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A Hovmark

Publications and source records attributed to A Hovmark.

At least 37 records · Page 2Linked to original sources
PubMed1987

Human epidermal Langerhans' cells in bullous pemphigoid.

Through the epidermal analysis of 13 patients with bullous pemphigoid compared to controls, using OKT6 monoclonal antibodies on the light microscopic level and electron-microscopy, we found a redistribution of the Langerhans' cells towards the basal membrane in combination with an increased total number of Langerhans' cells. This redistribution was also noted in clinically normal skin from patients with bullous pemphigoid. The findings may be consistent with the theory of antigen presentation.

Aged↗
PubMed1987

IgG subclasses of specific antibodies in Ixodes ricinus-borne borreliosis.

Ixodes ricinus-borne borreliosis may run a protracted course. In this study we investigated the different IgG subclasses of antibodies to borreliae at different stages of the disease. In addition to the dominant subclass IgG1 and IgG3 response was found in most cases. This antibody subclass pattern with contributions of IgG2 often persists into the late stage of the disease and may last for decades. The IgG subclass response elicited by this spirochaetosis does not conform to the expected IgG4 restricted response after chronic antigenic stimulation.

Adult↗
PubMed1986

Ultrastructural differences among spirochetes isolated from patients with Lyme disease and related disorders, and from Ixodes ricinus.

Previous studies on cells of strains B31 isolated in the U.S.A. from Ixodes dammini and strain G25 isolated in Sweden from Ixodes ricinus, showed that their ultrastructure was similar, but not identical. For this reason the studies were extended to spirochetes isolated directly from patients with Lyme disease and related disorders. Included in the present study were three strains isolated from skin, blood and spinal fluid, respectively, from patients with Lyme disease, two strains from patients with erythema chronicum migrans and one strain from a patient with acrodermatitis chronica atrophicans. Three additional strains isolated in Sweden from Ixodes ricinus were also studied. All spirochetes were examined after negative straining with 1% ammonium molybdate. The cells of each individual strain were identical except for one strain isolated from a tick. This isolate was found to consist of two morphologically different spirochetes. Comparison of morphological features of cells from various isolates revealed certain differences. The cells of the different strains could be divided into at least four groups for which cell size and shape as well as number of flagella varied. By morphological criteria, all cells were found to belong to the genus Borrelia.

Acrodermatitis↗
PubMed1986

Erythema chronicum migrans Afzelius in Sweden. A study on 231 patients.

In order to describe the clinical manifestations of erythema chronicum migrans Afzelius (ECMA) in Sweden and to compare them with those in Lyme disease in the United States, 231 patients with ECMA were investigated. Although there are many similarities between the two disorders the findings also point to differences. The skin lesions were of longer duration (median 5-6 weeks) than those in Lyme disease but less often multiple (8%). General symptoms were found in about half of the patients with a short disease duration (less than or equal to 3 weeks), but were usually mild. Laboratory abnormalities were noted in only a minority of the cases. At the time of diagnosis none of the patients had spirochete-induced arthritis, but in three of them cardiac involvement was suspected. Among 16 untreated patients meningitis later developed in two patients and arthritis in one. Diagnostic procedures such as serologic testing and cultivation of spirochetes are discussed.

Adolescent↗
PubMed1986

Clinical manifestations of acrodermatitis chronica atrophicans in 50 Swedish patients.

A study was made of 50 consecutive patients with untreated acrodermatitis chronica atrophicans (ACA). In all patients elevated anti-spirochetal antibody titers were found at indirect immunofluorescence and enzyme-linked immunosorbent assays, and histologically biopsies exhibited a dermal lymphocytic infiltrate with a moderate to rich admixture of plasma cells and telangiectases. Nine patients had a history consistent with spontaneously healing erythema chronicum migrans Afzelius (ECMA) on the extremity on which, after 0.5-8 years, ACA lesions developed. Eight patients had a history indicating previous cranial nerve involvement and nine had had periods of severe pains in the cervical or lumbar region. Two patients had developed ECMA, facial palsy and ACA in chronological order. In 15 patients radiographic abnormalities of joints and/or bone tissue were found. Besides ACA lesions, lichen sclerosus et atrophicus- or scleroderma-like lesions were found in six patients. The inflammatory ACA lesions were sometimes discrete and had been overlooked. Joint deformities, sclerotic lesions, diffuse edema or pain were the cardinal symptoms in some patients. The findings indicate that clinical recognition of ACA may be difficult and that a combination of clinical, histopathologic and serologic findings may be necessary to establish the diagnosis. The results are consistent with the concept that ACA is a late manifestation of infection by the same spirochete as causes ECMA and Bannwarth's syndrome.

