Przeglad dermatologiczny最新文献

In patients with eczema nummulare patch tests with a panel of 18 allergens were done with positive result in 9 (18%) cases. In 6 cases multivalent allergy was found. Most frequently positive tests were obtained with potassium dichromate. The tests showed participation of contact allergy in the development of changes in a part of patients with eczema nummulare.

The alterations in the ultrastructural feature of Langerhans cells in patients with allergic contact eczema were characterized by significant increase in number of Birbeck granules accompanied by the increase in volume of smooth- and rough-surfaced endoplasmic reticulum. These changes may be regarded as a morphological expression of the increase of the synthetic and secretory activity of the Langerhans cells. In the epidermis the Langerhans cells associated with immediately adjacent precursor cells (the so called indeterminate cells), lymphoid cells and keratinocytes form the morphologically visible and probably functional units.

An attempt of the epidemic analysis of skin occupational diseases in Poland from 1986 till 1988 has been made against the background of the general occupational pathology. The attention has been paid to the adjustment of the occupational dermatosis definition to the requirements of dermatological practice. The paper has presented the geography of skin occupational diseases (branches of industry, voivodeships) and their occurrence according to age, sex and time of exposure. Some conclusions aiming at the improvement of skin occupational diseases notification have been drawn.

Dermatological examination and patch tests with 34 rubber components were carried out in 114 tire manufacturers, 78 women and 36 men aged 29 years on average, with a mean duration of work in the plant 7 years. For correct interpretation of the obtained results patch tests with the same components were done in two control groups that is in 120 healthy subjects and 120 patients with contact dermatitis. Patch tests with proper concentrations of the studied components were evaluated after 48, 72 and 96 hours. Positive patch tests were found most frequently with antioxidants--16.6% (including IPPD--8.6%), followed by vulcanization accelerators--10.6%, and other rubber components--11.4% in all. During about 3 years of follow-up in 4 manufacturers contact allergic eczema was noted and polyvalent hypersensitivity to antioxidants and vulcanization accelerators without clinical manifestations of this hypersensitivity was diagnosed in 3 other subjects.

A case of atopic dermatitis was observed in a patient in whom clinical observation and radioimmunoassays failed to demonstrate any possible role of allergic mechanisms. The lesions were caused exclusively by contact with the irritating substances and mechanical pressure, even, at times, by pressure of clothes.

In the Institute of Venereology, 5351 patients (75.1% of males, 24.9% females), intravenous drug users (IVDU), have been tested for the presence of HIV antibodies in the period from Jan 1986 to Dec 31 1989. They were patients of detoxication wards and/or pensioners of drug treatment centers. HIV antibodies were determined by the EIA method (Abbott Recombinant HIV-1 EIA test), and positive results were confirmed by the western-blot technique. HIV antibodies were found in 292 patients: 228 males (78.1%) and 64 females (21.9%), which accounts for 5.5% of tested IVDU. In 1986-1987 all tests were negative, although the first HIV infection was confirmed in 1985 in homosexual group. The first positive HIV test in drug addicts was detected in Aug 1988 after testing of 2254 patients. In 1989 276 sera were positive for HIV antibodies (11.2%) among 2471 patients studied. Our study indicates that HIV infection is spreading rapidly in IVDU population. Infections of drug addicts with HIV represent 66% of total detected cases of HIV antibody-positive individuals in Poland; among 30 diagnosed AIDS cases 5 were drug users.

From urethra of 40 men with CTU, 190 bacterial strains were isolated, 110 before and 80 after treatment with OFX (400 mg daily for 5 days). Among the strains coexisting with Chlamydia trachomatis, Staphylococcus epidermidis (30.9%), Micrococcus (13.6%), Streptococcus group D (10.9%) and Staphylococcus aureus (10.9%) were isolated more frequently than others. The in vitro susceptibility testing showed that, in comparison to erythromycin, doxycycline, oxytetracycline and co-trimoxazole, OFX was the most active antimicrobial agent against the majority of bacteria (except streptococci) isolated from urethra in CTU cases in men. The OFX treatment was found to reduce the total number of isolated strains, including Staphylococcus aureus and Staphylococcus saprophyticus, without disturbing normal urethral flora.

Dermatological examination and patch tests were done in 114 manufacturers of tires, 78 women and 36 men, mean age 29 years, working in Stomil Plant. Patch tests included 15 substances in panels Standard I and II (excluding rubber components). The study demonstrated hypersensitivity to nickel and formalin (4.3% each), chromium and cobalt (3.5% each), and turpentine (2.6%), while hypersensitivity to other allergens was observed sporadically. A comparative analysis of the results of patch tests with antigens "Standard I and II" in confectioners and healthy and allergic persons showed that the per cent of positive tests in rubber industry workers was higher than in healthy subjects, and much lower than in patients with contact dermatitis.

Beta-lactamase-positive gonorrhoea was rather sporadic in Poland. In spring 1988 a marked rise was observed in the proportion of therapeutic failures in the treatment of gonorrhoea with procaine penicillin (4.8 million u) with probenecid among patient treated in the outpatient clinic of the Venereology Institute in Warsaw. The cause was infection with beta-lactamase producing gonococci. Up to June 1989 beta-lactamase production ability was tested in gonococci cultured from 415 patients (363 men and 52 women) with positive results in 73 cases (61 men and 11 women) that is in 18%. Most (85%) patients were treated with spectinomycin (2 g intramuscularly in men and 4 g in women in one dose) with cure in all cases. Treatment with tetracycline (2 g daily for 7 days) given to 12 patients failed in 2 cases. These results, if confirmed in other parts of the country, will cause the necessity of revision of the presently accepted indications for gonorrhoea treatment with penicillin with probenecid as the basic method.