Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3547
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
Warning: date() [function.date]: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'America/New_York' for 'EDT/-4.0/DST' instead in [path]/includes/functions.php on line 3734
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.D'J' 'D#/E) ( D e r m a l c e l l s ) **CHF G0G 'D.D'J' H*F-/1 EF .D'J' 'D4(CJ) ( R e t i c u l u m c e l l s ) H'D.D'J' HEF 'DF3J, 'D6'E ( M e s e n c h y m a l c e l l s ) . **6EF .D'J' 'D#/E) E' JDJ: 1 . 'D.D'J' 'DDJAJ) ( F i b r o l a s t s ) : *CHF G0G 'D.D'J' 'D#F3,) 'DDJAJ)( F i b r o u s t i s s u e ) H'D7D'! ( G r o u n d s u b s t a n c e s ) . H8'&A 'D.D'J' 'DDJAJ): *CHF 'DCHD',JF H'D#F3,) 'DE7'7J). *CHF 'D3C1J'* 'DE.'7J). *(FI 'DCHDH3*J1HD H'D3*J1HJ/'*. 2 . 'D.D'J' 'DF3J,J) ( H i s t i o c y t e s ) : G0G 'D.D'J' ,2! EF 'D,G'2 'D4(CJ 'D(7'FJ ( R e t i c u l o e n d o t h e l i a l s y s t e m ) . 'D.D'J' 'DF3J,J) GJ .D'J' #CD) H**H',/ %E' E*,HD) #H E+(*) 9DI 'D#F3,). 3 . 'D.D'J' 'D/BDJ)( M a s t o c y t e s ) : GJ .D'J' E*.55) -J+ *CHF 'DG3*'EJF H'DGJ('1JF H**H',/ G0G 'D.D'J' (C+1) AJ 'D7(B) 'D-DEJ) DD#/E) HAI 'D49J1'* 'D/EHJ) H'D7(B) 'D4(CJ) H-HD 2H'&/ 'D,D/. 4 . 'D.D'J' 'DDJEA'HJ) ( L y m p h o c y t e s ) : G0G 'D.D'J' DG' /H1 G'E AJ 'D*A'9D'* 'DEF'9J) ('D,3E. 5 . .D'J' 'D(D'2E' ( P l a s m a c e l l s ) : *CHF G0G 'D(1H*JF'* 'DEF'9J) 'DE6'/) ( I m m u n o g l o b u l i n s ) 6 . C1J'* 'D'J2JFHAJD ( E o s i n o p h i l s ) : G0G 'D.D'J' *EF9 H*C(- *A'9D'* 'DG3*'EJF. E-*HJ'* 'D#/E) **CHF 'D#/E) EF: 1 . #DJ'A 'DCHD',JF ( C o l l a g e n ) : **CHF 'D#/E) EF #DJ'A 'DCHD',JF 'D*J *F*,G' 'D.D'J' 'DDJAJ) H*9*E/ 3E'C) 'D#/E) 9DI 9/) 9H'ED #GEG' 'D9E1 H'D,F3 H'DEHB9. 7(B) 'DCHD',JF *CHF 7(B) F'9E) 37-J) *-* 'D(41) 9F/ 'D7(B) 'D-DEJ) H7(B) #.1I .4F) AJ 'D7(B'* 'D9EJB) EF 'D#/E). EF 5A'* #DJ'A 'DCHD',JF #FG' *$/J %DI *E'3C HDJHF) 'D,D/. 2 . #DJ'A 'DE1F) ( E l a s t i c f i b r e s ) : **/'.D G0G 'D#DJ'A E9 'DCHD',JF H,EJ9G' E-'7) ('D.D'J' 'DE.'7J) E*9//) 'D3C1J'*.
