Benign Pemphigoid?

Brunsting, Louis A.

doi:10.1001/archderm.1957.01550160015002

Cited by 156 publications

(15 citation statements)

References 4 publications

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“…In the present case both active and old organized foci were found at necropsy. Brunsting et al (1951) stated that there was little alteration in the tissue changes following cortisone treatment. We conclude that by prolonging life it is likely that a greater proportion of organized lesions will be found at necropsy.…”

Section: Blrnsis Medical Journ'almentioning

confidence: 99%

Gangrene of the Legs in Disseminated Lupus Erythematosus

Keat¹,

Shore²

1958

BMJ

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BwR 25MEDICAL JOURNAL abnormal in 8 out of 13 patients. However, the bromsulphthalein excretion and the percentage of esterified serum cholesterol were normal. Since these two tests are more specific, the possibility of misinterpretation of deranged protein metabolism as evidence of liver disease rather than as an integral feature of systemic scleroderma needs no emphasis.The hepatic fibrosis observed at operation in our first patient defies ready explanation, since there was no evidence of malnutrition, previous hepatic or biliary disease, generalized passive venous congestion, small intestinal defect, or ulcerative colitis. Though not subject to proof, it may be a direct manifestation of the viscero-sclerodermatous process. Massimo (1954) Eventual hepatic fibrosis is a recognized sequel to congestive hepatomegaly from cardiac and pulmonary scleroderma and might also be expected to occur in some patients with sclerodermatous haemorrhagic colitis, especially if there were concomitant steatorrhoea as exemplified in our second patient. Her " silver stool " was regarded as a product of these abnormalities. It is, however, equally admitted that the hepatic fibrosis and its complications in our two patients might be independent of the sclerodermatous process.Finally, we suggest that the possibility of the presence of oesophageal varices, as witnessed in both our patients, should be entertained during the standard radiological studies of visceral scleroderma. SummaryTwo illustrative cases, both in women, of scleroderma and hepatic fibrosis are fully reported. In each patient the salient feature was portal hypertension, including oesophageal varices, which led to recurrent haematemesis, an aspect apparently not previously described.The first patient survived a palliative subcardiac portoazygos disconnexion and remained well five years later, with no subsequent haematemesis. The second patient, whose illness was further complicated by a combination of sclerodermatous haemorrhagic colitisandsteatorrhoea to produce the " silver stool " sign, was treated conservatively for repetitive haematemesis. After prolonged invalidism she died in coma, as a result of haemorrhage from an oesophageal varix, some 20 months after her first haematemesis.The scant literature on hepatic fibrosis in systemic scleroderma is reviewed and the causation of such hepatic lesions is briefly discussed in relation to the observations on our two patients.Our thanks are due to Mr. N. C. Tanner for permission ts refer to the operative details in Case 1; to Mr. K. Moore for similar authority in relation to Case

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Section: Blrnsis Medical Journ'almentioning

confidence: 99%

Gangrene of the Legs in Disseminated Lupus Erythematosus

Keat¹,

Shore²

1958

BMJ

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“…Cyproheptadin1 2 (l-M ethyl-4(5-dibenzo-[a, e]cycloheptatrienyliden) -piperidin.HCl) ist ein sehr starker Serotonin-und Histam inantagonist [Sfone et al, 1961] -Händen, 1962;Brunsting, 1966;s. a. Selye, 1965], und bis auf Robinson et al [1962], die nur eine tem poräre Besserung sahen, wurde von den anderen Autoren die Cyproheptadinbehandlung als sehr wirksam hervorge hoben.…”

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Kasuistischer Beitrag zur Behandlung der Urticaria pigmentosa xanthelasmoidea bullosa mit Cyproheptadin

Haneke¹

1970

Dermatology

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A case of Urticaria pigmentosa xanthelasmoidea bullosa with generalized vascular symptoms (flushes) is reported. Blisters already appeared at the second day of life. The daily medication of 2 times 2 mg cyproheptadine soon stopped the formation of bullae, calmed the pruritus, and the flushes disappeared. Possible interrelationships between histamine and 5-hydroxytryptamine in the symptomatology of bullous urticaria pigmentosa are pointed out in the light of the action of cyproheptadine as a combined serotonin-histamine antagonist and of methysergide as a selective antiserotonin agent, respectively.

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“…Localized chronic head, neck, + ± pemphigoid [3] mucosa of mouth Disseminated generalized + ± cicatricial pemphigoid [14] show similar clinical and electron micros copical findings [7,11,12,15,16]. The rela tions between these two clinical entities however remain controversial and need fur ther investigation [5,12], As far as seen from the relatively few cases, the following criteria to differentiate can be established (table II).…”

Section: [2]mentioning

confidence: 99%

“…Brunsting and Perry [3] described the isolat ed involvement of head, neck and forehead skin as a distinct variant. Generalized cica tricial subepidermal blistering with histolog ical and immunopathological signs of bul lous pemphigoid has been published so far in 3 patients under the term 'disseminated scar ring pemphigoid' by Provost et al [14] and Braun-Falco et al [2], In this report we pres ent another patient with typical skin lesions of this third group and additional mucosal involvement, treated at our department re cently.…”

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confidence: 99%