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Biomedical subjects

G B Colver

Publications and source records attributed to G B Colver.

At least 19 recordsLinked to original sources

Myxoid cysts treated by infra-red coagulation.

The infra-red contact coagulator was applied to the treatment of myxoid cysts. The area beneath and around each lesion was infiltrated with local anaesthetic before coagulating the cyst with overlapping pulses. Initially four cysts were punctured and emptied of mucin but coagulation was delayed for 7 days. In this group there were two recurrences. The protocol was then changed so that coagulation was performed immediately after emptying the cyst. Fourteen cysts were treated in this way and there were two recurrences. The technique was well tolerated and local complications arose in five individuals.

Adult

Infra red coagulation for bleeding mucosal telangiectasia.

The technique of infra red coagulation is well suited to the destruction of superficial blood vessels in the skin and/or mucosal surfaces. A method is described here for the destruction of resistant bleeding telangiectasia of the palate and lip in Osler-Weber-Rendu syndrome.

Diathermy

Azathioprine in dermatology.

Azathioprine has been available for 30 years and is used in a variety of dermatologic conditions. In common with other systemic immunosuppressant drugs, it has potentially serious side effects in both the short and the long term. It has a favorable therapeutic ratio, however, and most side effects can be avoided by administering low doses for short periods. This review describes azathioprine's chemistry, drug interactions, adverse effects, and oncogenicity and then deals with its clinical applications. The well-established uses are discussed first, followed by less conventional ones. In severe, potentially fatal blistering diseases, azathioprine has an undisputed place in management. For intractable, disabling actinic reticuloid and atopic eczema, it has a smaller part to play, and its role is less clear.

Azathioprine

Familial acquired pigmented streaks in the nail.

A 40-year-old man developed multiple longitudinal pigmented streaks in his nails. His sister was also found to have a single streak on a fingernail. Neither had any history of drug ingestion or recent illness and examination failed to reveal any other signs in the skin or mucosal surfaces. A biopsy of the nail matrix at the base of one streak showed no evidence of a naevus or lentigo, the principal finding being pigmentary incontinence and excess macrophages.

Adult

The spectrum of malignant melanoma of the nail apparatus.

Unlike most morphological types of malignant melanoma, that of the nail apparatus is relatively rare--only 2% to 3% of one series. Although in the case of blacks and orientals, the incidence of malignant melanoma of the nail apparatus is proportionately more common. However, it is a serious disease with poor 5-year survival figures in the published series--21% to 50%. This poor prognosis may be an intrinsic function of the site and of other parts of the body, but the lateness of diagnosis in many of the published cases is of far more significance. In malignant melanoma at other body sites, late diagnosis usually relates to the patient not presenting early in the course of the disease; this may also apply to nail malignant melanoma. However, the frequency of failure of the first line physician or surgeon to recognize the clinical signs or to perform a biopsy from the correct site to obtain an accurate diagnosis is far more important.

Adult

Dermatitis due to intravesical mitomycin C: a delayed-type hypersensitivity reaction?

Mitomycin C is an alkylating agent, used by intravesical instillation to treat carcinoma of the bladder. Repeated instillations can induce cystitis and an eczematous eruption affecting the palms, soles and face. If these effects are due to delayed hypersensitivity with sensitization to mitomycin C occurring in the bladder wall, it should be possible to demonstrate antigen-presenting cells in the bladder wall and positive patch tests to the drug. Using an immuno-alkaline phosphatase method we have identified CDI+ cells in bladder epithelium and submucosa and have demonstrated Birbeck granules in a few cells. In further support of our hypothesis it was also possible to demonstrate delayed type hypersensitivity in 13 out of 26 patients who had received mitomycin instillations by applying the allergen as a patch test. These results indicate that the eczematous eruption in this group of patients is most likely a hypersensitivity reaction and that it may be mediated transvesically.

Administration, Intravesical

Serum-soluble interleukin 2 receptor in psoriasis. Failure to reflect clinical improvement.

