Immunological investigation of patients with chronic mucocutaneous candidiasis.
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Biomedical subjects
Publications and source records attributed to R C Staughton.
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Melanoma specific protein is immunologically related to altered naevus cell cytoplasm. It is excreted by patients with malignant melanoma but in no other malignancy. The protein has been detected in patients with actively developing halo naevi but not when repigmentation is taking place. It also occurs in patients with very active vitiligo but in no other pigment condition we have studied. It is suggested that the protein is a marker of active destruction of naevus cells by immune mechanisms and that the release of toxic materials during this immune reaction may be responsible for the production of the halo phenomenon and for the areas of vitiligo that may be seen elsewhere on the skin.
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Two patients with Sézary syndrome, refractory to conventional treatment, were given cyclophosphamide and antilymphocyte globulin (A.L.G) Both patients showed improvement. One patient subsequently died from widespread varicella and the other relapsed later. It is concluded that A.L.G. may be effective in this condition.
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Topical application of clobetasol propionate in a strength of 0-05% in cream or ointment (Dermovate) suppressed the hypothalamic-pituitary-adrenal axis in both normal people and patients with diseased skin. In normal people the 9 am serum cortisol level was suppressed when between 45 and 90 g was applied weekly. Insulin stress test results in patients with diseased skin showed an abnormally small response after long-term application of similar amounts. We conclude that long-term administration should be restricted to less than 50 g a week.
Widespread application of clobetasol propionate resulted in suppression of the hypothalamic pituitary axis in four patients. Three patients showed Cushigoid features and developed symptoms of adrenocortical insufficiency on withdrawal of clobetasol.