Publications by authors named "Graham A Johnston"

Article Synopsis
  • Atopic dermatitis (AD) is a prevalent skin condition that can occur in individuals of any age, and while dupilumab shows promising efficacy as a monoclonal antibody therapy, its use has been linked to a higher occurrence of ocular side effects.
  • The British Association of Dermatologists and the Royal College of Ophthalmologists developed guidance on how to manage these dupilumab-related ocular surface disorders (DROSD) after forming a multidisciplinary group to review literature and recommendations.
  • Key recommendations include that treatment with dupilumab should not be delayed for most eye issues, hydration drops are not advised as preventive measures, and specific guidance is provided for managing DROSD in both children under 7 and those older, with a focus on
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  • Acrylate polymers and cross-polymers (ACPs) are common in cosmetics, and a study by the BSCA and CTPA aimed to assess their potential for causing allergic reactions.
  • The study involved patch testing over 1300 patients for reactions to three specific ACPs, finding very few cases of irritant or doubtful reactions, with no confirmed allergies to one of the compounds tested.
  • The overall conclusion is that sensitization to these ACPs at the concentrations tested is rare, suggesting minimal risk of dermatitis in patients already sensitive to (meth)acrylates.
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Article Synopsis
  • The study compares the real-world effectiveness and safety of three treatments for atopic dermatitis: dupilumab, ciclosporin (CyA), and methotrexate (MTX), using data from the A-STAR register in the UK and Ireland.
  • It involved 488 patients (adults and children) and measured treatment outcomes like the Eczema Area and Severity Index (EASI) and quality of life scales over 12 months.
  • Results showed that dupilumab and CyA led to faster improvements in skin severity scores and overall patient outcomes compared to MTX, indicating dupilumab is an effective option in managing atopic dermatitis.
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Background: Patch testing is an important investigation when dermatitis is unresponsive to, or worsened by, topical corticosteroid treatment. There is a balance to be struck between testing too many allergens, which is expensive, time consuming and risks causing sensitization, and testing too few, which risks missing the diagnosis. The current British Society for Cutaneous Allergy (BSCA) corticosteroid series comprises eight allergens and was last updated in February 2007.

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Background: How many patients should we be patch testing? A previous study suggested that the minimum proportion of a population to be patch tested for allergic contact dermatitis was 1:700 annually.

Objectives: To evaluate if the current minimum rate for patch testing has changed over the 20 years since the previous study in order to maximize the value.

Methods: In cooperation with the British Society for Cutaneous Allergy, a proforma for collation of retrospective data between January 2015 and December 2017 was sent to patch-test centers in the United Kingdom (UK) and the Republic of Ireland (ROI).

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Background: Clinical surveillance of the prevalence of contact allergy in consecutively patch tested patients is a proven instrument to continually assess the importance of contact allergens (haptens) assembled in a baseline series.

Objectives: To present current results from the European Surveillance System on Contact Allergies, including 13 countries represented by 1 to 11 departments.

Methods: Anonymized or pseudonymized patch test and clinical data from various data capture systems used locally or nationally as transferred to the Erlangen data centre were pooled and descriptively analysed after quality control.

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Background: Studies suggest that patch testing with formaldehyde releasers (FRs) gives significant additional information to formaldehyde 1% aq. and should be considered for addition to the European baseline series (EBS). It is not known if this is also true for formaldehyde 2% aq.

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Background: There is currently no agreed cosmetic series for use across Europe.

Objectives: To establish allergens currently tested in local and national cosmetic series.

Method: Members of the European Surveillance System on Contact Allergy and the European Cooperation in Science and Technology project TD1206 ("StanDerm") were surveyed to establish their current practice.

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Following injury, the skin undergoes a wound healing process culminating in the formation of a mature scar. Millions of patients worldwide are left with scars every year as a result of trauma or surgery. Scars can be painful, disfiguring and disabling, yet patients report that clinicians are often dismissive of their concerns, unable to identify pathological scars and unaware of treatment options.

