Biomedical subjects
Publications and source records attributed to W J van de Staak.
In the period 1987-1990, 999 patients suspected of a contact allergy were patch-tested with Kathon CG 100 ppm active ingredients aq. Of these patients, 84 (8.4%) showed a positive reaction (70% females). In 62% of these cases clinical relevance was established. Most of them suffered from contact dermatitis of the face, the hands or the perianal region.
Twelve patients with chronic severe atopic dermatitis were treated with cyclosporin A (CsA) in a dose of 5.0 mg/kg/day. All patients except one showed a good therapeutic response. After week six, the CsA dose was reduced until an increased activity of atopic dermatitis was noticed (minimal effective dose). The minimal effective dose fluctuated with the severity of the atopic dermatitis. The mean minimal effective dose was approximately 4.0 mg/kg/day. Maintenance therapy with CsA for atopic dermatitis seems to be effective but may be hampered by side effects in the same way as CsA therapy is hampered by side effects in the treatment of psoriasis.
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Five patients with therapy-resistant plaque-type psoriasis were treated with cyclosporin. In cases where cyclosporin was not effective or in cases of relapse, etretinate was added. No additive therapeutic effect of etretinate was observed.
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2 patients with typical clinical and histological pictures of hyperkeratosis lenticularis perstans were described. Both patients showed abnormalities of the mucosal surface. The ultrastructural findings, both in the cutaneous and in the mucosal lesions, provide strong evidence that the mucosal abnormalities are a real component of hyperkeratosis lenticularis perstans.
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Glutathione was estimated in 98 blood samples from dermatological patients; in only two cases, both of contact eczema, a value considerably below normal was found. Glutathione reductase was assayed in blood samples from 139 different patients and 21 normal controls. The activity was significantly higher in atopic dermatitis (17 patients). A significantly greater variable was found among patients with non methotrexate-treated psoriasis (44), light sensitivity (12) and scleroderma (5). In the methotrexate-treated psoriatic group (24) and mean and variability did not differ significantly from normal. In most hospitalized patients a low glutathione reductase activity rose within a few weeks, but in a case of dermatitis herpetiformis a very low level persisted for 3 months. Blood samples with very low glutathione reductase activity, taken from a case of psoriasis and from a patient on griseofulvin treatment, gave a positive peroxide test and tended to hemolyze; these returned to normal together with the glutathione reductase activity.
In an electron-microscopic study of the skin of a patient with scleredema adultorum (Buschke) and diabetes mellitus, the unmyelinated nerve fibres showed accumulations of glycogen. On morphological grounds, these accumulations appeared to be located in the axons.
The phenomenon of lichenoid eruptions following medication with antimalarial, anti-arthritis and antibacterial medication is well documented in the literature. We report here the first case to be described as a result of anti-arthritis treatment with penicillamine, together with some biochemical studies of the effect of this compound on the enzyme glucose-6-phosphate dehydrogenase.
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