A du Vivier

King's College London, Londinium, England, United Kingdom

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Publications (80)227.64 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Alagille syndrome (arteriohepatic dysplasia) is a genetic disorder with autosomal dominant transmission which has been localized to chromosome 20p. Cutaneous manifestations include jaundice, pruritus, and widespread xanthomata. We report a child with severe Alagille syndrome in whom orthotopic liver transplantation caused rapid resolution of disfiguring xanthomas.
    Pediatric Dermatology 05/2009; 15(3):199-202. DOI:10.1111/j.1525-1470.1998.tb01314.x · 1.52 Impact Factor
  • J R Hughes, M Newbould, A W du Vivier, A Greenough
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    ABSTRACT: A characteristic vasculitis is an uncommon but well-recognized complication of severe Pseudomonas aeruginosa infection in the neonate. Although it is one of the most common gram-negative organisms responsible for overall nosocomial infection, it is a rare cause of intrauterine or intrapartum infection of the newborn. We describe a fatal Pseudomonas aeruginosa infection occurring in a very premature infant with widespread skin necrosis. Although this organism is relatively uncommon in the neonate, premature infants are at increased risk of infection, with a significant associated mortality. Early recognition and treatment are therefore very important.
    Pediatric Dermatology 03/2009; 15(2):122-4. DOI:10.1111/j.1525-1470.1998.tb01296.x · 1.52 Impact Factor
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    ABSTRACT: Between 1987 and 1989 the Cancer Research Campaign funded a health education programme for the early detection of cutaneous malignant melanoma in the general population in 6 health districts of England and 1 health board in Scotland (population of 3 million). The intervention was evaluated by studying its effects on annual and cumulative mortality rates for melanoma. Population-based data on mortality from melanoma were collected in the intervention areas, the health regions covering those areas, and 5 other health regions of England from 1981 to 1996. Deaths from melanoma in cases diagnosed after the start of the intervention were used to study cumulative mortality rates. The annual mortality rates for melanoma, 1981 to 1996, showed no significant difference in their trends between the intervention areas, and other areas of England and Wales. After adjustment for pre-intervention rates, there was also no significant reduction in cumulative mortality from melanoma in the intervention areas compared with the non-intervention areas: rate ratio 1.2 (95% Cl 0.9-1.7) in men, 0.9 (95% Cl 0.7-1.3) in females. The lack of a significant reduction in melanoma mortality associated with the intervention raises questions about this approach to early detection and emphasises the need for new strategies.
    British Journal of Cancer 10/2001; 85(6):803-7. DOI:10.1054/bjoc.2001.2012 · 4.82 Impact Factor
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    DA Buckley, L C Fuller, E M Higgins, A W du Vivier
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    ABSTRACT: Tinea capitis should be considered in all adults with a patchy inflammatory scalp disorderTinea capitis (scalp ringworm) is uncommon after puberty. When it occurs in adults the clinical features may be atypical and this may delay the diagnosis.1 Unless the possibility of dermatophyte infection is considered, unnecessary investigations may be performed and inappropriate treatment prescribed, as illustrated in the four cases described below. Case reports Case 1 A 45 year old Afro-Caribbean woman had had an itchy pustular eruption of the scalp with associated hair loss for several months. Her general practitioner had treated it unsuccessfully with neomycin and gramicidin ointment and oral flucloxacillin and metronidazole. During this period the woman underwent lymph node aspiration and chest radiography because she had an enlarged but painless cervical lymph node. Cytological examination showed a mixed population of lymphocytes, indicating reactive changes; in addition, the surgical house officer observed that the woman had “quite a nasty rash on her scalp.” At the time of her referral to the dermatology clinic she had circumscribed areas of hair loss over the crown, with peripheral inflammation, pustules, and scaling (fig 1). Culture of bacterial swabs had negative results and a presumptive diagnosis …
    BMJ Clinical Research 06/2000; 320(7246):1389-90. DOI:10.1136/bmj.320.7246.1389 · 14.09 Impact Factor
  • F J Child, L C Fuller, E M Higgins, A W Du Vivier
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    ABSTRACT: We recorded the diagnosis made in 461 black patients (187 children and 274 adults) attending a dermatology clinic between January and March 1996. In the childhood population, atopic eczema and tinea capitis were the most frequent dermatoses, comprising 63% of diagnoses recorded. In the adult population, acne and acne keloidalis nuchae were seen most frequently. Other conditions observed commonly were eczema, psoriasis, keloid scarring, pityriasis versicolor and postinflammatory changes. Our study demonstrates a wide spectrum of skin disease and includes disorders more common in black skin, disorders unique to black skin, those which present a greater cosmetic disability, and normal findings which have been mistaken for pathological disease.
