This study confirmed the strong association between the HLA-B*58:01 and allopurinol-induced SCAR in Hong Kong Han Chinese patients. A screening test for the HLA-B*58:01 allele should effectively reduce the risk for allopurinol-induced SCAR in Chinese populations.
Immunodeficiency due to anti-interferon-gamma autoantibody (anti-IFN-γ autoAb) is an emerging adult-onset immunodeficiency syndrome predominantly found in Southeast Asians. It is associated with severe or disseminated infections caused by non-tuberculous mycobacteria (NTM) and other opportunistic pathogens. We describe 3 patients with anti-IFN-γ autoAb who developed reactive and infective dermatoses, and thoroughly review the existing literature on dermatoses associated with the immunodeficiency syndrome. Case 1 developed Sweet's syndrome associated with Mycobacterium chelonae lymphadenitis and penicilliosis. Case 2 suffered from multiple episodes of lobular panniculitis during recurrent infections by NTM, Penicillium marneffei and Burkholderia pseudomallei. Both cases responded to immunomodulating agents including corticosteroid and non-steroidal anti-inflammatory drugs. Case 3 had direct skin invasion by M. chelonae and responded to prolonged anti-mycobacterial therapy. A novel working algorithm is proposed for the diagnosis and treatment of these patients who may be encountered by the dermatologist and histopathologist in clinical practice.
A rat tenotomy model was used to investigate the effect of combined conservative management and pulsed ultrasound (PUS) on the repair of tenotomized Achilles tendon. Hemitenotomy of right medial Achilles tendon was performed in 48 rats without suture, and patella tenotomy was performed to mimic immobilization and limb disuse of an injured limb. PUS and sham PUS were applied to the healing wound for the treatment group and control group for 5 min, 3 times per week for 2 or 4 weeks, respectively. Tensile tests showed that the ultimate tensile strength (UTS) and stiffness of the repaired tendon in the treatment group at 2 weeks reached 48.92 AE 18.39% and 62.48 AE 32.46% of the contralateral normal tendon strength, which were significantly higher than those of the control group (UTS, 30.36 AE 15.46%; stiffness, 33.90 AE 17.59; p < 0.05). At 4 weeks, UTS increased to 77.09 AE 15.31% and stiffness to 92.48 AE 31.12% in the treatment group, significantly higher than those in the control group (UTS, 54.33 AE 18.40%, p < 0.01; stiffness, 65.02 AE 25.48%, p < 0.05). Light microscopy revealed more regular, denser, and better aligned collagen fibers in the healing scar of the PUS-treated healing tendons. The findings suggested that PUS were able to accelerate the healing of the ruptured tendons. ß
Ocular and skin autofluorescence and vascular stiffness correlate in non-diabetic and Type 1 diabetes subjects and are increased in Type 1 diabetes. Tissue advanced glycation end-products correlate with vascular risk factors, including circulating advanced glycation end-products.
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