S.K. Jones

High dose nicotinamide in the treatment of necrobiosis lipoidica

An open study of high dose nicotinamide in the treatment of 15 patients with necrobiosis lipoidica is reported. Of 13 patients who remained on treatment for more than 1 month, eight improved. Improvement took the form of a decrease in pain and soreness, a decrease in erythema and the healing of ulcers if present, although the skin did not return completely to normal in any patient. There were no significant side‐effects, particularly with respect to diabetic control, an important finding as lesions tended to relapse if treatment was stopped.

Ultraviolet radiation (UVR) induces cell-surface Ro/SSA antigen expression by human keratinocytes in vitro: a possible mechanism for the UVR induction of cutaneous lupus lesions

Summary Antinuclear antibodies are useful markers of connective tissue disease. In this study, UVB but not UVA induced the expression of Ro/SSA antigen on keratinocyte surfaces in vitro. This expression was also found with the extractable nuclear antigens RnP and Sm, but not with single or double‐stranded DNA. The expression was prevented by blocking protein synthesis, suggesting that it was an active process. The results suggest that UVB exposure may result in the expression of Ro/SSA antigen on the surfaces of basal keratinocytes in vivo. This antigen could then bind circulating antibody leading to the cutaneous lesions in neonatal and subacute cutaneous lupus erythematosus.

Oral albendazole for the treatment of cutaneous larva migrans

Cutaneous larva migrans is becoming more common in the U.K. with the popularity of tropical countries as holiday destinations. We describe the increasing use of a new benzimidazole derivative, albendazole, which is very effective in the treatment of cutaneous larva migrans. In contrast to thiabendazole, it is virtually free from side‐effects and should, we feel, become the treatment of choice for this condition.

The effects of hormonal and other stimuli on cell‐surface Ro/SSA antigen expression by human keratinocytes in vitro: their possible role in the induction of cutaneous lupus lesions

Summary Ultraviolet B light (UVB) has previously been shown to induce the expression of the extractable nuclear antigens (e.g. Ro/SSA) on the surfaces of human keratinocytes in vitro. This study assessed whether injurious, metabolic, inflammatory, immunological or hormonal stimuli would also induce this expression or modulate that produced by UVB. No stimulus initiated expression alone, but 17‐β oestradiol doubled that found in response to UVB. These findings confirm the potential role of UVB in the initiation and potentiation of cutaneous lupus lesions and may help to explain the female preponderance of the disease.

Exfoliative dermatitis due to nifedipine.

We report the case of a 63‐year‐old Caucasian female, with reno‐vascular hypertension, who developed a generalized skin eruption with lichenoid histological features, induced by nifedipine. A repeat challenge with nifedipine confirmed that it was the causative agent.

Clear ultraviolet blocking lenses for use by PUVA patients

It is well recognized that patients receiving photochemotherapy (PUVA) need to wear UV‐blocking sunglasses on the day of ingestion of 8‐methoxypsoraIen. For many patients the wearing of tinted sun‐glasses causes difficulties because they interfere with colour perception, reduce definition in conditions of low background light and often because they are considered‘cosmetically unacceptable´. In this study the UV‐blocking properties of a number of lenses with little or no tint were assessed. The following lenses or lens coatings were found to be suitable for use by PUVA patients: Orcolite UV 400, Orma UVX, Rodenstock Lambda 400, Sola UV Gard 400 and Polaroid polarizing lenses.

Perioral blisters in a bug‐biting baby

We report peri‐oral blistering caused by biting a bug, Palomena prasina, commonly found in the U.K. This is just one of a number of insects commonly found in the U.K. which produce chemicals for defensive purposes that may injure human skin. Contact with insects should, therefore, be considered as a cause of blistering eruptions, even in Britain, especially in the young who are more likely to handle insects.