1. |
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2. |
- Bergfors, Elisabet, 1945, et al.
(författare)
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Patch testing children with aluminium chloride hexahydrate in petrolatum: A review and a recommendation
- 2019
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Ingår i: Contact Dermatitis. - : WILEY. - 0105-1873 .- 1600-0536. ; 81:2, s. 81-88
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Forskningsöversikt (refereegranskat)abstract
- Background: According to studies on adults, patch testing with aluminium chloride hexahydrate 2% pet. is insufficient to detect aluminium allergy, and a 10% preparation is recommended. Other studies suggest that a 2% preparation is sufficient for testing children. Objectives: To review three previously published Swedish studies on patch testing children with aluminium chloride hexahydrate 2% pet. Patients/Methods: Altogether, 601 children with persistent itching subcutaneous nodules (granulomas) induced by aluminium-adsorbed vaccines were patch tested with aluminium chloride hexahydrate 2% pet. and metallic aluminium in (a) a pertussis vaccine trial, (b) clinical practice, and (ca) prospective study. Results: Overall, 459 children had positive reactions to the 2% pet. preparation. Another 10 reacted positively only to metallic aluminium. An extreme positive reaction (+++) was seen in 65% of children aged 1 to 2 years as compared with 22% of children aged 7 years. From 8 years onwards, extreme positive reactions were scarce. Conclusions: Aluminium chloride hexahydrate 2% pet. is sufficient to trace aluminium allergy in children. Small children are at risk of extreme reactions. We thus suggest that aluminium chloride hexahydrate 10% pet. should not be used routinely in children before the age of 7 to 8 years.
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3. |
- Bergfors, Elisabet, 1945, et al.
(författare)
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Unexpectedly high incidence of persistent itching nodules and delayed hypersensitivity to aluminium in children after the use of adsorbed vaccines from a single manufacturer
- 2003
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Ingår i: Vaccine. - 0264-410X .- 0264-410X. ; 22:1, s. 64-9
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Tidskriftsartikel (refereegranskat)abstract
- During trials of aluminium adsorbed diphtheria-tetanus/acellular pertussis vaccines from a single producer, persistent itching nodules at the vaccination site were observed in an unexpectedly high frequency. The afflicted children were followed in a longitudinal observational study, and the presence of aluminium sensitization was investigated in the children with itching nodules and their symptomless siblings by patch tests. Itching nodules were found in 645 children out of about 76,000 vaccinees (0.8%) after both subcutaneous (s.c.) and intramuscular (i.m.) injection. The itching was intense and long-lasting. So far, 75% still have symptoms after a median duration of 4 years. Contact hypersensitivity to aluminium was demonstrated in 77% of the children with itching nodules and in 8% of the symptomless siblings who had received the same vaccines (P<0.001). Children with persistent itching nodules and/or aluminium sensitization should be warned about aluminium containing products (e.g. vaccines and antiperspirants). The reason for the high incidence of itching nodules after SSI vaccines is unknown and should be further investigated.
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4. |
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5. |
- Enerbäck, Charlotta, 1965, et al.
(författare)
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Cytogenetic analysis of 477 psoriatics revealed an increased frequency of aberrations involving chromosome region 11q
- 1999
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Ingår i: Eur J Hum Genet. ; 7:3, s. 339-44
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Tidskriftsartikel (refereegranskat)abstract
- Psoriasis is an inflammatory skin disorder affecting approximately 3% of the population. Genetic studies published so far have shown a complex genetic inheritance with heterogeneity and a putative major susceptibility locus in the HLA region on chromosome 6. We have collected a large amount of material consisting mostly of small nuclear families in order to perform a genome-wide scan for psoriasis-associated genes. In order to focus the scan properly on possible candidate regions, we performed a cytogenetic analysis of 477 unrelated psoriatics. We divided our findings into sporadic, affecting a minor fraction of the cells, and constitutional, i.e. they were present in all cells examined. We found three cases of balanced translocation, all of which involved chromosome 11q. Two of these had a breakpoint in q12-13, whilst one involved the telomeric part of chromosome 11q. In order to characterise further the breakpoint on 11q12-13, we used bacterial artificial chromosomes (BACs) analysed by fluorescent in situ hybridisation (FISH). We were able to show that the persons had a close, but not identical breakpoints; they were separated by at least 5 cM. The major atopy locus is located in this region, as well as a locus for insulin-dependent diabetes mellitus, both being conditions with a pathogenetic mechanism involving antigen presentation.
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6. |
- Enerbäck, Charlotta, 1965, et al.
