ABSTRACT
A male infant with skin lesions was born to a 28-year-old mother who was under treatment for pemphigus vulgaris (PV), diagnosed eight years earlier. Circulating IgG class pemphigus antibody was found in the infant's blood, and deposition of IgG in the intercellular spaces of the epidermis was seen. The infant's lesions resolved within three weeks, and pemphigus antibody titer became negative by seven weeks. The pathogenetic role of PV antibodies and the risk for a fetus of a mother suffering from PV are discussed.
Subject(s)
Immunity, Maternally-Acquired , Immunoglobulin G/analysis , Pemphigus/congenital , Pregnancy Complications/immunology , Adult , Azathioprine/therapeutic use , Female , Fluorescent Antibody Technique , Humans , Infant, Newborn , Male , Pemphigus/drug therapy , Pemphigus/immunology , Prednisone/therapeutic use , Pregnancy , Pregnancy Complications/drug therapyABSTRACT
Recently, favourable results have been reported from oral L-phenylalanine (Phe) combined with UVA/sunlight irradiation (Phe-UVA) in the treatment of vitiligo. In the present pilot study vitiligo patients were treated on a thrice weekly scheme of 50 mg Phe.kg-1 body weight and exposed to sunlight as a source of UVA. An observed 81% response on the skin disorder correlates with earlier figures; 43% responded within 3 months. The self-controlled treatment includes the risk of over-irradiation, as possibly happened with one patient. The repigmentation was predominantly of follicular pattern. The assumption that Phe plays a central biochemical regulatory role in melanin, catecholamine and antibody synthesis forms an attractive challenge for the explanation of repigmentation and requires further investigation.
Subject(s)
Phenylalanine/therapeutic use , Photochemotherapy , Sunlight , Ultraviolet Therapy , Vitiligo/drug therapy , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Netherlands AntillesABSTRACT
To assess the role of epidermal melanin in a patient with porphyria variegata and vitiligo, the MED was determined in pigmented and vitiliginous skin for wavelengths of 310, 405 and 500 nm. The energy required to elicit erythema by irradiating vitiliginous skin at 310 nm was half that for pigmented skin. For 405 nm the differences was 4-fold and at 500 nm 2-fold. A possible explanation for the different protection by melanin against light of 310, 405 and 500 nm is given. UV-B irradiation, as a potent stimulus for melanization of the skin, is proposed as an additive measure in the protection against photosensitivity reactions in porphyria patients.
