Summary The presence of cell-mediated immunity to dermatophytin antigens was studied in 63 patients infected with dermatophytes and in 31 uninfected controls using intracutaneous tests and the leukocyte migration agarose test (LMAT). Twenty-eight patients (44 %) showed delayed skin reactions to the dermatophytin antigens, while no delayed skin reactions were found in the selected non-infected controls. The dermatophytin antigens were found to cross-react with each other in the intracutaneous test. Twenty-three patients (43 %) showed inhibition in LMAT with the dermatophytin antigen while none of the controls showed inhibition. The results of the reactions in intracutaneous tests and in LMAT correlated well with each other both in patients and in controls. No correlation was found between the migration index and the size of the delayed cutaneous reaction to the corresponding antigen. It was found that the ability to develop the cell-mediated immunity correlated with the course of the dermatophytosis; repeated infections occurred in patients who showed poor responses to intracutaneous tests and to LMAT. The low proportion of patients exhibiting delayed cutaneous reactivity and migration inhibition in LMAT, limits the diagnostic value of these procedures. They have value in assessing the prognosis of the dermatophytosis. Zusammenfassung Das Vorkommen der zellulären Immunität gegen Dermatophytinantigene wurde bei 63 mitDermatophyten infizierten Patienten und bei 31 nicht-infiziertenKontrollpersonen durch intrakutane Teste und den Leukozyten-Migration-Agarose-Test (LMAT) studiert. Bei 28 Patienten (44%) traten verzögerte Hautreaktionen auf die Dermatophytinantigene auf, während bei den ausgewahlten nicht-infizierten Kontrollpersonen keine verzögerten Hautreaktionen gefunden wurden. Es wurde beobachtet, daß die Dermatophytinantigene im intrakutanen Test miteinander kreuzreagierten. Bei 23 Patienten (43 %) trat eine Inhibition im LMAT mit dem Dermatophytinantigen auf, während bei keiner der Kontrollpersonen eine Inhibition vorkam. Die Resultate der Reaktionen der intrakutanen Teste und des LMAT stehen in guter Korrelation miteinander sowohl bei den Patienten wie audi bei den Kontrollpersonen. Keine Korrelation wurde zwischen dem Migrationsindex und der Größe der verzögerten kutanen Reaktion auf das korrespondierende Antigen gefunden. Es wurde beobachtet, daß die Fähigkeit, die zelluläre Immunitat zu entwickeln, mit dem Verlauf einer Dermatophytose in Korrelation steht; rezidivierende Infektionen traten bei den Patienten auf, die schwache Reaktionen auf intrakutane Teste und auf den LMAT aufwiesen. Die niedrige Proportion der Patienten, die eine verzögerte kutane Reaktivität und Migrationsinhibition im LMAT aufwiesen, begrenzt den diagnostischen Wert dieser Methoden. Diese sind fur die Schätzung der Prognose einer Dermatophytose von Bedeutung.

The efficacy, safety and tolerability of calcipotriol cream was compared with betamethasone 17-valerate cream in the treatment of plaque-type psoriasis in a multicentre double-blind, parallel group study. Patients with stable mild-to-moderate chronic disease were randomized to treatment with either calcipotriol, 50 micrograms/g, in a cream formulation (210 patients) or betamethasone 17-valerate cream, 1 mg/g (211 patients). After a wash-out period of 2 weeks, the treatment was applied twice daily, without occlusion, for 8 weeks or to complete clearing. The severity of psoriasis was assessed using the PASI at baseline and after 4 and 8 weeks treatment. The mean percentage reduction of PASI from baseline to end of treatment was 47.8% in the calcipotriol group and 45.4% in the betamethasone group. The reduction from baseline was highly significant in both groups, but the difference between the groups was not significant. There was a difference in the reduction in thickness of the lesions in favour of calcipotriol. The investigator's as well as the patient's overall assessment of treatment response at end of treatment showed no difference between the two treatment groups. Treatment-related adverse events were more frequent with calcipotriol than betamethasone. Lesional/perilesional irritation was reported in 16% and 9% (P = 0.03), and facial irritation in 10% and 0.5% (P < 0.001), respectively. No change was found in serum levels of calcium. Calcipotriol in a cream formulation was effective, safe, well-tolerated, and equal in effect to betamethasone valerate cream.

There are conflicting reports in the literature about the existence of arteriovenous shunting in legs with chronic venous insufficiency. Using duplex scanning, we have earlier shown that there is lowered peripheral resistance in the arteries of legs with venous ulcer together with premature venous filling in angiography. In the present study we investigated the peripheral resistance in the arteries of 16 legs with chronic venous insufficiency without present ulcer. We compared the results with those obtained from 12 healthy legs and from 18 legs with venous ulcer. There was a highly significant inverse correlation between the severity of chronic venous insufficiency and the peripheral resistance in the popliteal, the dorsal pedal and the posterior tibial arteries (p < 0.001). These results suggest that there is arteriovenous shunting in legs with chronic venous insufficiency and that this phenomenon correlates with the degree of chronic venous insufficiency.

