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Thirteen patients with severe persistent psoriasis, intolerant of, or unresponsive to, other current treatments have been treated with cyclosporin (Cys) for periods varying from 12–25 (mean 18) months. The dose ranged from 1–4 mg/kg/day (mean 2.8 mg). There was a 72% reduction in the mean PASI score at 4 weeks, and at the end of the study, an 81% reduction. Adjuvant therapy with topical steroids was used in 11 of the 13 patients after the first 3 months of Cys treatment to persistent patches on an intermittent basis with beneficial effect. Six patients developed mild to moderate hypertension, in three this was controlled by a reduction in the dose of Cys, and in the other three by hypotensive agents. The mean serum creatinine rose from 72 to 90 μm/1 during the study. Hypertrichosis occurred in seven of the 13 patients. Low dosage Cys is an effective treatment for clearing psoriasis and maintaining improvement on a long-term basis. [ABSTRACT FROM AUTHOR]

On each of 10 patients with untreated plaque psoriasis, two symmetrical plaques were injected with cyclosporin A or placebo on six occasions over 12 days, in a double-blind manner. Biopsies taken from these lesions at 14 days were examined for differences in cellular composition using a double-labelling immunofluorescent technique. The cyclosporin-injected plaques cleared significantly better than those injected with placebo (P < 0.001). In the epidermis of the cyclosporin-injected plaques, total and HLA-DR+ CD4+ and CD8 + T cell numbers were significantly decreased compared to corresponding plaques treated with placebo (total CD4+, total CD8+, DR+ CD4+, P < 0.01; DR+ CD8+, P < 0.02). Similarly, T lymphocyte numbers in the dermis were decreased in the cyclosporin compared to placebo-treated plaques; the reduction in total CD4+ and DR+ CD8+ T cell numbers was statistically significant (P < 0.05). Although total numbers of epidermal dendritic cells were not significantly altered, the DR + CD1 - dendritic cell subpopulation was markedly decreased (P < 0.01) and DR-CD1 + dendritic cells increased (P < 0.05) in the plaques injected with cyclosporin compared to corresponding placebo-treated plaques. These findings show that cyclosporin injected in situ is effective in clearing psoriasis and probably exerts this beneficial effect by its action on T lymphocytes. A suitable topical preparation that allows penetration of the drug should prove helpful in the treatment of psoriasis. [ABSTRACT FROM AUTHOR]

Twenty nine patients with cicatrizing conjunctivitis were studied; 17 with a clinical diagnosis of cicatricial pemphigoid, five with a clinical diagnosis of pseudopemphigoid caused by long-term application of topical medication and seven who had a cicatrizing conjunctivitis from other causes. Biopsies from clinically uninvolved bulbar conjunctiva were taken for direct immunofluorescence and blood was taken for indirect immunofluorescence using normal human conjunctiva, oral mucosa and skin as substrates. On direct immunofluorescence, in vivo bound immunoglobulins were found along the basement membrane in 10 of the 17 patients with cicatricial pemphigoid, one of the five with pseudopemphigoid and two of the seven with a cicatrizing conjunctivitis associated with other diseases. Circulating anti-basement membrane zone antibodies were found only when conjunctiva was used as a substrate. These were present in seven of the patients with cicatricial pemphigoid, three of those with pseudopemphigoid and two of those with a cicatrizing conjunctivitis caused by other diseases. These results indicate that direct immunofluorescence is a useful, but not absolute diagnostic marker for ocular cicatricial pemphigoid. The results in the pseudopcmphigoid group argue that this is an immunologically mediated disorder indistinguishable from spontaneous cicatricial pemphigoid and probably triggered by the drugs. The presence of circulating antibodies should allow for precise identification of the antigen involved in cicatricial pemphigoid using SDS electrophoresis and Western blot analysis. [ABSTRACT FROM AUTHOR]

The article focuses on the role of sweat in the pharmacokinetics of ketoconazole and griseofulvin. Griseofulvin and ketoconazole have been shown to be quickly transfered by sweat to the surface of healthy skin. This effect in normal skin is very important in treatment with both griseofulvin and ketoconazole. There is possibility of indirect transfer of these drugs to fungal lesions by sweat from, for instance, adjacent normal skin and contact with apposing skin surfaces and clothes.

Presents several correspondence on health issues in Great Britain. Evaluation of motorcycle injuries related to courier service; Issues on gender reassignment; Correlation between child abuse and osteogenesis imperfecta; Presentation of a case of adult epiglottitis; Viability of compulsory treatment of mental illness.

Focuses on the skin diseases of persons with AIDS. Occurrence of kaposi's sarcoma among the homosexuals; Manifestations of AIDS; Infections present in persons with AIDS.

Investigates the clearance of psoriasis with low dose cyclosporine. Role of T helper lymphocytes in the pathogenesis of psoriasis; Inhibition of T helper cell function by the production of interleukin 2; Assessment on the dose related nephrotoxic effects of cyclosporine.

Presents a letter of the editor regarding the effect of isotretinoin on the polymorphonuclear leukocytes-dominated cutaneous lesions of dermatitis herpetiformis and subcorneal pustural dermatosis.

Describes a study concerning the treatment of psoriasis with cyclosporin A (CyA). Effectiveness of CyA; Recurrence of psoriasis after withdrawal of the drug; Observations noted from patients treated with CyA.

Describes a study which examined esophageal strictures in cicatricial pemphigoid. Rarity of cicatricial pemphigoid; Investigation of ten patients with cicatricial pemphigoid; Observations noted from the patients.