Dermatologica最新文献

59 patients suffering from vitiligo were investigated anamnestically and clinically with intradermal (prick tests) and laboratory tests (RAST and total IgE count) for the presence of atopy. Clinical manifestations (allergic rhinitis, asthma) and intense positive prick tests and RAST with an increase in total IgE count were found in 13 patients (22%). This frequency was significantly higher than that found in the normal population in our area (11.9%; p = 0.0212). These patients had a significantly higher incidence of vitiligo in their families (76.9 vs. 29.7% of the non-atopic; p less than 0.025), an earlier onset (14.1 vs. 24 years of the nonatopic) and a rapid worsening of the disease.

Cutaneous changes induced by aging can be quantified and monitored noninvasively by means of bioengineering tools. Skin elasticity, hydration, skin blood flow and skin surface pattern show age-related changes reflecting the damage of cutaneous structures involved. Impairment and degeneration of elastic and collagen networks are responsible for the progressive decrease in skin elasticity recorded during aging. Reduction in blood flow and water supply with probably defective stratum corneum binding result in reduced stratum corneum water content and transepidermal water loss. Morphological changes such as increased skin roughness, pigmentation and alteration of skin surface pattern appearing from the age of 30 years onwards may be investigated at a subclinical level allowing the detection of early signs of aging.

Biopsies taken from vulvar lesions in 12 women affected by vulvar lichen sclerosus et atrophicus (LSA) have been processed for immunohistological study. Activated (HLA-Dr+) T cells, associated with CD1a+ accessory cells, were found in the dermis in all cases, with architectural patterns varying in relation to the histological phase (early, well developed, old) of the lesion. Interestingly, the number of epidermal CD1a+ Langerhans cells (LCs) was increased in all cases, without any correlation with the amount of the dermal infiltrate and with the histological phase of the lesions. In fact, also in old lesions the number of epidermal CD1a+ LCs was increased, and the sparse dermal lymphoid cells showed a persistent HLA-Dr antigen expression. These data, indicating the persistent activation of epidermal antigen-presenting cells and lymphoid cells in all the evolutive phases of vulvar LSA, suggest a possible involvement of the skin immune system in the pathogenesis of LSA.

The published 9th case of circumscribed pilary dysembryoplasia of the palms is presented. Differences between this case and Becker's pigmented hair nevus, congenital smooth muscle hamartoma, circumscribed acquired hypertrichosis and pigmented nevus are discussed.

Tumor of the follicular infundibulum is a rare, benign proliferative follicular disorder. A case of multiple lesions in a 37-year-old woman is reported. The diagnosis was made histologically.

We report an additional typical case of neutrophilic eccrine hidradenitis, which was observed in a 57-year-old man with acute myelogenous leukemia. He developed this eruption following chemotherapy with cytarabine and mitoxantrone. A short review of the literature is presented.

The case of a 22-year-old Philippine woman with a nonhereditary, classical syndrome of steatocystoma multiplex with histological and ultrastructural findings is reported. The good results of CO2 laser therapy are shown and the literature is reviewed.

The number and affinity of glucocorticoid binding sites in peripheral mononuclear leukocytes of patients with atopic dermatitis (AD) and healthy controls were determined under baseline conditions and after a defined oral glucocorticoid treatment. Patients with AD (n = 15) exhibited significantly more glucocorticoid receptors (GR) per cell than the control group (n = 22), while the GR affinity did not differ. Methylprednisolone treatment resulted in a significant reduction of the GR sites per cell in the steroid-treated control group (n = 10) in contrast to the patients. The dissociation constant was not affected by methylprednisolone treatment in either group. In view of the therapeutic efficiency of glucocorticoids in AD and findings of abnormal cAMP and cAMP-phosphodiesterase activity, the elevated GR concentrations in AD lend support to the hypothesis of a compensatory GR upregulation due to an insufficient action of endogenous cortisol or to altered cAMP-induced GR expression.

We examined whether immunological disturbances could influence the development of scleroderma-like skin lesions in patients affected by the Spanish toxic oil syndrome (TOS). To this end, peripheral blood mononuclear cells (PBMC) were collected from 13 chronic patients and 8 control subjects. All patients had suffered a toxic-induced severe neuromyopathy, and 6, in addition, had developed sclerodermoid skin manifestations. The phenotypic profile and the concentrations of interleukin-2 (IL-2) and of molecules with B cell differentiation factor IgG activity (BCDF-IgG) in supernatants of phytohemagglutinin-stimulated lymphocytes were analyzed both in patients and in normal controls. Molecules with BCDF-IgG activity were found increased in supernatants of mitogen-stimulated lymphocytes from TOS patients. Concentrations of IgG secreted by staphylococcus aureus-SAC-B blasts in the presence of TOS PBMC supernatant was 88 +/- 32.62 ng/ml (mean +/- 1 SD) versus 53 +/- 5.34 ng/ml in the presence of control supernatant (p less than 0.01). Levels of BCDF-IgG activity in TOS PBMC supernatants positively correlated with IgG serum levels (r = 0.69, p less than 0.01). The phenotypic profile of lymphocyte populations and the production of IL-2 were not altered in TOS subjects. No statistically significant differences were observed in the lymphocyte distribution nor in the IL-2 and BCDF-IgG production when comparing patients with or without scleroderma-like skin lesions. The results indicate that there was a dysfunction of the immune response in TOS subjects, which, however, was not sufficient for the development of the sclerodermoid lesions.

The analogue of calcitriol, calcipotriol (MC 903, Daivonex) has been proven effective in the treatment of psoriasis, when given topically. However, the possible influence of cutaneously absorbed MC 903 on calcium metabolism is still unclear. We evaluated various parameters of calcium metabolism in 17 psoriatic patients treated for 5.4 +/- 2.3 (mean +/- SD) weeks with MC 903, on 16 +/- 6% of the body surface. The dose administered (100 g of Daivonex corresponding to 5 mg of MC 903) decreased the PASI score by 40.9 +/- 20.0% (p less than 0.001). Among these patients, 12 were studied before and after MC 903 therapy. In none could be detected any change in protein-adjusted calcium, ionized Ca, plasma levels of creatinine, alkaline phosphatase, osteocalcin, intact parathyroid hormone (PTH), calcidiol and calcitriol, or in daily or fasting urinary excretion of Ca or cAMP. After an MC-903-free period, 9 patients received 1.5 micrograms/day of calcitriol orally for 7 days. Whereas this treatment did not control the skin relapse in most of the patients, it induced a significant increase in plasma levels of protein-adjusted Ca and calcitriol, and in 24-hour urinary Ca excretion, as well as a significant fall in PTH as compared with pretreatment values. These results indicate that 150 micrograms/day of MC 903, despite a possible 1% absorption, i.e. a systemic dose of 1.5 micrograms, did not produce any detectable alteration of Ca metabolism, whereas an equivalent dose of oral calcitriol was associated with significant changes. The threshold dose of topical calcipotriol that might induce alterations similar to 1.5 micrograms/day of oral calcitriol remains to be evaluated.