Objective: To investigate the skin laser Doppler flux (LDF) in legs with severe chronic venous insufficiency (CVI). Design: Comparison of the legs with severe CVI with the healthy legs and with the patients' contralateral legs. Setting: Department of Dermatology, University of Turku, Turku, Finland. Patients and control subjects: Ten patients and eight age-matched subjects with healthy legs. Interventions: A single treatment using intermittent pneumatic compression (IPC) of 45 min duration. Main outcome measures: Laser Doppler flowmetry with the subjects in a recumbent and a sitting position. Results: The LDF values were higher for the legs with severe CVI than for the legs of healthy subjects ( p<0.001 in a recumbent and p<0.01 in a sitting position). A single IPC increased the LDF in a recumbent position in the patients' legs with severe CVI ( p=0.019) but had no significant effect on the LDF value in the sitting position. The venoarteriolar response was significantly better in the legs with severe CVI than in the legs of healthy subjects ( p<0.05). Conclusions: The LDF is increased in legs with severe CVI and a single IPC further increases it in a recumbent position. The venoarteriolar response is not impaired in legs with severe CVI.

A woman presented with palmar pustulosis and deep chest pain in association with osteitic lesions in the lower part of the sternum. Propionibacterium acnes was isolated and grew in pure culture from 6 surgically obtained bone specimens. The patient received clindamycin treatment for 6 months. Synovitis in both her wrists persisted and, based on a clinical suspicion of seronegative rheumatoid arthritis, she was treated with intramuscular gold and methotrexate with no apparent benefit. Subsequently, she was diagnosed with SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, and osteomyelitis). Our patient provides further data on the potential association between P. acnes and SAPHO syndrome.

The prevalence of leg ulcers varies from 0.6% to 1.15% in women 65 to 84 years of age and from 0.3% to 0.5% in men of similar age.' Most of the leg ulcers (80% to 90%) are of venous origin. Because local treatment is not always effective.r uncomplicated leg ulcers (ulcers without cellulitis or osteomyelitis) are often treated with systemic antimicrobial agents. Although short-term antimicrobial therapy is ineffective.P preliminary evidence indicates that long-term ciprofloxacin therapy may be beneficial. 6 However, placebo-controlled trials with standardized local treatment, including compression bandages, have not been performed.

Irritant contact dermatitis caused by occupational contact with nitroglycerin has been known since the end of the last century, Nitroglycerin is an allergen, and the transdermal drug deliver; systems for nitroglycerin recently used to treat angina pectoris have sensitized 4 patients with allergic contact dermatitis caused by nitroglycerin from explosives are described, and I patient who was sensitized by transdermal nitroplaster. On patch testing dynamite and/or the explosive components nitroglycerin, ethylene glycol dinitrate and dinitrotoluene gave allergic reactions. The following concentration and vehicles are suggested for patch testing: nitroglycerin 0.5–2% pet., dinitrotoluene and ethylene glycol dinitrate 0.1–0.5% pet., Persons exposed to nitroglycerin at work should try to avoid skin contact by using protective gloves. It is advisable that those who have become allergic to nitroglycerin should wear disposable protective gloves when handling explosives.

We present two patients, a 20-year-old female and an 18-year-old male, who suffered from persistent solid facial edema as a complication of acne vulgaris. They were treated with isotretinoin with moderate response and thereafter with lymph massage with further response. The female patient also received clofazimine with good response.

Forty-three patients with lichen planus (LP) were treated with either oral methoxsalen PUVA (10 cases), bath methoxsalen PUVA (13 cases) or no PUVA (20 cases). In the bath treatment series, a good or excellent clearing of the lesions was registered in 10 out of 13 cases after courses of 8-46 irradiations, while in the orally medicated group only 5 out of 10 had a similar response after 8-30 irradiations. In addition, 11 of the 23 PUVA-treated patients showed progressive improvement of their condition during the first few months after PUVA therapy. A clinical follow-up study was made 15 and 10 months later in the oral and bath PUVA groups, respectively, and at 10 months in the no-PUVA group. Six of the 23 PUVA-treated patients (23%) were found to be totally clear, but the remaining 17 patients (74%) had clinical signs of LP. Eleven of the 20 no-PUVA-treated patients (55%) showed total clearing. It is concluded that while both oral and bath methoxsalen PUVA regimens have a distinct immediate (1-2 months) clearing effect on LP, the late outcome of the rash is not better than with no UV treatment; PUVA treatment may possibly even prolong the ultimate course of LP.