    British Journal of Dermatology 10/1999; 141(3):512-7. DOI:10.1046/j.1365-2133.1999.03047.x · 4.10 Impact Factor
  • British Journal of Dermatology 09/1999; 141(2):378-80. DOI:10.1046/j.1365-2133.1999.03016.x · 4.10 Impact Factor
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    ABSTRACT: Recalcitrant viral warts are a troublesome therapeutic problem. Immunotherapy with the universal allergic contact sensitizer diphencyprone (DCP) has been used successfully in such cases. We have reviewed our experience of the use of DCP in the treatment of resistant hand and foot warts during an 8-year period. Sixty patients were sensitized to DCP during this time; the median duration of warts was 3 years. Twelve patients defaulted from treatment. Of the remaining 48 individuals, 42 (88%) cleared of all warts. The median number of treatments to clear was five (range one to 22) and the median time to clear was 5 months (range 0.5-14). Adverse effects occurred in 27 of 48 patients (56%), most commonly painful local blistering (n = 11), blistering at the sensitization site (n = 9), pompholyx-like reactions (n = 7) and eczematous eruptions (n = 4). Three of those who defaulted did so due to side-effects, one became pregnant and eight dropped out for unknown reasons. Three of the 48 patients who cleared or had at least six treatments also discontinued DCP therapy due to side-effects, but most tolerated treatment well. Twenty-five patients were followed up for periods of 1 month to 8 years (median 2 years) and none had a recurrence. DCP immunotherapy is an effective option for the treatment of recalcitrant viral warts but patients must be motivated to attend for sequential applications and must be warned about potential uncomfortable side-effects.
    British Journal of Dermatology 09/1999; 141(2):292-6. DOI:10.1046/j.1365-2133.1999.02978.x · 4.10 Impact Factor
  • D A Buckley, A W du Vivier
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    ABSTRACT: Topical immunotherapy of skin diseases has been used since the 1970s to treat conditions thought to result from an altered immunological state, mainly extensive alopecia areata and resistant viral warts. Despite its effectiveness, only a handful of dermatology departments in the UK currently provide such treatment. Any of three universal contact sensitisers may be used for topical immunotherapy; but diphencyprone (DCP) has advantages over dinitrochlorobenzene (DNCB) and squaric acid dibutyl ester (SADBE). Sensitisation of medical, nursing and pharmacy staff may be avoided by careful handling of the solutions. Local blistering and eczematous eruptions are the most common risks in patients undergoing treatment; vitiligo and erythema multiforme-like reactions are rare complications. Topical immunotherapy using DCP with close supervision is a useful option for severe alopecia areata and resistant viral warts.
    International Journal of Clinical Practice 04/1999; 53(2):130-7. · 2.54 Impact Factor
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    ABSTRACT: To determine whether Chinese herbal creams used for the treatment of dermatological conditions contain steroids. 11 herbal creams obtained from patients attending general and paediatric dermatology outpatient clinics were analysed with high resolution gas chromatography and mass spectrometry. Departments of dermatology and clinical biochemistry. Presence of steroid. Eight creams contained dexamethasone at a mean concentration of 456 micrograms/g (range 64 to 1500 micrograms/g). All were applied to areas of sensitive skin such as face and flexures. Greater regulation needs to be imposed on Chinese herbalists to prevent illegal and inappropriate prescribing of potent steroids.
