, p 55, p 65 in relatively weak grades. There were no evident clinical correlations with the reactivity of certain bands, nor signs of direct HIV infection in our patients. Apart from 3 cases with positive CMV reactivity (IgM), there was no cross/reactivity to HTLV I or EBV (IgM) and to topoisomerase (Scl 70) or other autoantibodies to various nuclear antigens related to scleroderma. It is not clear whether retroviruses are involved in the pathogenesis of scleroderma or whether these antibodies are due to molecular mimicry.
Angiokeratomas in Fabry's disease and Fordyce's disease: successful treatment with copper vapour laser.
Authors: Lapins J , Emtestam L , Marcusson J A
Published: July 2023

Two patients with multiple angiokeratomas on genitalia and thighs, one with Fabry's disease and one with Fordyce's disease, were treated with copper vapour laser light of 578 nm wavelength. The result was desirable, with destruction and disappearance of the lesions and minimal scarring and posttreatment hyper/ or hypopigmentation.
Eruptive syringoma mimicking urticaria pigmentosa. A case report.
Authors: Mertz H , Veien N K
Published: July 2023

A case of eruptive syringoma with the clinical features of urticaria pigmentosa is described. A histological specimen revealed a syringoma with an increased number of mast cells in the connective tissue.
Primary leiomyosarcoma of the skin. A histological and immunohistochemical analysis.
Authors: Schadendorf D , Haas N , Ostmeier H , Czarnetzki B M
Published: July 2023

We report a rare case of a cutaneous leiomyosarcoma on the extensor surface of the proximal part of the left arm of an 84/year/old man. The tumour exhibited a number of histological and immunohistochemical features which are characteristic of a leiomyosarcoma. Leiomyosarcomas are frequently misdiagnosed on clinical grounds. Therefore, clinical features, differential diagnosis, histological and immunohistochemical criteria, therapy and prognosis of this rare malignant tumour are summarized on the basis of the present case and previously published reports.
Longitudinal study of excretion of metabolites of polycyclic aromatic hydrocarbons in urine from two psoriatic patients.
Authors: Hansen A M , Poulsen O M , Menné T
Published: July 2023

Coal tar, which is widely used in the treatment of patients with atopic dermatitis, chronic eczema, and psoriasis, contains a large amount of polycyclic aromatic hydrocarbons (PAH). Some of the PAH compounds are known either to be carcinogenic or to potentiate the effects of other carcinogenic substances. In the present study, the excretion patterns of 1/hydroxypyrene (metabolite of pyrene) and alpha/naphthol (metabolite of naphthalene) in urine were studied in 2 patients, both treated once a day with coal tar pitch covering more than 50% of the skin. After 1 week of treatment, the concentration of both alpha/naphthol and 1/hydroxypyrene increased approximately 100 times. However, the concentration after 3 weeks of treatment was decreased to approximately the concentration measured before initiation of the treatment, even though the patients were coal tar/treated with unchanged intensity. The measured concentrations of alpha/naphthol and 1/hydroxypyrene in the urine of the 2 patients exceeded by order of magnitude the levels measured in the urine of occupationally exposed workers, and in view of the present study, epidemiological studies are needed to clarify to what extent coal tar treatment results in an increased risk of skin cancer, and e.g. bladder cancer.
Quantification of contact allergic inflammation: a comparison of existing methods with a scanning laser Doppler velocimeter.
Authors: Quinn A G , McLelland J , Essex T , Farr P M
Published: July 2023

