Indolent cutaneous prodrome of fatal HTLV-I infection.
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Biomedical subjects
Publications and source records attributed to G M Levene.
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The clinical details of four fair-skinned women with recurrent blistering and skin fragility are presented. All had considerable sun-exposure and had used sunbeds for years. Specific causes of bullous dermatoses including drug ingestion, porphyria, cutaneous amyloidosis and epidermolysis bullosa acquisita were excluded. Long-term recurrent exposure to high doses of sunbed radiation in chronically sun-damaged skin appears to be a further cause of pseudoporphyria.
Follicular mucinosis is usually regarded as an eruption consisting of follicular papules or infiltrated plaques with prominent follicular openings associated with loss of hair. We describe a patient who presented with an acute extensive dermatitis confined to the face which was later diagnosed as follicular mucinosis. We believe that such a florid presentation has not previously been reported in the literature and serves to illustrate the difficulty in distinguishing acute follicular mucinosis from acute eczematous dermatitis, pyogenic infections and inflammatory fungal infections.
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Methotrexate has been of proven value in the management of patients with severe psoriasis. Its long-term use, however, can be complicated by progressive hepatic damage which has necessitated regular liver biopsies. We have looked into the efficacy of liver ultrasonography as a non-invasive screening procedure to select those patients who may be developing liver changes. Eighty-seven investigations on 82 patients were performed, comparing liver ultrasound results with liver biopsy. Eight of these showed a degree of hepatic damage which was sufficient to indicate cessation of methotrexate, and all of these were detected by ultrasonography. Our results indicate that patients whose last liver biopsy was normal could be allowed an extended interval between biopsies provided their intervening ultrasound scans remained normal.
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