Carbamix is redundant in the patch test series.
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Biomedical subjects
Publications and source records attributed to R A Logan.
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We have re-examined the site of deposition of IgG anti-basement membrane zone antibodies in 228 sera from suspected cases of bullous pemphigoid (BP), using 1.0 M sodium chloride split-skin as substrate for indirect immunofluorescence. Nine sera (4%) produced fluorescence on the floor of the split suggesting sub-basal lamina antibody deposition compatible with a diagnosis of epidermolysis bullosa acquisita (EBA). This ultrastructural localization was confirmed in only three of these nine by immuno-electron microscopy. Clinical details were available on six of these nine cases, and none had clinical features suggesting EBA. We have found the split-skin immunofluorescence technique unhelpful in identifying 'missed' cases of EBA. The prevalence of EBA presenting as BP would appear to be very low indeed in the U.K.
A double-blind controlled trial of low-dose prophylactic oral psoralen photochemotherapy (PUVA) and ultraviolet-B (UVB) irradiation therapy was undertaken from April to September 1983 in 42 patients with polymorphic light eruption (PLE). Patients were randomly allocated to three groups, PUVA with oral 8-methoxypsoralen (8-MOP), UVB with oral placebo, and control low-dose UVA with oral placebo. The initial dose given to each active treatment group was a third of the predetermined minimal phototoxic or erythema dose, followed three times weekly for 6 weeks by doses incremented by an eighth on each occasion in the PUVA group and by a seventh in the UVB group. Ultraviolet radiation exposure was monitored throughout with polysulphone film lapel badges. Patients recorded their symptoms on a visual analogue scale. Symptoms of rash and itch in patients treated with PUVA and UVB were significantly less affected by increasing exposure to ultraviolet radiation than were these symptoms in control patients.
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Three cases of onycholysis following, and apparently caused by, sun exposure are reported. No case was associated with drug ingestion or demonstrable metabolic abnormality. Cutaneous phototesting of all patients with an irradiation monochromator was within normal limits, although the action spectrum for the defect may lie in the ultraviolet-A (UV-A) region. This appears to be the first report of spontaneous photo-onycholysis.
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Cimetidine infusion (100 mg h-1) reduced the acid secretory response to insulin infusion (0.03 units Kg-1h-1) when compared to paired control tests in 6 healthy volunteers. There was no significant difference between cimetidine and control tests in terms of pepsin output or serum gastrin concentrations. Cimetidine also reduced the acid secretory response when administered after 90 minutes of insulin had established a secretory response in extended tests in 3 additional volunteers. Cimetidine may have therapeutic potential in the peptic ulcer diathesis.
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