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Biomedical subjects

F A Ive

Publications and source records attributed to F A Ive.

At least 37 records · Page 2Linked to original sources

Dermatomyositis. Disease associations and an evaluation of screening investigations for malignancy.

Fifty-three adult patients (19 men, 34 women) with dermatomyositis were studied. Two had dermatomyositis associated with benign disorders. Twenty-three (43%) had a malignancy; the risk of malignancy increased with age, but there was no sex difference. Seven malignancies were recurrences and 9 were diagnosed during investigation of dermatomyositis; these 16 were suspected clinically or from abnormal results of simple investigations. Extensive screening tests did not increase the number of malignancies diagnosed. In 7 patients, a diagnosis of malignancy was made more than 9 months after onset of dermatomyositis, although a relationship between malignancy and dermatomyositis was uncertain in two cases; the diagnosis of gynecological malignancy was missed in 2 patients despite appropriate investigations, 1 patient had poorly controlled dermatomyositis, and in 2 patients late diagnosis of malignancy was due to failure to reinvestigate relapse of previously stable dermatomyositis.

Adult↗

Treatment of seborrhoeic dermatitis with ketoconazole: I. Response of seborrhoeic dermatitis of the scalp to topical ketoconazole.

A randomized, double-blind, placebo-controlled cross-over study was made of ketoconazole shampoo in the treatment of 20 subjects with seborrhoeic dermatitis of the scalp. Responses were measured by clinicians using clinical gradings, and by the patients using a linear analogue scale. Scaling and itching of the scalp improved significantly with ketoconazole and no response was seen with placebo. Topical ketoconazole appears to be an effective therapy for seborrhoeic dermatitis of the scalp, and more suitable for long-term treatment than the oral preparation.

Administration, Topical↗

Skin clips are contraindicated when there is nickel allergy.

Four patients are described who developed generalized dermatitis following surgical wound closure with disposable skin clips. In 3 of them a vesicular palmar eczema was a prominent feature. They were found to have contact allergy to nickel, a component of the clips. If skin clips are to be used to close a surgical wound, it should be established that the patient is not allergic to nickel.

Adult↗

The nature of mycosis fungoides.

Thirty-four patients with a clinical diagnosis of plaque stage mycosis fungoides, poikiloderma atrophicans vasculare (poikiloderma) and parapsoriasis en plaques (parapsoriasis) were investigated for evidence of extracutaneous disease using a biochemical screen, blood films, bone marrow examination, chest radiograph, abdominal ultrasound, isotope liver scan, liver biopsy and lymphangiography. Skin biopsies were also taken from these patients and, in order to rule out non-specific histological change, from 29 controls with inflammatory skin disease; the slides were examined blind by two independent observers for evidence of mycosis fungoides or poikiloderma and graded accordingly. Both observers were able to differentiate significantly histological grades of mycosis fungoides corresponding to the clinical diagnosis although exact histological grades only corresponded on 35 per cent of slides. Features graded as classical or probable mycosis fungoides were found in between 22 and 67 per cent of patients with parapsoriasis and between 67 and 100 per cent of those with poikiloderma. We found no evidence of extracutaneous disease in any of our patients. Lymphangiograms were abnormal in 30 of 31 examinations but the changes were non-specific and did not correspond to disease type, duration or extent. Four patients had apparently unrelated co-existing disease including chronic lymphatic leukaemia in two, a monoclonal gammopathy and autoimmune haemolytic anaemia. This study shows that in its early stages mycosis fungoides is predominantly if not primarily a cutaneous disease. The findings also suggest that parapsoriasis and poikiloderma are part of the same disorder as mycosis fungoides or evolve into it. Aggressive treatment to prevent progression to mycosis fungoides plaque and tumour stage should therefore be tried. The findings support the idea that mycosis fungoides is a reactive rather than a neoplastic disorder.

Adolescent↗

Follicular molluscum contagiosum.

Four cases are reported in which atypical molluscum contagiosum lesions were found, arising from follicular epithelium. All the patients were adults and two had a history of atopic dermatitis. Histology showed intradermal nodules containing typical molluscum cells but lacking normal direct communication to the skin surface. This is the first description of true follicular involvement in molluscum contagiosum.

Adult↗

PUVA treatment of scleromyxoedema.

Treatment of a 60-year-old woman with scleromyxoedema with 8-methoxypsoralen and UV-A radiation (PUVA) resulted in significant clinical and histological improvement but no change in circulating paraprotein.

Female↗

The response of seborrhoeic dermatitis to ketoconazole.

A randomized double-blind placebo-controlled cross-over study was made of ketoconazole 200 mg daily in nineteen patients with seborrhoeic dermatitis. All had scalp lesions and sixteen had seborrhoeic dermatitis at other sites. Responses were measured by clinician and patients independently, using a linear analogue scale. Body and scalp lesions and itch regressed considerably and significantly with ketoconazole in all but five patients, three of whom subsequently responded to a higher dose. The patients studied with seborrhoeic dermatitis had been sent by their family doctors in answer to a request for patients with dandruff, and the clinical difference between the two was found to be only of degree. Three patients with dandruff without erythema were studied separately using the same study design: all three responded similarly to those with seborrhoeic eczema. It is concluded that Pityrosporum yeast infection is the immediate cause of seborrhoeic dermatitis and that dandruff is its mildest manifestation.

Adolescent↗

Allergic contact dermatitis due to highly reactive halogenated compounds.

10 cases of dermatitis in a fine organic chemicals plant are reported. These cases were all due to exposure to chemical compounds with reactive bromine or chlorine atoms. This type of chemical is always extremely irritant, but evidence is put forward to suggest that these cases were the result of allergic sensitization. Chemicals with reactive halogen atoms should always be handled with extreme care and patch testing should be approached with caution.

Adult↗