(författare)
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Evidence that HLA-Cw6 determines early onset of psoriasis, obtained using sequence-specific primers (PCR-SSP)
- 1997
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Ingår i: Acta Derm Venereol. ; 77:4, s. 273-6
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Tidskriftsartikel (refereegranskat)abstract
- Psoriasis vulgaris has previously been shown to associate with certain HLA alleles. HLA-Cw6 is considered to be the primary association, based on calculations of relative risk after serological typing. This association is reportedly more pronounced in early- than in late-onset psoriasis. We performed a PCR-based typing with sequence-specific primers, which has been shown to give a more complete result than serology. Two hundred and one unrelated patients with psoriasis, with a mean age of 40 years, and 77 healthy controls were typed. Two thirds (67%) of the patients were positive for one or two copies of the allele, while the corresponding figure for the control group was 12%. A significant peak for age at onset of 21 or younger was seen for the Cw6 carriers. For patients older than 21 at onset, the frequency of Cw6 was significantly lower; e.g. for patients with an age at onset between 30 and 35 the frequency was comparable to the level of the control group. The high frequency of Cw6 among patients with an age at onset of 21 or younger is in agreement with data of other groups. In comparison with this age-at-onset group the frequency of Cw6 is sharply reduced among patients with an age at onset of 22 years or older, which contrasts with earlier studies. This may reflect differences between population groups but may also be due to the higher sensitivity of the PCR-based HLA-Cw6 typing method. In view of these findings, we suggest that psoriasis is a genetically determined disease, in which the additional presence of HLA-Cw6 is associated with the characteristic of early onset.
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7. |
- Enerbäck, Charlotta, 1965, et al.
(författare)
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S gene (Corneodesmosin) diversity and its relationship to psoriasis; high content of cSNP in the HLA-linked S gene
- 2000
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Ingår i: J Invest Dermatol. - 0022-202X .- 0022-202X. ; 114:6, s. 1158-63
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Tidskriftsartikel (refereegranskat)abstract
- Psoriasis is a heterogeneous disease in which several reports suggest the presence of a susceptibility gene in or in the proximity of the human leukocyte antigen complex in chromosome 6p. There is an association between HLA-Cw6 and young onset of the disease. The S gene (corneodesmosin), located 160 kb telomeric of HLA-C, is a strong candidate for psoriasis due to its reportedly exclusive expression in differentiating keratinocytes. We have studied this gene in a large Swedish psoriasis population and we report a strikingly high degree of polymorphism in the coding parts of the gene, 1 every 100 base pairs. We used a stratified approach to compare the polymorphic variants in patients and controls. A single nucleotide polymorphism in the coding region leading to an amino acid exchange (Ser-->Phe) that differed significantly between patients and controls was identified (position 619). Owing to a high allele frequency in a larger control group, however, and an insignificant influence of the variant on the age at onset distribution curve based on a large psoriasis population, we could not confirm that this coding single nucleotide polymorphism was involved in disease etiology. We also examined the single nucleotide polymorphism in position 1243, recently proposed to have an influence on the pathogenesis of the disease. This polymorphism showed less association to the disease as compared with the single nucleotide polymorphism at positions 619 and 722. Such a high degree of variation present also in an HLA gene which is not involved in immune response indicates the difficulty involved in assessing the role of a specific allele in the pathogenesis of a complex disease in this region. A strong association effect due to linkage disequilibrium in an extended region in the HLA complex is also a complicating factor.
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8. |
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9. |
- Enerbäck, Charlotta, 1965, et al.
(författare)
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Stronger association with HLA-Cw6 than with corneodesmosin (S-gene) polymorphisms in Swedish psoriasis patients.
- 2000
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Ingår i: Archives of dermatological research. - : Springer Science and Business Media LLC. - 0340-3696 .- 1432-069X. ; 292:11, s. 525-30
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Tidskriftsartikel (refereegranskat)abstract
- Psoriasis vulgaris is strongly associated with certain human leukocyte antigens, especially in early onset. The purpose of this study was to study the HLA-Cw6 allele and its contribution to disease susceptibility in a set of 104 families with at least two affected siblings. A sequencing method was utilized to examine the two exons that build up the antigen binding site of the C locus receptor. DNA from patients homozygous for Cw6 based on haplotype information were sequenced. The results confirmed the identity of the Cw6 allele in affected individuals with the consensus sequence for Cw*0602. We screened the set of families for psoriasis patients homozygous for Cw6 and found 11 individuals with a mean age at onset of 16.1 years. The corresponding figure for the Cw6 heterozygotes was 18.45 years and for the Cw6-negatives 22.36 years. This is indicative of a gene dose effect. We performed a transmission disequilibrium test (TDT) on the Cw6 allele per se, used as a biallelic marker. The analysis resulted in a P-value of 5.3 x 10(-17) (t167/nt45). This greatly exceeds our previous results of a TDT in the region, including microsatellite markers and single nucleotide polymorphisms (SNPs) in the coding part of the S gene (corneodesmosin), which is a suggested candidate gene in the region. The maximum nonparametric linkage (NPL) value was also reached using HLA-C as a marker. We conclude that Cw6 is the allele which shows the highest degree of association with psoriasis in our set of families and we propose that it directly influences the age at onset of the disease rather than increasing the genetic load in accordance with a polygenic theory.
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10. |
- Enlund, Fredrik, 1968, et al.
(författare)
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Analysis of three suggested psoriasis susceptibility loci in a large Swedish set of families: confirmation of linkage to chromosome 6p (HLA region), and to 17q, but not to 4q
- 1999
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Ingår i: Hum Hered. ; 49:1, s. 2-8
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Tidskriftsartikel (refereegranskat)abstract
- Psoriasis is known to be a heterogeneous disease with so far three reported major psoriasis susceptibility loci on chromosome 4q, 6p and 17q. In this study we investigated three reported gene locations by nonparametric and parametric linkage analysis in a large family set consisting of 104 families (153 sib pairs) from Sweden. We could confirm linkage to chromosome 6p. A maximum heterogeneous lod score of 2.78 was reached at locus D6S276 (alpha = 0.60). Allelic association studies within the HLA region indicated linkage disequilibrium at locus TNFbeta with a significant p value of 0.0009. Furthermore, we obtained weak evidence of linkage to the locus on chromosome 17q while no evidence of linkage could be found to the chromosome 4q region.