Acrodermatitis↗
PubMed1986

Joint and bone involvement in Swedish patients with Ixodes ricinus-borne Borrelia infection.

The presence of signs of joint involvement was investigated in 231 patients with erythema chronicum migrans Afzelius (ECMA), in 50 patients with acrodermatitis chronica atrophicans (ACA), in four patients with spirochete-induced facial palsy and in one patient with pericarditis and serologic evidence of Borrelia spirochetal infection. Only one of 16 untreated patients with ECMA developed arthritis. The patient with pericarditis had suffered from arthritis for 2 months when the cardiac symptoms developed. Thirteen of the patients with ACA had luxations/subluxations of small joints in the hands or feet and/or arthritis in large joints. In four of the patients with ACA, periosteal thickening of bones was found. The results indicate that joint abnormalities are not uncommon in patients with ACA. However, arthritis during the first year of tick-borne spirochetal infection was less common in Sweden than has been reported among patients with Lyme disease in the United States.

Acrodermatitis↗
PubMed1986

Acrodermatitis chronica atrophicans--a spirochetosis. Clinical and histopathological picture based on 32 patients; course and relationship to erythema chronicum migrans Afzelius.

The recent discovery that spirochetes transmitted by the tick Ixodes ricinus are involved in the etiology of erythema chronicum migrans Afzelius (ECMA), Bannwarth's syndrome, and acrodermatitis chronica atrophicans (ACA) has thrown new light upon these disorders. Thirty-two patients showing clinical and serological evidence of ACA were investigated. Histologically, constant findings in active ACA lesions were telangiectases and a lymphocytic infiltrate with a moderate to rich admixture of plasma cells. Clinically, besides ACA lesions, lichen sclerosus et atrophicus (LSA)-like lesions were found in five patients. Four of these patients displayed a histopathological picture compatible with LSA. These findings suggest a relationship between ACA and LSA. In six patients spontaneous healing of ECMA was followed by ACA lesions after a latency period of 1-8 years. Six patients reported histories of cranial nerve involvement. Radiography revealed subluxation of joints in hands or feet in six patients, and periosteal thickening in another three patients. The results indicate that ACA may be a late manifestation of infection with the same spirochete that causes ECMA and Bannwarth's syndrome. If untreated, the infection may continue for many years and result in irreversible degenerative lesions.

Acrodermatitis↗
PubMed1986

Expression of HLA-DQ antigens on keratinocytes in Borrelia spirochete-induced skin lesions.

Skin biopsies were investigated with two different immunohistochemical techniques, thus revealing HLA-DQ antigens on HLA-DR-expressing keratinocytes in the late skin manifestations of a Borrelia spirochete infection. In the early skin lesions only HLA-DR antigens were present on the keratinocytes. The invariant gamma chain of class II transplantation antigens was observed on keratinocytes in 1:5 of the late cases. Upon penicillin treatment detectable HLA-DR and HLA-DQ antigens disappeared completely from the keratinocytes. Furthermore, the mononuclear cell infiltrates dominated by anti-Leu 1 and anti-Leu 3a-reactive cells and containing many cells with markers for activation (HLA-DR, HLA-DQ, transferrin, and interleukin 2 receptors) diminished markedly. The possibility that the expression of different class II transplantation antigens on keratinocytes might reflect separate functional demands of these cells or an altered immunological reactivity in the host, is discussed. The precise functional role of the temporary expression of the class II antigens on non-lymphoid cells, however, remains an enigma.

