Multicentre patch test study of air-oxidized ethoxylated surfactants.

Frequent exposure to water and surfactants is considered to be the main cause of hand eczema from wet work. Ethoxylated surfactants are susceptible to oxidation and some of the oxidation products formed have proved to be contact sensitizers in guinea pigs. The question of human sensitization to oxidized surfactants was addressed in a multicentre study in the Stockholm region.

Peripheral neuropathy in acrodermatitis chronica atrophicans - effect of treatment.

Forty-seven patients with the late borrelial manifestation acrodermatitis chronica atrophicans (ACA) and with objective neurological and/or neurophysiological findings were followed up after antibiotic treatment with dermatological, serological, neurological and neurophysiological controls. Despite a good therapeutic effect on ACA lesions, specific antibody values and symptoms of irritative nerve lesions, the objective neurological and neurophysiological findings of nerve deficit remained unchanged. There was no progress of neuropathy findings during the follow-up time.

Polyneuropathy in late Lyme borreliosis - a clinical, neurophysiological and morphological description.

In a prospective study, detailed clinical and neurophysiological examinations were performed in 17 patients with polyneuropathy associated with the late borrelial manifestation acrodermatitis chronica atrophicans (ACA). Similar clinical and neurophysiological signs were found in most of the patients. The findings were those of a sensory polyneuropathy, mainly affecting large nerve fibres.

No evidence for specific in vitro lymphocyte reactivity to HgCl2 in patients with dental amalgam-related contact lesions.

Blood lymphocytes from 20 patients with oral contact lesions to dental amalgam and 10 healthy individuals were analyzed for HgCl2-induced proliferation in vitro, using both a modified assay and a conventional assay. The release of interferon-gamma (IFN-gamma) was measured in cell supernatants. Six patients displayed positive reactions in patch tests to mercuric compounds.

[Despite better knowledge of pathogenesis and treatment: atopic eczema--a disease with increasing incidence in Sweden].

The past twenty years have witnessed an increasing incidence of atopic dermatitis in Western Europe. The article consists in a discussion of the pathogenesis, clinical signs and treatment of this common skin disease. Both an IgE-mediated reaction on epidermal Langerhans cells, and a physiological/biochemical defect of the skin barrier structure may be crucial factors of the multifactorial pathogenesis.

Acrodermatitis chronica atrophicans: histopathologic findings and clinical correlations in 111 cases.

We studied 111 consecutive, untreated and serologically confirmed patients with acrodermatitis chronica atrophicans. Emphasis was on the histopathologic patterns of erythematous and fibrous lesions, and on an assay used to correlate histopathologic findings with such clinical features as fibrous nodules, ulnar bands and the pain reaction allodynia. There was a significant correlation between allodynia and signs of marked inflammation, but not between allodynia and neural and perineural cell infiltrates or fibrosis.

Peripheral neuropathy in acrodermatitis chronica atrophicans - a late Borrelia manifestation.

Clinical and/or neurophysiological signs of peripheral neuropathy were found in 64% of 63 consecutive untreated patients with the late borrelial manifestation acrodermatitis chronica atrophicans (ACA). The neuropathy frequency was significantly higher in the patients than in 30 age- and sex-matched control persons of whom 27% had neuropathy findings. The most common neuropathy in ACA was a symmetric distal sensory polyneuropathy.

Polymerase chain reaction for detection of Borrelia burgdorferi DNA in skin lesions of early and late Lyme borreliosis.

The aim of this study was to evaluate the polymerase chain reaction (PCR) as a diagnostic tool for Lyme borreliosis on large numbers of samples from clinically well-defined cases of early and late cutaneous borreliosis. Skin biopsy specimens from patients with erythema migrans and acrodermatitis chronica atrophicans were analysed blindly together with an equal number of control biopsies. Using two different dilutions of each DNA specimen increased the number of total positives detected.

Roxithromycin in Lyme borreliosis: discrepant results of an in vitro and in vivo animal susceptibility study and a clinical trial in patients with erythema migrans.

