ABSTRACT
BACKGROUND: Solar urticaria is a rare photosensitive disease, and its differential diagnosis with respect to polymorphous light eruption is sometimes difficult. We report our experience with 25 cases of solar urticaria and discuss the pitfalls in phototesting such patients. OBSERVATION: The most important locations in this patient series are the V of the neck and the arms, which are similar to those of polymorphous light eruption. In all of the patients, however, the lesions appeared within 30 minutes of sun exposure or phototesting and disappeared within 24 hours. Notably, 12 (48%) of the patients had a history of atopy. Phototesting helps confirm the diagnosis, but, in some patients, this was difficult. CONCLUSIONS: A negative phototest result from a single light source does not necessarily exclude a diagnosis of solar urticaria. In patients in whom phototesting elicits negative reactions, other light sources should be used, and, if the phototest result is still negative, a provocative test with natural sunlight should be done. Histamine1-receptor antihistamines are a useful first-line therapy, although more severely affected persons may require prophylactic courses of phototherapy or photochemotherapy. The main problem is maintenance treatment.
Subject(s)
Photosensitivity Disorders/etiology , Skin Tests/methods , Sunlight/adverse effects , Urticaria/etiology , Adolescent , Adult , Aged , Arm/pathology , Dermatitis, Atopic/complications , Diagnosis, Differential , Facial Dermatoses/diagnosis , Facial Dermatoses/etiology , Foot Dermatoses/diagnosis , Foot Dermatoses/etiology , Hand Dermatoses/diagnosis , Hand Dermatoses/etiology , Histamine H1 Antagonists/therapeutic use , Humans , Leg Dermatoses/diagnosis , Leg Dermatoses/etiology , Light , Middle Aged , Neck/pathology , Photochemotherapy , Photosensitivity Disorders/diagnosis , Photosensitivity Disorders/drug therapy , Photosensitivity Disorders/prevention & control , Phototherapy , Shoulder/pathology , Skin Tests/instrumentation , Time Factors , Urticaria/diagnosis , Urticaria/drug therapy , Urticaria/prevention & controlABSTRACT
The immune responsiveness to bovine retinal S-antigen and opsin has been investigated in some retinal disorders by means of in vitro lymphocyte proliferation, leukocyte migration inhibition and enzyme linked immune sorbent assays (ELISA). Sensitisation to S-antigen was observed in serpiginous choroiditis, but not in acute posterior multifocal placoid pigment epitheliopathy (APMPPE) or retinitis pigmentosa. No significant immune responsiveness was detected to opsin in any of the three diseases. Elevated antibody titers to S-antigen were observed in some individual patients and healthy subjects. However, none of the patient groups exhibited an elevated antibody titer as compared to the control group. Although serpiginous choroiditis and APMPPE share some prominent clinical characteristics, the sensitisation in the former disease may perhaps be attributed to more severe and prolonged damage of the photoreceptor cells and blood-retina barrier. A combination of previous and present results suggests that in immunological investigations of retinitis pigmentosa patients it is more effective to use human than bovine S-antigen as test antigen because a species specific epitope seems to be involved.
Subject(s)
Antigens/immunology , Choroiditis/immunology , Eye Proteins/immunology , Pigment Epithelium of Eye , Retinitis Pigmentosa/immunology , Antibody Formation , Arrestin , Cell Migration Inhibition , Choroiditis/pathology , Eye Diseases/immunology , Humans , Lymphocyte Activation , Rod OpsinsABSTRACT
Eighty-two consecutive aphakic or pseudophakic retinal detachments were treated by buckling and vitrectomy procedures. Functional results (86.6%) and the incidence of proliferative vitreoretinopathy (11%) were comparable with reports of cases treated by the classic method.
Subject(s)
Aphakia/complications , Cataract/complications , Retinal Detachment/surgery , Vitrectomy/methods , Eye Diseases/etiology , Humans , Postoperative Complications , Recurrence , Retinal Detachment/complications , Retinal Diseases/etiology , Visual Acuity , Vitrectomy/adverse effects , Vitreous BodyABSTRACT
This paper discusses the characteristic features of 'morning glory' syndrome, observed in 49 patients, described in the literature and in three personal observations. 'Morning glory' syndrome is frequently associated with strabismus (20/49 patients), non-rhegmatogenous retinal detachment (13/56 eyes) or remnants of the hyaloid system (10/56 eyes). Association with basal encephalocele has been encountered three times. The 'morning glory' syndrome usually affects only one eye, although four bilateral cases have been described. The family history was negative, except in the cases discussed by Handmann (1929) and by Rieger (1977), where father and son presented the optic disc anomaly. In Rieger's family there was also familial renal hypoplasia. Morning glory syndrome is not to be considered as a true coloboma, but rather as a posterior ectasia, due to disturbance in the development of the sclera.