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7 . DD,D/ H8JA) EF'9J) (H'37) .D'J' л D' F,1G'F3╗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a m e l l e r " 'D-'HJ) 9DI 4-HE *D9( /H1'K G'E'K AJ -E'J) 'D,D/. 'DC+J1 EF 'DE1C('* E+D 'D4-HE /'.D 'D.D'J' @ 'D.D'J' 'DE*B1F) @ 'D-EH6 'D"EFJ(+) H'D#ED'- 'D#.1I AJ 'D91B H'DEA12'* 'D/GFJ) 'DEH'/ 'DF'*,) 9F *.1( 'D(1H*JF'* 'DB1FJ) CD *DC 'DEH'/ *4CD -',2'K G'E'K DEF9 6J'9 'DE'! H'D-A'8 9DI p H 'D,D/ AJ -'D*G' 'DE+'DJ). 'D7(B) 'DB1FJ) *D9( 'D/H1 'D#GE C-',2 6/ 'D'D*G'('* 'DE.*DA). JD9( 'D,D/ C0DC /H1'K G'E'K C-',2 +F'&J 'D'*,'G DEF9 9(H1 'DE'! DD/'.D HAB/'F 'DE'! %DI 'D.'1, C0DC %0 #F 'D(41) GJ 'D-',2 'D1&J3I A%0' #2JD* A%F 'D#/E) 'D('BJ) *CHF F'A0) (4CD C'ED.
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h e a l i n g ) J92I %DI 'DGJJ3*'EJF'*. 'D*91B JCHF F*J,G 'D('JDHC'1(JF. 'D*./J1 J9H/ DDE./1'* 'DEH69J).
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8 . 'DEH'/ 'DE0'() ('D4-HE *3'9/ 9DI FAH0 'DEH'/ 'DE7(B) 9DI 37- 'D,D/ H'DG1EHF'* H'D3*J1HJ/ HAJ*'EJF" D " H'D#ED'- 'DCDH1JF H'DC(1J*'* JECF #F *FA0 EF 37- 'D,D/. 'D:'2'* H'DEH'/ 'D7J'1) JECF C0DC #F *9(137- 'D,D/. 'DE1',9 A b r a h a m W , D o w n i n g D T . P r e p a r a t i o n o f m o d e l m e m b r a n e s f o r s k i n p e r m e a b i l i t y s t u d i e s u s i n g s t r a t u m c o r n e u m l i p i d s . J I n v e s t D e r m a t o l 1 9 8 9 ; 9 3 : 8 0 9 - 1 3 . 1 B r e a t hnach AS. Embryology of human skin. A review of ultrastructural studies. The Herman Beerman Lecture. J Invest Dermatol 1971; 57: 133 - 43 .2 Breathnach AS. An Atlas of the Ultrastructure of Human Skin. London: J. & A. Churchill, 1971 .3 Biochemistry and Physiology of the Skin Vol 2. New York and Oxford: Oxford University Press, 1983: 1255-95 .4 Blank IH. Cutaneous barriers. J Invest Dermatol 1965; 45: 249-56 .5 Elias PM. Epidermal lipids, membranes, and keratinization. Int J Dermatol 1981; 20: 1-19 .6 Deutsch TA, Esterly NB. Elastic fibers in fetal dermis. J Invest Dermatol 1975; 65: 320-3 .7 Farmer ER, Hood AF, eds. Pathology of the Skin. London: Prentice Hall International, 1990 .8 Goldsmith LA, ed. Biochemistry and Physiology of the Skin 2nd edn. New York: Oxford University Press, 1991 .9 Holbrook KA, Odland GF. Regional development of the epidermis in the first trimester embryo and the second trimester fetus (ages related to the timing of amniocentesis and fetal biopsy). J Invest Dermatol 1980; 74: 161-8 .10 Holbrook KA, Hoff MS. Structure of the developing human embryo and fetal skin. Semin Dermatol 1984; 3: 185-202 .11
