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Biomedical subjects

H J Dodd

Publications and source records attributed to H J Dodd.

At least 19 recordsLinked to original sources
PubMed1996

A case of linear IgA bullous dermatosis with IgA anti-type VII collagen autoantibodies.

In this study we present a patient with the sublamina densa type of linear IgA bullous dermatosis (LABD), with IgA autoantibodies reactive with the 290-kDa type VII collagen (the epidermolysis bullosa acquisita (EBA) antigen) and with immunoblotting of normal human dermal extracts. The clinical and histological features of the present case were compatible with those of LABD but quite different from those of EBA. Although EBA sera reacted with the bacterial fusion protein of the N-terminal globular (NC1) domain of type VII collagen, this patient's serum did not show reactivity. Furthermore, ultrastructural localization of target epitopes on the anchoring fibrils in this patient was considerably different from EBA. These results indicate that, whereas EBA antibodies react with the NC1 domain of type VII collagen, the epitope in this case is different from that of EBA (and is most likely on the central triple helical domain). This difference may be responsible for the clinical presentation in this patient being distinct from that of EBA.

Autoantibodies↗
PubMed1993

The effect of compression on venous stasis.

Skin blood flow in the lower leg is increased by external compression in standing subjects. This prevents the hypoxia induced by standing. The maximum increase in oxygen tension is seen when the external pressure is 40-50 mmHg. Pressures in the range of those produced by lightweight elastic stockings were found to be ineffective. Our results uphold the commonly held clinical opinion that only compression bandages or strong stockings are effective in the treatment of venous ulcers. External compression when the subject is recumbent causes skin oxygen tension to fall. Uniform external pressure exceeding 10 mmHg should therefore be avoided in the prophylactic treatment of post-operative deep-vein thrombosis. This observation suggests that when the patient is confined to bed, only lightweight stockings are safe in the prophylaxis of post-operative deep-vein thrombosis.

Adult↗
PubMed1990

Venous leg ulcers and arthropathy.

Reduced ankle mobility impairs the venous muscle pump and this leads to an increase in mean venous pressure in the lower leg. We have previously shown that pressure-induced venous distension leads to cutaneous hypoxia which is caused by arteriolar vasoconstriction in response to a spinal reflex. The prolonged cutaneous hypoxia which is thus a consequence of sustained elevation of venous pressure is an important factor in the development of gravitational ulcers. It is postulated that the increased incidence of leg ulcers in patients with rheumatoid arthritis is the result of impairment of the efficiency of the venous muscle pump by reduced ankle mobility. Conversely, the elevation of venous blood pressure in patients with venous insufficiency may lead to arthropathy in the ankle. The hypothesis is presented that prolonged elevation of venous blood pressure causes injury to both the ankle joint and veins leading to chronic reciprocal damage to both. This explains the frequent association between arthropathy of the ankle and venous leg ulcers.

Ankle Joint↗
PubMed1989

The short-term benefit and long-term failure of ultraviolet light in the treatment of venous leg ulcers.

Ultraviolet light has in the past been advocated for the treatment of venous leg ulcers on the assumption that it increases skin blood flow and reduces skin hypoxia. Our results show that UV light increases skin-oxygen tension of the lower leg and inhibits the normal vasoconstrictor response on standing. However, this effect is short lived and is followed after 2 days by a return of the vasoconstrictor reflex and a marked decrease in skin oxygenation which continues for at least 2 weeks. Since UV irradiation improves skin oxygenation for only 48 h, it cannot be recommended as a form of treatment for venous leg ulcers.

Adult↗
PubMed1989

Surgical correction of venous incompetence restores normal skin blood flow and abolishes skin hypoxia during exercise.

Posture has long been recognized to be a crucial factor in the etiology of venous leg ulcers. Activation of the stretch receptors in the veins by venous distention induces reflex vasoconstriction and hypoxia. In patients with defective venous return, exercise fails to reduce venous pressure when the legs are dependent; therefore, hypoxia persists during exercise. Surgical treatment of venous incompetence abolishes the abnormal venous reflux and restores the normal vasodilator response to exercise, thereby correcting the sustained hypoxia observed in patients with venous leg ulcers.

Bandages↗
PubMed1988

Seborrheic dermatitis and malignancy. An investigation of the skin flora.

The skin flora of patients with disseminated malignant disease and seborrheic dermatitis has been investigated and compared with controls as well as with otherwise healthy patients suffering from seborrheic dermatitis. Although significant differences were detected in both bacterial and yeast counts between different sites on the body, no significant qualitative or quantitative differences were found between the three groups of subjects. Whereas abnormalities of the skin flora have been described in seriously ill patients and in individuals subjected to occlusion, we were unable to demonstrate any changes in skin flora in patients with malignant disease and seborrheic dermatitis. Our results do not support the view that increased numbers of Pityrosporum yeasts are important in the pathogenesis of seborrheic dermatitis.

Bacteria, Aerobic↗
PubMed1985

Cutaneous malignant histiocytosis--a clinicopathological review of five cases.

Malignant histiocytosis is a rare, and usually fatal, tumour which may involve the skin. The clinical and pathological changes are described in five patients who presented with skin nodules as the initial feature. We witnessed spontaneous healing of lesions, a previously described phenomenon which may cause diagnostic confusion. It is suggested that patients presenting with malignant histiocytosis confined to the skin form a sub-group with a more favourable prognosis.

Adult↗
PubMed1985

Oral acyclovir in the suppression of recurrent non-genital herpes simplex virus infection.

In a double-blind, placebo-controlled, cross-over trial in 11 patients suffering eight or more episodes of recurrent non-genital herpes simplex virus (HSV) infection per annum, only two patients experienced a recurrence during treatment with oral acyclovir (200 mg 4 times daily) for up to 12 weeks, compared with nine during placebo treatment (P = 0.016). Although lesion development was effectively suppressed in nine of the patients whilst taking acyclovir, the development of prodromal symptoms, and occasionally erythema, was reported by five. There was no difference between acyclovir and placebo in the time to the next recurrence following completion of treatment. No patient reported any side effects of either placebo or acyclovir therapy. It is believed that this is the first report of any form of oral therapy which is effective in suppressing recurrent non-genital HSV infection in immunocompetent patients.

Acyclovir↗