Evidence-based Danish guidelines for the treatment of Malassezia-related skin diseases.

Internationally approved guidelines for the diagnosis and management of Malassezia-related skin diseases are lacking. Therefore, a panel of experts consisting of dermatologists and a microbiologist under the auspices of the Danish Society of Dermatology undertook a data review and compiled guidelines for the diagnostic procedures and management of pityriasis versicolor, seborrhoeic dermatitis and Malassezia folliculitis. Main recommendations in most cases of pityriasis versicolor and seborrhoeic dermatitis include topical treatment which has been shown to be sufficient.

Diagnostic and neural analysis of skin cancer (DANAOS). A multicentre study for collection and computer-aided analysis of data from pigmented skin lesions using digital dermoscopy.

Background: Early detection of melanomas by means of diverse screening campaigns is an important step towards a reduction in mortality. Computer-aided analysis of digital images obtained by dermoscopy has been reported to be an accurate, practical and time-saving tool for the evaluation of pigmented skin lesions (PSLs). A prototype for the computer-aided diagnosis of PSLs using artificial neural networks (NNs) has recently been developed: diagnostic and neural analysis of skin cancer (DANAOS).

Polyunsaturated fatty acids in plasma, red blood cells and mononuclear cell phospholipids of patients with atopic dermatitis.

Recent studies of polyunsaturated fatty acids (PUFA) in plasma and blood cell components of patients with atopic diseases have indicated disordered fat metabolism as linoleic acid (18:2n-6) tends to be increased while the more unsaturated fatty acids, such as gamma-linolenic acid (18:3n-6) and arachidonic acid (20:4n-6) are present in decreased amounts. To further clarify these abnormalities, we examined the PUFA content in phospholipids derived from plasma, red blood cells and mononuclear cells (MNC) in patients with atopic dermatitis. In plasma no significant differences were found between patients and controls.

Increased urinary excretion of 1.4-methyl-imidazoleacetic acid in patients with atopic dermatitis.

To investigate whether the overall histamine turnover is increased in patients with atopic dermatitis, without respiratory disease, the urinary excretion of the main histamine metabolite 1.4-methyl-imidazoleacetic acid (MIAA) was examined in 23 patients and in 23 age- and sex-matched non-atopic controls. The patients excreted significantly more MIAA than the controls.

Eosinophilic cellulitis: five cases.

Five cases of eosinophilic cellulitis or Wells' syndrome are described. While only few children have been included in earlier reports, 4 of the 5 patients in the present paper were below 10 years of age, with the youngest being only 20 months when the disease started. One of the children developed hard and tender subcutaneous swellings on the scalp, the histology of which showed extensive subcutaneous necrotizing granulomas.

Reduction of the number of immunocompetent cells in the acute stage of herpes zoster.

Circulating and in situ mononuclear cell subsets were phenotypically characterized during both the acute and convalescent phase of herpes zoster infections in 14 patients. In peripheral blood a significant reduction in the absolute number of Leu 4+ T cells, Leu 2a+ suppressor/cytotoxic T cells, Leu 3a+ helper/inducer T cells, Leu 7+ killer cells, and B1+ B cells were found during the acute stage compared to convalescents and normal controls. In contrast no change in the absolute number of MO2+ monocytes was seen in the acute stage of the disease.

Dapsone in the treatment of cutaneous lupus erythematosus.

Thirty-three patients with chronic discoid lupus erythematosus (DLE) who had received dapsone for 1-27 months were reviewed. The dapsone treatment gave excellent results in 8 patients (24%), some effect in 8 patients (24%), while no response was seen in 17 patients (52%). Of the patients who had earlier been treated with hydroxychloroquine (HCQ), 76% responded excellently to the treatment.

Circulating lymphocyte subsets in patients with alopecia areata.

Lymphocyte subsets in peripheral blood of fourteen patients with patchy alopecia areata or alopecia universalis were estimated using monoclonal antibodies and immunofluorescence. The median percentage of circulating Leu 2a, 3a, 4 and 7 positive cells ("T-suppressor/cytotoxic", "T-helper/effector", total T-cells and killer and natural killer cells) were normal.

