Long-term results of topical PUVA in necrobiosis lipoidica.

The aim of our study was to evaluate the long-term results of topical psoralen ultraviolet A (PUVA) in patients with necrobiosis lipoidica (NL), in whom conventional methods (pentoxifylline, vitamin E, tretinoin, and topical or intralesional corticosteroids) had failed. The study comprised 10 women (age range 17-44 years), six of whom were insulin-dependent diabetics and four were diabetes-free. Duration of NL ranged from 3 to 10 years. The patients were treated with a 0.005% aqueous solution of 8-methoxypsoralen, applied topically for 30 min, and subsequently irradiated with UVA three times weekly. All the patients experienced almost complete remission (softening of skin lesions, no hyperpigmentation, lack of lesion progression) after a mean of 47 sessions (mean UVA cumulative dose 69.5 J/cm2). They were followed up for 12-24 months, during which time two recurrences, both in diabetic patients, were observed after 8 and 12 months of treatment cessation, which further resolved after another course of topical PUVA. We conclude that topical PUVA is well tolerated by NL patients and may serve as an alternative therapeutic regimen.

Immunopathological examination of esophagus as a useful criterion of cure in pemphigus vulgaris.

BACKGROUND: We performed histopathological and immunopathological examinations of the esophagus in patients with pemphigus vulgaris during clinical remission. METHODS: In the group of 14 patients without serum antibodies, five were treated with low doses of steroids and cyclophosphamide (as maintenance treatment), while nine had already completed the therapy. RESULTS: In all five cases under maintenance treatment we found bound pemphigus antibodies in vivo. Acantholysis was present in two of these. In all nine non-treated patients, acantholysis and immunopathological findings were negative. CONCLUSIONS: Our studies reveal that the absence of bound 'pemphigus vulgaris' antibodies in the esophagus by immunological examination could be regarded as proof of complete cure and could be the decisive finding to stop pemphigus treatment.

Estimation of SLE activity based on the serum level of chosen cytokines and superoxide radical generation.

We estimated the serum levels of IL-6, TNF-alpha and IL-10, and generation of superoxide radicals, as well as their mutual dependence, in 63 SLE patients at various stages of disease activity. Our results indicate a statistically significant increase of the serum levels studied, and an increase of superoxide anion generation by granulocytes, in correlation with SLE activity. These results indicate that oxygen metabolism and the examined cytokines play an important role in pathogenesis of SLE. The assessment of these parameters can be useful in the estimation of disease activity.

Pemphigus foliaceus: an unusual clinical feature and case reports.

Two cases of pemphigus foliaceus in 70-year-old women have been presented. The initial clinical picture, as well as results of histopathologic examinations, suggested the diagnosis of eczema. Because the therapy was not successful and changes in the clinical picture were observed, repeated histopathologic and immunofluorescent examinations were carried out. Presence of immunologic findings characteristic for pemphigus foliaceus formed the basis for verification of the diagnosis and administration of an appropriate therapy.

[Immunopathological studies of the skin of patients with pemphigoid at different stages of the disease]. / Badania immunopatologiczne skóry pacjentów z pemfigoidem w róznym okresie choroby.

The aim of the investigation was to demonstrate whether there is a correlation, in patients with bullous pemphigoid (BP), between the presence of immune deposits in the skin and the activity of the pathological process. We investigated 39 cases with a BP anamnese dating from 3 months up to 17 years. We repeated the investigations several times by means of direct immunofluorescence method in different disease activity. It was demonstrated that there is a complete correlation between the disappearance of the immune deposits in the skin and the remission of the disease. Moreover, it has been shown, that the complement disappears earlier than IgG fraction. These results show the role of the antibasement zone antibodies and especially the complement in the inducement of BP lesions.