Search

Suction blisters were raised on psoriatic lesions and normal appearing skin. The epidermis was separated at the epidermal-dermal junction. Scanning electronmicroscopy of the dermal side of the blister-roofs from normal looking skin and almost healed psoriatic lesions showed stellate cells probably formed by cytoplasmic extensions ending at desmosomes. In non-treated psoriatic plaques the cells were rounded and lacked the stellate extensions.

The localization of transferrin and C3d receptors in various skin lesions and normal appearing skin have been studied on sections with the PAP technique. The transferrin receptor was recognized in the lower epidermis from psoriatic plaques. Here it was more evident than in other inflammatory or hyperproliferative disorders where it was mainly detected on the basal cells. In healthy skin or lesions of lichen planus, scleroderma and ichthyosis the transferrin receptor was not detected in the epidermis. The C3d receptor was in normal skin found on the basement membrane and on elastic fibres in the papillary dermis. The basement membrane was strongly marked in pemphigoid but was not seen in lichen planus and Ehlers-Danlos syndrome. In patients with urticaria factitia, contact dematitis, psoriasis and Darier's disease the suprabasal cells also expressed C3d whereas in other dermatoses the epidermis was negative. Colloid bodies in lichen planus and GVH reactions expressed both the transferrin receptor and C3d.

A short term anthralin application schedule was used at home in 42 patients with severe psoriasis. In another group of 21 patients treated at our day care center, UV-B irradiation was added when the surplus of anthralin had been washed off. Good healing results within 3-8 weeks were noted in most patients. To prevent relapses 31 patients continued the anthralin treatment once or twice a week after healing. In 15 cases this was combined with UV irradiation. One patient relapsed after a severe infection, but 16 others were observed for 6-9 months and 14 for 3-5 months without relapses. Irritation of non-affected skin is common especially at the beginning of the treatment and some staining of clothes and linen can occur. With proper information about this, the treatment is well accepted by the patient who generally finds it reasonably simple without the need of special protective dressings.

In patients with chronic urticaria, adverse reactions to food additives are worth looking for. Improvement on a diet free from the additives and a positive double-blind provocation test is today the only way to prove the diagnosis. The mechanism for such adverse reactions is still obscure.

Fresh farm and dairy products are increasingly being replaced by manufactured and prepared convenience foods. With this change there has been an increased use of food additives. We have now more than 2,500 chemicals that can be added to enhance the quality and facilitate the preparation of food. The largest group consists of 1,200 flavoring agents. The main types of additives and their amounts are listed in Table 1. Their chemical structure, properties, occurrence, and regulatory status are described in two books edited by Furia (1972) and Furia and Bellanca (1971). Hypersensitivity reactions to such products have been reported, especially for coloring agents, preservatives, and antioxidants. These chemicals can also be added to drugs in quantities which are high enough to produce symptoms (Juhlin et al. 1972). The structures of some common offenders are given in Fig. 1.

We report on a man whose scalp hair was reddish since childhood but changed into dark-brown after the age of 50. His pubic hair and beard remained carrot coloured. A high level of arsenic in his scalp hair seemed to be a possible cause of the change from pheomelanogenesis to eumelanogenesis.

A variety of different, experimentally induced human skin inflammatory stimuli including UV-A (Barr et al., 1982a; Gilchrest et al., 1982), UV-B (Black et al., 1978, 1980; Hensby et al., 1980; Black, Hensby & Greaves, 1982), UV-C (Camp et al., 1978), infra-red (Hensby et al., 1982), trafuril (Plummer et al., 1977) and anthralin (Barr et al., 1982b) cause marked and prolonged elevations of the recoverable levels of arachidonic acid and its cyclo-oxygenase products. The known pharmacology of many prostanoids (products of the prostaglandin cyclo-oxy-genase system) including vasodilatation and synergism with other inflammatory mediators (Hensby, Kingston & Greaves, 1976; Camp, 1982) would suggest a role for prostanoids in various human skin diseases, particularly those associated with an inflammatory component. We now report the preliminary results that we have obtained for the recoverable levels of four prostanoids, namely PGE2, PGD2, PGF2x, and 6-oxo-PGF1x in four human skin disorders, viz. psoriasis, tuberculin delayed hypersensitivity, vitiligo and scleroderma.

