British Journal of Dermatology

BYROM, N.A.; TIMLIN, D.M.

doi: 10.1111/j.1365-2133.1979.tb05574.xpmid: 312651

SUMMARYWe have searched the literature for data on the in vitro assessment of immune status in atopic eczema patients, and have found much confusion. The major findings are tabulated. It is concluded that atopic eczema is a form of immune deficiency, although it is unclear whether this is a primary or secondary defect.Most authors find a T‐lymphocyte deficit while eosinophils, B lymphocytes and serum IgE are increased. Serum IgE levels appear to be correlated with severity of eczema symptoms.We have previously suggested that T‐lymphocyte levels are overestimated in eczema when fetal calf serum is used in the E‐rosette assay. Analysis of the literature for the effect of this serum in the assay confirms that there is a T‐lymphocyte deficit in atopic eczema, but that the serum masks it.Thus, much of the confusion surrounding this issue can be resolved.

BYROM, N.A.; STAUGHTON, R.C.D.; CAMPBELL, MARY‐ANN; TIMLIN, D.M.; CHOOI, M.; LANE, A.M.; COMPEMAN, P.W.M.; HOBBS, J.R.

doi: 10.1111/j.1365-2133.1979.tb05575.xpmid: 312652

SUMMARYThirty children with atopic eczema were compared with an equal number of age‐matched healthy children. The mean peripheral blood T‐lymphocyte level was lower in the eczema group (mean 1,197/mm2 as against 1,702/mm3; P= 0.003). This difference was abolished in vitro by thymosin, a thymic hormone extract.Positive correlations were found between eczema severity and: eosinophilia; hyperimmunoglobulinaemia E; but not T lymphopaenia.Thymosin‐inducible T‐cell (Ti) counts correlated with plasma IgE levels, suggesting that these Ti cells may be immature suppressor T cells. If this T‐cell deficiency represents inadequate suppression of IgE responses, then a trial of treatment with thymosin appears to be warranted.

BRAATHEN, L.R.; FØRRE, Ø.; NATVIG, J.B.; EEG‐LARSEN, T.

doi: 10.1111/j.1365-2133.1979.tb05576.xpmid: 375967

SUMMARYTissue sections from diseased skin of sixteen patients with atopic dermatitis were investigated with haematoxylin‐cosin and toluidine‐blue staining, with direct immunofluorescence staining using FITC‐conjugated antisera against IgG F(ab′)2 and IgM, and with the indirect immunoflourecence method utilizing specific rabbit anti‐human T lymphocyte antiserum with FITC‐conjugated goat anti‐rabbit Ig antiserum as the second layer.Furthermore, cryostat sections were investigated in a closed chamber immune adherence method using aminoethylisothiouronium bromide (AET) treated sheep red blood cells to detect E receptors on T lymphocytes, and with various types of coated sheep red blood cells to detect cells with IgG Fc receptors and complement factor C3b receptors.All sections presented dermal perivascular infiltrates of mononuclear cells as judged by haematoxylin‐cosin staining. Staining with toluidine‐blue demonstrated varying numbers of mast‐cells, but in no case pathologically increased number. The majority of the infiltrating cells presented rimlike membrane fluorescence with the anti‐T antiserum, and the AET treated sheep red blood cells (SRBC) adhered to the infiltrates, thus indicating a predominance of T lymphocytes in the skin infiltrates of atopic dermatitis.

RING, JOHANNES; SENTER, THOMAS; CORNELL, ROGER C.; ARROYAVE, CARLOS M.; TAN, ENG M.

doi: 10.1111/j.1365-2133.1979.tb05577.xpmid: 444425

SUMMARYFifteen patients with atopic dermatitis were investigated to evaluate the total of complement and histamine. In five patients total serum complement haemolytic activity (CH50) was significantly decreased as was the haemolytic activity of complement components C2 (C2H50) and C3 (C3H50) By counter immunoelectrophoresis split products of C3 were detected. There was no evidence for alternative pathway activation or the presence of an activator of the alternative pathway. In three patients plasma histamine concetrations were elevated. The intensity of the complement and histamine changes observed seemed to be correlated to the severity of the disease.

ROWDEN, G.; PHILLIPS, T.M.; LEWIS, M. G.

doi: 10.1111/j.1365-2133.1979.tb05578.xpmid: 444426

SUMMARYAn antiserum against human B‐lymphoblastoid cell membrane alloantigens (Ia‐like antigens) was used to study the presence of such antigens on dendritic cells in human epidermis. Only Langerhans cells and the majority (85%) of so‐called indeterminate cells were positively stained, as shown by ummuno‐electron microscopy. Fifteen percent of the indeterminate cells were negative and were considered to be immature melanocytes. A relationship exists between the indeterminate cell and the Langerhans cell. A proposal is made concerning emigration of Langerhans cells in response to haptenic stimulation, and the immigration of indeterminate cells to restore the status quo.

