Objective: To evaluate the role of the enzyme-linked immunosorbent assay (ELISA) test for the detection of antibodies to desmoglein 1 (dsg1) and desmoglein 3 (dsg3) in the diagnosis of pemphigus vulgaris (PV), and its...Objective: To evaluate the role of the enzyme-linked immunosorbent assay (ELISA) test for the detection of antibodies to desmoglein 1 (dsg1) and desmoglein 3 (dsg3) in the diagnosis of pemphigus vulgaris (PV), and its correlation with disease severity and clinical presentation (mucosal PV, cutaneous PV, mucocutaneous PV). Methods: Twenty-seven active PV patients and 26 controls with other dermatologic disorders were included in the study. The severity of oral and cutaneous involvement was assessed and recorded. ELISA test for the measurement of anti-dsg1 and anti-dsg3 antibodies was performed (Medical and Biological Laboratories Co. Ltd., Nagoya, Japan). The cut-off ELISA value for both anti-dsg1 and anti-dsg3 was taken as 20. Results: Of the 27 patients, 26 were ELISA positive for anti-dsg1 antibodies and 23 for anti-dsg3 antibodies. Of the controls, two were positive for anti-dsg1 and none for anti-dsg3 antibodies. The sensitivity and specificity of ELISA for anti-dsg1 in the diagnosis of PV were 96.3% and 92.3% , respectively. For anti-dsg3, they were 85.2% and 100% , respectively. The different morphologic types of PV could not be differentiated on the basis of antibody profile; however, a direct correlation between anti-dsg3 titers and the severity of oral disease was noted, and also between antidsg1 titers and the severity of cutaneous disease. Conclusions: ELISA (dsg1 and dsg3) is an efficient tool for confirming the diagnosis of PV. Specific antibody titers correlate with disease severity; however, desmoglein testing cannot differentiate between the various morphologic subtypes of PV.展开更多
Background: Unilateral nevoid telangiectasia (UNT) is a unique vascular dermatosis of ambiguous etiology. The therapeutic role of pulsed dye laser in this condition, especially in individuals with skin types III and I...Background: Unilateral nevoid telangiectasia (UNT) is a unique vascular dermatosis of ambiguous etiology. The therapeutic role of pulsed dye laser in this condition, especially in individuals with skin types III and IV, has not been elucidated completely. The aim of this study was to assess the response to flash-lamp pulsed dye laser of UNT in Indian patients. Methods: A detailed analysis of nine confirmed cases of UNT patients was undertaken to determine the possible etiologic association of this disease. Six cases were treated with pulsed dye laser in combination with cryogen cooling using the following parameters: spot size, 7 mm; fluence, 5-7.5 J/cm2; wavelength, 585 nm; pulse duration, 450 μs. The procedure was repeated every 4-6 weeks and the response was assessed both clinically and photographically before each session. Results: The cases had a mean age of presentation of 20.6 years with an age of onset varying from 2.5 to 23 years. The lesions were located on the head and neck region in four patients, upper limb in four, and lower limb in one. No significant etiologic association could be established. Of the six cases treated with pulsed dye laser, a moderate response (26-50%lightening) was achieved in all cases after a mean of 2.33 sessions, a good response (51-75%lightening) was observed in four patients after 3.25 sessions, and an excellent response (> 75%lightening) was found in three patients after 3.66 sessions. Mild and reversible pigmentary alterations occurred in five cases, with mild textural change in one case. There was no scarring. No recurrence was observed. Conclusion: Pulsed dye laser is a useful modality for treating UNT in Indian patients. Reversible pigmentary changes are the major side-effects.展开更多
We describe a 3-year-old male patient with the ichthyosis follicularis, alopecia and photophobia (IFAP) syndrome, who developed cutaneous and ocular involvement in infancy. In addition, he had growth retardation and b...We describe a 3-year-old male patient with the ichthyosis follicularis, alopecia and photophobia (IFAP) syndrome, who developed cutaneous and ocular involvement in infancy. In addition, he had growth retardation and borderline intelligence; no other systemic involvement was found on detailed investigation. A moderate response to acitretin therapy (1 mg/kg) administered for 6 monthswas observed, with improvement in cutaneous features and corneal erosions and no change in alopecia or photophobia.展开更多
