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P R Lane

Publications and source records attributed to P R Lane.

At least 19 recordsLinked to original sources

Actinic prurigo: clinical features and prognosis.

BACKGROUND: Actinic prurigo, an idiopathic familial photodermatosis, has been described in Amerindians in Manitoba, Canada, as well as in the United States, Mexico, and South America. OBJECTIVE: Our purpose was to describe the clinical features and prognosis of actinic prurigo in Amerindians in Saskatchewan, Canada. METHODS: Clinical examinations, questionnaires, phototesting, and laboratory tests were used. RESULTS: We present a series of 93 Amerindian patients. The face is the most commonly involved area. A hereditary tendency, cheilitis, and pruritus are prominent features. One third of patients report some lesions, often minor, during the winter. The majority of patients phototested were sensitive to ultraviolet A light. CONCLUSION: We find the age of onset of actinic prurigo to be the most important feature in determining the type of eruption and the prognosis for the patient. In general the younger ages of onset (up to 20 years of age) are associated with cheilitis and more acute eruptions and are more likely to improve over 5 years. Those who develop actinic prurigo as adults (21 years of age and older) tend to have a milder and more persistent dermatosis.

Adolescent

HLA typing in polymorphous light eruption.

Human leukocyte antigen typing of 41 white patients with polymorphous light eruption (limited concept) showed no significant differences when compared with the typing of 51 white control subjects. We previously found that actinic prurigo, an idiopathic photodermatosis particularly associated with Amerindians, has a positive association with antigens A24 and Cw4 and a negative association with A3. We suggest, on the basis of both laboratory and clinical findings, that polymorphous light eruption (limited concept) and actinic prurigo are two different and distinct diseases.

Adolescent

HLA typing in actinic prurigo.

Thirty-two actinic prurigo patients of Cree ancestry underwent human lymphocyte antigen (HLA) typing and were compared with 32 control subjects of Cree ancestry. We found a significantly increased frequency of HLA-A24 and Cw4 antigens and a significant decrease in the frequency of the A3 antigen in actinic prurigo patients. These HLA associations may be helpful in determining whether actinic prurigo is a distinct disease or a variant of polymorphous light eruption.

Adolescent

Risk factors for squamous cell carcinoma of the skin in Saskatchewan, Canada.

Completed questionnaires regarding suspected risk factors for skin cancer were completed by 178 cases of SCC of the skin in Saskatchewan, Canada, and 284 age- sex- and location-matched controls. Significant risk factors identified using chi2 analyses were: farming, family history of skin cancer, light eye color, blond or red hair color, skin types I or II, obvious freckles in childhood, history of severe sunburn, and the use of the herbicide 2,4-Dichlorophenoxy acetic acid. The following relative risks were identified: (1) All cases of SCC of the skin and matched controls: agricultural occupation 1.49, history of severe sunburn 1.49. (2) All men with SCC of the skin and matched controls: history of severe sunburn 1.36 (3) All women with SCC of the skin and matched controls: agricultural occupation 1.83, and skin types I or II 1.48. No association was noted on our study between a history of psoriasis and development of SCC. Neither was an association between smoking and SCC found.

Carcinoma, Squamous Cell

A psychosocial assessment of patients with basal cell carcinoma.

We performed a controlled study to investigate the psychosocial problems of patients diagnosed and treated for basal cell carcinoma (BCC) as compared to the general population. Thirty-nine BCC patients and 39 matched controls answered a psychosocial questionnaire. Chi square analysis of the questionnaire results revealed no statistically significant difference between the BCC patients and the control group. In conclusion, no more psychosocial problems were found in BCC patients than in members of the general population.

Adaptation, Psychological

Treatment of actinic prurigo with intermittent short-course topical 0.05% clobetasol 17-propionate. A preliminary report.

Actinic prurigo is a chronic familial photodermatosis that occurs mostly in Amerindians. Eight patients with actinic prurigo were given intermittent 3- to 14-day courses of topical 0.05% clobetasol 17-propionate cream or ointment in 1988 and 1989. Seven out of eight patients cleared or markedly improved. All of the patients had been resistant previously to milder topical corticosteroids. There have been no side effects. This therapy offers an effective alternative to systemic corticosteroids, oral psoralen with long-wave UV radiation in the A range, or thalidomide.

Administration, Topical

Risk factors for basal cell carcinoma.

Completed questionnaires regarding suspected risk factors for basal cell carcinoma (BCC) were completed by 538 basal cell carcinoma patients and 738 age-, sex-, and location-matched controls in Saskatchewan. Significant risk factors were identified using chi2 analyses. Relative risks were subsequently computed. The following relative risks were identified: occupation of farming, 1.29; prominent freckles in childhood, 1.23; family history of skin cancer, 1.22; sunburn, 1.19; Irish, Scottish, Welsh mother, 1.19; light skin color, 1.18; red/blond hair color, 1.16; and working outdoors more than 3 hours/day in winter, 1.13: The average age of cases of BCC with a family history of skin cancer was significantly lower than cases of BCC with no family history of skin cancer (63.86 vs. 67.02 years, p = 0.018). No association was noted between BCC and psoriasis.

