A survey of 115 pemphigus patients who have been followed for 4-24 years was carried out in an attempt to analyze the possible factors influencing the course and prognosis of the disease. At the time of the study, 45 patients were in complete remission, 45 still had lesions, and 25 had died. In 12 cases, the death occurred from causes related to the disease or consequences of treatment. The comprehensive statistical analysis revealed that a good prognosis may be expected for patients who, in the initial stage of the disease, show involvement of the skin only (p less than 0.05) and when systemic steroid therapy is instituted within half a year of appearance of the disease (p less than 0.05). There were no significant differences in the rate of recovery and mortality between the different groups of patients in regard to the initial dose of prednisone. A daily dose of 120 mg of prednisone was sufficient to control the lesions in most of the severe cases and less contributory to death in comparison with previous studies.
The concentration of zinc in the skin has been determined noninvasively in patients with varicose vein ulcers. The examinations were performed with the use of diagnostic x-ray spectrometry, a method based on x-ray fluorescence for in vivo noninvasive evaluation of trace elements. Four skin foci were examined: at the periphery of the ulcer and control areas in a nonulcerated area in the diseased leg, in the noninvolved leg, and in the proximal inner surface of the arm. Zinc levels around the ulcer (mean +/- SD, 9.8 +/- 4.0 micrograms of zinc in 1 g of wet tissue) were higher than those in the nonulcerated skin in the diseased leg (6.9 +/- 3.0 micrograms/g, p greater than 0.05) and those in the noninvolved leg (5.4 +/- 2.0 micrograms/g, p less than 0.01). The concentration of zinc in the inner proximal surface of the arm (9.8 +/- 2.8 micrograms/g) was significantly higher than those of a control group (5.3 +/- 1.9 micrograms/g, p less than 0.01). These results suggest a defect of zinc distribution in patients with varicose vein ulcers.
TOTHEEDITOR: Atypical forms of pemphigus have been recognized recently, some of them drug-induced. Several clinical conditions permit the detection of "pemphigus-like" antibodies (intercellular and/ or circulating), as seen in thermal burns,' drug reactions,' erythema multiforme, J and other bullous diseases." Those findings suggest the possibility that the effect on epidermal proteins by heat or by drugs might produce antigenicity of its components.' It remains to be determined how to differentiate between drug-induced pemphigus and any eruption with pemphigus-like antibodies.We describe a case clinically manifested as bullous eruption following drug ingestion. Immunofluorescence (IF) studies and histopathology findings supported the diagnosis of drug-induced pemphigus.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.