Subject(s)
Radiation Monitoring/methods , Ultraviolet Rays , Ultraviolet Therapy/standards , Calibration , Clinical Governance , Equipment Design , Equipment Failure , Forecasting , Humans , Patient Safety , Radiation Dosage , Radiation Exposure/analysis , Radiation Monitoring/instrumentation , Reproducibility of Results , Skin/radiation effects , Spectrum Analysis/instrumentation , Ultraviolet Therapy/instrumentation , Ultraviolet Therapy/trendsABSTRACT
Expression of the p53 tumor suppressor gene product was determined in keratoses and skin cancers associated with psoralen photochemotherapy (PUVA). An immunocytochemical study was employed using CM-1 (polyclonal) and Do-1 (monoclonal) antibodies to human wild-type p53. Thirty-two cutaneous lesions and 20 perilesional PUVA-irradiated skin biopsies were examined from 7 patients, all of whom had received more than 200 PUVA treatments and/or a cumulative UVA dose of greater than 1000J/cm2 as treatment for widespread plaque psoriasis. p53 immunoreactivity was seen in 7 of 15 squamous cell carcinomas (46.7%), 5 of 8 dysplastic keratoses (62.5%) and in no basal cell carcinomas or benign keratoses. The overall prevalence of p53 immunoreactivity in 46.2% of malignant or dysplastic PUVA-associated skin tumors is similar to that previously found by our group in comparable skin tumors from the general population. Most patients with lesions showing positive p53 immunoreactivity had, however, been exposed to additional risk factors before receiving PUVA therapy. p53 gene sequencing of PUVA-associated non-melanoma skin cancer (NMSC) may clarify whether p53 mutation contributes to the development of these tumors and whether this relates to PUVA therapy or prior carcinogen exposure.
Subject(s)
Neoplasms, Radiation-Induced/metabolism , PUVA Therapy/adverse effects , Skin Neoplasms/etiology , Skin Neoplasms/metabolism , Tumor Suppressor Protein p53/metabolism , Adult , Carcinoma, Basal Cell/etiology , Carcinoma, Basal Cell/metabolism , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/etiology , Carcinoma, Squamous Cell/metabolism , Carcinoma, Squamous Cell/pathology , Female , Humans , Immunohistochemistry , Keratosis/etiology , Keratosis/metabolism , Keratosis/pathology , Male , Microwaves , Middle Aged , Neoplasms, Radiation-Induced/pathology , Reference Values , Skin/metabolism , Skin/pathology , Skin/radiation effects , Skin Neoplasms/pathologyABSTRACT
A mix of 3 sesquiterpene lactones (SL) (SL mix 0.1%) was evaluated over a 4-year period. Of 7420 patients with eczema investigated by patch testing, 135 (68 male, 67 female) (1.8%) demonstrated positive reactions, 114 (84%) considered clinically relevant. Females outnumbered males until the age of 60, after which men were more commonly affected. The clinical patterns varied from patients presenting with generalized eczema (20%) or eczema of the hands and face (24%), to patients with hand (36%) or facial eczema (11%) alone. 48 patients were investigated for suspected photosensitivity and 29 (21 male, mean age 69 years, and 8 female, mean age 66 years) had abnormal cutaneous monochromatic irradiation tests. These results highlight the varied clinical presentation of SL contact dermatitis and its association with chronic actinic dermatitis. The SL mix proved reliable and safe, supporting its inclusion in the European standard series of contact allergens.
Subject(s)
Dermatitis, Allergic Contact/complications , Lactones/adverse effects , Photosensitivity Disorders/complications , Plants , Sesquiterpenes/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Dermatitis, Allergic Contact/etiology , Dermatitis, Allergic Contact/pathology , Female , Humans , Male , Middle Aged , Photosensitivity Disorders/pathology , Sesquiterpenes, EudesmaneABSTRACT
A patient with acute asthma developed severe sensorimotor neuropathy while being ventilated with isoflurane and receiving vecuronium and fentanyl. The neuropathy resolved spontaneously within three months of the episode. This unusual complication may result from prolonged use of inhalational anaesthesia or of vecuronium, or both.