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GABA-containing tea has gained popularity as an accessible intervention to reduce the impact of chronic stress-induced autonomic imbalance and increased risk for cardiovascular disease despite a lack of evidence concerning the γ-aminobutyric acid (GABA) content in a cup of the tea and its effects on physiological and psychological stress as measures of cognitive function. We aimed to measure the effects of GABA-fortified tea consumption on heart rate variability (HRV) and stress in 30 participants using a pre-post cohort study design. Ten minute lead II ECG recordings were analyzed with Kubios software.

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Background: Polysensitization, defined as being allergic to three or more haptens from the European baseline series, is considered to reflect increased susceptibility to developing a contact allergy, and is likely to be associated with an impaired quality of life.

Objectives: To evaluate the prevalences of polysensitization across Europe and to analyse factors associated with polysensitization.

Methods: Patch test data collected by the European Surveillance System on Contact Allergies (ESSCA; www.

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Background: Pyoderma gangrenosum (PG) is an uncommon dermatosis with a limited evidence base for treatment.

Objective: We sought to estimate the effectiveness of topical therapies in the treatment of patients with PG.

Methods: This was a prospective cohort study of UK secondary care patients with a clinical diagnosis of PG that was suitable for topical treatment (recruited between July 2009 and June 2012).

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The terpenoid lactones from Ginkgo biloba, bilobalide and ginkgolides, have been shown to act as negative modulators at α1β2γ2L GABAA receptors. They have structural features similar to those of the chloride channel blocker picrotoxinin. Unlike picrotoxinin, however they are not known to produce convulsant effects.

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Purpose: Rosmarinus officinalis, traditionally known as rosemary, has been widely used in traditional medicines and has long been known as the herb of remembrance. However, few studies have investigated the effects of non-volatile components of rosemary on central nervous system function.

Methods: Fractionation of R.

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Flavonoids that are found in nutraceuticals have many and varied effects on the activation of ionotropic receptors for GABA, the major inhibitory neurotransmitter in our brains. They can act as positive or negative modulators enhancing or reducing the effect of GABA. They can act as allosteric agonists.

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Objective: To determine whether ciclosporin is superior to prednisolone for the treatment of pyoderma gangrenosum, a painful, ulcerating skin disease with a poor evidence base for management.

Design: Multicentre, parallel group, observer blind, randomised controlled trial.

Setting: 39 UK hospitals, recruiting from June 2009 to November 2012.

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Analogues of the neurotransmitter GABA containing unsaturated bonds are restricted in the conformations they can attain. This review traces three such analogues from their synthesis to their use as neurochemicals. trans-4-Aminocrotonic acid was the first conformationally restricted analogue to be extensively studied.

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In this overview, we highlight some recent advances in the interaction of natural and synthetic flavonoids with ionotropic GABA receptors. Examples of positive, negative, and neutralizing allosteric modulators as well as allosteric agonists are given. Flavonoids appear to act via multiple binding sites on GABA receptors.

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The inhibitory neurotransmitter γ-aminobutyric acid (GABA) acts through various types of receptors in the central nervous system. GABAρ receptors, defined by their characteristic pharmacology and presence of ρ subunits in the channel structure, are poorly understood and their role in the cortex is ill-defined. Here, we used a targeted pharmacological, NMR-based functional metabolomic approach in Guinea pig brain cortical tissue slices to identify a distinct role for these receptors.

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Muscimol, a psychoactive isoxazole from Amanita muscaria and related mushrooms, has proved to be a remarkably selective agonist at ionotropic receptors for the inhibitory neurotransmitter GABA. This historic overview highlights the discovery and development of muscimol and related compounds as a GABA agonist by Danish and Australian neurochemists. Muscimol is widely used as a ligand to probe GABA receptors and was the lead compound in the development of a range of GABAergic agents including nipecotic acid, tiagabine, 4,5,6,7-tetrahydroisoxazolo(5,4-c)pyridin-3-ol, (Gaboxadol(®)) and 4-PIOL.

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