Arthropathy associated with palmoplantar pustulosis.

A survey of 170 patients with a diagnosis of palmoplantar pustulosis (PPP) has been undertaken. Detailed family histories of our patients were compiled, dermatological and rheumatological examinations were made. Radiography was performed in patients with clinical suspicions of spinal and/or sacroiliacal, sternoclavicular and sternocostal joint involvement. Active chest-wall symptoms were screened by scintigraphy. Twenty-five patients (16 females, 9 males, with an age range of 32-66, mean 51 years) had some rheumatic complaints. Fifteen of them (60%) had anterior chest-wall involvement, 6 (24%) sacroiliitis (3 of whom also had AS) and 11 (44%) peripheral arthropathy. Six other patients suffered from transient and migratory joint pain. The joint disease was mild in all but 6 cases. Laboratory tests showed increased ESR in 6 patients (24%); only 3 of these patients had elevated CRP. A slightly elevated haptoglobin and/or orosomucoid were found in 12 cases (48%). Elevated IgA was present in 4, IgG in 2 and IgM in 1 patient. Fungal and bacteriological cultures of the skin were negative. A family history of psoriasis was present in 4 patients (16%), of psoriatic arthropathy in 1 patients (4%) and of PPP in 2 patients (8%). Six patients (24%) had concomitant psoriasis. No association between PPP H1a-AC antigens was found. A high incidence of HLA-B27 antigen, present in 8 patients (32%), was documented. A similar association with HLA-B27 has been found in patients with psoriatic arthritis (16). The feeble association with HLA-B13,-17,-37 and CW6 found in psoriasis was not present.(ABSTRACT TRUNCATED AT 250 WORDS)

Penetration of ampicillin into urethral and cervical secretions after oral administration of bacampicillin.

The study comprised 24 male and 24 female patients treated either for uncomplicated gonorrhoea or as a prophylaxis. A single dose of 800 mg of bacampicillin + 1.0 g probenecid was administered orally to each patient. The concentrations of ampicillin in urethra and cervix were assayed by means of alginate swabs that were used as diffusion centres on agar diffusion plates. The inhibition zones were compared with a standard series of swabs containing known amounts of ampicillin. The amounts of secretions absorbed into the swabs were determined by weighing each swab before and after taking the specimen. The median ampicillin concentration in the male urethra one hour after the single dose of bacampicillin plus probenecid was 2.0 micrograms/ml of urethral secretion and increased to 3.2 micrograms/ml two hours after administration of the antibiotic. In the female urethra, the median concentrations of ampicillin were 1.5 micrograms/ml and 2.3 micrograms/ml of urethral secretion one and two hours, respectively, after the same dosage as above. The corresponding ampicillin concentrations in the cervical secretion were 1.6 micrograms/ml and 2.9 micrograms/ml, respectively.