FRANKI, JORMA E.; ESKOLA, JUSSI; HOPSU‐HAVU, VÄINÖ K.

doi: 10.1111/j.1365-2133.1979.tb05579.xpmid: 312653

SUMMARYThe peripheral blood lympochytes of the psoriatic patients studied initially showed a normal response to phytohaemagglutinin (PHA) and to purified protein derivative of turberculin (PPD) in a microculture using whole blood, but a lower than normal response to a high concentration of concanavalin A (Con A). The initial level of E‐rosette‐forming T cells in psoriatic patients (51.3%) was significantly lower than that in healthy controls (66.7%).A single exposure to 8‐methoxypsoralen (8‐MOP) and UVA light (PUVA) did not suppress the lymphocyte responses to PHA, Con A or PPD, rather the responses showed a tendency to be slightly increased. Similarly, no changes in the mitogen responses of peripheral blood lymphocytes were recorded during or after 12 weeks PUVA therapy for psoriasis. The lymphocytes still showed a weaker than normal response to a high concentration of Con A. However, the percentage of E‐rosette‐forming T cells in the peripheral blood increased from 51.3% to 62.8% after 12 weeks PUVA therapy.The low initial level of E‐rosette‐forming T cells was found to correlate more closely with the activity than with the extent of the disease. The increase found in the E‐rosette‐forming cells during PUVA therapy did not correlate with the improvement of the psoriatic lesions. The low response of peripheral blood lymphocytes of psoriatic patients to a high concentration of Con A correlated with the age of the patients but not with the activity or extent of the disease.

KAVASNIČKA, JAN; ŘEZÁČ, JAN; ŠVEJDA, JIŘÍ; DUCHKOVÁ, HANA; KAZE, FRANTIŠEK; ŽALUD, PAVEL; RICHTER, JOSEF

doi: 10.1111/j.1365-2133.1979.tb05580.xpmid: 444427

SUMMARYEvidence of disseminated intravascular coagulation was recorded in eight patients with toxic epidermal necrolysis (TEN)—Lyell's syndrome.Patients wee treated with low doses of heparin in combination with the usual treatment of TEN, i.e. maintenance of fluid and electrolyte balance, systemic corticosteroids, antibiotics and aseptic dressings, in the Intensive Care Unit environment.It is suggested that the alteration of haemostasis and inter‐related biological systems, such as activation of components of complement, kinins and immunoglobulins, may affect the outcome of TEN.

PYE, R.J.; PEACHEY, R.D.G.; BURTON, J.L.

doi: 10.1111/j.1365-2133.1979.tb05581.xpmid: 444428

SUMMARYWe report six patients with a previously undescribed but characteristic pustular dermatosis confined to the scalp. All the patients were elderly women who developed chronic, extensive, pustular, crusted and occasionally eroded lesions of the scalp which produced scarring alopecia. Investigations were essentially negative and skin biopsies showed only non‐specific changes of atrophy and chronic inflammation, sometimes with increased plasma cells in the infiltrate. The condition did not respond to antibioties, but was suppressed by potent topical steroids.

BURTON, J.L.; BEN HALIM, M.M.; MEYRICK, GAY; JEANS, W.D.; MURPHY, D.

doi: 10.1111/j.1365-2133.1979.tb05582.xpmid: 444429

SUMMARYCutaneous processes which are thought to be influenced by androgenic stimulation include the development of male‐pattern alopecia, terminal hair distribution, sebum excretion rate, maximal sweat secretion rate and skin thickness. We measured these indices in forty‐eight normal men, together with muscle, fat and bone thickness and plasma testosterone. There was a significant correlations between hair density on the forearm, leg and chest, but no other significant correlations were found. We conclude that bald men are no more ‘masculine’ than those with good scalp hair growth, if masculinity is defined in terms of end‐organ response to androgenic stimulation.

PARRA, CRISTOBAL A.; DE PARRA, NÉLIDA PIZZI

doi: 10.1111/j.1365-2133.1979.tb05583.xpmid: 444430

SUMMARYThe diameter of collagen fibrils was studied in a patient with porphyria cutanea tarda in a specimen obtained from the sclerodermatious skin of the back. A bimodal distribution of the diameter of the fibrils was observed with maxima at 33.5 nm and 68.7 nm. The mean diameter was 67 nm with a standard deviation of 10.6 nm. These results are similar to those obtained previously in localized seleroderma (morphoea).