Antineutrophil Cytoplasmic Antibodies (ANCA) in Patients with Behcet's Disease / 대한피부과학회지

BACKGROUND: Antineutrophil cytoplasmic antibodies(ANCA) are autoantibodies against cytoplasmic constituents of neutrophils, and have been detected in patients with idiopathic necrotizing glomerulonephritis, crescenteric glomerulonephritis, Wegener's granulomatosis, and polyarteritis nodosa. The induction of ANCA may result in neutrophil mediated vascular injury. In Behest's disease mucosal and cutaneous lesions are often characterized by small vessel vasculitis. So the endothelial cell damage probably mediated by polymorphonuclear leukocytes has been regarded as an important pathophysiological mechanism in the disease. However, the literature has not showed the presence of ANCA in the disease, and it has been generally accepted that ANCA cannot be incriminated as a contributing factor to the abnormalities of neutrophils in Behcet's disease. OBJECTIVE: We examined the presence of ANCA in sera of 7 patients with Behest's disease. METHOD: We examined clinical and laboratory findings of 61 patients with Behest's disease, who also had cutaneous manifestations due to vascular disorders. ANCA were demonstrated in the sera of the patients by the indirect immunofluorescence method. RESULT: We found ANCA in the sera of 7 patients with complete or incomplete types of Behcet's disease. CONCLUSION: We do not yet know the meanings of the ANCA that were detected in Behest's disease. Moreover, we cannot retort against previous reports showing that ANCA were meaningless in Behest's disease in the aspects of pathophysiology. However, it is clear that ANCA can be detected in patients with Behcet's disease, so it is necessary to investigate more about ANCA in Behest's disease.

Photoallergic Dermatitis due to 8-Methoxypsoralen

One adverse effect of PUVA therapy is the development of severe dermatitis. Only a few cases of photoallergy to psoralens during PUVA therapy have been reported. We describe herein a patient with photoallergic dermatitis induced by PUVA with 8-methoxypsoralen(8-MOP). A 38-year old woman with generalized vitiligo had acute pruritic exanthematous maculopapular lesions in the treated areas after PUVA therapy with 8-MOP. A patch test and photopatch test were performed with 8-MOP, 5-MOP, and 4,5,8-trimethylpsoralen(TMP). The patch test carried out with these psoralen derivatives were all negative, but the photopatch test showed a positive reaction to 8-MOP. The patient consequently had PUVA therapy with 5-MOP and she had no further experience of a photoallergic reaction.