Sara Pisanty

HLA-B51 may serve as an immunogenetic marker for a subgroup of patients with Behcet's syndrome

Epidemiologic data, family history, clinical data, HLA typing, neutrophilic chemotaxis, and immunofluorescence of clinically normal non-sun-exposed skin were studied in 46 Israeli non-Ashkenazi Jewish and Arab patients with Behçets syndrome. HLA-B51 was present in 71 percent of the patient group as compared with 13 percent of the control group (relative risk = 17.1). In four of 30 families in the B51-positive group, there was a close relative of the proband with Behçets syndrome who was carrying the HLA-B51 antigen. Neutrophilic chemotaxis in this group was enhanced in 80 percent of the patients, and in most patients no deposition of immunoglobulin in the dermo-epidermal junction was observed, whereas C3 was present in papillary vessels. In the B51-negative group, the family history was negative for Behçets syndrome, neutrophilic chemotaxis was enhanced in only two of eight patients, and in four of six patients, IgM deposition was detected in the dermo-epidermal junction. It is concluded that in Israeli non-Ashkenazi Jews and Arabs, there is a significant association between HLA-B51 and the risk of developing Behçets syndrome. The B51-positive patient group has a family history of the disease, enhanced neutrophilic chemotaxis, and a lack of immunoglobulin deposition in the dermo-epidermal junction.

Scleroderma: Oral manifestations

An oral clinical and radiologic study of twenty-one patients suffering from scleroderma revealed that in one half of the patients the blood sedimentation rate and the antinuclear factor were elevated. When both these laboratory findings were present at the same time, they proved to be well correlated. The majority of the patients had limited mouth opening. Gross jawbone changes affecting the mandibular condyle, coronoid process, and posterior part of the ascending ramus occurred in four patients. There was no correlation in these four patients with regard to the bone changes and clinical and laboratory findings or to age and duration of illness. Widening of the periodontal ligament space, as measured in a meticulous manner, was a feature in all twenty-one patients and in all teeth.

The effect of steroid hormones on buccal mucosa of menopausal women

The effects of local application of estrone and progesterone on the oral mucosa was studied in sixty-one patients. These included forty-one postmenopausal women with various subjective oral complaints, ten postmenopausal women with no oral complaints, and ten normally menstruating women. Subjective complaints (dryness, bad taste, burning sensation, and viscous saliva), quantity of saliva, and histologic changes in buccal mucosa were evaluated before and after treatment. Treatment comprised three modalities: an ointment containing estrone alone; another ointment of estrone and progesterone; and a third with a placebo base. These were massaged three times daily over the gingivae and oral mucosa for 30 days. A significant increase in secretion of saliva was observed with all three treatment modalities. Biopsies showed marked proliferative changes with all three types of ointment. A moderate improvement in subjective complaints followed all types of medication. These results indicate no specific effect of female sex hormones on the factors considered in this study. It appears that simple, repeated massage with any suitable ointment base is an effective method of inducing proliferative changes in atrophic buccal mucosa, increasing salivary secretion, and alleviating some of the subjective oral complaints of postmenopausal women.

Familial hypoparathyroidism with candidiasis and mental retardation

Five new cases of the syndrome of hypoparathyroidism, candidiasis, and mental retardation are described and the importance of the dental findings in contributing toward a definite diagnosis is stressed. The close consanguineous relationship of the parents, first cousins in all of these cases, makes imperative the consideration of the concept that the syndrome is a congenital defect, transmitted by a recessive gene.

PEMPHIGUS VULGARIS AFTER INFECTION BY EPSTEIN-BARR VIRUS

The Correspondence Section serves as a forum for opinion exchange about subjects of general interest such as dermarologic training, relations between dermatologists and pharmaceutical houses, governmental control ol dermatology and medical practice in general, peculiarities of dermatology related to geographic, climatic, or racial factors, the flow of information and publications, as well as other concerns the readership might have. Contributions are welcome and should conform to the usual format for correspondence. Manuscripts will undergo standard editorial procedures. Submit all correspondence to Mauricio Goihman-Yabr, M.D., Ph.D., Editor, Jet International M-154, P.O. Box 020010, Miami, FL 33102.

Lichenoid Lesions of Oral Mucosa Associated with Ketoconazole/Lichenoide Herde der Mundschleimhaut bei Ketoconazol-Therapie

Summary: In eight consecutive patients successfully treated with ketoconazole for oral candidiasis and onychomycosis, a lichenoid dysplasia of the oral mucosa and skin occurred during the course of therapy. Some of the histological features mimicked lichen planus, whilst the immunof‐luorescent tests were negative for IgG, IgA, IgM, C3 and fibrinogen. The dermatosis persisted for more than three months after withdrawal of the drug. Various possibilities for the pathogenesis of the reactive disorder are discussed.

Bilateral lipomas of the tongue

Multiple lipomas of the tongue are quite rare and are seldom reported in the literature. Presented herein is the case of a 76-year-old man with four symmetrical asymptomatic bilateral double lipomas of long standing on the tongue.

Lack of influence of cyclosporin A on levels of gingival procollagen types I and III mRNAs in rats of different ages

Previous studies showed that gingival overgrowth following cyclosporin A (CsA) administration is not associated with an increase in interstitial collagen. It also was shown that CsA causes a significant decrease in collagen content within the gingival stroma. In order to determine whether this decrease is caused by down-regulation of collagen mRNA, the procollagen mRNA level in gingiva of young and old rats was measured correlated with the ratio of interstitial collagen to DNA in these regions. Hybridization of 32P-labelled cDNA probes for procollagen types I and III with total RNA extracted from the molar gingiva showed that administration of Csa did not change the steady-state levels of mRNAs for both procollagens in the gingiva of either young or old rats. The ratio of gingival interstitial collagen to DNA was significantly reduced in the CsA-treated animals (4.2 +/- 0.85) relative to the controls (7.8 +/- 1.6). It is concluded that the reduction in interstitial collagen following CsA treatment is not age-related, and is most probably caused by increased degradation rather by decreased biosynthesis.

The Melkersson-Rosenthal syndrome

Abstract A case of Melkersson-Rosenthal syndrome is reported, and the pertinent literature is reviewed. The diagnosis was based upon the following findings: (1) persistent swelling of the upper lip, the nose, the palate, and the periorbital region, (2) scrotal tongue, and (3) persistent headaches. The diagnosis was confirmed by a biopsy of the upper lip. According to the histopathologic report, the case was further classified as a lymphedematous type.

Gingival pemphigus vulgaris: Report of a case

Abstract A case of pemphigus vulgaris in which the lesions were confined to the gingival mucosa is reported. Diagnosis was based on the clinical presentation and confirmed by histologic study and direct immunofluorescence. Indirect immunofluorescence was negative. The patient responded to steroid therapy. The significance of the negative indirect immunofluorescence test in early pemphigus vulgaris is discussed.