Perimenstrual dermatitis secondary to a copper-containing intrauterine contraceptive device.
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Biomedical subjects
Publications and source records attributed to L Randazzo.
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We report three patients who developed a generalized rash with oral, genital or perianal ulcerations as a result of acute infection due to HIV. The primary infection was diagnosed by seroconversion (by means of EIA and Western blot techniques). Definitive diagnosis was established on days 52, 85 and 97 after the appearance of the rash. The p24 protein of the HIV was only detected in the early phase of the disorder in the two cases in which this study was carried out.
The histopathological changes observed in the cutaneous rash of three patients who suffered the acute phase of HIV infection are described. In all three patients a perivascular and interstitial inflammatory infiltrate was present in the upper and mid-reticular dermis. In one biopsy isolated areas of epidermal necrosis were observed and in the two other biopsies a perifollicular inflammatory infiltrate was detected with perforation in one case. Furthermore, a periductal infiltrate was observed in one of these biopsies.
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An analysis is made of the effectiveness of terfenadine at dosages of 60 and 120 mg, of cetirizine at a dose of 10 mg, and of loratadine and ebastine at a dose of 10 mg in inhibiting the papule induced by 20 mcg of intradermal histamine. Although all produced significant inhibition, cetirizine and terfenadine 120 mg showed a significantly greater inhibition coefficient than loratadine.
Substance P is a decapeptide which forms part of the group known as neuropeptides, that is, peptides released by some neurones such as the slow-conducting C fibres and the rapid-conducting A-delta fibres. These neurones belong to the category of non-adrenergic non-cholinergic nerves (NANC), which perform their action through a mechanism known as "axonic reflex". This mechanism is an antidromic stimulation which produces a secretion of neuropeptides, especially substance P. It is known that substance P, once released, is able to exert a number of actions including among others inflammatory and bronchospastic activities and a stimulation of the immunologic system. Other effects attributed to this substance are an increase in capillary permeability and oedema and the perpetuation of certain conditions such as asthma, rhinitis and chronic urticaria or hives. The production, metabolism and actions of this neuropeptide are described.
Six young healthy volunteers were used as experimental models to study the efficacy of cetirizine 10 mg and terfenadine 60 mg with regard to the onset of action and duration of the peripheral antihistaminic effect (cutaneous activity). For this purpose, 10 micrograms of histamine were used administered as intradermal injection at the internal border of the forearm at times 0', 30', 60', 90', 120', 180', 240', 360', 480' and 24 h after the intake of the drug, with a minimum interval of 7 days between one drug and the other. The inhibition of the cutaneous activity of histamine was assessed by planimetry of the papule transferred to adhesive paper. Both antihistamines were well tolerated by the oral route and our patients did not refer any anticholinergic side effects nor sedation, which are classically described in relation to first generation anti-H1 drugs. When comparing both antihistamines as to their ability to inhibit the response, there are no differences between them at 30', but from this time point up to 24 h cetirizine inhibits significantly more than terfenadine the response to histamine; cetirizine achieves its maximal effect at 180', while terfenadine does so at 240'; both drugs maintain their maximal effect antil 480' and, as was previously mentioned, at these doses cetirizine shows a higher percentage of inhibition than does terfenadine at equal time points.
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A study was made of 55 patients with skin prick test results for Plantago lanceolata of 3 mm2 or more. They were evaluated in relation to the response elicited by 10 mg/ml of histamine HCl. Patients with a response to Plantago less intense than the response to histamine were considered as having a "negative" response, whereas those whose response to Plantago was more intense than the response to histamine were considered as having a "positive" response. In 35 cases a radioallergosorbent test (RAST) was performed and in 22, nasal provocative testing (NPT). The frequency of positive response was 0.63 for skin tests, 0.11 for RAST and 0.72 for NPT. Among the patients with positive NPT, the frequencies of positive response to skin tests and RAST were 0.71 and 0.6 (p < 0.05), respectively. Results are discussed and study methods are proposed.
We studied 66 patients allergic to mould Alternaria. 53% males and 47% females, with 60% diagnosed as having asthma versus 40% rhinitis, only 29% had allergy to Alternaria without any other cutaneous reactivity while 71% were polisensitized, more frequently to D. pteronyssinus, grass pollen, Cladosporium and cat epithelium. We compared the patients allergic to Alternaria with those allergic to grass pollen and D. pteronyssinus.
Seventy atopic patients were studied. Pin-prick skin tests with cat epithelium extract (Ifidesa-Aríste-gui) were made. The results were compared by dividing the patients into a group with clinical manifestations of contact with cats and a group without clinical manifestations of contact with cats. Our results show that skin tests for cat epithelium, such as those carried out routinely in clinical practice, are not very sensitive or specific, and, therefore, are not suitable for diagnosis or prevalence studies.
The diagnosis of Alternaria allergy is difficult and tests in vivo and in vitro usually do not give results as satisfactory as those obtained with other allergens. We studied 33 patients with a cutaneous response of 2 mm2 or more to skin-prick tests for Alternaria (extract containing 104 micrograms/ml of Alt-1). Results were compared with those of RAST. Skin tests were positive in 75.8% of cases (the resulting papule was the same size as or larger than that elicited by 10 mg/ml histamine) and negative in 24.2% of cases. RAST was positive in 75% of cases and negative in 25%. There was no significant difference in the frequencies. RAST was positive four times more often in males than in females; when these figures were corrected for population data, the ratio was 2:1. The coefficient of correlation between the intensity of skin-test and RAST results was r = 0.51 (p < 0.05). These findings are evaluated and results are discussed.