A new semisynthetic macrolide roxithromycin was evaluated for its potential use in the treatment of Lyme borreliosis. Using a macro-dilution broth technique, Borrelia burgdorferi was shown to be susceptible to roxithromycin with a minimal bactericidal concentration (MBC) of 0.06-0.

Comments on the course and classification of Lyme borreliosis.

On the basis of answers by clinicians to a questionnaire concerning the classification and staging of Lyme borreliosis, the following classification is proposed: EARLY LYME BORRELIOSIS Localized infection: Erythema migrans and borrelial lymphocytoma without signs or symptoms of disseminated infection. (Regional lymphadenopathy and/or minor constitutional symptoms may be present). Early disseminated infection: Multiple erythema migrans-like skin lesions.

Comparison of four different serological methods for detection of antibodies to Borrelia burgdorferi in erythema migrans.

Three different enzyme-linked immunosorbent assays (ELISA) and Western blot were compared in regard to the detection of antibodies to Borrelia burgdorferi in sera from 100 patients with erythema migrans and from 100 controls. For IgG detection, a commercial indirect ELISA kit with flagellum antigen (flagellum ELISA) was significantly more sensitive than the routinely-used indirect ELISA with sonicated whole-cell antigen (sonicate ELISA) (p = 0.008).

Lyme borreliosis: aspects of tick-borne Borrelia burgdorferi infection from a dermatologic viewpoint.

During this decade, Lyme borreliosis has emerged as an important health problem, especially in Europe and in the United States, and there has been an explosive growth of knowledge about this condition. The true incidence of lxodes-borne borrelial infection is probably increasing, at least in parts of the world, but the reported increase is also partly attributable to a greater recognition and awareness of this infection. This paper reviews the basic knowledge about Borrelia burgdorferi, its vectors, and its reservoirs.

Brainstem response audiometry in chronic Lyme borreliosis.

Auditory brainstem responses (ABR) were investigated in 26 patients with acrodermatitis chronic atrophicans, which is a late manifestation of Lyme borreliosis. Nine of the patients showed pathological ABR, four of them unilaterally and five bilaterally. The main pathological findings were: 1) Poor reproducibility of waves IV-V or of wave V; 2) Increased latency of wave V.

First isolations of Borrelia burgdorferi from rodents collected in northern Europe.

Spirochetes were found in 13% of Ixodes ricinus collected from an island, near Stockholm where human borreliosis is endemic. Borrelia burgdorferi was cultivated from the kidney and/or spleen of wild rodents (Clethrionomys glareolus and Apodemus flavicollis) from the same island. Spirochetes were identified as Borrelia burgdorferi by indirect immunofluorescence assays using species and genus specific monoclonal antibodies.

Tick-borne borreliosis and facial palsy.

During a one-year period, 82 consecutive patients seeking medical attention for facial palsy primarily of unknown etiology were examined for underlying Ixodes ricinus-borne borreliosis. Evidence of the infection was found in 16 (20%) of the patients, most of whom had cerebrospinal fluid findings indicating meningeal involvement. Among 9 children included in the study, borreliosis was found in 6 cases.

IgG subclasses of specific antibodies in Ixodes ricinus-borne borreliosis.

Ixodes ricinus-borne borreliosis may run a protracted course. In this study we investigated the different IgG subclasses of antibodies to borreliae at different stages of the disease. In addition to the dominant subclass IgG1 and IgG3 response was found in most cases.

Human epidermal Langerhans' cells in bullous pemphigoid.

Through the epidermal analysis of 13 patients with bullous pemphigoid compared to controls, using OKT6 monoclonal antibodies on the light microscopic level and electron-microscopy, we found a redistribution of the Langerhans' cells towards the basal membrane in combination with an increased total number of Langerhans' cells. This redistribution was also noted in clinically normal skin from patients with bullous pemphigoid. The findings may be consistent with the theory of antigen presentation.