SKIN LESIONS IN HIV-POSITIVE AND HIV-NEGATIVE PATIENTS IN SOUTH INDIA

Background. Various dermatologic conditions have been reported to occur with increased frequency in human immunodeficiency virus (HIV)-positive individuals, but there are only a few studies comparing the prevalences of skin diseases in HIV-positive patients with those in matched HIV-negative controls. Methods. Skin lesions in 129 HIV-positive patients and 258 HIV-negative controls were studied prospectively over an 18-month period from October 1991 to March 1993. Results. Oral Candida, tinea cruris, and ichthyosis were significantly more common in HIV-positive patients compared to controls. Several other dermatologic conditions were found only in the HIV-positive group. Conclusions. The pattern of skin lesions in Indian patients with HIV infection may be different from that in the West.     

SERUM LEPTIN, ATHEROGENIC LIPIDS AND GLUCOSE LEVELS IN PATIENTS WITH SKIN TAGS

Aim:

To investigate the relationship between serum leptin, atherogenic lipid and glucose levels in patients with skin tags and healthy controls.

Materials and Methods:

A total of 58 patients, with at least three skin tags, aged 24 to 85 years, and 31 healthy controls aged 30 to 70 years, were examined in the present study. The subjects in all the groups were selected with statistically similar Body Mass Index (BMI). Fasting concentrations of plasma glucose, serum lipids including triglyceride, total cholesterol, and high-density lipoprotein cholesterol (HDL) and low-density lipoprotein cholesterol (LDL), HbA1c, and leptin were measured by enzyme-linked immunosorbent assay (ELISA). In addition, serum LDL level was calculated using Friedewald''s formula.

Results:

There was no significant difference in age, sex, BMI, HbA1c, triglyceride, HDL and leptin levels between the groups. Skin tags group showed significantly higher levels of total cholesterol and LDL, when compared with the healthy controls groups (P < 0.01). In addition, regression analysis showed that leptin level was positively correlated to serum triglyceride level (r = 0.265, P = 0.044).

Conclusion:

Total cholesterol and LDL serum levels should be controlled in patients with skin tags. On the other hand, glucose, leptin and HbA1c serum levels may not be as important as is being considered in recent times.     

TRANSEPIDERMAL WATER LOSS IN PATIENTS WITH DERMATITIS

SUMMARY.— Using an electrolytic hygrometer, the Transepidermal Water Loss (T.W.L.) from the skin was measured in normal individuals and in patients with dermatitis (eczema). It was found that there was a close correlation between T.W.L. and the state of activity of the dermatitis; and that there was a gradual reduction in abnormally raised T.W.L. in parallel with the return to normal of the skin response (dermatitis). Sweating did not contribute to the increased insensible water loss in dermatitis under the fixed limits of ambient temperature and humidity of this investigation.     

GRANULAR DEPOSITS OF IMMUNOGLOBULINS IN THE SKIN OF PATIENTS WITH DERMATITIS HERPETIFORMIS. AN IMMUNOFLUORESCENT STUDY

SUMMARY.— Direct immunofluorescent technique applied to skin sections revealed the occurrence of granular deposits of immunoglobulins in the basement membrane zone of the uninvolved skin from 10 of 12 patients with dermatitis herpetiformis, whereas sections from all 12 patients with pemphigoid yielded a homogeneous immunofluorescent staining pattern.
By indirect immunofluorescent technique "basement membrane antibodies" could be demonstrated in the sera from only 7 of 12 patients with pemphigoid.
The implications of the in vivo occurrence of immunoglobulins with regard to the pathogenesis of dermatitis herpetiformis and the possibilities for diagnostic applications of the presented findings are discussed.     

ALTERED SKIN REFLECTANCE IN PATIENTS WITH EPITHELIOMA

SUMMARY. The reflectance of monochromatic light projected on to 2 skin areas, one chronically exposed to sunlight (forehead) and the other shielded from it by clothing (buttock) has been determined in a group of patients suffering from epitheliomas of the face and in a control group. The forehead/buttock reflectance ratio (c) was computed and found to be significantly increased within the wavelength range from 480 578 nm in subjects with epitheliomas. These results reveal the existence in the skin of these patients of some as yet unknown morphological changes. The occurrence of these changes may be the expression of a predisposition to cancer related to an altered absorption of sunlight by the skin of patients with epitheliomas.     

IMMUNOGLOBULINES IN DERMATITIS HERPETIFORMIS AND VARIOUS OTHER SKIN DISEASES

SUMMARY.— Lowering of the mean IgM-globulin value and elevation of the mean IgA-globulin value were noted in a group of 21 patients with dermatitis herpetiformis. IgM levels determined before and after dapsone therapy revealed no clear evidence of a dapsone effect on this immunoglobulin. No relationship was noted between the IgM-globulin levels and the intestinal mucosa biopsy grading. Fluctuations in the IgM values were noted and in some patients a fall in this immunoglobulin occurred during an exacerbation the disease. Immunoglobulin patterns were studied in 7 other skin diseases. The abnormalities noted in psoriasis closely paralleled those found in dermatitis herpetiformis.     

