Oriented fibrin crystallization: a phenomenon of hypersensitivity to bacteria in psoriasis, vasculitis and other dermatoses

Juhlin, Lennart; Shelley, Walter B.

doi:10.1111/j.1365-2133.1977.tb05200.x

Cited by 23 publications

(8 citation statements)

References 11 publications

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“…We also considered that local physical or chemical injury may have played a role in inducing our patient's lesions, but clearly the process has distinctive features and is rare. Bacteria 5 and Pityrosporum organisms 6 in the infundibulum of follicles may induce crystalline structures. Urate‐like crystals that may be negatively birefringent can be seen with cholesterol.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing infundibular crystalline folliculitis.

2001

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We describe a 22-year-old woman with a background of acne who developed multiple folliculocentric facial papules associated with sharply demarcated waxy, keratotic plugs. Multiple skin biopsies showed umbilicated craters that were filled with dispersed bundles of eosinophilic filaments embedded in a pale amorphous matrix forming a plug. The plugs bulged into the upper dermis. Serial sections showed vacuolar and filamentous destruction of the infundibular and adjacent perifollicular epithelium and a close relationship of the crystalline necrosis to follicles. Electron microscopy revealed that the filamentous bundles were tonofilaments. No fresh material was available for polarization and the paraffin sections failed to polarize. The clinical and pathological findings of the lesions in our patient were identical to those reported as a new perforating disorder with urate-like crystals. Our case indicates that the process may represent crystalline folliculocentric necrosis rather than a primary perforating disorder. The nature and basis of the crystals that have a urate-like appearance remain to be determined.

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Section: Discussionmentioning

confidence: 99%

Necrotizing infundibular crystalline folliculitis.

2001

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“…The fibrin microclot formation test when bacterial lipopolysaccharides is added to the patient's blood in vitro was positive in 56",', of the patients tested. The microclots are never seen in healthy subjects but occur in blood from patients with such disorders as vascuhtis, psoriasis, severe eczema and ulcerative colitis (Juhlin & Shelley, 1977). That the test was positive in 24/^,, without adding lipopolysaccharides indicates the presence of circulating endctoxins.…”

Section: Laboratory Investigationsmentioning

confidence: 97%

“…The test was performed as earlier described in detail (Juhlin & Shelley, 1977). Bacterial lipopolysaccharides (£.…”

Section: Microcloi Generation (Mcg) Testmentioning

confidence: 99%

Recurrent urticaria: clinical investigation of 330 patients

1981

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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%.

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“…A second possibility is the development of a complex immune response to microbial antigens present in tissues (18,19). Findings supporting this option were published as long ago as the late 1970s (20), which became very probable with the publication of microbial ® ndings in 1990 (21). In recent years more and more scientists have mentioned superantigens as one of the most important psoriasis-triggering mechanisms (11,22).…”

Section: Discussionmentioning

confidence: 97%

Subclinical Microbial Infection in Patients with Chronic Plaque Psoriasis

Bartenjev¹

2000

Acta Dermato-Venereologica

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Epidemiological evidence implicates bacterial infection as a common triggering stimulus for psoriasis. Recent studies suggest that continuing, subclinical streptococcal and staphylococcal infections might be responsible not only for relapse of acute guttate psoriasis but also for a new episode of chronic plaque psoriasis. In this study 195 patients suffering from a severe form of chronic plaque psoriasis hospitalized between 1996 and 1998 were examined. The presence of subclinical microbial infection of the upper respiratory tract was studied by the cultivation of pathogens from this area. Patients with other provoking factors, such as a positive history of taking any drugs that may exacerbate psoriasis, endocrine and metabolic factors, alcohol abuse, trauma, dental focus and clinically evident bacterial infection, were excluded. Subclinical streptococcal and/or staphylococcal infections were detected in 68% of tested patients and in only 11% of the control group. The results of this study indicate that subclinical bacterial infections of the upper respiratory tract may be an important factor in provoking a new relapse of chronic plaque psoriasis. Searching for, and eliminating, microbial infections could be of importance in the treatment of psoriasis.

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Oriented fibrin crystallization: a phenomenon of hypersensitivity to bacteria in psoriasis, vasculitis and other dermatoses

Cited by 23 publications

References 11 publications

Necrotizing infundibular crystalline folliculitis.

Necrotizing infundibular crystalline folliculitis.

Recurrent urticaria: clinical investigation of 330 patients

Subclinical Microbial Infection in Patients with Chronic Plaque Psoriasis

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