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Biomedical subjects

K S Ryatt

Publications and source records attributed to K S Ryatt.

At least 19 recordsLinked to original sources
PubMed2001

Vancomycin-induced linear IgA disease with autoantibodies to BP180 and LAD285.

Linear IgA disease (LAD) is an acquired autoimmune subepidermal bullous disease characterized by the linear deposition of IgA at the basement membrane zone. A minority of cases are induced by drugs, of which the most frequently implicated is vancomycin. The target antigens in idiopathic LAD are heterogeneous, but have not previously been reported in vancomycin-induced LAD. We report three cases, and in two of these we investigated the target antigens. In both we identified IgA antibodies to LAD285 and IgA and IgG antibodies (dual response) to BP180.

Aged↗
PubMed2000

Cefuroxime induced lymphomatoid hypersensitivity reaction.

An 84 year old woman developed erythematous blotchy erythema and purpuric rashes over the lower limbs three days after being started on intravenous cefuroxime for acute diverticulitis. A skin biopsy specimen showed a mixed infiltrate of lymphoid cells and eosinophils; many of the lymphocytes were large, pleomorphic, and showed a raised mitotic rate. Immunohistochemistry showed the infiltrate to be T cell rich, with all the large cells being CD30 positive. Typical mycosis fungoides cells, marked epidermotropism, and Pautrier's abscesses were not seen. The rash disappeared 10 days after cessation of cefuroxime and the patient remained asymptomatic 15 months later. This apparent cutaneous T cell lymphoma-like reaction is best described as lymphomatoid vascular reaction. The drug induced immune response with an atypical cutaneous lymphoid infiltrate mimics a cutaneous pseudolymphoma.

Aged↗
PubMed1995

A comparison of 2 weeks of terbinafine 250 mg/day with 4 weeks of itraconazole 100 mg/day in plantar-type tinea pedis.

This double-blind, parallel group study compared a 2-week course of terbinafine 250 mg/day with a 4-week course of itraconazole 100 mg/day. A total of 190 patients were enrolled, of whom 129 were evaluable for efficacy. At week 8, 69% of patients treated with terbinafine were classified as effectively treated (mycological cure, and clinical assessment total score < or = 2) vs. 67% in the itraconazole group. At week 16, however, the rating for effective treatment increased to 71% of the terbinafine group, but decreased to 55% of the itraconazole group. This difference was of borderline statistical significance (P = 0.06). The results of this study demonstrate that both drugs can be used safely, and that 2 weeks' treatment with terbinafine 250 mg daily is as effective as 4 weeks' treatment with itraconazole 100 mg daily, but with fewer long-term relapses.

Adolescent↗
PubMed1990

Idiopathic recalcitrant facial flushing syndrome.

This report neologizes a new syndrome name, idiopathic recalcitrant facial flushing syndrome, to describe all cases of persistent facial flushing with unknown etiology. Three cases of recalcitrant flushing are described. Therapy with a variety of modalities, monitored objectively with laser Doppler velocimetry, proved unsuccessful. Some investigational and management aspects of difficult cases of idiopathic flushing are reviewed.

Facial Dermatoses↗
PubMed1988

Methodology to measure the transient effect of occlusion on skin penetration and stratum corneum hydration in vivo.

The effect of short duration occlusion on skin penetration and stratum corneum water content was studied in vivo in eight human subjects. Percutaneous absorption of hexyl nicotinate was monitored non-invasively by laser Doppler velocimetry (LDV) following each of three randomly assigned pre-treatments: untreated control, 30 min occlusion with a polypropylene chamber and 30 min occlusion followed by exposure to ambient conditions for 1 h. Stratum corneum water content after the same pre-treatments was measured with the dielectric probe technique. The local vasodilatory effect of the nicotinic acid ester was quantified using LDV by the onset of increased blood flow, the time of maximal increase in response, the magnitude of the peak response and the area under the response-time curve. Each of these parameters was significantly different, immediately following occlusion, from the untreated control values. However, if the occluded site was exposed for 1 h prior to hexyl nicotinate application these parameters did not differ significantly from the controls. Stratum corneum water content (expressed as a percentage of a maximal value) showed the same behaviour: the pre-treatment control value was 31.8 +/- 4.8%; after 30 min occlusion, this had risen to 46.9 +/- 6.2%; 1 h later, the reading had returned to 32.1 +/- 6.2%. There was a significant correlation between stratum corneum water content and area under the LDV response-time curve. It appears, therefore, that this method may be useful for quantifying the relationship between increased stratum corneum hydration and enhanced percutaneous absorption in vivo in man.

Adult↗
PubMed1986

Pharmacodynamic measurement of percutaneous penetration enhancement in vivo.

Enhanced skin penetration of hexyl nicotinate was measured in human subjects using laser Doppler velocimetry (LDV). The local pharmacodynamic response (vasodilatation) to hexyl nicotinate permitted the kinetics and extent of penetration to be evaluated following topical application of 10 mM drug in a 60:40 v/v propylene glycol: isopropyl alcohol vehicle. Prior to hexyl nicotinate administration, the application site was either untreated (control) or subjected to one of four 30-min pretreatments: (a) occlusion with a polypropylene chamber; (b) occlusion (as in a) in the presence of 0.3 mL of the vehicle; (c) occlusion (as in a) in the presence of 0.3 mL of the vehicle containing 25% 2-pyrrolidone; and (d) occlusion (as in a) in the presence of 0.3 mL of the vehicle containing 25% laurocapram (1-dodecylhexahydro-2H-azepin-2-one). The time-course and magnitude of the LDV response were characterized by the onset of action, time to peak, peak height, and area under the curve (AUC). The onset of action and time to peak were significantly shortened, and the peak height and AUC significantly increased with pretreatments a-d. For example, time to peak values were 35 +/- 4, 29 +/- 3, 22 +/- 5, 19 +/- 4, and 17 +/- 4 min for control and pretreatments a-d, respectively (n = 8). Pretreatments with vehicle, vehicle plus 2-pyrrolidone, and vehicle plus laurocapram did not cause LDV-detectable alterations in skin blood flow. The data support, therefore, a novel, simple, noninvasive, and objective demonstration of enhanced skin penetration of hexyl nicotinate in humans.

Adult↗
PubMed1984

Short-contact dithranol therapy--a comparison with the Ingram regime.

We have compared a short-contact dithranol regime with the traditional Ingram regime in the treatment of forty-three patients with plaque psoriasis. The Ingram regime produced a significantly faster rate of improvement of the psoriasis than the short-contact regime. The degree of relapse 12 weeks after stopping treatment was identical for both regimes. The irritant effect was more troublesome with short-contact dithranol therapy. Nevertheless, short-contact dithranol regimes may have a place in home treatment.

Administration, Topical↗
PubMed1984

Short-contact modification of the Ingram regime.

"Minutes' (30 minutes) and "short-contact' (2 hours) therapy with dithranol in Lassar's paste were compared (using a paired comparison method) with the Ingram regime in twenty-one and twelve patients respectively. Both "minutes' and "short-contact' regimes were effective in clearing psoriasis; the latter was the more effective of the two and proved just as good as the standard Ingram regime of 24-hour application. "Short-contact' therapy with dithranol in Lassar's paste should therefore reduce out-patient attendance and time off work, save valuable nursing time and allow a more social life.

Administration, Topical↗