W. Frain‐Bell

Contact allergic sensitivity to plants and the photosensitivity dermatitis and actinic reticuloid syndrome.

Contact allergic sensitivity to oleoresin extract from Compositae plants was found to be usually present in individuals suffering from the photosensitivity dermatitis and actinic reticuloid syndrome. It was demonstrated in forty‐seven out of fifty‐five examples of this syndrome. These results provide support for the view that contact allergic sensitivity is an important aspect of the state of chronic photosensitivity in the middle‐aged and elderly male.

The syndrome of chronic photosensitivity dermatitis and actinic reticuloid.

In a Study of thirty‐four male subjects suffering from the syndrome of chronic photosensitivity dermatitis and actinic reticuloid the clinical, histological and photobiological features were such as to suggest that they were in fact examples of a single entity in which the degree of response to ultraviolet and visible light varied. Although a wide action spectrum involving UV and visible wavelengths invariably occurred with the classical clinical and histological features of actinic reticuloid (Ive et al., 1969) a broad action spectrum with similar histological appearances was also noted in some of the subjects in whom the morphological changes were those of a chronic dermatitis confined to exposed sites.

The relationship between exposure to fragrance materials and persistent light reaction in the photosensitivity dermatitis with actinic reticuloid syndrome

Contact allergic sensitivity to allergens such as plants of the Compositae family is a feature of the chronic skin reaction seen in the photosensitivity dermatitis with actinic reticuloid syndrome. In fifty patients with this syndrome an increased incidence of contact allergic sensitivity to some common fragrance materials was demonstrated. Evidence is also presented, both by in vitro and in vivo studies, which indicates that a phototoxic mechanism is involved. The relevance of continued exposure to common allergens and their involvement in photosensitization mechanisms is discussed in an attempt to explain the state of ‘persistent light reaction.’

TRANSEPIDERMAL WATER LOSS IN PATIENTS WITH DERMATITIS

SUMMARY.— Using an electrolytic hygrometer, the Transepidermal Water Loss (T.W.L.) from the skin was measured in normal individuals and in patients with dermatitis (eczema). It was found that there was a close correlation between T.W.L. and the state of activity of the dermatitis; and that there was a gradual reduction in abnormally raised T.W.L. in parallel with the return to normal of the skin response (dermatitis). Sweating did not contribute to the increased insensible water loss in dermatitis under the fixed limits of ambient temperature and humidity of this investigation.

The construction and development of a grating monochromator and its application to the study of the reaction of the skin to light

The construction and performance of equipment consisting of a 1600 W xenon arc light source and a grating monochromator are described. Its suitability for use in the investigation of the reaction of the skin to ultraviolet (UV) radiation and to visible light is discussed.

A study of benoxaprofen-induced photosensitivity

A study of the abnormal sunlight response seen in nine patients taking benoxaprofen showed that the action spectrum was between 310 and 325 nm, which is similar to the drugs absorption spectrum. In vitro studies using three separate methods indicated that benoxaprofen has a powerful phototoxic action which may be directed mainly against cellular membranes.

The action spectrum in polymorphic hght eruption

A Study of fifty‐six cases of polymorphic light eruption has shown that the action spectrum frequently lies in both the long ultraviolet wavelengths (320‐400 nm) and the short ultraviolet wavelengths below 320 nm.

A study of cutaneous photosensitivity induced by amiodarone

Amiodarone‐induced cutaneous photosensitivity was studied in 12 subjects treated with the drug. The action spectrum for the abnormal response to sunlight was shown to be within the range of 335–460 (±30) nm. The clinical features of the photosensitivity response suggested that it was most probably a phototoxic reaction, a conclusion supported by the results in in vitro studies which indicated activity mainly against cell membranes. Of the five in vitro models used, three—namely photohaemolysis, the inhibition of DNA synthesis in PHA stimulated lymphocytes and the killing of mouse peritoneal macrophages—provided unequivocal evidence of the phototoxic potential of both amiodarone and its major metabolite, desethylamiodarone. In each model desethylamiodarone produced a greater effect by a factor of between 2 and 10. In vitro, UV‐B wavelengths produced a greater effect than UVA but the difference between the effective wavelengths in vivo and in vitro might be explained by the greater absorption of the shorter wavelength UV‐B in the opidermis. Zinc oxide‐containing preparations appeared to be the most effective in reducing the cutaneous photosensitivity. It is suggested that the long‐term cutaneous pigmentation resulting from oral amiodarone has a significant photosensitivity component.

Thiazide‐induced photosensitivity: a study of 33 subjects

The clinical features, action spectrum and subsequent course, are described in 33 subjects with thiazide‐induced photosensitivity. The reaction appeared to be phototoxic in nature. The wavelengths involved were those of the longer UVA and, not infrequently, also the shorter UVB waveband. In most instances withdrawal of the drug resulted in clearance of the clinical reaction and a return of the action spectrum to normal. In the few subjects in whom the photosensitivity persisted, either in the form of the clinical reaction or an abnormal action spectrum, or both, either a specific photodermatosis was present or another potentially photoactive drug was being taken. In no instance, was there evidence of the induction of long‐term chronic photosensitivity (persistent light reaction) following the withdrawal of the thiazide drug.

Photochemotherapy in the treatment of psoriasis

This article describes the satisfactory clinical improvement obtained in the majority of a group of 72 patients with psoriasis of various types as a result of the oral and/or topical administration of 8–methoxypsoralen followed by long wavelength ultraviolet irradiation. The irradiation source used was that of conventional longwave UV fluorescent tubes mounted in a specially constructed cubicle.