A. Legori

Immunohistologic evaluation of the effect of cyclosporine treatment on the lichen planus immune infiltrate.

We have investigated immunohistologically the cutaneous immune infiltrate in the lesions of five patients with severe, extensive lichen planus of recent onset before and after 15 days of oral, low-dose cyclosporine therapy (3 mg/kg/day). Before therapy, we observed an abnormal bandlike cellular infiltrate localized in the papillary dermis, composed mostly of CD3+ cells, with a prevalence of CD4+ cells. Infiltrating lymphocytes showed markers of activation (HLA-DR antigens and interleukin 2 receptor), and there were many Langerhans (CD1+) cells in the dermal infiltrate. After 15 days of cyclosporine therapy, we observed a dramatic decrease in the total number of T cells and a corresponding decrease in interleukin 2 receptor-positive activated CD25+ cells and in antigen-presenting cells (CD1+ and CD14b+). These changes were concurrent with clinical improvement. Our results are compatible with the hypothesis that the inhibition of CD4 T cells by cyclosporine might explain the drugs therapeutic action and that the interaction between antigen-presenting cells and CD4 T cells is important in the pathogenesis of lichen planus.

Allergic contact dermatitis from beta-interferon in eyedrops

Painful itching and burning started within a few min of exposure, and increased throughout (Fig. !). Itching decreased after the end of exposure while burning continued to increase for at least 10 min post-exposure. After the exposure, the dorsal skin of the hand was moderately erythematous and swollen. The swelling was gone at 100 min post-exposure. 6 h post-exposure, a severe purpuric eruption appeared, which was maximal after 1-2 days and remained for several weeks. The concentration of d-limonene in the blood during dermal exposure was low compared to d-limonene concentrations in blood during inhalation exposure ( 4) (Fig. 2).

Cross-reactions in patch testing and photopatch testing with ketoprofen, thiaprophenic acid, and cinnamic aldehyde.

In the last 7 years, we have studied 123 patients with allergic reactions to topical arylpropionic anti-inflammatory drugs. We have investigated the rate of sensitization and the irritant potential of one of them, ketoprofen, and its cross-reactivity with such other derivatives as ibuproxam, ibuprofen, naproxen, fenoprofen, flurbiprofen, and thiaprofenic acid. Sensitization was single in most cases, and ketoprofen was the drug most often involved. The combination most frequently found was ketoprofen plus ibuproxam. The most frequent cross-reactions were to fragrance mix, especially cinnamic aldehyde and balsam of Peru, both contact and photocontact sensitizers. Because there is a ketonic group in the molecule of ketoprofen and cinnamic aldehyde and after conversion of thiaprofenic acid, this could be the trigger for this particular allergy and cross-reactivity.

Allergic contact dermatitis from Tektamer 38 (dibromocyanobutane).

I. Felix R H, Comaish J S. The value of patch and other skin tests in drug eruptions. Lancet 1974: 1: 1017-1019. 2. Silva R, Machado A, Brandao M, Gom;alo S. Patch test diagnosis in carbamazepine eruthroderma. Contact Dermatitis 1986: 15: 254-255. 3. Roberts D L, Marks R. Skin reactions to carbamazepine. Arch Dermato/1981: 117: 273-275. 4. Crill WE. Carbamazepine. Ann Intern Med 1973: 79: 844-847.

Gruppo Italiano Ricerca Dermatiti da Contatto ed ambientali italian multicenter study of allergic contact photodermatitis: epidemiological aspects

A total of 1,050 patients with histories and clinical pictures suggestive of photoallergic contact dermatitis were seen. All the patients underwent photopatch tests with haptens proposed by the Gruppo Italiano Ricerca Dermatiti da Contatto plus other substances suggested by each patients history. Two hundred fifty-nine patients (24.6%) were positive to at least one test substance of the standard series or to substances added. Typical photoallergic reactions were seen in 198 subjects (259 minus 40 toxic photodermatitis to chlorpromazine and 21 to promethazine), which represents 18.8% of the total population. Topical drugs represent the most involved substances in photodermatitis. The incidence in our population was about equal for antimicrobial agents, additives to fragrances, and fragrances themselves. Other allergens found were salicylanilides, whereas sun-screening agents were the fifth group of haptens but with clear-cut relevance. This study is a first attempt to organize the data about results of photopatch tests applied to Italian patients.

Changes in solar energy reaching the earth: a study of total solar, UVA and UVB radiation in a highly polluted Northern Italian area*

The environment can cause and maintain a number of dermatoses, such as contact dermatitis and photodermatitis. We have recently noted a greater incidence of photodermatitis, even in subjects who declared that they had had no excessive photo exposure and/or who had tolerated normal exposure to sun in previous years. This indicated a possible change in solar irradiation. Consequently, we undertook a study of the climatic and meteorological conditions in northern Italy over the last 12 years (1978–1990). The following variables were considered: air temperature, relative humidity, solar UVA and UVB radiation, both scattered and direct. Annual data show that there has been an increase in scattered solar energy but no change in direct irradiation. There has been a clear reduction in humidity and slight increases in temperature. This is the first Italian report of climatic variations, especially of scattered sun irradiation.