Serum neopterin levels in spontaneous urticaria and atopic dermatitis.

Serum neopterin may be considered a diagnostic marker of the degree of activation of the immune system. This preliminary study was performed to measure serum neopterin levels in patients with acute spontaneous urticaria (ASU), chronic spontaneous urticaria (CSU) and atopic dermatitis (AD). In total, 180 patients [96 men, 84 women; mean age 23.1 years; 41 with spontaneous urticaria (13 ASU and 28 CSU), 48 with AD] and 96 healthy controls were enrolled in the study. Patients with ASU had the highest neopterin levels, and all three groups of patients (ASU, CSU and AD) had higher values than normal subjects. This preliminary study demonstrates that serum neopterin could be a biomarker of immune activation in patients with SU or AD.

Recombinant birch allergens (Bet v 1 and Bet v 2) and the oral allergy syndrome in patients allergic to birch pollen.

BACKGROUND: IgE cross-reactivity between pollen and food allergens represents the molecular basis for oral allergy syndrome (OAS). OBJECTIVE: To evaluate specific IgE for Bet v 1 and Bet v 2 in the serum of patients sensitized to birch pollen and to identify whether IgE antibodies to Bet v 1 and Bet v 2 were predictors of OAS. METHODS: Thirty-three patients with skin prick test results and radioallergosorbent assay test results positive to birch pollen, 12 (36%) of whom had OAS symptoms, were enrolled in the study. Serum levels of specific IgE were determined by the fluoroenzyme immunoassay technique. RESULTS: The t test revealed significantly higher serum IgE levels against Bet v 1, Bet v 2, and birch pollen in the 12 symptomatic patients with respect to those without OAS (32.4 vs 12.4 kU/L, 7.6 vs 1.3 kU/L, and 42.3 vs 17.3 kU/L, respectively). Attempts to establish a threshold value of serum IgE antibirch pollen and the appearance of OAS revealed that a level of 20 kU/L or more yields an efficiency of the test equal to 70%. CONCLUSIONS: In our study, quantitative birch specific IgE level proved useful in predicting clinical allergy symptoms with birch exposure.

In patients with dermatitis herpetiformis distribution of transglutaminase in cutaneous tissue does not differ from controls.

BACKGROUND: Dermatitis herpetiformis may be regarded as the cutaneous counterpart of coeliac disease. These conditions are related to the ingestion of gluten and both are characterised by circulating antibodies against tissue transglutaminase. AIMS: To study the distribution of tissue transglutaminase in the skin of dermatitis herpetiformis patients and controls, and to investigate whether the dermal IgA deposits, diagnostic for dermatitis herpetiformis, are related to tissue transglutaminase expression in the skin. METHODS: A series of 11 patients with dermatitis herpetiformis had a 4 mm punch biopsy taken from the uninvolved perilesional skin. A group of 16 controls, undergoing surgical removal of benign nevi, gave perilesional skin. Biopsies were covered with OCT and frozen at -80 degrees C. After washing, skin biopsy sections were incubated with an IgG anti-tissue transglutaminase mouse monoclonal antibody. After washing, sections were incubated with anti-mouse IgG. RESULTS: The anti-tissue transglutaminase monoclonal antibody specifically recognised the basal epidermal cells. This staining was no different between patients and controls. CONCLUSION: Our results suggest that tissue transglutaminase can be recognised in the basal epidermal layer both of patients with dermatitis herpetiformis and controls. Since this distribution does not correspond to the distribution of dermal IgA deposits, it is concluded that dermatitis herpetiformis dermal IgA deposits are not due to antibodies directed against cutaneous tissue transglutaminase.

Predicting visual assessment of allergic patch test reactions by non-invasive measurements.

The quantification of allergic patch test reactions to several compounds was evaluated on patients using laser Doppler velocimetry (LDV), transepidermal water loss and colorimetry. The correlation between visual scores and instrumental measurements was investigated by the implementation of a modern statistical method: a classification tree. The LDV showed the highest correlation with the severity of the reaction. The best prediction model was obtained when the data of the three instruments were considered together. Using the classification tree methodology, a model of classification, independent of human observation, was developed. The technique can not only predict an allergic reaction for a new patient, but can also give a measure of how reliable its predictions are. This new method, when entirely standardised and approved, could help in the harmonisation of patch test reactions in different laboratories, thus allowing a more homogenous interpretation of these reactions.