Responses to a range of doses of common contact dermatitis/producing allergens were measured using a novel scanning laser Doppler velocimeter and three commonly used conventional measurement techniques. The techniques were compared in terms of sensitivity, measurement error, range of the linear portion of the dose/response curve and ease of use. The detection thresholds of the objective methods did not differ significantly and did not detect responses at concentrations less than those required to produce a visible response. Of the objective methods the range of linearity was greatest when reactions were measured using change in skin fold thickness, erythema or area of inflammation. Measurement error was greatest with measurements made using the conventional laser Doppler velocimeter. Present instrumental methods are no more sensitive than visual assessment in the reading of patch test reactions. The conventional laser Doppler velocimeter was least suited for measurement of allergic contact hypersensitivity reactions as readings are time/consuming, show detectable changes over a more limited range of allergen concentration, and have a larger measurement error than the other methods. There is no single best method for measuring allergic contact hypersensitivity reactions. Useful data over a wide range of allergen concentrations can best be obtained by measurement of skin fold thickness, erythema or area of reaction using the scanning laser Doppler velocimeter. The scanning laser Doppler velocimeter has the added advantages of being able to measure area of reaction without contact with the skin surface and to measure reactions at all skin sites.
Cutaneous T cell lymphoma of signet ring cell type: a specific clinico/pathologic entity.
Authors: Vaillant L , Monégier du Sorbier C , Arbeille B , De Muret A , Lorette G
Published: July 2023

We describe a new case of signet ring cell peripheral T cell lymphoma in a 45/year/old man. This lymphoma had a very indolent course, since//without treatment//the clinical staging has shown no evidence of disease progression 11 years after initial symptoms. Immunophenotype indicated pan T antigens (Leu 4 CD3, Leu 1 CD5) and T suppressor cytotoxic antigen (IOT8 CD8) expression. Several T antigens (Leu 5b CD2, Leu 9 CD7, Leu 3a CD4) were not expressed. The proliferation index was less than 5% with Ki 67 monoclonal antibodies. The ultrastructural study showed characteristic cytoplasmic vacuoles containing microvesicles. Five cases of signet ring T cell lymphoma, which were very similar to our case, have been previously described. Their characteristics were primary cutaneous presentation, indolent course, good response to current therapies and a long survival period. The indolent course of these signet ring cell lymphomas may indicate that this type of lymphoma is a low grade malignant lymphoma and not only a morphological pattern.
Effect of a single exposure to in vivo UVB radiation on the allogeneic mixed lymphocyte reaction of spleen cells.
Authors: Kitajima T , Imamura S
Published: July 2023

We investigated the effect of a single exposure to in vivo UVB radiation on the splenic T cell alloreactivity and antigen presenting cell (APC) function needed for alloantigen presentation. Splenic T cells from UVB/irradiated C57BL/6 mice were used as responders, and spleen cells from UVB/irradiated BALB/c mice were used as stimulators for a source of APCs in mixed lymphocyte culture. A single UVB radiation suppressed T cell alloreactivity, although the proliferative response to T cell mitogens was still normal. Moreover, UVB radiation impaired APC function. FACS analysis revealed a reduction not in the number of APCs but the intensity of class II alloantigen expression on APCs. Our findings suggest that, unlike repeated UVB exposure which impairs splenic APC function by the decrease in the number of APCs, a single UVB exposure impairs APC function by decreasing class II alloantigen expression.
An endocrinological study of patients with primary cutis verticis gyrata.
Authors: Palazzo R , Schepis C , Ruggeri M , Baldini L , Pizzimenti A , Arcoraci V , Spina E
Published: July 2023

An endocrinological study of 15 psychiatric patients with primary cutis verticis gyrata (CVG) and 7 control patients was carried out. The investigation of the pituitary/gonadal axis, pituitary/adrenal axis, pituitary/thyroid axis, prolactin and human growth hormone (basal values and circadian biorhythms) did not show any significant difference between the CVG and the control patients. Only levels of free testosterone were significantly lower in patients with CVG than in the control group (p < 0.05), probably reflecting an increased peripheral use of testosterone.
Acanthosis nigricans and bile duct malignancy.
Authors: Ravnborg L , Thomsen K
Published: July 2023

A case of acanthosis nigricans associated with a metastatic adenocarcinoma is presented. To our knowledge this is the first one reported in the literature. The primary tumour is unknown, but it is presumably a cholangiocarcinoma. The skin changes preceded the detection of malignancy by 2 years, during which the skin lesions progressed though the patient was still in good health. If malignant acanthosis nigricans is suspected and the underlying malignancy cannot be found at the initial screening, repeated screenings are necessary because of the time factor.