Impetigo herpetiformis: A case report

Impetigo herpetiformis: A case report

Posters- Psoriasis and related disorders Plasma levels of selected cytokines and acute phase proteins in 2 groups of psoriatic patients treated with c...

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Posters- Psoriasis and related disorders Plasma levels of selected cytokines and acute phase proteins in 2 groups of psoriatic patients treated with cyclosporin A or methotrexate G. Chodorowska, D. Czelej, D. Krasowska, A. Pietrzak, B. Lecewicz-Torun. Deparhneut of Dermatology, Medical School, Lubfin, Poland Two groups of male patients were treated with the potent antipsoriatic agents. I/ 13 patients were given cyclosporin A at a daily dose of 2.5 mglkg. Mean duration of treatment was 11 weeks. 2/ 18 patients were given methotrexate 3 times a week, at a weekly dose of 30 mg. Mean duration of treatment was 5 weeks. The plasma levels of: IL-2, IL-2R, IL-6, IFN-y, TNF-(w, GM-CSF, C-reactive Protein and (r-2 Macroglobulin were measured before and after treatment. Mean levels of examined cytokines and acute phase proteins were significantly higher before treatment in all psoriatic patients when compared to the healthy control. After treatment values of the measured parameters were deeply decreased in both groups of patients, but cyclosporin A proved to be more efficient in reducing the levels of examined proteins. A case report I P465 Impetigo herpetiformis: T. Uygur Derin. T. Mansur, 0. Giiney, M. 8zcivan. HaydarpaFa Numune Hospital, Isranbul, Turkey Impetigo herpetiformis is usually considered to be an acute pustular phase of psoriasis precipitated by a metabolic state such as hypoparathyroidism or pregnancy or both. We report a case of 32 year-old patient who presented with fever, chills and a generalized eruption. She was in the 36th week of her third pregnancy. She had no other skin disease prior to this episode. She had a medical history of a thyroidectomy 13 years ago. Physical examination showed erythematous patches studded with tiny superficial pustules all over the body. Chvostek’s and Trousseau’s signs were positive. Laboratory investigation showed the following values: sedimentation rate 90 mm/h; white blood cell count 143OO/cu mm with 90% neutrophils 6% lymphocytes, 3% monocytes, 1% eosinophils; serum calcium 3.2 mg/dl; phosphorus 6. I gr/dl; alkaline phosphatase 498 IU/ml; LDH 1110; parathormone 1.9 pg/ml (N = 12-72). Cultures from pustules showed no growth. A biopsy specimen of the pustule showed a subcorneal pustule filled with neutrophils. The patient was treated with intravenous fluid replacement, calcium glubionate, calcitriol. She had a normal healthy baby after induced delivery. After delivery, serum calcium level returned promptly to normal and the skin lesions resolved completely. I P466

Freqency of complement components (C3, BF, C4A, C4B) allels appearance in patients with psoriasis vulgaris

M. Cislo, J. Halasa, E Wpsik, P Nockowski, P. KuSnierczyk. Department of Dermatology, Wtxxtaw; Institute of Immunology and Experimental Therap): Polish Academy of Sciences, Wroctaw, Poland Immunologic reactions influenced by complement components among which some (BF, C4) are coded by histocompatibility

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antigens of class III, play an important role in the pathogenesis of psoriasis vulgaris.Since they have a few allels an attempt of comparing frequency of their appearance in patients with psoriasis vulgaris and in healthy population was made. Frequency of appareance of allels for C3 and BF genes was comparable in both examined groups. Allel C4A 6 was 2.4 times more, and allel C4B 2 was 2.4 times less frequently encountered in patients with psoriasis as compared to healthy individuals.Rare encountered allel C4B 3 was 11 times more frequently found in patients with psoriasis as compared to healthy population. Since C4A and C4B genes are conjugated with HLA Cw6 gene which seems to be attributed to psoriasis vulgaris, differences in their allels expresion may contribute to better understanding of genetic ground of the disease. I P467

Psoriasis vulgaris: contemporary possibilities of diagnostics and therapy

T. JoviCt, M. Paravina*, M. Stanojevif’. ‘PharmaceuticalChemical Industry D.D. “Zdravije”, Leskovac; 2The Clinic of Skin and Venereal Diseases, NiS, Yugoslavia The authors, by analyzing 196 patients affected with Psoriasis vulgaris, treated in the period of 1990. to 1996. year, explained the methods of contemporary diagnostics and therapy of this disease. Besides the history of the disease and characteristic clinical picture which was followed by characteristic phenomena of the disease, the diagnosis is made on the ground of a very specific pathohystological finding. The treatment of the therapy is based on simultaneous application of general and local therapy that must be followed by the diet as well as with a suitable physical therapy in the sense of hydrotherapy and photo-chemotherapy. The obtained results presented by the tables enable an insight into percentage of appropriate diagnostic and therapeutic methods and their efficiency. The poster abounds in the photos of characteristic phenomena and clinical signs manifested in Psoriasis vulgaris. I P468

The enkephalin levels in psoriasis treatment with heliobalneotherapy

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J. Nissen, W. Avrack, E.S. Hansen, K. Kragballe. Dept. of Dermatology, Marselisborg Hasp, Aarhus; Skin Clinic, Copenhagen; Dept. of Pathology, Aarhus, Denmark Increased enkephalin levels are present in psoriatic lesions. The purpose was to determine the effect of heliobalneotherapy on enkephalin levels in psoriatic skin. Ten patients were treated at the Dead Sea for 4 weeks, and keratome biopsies were obtained. The enkephalin levels were measured by radioimmunoassay. Despite a complete clinical clearance, there was only a slight reduction in the amount of enkephalin (21%) after therapy. Furthermore, the level of enkephalin was high in uninvolved psoriatic skin after heliobalneotherapy. Immunohistochemical staining of punch biopsies showed enkephalin immunoreactivity in both keratinocytes and monocytes/lymphocytes. These findings might result from a stimulatory effect of UV irradiation on skin enkephalin levels. Therefore, normal persons were exposed to a single dose of UVA and UVB light (2 MED). UVA,