    BMJ Clinical Research 03/1999; 318(7183):563-4. DOI:10.1136/bmj.318.7183.563 · 14.09 Impact Factor
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    E M Higgins, L C Fuller, A W du Vivier, D Tovey
    British Journal of General Practice 10/1997; 47(422):594. · 2.36 Impact Factor
  • L. C. Fuller, F. J. Child, E. M. Higgins, A. W. R du Vivier
    Melanoma Research 01/1997; 7(2). DOI:10.1097/00008390-199704000-00016 · 2.10 Impact Factor
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    Journal of the Royal Society of Medicine 12/1996; 89(11):647-8. · 2.02 Impact Factor
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    ABSTRACT: This prospective study was undertaken to determine whether the 2-mm punch biopsy technique yields specimens of sufficient size and quality to allow a reliable histological diagnosis to be made. A histopathological comparison was made between tissue obtained from a 2-mm punch biopsy and a standard ellipse biopsy taken from a wide range of dermatoses and benign and malignant skin tumours. In 79 of the 84 cases studied, the same histopathological diagnosis was reached with the 2-mm punch biopsy and the standard ellipse. Use of the 2-mm punch biopsy technique produces specimens which allow an accurate histological diagnosis to be made in a wide range of dermatological conditions. Skin biopsy techniques should ideally be quick and easy to perform, yielding specimens of high quality and adequate size while leaving the smallest possible tissue defect and a good cosmetic result. The aim of this study was to compare the effectiveness of the 2-mm punch biopsy with that of the standard ellipse biopsy technique in providing skin specimens which permit an accurate pathological diagnosis to be made.
    Clinical and Experimental Dermatology 02/1996; 21(1):11-13. DOI:10.1111/j.1365-2230.1996.tb00002.x · 1.23 Impact Factor
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    ABSTRACT: The aim of the study was to assess the completeness and accuracy of cancer registration for cutaneous malignant melanoma. The study was conducted in seven health districts in England and one health board in Scotland from 1987 to 1989 with a total resident population of 3.6 million. Records from pigmented lesion clinics and pathology laboratories collected during the Cancer Research Campaign's health education programme to promote the early detection of melanoma were matched with cancer registrations from a total of five regional cancer registries. In England 74% out of a total of 642 cases of invasive malignant melanomas (ICD 172) and 44% out of a total of 155 in situ melanomas (ICD 232) had been registered compared with 96% and 100% respectively in Scotland. A significantly higher proportion of late-stage cases was found among registered than among non-registered cases in England (P < 0.001). In all registries the majority of superficial spreading in situ melanomas were miscoded as invasive cases. The annual incidence of invasive malignant melanoma in the English study areas was found to be seven per 100,000 in men and 11 per 100,000 in women, similar to that reported in Scotland. The registries are best at recording thick or late-stage melanomas. As the skin cancer target for Health of the Nation depends on monitoring trends in the incidence of malignant melanoma, future improved ascertainment of cases and changes in the type of cases being registered must be taken into account.
    British Journal of Cancer 08/1995; 72(1):224-8. DOI:10.1038/bjc.1995.307 · 4.82 Impact Factor
  • P Todd, P Norris, J.l.m. Hawk, A W Du Vivier
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    ABSTRACT: We report the case of a 72-year-old male patient who developed a florid photosensitive eruption while on ranitidine therapy. Ultraviolet A sensitivity was detected by irradiation monochromator testing, suggesting drug-induced photosensitivity. Ranitidine was concluded to be the cause of his photosensitivity since the eruption resolved and the phototest abnormalities returned to normal following cessation of therapy. Similar cases have been reported to the Committee on Safety of Medicines but not published.
