Etiology of erythema nodosum.

One hundred patients with biopsy-proven erythema nodosum were studied at Ramathibodi Hospital from 1982 to 1992 to find out the etiology of this disease. Eighty-eight were females while twelve were males, with an age range from 6 to 72 years old (mean, 31 years old). Abnormal laboratory findings in these patients included elevation of erythrocyte sedimentation rate (76.9%), increase anti-streptolysin-O titer (10.7%), abnormal chest roentgenogram (16.7%), positive tuberculin test (50%). The cause of erythema nodosum is still unknown in a large group of patients, and it was found only in twenty-eight patients (28%). Twelve patients had tuberculosis, seven had history of antibiotic administration, six probably had streptococcal infection and the other three had Behcet's disease.

Predictive patch testing of "Medigloves" on humans using the repeated insult technique.

The predictive patch tests using the repeated insult technique with pieces of ETO sterilized "Medigloves" on 200 human subjects showed negative allergic reactions in all cases. Therefore, the sensitizing potential of "Medigloves" is quite low, if any. Mild to severe forms of miliaria rubra were occasionally observed in about one fourth of the subjects during the induction and challenge periods since the weather was quite warm and humid. However, three subjects who developed more pronounced miliaria rubra on the skin underneath rubber-glove squares were selected for provocative use tests. The results were negative in all cases. A subject who showed a false-positive allergic reaction also showed negative results in a provocative use test and in patch tests with standard rubber chemicals and pieces of "Medigloves" from various batches. Occlusive patch tests for 72 hours with Mediglove pieces from the same batch used in the initial test challenge phase were repeatedly negative when performed during the cool time of the year. In tropical countries, predictive closed patch tests employing solid occlusive materials should be done during cool weather in order to prevent or minimize the occurrence of miliaria. In hot weather, this is a common source of false positive reactions.

Cutaneous leukocytoclastic vasculitis: clinical and laboratory features of 45 patients seen in Ramathibodi Hospital.

Forty-five patients with histologically proved cutaneous leukocytoclastic vasculitis were studied with regard to the clinical features, laboratory findings and etiology. There were 12 males and 33 females, with an age range of 13 to 64 years. The most common skin lesions were palpable purpura which appeared mostly on the lower part of the legs. Renal involvement was the most common systemic manifestation, which occurred in 45 per cent of the patients. Abdominal pain occurred in 42 per cent of the male patients while none of the female patients had this symptom. Arthralgia occurred in 20 per cent of the patients. The most common laboratory abnormalities were elevation of ESR, which was significantly more common in females than in males (P = 0.047). The possible etiology of leukocytoclastic vasculitis was identified in 5 patients, these included streptococcal infection in 2 patients, in the other patients the possible causes were penicillin hypersensitivity, systemic lupus erythematosus and livedoid vasculitis, respectively.