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11. |
- Enlund, Fredrik, 1968, et al.
(författare)
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Psoriasis susceptibility locus in chromosome region 3q21 identified in patients from southwest Sweden
- 1999
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Ingår i: Eur J Hum Genet. ; 7:7, s. 783-90
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Tidskriftsartikel (refereegranskat)abstract
- We have performed a pair-wise linkage study in the search for psoriasis susceptibility regions. A preliminary scan was performed on 20 families. In this set we obtained indications of linkage on chromosome 3q21. This region was further investigated using material from a total of 104 families (set 1B) resulting in a non-parametric linkage (NPL) of 1.77. The material was stratified in families whose parental origin is in southwest Sweden (set 1C). A maximum NPL value of 2.77 was obtained in this group. A transmission disequilibrium test (TDT) was performed on the stratified material (set 1C) and a significant P value of 0.005 was obtained, at marker D3S1269. The locus was confirmed with TDT in replicate material consisting of 148 families in which a single member was affected (P value 0.0007) at marker D3S1551. Thus, we have observed a significant P value using TDT in the vicinity of markers D3S1269/D3S1551, suggesting a novel psoriasis susceptibility region.
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12. |
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13. |
- Friberg, Camilla, et al.
(författare)
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Analysis of chromosome 5q31-32 and psoriasis: confirmation of a susceptibility locus but no association with SNPs within SLC22A4 and SLC22A5.
- 2006
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Ingår i: The Journal of investigative dermatology. - : Elsevier BV. - 0022-202X. ; 126:5, s. 998-1002
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Tidskriftsartikel (refereegranskat)abstract
- We have previously reported a region on chromosome 5q as a possible susceptibility region for psoriasis. This cytokine cluster-rich region has also been suggested as a susceptibility locus in other autoimmune or inflammatory diseases including Crohn's disease (CD) and rheumatoid arthritis (RA). Three specific single-nucleotide polymorphisms (SNPs) have been reported to associate with RA and CD and to change the functional activity of two organic cation transporters, solute carrier family 22 member 4/5 (SLC22A4) and (SLC22A5). In this study, we have analyzed these SNPs for an association with psoriasis. We have also performed a denser linkage analysis of this region with an additional 31 microsatellite markers. We were not able to detect any association with any of the three SNPs analyzed. However, our linkage result supports the involvement of this region in the etiology of psoriasis. We obtained a peak non-parametric linkage value of 3.1 for marker D5S436 in a subgroup of patients with joint complaints. This result supports the findings in another study of psoriasis patients originating from Iceland in which the authors obtained a peak logarithm of the odds score of 2.6 for marker D5S2090, only 2 Mb from D5S436. This suggests a psoriasis susceptibility locus on chromosome 5q32 that is involved in the arthritic phenotype of the disease.
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14. |
- Gente-Lidholm, Anette, et al.
(författare)
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Comparison of reactivity to a metallic disc and 2% aluminium salt in 366 children, and reproducibility over time for 241 young adults with childhood vaccine-related aluminium contact allergy
- 2018
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873. ; 79:1, s. 26-30
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Tidskriftsartikel (refereegranskat)abstract
- Background: An aluminium hydroxide-adsorbed pertussis toxoid vaccine was studied in 76 000 children in the 1990s in Gothenburg, Sweden. Long-lasting itchy subcutaneous nodules at the vaccination site were seen in 745 participants. Of 495 children with itchy nodules who were patch tested for aluminium allergy, 377 were positive. In 2007-2008, 241 of the positive children were retested. Only in one third were earlier positive results reproduced. Objectives: To further describe patch test reactions to different aluminium compounds in children with vaccine-induced aluminium allergy. Patients/Methods: Positive patch test results for metallic aluminium (empty Finn Chamber) and aluminium chloride hexahydrate 2% petrolatum (pet.) were analysed in 366 children with vaccine-induced persistent itching nodules tested in 1998-2002. Of those, 241 were tested a second time (2007-2008), and the patch test results of the two aluminium preparations were analysed. Results: Patch testing with aluminium chloride hexahydrate 2% pet. is a more sensitive way to diagnose aluminium contact allergy than patch testing with metallic aluminium. A general decrease in the strength of reactions to both aluminium preparations in 241 children tested twice was observed. Conclusions: Aluminium contact allergy can be diagnosed by patch testing without using metallic aluminium.
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15. |
- Gente-Lidholm, Anette, et al.
