Henning Schmidt

PUVA‐induced bullous pemphigoid

The disixibution of lesions in pemphigus erythematosus is ascribed to the adverse effect of sunlight on this type; of pemphigus. It has been shown that a positive Nikolsky-sign could be provoked by exposure to an erythema-producing dose of UV-light (Cram & Winkelmann, 1965). UV-light of wave lengths shorter than 320 nm applied to the normal skin of six patients, four with pemphigus vulgaris and two with bullous pemphigoid, produced fresh histological and immunohistochemical changes in the irradiated sites (Cram & Fukuyama, 1972). This report concerns the provocation of bullous pemphigoid in two psoriatics during oral treatment with 8-raethoxypsoralen (8-MOP) and UVA (PUVA therapy).

Beta-carotene in erythropoietic protoporphyria: 5 years' experience.

36 patients from 19 families with erythropoietic protoporphyria were treated for about 5 years during the summer months with beta-carotene alone or beta-carotene plus canthaxanthin in daily doses of 50-200 mg. The effect of the treatment was evaluated clinically on the basis of information provided by the patients regarding the period of time they could stay in the sun. 18 patients became completely free of symptoms, 16 patients improved to some extent, and 2 patients noted a slight effect. Apart from the carotenaemia, no side-effects were recorded.

Etretinate (Tigason®) and Betamethasone Valerate (Celeston Valerate®) in the Treatment of Psoriasis

A randomized trial with 146 psoriatic patients studied the relative merits of (1) oral etretinate (daily dose approximately 1 mg/kg body weight); (2) 0,1% betamethasone valerate cream twice daily, and

Petechial reaction following patch testing with cobalt

A total of 132 patch tested patients reacted with petechial reactions to cobalt chloride 1 % in petrolatum; 23 were retested with various concentrations of cobalt. In about 60% of those retested the petechial reaction could be reproduced. Histopathological examination showed slight perivascular tymphocytic infiltration, swollen endothelium and extravasation of erythrocytes but no signs of vasculitis.

Occurrence of lichen planus in a family. Genetic susceptibility or coincidence

A family is presented in which three out of five members suffered from lichen planus. The two children with the disease had inherited the same HLA haplotype from the father, also suffering from lichen planus. A healthy son had the other HLA haplotype from his father. This observation points to a susceptibility gene existing and that this gene may be located in the HLA region.

Treatment of Dyskeratosis Follicularis Darier with the Retinoic Acid Derivative Ro 10–9359 (Tigason®)

The results of treatment of 29 patients with Dariers disease with the aromatic retinoid Ro 10-9359 are reported. Therapeutic tests for a period of more than 18 months seem to justify its use in Dariers disease. With a modest dose it is possible to keep the symptoms at an acceptable level, i. e., 50% clearing or more without too troublesome side effects. Because of the side effects the dosage must be fixed individually. It is pointed out that with the development of Ro 10-9359, an efficient remedy for Dariers disease has become available for the first time.

Benign chronic bullous dermatosis of childhood associated with coeliac disease

SIR, We were very interested in the article by Marsden et al. (1980) on benign chronic bullous dermatosis of childhood (BCBDC) which seems to be a distinct clinical entity among the bullous diseases of childhood (Marsden, Skeete & Black, 1979; Chorzetski & Jablonska, 1979). Dr Marsden and co-workers (1980) state that BCBDC among other features is different from dermatitis herpetiformis in not being associated with coeliac disease. We want to present a typical case of BCBDC associated with and preceded by coeliac disease; however, both diseases were selflimiting during childhood. The patient was an 11-year-old boy who was admitted to the Paediatric Department, Odense University Hospital, at 2 years of age due to increasing fatigue, loss of appetite, failure to thrive and voluminous light coloured stools. On examination he was found to be slim, anaemic, and with sparse subcutaneous fatty tissue and a protuberant abdomen. Laboratory findings showed a low total serum protein, hypocalcaemia and an increased content of fat in the stools. Jejunal X-ray examination revealed clumping of the barium. A diagnosis of coeliac disease was based on the typical clinical picture. A gluten-free diet quickly improved his general condition, his weight increased, and his stools normalized. A jejunal biopsy was not performed.

Atopic dermatitis and congenital deafness

In a family with perceptive, non‐progressive hearing loss several of the members suffered from atopic dermatitis. The proband had a severe atopic dermatitis and an extremely high IgE value. Some of the family members suffered from atopic dermatitis, others from deafness, and some from both diseases. The co‐existence of these two disorders has been previously described in two families. Atopic dermatitis and perceptive, non‐progressive congenital deafness might be genetically associated.

Treatment Modalities of Psoriatics Over a 6-Year Period (1975–1981)

For an evaluation of the various treatments given to psoriatics, a total of 243 outpatients, all seen in 1975, were followed during a 6-year period. 18.1% underwent only one sort of treatment, 44.9% two sorts and 18.1% three sorts. The rest underwent four or more treatment modalities. Topical steroids were the most commonly used form of therapy given to 88.5%. Grenz-rays were given in small amounts to 73.3%, most often as a supplement to topical steroids. Methotrexate was given to 12.3%, PUVA to 13.6%, etretinate to 3.3% and UVB to 1.2%. 26.3% were treated as inpatients during the observation period, and finally 7.0% were treated at the Dead Sea.

The Retinoic Acid Derivative Ro 11-1430 (Tasmademi®) in Patients with Acne vulgaris not Tolerating Retinoic Acid

In a double-blind randomized comparative multicenter trial, consisting of 29 patients with acne vulgaris who were unable to tolerate daily applications of retinoic acid, the retinoic acid derivative Ro 11–1430 (0.1% vanishing cream) was compared in a 6–8 weeks topical treatment with vanishing cream alone (placebo). Regarding efficacy, for most criteria measured the response was always better with Ro 11–1430 than with placebo, although the differences were not always statistically significant for several reasons, one probably being the small number of patients in the trial. Regarding tolerance, both treatments were satisfactory. Ro 11–1430 and placebo did not differ significantly regarding frequency and severity of erythema, desquamation and burning. These results suggest that treatment with Ro 11–1430 should be considered in acne patients who are unable to use retinoic acid due to severe local reactions.