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Hashimoto K, Gross BG, Lever WF. The ultrastructure of the skin of human embryos. I. The intraepidermal eccrine sweat duct. J Invest Dermatol 1965; 45: 139-51 .12 Lever WF, Schaumburg-Lever G. Histopathology of the Skin 7th edn .13 Briggaman RA, Wheeler CE. Epidermal-dermal interactions in adult human skin. II. The nature of the dermal influence. J Invest Dermatol 1971; 56: 18-26 .14 Montagna W, Yun JS. The skin of primates. XVI The skin of Lemur mongoz. Amer J Phys Anthrop 1963; 21: 371-81. Philadelphia: Lippincott, 1990 .15 McKee PH. Pathology of the Skin. Philadelphia: Lippincott, 1989 .16 Scheuplein RJ, Bronaugh RL. Percutaneous absorption. In: Goldsmith LA, ed .17 Smith JG, Jr, Fischer RW, Blank H. The epidermal barrier: a comparison between scrotal and abdominal skin. J Invest Dermatol 1961; 36: 337-41 .18 Scheuplein RJ, Bronaugh RI. Percutaneous absorption. In: Goldsmith LA, ed Biochemistry and Physiology of the Skin Vol II. New York and Oxford: Oxford University Press, 1983: 1255-95 .19 Wertz PW. Lipids of keratinizing tissues. In: Bereiter-Hahn J, Matoltsy AG, Richards KS, eds. Biology of the Integument. Vol 2: Vertebrates. Berlin: Springer-Verlag, 1986; 815-23 .20 Yardley HJ. Epidermal lipids. In: Goldsmith LA, ed. Biochemistry and Physiology of the Skin. New York: Oxford University Press , 1 9 8 3 : 3 6 3 - 8 1 . 2 1 'DA5D 'D+'D+ 71B *4.J5 'D#E1'6 'D,D/J) EF 'DEGE #F F*9'ED E9 'D-'D'* 'D,D/J) (71JB) 9DEJ) -*I J*3FI 'DH5HD %DI *4.J5 /BJB HF*'&, 9D',J) A9'D) *1J- 'DE1J6 EF 4CH'G HJECF #F J*E 0DC ('D.7H'* 'D*'DJ):
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'D*-22( L i c h e n i f i c a t i o n ) : 2J'/) 3E'C) 'D,D/ HB/ J*(9 0DC 2J'/) AJ #5(': 'D,D/. 'D*DJA( F i b r o s i s ) : *4CD F3J, DJAJ :2J1. 'D.1', ( A b s c e s s ) : *,E9 EH69J DD5/J/ AJ ,HA ( CGA) J*4CD EF *.1( #H *F.1 'DF3J,. 'D-E1) ( 'D*G'( 'DF3J, 'D.DHJ) ( C e l l u l i t i s ) : 'D*G'( AJ 'DF3J, 'D.DHJ .'5) 'DBJ-J EFG AJ 'D#/E) 'D9EJB) H'DF3J, E'*-* 'D,D/. 'D*BJ- 'D,D/J ( 'D/(JD)) ( P y o d e r m a ) : 'D*G'( ,D/J BJ-J. 'D-'5) ( 'D+9D()) ( A l o p e c i a ) : 6J'9 'D491 'DEH69J #H 'D9'E HB/ JF,E 0DC 9F 9/) 9H'ED ,G'2J) #H EH69J). 'D+9D() B/ *CHF (/&J) #H +'FHJ) D#E1'6 ,D/J) #HDJ) E+D 'D#F*'F'* 'D,1+HEJ) #H 'DA71J). 'D'FA'B ( B u r r o w ) : BF') 5:J1) AJ 'D,D/ *-*HJ 9DI H-J/'* 'D.DJ) E+D 'D,1(. 'D2$'F( C o m e d o ) : 'F-('3 'DC1'*JF H'D/GHF AJ A*-) 'DBFH'* 'D/GFJ) 'DE*H39). 'DH1E 'D/EHJ( H e m a r t o m a ) : 4() H1E J-*HJ 9DI /E. 'DC/E'* ( E c c h y m o s i s ) : EF7B) EF 'DF2A (B71 #C+1 EF 2 3E. 'DFE4'* ( P e t e c h i a e ) : F2A FB7J -H'DJ 1 @ 2 EDE B71'K. 'D*5(:'* ( S t a i n s ) : A17 *5(9 EH69J J*DH (96 #E1'6 'D,D/. 'D*B41 ( 'D*H3A) ( E x f o l i a t i o n ) : HGJ 'F47'1 'DC1'*JF 'D#/EJ %DI B4H1. 'D5(': 'D/EHJ ( H e m o s e d r o s e s ) : 'D'D*G'( 'D,D/ 'D5(':J J*(9 'D*,E9'* 'D/EHJ) *-* 'D,D/. 'DFH'3J1( F i s t u l a ) : HGJ EE1 EF 'D7(B) 'D9EJB) %DI 37- 'D,D/ #H (JF (FJ*JF HGJ E:7J 9'/) ((41) 4'&C). *B1F 'D,D/ ( K e r a t o d e r m a ) : 2J'/) AJ 3E'C) 'D7(B) 'DB1FJ). 'D.7H7( S t r i a ) : "A'* .7J) JF,E 9F 4/ 'D,D/ 3H'! AJ2JHDH,J'K #H E16J'K. 'D+AF ( C a l l o u s ) : 3E'C) B1FJ) AJ 'D,D/. 'D/.F ( M i l i u m ) : CJ3) (J6'! 5:J1) *-*HJ 9DI E'/) CJ1'*JFJ). 'DF'(*G ( V e g e t a t i o n s ) : HGH FEH F3J, E16J J-*HJ 9// EF C*D -DEJ) E*B'1(). 'DH1E 'D-DJEI( P a p i l l o m a ) : C*D) *4(G 'D-DE) *(12 EF 37- 'D,D/.
