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Biomedical subjects

J Manonukul

Publications and source records attributed to J Manonukul.

8 recordsLinked to original sources

Mast cells in leprosy and leprosy reaction.

BACKGROUND: Mast cells can be visualized in routine, acid-fast-staining, paraffin tissue section as metachromatic staining cells, and can be activated to release inflammatory mediators which play a role in the cell-mediated immune response. METHODS: Skin biopsy tissues were taken from the most active skin lesion of each leprosy patient at the time of diagnosis (nonreactional group) and at the time of reaction (reactional group) during the years 1994-1997 in the leprosy clinic at the Department of Dermatology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Thailand. Mast cells were identified by metachromatic staining (purple) in Fite's stain sections and reported as the average number of cells per high power field in three compartments: at the center and periphery of the granuloma and in the interstitium. The data were analyzed in three groups: nonreactional group, type I, and type II leprosy reactions. The mast cell count of each group and each compartment of the section, expressed as the mean +/- standard error, was compared. RESULTS: A total of 95 persons were included in the study, but 108 tissue sections were obtained due to nine cases having more than one section. Of these patients, 63 cases (66.32%) had no reaction, 19 cases (20%) had type I reaction, and 13 cases had type II reaction. There was no difference in age and sex among these groups. The mast cell count in the interstitium was higher than that within the granuloma, both at the center and at the periphery, in every type, and the count in this area reduced significantly in leprosy reactions, both type I and type II, compared with the nonreactional group. CONCLUSIONS: The change in the average mast cell number in nonreactional leprosy and leprosy reactions may indicate the important role of mast cells in dynamic changes in the cell-mediated immune response in leprosy and leprosy reactions.

Adult↗

Preschool sarcoidosis.

Sarcoidosis is a multisystemic granulomatous disorder of unknown etiology, most commonly affecting young adults and presenting most frequently with bilateral hilar lymphadenopathy, pulmonary infiltration, and skin or eye lesions. Sarcoidosis in children under the age of 4, preschool sarcoidosis, is rare and has very different clinical mainfestations characterized by the typical triad of skin, eye and joint involvement without lung disease. Diagnosis is established when compatible clinical findings are supported by histological evidence of widespread noncaseating epithelioid-cell granulomas in more than one organ or a positive Kveim-Siltzbach skin test. This report describes a 2-year-old Thai girl with typical clinical manifestations of preschool sarcoidosis. The histopathological studies of tissue specimens and the laboratory investigations support the diagnosis of sarcoidosis. The patient responded to systemic corticosteroid therapy.

Adrenal Cortex Hormones↗

Pruritic papular eruption in HIV seropositive patients: a cutaneous marker for immunosuppression.

BACKGROUND: Previous reports have shown the correlation between certain skin disorders and immune status in human immunodeficiency virus (HIV) infected patients. Pruritic papular eruption (PPE) is the most common cutaneous manifestation in HIV infected patients. The purpose of this study is to define the relationship between the presentation of PPE and the immune status in HIV infection, as measured by the T-cell subset, and to establish the usefulness of this common eruption as a predictor of CD4 count. METHOD: In this cross-sectional study, 20 HIV-positive patients with characteristics of PPE were studied. Clinical data, skin biopsy, and immune status, evaluated by measuring CD4, CD8, and CD4/CD8, were investigated. RESULTS: Seventy-five per cent of patients already had antecedent skin disorders, so PPE is not a leading symptom in HIV infected patients; 81.25% of PPE patients had an advanced degree of immunosuppression with a CD4 count below 100/mm3 and 75% below 50/mm3. CONCLUSIONS: PPE can be regarded as a cutaneous marker of advanced HIV infection.

Adult↗

Successful treatment of cytophagic histiocytic panniculitis by cyclosporin A: a case report.

This is a report of a case, 7 1/2 year-old-boy having chronic febrile and recurrent crops of painful subcutaneous nodules on lower extremities, which had previously been diagnosed as Weber-Christian disease, which progressed to have cytophagic histiocytic activity in the skin, bone marrow with abnormal liver function and hemorrhagic diathesis. He was subsequently treated with corticosteroid without good response. After he was diagnosed as having cytophagic histiocytic panniculitis, cyclosporin A was administered intravenously in an initial dosage of 1 mg/kg/day and in oral maintenance dose of 10 mg/kg/day with a successful response and the patient completely recovered within 6 months with mild hypertension as an adverse effect.

Child↗

Satoyoshi syndrome.

Satoyoshi syndrome is a very rare disorder of unknown etiology, characterized by progressive, intermittent, painful muscle spasms, alopecia universalis, diarrhea or unusual malabsorption, various endocrine disorders, and secondary skeletal abnormalities. This report describes a 9-year-old Thai girl who developed alopecia universalis when she was 6 years old. At age 7 years, she began to have recurrent, painful muscle spasms. The spasms progressed in time, producing recurrent patella dislocation. The laboratory investigations and radiologic study were compatible with Satoyoshi syndrome. She was treated with oral corticosteroid therapy, with marked improvement of her muscle spasms and alopecia. She underwent corrective surgery for deformities of both knees with a normal healing process.

Alopecia↗