(författare)
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Long-term clinical course and prognosis of vaccine-related persistent itching nodules (1997-2019): An observational study
- 2022
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Ingår i: Vaccine: X. - : Elsevier BV. - 2590-1362. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Vaccines adsorbed to aluminium can induce long-lasting intensely itching subcutaneous nodules (granulomas) at the injection site as well as contact allergy to aluminium. In clinical trials of a new acellular pertussis vaccine performed in the 1990s (Gothenburg, Sweden) with 76 000 participants, itching nodules were reported in 745 children. A positive patch test to aluminium was verified in 77% of the tested children with itchy nodules. Aim: To describe the long-term clinical course and prognosis of vaccine-related itching nodules caused by aluminium-containing pediatric vaccines and to estimate the risk for new symptoms after future vaccination with aluminium-containing vaccines. Methods: 745 children with vaccine-related itching nodules were followed by regular interviews/questionnaires for more than 20 years. 723 of them received a booster dose of diphtheria/tetanus vaccine either with or without aluminium adjuvant during the follow-up time. Results: Most study participants (86%) reported a full recovery from their itching nodules after a median duration of 6.6 years. Only a few of the diphtheria/tetanus-booster-vaccinated children (3%) reported mild transient itching and swelling at the new injection site. Conclusion: Vaccine-induced itching granulomas caused by an aluminium-adsorbed acellular pertussis toxoid vaccine seem to disappear over time. Future vaccinations with aluminium-adsorbed vaccines can be performed with little risk for new itching nodules later in life. (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
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16. |
- Gente-Lidholm, Anette, et al.
(författare)
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Long-term prognosis of vaccine-induced contact allergy to aluminium: Third patch-test with additional test preparations
- 2023
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Ingår i: Contact Dermatitis. - 0105-1873. ; 89:5, s. 359-367
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Tidskriftsartikel (refereegranskat)abstract
- Background A high incidence of local itching subcutaneous nodules and aluminium allergy was observed in clinical trials of a new aluminium adsorbed pertussis vaccine in Gothenburg, Sweden, in the 1990s. A total of 495 children with itching nodules were patch tested with aluminium chloride hexahydrate 2% and an empty Finn Chamber (R), 377 (76%) with positive reactions. When 241 of them were re-tested some years later 186 (3 out of 4) had unexpectedly lost their patch test reactivity.Aim To investigate the long-term prognosis of vaccine-induced contact allergy to aluminium by a third patch test about 20 years after Patch test I.Methods Twenty individuals with positive and 11 with negative results in Patch test II were tested a third time with the same sensitisers as in in the first two tests. Three additional aluminium preparations were also tested.Results A total 15 out of 20 persons with positive results in the second test had lost their patch test reactivity. Two of 11 with negative tests had turned positive again. The addition of the preparations gave no conclusive results.Conclusion Contact allergy to aluminium caused by vaccination with aluminium-adsorbed vaccines in childhood seems to fade away with time as measured by loss of patch test reactivity.
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17. |
- Gente-Lidholm, Anette, et al.
(författare)
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Loss of patch-test reaction to aluminium years after vaccination with aluminium adjuvants in a population of 76.000 children.
- 2010
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Ingår i: Contact Dermatitis. - 0105-1873 .- 1600-0536.
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Konferensbidrag (refereegranskat)abstract
- During trials of aluminium adsorbed diphtheria–rntetanus/acellular pertussis vaccines from a single producer,rnpersistent intensely itching nodules at the vaccination site werernobserved in an unexpectedly high frequency (about 1%) in thernstudy area around Gothenburg, Sweden. All afflicted childrenrnwere offered patch testing for aluminium. Among the childrenrnsensitisation to aluminium was demonstrated in a highrnfrequency (77%). The children demonstrated positive patchrntests for aluminium were offered to repeat the test 5 years later.rnObjectives: To study the clinical course of itching nodules andrncontact allergy to aluminium.rnMethods: Two hundred and fifty children with itching nodulesrnat the injection site after vaccination with aluminium adsorbedrndiphtheria–tetanus/acellular pertussis vaccines that earlier hadrnshown a positive patch test reaction to aluminium, wherernrepeated the patch test more than 5 years later. Thernchildren were patch tested in the same way as beforernwith aluminiumchloridehexahydrate 2% in petrolatumrn(Chemotechnique Diagnostics, Sweden) in plastic chambersrnfrom the same manufacturer, and also with an empty FinnrnChamber (Epitest, Finland). The tests were read on day threernusing the ICDRG’s criteria.rnResults: Among the 250 children tested, approximately 75% hadrnno remaining positive patch test to aluminium. Only a few of thernchildren presented still itching nodules.rnConclusion: Three out of four children with earlier shownrncontact allergy to aluminium had lost their patch testrnreactivity 5 years later.
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18. |
- Hewett, D., et al.
(författare)
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Identification of a psoriasis susceptibility candidate gene by linkage disequilibrium mapping with a localized single nucleotide polymorphism map
- 2002
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Ingår i: Genomics. - : Elsevier BV. - 0888-7543 .- 0888-7543. ; 79:3, s. 305-14
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Tidskriftsartikel (refereegranskat)abstract
- Psoriasis is a chronic inflammatory disease of the skin with both genetic and environmental risk factors. Here we describe the creation of a single-nucleotide polymorphism (SNP) map spanning 900-1200 kb of chromosome 3q21, which had been previously recognized as containing a psoriasis susceptibility locus, PSORS5. We genotyped 644 individuals, from 195 Swedish psoriatic families, for 19 polymorphisms. Linkage disequilibrium (LD) between marker and disease was assessed using the transmission/disequilibrium test (TDT). In the TDT analysis, alleles of three of these SNPs showed significant association with disease (P<0.05). A 160-kb interval encompassing these three SNPs was sequenced, and a coding sequence consisting of 13 exons was identified. The predicted protein shares 30-40% homology with the family of cation/chloride cotransporters. A five-marker haplotype spanning the 3' half of this gene is associated with psoriasis to a P value of 3.8<10(-5). We have called this gene SLC12A8, coding for a member of the solute carrier family 12 proteins. It belongs to a class of genes that were previously unrecognized as playing a role in psoriasis pathogenesis.