A patient is described with both polymorphous light eruption (PLE) and aquagenic urticaria appearing at 29 yr of age. Her father had the same symptoms after exposure to solar irradiation or water. Four to 6 h after 5-15 min sun-exposure, both had symptoms of general malaise and swelling of various joints. The skin symptoms in our patient were initially urticarial and later mainly papular and vesicular. They were elicited by irradiation with low doses of 300-360 nm and also appeared after 400 and 500 nm. Window glass offered little protection. PUVA treatment improved both conditions remarkably.

The following in vitro methods are predominantly discussed: Specific IgE determination (RAST). The test can be used to detect allergies of the immediate type such as anaphylactic shock and urticaria. Antibodies can be detected to a limited number of drugs such as penicillin, ACTH, TSH, insulin, asparaginase and proteins of animal sources. Degranulation of basophil leucocytes and histaminliberation have been used for many years. The practical value of the test has been limited but improved methods for analysis have given the tests hopes for a come-back. Cellular tests like lymphocyteproliferation and macrophage inhibition test (MIF) do not yet give such information which make them helpful as practical tests to detect drug allergy.

This review is based on information in the literature and on allergic reactions reported to the Swedish National Board of Health and Welfare from 1965 to 1979. All doctors in Sweden are supposed to report all severe side effects and side effects which are not well known, especially adverse reactions to new drugs. The effects are then judged as certain, probable, or possible. Only certain and probable allergic reactions will be considered here.

Pharyngeal gonococcal infection is a not uncommon manifestation of gonorrhea. Its prevalence depends on the type of population selected for evaluation and varies between 0 and 16%. Diagnosis requires at least two specimens, one from the throat and one from the tonsillar crypts and the performance of the fermentation test. Transmission of N. gonorrhoeae to the throat is common by fellatio, uncommon by other kinds of contact. Results of auxotyping are non-uniform. for treatment penicillin

After the addition of E. coli polysaccharide to blood from patients with deep inflammatory acne, microclots formed in all patients, whereas this was rarely seen in mild acne and never in controls. Furthermore, spontaneous microclot formation without addition of endotoxin was seen in 5 of the 10 patients with the most severe acne.

Free anthralin was detected in the stratum corneum and in hair follicles in histological sections of patients with psoriasis undergoing short contact therapy. A solution of sodium borate was used to provoke a yellow fluorescent complex. There was a strong fluorescence especially on the plaques and anthralin could be detected in psoriatic plaques up to 48 hours after treatment. It was difficult to completely eliminate the drug by washing with soap and anthralin could even be detected on non-treated areas.

522 patients attending the Venereal Disease Clinic of the University Hospital in Uppsala Sweden between September 1967 and February 1968 were studied to determine the influence of the use of contraceptive gestogen pills on human sexual behavior and on the possible spread of gonorrhea. The patients were diagnosed for presence of gonorrhea and surveyed orally by a special interviewer. Mong the 250 women seen 28.4% were university students and 70.4% of these used oral contraceptives (OCs); 50.1% of the nonstudents used OCs. There was noted a considerable increase in OC use over the previous year when OC use was 48% and 18% respectively. Condom use remained constant at 30% for both periods. The number of sexual partners and frequency of intercourse was significantly higher among women taking pills (p less than .05) and highest in the 20-25 year age group (p less than .01). Sexual intercourse increased 25% among all women using OCs. This increased sexual activity probably increases the risk of gonococcal infection. 67% of the women were diagnosed with the disease and a diagnosis was made with equal frequency among pill users as nonpill users. Evidence indicating increased susceptibility of the mucosa to gonococcal infection with OC use was absent.(AUTHORS MODIFIED)