Head and neck atopic dermatitis and malassezia-furfur-specific IgE antibodies.

BACKGROUND: Atopic dermatitis of the head and neck (HNAD) has been recognized as a separate entity. Malassezia furfur, a lipophilic yeast, is considered to be a pathogenic allergen in this form of atopic dermatitis. OBJECTIVE: The purpose of this study was to determine the level of IgE anti-M.-furfur antibodies and their relation to the severity of the disease. METHODS: IgE anti-M.-furfur antibodies were assayed in 106 patients with HNAD. Controls included 25 patients with non-HNAD, 20 with nonatopic dermatitis and 16 with seborrheic dermatitis (including 4 with AIDS). RESULTS: There was a highly significant correlation between the level of anti-M.-furfur IgE and clinical severity. Furthermore, there was a significant but smaller correlation between total IgE and clinical severity. In patients with HNAD, total IgE was higher amongst men. CONCLUSION: IgE anti-M.-furfur antibodies are a good and specific marker for HNAD. IgE M. furfur levels are strongly correlated with the severity of the disease.

[Histamine-release and migraine]. / Histaminolibération et migraine.

Some studies suggested a role for histamine in the pathogenesis of the migraine. So we decided to investigate the histamine-release in two groups of patients: 8 common migraine patients, 8 healthy subjects. Plasma from either controls or migraineurs were mixed with the same control whole blood and histamine release was measured using a radio-enzymatic assay. Migraine plasma induced an histamine release significantly more important than control plasma (p less than 0.01). The nature of an "histamine releasing factor" in the plasma of migraine patient is discussed. This work is an argument for a possible immuno-allergic process in migraine.

[Dermatopolymyositis during desensitization with candidin]. / Dermatopolymyosite au cours d'une désensibilisation à la candidine.

A dermatopolymyositis observation is reported. An urticaria has preceded the dermatopolymyositis and has been treated by a desensitivity procedure. The possible connection between this treatment and the dermatopolymyositis occurring is debated. This observation gives the opportunity to point out the importance of a thorough knowledge of the phenomena involved by such a treatment.

[Common migraine. Changes in conjugated and unconjugated catecholamines]. / Migraine commune. Variations des catécholamines conjuguées et non conjuguées.

Plasma levels of conjugated and unconjugated catecholamines were measured in 27 migraineurs between attacks, in 9 migraineurs 1 to 2 hours after the onset of an attack, and in 30 controls. There were no significant changes in conjugated catecholamines; in contrast, a significant rise (p less than 0.01; KS test) in unconjugated dopamine, noradrenaline and adrenaline levels was observed during attacks. These results confirm that migrainous attacks are associated with platelet activation and with overactivity of the sympathetic system.

[Alcohol and urticaria]. / Alcool et urticaire.

The relationship of alcohol intake and urticaria is complex. The mechanism of action may be related to a hypersensitivity reaction to ethyl alcohol or to the other components of alcoholic drinks. Urticaria may also result from the pharmacological effects of alcohol or from the histamine content of the drink. The authors review the literature about hypersensitivity to alcohol and to the different components of alcoholic drinks, especially added compounds. The appropriate sensitivity tests for making this diagnosis are described.

[Bronchopulmonary aspergillosis (author's transl)]. / Aspergilloses bronchopulmonaires.

Bronchopulmonary infections with Aspergillus give rise to three different pathological entities. Allergic bronchopulmonary aspergillosis, found in patients with an atopic predisposition, is marked by dyspnea of the asthmatic type associated with labile radiologically detectable infiltrates, blood hypereosinophilia, enhanced total IgE levels, specific IgG fractions, and positive immediate reactions to skin tests. The long-term risk is the development of proximal bronchiectasis. Dosage and duration of corticotherapy are function of eosinophilia and total IgE levels. Pathogenicity is similar to that of extrinsic allergic alveolitis, probably involving disturbances in immune complexes from a type I reaction. Intracavital pulmonary aspergillosis involves mycotic development within a cavity or a complicating parenchymatous lesion. Severe hemoptysis may occur. Medical treatment is ineffective, and radical surgery is necessary in patients able to support operative procedures, which vary as a function of the condition of the patient. Diffuse aspergillosis occurs in immunodeficient patients, usually during the acute phase of chemotherapy induction. Spread of the disease is either from the upper respiratory tract or through the blood as septicemia. A nosocomial origin is frequent. Diagnosis depends more on the presence of hyphae in tissue biopsy specimens than cultures or serological tests which are too unreliable. Treatment is with amphotericin B preferably associated with 5 fluorocytosin.