白癜风患者血清及皮肤组织液铜锌含量测定

本文用感应藕合等离子发射光谱仪,测定了27例白癜风患者和36例健康人血清中铜锌两种微量元素的含量,并对其中24例白癜风患者无病变部位和白斑部位的皮肤吸力水疱疱液进行了测定。结果显示白癜风患者血清中铜锌的含量均低于正常对照组,病人白斑部位组织液铜含量明显低于无病变部位,提示白癜风发病与铜锌两种微量元素有关。     

EFFICACY AND TOLERABILITY OF CEFDITOREN PIVOXIL IN UNCOMPLICATED SKIN AND SKIN STRUCTURE INFECTIONS IN INDIAN PATIENTS

Background:

Uncomplicated skin and skin structure infections (uSSSI) are commonly encountered community-acquired infections and are typically confined to the superficial layers of the skin. Hence, they seldom lead to the destruction of skin structures.

Aims:

To evaluate the efficacy and tolerability of cefditoren pivoxil in uSSSI in Indian patients.

Methods:

One hundred and seventy-eight patients diagnosed with uncomplicated SSSI were enrolled in this randomized, comparative, multicentric study. Patients received either cefditoren pivoxil or cefdinir for ten days. Efficacy was assessed both clinically and microbiologically. Safety evaluation consisted of reporting of type, frequency, severity, and causal relationship of adverse events.

Results:

One hundred and fifty-one patients completed the study. Clinical and bacteriological efficacy of cefditoren pivoxil was comparable to that of cefdinir in the treatment of uSSSI. One hundred and five patients were eligible for per protocol (PP) analysis of bacteriological outcome and clinical efficacy. Clinical cure or improvement was achieved in 98.00% patients treated with cefditoren pivoxil and 98.18% patients treated with cefdinir. In the modified Intent to Treat (mITT) patient population, clinical cure or improvement was recorded in 97.33% patients treated with cefditoren pivoxil and 96.20% patients treated with cefdinir. Microbiological eradication (or presumed eradication) was recorded in 88.00% patients treated with cefditoren pivoxil and 94.55% patients treated with cefdinir. The above differences in the outcome rates between the two drugs were not statistically significant. Six adverse events (AEs) (two in cefditoren group and four in cefdinir group) were reported in this study.

Conclusion:

Cefditoren pivoxil 200 mg b.i.d. was effective and well tolerated in the treatment of uSSSI.     

VARIATIONS IN SKIN SURFACE LIPID COMPOSITION AND SEBUM EXCRETION RATE WITH DIFFERENT SAMPLING TECHNIQUES II

Summary.— The technique of Sellotape stripping was used to investigate the role of the stratum corneum in modifying sebum excretion rate and skin surface lipid composition.
All experiments were performed on the forehead. The stratum corneum influences the rate of sebum excretion as Sellotape stripping produced a significant increase in sebum excretion rate, but this effect was abolished by systemic antibiotics.
Skin surface lipid composition, when sampled by absorbent papers, was not influenced by Sellotape stripping, but when sampled by an ether-soaked sponge after Sellotape stripping, had a lessened epidermal lipid contribution. Thus the stratum corneum modifies skin surface lipid composition when sampled by an organic solvent.
Absorbent papers may be preferable to other sampling techniques on the forehead in the investigation of the role of sebaceous biochemical factors in the pathogenesis of acne vulgaris.     

SKIN LESIONS ASSOCIATED WITH SJÖGREN'S SYNDROME AND ANTICYTOPLASMIC ANTIBODIES IN SLE PATIENTS

Among forty-two systemic lupus erythematosus patients, three had antibodies against cytoplasmic antigens SSA and SSB. All three patients showed annular nonscarring erythema as a sign of their illness. The most predominant site of skin lesions was the face, but trunk and extremities were involved as well. All of the patients had clinically distinct Sjögren's syndrome following the onset of their skin lesions. These findings suggest that systemic lupus erythematosus patients with anticytoplasmic antibodies might often have accompanying clinical features of nonscarring erythema and Sjögren's syndrome.     

INCIDENCE OF ALLERGIC REACTIONS TO COAL TAR DYES IN PATIENTS WITH COSMETIC DERMATITIS

One hundred sixty-two patients with cosmetic dermatitis, 64 pigmented and 98 non-pigmented, have been studied using patch and photopatch tests with 11 coal tar dyes used in cosmetics. Incidence of allergic reactions to the dyes was the following: brilliant lake red R 8.6%, toluidine red 1.9%, lithol red calcium salt 1.9%, permanent orange 1.9%, carbanthrene blue 1.4%, erythrosine aluminum lake 0.7% and the remaining 5 dyes 0.0%. The incidence of allergic reactions to brilliant lake red R was significantly higher than that to the other 10 dyes (α=0.01). Thirteen of the 64 patients with pigmented dermatitis (20.3%) displayed allergic reactions to this dye, in contrast to only one out of 98 patients with nonpigmented dermatitis (1.0%), which is a significant difference at the 0.5% level. Doubtful photoallergic reactions to brilliant lake red R were seen in four patients, but no certain photoallergy to the dye was found. Thus, photoallergic cosmetic dermatitis from brilliant lake red R is presumed to be quite rare. Photopatch testing with the 11 coal tar dyes showed only one positive reaction to toluidine red in one patient.