Biomedical subjects
Publications and source records attributed to A P Bewley.
We describe a patient with acute generalized eosinophilic pustuloderma induced by mesalazine therapy. The patient responded to cessation of mesalazine and treatment with systemic corticosteroids. This type of unusual pustuloderma to mesalazine has not to our knowledge been described before.
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Necrotizing fasciitis is an uncommon condition which may complicate any surgical procedure, including 'minor' dermatological procedures. However, it may arise de novo in the absence of any discernible trauma. We report a patient who acquired a fulminant form of this condition following excision of a malignant melanoma. The development of necrotizing fasciitis in association with melanoma has not previously been reported.
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Erythropoietic protoporphyria is an uncommon disorder which causes a photosensitive cutaneous reaction, and occasionally hepatic dysfunction in affected individuals. We report a patient with erythropoietic protoporphyria who improved symptomatically during her two pregnancies. In the latter pregnancy, quantitative levels of plasma and erythrocyte protoporphyrins were reduced by more than half during the pregnancy compared with the levels before pregnancy and during lactation.
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OBJECTIVE AND DESIGN: To determine whether or not cetirizine and loratadine inhibit codeine- induced histamine release in human skin in vivo, we conducted a placebo-controlled double-blind trial in which histamine release was assessed by dermal microdialysis. SUBJECTS: A group of ten normal volunteers were studied, each subject visiting the laboratory on three occasions with intervals of at least 2 weeks between visits. TREATMENT: Cetirizine, loratadine (both 10 mg) or placebo was given orally 4 h before provocation of weal and flare responses in the skin by intradermal injection of 25 microliters of 3 or 10 mg/ml codeine 1 mm from the centre of individual 216 microns diameter microdialysis fibres inserted in the dermis. METHODS: Dialysate was collected at 2 min intervals for 4 min before and 20 min after codeine injection and histamine assayed spectrofluorometrically. Weal and flare responses to codeine were assessed in the opposite arm. RESULTS: Histamine concentrations in the microdialysis fibre outflow with 3 and 10 mg/ml codeine were maximal at 2-4 min when 910 +/- 156 and 1194 +/- 304 nM respectively were found in the placebo group. Cetirizine and loratadine did not modify either the kinetics or total histamine release while significantly (p < 0.01) inhibiting weal and flare responses. CONCLUSIONS: Neither cetirizine nor loratadine inhibited codeine-induced histamine release or modified the time course of its release in human skin in vivo when given in clinically used doses which are sufficient to significantly reduce weal and flare responses.
We report a patient with the glucagonoma syndrome and octreotide-resistant necrolytic migratory erythema (NME). The NME responded on two occasions to an intravenous infusion of essential fatty acids (EFA) and amino acids (AA). A deficit of serum EFA prior to treatment was corrected following the infusion, whilst plasma AA were low before and after treatment. These findings indicate that NME, in the glucagonoma syndrome, may respond to correction of the EFA deficit, and that NME may be a disease of EFA deficiency.
Systemic sclerosis is an uncommon multisystem disorder of unknown aetiology which predominantly affects the skin. Cardiac involvement, which is far more common than was originally realized, may affect any part of the heart but most frequently affects the left ventricular myocardium. Right ventricular dysfunction is usually associated with pulmonary vascular disease. We report a case of systemic sclerosis associated with right ventricular cardiomyopathy in whom pulmonary artery pressures were normal.
We report the successful treatment of a 36-year-old man with recalcitrant pemphigus vulgaris by pulsed intravenous immunoglobulin therapy, dexamethasone and cyclophosphamide. In addition to clinical resolution, indirect immunofluorescence antibodies have since largely been undetectable.
We describe an HIV positive patient with histologically confirmed cutaneous and oral lesions of bacillary angiomatosis, an unusual clinical presentation. As far as we are aware, this is the first reported case of cutaneous bacillary angiomatosis in the U.K.
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Genital porokeratosis of Mibelli is rare. We report a patient with lesions affecting the penis, scrotum and natal cleft and discuss the aetiology, clinical presentation and treatment of the condition.
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Labial fusion is a common condition seen most frequently in infants and young children. While most cases are "physiological," we believe it can occasionally be the presenting feature of genital lichen sclerosus.
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