文摘Objective: To evaluate the role of the enzyme-linked immunosorbent assay (ELISA) test for the detection of antibodies to desmoglein 1 (dsg1) and desmoglein 3 (dsg3) in the diagnosis of pemphigus vulgaris (PV), and its correlation with disease severity and clinical presentation (mucosal PV, cutaneous PV, mucocutaneous PV). Methods: Twenty-seven active PV patients and 26 controls with other dermatologic disorders were included in the study. The severity of oral and cutaneous involvement was assessed and recorded. ELISA test for the measurement of anti-dsg1 and anti-dsg3 antibodies was performed (Medical and Biological Laboratories Co. Ltd., Nagoya, Japan). The cut-off ELISA value for both anti-dsg1 and anti-dsg3 was taken as 20. Results: Of the 27 patients, 26 were ELISA positive for anti-dsg1 antibodies and 23 for anti-dsg3 antibodies. Of the controls, two were positive for anti-dsg1 and none for anti-dsg3 antibodies. The sensitivity and specificity of ELISA for anti-dsg1 in the diagnosis of PV were 96.3% and 92.3% , respectively. For anti-dsg3, they were 85.2% and 100% , respectively. The different morphologic types of PV could not be differentiated on the basis of antibody profile; however, a direct correlation between anti-dsg3 titers and the severity of oral disease was noted, and also between antidsg1 titers and the severity of cutaneous disease. Conclusions: ELISA (dsg1 and dsg3) is an efficient tool for confirming the diagnosis of PV. Specific antibody titers correlate with disease severity; however, desmoglein testing cannot differentiate between the various morphologic subtypes of PV.
文摘Background: Unilateral nevoid telangiectasia (UNT) is a unique vascular dermatosis of ambiguous etiology. The therapeutic role of pulsed dye laser in this condition, especially in individuals with skin types III and IV, has not been elucidated completely. The aim of this study was to assess the response to flash-lamp pulsed dye laser of UNT in Indian patients. Methods: A detailed analysis of nine confirmed cases of UNT patients was undertaken to determine the possible etiologic association of this disease. Six cases were treated with pulsed dye laser in combination with cryogen cooling using the following parameters: spot size, 7 mm; fluence, 5-7.5 J/cm2; wavelength, 585 nm; pulse duration, 450 μs. The procedure was repeated every 4-6 weeks and the response was assessed both clinically and photographically before each session. Results: The cases had a mean age of presentation of 20.6 years with an age of onset varying from 2.5 to 23 years. The lesions were located on the head and neck region in four patients, upper limb in four, and lower limb in one. No significant etiologic association could be established. Of the six cases treated with pulsed dye laser, a moderate response (26-50%lightening) was achieved in all cases after a mean of 2.33 sessions, a good response (51-75%lightening) was observed in four patients after 3.25 sessions, and an excellent response (> 75%lightening) was found in three patients after 3.66 sessions. Mild and reversible pigmentary alterations occurred in five cases, with mild textural change in one case. There was no scarring. No recurrence was observed. Conclusion: Pulsed dye laser is a useful modality for treating UNT in Indian patients. Reversible pigmentary changes are the major side-effects.
文摘We describe a 3-year-old male patient with the ichthyosis follicularis, alopecia and photophobia (IFAP) syndrome, who developed cutaneous and ocular involvement in infancy. In addition, he had growth retardation and borderline intelligence; no other systemic involvement was found on detailed investigation. A moderate response to acitretin therapy (1 mg/kg) administered for 6 monthswas observed, with improvement in cutaneous features and corneal erosions and no change in alopecia or photophobia.