Non-invasive evaluation of topical calcipotriol versus clobetasol in the treatment of psoriasis.

Topical treatment of psoriasis with calcipotriol has been proven effective. The efficacy of calcipotriol has been compared to that of topical corticoids in a number of studies using subjective visual scoring systems such as the PASI index. The purpose of this study was to compare, with objective data, the efficacy of calcipotriol and clobetasol propionate 0.05% in the treatment of plaque type psoriasis. Transepidermal water loss (TEWL) and laser Doppler velocimetry (LDV) were used to monitor restoration of water barrier and normalization of blood flow, respectively, in psoriatic plaques of the limbs of 24 male patients during 3 weeks of treatment. Data were compared to subjective evaluation using the PASI index of the same areas. Significant differences were recorded during treatment in both groups. The results correlated well with the PASI score. Clobetasol was faster in restoring barrier function than calcipotriol. However, no significant differences were detected between the two groups. The use of vitamin analogues may be effective in the topical treatment of psoriasis by normalizing skin biophysical parameters and minimizing the risks of side-effects induced by potent topical corticoids.

Morphometric computerized analysis as a method to assess skin atrophy caused by corticosteroids.

We have employed morphometric computerized analysis to quantify changes in atrophic skin. Atrophy was induced on volunteers by means of the Duhring chamber assay, using two commercial corticosteroids with a steroid-free base as control. After 20 days, atrophy was assessed by subjective examination and rated on a five-point scale. After 10 and 20 days, positive replicas of the areas under test were obtained. Photographic reproductions of these replicas were stored in the image memory of an interactive automatic computerized image analysis system, Kontron Zeiss Ibas 2, and processed with a suitable program. After selection of the measurement area by means of a circular measurement window, the 'continuous tone' image was converted to a 'binary' one by means of a dynamic discrimination function, in order to perform an automatic evaluation of the percentage area corresponding to the shadows cast by the surface markings. Morphometric computerized analysis proved to be a sensitive method for quantifying skin atrophy. A high degree of correspondence with subjective examination was shown. The method allows an objective differentiation between a mid-potency and a high-potency topical corticosteroid.

Flagellate dermatitis after bleomycin. A histological and immunohistochemical study.

A case of flagellate dermatitis after administration of bleomycin is reported in a patient with Hodgkin's disease. Histopathological and immunohistochemical analysis revealed a drug-induced skin toxic reaction rather than a lymphomatous infiltrate. Pigmentary changes observed after the early erythematous eruption were due to a postinflammatory effect.

[Psoriasis-pemphigoid association. Description of a case]. / Associazione psoriasi-pemfigoide. Descrizione di un caso.

The paper describes a case of an 85-year-old woman affected by psoriasis for 30 years who developed bullous pemphigoid after UVB treatment. Immunological and histological findings were typical of bullous pemphigoid cell-poor type. Bullous eruptions cleared following combined therapy with betamethasone and azathioprine. The literature on the subject and pathogenetic hypotheses for this unusual association are discussed.

Low-dose isotretinoin in severe acne.

A selected group of 60 patients who had been resistant to previous systemic antibiotic therapy was treated with low-dose isotretinoin (0.5 mg/kg/day in two doses) for 12 to 20 weeks. The results confirmed the efficacy of the drug on pustular, nodular and cystic acne even with low-dose treatment. In only one case was it necessary to suspend the treatment because of an increase in serum cholesterol and triglycerides. The authors therefore advise the use of low dosage and that treatment should be restricted to cases of severe acne.

Effects of a topical preparation on some hair growth parameters, evaluated utilizing a morphometric computerized analysis.

Synopsis The action of a topical preparation on some hair growth parameters has been evaluated. The morphometric computerized analysis applied to photographic images of a predetermined area (with shots after cutting and after 96 h) enabled an estimation of the percentage of elements in active growth phase compared to the total number, the length of all elements and that of the sole elements in active growth phase after 96 h and the growth with respect to the base values; statistically significant differences are observed before and after 60 days treatment. L'évaluation des effets d'un topique sur quelques paramètres de la croissance des cheveux à travers une analyse morphométrique informatisée.