The frequency of autoimmune disorders was determined in 373 vitiligo patients and in controls matched for sex, age and race. Vitiligo patients had an increased frequency of clinical autoimmune diseases of thyroid (7.5%), stomach (0.8%), parathyroid (1%), adrenal gland (1.3%). Vitiligo patients, without clinical signs of overt autoimmune diseases, also had a statistically significant increase in the frequency of gastric parietal cell (p < 0.001), thyroid microsomal (p < 0.05) and adrenal autoantibodies (p < 0.05). This increased incidence of autoimmune manifestations was correlated with the duration of vitiligo. Furthermore in 94% of the patients with parietal cell autoantibodies a gastric biopsy showed atrophic gastritis. In addition, in 48% of the patients with thyroid microsomal autoantibodies and in 2 out of 6 patients with adrenal autoantibodies without overt diseases at the beginning of the study, the functional investigation of the target organs during the follow-up allowed the detection of the presence or that of the subsequent development of clinical or subclinical dysfunction.

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Anticardiolipin antibodies (aCL) of immunoglobulin (Ig) G and M classes were determined in 28 patients affected with chronic discoid lupus erythematosus (CDLE), comparing their prevalence and levels to those in 60 healthy subjects matched for age and sex. A high and significant frequency of IgG (67.8%) and IgM (50.0%) aCL together with prevalence of high antibody levels was found in CDLE patients, while healthy controls had IgG and IgM aCL in 1.6% and 3.3% of cases respectively. Clinical features in keeping with the diagnosis of antiphospholipid syndrome were found in one patient (3.5%), which, as the first manifestation of the syndrome, showed a pulmonary thromboembolism which appeared some days after prolonged exposure to the sun. These results provide additional data on autoimmune phenomena in CDLE and suggest that aCL test should be considered as useful aids in immunological diagnosis of CDLE.

We analyzed the cutaneous reactions to systemic analgesic-antipyretics and nonsteroidal anti-inflammatory drugs reported to the spontaneous reporting system of the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED). The system has been active since 1988, with periodic intensive surveillance exercises, and 202 dermatologists have collaborated. Up to December 1991, 2,137 reactions had been collected, of which 713 were reactions to systemic analgesic-antipyretics and nonsteroidal anti-inflammatory drugs. A general profile of the reactions was identifiable. It included, in order of frequency, urticaria/angioedema, fixed eruptions, exanthemas, erythema multiforme and Stevens Johnson syndrome. Fixed eruptions and Stevens Johnson syndrome were reported with exceedingly high frequency in association with feprazone. Our system also revealed previously unreported reactions, including fixed eruption to nimesulide, fixed eruption to piroxicam and fixed eruption to flurbiprofen.

Oral lichen planus can cause considerable inconvenience to the patient and is often resistant to the various therapeutic options used, tending to become chronic. The monochromatic excimer light 308 nm is UVB radiation generated and has already been used with good results in the treatment of psoriasis, vitiligo and, less frequently, lichen cutaneous. The purpose of this study is to assess the clinical efficacy of monochromatic excimer light in the treatment of symptomatic oral lichen planus. Twenty patients were treated weekly with single phototherapic sessions. The therapy was suspended on achieving a total score of gravity at least 35% or less than the score of departure. At the end of the study scoring on the size of lesions, intensity of white, intensity of erythema, grade of sick oral gingiva, for both gingival and non-gingival lichen was improved. The statistical processing found a highly significant reduction in post-therapy (p< 0002) of all subjective manifestations tested. Side effects were not observed. Our study shows that monochromatic excimer light 308 nm would appear to be an effective and well-tolerated treatment for oral lichen planus and could represent a new additional therapeutic strategy.