    Clinical and Experimental Dermatology 04/1995; 20(2):146-8. DOI:10.1111/j.1365-2230.1995.tb02720.x · 1.23 Impact Factor
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    ABSTRACT: From 1987 to 1989 a campaign to promote the early detection of cutaneous malignant melanoma was conducted in the areas of seven health authorities in England and Scotland (total population 3.6 million). Data were collected on 17,155 patients attending pigmented lesion clinics (PLCs) in each study area during the campaign. After a dramatic rise in PLC referral rates in the first month of the campaign the average monthly referral rate among the target population in the study period settled to an average of 13 per 10(5), a twofold increase compared with the pre-campaign period. Over 85% of patients at all PLCs were seen within 4 weeks of referral from their general practitioners. The melanoma to non-melanoma detection ratio was (1:33). The organization of future early detection initiatives needs careful review and planning, in order to improve their effectiveness in all sections of the population, and to enable health services to cope with the increased work-load.
    British Journal of Dermatology 04/1995; 132(3):405-13. DOI:10.1111/j.1365-2133.1995.tb08674.x · 4.10 Impact Factor
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    ABSTRACT: The effect on the detection and characteristics of melanoma, resulting from the Cancer Research Campaign's health education programme to promote the early detection of melanoma in the general population, was studied from 1987 to 1989. The seven study areas in England and Scotland yield a target population of 3.6 million. Data were collected from local clinic-based registers, pathology laboratories, and the cancer registries. The average annual incidence rates of melanoma were seven and 12 per 10(5) in males and females, respectively, age-standardized to England and Wales, 1988. These rates are similar to the national figures for Scotland, where there is a national melanoma register, but higher than those reported by the English and Welsh cancer registries. The incidence was significantly higher in females than males (P < 0.001), and increased with age. Fifty-three per cent and 65% of cases in males and females, respectively, were thin (Breslow thickness < or = 1.5 mm), similar to the national figures from Scotland. No significant decrease in the incidence of late-stage tumours was found in either sex as a result of the campaign. Because of difficulties with ascertainment of cases in England, the main evaluation will focus on future trends in mortality rates for melanoma.
    British Journal of Dermatology 03/1995; 132(3):414-21. DOI:10.1111/j.1365-2133.1995.tb08675.x · 4.10 Impact Factor
  • C. Fuller, F Child, E. Higgins, A. du Vivier
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    Journal of the Royal Society of Medicine 06/1994; 87(5):292-3. · 2.02 Impact Factor
  • E M Higgins, A W du Vivier
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    ABSTRACT: Certain skin disorders have now been demonstrated to be affected by alcohol misuse, in particular psoriasis and discoid eczema. The pattern of involvement in psoriasis differs from psoriasis vulgaris in character and distribution, and tends to be more difficult to treat. Discoid eczema appears to be specifically related to alcohol excess and is associated with deranged liver function tests. Rosacea, post-adolescent acne, superficial infections and porphyria cutanea tarda may also be markers of alcohol misuse. These disorders occur early and are quite distinct from the traditional cutaneous stigmata of established liver disease. The association between alcohol and skin disease is under-reported, as alcohol misuse may go undetected in a general clinic unless specifically sought. Alcohol has a profound influence on immune function and induces changes in the cutaneous vasculature. The relevance of these effects to the pathophysiology of alcohol-related skin disease is discussed.
    British Medical Bulletin 02/1994; 50(1):85-98. · 3.95 Impact Factor

Publication Stats

903 Citations
227.64 Total Impact Points


  • 1979–2009
    • King's College London
      Londinium, England, United Kingdom
  • 1979–1988
    • The Kings College
      Brooklyn, New York, United States
  • 1983
    • University Hospital Estaing of Clermont-Ferrand
      Clermont, Auvergne, France
  • 1978
    • Temple University
      Philadelphia, Pennsylvania, United States