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19. |
- Inerot, Annica, 1949, et al.
(författare)
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Collecting a set of psoriasis family material through a patient organisation; clinical characterisation and presence of additional disorders.
- 2005
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Ingår i: BMC Dermatology. - : Springer Science and Business Media LLC. - 1471-5945. ; 5:10
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to describe the clinical characteristics of a population of psoriatics sampled from a patient organisation and not from hospitals or out-patient clinics. Furthermore, we wanted to compare siblings with and without psoriasis regarding the occurrence of other diseases.At the end of 1991, we initiated a project which aimed to study genetic factors leading to psoriasis. Firstly, we sent questionnaires to all the members of the Swedish Psoriasis Association. We then examined 1,217 individuals (570 with psoriasis) from 310 families, in their homes in the southern part of Sweden. All the available family members were examined clinically and asked about the course of the skin disease and the occurrence of other diseases. The eight hundred members of the proband generation were divided into two groups, with or without psoriasis, and their clinical features were compared.Most individuals in this study population had a mild form of psoriasis. The siblings with psoriasis had joint complaints significantly more frequently than their siblings without the skin disease and those with joint complaints had more widespread skin disease. Among the other studied concomitant diseases (iritis, heart or hypertension disease, endocrine disease, inflammatory bowel disease and neurological disease), we were not able to find any difference. Seventy-seven of 570 persons were found to be in remission (13.5%). Females had a mean onset 2.5 years earlier than males. We were not able to find any correlation between the extent of the skin disease and age at onset. Twice as many persons with joint complaints were found among those with psoriasis than among those without, 28% versus 13%. Almost half (48%) the psoriatics who also had joint complaints had psoriasis lesions on their nails. Endocrine disorders were found in 9% of those without any allele for Cw6, but only in 1% of those who had Cw6. In fact, none of 183 Cw6 carriers had diabetes, as compared to the population prevalence of 3-5% in Sweden.With the exception of joint complaints, persons with psoriasis, collected from a patient organisation, did not have an increased frequency of (studied) co-existing diseases.
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20. |
- Inerot, Annica, 1949, et al.
(författare)
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LOCAL ITCHING AND SWELLING THREE DAYS AFTER TATTOOING WITH YELLOW AND GREEN COLORS IN A YOUNG WOMEN, KNOWN TO BE CONTACT ALLERGIC TO ALUMINIUM
- 2013
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Ingår i: European Congress on Tattoo and Pigment Research, Nov 13-14, 2013, Copenhagen.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Aim: To highlight the risk of local contact dermatitis from aluminum in a tattoo, a case report. Method: Observing an 18 years of age women seeking medical care three days after having tattooed a flower decoration on her right arm. Background: At the age of 10 she had problems with itching and eczema on her upper left arm after vaccination and in her armpits, when using deodorants. A dermatologist referred her to a patch test clinic on the suspicion of contact allergy to aluminum. The patch test showed a strong reaction (+++) to aluminum chloride hexahydrate 2, 0 % in petrolatum. Eight years later – on a Monday – she asked a tattoo parlor to make a four-colored decoration of her right arm. She asked them before if there were any aluminum in the tattoo and was reassured that this was not the case. The tattooing was done in black, red, yellow and green colors. On Thursday she had severe itching and swelling where there was yellow and green tattooing. She had no reaction at all where there were black or red colors. She was recommended local steroid application. Results: The itching continued for around a year. The yellow color was analysed and contained 960 microgram aluminum per gram. Conclusions: Individuals with an earlier subcutaneous itching nodule from vaccination could get long lasting contact dermatitis after a tattoo.
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21. |
- Inerot, Annica, 1949
(författare)
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Lymfom i huden
- 2018
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Ingår i: Svensk Geriatrik. ; :3, s. 12-17
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Beskrivning och handläggning av personer med misstänkt hudlymfom. Artikeln är riktad till kollegor inom geriatrik och primärvård.
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22. |
- Inerot, Annica, 1949
(författare)
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Population genetic studies of psoriasis
- 2000
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psoriasis is a genetically determined, common skin disease affecting about 3 % of the population. The inheritance pattern has earlier been unclear. In collaboration with the Swedish Psoriasis Association, we have collected information on the occurrence of psoriasis in the families of 11,366 members of the Association.Analysis of the answers to a questionnaire showed that 64% of all probands had no parents with psoriasis. The distribution of psoriasis in the parents, the siblings and among the children of probands was compatible with an autosomal recessive inheritance. The cumulative incidence of psoriasis in the elderly can be estimated to 5% and the gene frequency in the population to 25%.Analysis of the ages of onset shows that there is a peak of onset in puberty and that women develop the disease earlier than men. There was a correlation of the onset ages between siblings. Assuming a recessive inheritance, we have calculated the gene frequencies for different onset ages. The earliest onset age, in puberty, is found to have the highest gene frequency, 25%.The risk of acquiring psoriasis depending on the occurrence of psoriasis in the family has been determined empirically. The life-time risk varies from 24%, which is the risk if one sibling already has the disease, to 83%, which is the risk if both parents and one sibling are affected. The risk of getting psoriasis at a certain age is dependent on the age at onset of psoriasis in the affected parent.Family members from 310 families have been examined, altogether 1217 individuals. The body location and extent of psoriasis have been recorded. Remission of the skin disease was found in 13.5% at examination. The accuracy of diagnosis of psoriasis given by the proband was high. We compared concomitant diseases, in the cardiovascular, neurological and endocrine systems, and in joints, as well as iritis and inflammatory bowel disease, in the sibling generation. We found a strong association with joint complaints in persons with psoriasis. For the rest of the disorders studied, we could not find any significant difference. Presence of HLA-Cw6 seemed to protect against diabetes mellitus.