Interleukin 2 (IL-2) is a T-cell growth factor produced by activated T cells. The cellular receptor for IL-2 is also expressed on activated T cells and one of its component molecules can be shed from the cell and measured as a soluble protein (sIL-2R). Blood levels of sIL-2R can be used to monitor in vivo immune activation and have been shown to correlate with clinical disease activity in conditions such as rheumatoid arthritis and atopic eczema. The present study shows that serum sIL-2R levels are raised in patients with chronic plaque psoriasis. These elevated serum levels were maintained during successful treatment of the skin lesions with topical tar preparations. This is in contrast to atopic eczema where serum sIL-2R levels fall with treatment and may indicate that topical treatment of psoriasis does not correct the underlying state of immune activation, even when resolution of the skin plaques is achieved.

Administration, Cutaneous

Soluble interleukin 2 receptor in atopic eczema.

OBJECTIVE: To determine whether serum soluble interleukin 2 receptor concentrations are related to disease activity in atopic eczema. DESIGN: Single cohort longitudinal study with controls. SETTING: Outpatient and general medicine departments in secondary referral centre. PATIENTS: Of 15 patients aged 17-57 with severe atopic eczema, all with acute exacerbations of disease, 13 were admitted to hospital and two treated as outpatients until the skin lesions had resolved or greatly improved. Nineteen controls gave single blood samples. INTERVENTIONS: Daily skin dressing with betamethasone valerate (0.025%) and ichthammol paste and tubular dressings. END POINT: Resolution of or considerable improvement in skin lesions. MEASUREMENTS AND MAIN RESULTS: Enzyme linked immunosorbent assays (ELISA) were used to measure serum soluble interleukin 2 receptor concentrations in blood samples taken on admission, at intervals subsequently, and on discharge. Clinical scores of disease activity were also made. Median concentrations on admission were significantly higher (770 U/ml) in the patients than the controls (300 U/ml). Concentrations fell significantly during treatment. In 25 assessments made at different times in 13 patients serum soluble interleukin 2 receptor concentration correlated significantly (R = 0.73) with clinical disease activity. CONCLUSIONS: Cellular immunopathogenic mechanisms contribute to atopic eczema. Immune activation can be measured in atopic eczema by measurements of soluble interleukin 2 receptor, and this should facilitate assessment of response to treatment.

Acute Disease

Post-irradiation morphoea.

We present details of nine patients who developed morphoea after radiotherapy. In every patient morphoea began within the irradiated area and in four spread beyond it. We believe the irradiation triggered the morphoea despite the absence of any clear-cut relationship to dosage or severity of the acute reaction. Dermatologists and radiation oncologists should be aware that this condition may lead to the mistaken diagnosis of a local tumour recurrence.

Adult

Failure of a helium-neon laser to affect components of wound healing in vitro.

The red light of a helium-neon (He-Ne) laser has been reported to stimulate wound healing and cell growth. To investigate the nature of its influence on wound healing we have studied seven components of the healing process in vitro: human skin fibroblast, epithelial and endothelial cell proliferation, cellular migration from skin explants, collagen lattice contraction, collagen synthesis and glycosaminoglycans (GAG) secretion. We used a 5 mW He-Ne laser emitting a I mm diameter beam of wavelength 633 nm. Cellular proliferation was not affected by irradiation three times a day for 3 days. There was no effect on cellular migration or on the rate of collagen lattice contraction. The rate of collagen synthesis, measured as the incorporation of 3H-proline into collagenase-sensitive protein, was no greater than that of controls and GAG secretion did not increase in the irradiated group. We have not found any significant effects of He-Ne irradiation.

Cell Division

The infrared coagulator in dermatology.

The infrared coagulator was developed 10 years ago in West Germany. It shares some properties with an infrared laser but differs by virtue of its noncoherent, multispectral light source. It has evolved to become a cheap, portable instrument with a wide spectrum of applications in medicine, including dermatology. The treatment of tattoos and vascular lesions with the infrared coagulator is discussed, along with the technical considerations and limitations associated with this instrument.

Animals