Adult

Patch testing in actinic prurigo.

42 out of 93 Saskatchewan Indians (32 female (F) and 10 male (M] with actinic prurigo were patch tested to standard series allergens between 1983 and 1987. Positive reactions were most frequently seen with nickel (3F:2M) and colophony. All 3 positive patch tests to colophony were in males. The same patients were also patch tested to extracts of 21 Saskatchewan plants and 3 Hollister-Stier plant extracts. Only 1 male and 2 females had positive patch tests. None of these 3 had rashes on the eyelids, behind the ears or under the chin. We conclude that plant contact dermatitis is unlikely to be mistaken for actinic prurigo in Saskatchewan.

Adolescent

Isotretinoin therapy for acne: a population-based study.

The use of isotretinoin over a 2-year period was retrospectively studied in Saskatchewan. The database of the Saskatchewan Prescription Drug Plan was used to obtain the names of physicians who prescribed isotretinoin as well as the names of patients for whom it was prescribed. Of the 861 such patients 161 had been instructed to use the drug for at least 4 months by 42 physicians. Questionnaires were returned by 86 of the 161 patients and 22 of the 42 physicians. The responses confirmed that isotretinoin therapy is highly effective for acne. However, at least half of the patients for whom the agent was prescribed apparently did not complete a full 4- to 5-month course of treatment, and of the 34 women (average age 28 years) who responded to the questionnaire 12 (35%) did not use a method of contraception, which is a matter of concern in view of isotretinoin's teratogenic effects.

Acne Vulgaris

Diphencyprone.

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Adolescent

Results of routine patch testing of 542 patients in Saskatoon, Canada.

542 patients (330 women, 212 men) with suspected allergic contact dermatitis were patch tested to standard series allergens between January 1983 and June 1987. Positive reactions were most frequently seen with nickel (17.4%), ethylenediamine (8.7%), formaldehyde (7.4%), colophony (7.0%), potassium dichromate (6.1%) and neomycin (5.7%). Patients with dermatitis involving the legs were significantly more likely to be allergic to ethylenediamine (p = 0.01) and benzocaine (p = 0.04) than those with dermatitis not involving the legs. Neomycin allergy was not associated with dermatitis involving the legs. Patients allergic to ethylenediamine were significantly more likely to be allergic to neomycin than patients not allergic to ethylenediamine (p = 0.002).

Adolescent

Perioral dermatitis: an uncommon condition?

To document the persistence of perioral dermatitis at dermatology clinics at University Hospital, Saskatoon, we reviewed the charts of all patients with the condition seen between January 1983 and March 1985. Patients with rosacea referred to the clinics during the same period were used as a comparison group. A total of 80 patients with perioral dermatitis and 117 patients with rosacea were seen during the study period; most were female. Those with perioral dermatitis were significantly younger and had a significantly shorter mean duration of the eruption before presentation than those with rosacea (p less than 0.001). The distribution of the lesions was different in the two groups. Sixty-eight (85%) of the patients with perioral dermatitis and 45 (38%) of those with rosacea had used topical corticosteroids, a postulated risk factor for perioral dermatitis; the use of potent topical corticosteroids was frequent in both groups. Despite continuing medical education on the dangers of chronic use of these agents for eruptions on the face, physicians continue to prescribe them.

Adrenal Cortex Hormones

Questionnaire survey of pruritus and rash in grain elevator workers.

51.4% of 1,954 grain elevator workers surveyed in 1978 and 1979 complained of pruritus following exposure to grain dusts. 95% of 796 grain elevator workers surveyed in 1985 noted that pruritus following exposure to grain dust was of short duration. Exposure to barley dust and oat dust provoked the greatest number of complaints. Those with a past history of infantile eczema were significantly more likely to complain. Younger workers were more likely to complain than older workers. 13.1% of those surveyed in 1985 complained of a rash following exposure, in 35% of whom it lasted more than 1 day. Nasal congestion, ocular and oropharyngeal irritation were also frequent complaints.

Adult

Dermatitis herpetiformis and vitiligo.

We report the fourth case of coexisting dermatitis herpetiformis and vitiligo. This patient's HLA haplotype is HLA-B8 DR3, which is characteristic of dermatitis herpetiformis. The autoimmune features of both disorders suggest that their coexistence is not coincidental.

Dermatitis Herpetiformis

Allergic contact dermatitis due to a herbicide (barban).

Canadian farmers are using increasing amounts of herbicides. Often they do not use adequate skin protection. Two cases of severe allergic contact dermatitis due to the herbicide barban are described. Patch testing with various substances, including barban, confirmed the diagnosis. Sensitization studies in guinea pigs and in one of the authors showed that barban is a potent sensitizer. It is recommended that if skin contact with barban occurs the skin be washed immediately with soap and water.

Adult