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23. |
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24. |
- Inerot, Annica, 1949, et al.
(författare)
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Symptoms and signs reported during patch testing
- 2000
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Ingår i: Am J Contact Dermat. - 1046-199X. ; 11:1, s. 49-52
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:In a pilot questionnaire study, there was a high frequency of subjective complaints and distant skin reactions during patch testing as reported at the day of test reading, particularly in female patients. OBJECTIVE: To document in a controlled study possible side-effects of a generalized nature occurring during the test procedure. METHODS: A questionnaire study on symptoms and signs reported at application and at reading of standard patch tests was conducted with 401 patients, with the patients serving as their own controls. RESULTS: An eczematous flare-up during patch testing was observed in 3.7% of the patients. There were plenty of different symptoms of malaise but, with one exception (itch on the back), the number of symptoms tended to be less on the day of reading than on the day of application of the tests. This held true also for itch occurring in the patients' dermatitis. There was no statistical correlation between symptoms and signs on the one hand and positive patch tests on the other. CONCLUSION: Distant skin reactions and impairment of general health occurring during patch testing are often reported at the time of test reading. However, with the exception of itch on the back, symptoms and signs are rather less common after the application of patch tests than before.
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25. |
- Inerot, Annica, 1949, et al.
(författare)
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Unusual presentation and progression of CD30 positive anaplastic large cell lymphoma
- 2015
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Ingår i: In a memory stick, given to all attendeces of this conference.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction and Objectives: Unexpected pathology in a skin lesion on one finger growing during one year, preliminary dermatology diagnosis were among others mycobacterium marinum and leishmaniasis. Materials and methods: A 69 year old male was referred to our dermatology clinic because of a slowly growing mass on one of his fingers. He was otherwise healthy. He has lived in Sweden for many years, but was born in southwest Asia, last visit there was in 2012. He had an aquarium at home. Results: At first visit he had a big mass on his left forth finger but no other skin lesions and his general health was good. The preliminary dermatology diagnosis was mycobacterium marinum infection and he was put on antibiotics and a skin biopsy was taken. Three weeks later there were no signs of improvement. A second diagnosis was considered, leishmaniasis. Histopathology showed normal epidermis. In the dermis there was very dense pleomorphic large cell infiltrates with blastlike morphology. Immunohistochemistry revealed these cells to be Tlymphocytes with CD30 +, CD2 +, CD3 +, CD4 +, CD5 +. ALK and EMA were negative as well as test for Mycobacteria and leishmaniasis. Radiation therapy was started. He received 40 Gy with good regression of the tumour mass. Only few weeks later numerous skin tumours developed over the body, mostly arms and legs. Methotrexate was given, 15-20 mg per week, initially a tendency to response but after 6 months several tumours were dramatically enlarged with ulcerations progressing into oozing, eruptive and bad smelling wounds. General health was still good but he suffered from skin tumor pain. He was hospitalized for further evaluation and to alleviate the pain. Blood test now showed some anemia, but no other significant alterations. CTscan showed enlarged lymph nodes in the groin area, but not accessible for punction or excision. In one of the nose cavities a tumour mass gave him problems with nasal congestion. Tissue sample from this nasal tumor showed high malignant Tcell lymphoma. Treatment with CHOP was given for six sessions during 2 months. He had a complication with septicemia after the first session but could continue the treatment and already after the third session the skin tumours started to regress. After completion of the CHOP a new CTscan revealed also regress of the lymph nodes in the groin, from 18 to 11 mm and a total regress of the mass in the nose cavity. The patient is at home with his family and will have future checkups in the hospital. Conclusion: Anaplastic large cell lymphoma (CD30+) is considered indolent and sometimes selfhealing. This case illustrates both an unusual presenting symptom and shortly thereafter widespread tumours, not selfhealing and without response to methotrexate. With help from colleagues in haematology the patient got treatment with CHOP with good response. Follow up time is only 4 months.
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26. |
- Isaksson, Marléne, et al.
