[Reiter's disease and prostatitis. Treatment with tetracycline].
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Biomedical subjects
Publications and source records attributed to H Zachariae.
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Urinary histamine was studied in 11 patients with severe atopic dermatitis and 17 controls, as well as in seven atopics prior to and 6 months following hyposensitization. No statistically significant differences were found between the groups. Urinary histamine seems to be of no value as an indicator of disease activity in atopic dermatitis.
Two infants suffering from histiocytosis X were treated successfully with a topically applied nitrogen mustard. All cutaneous symptoms disappeared completely within 2 weeks in one case while the skin improved significantly in the other. No irritation or dermatitis was experienced from the treatment. The only side-effect noted was hyperpigmentation.
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The changes in disease pattern in a Danish skin clinic during the period 1947 to 1977 is reported. The data rest upon comparisons from patient registrations taken with ten years interval. The study also comprises comparison of frequencies of positive patch tests between 1947 and 1977. The data show, that the disease pattern was far from stable. An increased frequency was registered in atopic dermatitis, allergic contact dermatitis, drug eruptions, urticaria, skin cancer, psoriasis and viral diseases. While reductions were found in all other infectious diseases, seborrheic dermatitis, and so called "non classified eczema". The changes are postulated to be of a multifactorial origine. Environment was supposed to be the main factor in regard to contact dermatitis and some infections and to be of great importance to skin cancer, while better therapeutic posibilities seem to have influenced the frequency of most of the remaining disease groups. Pronounced changes were also registered among the ten most commonly detected contact allergens. It is stated that preventive measures are extremely important within this area. The decrease in contact allergy to balsam of Peru is used as an example of the effects of good preventive medicine.
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Dermabrasion was carried out in 5 patients with severe Darier's disease. All patients improved significantly within the treated areas. In general, over 75% of the dermabraded skin remained free of disease for more than 2-1/2 years after surgery. It is suggested that skinplaning should include the entire papillary dermis in order to obtain the beneficial effect.
Seventy-five liver biopsies were performed in 30 psoriatics and 5 patients with mycosis fungoides undergoing treatment with photochemotherapy with 8-methoxypsoralen and UVA light. All patients had pre- and post-PUVA biopsies, the latter after one year. Five psoriatics had a further biopsy after 2 1/2 years of treatment. No statistically significant differences were found between biopsies taken before and after treatment.
The case is described of a 44-year-old man with acquired cutis laxa. The primary clinical manifestation was an erythema of the chest. Gradually there developed persistent circumscribed lesions in other areas of the skin, spreading into large erythematous plaques with loose skin. Slight restrictive ventilatory insufficiency, elongation of the vocal cord and diverticulosis of the colon were also found, indicating a chronic and widespread disorder. Skin biopsies showed diminution and degeneration of the elastic fibres. The light-microscopic features were subdivided in relation to the various skin manifestations. Ultrastructure of the skin showed various amounts of electron-dense, amorphous material and loosely bound microfibrils in and around elastic and collagen fibres as well as some microfibrils with knobs in the interfibrouer, were found normal. It is suggested that the first changes in the elastic fibres induced an inflammatory response and mild mucinous changes of the collagen fibres. Furthermore elastic fibres seemed to be replaced by newly formed collagen.
A report is given of the successful treatment with transfer factor as an additional therapeutic agent of a patient in the tumour stage of mycosis fungoides who had not responded to conventional treatment with nitrogen mustard, methotrexate, or grenz rays alone. Besides twelve injections of transfer factor, the patient received X-irradiation, 1 400 r (50 kV 1 mm Al) in all, to three tumours. The combined treatment induced sustained remissions. When that patient died from a coronary infarct 5 years after treatment began, autopsy showed no evidence of mycosis fungoides at all.
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The patterns of drug resistance and the frequency of conjugative R plasmids in intestinal Escherichia coli from 88 patients treated for a skin disease (acne vulgaris) with low oral doses of tetracycline are reported. The proportion of patients with resistant bacteria was progressively greater in patients who received tetracycline for 1 week, 4 weeks, or longer (from 50 to 88%). No multiply drug-resistant bacteria were detected before treatment or after 1 week of treatment. After more than 4 weeks of treatment, multiply drug-resistant E. coli were isolated from about 50% of the patients. The origin and selection of R plasmid-determined multiple drug resistance are discussed.
HL-A typing was performed on 97 patients with pustular psoriasis. HLA-B27 was found increased for the combined three subgroups: localized psoriasis of palms and soles, acrodermatitis continua and generalized pustular psoriasis, who were associated with a high incidence of arthritis. These subgroups have this in common with Reiter's disease indicating a link between the entities. In persistent palmo-plantar pustulosis an increased incidence of HLA-Bw35 was found. HLA-B13, HLA-B17 and HLA-Bw37 which are found markedly increased in psoriasis vulgaris were in acrodermatitis continua, generalized pustular psoriasis and persistent palmo-plantar pustulosis either absent or not increased as compared with the control population. 7 of 30 patients with localized psoriasis of palms and soles had one of these antigens. Our findings confirm that psoriasis vulgaris and pustular psoriasis as such, seem to be different aetiological entities. Some patients with localized psoriasis of palms and soles may be true psoriatics which besides their psoriasis have a tendency to develop a pustular reaction in their palms and soles similar to persistent palmo-plantar pustulosis.
Thirty psoriatics were treated for 2 weeks on a double-blind controlled basis with desoximetasone (0.25%) and with hydrocortisone butyrate (0.1%). It was a randomised left-right comparative trial. Thirteen out of 27 patients preferred desoximetasone, 3 patients preferred hydrocortisone butyrate. There was also a significantly better effect of desoximetasone as judged by the observer after the second week of treatment.
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