Biomedical subjects
Publications and source records attributed to C R Darley.
A case of a rare condition with which dermatologists are unlikely to be familiar is presented. The lesions involve the tubular bones and therefore usually present to orthopaedic surgeons. This is the first case affecting a distal phalanx to be reported.
Explore the source record for details and available documents.
Notalgia paresthetica is a sensory neuropathy characterized by infrascapular pruritus, burning pain, hyperalgesia, or tenderness. To assess whether the symptoms may be caused by alterations in the cutaneous innervation, skin from the affected area of patients (n = 5) was compared with controls (n = 10) comprising the contralateral unaffected area from the same patients and site-matched biopsies of normals, using immunohistochemistry. Frozen sections were immunostained with antisera to the neuropeptides substance P, calcitonin gene-related peptide, vasoactive intestinal polypeptide, and neuropeptide with tyrosine, and to the general neural marker PGP 9.5 and the glial marker S-100 to show the overall innervation and glial cells, respectively. No discernible change in the distribution of neuropeptide-immunoreactive axons was found, but all of the specimens from the affected areas had a significant increase in the number of intradermal PGP 9.5-immunoreactive nerve fibers compared with unaffected areas from the same patients and normal controls. Epidermal dendritic cells immunoreactive for S-100, possibly Langerhans cells, were substantially increased. It is concluded that there is an increase in the sensory epidermal innervation in the affected skin areas in notalgia paresthetica, which could contribute to the symptoms, and that neural immunohistochemistry of skin biopsies could be helpful in the diagnosis of the disease.
The case is described of a young woman who experienced a marked worsening of her acne as a result of friction, salt water and heat. She had crossed the Atlantic Ocean in a sailing boat and spent several months in the tropics.
A monoclonal antibody (LH 7.2) to the carboxy terminal of type VII collagen has been used in an indirect immunoperoxidase method on frozen sections of biopsies of benign compound and intradermal cellular naevi, dysplastic naevi, and malignant melanomas, to label the epidermal basement membrane. Benign intradermal naevi had an intact membrane with the dermal naevus cell component lying beneath it. Compound naevi showed proliferating junctional nests of naevus cells pushing through the membrane towards the dermis beneath. In contrast, dysplastic naevi and melanomas showed a progressive displacement of the membrane downwards. Thin lesions were confined above the membrane. With increasing tumour thickness, discontinuities in the membrane were seen and foci of invasive growth through the line of the membrane were identified. These studies suggest that the good prognosis of thin melanomas is associated with confinement of the tumour within an expanded epidermis above the basement membrane.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The characteristic clinical and histological features of three cases of malignant eccrine poroma are discussed, in addition to the metastatic disease that had occurred in two cases. These cases were compared with previously reported cases of malignant eccrine poroma that had metastasised, and it is suggested that a strict classification of malignant eccrine sweat gland tumours should be made.
A controlled trial of contact allergen therapy of alopecia areata (AA) using squaric acid dibutyl ester (SADBE) was performed on 17 patients. The right side of the patient's scalp was treated and the left side acted as an untreated control. Minimal signs of terminal hair growth were present in only 3 patients after 8-12 weeks of therapy. A majority of patients experienced adverse effects which led to the early withdrawal of 2 patients and the premature termination of the trial. We do not recommend the use of SADBE in the treatment of AA.
The effect of ultraviolet-A (UV-A) irradiation in combination with 'short contact' dithranol treatment was studied in ten patients with chronic plaque psoriasis. Increasing concentrations of dithranol were applied daily to the psoriatic plaques on both sides of the body. One side was irradiated with UV-A daily. There was no difference in the rate of clearance between the two sides. The effectiveness of 'short contact' dithranol was confirmed.
During the course of a controlled clinical study the patients' facial acne was assessed using a 0-10 visual-tactile grading system and by lesion counting. In addition, black-and-white photographs and colour slides were taken at each patient visit and subsequently assessed by a panel of three dermatologists. Scores obtained from each method of assessment were subjected to statistical analysis and correlations between the techniques were evaluated. We conclude that a well thought out clinical grading system is the best overall method as it provides a meaningful assessment with speed and reasonable accuracy.
We have evaluated a number of diluted and undiluted topical corticosteroid preparations in terms of vasoconstrictor potency, clinical efficacy and skin thinning effects. We conclude that, for the materials tested so far, an area under the curve measurement obtained from serial readings of the vasoconstrictor assay allows reasonably accurate predictions to be made concerning the relative clinical efficacy and skin thinning potential of these agents. If further work with a wide range of topical corticosteroids confirms our findings, the value of the vasoconstrictor assay as a predictive model will be enhanced.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
52 patients with a clinical diagnosis of verruca plantaris were entered into a randomised study of acyclovir cream versus placebo cream versus liquid nitrogen. 47 completed the initial 8-week assessment period. At first, liquid nitrogen was used as a positive control but after the entry of 33 patients it was discontinued as an initial therapy in order to obtain maximal numbers of patients on the cream treatments. At the end of the 8-week assessment period 5 of 18 (placebo cream), 7 of 18 (acyclovir cream) and 1 of 11 (liquid nitrogen) patients were completely cleared of their plantar warts. Patients who failed to clear on cream or liquid nitrogen treatments after the initial assessment period but who wished to continue therapy were subsequently treated with liquid nitrogen. Of a total of 27 patients treated vigorously with liquid nitrogen, for periods of time ranging from 2 to 34 weeks, only 11 were completely cleared of their warts at the end of the study. It is concluded that liquid nitrogen should not be considered as a routine treatment for plantar warts and that acyclovir cream is no better than placebo in the treatment of this condition.
Explore the source record for details and available documents.