(författare)
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Multicentre patch testing with compositae mix by the Swedish contact dermatitis research group
- 2011
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Ingår i: Acta Dermato-Venereologica. - : Society for Publication of Acta Dermato-Venereologica. - 0001-5555 .- 1651-2057. ; 91:3, s. 295-298
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Tidskriftsartikel (refereegranskat)abstract
- Sesquiterpene lactone mix detects contact allergy to these compounds present in the plant family Asteraceae. This marker is present in many baseline series. An additional marker is Compositae mix, which is not present in many baseline series. To investigate whether this allergen should be inserted into the Swedish baseline series, sex dermatology centres representing the Swedish Contact Dermatitis Research Group included Compositae mix into their baseline series for 1.5 years. Of 2818 patients tested, 31 (1.1%) reacted to Compositae mix and 26 (0.9%) to Sesquiterpene lactone mix. Active sensitization to Compositae mix was noted in two cases. Only 0.4% of Asteraceae contact allergy cases would have been missed if Compositae mix had not been tested, a frequency too low to merit its inclusion in the baseline series. Due to obvious geographical differences in frequency in frequency of simultaneous allergic reactions to Compositae mix and Sesquiterpene lactone mix, the question as to whether specific baseline series (including Compositae mix or not as a "tail" substance) should be used in the different centres must be addressed. Another option could be to remove Sesquiterpene lactone mix from the baseline series and substitute it with Compositae mix.
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27. |
- Kainu, Kati, et al.
(författare)
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Association of psoriasis to PGLYRP and SPRR genes at PSORS4 locus on 1q shows heterogeneity between Finnish, Swedish and Irish families.
- 2009
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Ingår i: Experimental dermatology. - : Wiley. - 1600-0625 .- 0906-6705. ; 18:2, s. 109-15
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Tidskriftsartikel (refereegranskat)abstract
- A susceptibility locus for psoriasis, PSORS4, has been mapped to chromosome 1q21 in the region of the epidermal differentiation complex. The region has been refined to a 115 kb interval around the loricrin (LOR) gene. However, no evidence of association between polymorphisms in the LOR gene and psoriasis has been found. Therefore, we have analysed association to three candidate gene clusters of the region, the S100, small proline-rich protein (SPRR) and PGLYRP (peptidoglycan recognition protein) genes, which all contain functionally interesting psoriasis candidate genes. In previous studies, the SPRR and S100 genes have shown altered expression in psoriasis. Also polymorphisms in the PGLYRP genes have shown to be associated with psoriasis. We genotyped altogether 29 single nucleotide polymorphisms (SNPs) in 255 Finnish psoriasis families and analysed association with psoriasis using transmission disequilibrium test. A five-SNP haplotype of PGLYRP SNPs associated significantly with psoriasis. There was also suggestive evidence of association to SPRR gene locus in Finnish families. To confirm the putative associations, selected SNPs were genotyped also in a family collection of Swedish and Irish patients. The families supported association to the two gene regions, but there was also evidence of allelic heterogeneity.
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28. |
- Lindberg, Magnus, et al.
(författare)
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Are adverse skin reactions to cosmetics underestimated in the clinical assessment of contact dermatitis? A prospective study among 1075 patients attending Swedish patch test clinics.
- 2004
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555. ; 84:4, s. 291-295
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Tidskriftsartikel (refereegranskat)abstract
- It is known that cosmetics and skin care products can cause adverse skin reactions. However, the frequency of adverse reactions reported to the Medical Product Agency (MPA) in Sweden is low. The purpose of the present study was to evaluate the occurrence of adverse skin reactions to cosmetics among patients referred for standard patch testing owing to suspected contact dermatitis in general, most frequently hand eczema. Consecutive patients at four patch test clinics in Sweden were invited to participate; 1075 were included. Of these, 47.3% (54.2% women and 30.8% men) reported current or previous adverse skin reactions to cosmetics and skin care products. This group showed significantly more positive patch test reactions, a higher prevalence of atopic dermatitis and the dermatitis was more frequently located in the face and neck region. Our results show that patients referred for standard patch testing have--or have had--a large proportion of self-reported adverse reactions to cosmetics or skin care products. We conclude that among patients with suspected contact dermatitis, adverse reactions to cosmetics can be a more important aetiological and/or complicating factor than is commonly acknowledged and that the reporting of such reactions to the MPA probably can be improved.
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29. |
- Nyman, Gunnar, 1954, et al.
(författare)
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Contact allergy to beeswax and propolis among patients with cheilitis or facial dermatitis
- 2019
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Ingår i: Contact Dermatitis. - : Wiley. - 0105-1873 .- 1600-0536. ; 81:2, s. 110-116
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Tidskriftsartikel (refereegranskat)abstract
- Background: Beeswax, both white and yellow, has many uses, such as in lip balm. This material can cause contact allergy, although not many cases have been described. Methods: Ninety-five patients with contact cheilitis, facial eczema or a suspicion of contact allergy to beeswax were patch tested with yellow and white beeswax and with propolis, in addition to the Swedish baseline series. Patients who reacted positively to beeswax were additionally tested with caffeic acid, and two derivatives thereof that are believed to be important haptens in propolis. Results: Seventeen patients had positive reactions to beeswax. Fourteen of these patients had been tested with both yellow and white beeswax. Among those 14, eight had positive reactions to both types of wax, five only to yellow wax, and one only to white wax. Of the 10 wax-positive patients tested with caffeic acid derivatives, three reacted positively. Fourteen beeswax-positive patients also had positive reactions to propolis. Conclusion: Patch testing cheilitis patients is important, as contact allergy is common. Our suggestion is to patch test, apart from the baseline series and the patient's own products, also with beeswax and propolis. Many beeswax-allergic cheilitis patients would not have been diagnosed with a relevant contact allergy if only the Swedish baseline series had been used.
