Immunoglobulins in tears and sera in patients with atopic dermatitis.

The aim of the study was to investigate the role of circulating (i.e., present in the serum) and locally produced (i.e., in the lamina propria of mucous membranes) immunoglobulins including IgE. The IgG, IgA, IgM immunoglobulins, and IgE (total and specific) were measured in patients' sera with atopic dermatitis (AD) (n = 93). As control subjects 83 healthy volunteers, matched for sex and age, were included. The IgG and IgM levels were within the normal range. Mean value of the total IgA (2.55 +/- 0.26 g/L, in controls 1.49 +/- 0.32 g/L) and IgE (609 IU/mL, in controls below 40 IU/mL) levels were significantly elevated (p < 0.05) in sera of AD patients. Based on the serum total IgE levels (above or below 40 IU/mL) the patients were divided into RAST-positive and RAST-negative types of allergy, respectively. RAST-positive AD (n = 79) showed hypersensitivity to inhalant and food allergens determined by the specific IgE test. The majority of RAST-positive AD cases (n = 68) presented only skin manifestations, while the rest of the patients (n = 11) had rhinoconjunctivitis as well. RAST-positive AD patients with rhinoconjunctivitis showed an increased IgE level in tears (above 10 IU/mL). The specific IgE test positivity in tears correlated with elevated serum total IgE levels and specific IgE positivity (r = 0.925). Total and allergen-specific IgE in the tears can be used to diagnose allergy in vitro. It is believed that the mucosal permeability is enhanced in the atopic inflammatory process, and this may facilitate the transmission of environmental allergens.

Immunomodulatory treatment with low-dose interferon-alpha and oral retinoic acid in lymphangioma-like Kaposi's sarcoma.

BACKGROUND: The presence of lymphangiectasis without the characteristic spindle cell proliferation may lead to diagnostic difficulties in Kaposi's sarcoma. Although the literary data mention that the lymphangioma-like tumors may occur in Kaposi's sarcoma, there have been few specific reports and case presentations published. OBSERVATIONS: A case of lymphangioma-like Kaposi's sarcoma in association with IgG/lambda type paraproteinaemia is reported in a 60-year-old man. The HSV8 DNA sequence could be detected by PCR analysis from lesional skin. CONCLUSION: The beneficial effect of alpha-2 interferon (4.5 million units per week) combined with retinoic treatment (0.5 mg/body weight of isotretinoin) caused the regression of the skin rashes while improving the values of immunological tests (T cell function, quantity of paraproteins). The patient's improved general condition and the ameliorating immunological parameters were due to the combination of two regimens applied in a low-dose the alpha-2 interferon (tumor regression) and the oral isotretinoid (antitumor activity, reduction of IL-6 receptor display) treatment.

Cancer protection in xeroderma pigmentosum variant (XP-V).

We describe herein a brother and sister diagnosed with xeroderma pigmentosum variant (XP-V) in early adult life, who presented with increased sensitivity to sunlight and with cutaneous carcinomas on sun-damaged skin. The 27-year-old male farmer (Case 1.) was diagnosed with advanced squamous cell carcinoma (SCC) and multiple actinic lesions. Surgical removal of these lesions was performed. Three months later he died of multiple pelvic metastases of SCC. His 29-year-old sister (Case 2.) was operated on for different tumors, histologically SCC-s or basal cell carcinomas (BCC), or praecancerous conditions many times. After a two year interval she was treated with low dose isotretinoin (2 mg/body weight). Diagnosis of XP-V was based on unscheduled DNA analysis (USD) and on clinical symptoms. We observed that during the long lasting isotretinoin treatment the tumor frequency dropped to a quarter. Therefore, the isotretinoin treatment seems to be a good approach for cancer prevention in conditions with high predisposition to skin cancer, such as in XP-V.

Xeroderma pigmentosum variant or pigmented xerodermoid.

We describe herein a 29-year-old patient who was recognized as having a xeroderma pigmentosum variant or pigmented xerodermoid in the early adult life since sunlight sensitivity caused degenerative changes in the skin and cutaneous carcinomas. The patient had 11 skin tumours removed over an interval of two years, of which four proved to be squamous cell carcinoma, one basal cell carcinoma and six precancerous conditions. Then the patient was treated with isotretinoin at a dosage of 2 mg per kilogram of body weight per day for two years. During two years of treatment with isotretinoin a further three tumours were removed givind a histological result of basal cell carcinoma and Bowen's diseases. The patient tolerated well this low dosage retinoid treatment. Only 50 or so of these patients are described in the world literature.

[Formation of secretory immunoglobin by the hepatic clearance mechanism]. / Die sekretorische Immunglobulinbildung durch den hepatischen Clearence-Mechanismus.

In patients suffering predominantly from several types of dermatosis as well as from cholecystitis and cholelithiasis relationships to the formation of secretory immunoglobulin by the hepatic clearance mechanism have been investigated. In the duodenal content and in operatively yielded gall-bladder bile, immunoglobulins, complement C3, and albumin were detected. The amount of immunoglobulins and of albumin in the duodenal content was substantially increased if infectious germs could be detected in the stomach content.