Comparison of patch test results in 2 clinics reflecting different populations.
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Biomedical subjects
Publications and source records attributed to P V Harrison.
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Two sisters developed a bullous skin disease in early childhood. The disease had features of junctional epidermolysis bullosa but differed clinically from previously recorded variants.
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In a single blind trial, 16 in-patients with psoriasis were treated with short contact dithranol in stiff Lassar's paste and in a stiff emulsifying ointment base of equivalent stiffness. The preparations were equally effective in clearing psoriasis and well tolerated. Perilesional treatment burns, reported with soft ointments, were not seen with the stiff emulsifying ointment preparation. Furthermore, unlike the paste, excess stiff emulsifying ointment can be removed by simply wiping with a moistened cloth, thus greatly facilitating home management of psoriasis.
Twenty-four patients between them received 86 low-dose methotrexate infusions (given over 36 or 48 h) delivered by a Graseby syringe pump in addition to conventional topical therapy during hospital admission for treatment of severe psoriasis (either erythrodermic or severe widespread plaque-type). The average length of hospital stay, usually the time taken to achieve complete clearance, and the average relapse time in the group of patients overall showed no differences from a control group of 25 patients (matched for age and sex) having a similar severity of psoriasis treated without methotrexate. However, separation of the patients into three sub-groups (erythrodermic, severe and 'unstable' widespread plaque-type, and severe and 'stable' widespread plaque-type disease) revealed that erythrodermic patients, as expected, cleared significantly quicker when receiving methotrexate although severe and 'unstable' widespread plaque-type patients had their clearance times possibly prolonged by short-term methotrexate administration. Although methotrexate is commonly used for long-term management of patients with severe psoriasis, short-term methotrexate administered in this manner cannot necessarily be recommended for severe widespread plaque-type disease. Measurement of methotrexate levels in a further 24 patients with severe psoriasis receiving 47 low-dose infusions revealed relatively constant and predictable methotrexate concentrations. Acute side-effects of methotrexate given by the infusion method were minor and uncommon, the infusion being well tolerated by patients. However, the low-dose infusion technique did not, apparently, offer any advantage over conventional methotrexate administration.
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