No abstract

A radioassay method allowing measurements of low concentrations of circulating hyaluronate was used in a study of serum hyaluronate concentrations in 44 patients with psoriasis. Twenty-three of them had only skin lesions and 21 had both skin lesions and arthropathy. In both of these groups significantly elevated serum levels of hyaluronate were found. The highest values were observed in those with widespread and active skin disease and/or active arthritis. Serum hyaluronate positively correlated with the plasma concentrations of alpha 1-antitrypsin and haptoglobin and also with ESR, which may indicate a relationship between acute inflammation and increased production of hyaluronate. Seven patients with widespread atopic dermatitis included for comparison had normal hyaluronate values. In blister fluid from lesional skin in two patients with acute psoriasis, very high concentrations of hyaluronate were found, in comparison with the concentrations in blister fluid from non-involved skin. The increased concentration of serum hyaluronate in psoriasis indicates involvement of dermal and synovial tissue in psoriasis, in addition to the epidermal changes.

The presence of eosinophils and eosinophil cationic protein (ECP) in the involved and non-involved skin in patients with psoriasis was studied using a polyclonal antibody specific for ECP and a monoclonal antibody (EG2) specific for activated eosinophils and secreted ECP. ECP immunoreactive eosinophils were found in all the specimens from involved psoriatic skin. In new lesions in patients with rapidly progressive disease, intense ECP immunoreactivity was detected both intra- and extracellularly, particularly in the upper third of the epidermis and usually in association with granulocytes. In stable or slowly progressive lesions, less ECP was observed. The EG2-immunoreactivity was positive in the same areas. ECP was also determined in suction-blister fluid from lesional and non-involved skin in psoriasis patients and in healthy subjects. The ECP concentration was greatly elevated in the fluid from lesions in patients with more acute and progressive disease.

Hyaluronate concentrations were measured in suction blister fluid from blisters raised on the abdominal skin of 12 healthy control subjects, on unaffected skin of 14 patients with psoriasis, and on lesional skin from 12 of these patients. The concentrations of hyaluronate in blister fluid from the controls and from the uninvolved skin of patients with psoriasis were within the same range (2.9-10.5 and 2.4-7.8 mg/l, respectively). Six of the patients had active, widespread, untreated psoriasis and in these cases the hyaluronate concentration in blister fluid from lesional skin was greatly increased (24-30 mg/l). Patients with stable or regressing psoriasis had no significant increase in hyaluronate levels in the blister fluid from lesional skin compared with the controls (range 4.6-12.4 mg/l). Patients with active psoriasis had significantly higher serum hyaluronate concentrations than the controls and those with inactive psoriasis.

Mold dust exposure in the trimming departments of sawmills may cause inhalation fever as well as allergic alveolitis. Responses to questionnaires sent to 2,052 workers from trimming departments of 233 Swedish sawmills showed that one of five workers experienced work-related febrile attacks. A single case of allergic alveolitis was found.