A Lundin’s research while affiliated with Akademiska Sjukhuset and other places

A population of 1,077 persons (568 men; mean age 21 years old and 509 women; mean age 28.5 years old), students at a college of health and caring science and conscripts, were interviewed about their use and any side effects of cosmetics and toiletries during the last five years. Soap, toothpaste and deodorants were used daily by more than 80% of all the participants. Six per cent of the men and 18% of the women claimed adverse reactions from a total of 180 cosmetic products. Most commonly reported were eczematous reactions. Among the men the largest number of adverse effects was correlated to the use of deodorants. In women eye cosmetics were by far the most commonly claimed offending products. When persons reporting side effects were patch tested with a test panel containing several cosmetic allergens, 29% of them showed positive results, but only 11 of the 40 positive test reactions were evaluated as being relevant. In accordance with earlier reports, only a minor proportion of the subjects could thus be declared contact allergic and it is suggested that most of the cosmetic-related side effects were of the irritant type.

Topical treatment with retinoic acid (tretinoin, vitamin A acid) has been reported to partly reverse signs of photodamage. To determine whether the histochemical distribution of hyaluronan (hyaluronic acid, HYA) in the epidermis and dermis and the amounts of HYA and retinoic acid in suction blister fluid were influenced by such topical treatment, 14 subjects healthy apart from moderate photodamage were instructed to treat the lateral forearm with 0.01-0.05% retinoic acid cream for 6 months. In a study of the short-term effects, another six subjects applied 0.05% retinoic acid cream for 2 weeks. After 6 months the thickness of the vital epidermis had increased by 23%. The HYA staining was based on a specific immunohistochemical method in which hyaluronan-binding protein is used. Before treatment HYA was seen as a meshwork around the cells in the upper half of the stratum spinosum. After 6 months of treatment this meshwork had increased in thickness by 31% compared with pretreatment specimens. The HYA staining was already intense in the papillary dermis before treatment and no difference was observed after 6 months' treatment. The mean concentration of HYA in blister fluid had increased significantly (43%) after 2 weeks of treatment whereas after 6 months there was no significant difference in this respect between the treated and untreated arm. The increase in the thickness of the epidermal HYA meshwork after 6 months and the blister fluid HYA after 2 weeks may indicate that HYA is involved in the epidermal change induced by topical retinoic acid therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

In suction blister fluid from active psoriatic lesions we have previously found elevated concentrations of hyaluronan. The aim of this investigation was to study the localization of hyaluronan with a histochemical method, in biopsy specimens from lesions of 13 patients with progressive psoriasis. Ten normal subjects and seven patients with allergic contact dermatitis were also studied. In normal epidermis the highest intensity of hyaluronan staining was found in the intercellular spaces in the middle and upper spinous layer, whereas the staining was much weaker in the basal layer. No hyaluronan was detected in the granular layer or in the orthokeratotic stratum corneum. In the dermis there was pronounced staining of the papillary dermis and around the sebaceous glands, sweat glands, hair follicles and blood vessels. In six of the 16 specimens from psoriatic lesions the normal epidermal meshwork of hyaluronan was partly absent and replaced by diffuse staining of both the spinous and the basal layer. In the remaining ten of these 16 specimens the same type of meshwork was found in stratum spinosum as in normal skin. The parakeratotic stratum corneum contained hyaluronan, in contrast to the normal stratum corneum, where no hyaluronan was present. The pattern of hyaluronan staining in the dermis of the psoriatic lesions did not differ from that in normal dermis. In the majority of the allergic patch test reactions the junction was less distinct than in normal skin between dermis and epidermis and the normal hyaluronan pattern of the basal layer was abolished and replaced by a diffuse staining throughout the layer.(ABSTRACT TRUNCATED AT 250 WORDS)

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.

To evaluate if whole body UVB irradiation has effects on the neutrophil function, eleven patients with mild to moderate psoriasis and 14 healthy subjects were treated with whole body UVB irradiation 3 times weekly for 4 weeks. Eight healthy untreated subjects served as controls. After 2 weeks of treatment the individual change of phagocytosis measured by the ingestion of IgG-coated particles was related to the pre-treatment value both in the psoriatic patients and healthy subjects (p less than 0.05 and p less than 0.001, respectively). Similar results were obtained for ingestion of IgG-C3b-coated particles. Thus, the change in phagocytic rate seemed to be dependent on the functional activity before treatment. UV irradiation of PMNs in vitro did not influence the phagocytic rate. After 4 weeks of UV treatment the healthy subjects showed a significant decrease in the rate of phagocytosis of IgG-C3b particles (p less than 0.02) and of the serum chemokinetic activity (p less than 0.01). In the psoriatic patients the mean chemokinetic activity in heated sera was decreased after 2 weeks (p less than 0.02). There appeared to be no relation between improvement of psoriasis and changes in PMN function. In an untreated group of healthy subjects no significant changes in neutrophil function were found. The results indicate that there is a change in PMN function during UVB treatment. The degree of change seems to vary, not only between individuals but possibly also between groups, e.g. healthy subjects compared with psoriatic patients.

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/1, 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/1). 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/1). Patients with active psoriasis had significantly higher serum hyaluronate concentrations than the controls and those with inactive psoriasis.

Twenty patients with palmoplantar pustulosis (PPP) and 21 patients with psoriasis were compared with respect to the chemotactic response and random migration of their neutrophils (PMNs) and to the chemotactic and chemokinetic activities of their serum. The Boyden chamber technique was used. Compared with the reference group, the PPP neutrophils showed a significant decrease in random migration (p = 0.036) and chemotactic response to casein (p = 0.031), but not to zymosan-activated serum. The psoriasis PMNs had normal chemotactic response, but decreased random migration (p = 0.001). The chemokinetic effects of serum from PPP and psoriatic patients on normal neutrophils were increased (for PPP, p = 0.019 and for psoriasis p = 0.024). The chemokinetic activity of the heated sera was decreased and inversely correlated to the serum level of IgA in both disorders (PPP, p = 0.021; psoriasis, p = 0.013). The chemotactic activity of serum on normal PMNs was decreased in both conditions (PPP, p = 0.001; psoriasis, p = 0.047); this was due to the presence of chemotactic factor inhibitors in 34% of the sera. It seems likely that the high chemokinetic effect of serum both from the PPP and from the psoriasis patients compensates for the slightly low or normal migratory activity of neutrophils from these patients.