Contact DermatitisVolume 15, Issue 4 p. 246-249 Lettuce allergy: sensitizing potency of allergens B. M. Hausen, B. M. Hausen Department of Dermatology, Division of Allergology. University Hospital, Hamburg, W-GermanySearch for more papers by this authorK. E. Andersen, K. E. Andersen Dermatology Clinic, Roskilde, DenmarkSearch for more papers by this authorI. Helander, I. Helander Department of Dermatology. University of Turku, Turku, FinlandSearch for more papers by this authorK. H. Gensch, K. H. Gensch Pharmaceutical Institute, Free University of Berlin, Berlin, FRGSearch for more papers by this author B. M. Hausen, B. M. Hausen Department of Dermatology, Division of Allergology. University Hospital, Hamburg, W-GermanySearch for more papers by this authorK. E. Andersen, K. E. Andersen Dermatology Clinic, Roskilde, DenmarkSearch for more papers by this authorI. Helander, I. Helander Department of Dermatology. University of Turku, Turku, FinlandSearch for more papers by this authorK. H. Gensch, K. H. Gensch Pharmaceutical Institute, Free University of Berlin, Berlin, FRGSearch for more papers by this author First published: September 1986 https://doi.org/10.1111/j.1600-0536.1986.tb01350.xCitations: 20AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume15, Issue4September 1986Pages 246-249 RelatedInformation

Four patients who were suffering from typical lichen amyloidosus were treated with etretinate (Tigason®). Itching was relieved in all cases within 2 weeks. The lesions were completely cleared in three cases within 10-20 weeks and markedly improved in one case. No amyloid material could be detected in skin biopsies taken after the treatment period of several months. No immediate relapses were observed after discontinuation of the etretinate treatment.

We studied skin test reactivity to five commonly used antigens by testing 150 healthy adults. The delayed hypersensitivity (DH) skin test is widely used to assess the immune status of patients. The battery of antigens suitable for use may vary in different countries, but the reactivity to the antigens in our population did not differ remarkably from reports of other authors. The reactivity rates were: candida 32.7%, mumps 86%, streptokinase-streptodornase (SK-SD) 70%, trichophyton 0% and tuberculin 58.7%. Sixteen of the subjects were retested after 2 weeks. Only eight of them showed unchanged reactions to all five antigens. Specific IgG antibody concentrations measured by enzyme-linked immunosorbent assay (ELISA) against each of the five antigens in the serum of 42 subjects before and after testing showed great inter-individual variation. The antibody concentration did not correlate with the DH skin test results, but the testing itself increased the production of anti-mumps- and anti-SK-SD-antibodies.

Contact DermatitisVolume 11, Issue 4 p. 249-249 Contact dermatitis to lettuce Inkeri Helander, Inkeri Helander Department of Dermatology, University of Turku, SF-20520 Turku, FinlandSearch for more papers by this author Inkeri Helander, Inkeri Helander Department of Dermatology, University of Turku, SF-20520 Turku, FinlandSearch for more papers by this author First published: September 1984 https://doi.org/10.1111/j.1600-0536.1984.tb00993.xCitations: 13AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Rinkel H J, Balyeat R M. Occupational dermatitis due to lettuce. JAMA 1932: 98: 137– 138. 2 Morris G E. Dermatoses among food handlers. Industrial Medicine Surgery 1954: 23: 343– 344. 3 Krook G. Contact dermatitis due to lettuce, Lactuca saliva. Contact Dermatitis Newsletter 1973: 13: 346. 4 Vail, J T Jr, Mitchell, J C. Occupational dermatitis from Chichorium intybus, C. endivia and Lactuca sativa var. longifolia. Contact Dermatitis Newsletter. 1973: 14: 413. 5 Friis B, Hjorth N, Vail J TJr, Mitchell J C. Occupational contact dermatitis from Cichorium (chicory, endive) and Laciuca (lettuce). Contact Dermatitis 1975: 1: 311– 313. 6 Krook G. Occupational dermatitis from Lactuca saliva and Cichorium (endive). Contact Dermatitis 1977: 3: 27– 36. 7 Fregert S, Sjöborg S. Unsuspected lettuce immediate allergy in case of delayed metal allergy. Contact Dermatitis 1982: 8: 265. 8 Piritä V. Chamber test versus patch test for epicutaneous testing. Contact Dermatitis 1975: 1: 48– 52. 9 Hannuksela M, Lahti A. Immediate reactions to fruits and vegetables. Contact Dermatitis 1977: 3: 79– 84. Citing Literature Volume11, Issue4September 1984Pages 249-249 ReferencesRelatedInformation

Contact DermatitisVolume 9, Issue 4 p. 327-328 Contact urticaria to zinc diethyldithiocarbamate (ZDC) Inkeri Helander, Inkeri Helander Department of Dermatology, University of Turku, SF-20520 Turku 52, FinlandSearch for more papers by this authorAnitta Mäkelä, Anitta Mäkelä Department of Dermatology, University of Turku, SF-20520 Turku 52, FinlandSearch for more papers by this author Inkeri Helander, Inkeri Helander Department of Dermatology, University of Turku, SF-20520 Turku 52, FinlandSearch for more papers by this authorAnitta Mäkelä, Anitta Mäkelä Department of Dermatology, University of Turku, SF-20520 Turku 52, FinlandSearch for more papers by this author First published: August 1983 https://doi.org/10.1111/j.1600-0536.1983.tb04413.xCitations: 51AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume9, Issue4August 1983Pages 327-328 RelatedInformation