A questionnaire was used from 1972-1978 for 330 consecutive patients with recurrent urticaria of 3 months to 40 years duration. Fifty men and fifty women had only urticaria. The rest had both urticaria and angio-oedema and most of them were women between 24 and 38 years of age. Urticarial attacks were less frequent during the daytime. A personal history of rhinitis, asthma or atopic dermatitis was recorded in more than one-third. Nasal polyps, migraine and arthralgia were found in 6-7% of the patients. Severe psychiatric problems were mentioned by 16%. Abdominal problems, mainly gastritis, were described by 44%. A history of side effects from drugs was found in 32% of the patients. Food was mentioned as a factor worsening the weals by 30% and drinks by 18%. Fruits, vegetables and nuts were the most common. Despite all cases with physical urticaria having been excluded, physical factors such as exercise were considered by 20% to make the urticaria worse. Provocation tests with various food additives such as azo dyes, benzoates, butylated hydroxytoluene (BHT), butylated hydroxyanisole (BHA) sorbic acid, quinoline yellow, carotene, canthaxanthine, annatto and nitrite revealed one or more positive reactions in one-third of the patients, one-third showed negative provocation tests and, in the rest, one or several tests were questionable. Routine history of other diseases. The fibrin microclot generation test which test which indicates the presence of circulating endotoxins was positive in 24%.
Transplantations are the methods of choice in stable types of leucoderma. Progressive, widespread vitiligo vulgaris should never be selected for transplantation.
The aim of this study was to test the usefulness of a melanocyte-enriched cell suspension for the treatment of leucoderma. After removal of a superficial (4-30 cm2) skin sample, the cells were mechanically separated in a trypsin-EDTA solution, centrifuged and washed in a melanocyte medium. The melanocyte-enriched epidermal cell suspension devoid of stratum corneum and stratum granulosum was then applied to the dermabraded depigmented skin. The 26 patients treated had piebaldism (three), vitiligo vulgaris (17), segmental vitiligo (three), halo naevi (one), naevus depigmentosus (one) and chemical leucoderma (one). In patients with widespread piebaldism we found that by diluting the cell suspension the recipient area could be increased to up to 10 times the size of the donor area with the same good results as without or with less dilution. In patients with vitiligo areas of between 50 and 90 cm2, the recipient areas were increased three- to fivefold in the donor area. Patients with piebaldism, segmental vitiligo and halo naevi healed completely, as did most patients with vitiligo. In naevus depigmentosus no effect was seen. Our new method for treatment of leucoderma has the advantage that cell culture is not needed and that it is more suitable than epidermal sheet grafts when several small areas are to be treated.
Solid spherical particles (radius 300–700 Å) of methyl‐methacrylate marked with a fluorescent dye were administered to dogs by continuous intravenous injection in order to obtain a steady plasma concentration. Lymphatics were cannulated and lymph collected from four regions of the body: leg, liver, heart and bronchial lymphatics. The passage of particles across the blood‐lymph barrier was measured by means of simultaneous concentration measurements in blood and lymph, Particles up to 700 Å radius readily passed into liver lymph with a lymph‐plasma ratio of approximately 0.20 in the “steady state”. No measurable amounts of these particles were found in the lymph from leg, heart or bronchial lymphatics. In these regions protein molecules of “effective diffusion radii” up to 120 Å pass into lymph. If the large proteins pass by “bulk flow” through water filled pathways the size of these pathways or “capillary leaks” would lie between 120–300 Å radius.
The effects of the cutaneous application of EMLA cream (a eutectic mixture of lignocaine and prilocaine in their base form) were studied in volunteers. When tested by pin-prick, EMLA cream 2.5% and 5% produced analgesia of the area tested, the cream being most effective if left in contact with the skin for 60 min. The pain produced by the insertion of an i.v. cannula was successfully blocked by the application of this formulation, especially if applied to the antecubital area. Temporary blanching of the skin areas was frequently observed on removal of the occlusive tape bandages, but prolonged, or repeated, application of 5% EMLA cream did not produce local skin reactions. Tests for delayed hypersensitivity reactions were negative. Plasma concentrations of lignocaine and prilocaine were low after a standard application.
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