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Biomedical subjects

R Lever

Publications and source records attributed to R Lever.

18 recordsLinked to original sources
PubMed1992

Allergic contact dermatitis in atopic dermatitis.

Of 73 adult patients attending a clinic specially provided to treat patients with atopic dermatitis, 31 (42%) showed one or more positive patch reaction on contact testing. There was a striking female preponderance in the patch test positive group (26F:5M) in contrast to those with negative test results (9F:17M). The commonest allergens identified were fragrances in 13 patients, nickel (7), rubber (5), lanolin (4) and formaldehyde (3). In 21 patients, topical preparations, cosmetic or medically prescribed, could be implicated. Contact sensitivity seems to be relatively common in adult patients who have a continuing problem with their atopic dermatitis. Recognizing this sensitization may be important in their management.

Adolescent↗
PubMed1990

Assessment of a contact-plate sampling technique and subsequent quantitative bacterial studies in atopic dermatitis.

The aerobic bacterial flora of 20 patients with atopic dermatitis and 19 control subjects was extensively sampled using the Williamson and Kligman scrub technique and a contact-plate method (cysteine lactose electrolyte deficient media). Comparison of the two quantitative techniques showed that the contact plate is a reliable and convenient alternative to the scrub technique for the quantification of Staphylococcus aureus, micrococci and coagulase negative staphylococci. Quantification of bacterial flora using both techniques showed high rates of colonization by S. aureus on both involved and clinically normal skin of patients with atopic dermatitis. A linear increase in S. aureus counts with increasing severity of dermatitis was found. In contrast, diphtheroids showed a trend of decreasing isolation rates and counts as the severity of the dermatitis increased. Isolation rates and absolute counts for micrococci/coagulase negative cocci were unaffected by the severity of the dermatitis.

Adult↗
PubMed1989

Multiple clear cell acanthomas--treatment by cryotherapy.

Clear cell acanthomas (Degos' acanthomas) are usually solitary tumours and an excisional diagnostic biopsy therefore provides effective treatment. Such an approach is, however, impractical in the much rarer condition of multiple clear cell acanthomas where up to 30 lesions have been described on one patient. We describe a case of multiple clear cell acanthomas in which cryotherapy provided a quick and convenient method of treatment resulting in minimal scarring especially when compared to excision biopsy.

Carcinoma, Squamous Cell↗
PubMed1988

Staphylococcal colonization in atopic dermatitis and the effect of topical mupirocin therapy.

Forty-nine patients with atopic dermatitis entered a double blind placebo controlled cross-over study of mupirocin, a new topical antistaphylococcal antibiotic. Forty-five patients were evaluable. Quantitative bacteriological assessment before treatment showed that heavy colonization of the skin with Staphylococcus aureus was present in nearly all patients even in the absence of overt infection. However, the bacterial count was significantly reduced by 2 weeks' treatment with topical mupirocin, but not by the placebo. Moreover, a significant reduction of clinical severity was also observed after treatment with mupirocin, which was maintained over the following 4 weeks, although recolonization occurred during this period, with bacterial counts rising to pre-treatment levels. Despite recolonization, clinical deterioration was not observed during the trial period. No serious side-effects were observed. Phage typing showed that 50% of patients carried more than one bacterial phage type. Recolonization in eight patients (17%) was with a 'new' strain that had not previously been isolated.

Administration, Topical↗
PubMed1987

Immunophenotyping of the cutaneous infiltrate and of the mononuclear cells in the peripheral blood in patients with atopic dermatitis.

Fourteen adult patients with chronic atopic dermatitis and active skin lesions had a skin biopsy and venous blood sample taken on the same day. Absolute numbers of circulating lymphocytes were normal in all patients. Fluorescence-activated cell sorter (FACS) analysis revealed normal numbers of total T lymphocytes and T-helper and T-suppressor subsets (helper:suppressor ratio, 2:1) in the atopic patients' peripheral blood, but an increase in circulating B lymphocytes and in HLA-D-related antigen-bearing cells. The skin biopsy showed a dermal infiltrate of predominantly T-helper lymphocytes (helper:suppressor ratio, 7:1). These cells showed strong HLA-DR plasma membrane staining. There was no HLA-DR staining in the membranes of epidermal keratinocytes. Using a monoclonal antihuman IgE, positive staining was observed in the dermis, though none was identified in the epidermis. The dermal anti-IgE staining was concentrated around clusters of T lymphocytes.

Adolescent↗
PubMed1986

A prospective study of the histological changes in the skin in patients receiving bone marrow transplants.

Fourteen patients who received a bone marrow transplant (BMT) as treatment for leukaemia were included in a prospective study of the histological changes in the skin. The aim of this study was to improve the early diagnosis of graft-versus-host disease (GVHD). It was found that the clinically 'normal' pre-transplant skin was in some cases histologically abnormal on H & E examination in patients who were on regular maintenance cytotoxic chemotherapy. These changes were similar to some of the features of GVHD. Immunocytochemistry, although not specific, was found to be helpful in the diagnosis of some cases of GVHD. Suggestive features included a reduction in the numbers of Langerhans cells, an increase in the number of suppressor (OKT8+) cells in the dermal infiltrate and the presence of Ia positivity of the keratinocytes in the epidermis.

Adult↗
PubMed1975

Tape/slide programmes for independent study. Methods of presentation to students.

Programmed audio tape/slide presentations have been presented to students by a variety of methods, (a) individual or pairs of students using automatic equipment in study booths; (b) students using simple portable equipment in or out of the learning centre; (c) groups of students in which discussion was encouraged; and (d) groups of students in which the student answered the questions individually without discussion. Each method has its advantages and disadvantages. With the exception of the groups without discussion, all were popular and chosen by a significant number of students as the method of choice. Automatic equipment in study booths was the most popular single method though the use of simple portable equipment had particular advantages. The majority of students prefer to have access to more than one method of presentation and attempts should be made to provide the learner with a variety of opportunities. The use of individual learning materials by groups of students should be further explored.

Attitude↗