Delusions of infestation treated with pimozide: a follow-up study.

Fourteen patients with monosymptomatic delusions of infestation were followed-up 19-48 months after treatment with pimozide was terminated. Seven patients had remained in remission since the treatment. Three had developed relapses, but were without symptoms with intermittent treatment.

Recall of UVB-induced erythema in breast cancer patient receiving multiple drug chemotherapy.

One day after sunbathing, a breast cancer patient received intravenous methotrexate, cyclophosphamide and 5-fluorouracil and had a recall of her UV erythema over the following week. Phototesting with UVA and UVB prior to and after a subsequent chemotherapy treatment showed a UVB-induced recall of erythema, as well as a phototoxicity-like response. Skin biopsies from test sites were compatible with phototoxic dermatitis.

Sister chromatid exchange in patients treated with methotrexate for psoriasis.

Sister chromatid exchange (SCE), which is considered a sensitive method in evaluation of mutagenicity and may be an indicator of carcinogenicity, was determined in lymphocytes from 8 patients with severe psoriasis who underwent treatment with oral methotrexate (MTX). During the treatment period (median 118 days, range 50-298 days) a significant increase in SCE compared to the pretreatment value was found in 1 patient only. It is concluded that no long-term damage as measured by SCE occurs in lymphocytes from psoriasis patients treated with MTX.

Urticaria pigmentosa treated with oral disodium cromoglycate.

4 patients with urticaria pigmentosa were treated with oral disodium cromoglycate (DSCG) for 2 months. During the treatment urine excretion of the main histamine metabolite, 1,4-methylimidazoleacetic acid (MIAA), was determined, and sequential skin biopsies were examined. DSCG was found to have beneficial effect on pruritus and whealing in 3 patients.

Acute febrile neutrophilic dermatosis with genital involvement.

More than 80 cases of acute febrile neutrophilic dermatosis have been published since Sweet in 1964 described the syndrome. Besides skin eruptions, some patients have mucous membrane lesions involving mouth and lips. This report describes a patient with a pustular eruption consistent with Sweet's syndrome, who is believed to be the first with involvement of genital mucosa.

Pityriasis amiantacea and psoriasis. A follow-up study.

59 patients with pityriasis amiantacea (PA) were followed up after 8 years on average. 15% had suffered from psoriasis and 19% were aware of psoriasis in their relatives. The incidence of psoriasis was significantly higher (p less than 0.

Oral disodium cromoglycate treatment of atopic dermatitis.

Fourteen adults and 10 children with active atopic dermatitis entered this double blind cross-over study of oral disodium cromoglycate (DSCG) (adults 200 mg qid, children 100 mg qid) compared with placebo. Oral DSCG and placebo were given for 6 weeks in random order. According to the investigators' assessments of eczema, significant differences between active and placebo were found after 6 weeks' treatment, DSCG being favoured (P less than 0.

Discoid lupus erythematosus and carrier status of X-linked chronic granulomatous disease.

Discoid lupus erythematosus (DLE)-like lesions and recurrent aphthous-like stomatitis have often been described in carriers of X-linked chronic granulomatous disease (CGD). The capacity of the polymorphonuclear leucocytes to reduce nitroblue tetrazolium (NBT) after stimulation with phorbol myristate acetate (NBT test), a function of normal oxidative metabolism, was determined in 34 patients with DLE of whom 17 also suffered from recurrent stomatitis. The NBT test turned out to be normal in all 34 patients, indicating that none of them were carriers of X-linked CGD.

Skin carcinomas and treatment with photochemotherapy (PUVA).

A 3 1/2-year follow-up study of 198 patients treated with photochemotherapy (PUVA) revealed a total of 18 carcinomas developed in 11 patients. There were 12 basal cell carcinomas and 6 squamous cell carcinomas, localized mainly on non-sun-exposed areas. Furthermore 9 actinic keratoses were diagnosed in 8 patients.