Richard L. Dobson

Association between fluorescent antinuclear antibodies, capillary patterns, and clinical features in scleroderma spectrum disorders

Antinuclear antibody and in vivo capillary patterns were studied in 33 patients with Raynauds phenomenon only and in 68 patients with scleroderma spectrum disorders; the results were correlated with clinical and laboratory findings. In addition, antinuclear antibody results in the groups with Raynauds phenomenon only and scleroderma spectrum disorders were compared with those found in 70 patients with systemic lupus erythematosus (SLE). Distinct antinuclear antibody profiles were observed in the three diagnostic groups. Comparison of patients with anticentromere antibodies with others in the group with scleroderma spectrum disorders demonstrated that anticentromere antibody-positive patients tended to have a milder disease: less skin and visceral involvement, less frequent presence of hypertension, anemia, and elevated sedimentation rate. These differences did not, however, reach statistical significance. Comparison of patients with scleroderma spectrum disorders according to in vivo capillary patterns revealed that those with an active pattern had significantly more extensive skin involvement than those with a slow pattern. Visceral involvement tended to be greater in all organ systems in the group with an active pattern and reached statistical significance for muscle and kidney. Hypertension was also significantly more frequent in the group with an active pattern than in the group with a slow one. The latter was positively correlated with the presence of anticentromere antibody.

EFficacy of the drionic unit in the treatment of hyperhidrosis

A portable iontophoretic device (the Drionic unit) has recently been introduced for the treatment of hyperhidrosis. Twenty-two patients with hyperhidrosis were treated at twenty-seven sites (axillae, palms, soles) with this unit. Sweat output was measured by use of Persprint paper and the data were quantified by an image analysis computer. The data clearly demonstrate the efficacy of the Drionic unit at all treatment locations in the great majority of subjects. One month posttreatment follow-up showed a statistically significant continued sweat inhibition at the palmar sites. Side effects were common, but none was severe enough to necessitate discontinuation of treatment. Based on the results of this study, we conclude that the Drionic unit appears to have a definite place in the treatment of hyperhidrosis.

Gm allotypes in Blacks with systemic lupus erythematosus

Serum samples were collected from 328 healthy American Blacks and from 61 American Blacks with systemic lupus erythematosus (SLE). Sera were typed for the Gm1,2,3,5,6,13,17, and 21 allotypes as well as for the Km(1) allotype. The frequency of Gm phenotype 1,17;5,6,13 was significantly increased in the SLE patients (p = 0.0001, RR = 3.19, EF = 0.29). Our data suggest the existence of at least two immunoglobulin allotype associated genes that somehow interact to increase susceptibility to SLE in Blacks. To our knowledge, this is the first report of an association of Gm and SLE in Blacks.

Direct and indirect immunofluorescent findings in dermatomyositis

Three skin biopsies (proximal nailfold, extensor forearm and buttock) and serum samples were studied by direct and indirect immunofluorescence, immunodiffusion and radioimmunoassay techniques in 6 patients with dermatomyositis. A variety of seroligic and immunopathologic abnormalities was observed in the patients. Three of ft patients had antinuclear antibodies (ANA) of a speckled pattern mixed with a peculiar dot pattern. Epidermal intercellular deposits of immunoglobulins were seen in the nailfold biopsies of 2 patients; one of them also had IgG deposits in the cytoplasm of epidermal cells. Forearm and buttock biopsies were negative.

An outbreak of contact dermatitis in farm workers

Fourteen of twenty-six migrant workers developed contact dermatitis at a single tomato-strawberry farm in Tennessee. Investigation identified one of eleven pesticides used by the farmer, 2,4-dichloro-6-(o-chloroanilino)-s-triazine anilazine; Dyrene), as the cause of the dermatitis in six of seven workers who were available for patch testing. As a result of this investigation, the label on Dyrene has been revised to warn users of possible sensitization.

Immune complexes and antinuclear, antinucleolar, and anticentromere antibodies in scleroderma.

Forty-one patients with various forms of systemic sclerosis (scleroderma) and positive antinuclear antibodies of nucleolar (ten patients), speckled (eleven patients), or centromere pattern (twenty patients) were selected for study of immune complexes by the radioisotope labeled Clq binding and the radioisotope labeled protein A binding methods. The presence of immune complexes was found by the Clq binding assay in sixteen patients (39%) and by a protein A binding assay in eight patients (20%). Overall, 46% of patients (19/41) had immune complexes. A lower incidence of organ involvement and fewer positive results in the screening of serum immune complexes were observed in patients with centromere antibody (35%) than in patients with nucleolar (60%) or speckled pattern (55%). Patients with immune complexes had higher frequencies of kidney, heart, and muscle involvement and digital ulceration than did patients with no detectable immune complexes, but the differences were not statistically significant. Diffuse skin involvement was not related to the presence of immune complexes.

Mononuclear cell phenotypes in patients with psoriasis.

Mononuclear blood cells from 19 patients with psoriasis were stained with a panel of monoclonal antibodies which detect total T lymphocytes, their helper/inducer and suppressor/cytotoxic subsets and Ia-positive lymphocytes and monocytes. Fluorescence-positive cells were enumerated by cell flow cytometry. In these patients, percentages of all mononuclear cell studies were within reference range with few, sporadic exceptions. Statistical analysis of data showed no significant differences between patient values and reference values from a panel of 100 normal subjects.