Joseph Lister: a neglected master of investigative dermatology.
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Biomedical subjects
Publications and source records attributed to J A Savin.
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This study of the relationship between nocturnal scratching and sleep is based on an analysis of 17 overnight polygraphic records of the scratch bouts and EEG of severely itchy patients. Our patients spent little time in deep orthodox sleep (stages 3 and 4), which was absent from 7 of the 17 records. Bouts of scratching were found to occur in all stages of sleep but were most numerous in stage 1 (light orthodox sleep). Sleep tended to remain stable, i.e. in a single sleep stage, for the 40 s immediately before a bout of scratching but had often changed to a more superficial stage by the time the bout had ceased, implying perhaps that scratching itself was the event linked most closely with arousal.
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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.
We report eight patients with ulcerative colitis who have subsequently developed pemphigoid. Four patients were investigated to determine the pattern of pemphigoid antibody staining on whole and chemically split skin and oral mucosa to distinguish between pemphigoid and epidermolysis bullosa acquisita. The findings were suggestive of pemphigoid with a predominantly epidermal pattern. Three patients were studied for the presence of antibodies against the colon (which were absent). The relationship between pemphigoid and ulcerative colitis is discussed in relation to a case-control study.
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Fifty patients with extensive alopecia areata took part in a prolonged double blind trial to compare the effect of 1% minoxidil in unguentum merck with that of unguentum merck alone. There was no significant difference between the hair growth of patients treated with the placebo or with the active compound.
We describe a patient who developed Sweet's syndrome, carefully investigated, one year before an acute myelomonocytic leukaemia developed. Such patients need to be followed up for at least five years before this possible association can be disproved.
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