Acrodermatitis↗
PubMed1986

The spirochetal etiology of lymphadenosis benigna cutis solitaria.

Ten patients with a clinical diagnosis of lymphadenosis benigna cutis (LABC) solitaria were investigated. Four of the patients knew that they had received a tick bite during the year prior to the appearance of the LABC lesion. Five patients had had a migrating erythema, indicating a previous erythema chronicum migrans Afzelius, near the site where the LABC lesion had developed. In one patient meningitis and a facial palsy occurred. Elevated titers of antibodies against Borrelia spirochetes were found in sera from six of nine patients. Spirochetes were cultivated from one out of two biopsies from LABC lesions. The clinical findings, the results of the serologic tests and the successful cultivation of spirochetes show that Ixodes ricinus-transmitted Borrelia spirochetes can cause LABC solitaria.

Adult↗
PubMed1985

Facial palsy.

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Erythema↗
PubMed1985

Tick-borne spirochetes as a cause of facial palsy.

Twenty consecutive patients visiting an otolaryngological department in Sweden with a facial palsy were investigated for serological signs of tick-borne spirochete infection. Four patients showed serological evidence of and had a medical history compatible with a tick-borne spirochetosis. Spinal fluid analyses were performed in 3 of these patients and showed elevated specific antispirochetal antibody titres and an increase in mononuclear cells. The importance of a correct diagnosis and of antibiotic therapy in patients with spirochete-induced facial palsy is emphasized.

Adolescent↗
PubMed1985

Successful cultivation of spirochetes from skin lesions of patients with erythema chronicum migrans Afzelius and acrodermatitis chronica atrophicans.

Spirochetes could be cultivated from 9 out of 13 skin biopsies from patients with erythema chronicum migrans Afzelius (ECMA) and from 2 out of 5 biopsies from patients with acrodermatitis chronica atrophicans (ACA) by using a newly modified serumless Kelly's medium. The different spirochete strains grew best at a low oxygen tension. Attempts to grow spirochetes from blood and cerebrospinal fluid failed. The cultivation of spirochetes from secondary ECMA lesions favours the presumption that a spirochetemia may occur in ECMA. The isolation of spirochetes from an ACA patient who had a disease duration of greater than 10 years proves that the spirochetes may survive in the human body for a considerable time.

Acrodermatitis↗
PubMed1985

An immunohistochemical staining of epidermal Langerhans' cells in tinea cruris.

Epidermal Langerhans' cells (LC) were investigated in fresh cryostat sections of ten biopsies from patients with mycologically proven tinea cruris, using OKT6 monoclonal antibodies and avidin-biotin-immunoperoxidase. Compared to the controls, more epidermal LC and an increased number of LC in the upper half of the epidermis were found in the sections from tinea patients. In a double staining method for both OKT6-positivity and hyphae, a tendency towards a gathering of LC and fungal elements was found. The results of this study are in agreement with the theory that epidermal LC are responsible for the antigen uptake in dermatophytosis.

Adult↗
PubMed1985

Serologic studies of erythema chronicum migrans Afzelius and acrodermatitis chronica atrophicans with indirect immunofluorescence and enzyme-linked immunosorbent assays.

To determine whether antibodies to Borrelia spirochetes were present, sera from 88 patients with uncomplicated erythema chronicum migrans Afzelius (ECMA), from 9 patients with ECMA-related extracutaneous complications and from 26 patients with acrodermatitis chronica atrophicans (ACA) were submitted to an enzyme-linked immunosorbent assay (ELISA) and an indirect immunofluorescence (IF) assay. The assays were calculated to be 95% specific. There was good correlation between the IF test with a polyvalent conjugate and IgG ELISA. Of patients with uncomplicated ECMA, 18% were seropositive by IgG ELISA and 11% by IgM ELISA, and 15% showed elevated IF titers. Elevated serum antibody levels of IgG as measured by ELISA and elevated IF titers were found in all patients with extracutaneous complications and in the patients with ACA. Declining IgG titers were observed at follow-up 6-12 months after therapy, but the majority of the patients with ACA were still seropositive.

Acrodermatitis↗