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S H Wakelin

Publications and source records attributed to S H Wakelin.

At least 55 records · Page 3Linked to original sources
PubMed1998

The effect of patch duration on the elicitation of para-phenylenediamine contact allergy.

To study the length of exposure time required to elicit para-phenylenediamine (PPD) allergic reactions, patients known to be allergic to PPD were recruited and patch tested. A group of 7 patients were patch tested with 1% PPD in pet. for 15 min, 30 min and for 120 min. The remaining 9 patients were patch tested with 1%, 0.3%, 0.1% and 0.01% PPD for 15 min, 30 min and for 120 min each. With exposure for 120 min, 11 of 16 subjects reacted to 1% PPD and 2 of 9 reacted to 0.01%. With exposure of 15 min, 6 of 16 reacted to 1% PPD and 0 of 9 reacted to 0.01% PPD. This study showed marked inter-individual variability in eliciting a reaction to the PPD molecule on patch testing, with regard to both the exposure time and the concentration required.

Adolescent↗
PubMed1997

Compositae sensitivity and chronic hand dermatitis in a seven-year-old boy.

Compositae dermatitis is rare in childhood, with few cases documented in the literature. We report a 7-year-old boy who presented with a dermatitis mainly affecting his dominant hand. Patch testing revealed contact sensitivity to sesquiterpene lactone (SL) mix, and subsequent testing with Compositae oleoresins showed sensitivity to daisy, dandelion and chrysanthemum. The dermatitis improved on avoidance of handling plants. We have not documented any other cases of Compositae sensitivity in 187 other children, aged under 16 years, who have undergone patch testing with SL mix between 1992 and 1996 in our department. This case illustrates that Compositae sensitivity may present with a localized dermatitis and that, although uncommon, sensitization may occur in early childhood.

Allergens↗
PubMed1997

Transient leukaemia cutis in chronic lymphocytic leukaemia.

Leukaemia cutis arises due to cutaneous infiltration of neoplastic leukocytes or their precursors. Recent evidence suggests that this sign does not necessarily herald a poor prognosis. We describe a 72-year-old woman with B-cell chronic lymphatic leukaemia (CLL) who developed a papular eruption on her breast at the site of a recent herpetic eruption. Histology and immunostaining showed a dense dermal B-cell infiltrate in keeping with leukaemia cutis. The papules cleared in 6 months without treatment, leaving atrophic scars. The histological features and possible aetiological mechanisms of post-herpetic papular eruptions in CLL are reviewed.

Aged↗
PubMed1997

Linear IgA disease: a report of two dermal binding sera which recognize a pepsin-sensitive epitope (?NC-1 domain) of collagen type VII.

Linear IgA disease is a subepidermal blistering disease characterized by IgA autoantibody deposition at the basement membrane zone of skin and mucosa. The antigens targeted in linear IgA disease have been defined by their molecular weight and localization. It has been proposed that a minority of linear IgA disease sera that bind to the dermal aspect of salt-split skin target collagen type VII. We have identified two patients with linear IgA disease using dermal binding IgA autoantibodies on salt-split skin which recognize collagen type VII by immunoblot analysis. The reactive epitope was destroyed by the proteolytic enzymes pepsin, which destroys the NC-1 domain of collagen type VII, and protease type VIII. Localization studies compared the IgA autoantibodies from these patients with the monoclonal antibody LH7.2 to the NC-1 domain of collagen type VII and showed colocalization on a dermal cylindroma tumour tissue, and a similar distribution with immunogold electron microscopy, using purified blister fluid from one patient. We propose from these results that the IgA autoantibodies from these two patients recognize the NC-1 domain of collagen type VII, the classical immunodominant epitope for epidermolysis bullosa acquisita.

Adult↗
PubMed1997

Transient leukaemia cutis in chronic lymphocytic leukaemia.

Leukaemia cutis arises from cutaneous infiltration by neoplastic leukocytes or their precursors. Recent evidence suggests that this sign does not necessarily herald a poor prognosis. We describe a 72-year-old woman with B-cell chronic lymphatic leukaemia who developed a papular eruption of her breast at the site of a recent herpetic eruption. Histology and immunostaining showed a dense dermal B-cell infiltrate in keeping with leukaemia cutis. The papules cleared in 6 months without treatment, leaving atrophic scars. The histological features and possible aetiological mechanisms of post-herpetic papular eruptions in chronic lymphatic leukaemia are reviewed.

Aged↗
PubMed1997

Epidermolysis bullosa acquisita associated with epidermal-binding circulating antibodies.

Epidermolysis bullosa acquisita (EBA) is a rare, immunobullous disease, characterized by circulating and tissue-bound antibodies against type VII collagen (C7) of anchoring fibrils in the cutaneous basement membrane zone. These antibodies localize to the dermal aspect of salt-split skin on indirect and direct immunofluorescence (IMF). We report two patients with clinical features of EBA, in whom circulating IgG antibodies bound to the epidermal aspect of salt-split skin. In both patients direct IMF of salt-split perilesional skin revealed dermal IgG deposits, and direct immunogold immunoelectron microscopy showed antibody deposits in the region of anchoring fibrils. Their serum failed to react with epidermal or dermal extracts on Western immunoblotting. Epidermal-binding antibodies have not been reported previously in association with EBA, and the IMF findings in these cases suggest the development of autoantibodies to additional epidermal-associated antigens. Target antigen heterogeneity has been reported in most other immunobullous diseases, and may be a hitherto unrecognized feature of EBA.

Adult↗
PubMed1996

Poikilodermatous and verrucous mycosis fungoides.

Mycosis fungoides (MF) is a cutaneous lymphoma of presumed T-helper cell origin. It usually presents with patches and infiltrated plaques, but a wide range of atypical forms have also been described. We report a 48-year-old man who had a 2-year history of a pruritic, warty plaque on the right palm with surrounding poikilodermatous changes. He subsequently developed additional macules of poikiloderma atrophicans vasculare (PAV) on the right upper limb and abdomen. Biopsies from the arm showed poikilodermatous changes, and the warty plaque had features of MF. Verrucous or hyperkeratotic lesions appear to be an uncommon presenting feature of MF with few case reports in the literature to date. This presentation may be associated with considerable diagnostic delay, and MF should be considered in the differential diagnosis of acquired verrucous lesions. This case also illustrates that PAV may herald cutaneous malignancy, and that patients with this condition require close follow up.

Hand Dermatoses↗
PubMed1996

Lithium-induced follicular hyperkeratosis.

A wide range of cutaneous reactions have been described in association with lithium therapy. Follicular eruptions have been noted briefly, but are not well documented in the dermatological literature. We report a 68-year-old man who developed a florid erythematous follicular eruption on the extensor surfaces of the limbs, with macular truncal erythema 6 months after commencing lithium therapy. His blood lithium levels were within the therapeutic range and there was no clinical evidence of lithium toxicity. Histology of lesional skin showed perifollicular inflammation and follicular plugging. The eruption improved on drug withdrawal. The cutaneous reactions to lithium and possible pathogenic mechanisms are discussed.

Aged↗