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30. |
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31. |
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32. |
- Samuelsson, Lena, 1962, et al.
(författare)
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A genome-wide search for genes predisposing to familial psoriasis by using a stratification approach
- 1999
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Ingår i: Hum Genet. - 0340-6717 .- 0340-6717. ; 105:6, s. 523-9
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Tidskriftsartikel (refereegranskat)abstract
- We have performed a genome scan, using markers spaced by 10 cM, in the search for psoriasis-susceptibility loci. The family material of 134 affected sibling pairs was ascertained on the basis of a population genetic study in which 65% of the probands had two healthy parents. Genotyping results were analyzed for non-random excessive allele-sharing between sib pairs by using GENEHUNTER ver 1.1. A stratification approach was applied to increase the homogeneity of the material by means of an operational definition of joint complaints among affected individuals. Significant linkage to the human leukocyte antigen region on chromosome 6p in a cohort including 42 families without joint complaints (nonparametric linkage score of 2.83, P=0.002) strongly supported the validity of this operational definition as it replicated results from an earlier linkage report with similar stratification criteria. New candidate regions on chromosomes 3 and 15 were identified. The highest non-parametric linkage values in this study, 2.96 (P=0.0017) and 2.89 (P=0.0020), were reached on chromosome 15 in a subgroup with joint complaints and on chromosome 3 in a subgroup without joint complaints. In addition, confirmation of previously reported loci was established on chromosomes 4q, 6p, and 17q. This study indicates that distinct disease loci might be involved in psoriasis etiology for various phenotypes.
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33. |
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34. |
- Swanbeck, Gunnar, 1934, et al.
(författare)
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A population genetic study of psoriasis
- 1994
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Ingår i: Br J Dermatol. - 0007-0963. ; 131:1, s. 32-9
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Tidskriftsartikel (refereegranskat)abstract
- We present epidemiological data for 5197 families with psoriasis. Errors in reporting have been analysed. Analysis of the data provides indications of random mating with respect to whether the partner has the skin disease or not. Data on psoriasis among parents, siblings and children are provided, and particular attention has been paid to the age at onset of psoriasis. Psoriasis was present in the parents of about 36% of the probands. In families in which one or both parents have psoriasis, the occurrence of the disease among the siblings does not provide any information which differentiates between a dominant and recessive mode of inheritance, but is compatible with both. In families in which neither parent had psoriasis, provided there was a proband with psoriasis, the probability of the siblings suffering from psoriasis was close to 0.25, indicating a recessive mode of inheritance. The distribution of psoriasis among the parents of all probands, and among the children of probands, was also compatible with this mode of inheritance. The prevalence of psoriasis in the elderly was estimated to be about 5%, and the gene frequency in the whole population 25%. These findings show that, with regard to first-degree relatives, the inheritance of psoriasis can fit an autosomal recessive model. The concept of a recessive mode of inheritance may be used as a basis for genetic counselling.
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35. |
- Swanbeck, Gunnar, 1934, et al.
(författare)
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Age at onset and different types of psoriasis
- 1995
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Ingår i: Br J Dermatol. ; 133:5, s. 768-73
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Tidskriftsartikel (refereegranskat)abstract
- The age at onset of psoriasis has been analysed for 11,366 psoriasis patients. The age at onset for siblings of probands has been analysed for 805 probands having one affected sibling and for 179 probands having two affected siblings. The age at onset curve for all probands shows a dominating maximum at about puberty but also indications for two more maxima at about 30 and 50 years of age, respectively. A more relevant picture of the risk of getting psoriasis at different ages is obtained if the onset for old people having psoriasis is investigated. The three maxima come out more clearly in this case, and the puberty maximum is not so dominating. For the families with one proband and two affected siblings there is a statistically significant correlation (P < 0.001) between the age at onset of the proband and of the siblings, and also between the siblings. The correlation coefficient is between 0.30 and 0.45. For the probands with one affected sibling, the ages at onset of the siblings mainly fall in the same range as those of the probands. These data indicate three groups of patients with respect to age at onset. However, the overlap between the different groups is considerable. The data presented are compatible with three, possibly genetically different, variants of psoriasis vulgaris. By studying the occurrence of psoriasis among parents of the probands, the gene frequency can be estimated assuming a recessive mode of inheritance. It then turns out that the gene frequency of the group with the earliest age at onset has a gene frequency of about 0.25, the next earliest, 0.18, and the latest, 0.14.
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36. |
- Swanbeck, Gunnar, 1934, et al.
(författare)
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Genetic counselling in psoriasis: empirical data on psoriasis among first-degree relatives of 3095 psoriatic probands
- 1997
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Ingår i: Br J Dermatol. ; 137:6, s. 939-42
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Tidskriftsartikel (refereegranskat)abstract
- The risk of getting psoriasis dependent on the occurrence of psoriasis in the family has been determined empirically. Altogether 3717 families with one or both parents who had psoriasis have been analysed with regard to the number of children with or without psoriasis. The lifetime risk of getting psoriasis if no parent, one parent or both parents have psoriasis is 0.04, 0.28 and 0.65, respectively. If there is already one affected child in the family, the corresponding risks are 0.24, 0.51 and 0.83, respectively. The risk of getting psoriasis before the age of 32 years is dependent on the age-of-onset of psoriasis in one affected parent.
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37. |
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38. |
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39. |
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