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'DBD'9 ( A p h t h a e ) : B1- 5:J1) AJ 'D#:4J) 'DE.'7J). 8'G1) CH(F1 ( 'DC*H(J) 'D0'*J) ( K o e b n e r s p h e n o m e n o n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A u e r b a c h A D . D i a g n o s i s o f d i s e a s e s o f D N A s y n t h e s i s a n d r e p a i r t h a t affect the skin using cultured amniotic fluid cells. Semin Dermatol 1984; 3: 172-84 .1 Auerbach AD. Diagnosis of diseases of DNA synthesis and repair that affect the skin using cultured amniotic fluid cells. Semin Dermatol 1984; 3: 172-84 .2 Ahlstedt S, Eriksson N, Lindgren S et al. Specific IgE determination by RAST compared with skin and provocation tests in allergy diagnosis with birch pollen. Timothy pollen and dog epithelium allergens. Clin Allergy 1974; 4: 131-140 .3 Boyd AS, Neldner KH. The isomorph i c r e p o n s e o f K o e b n e r . I n t J D e r m a t o l 1 9 9 0 ; 2 9 : 4 0 1 - 1 0 . 4 C o m m i t t e e o n P r o v o c a t i v e F o o d T e s t i n g . I d e n t i f i c a t i o n o f f o o d a l l e r g e n s . A n n A l l e r g y 1 9 7 3 ; 3 1 : 3 7 5 - 9 2 . 5 'DA5D 'D1'(9 71B '3*B5'! 'D#E1'6 'D,D/J) 71B 'D'3*B5'! E' B(D 'DHD'/) ( P r e n a t a l d i a g n o s i s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л GJE'*HC3JDJF╗ л 'JH2JF╗ #H л ,JE2'╗ . G0G JECF #F *A-5 (9/3) BDJD) 'DBH) HEF +E (9/3) 9'DJ) 'DBH) D#.0 AC1) -HD E-*HJ'* 'DD7'.). 'D71B 'D9'EG D'3*B5'! 'D'E1'6 'D,D/JG D7'.) *2'FC( T z a n k t e s t ) : 'DA-5 'DF3,J EF B'9/) 'DAB'9) DC4A 'D"A'* 'DAB'9J) AJ E98E 'D'F/A'9'* 'DAB'9J) A%F 'DD7'.) 3HA *(/J .D'J' 'D*G'(J) AB7 AJ 'DAB'9 HJECF #F JD'-8 .D'J' 4'&C) 0'* FHI 6.E) H3J*H(D'3E' C+JA) AJ 'D-D' 'D(3J7. /'! 'DEF7B) H,/1J 'DE'! 3HA *(/J 'DD7'.) .D'J' 917D) H-J/) HE*9//) 'DFHI H*FC3 ('DHFJ 'D4CD AJ 'DFHI. 'D*F8J1 'D.'1,J( D i a s c o p y ) : H3JD) (3J7) *AJ/ AJ %6'A) E9DHE'* DD*4.J5 AJ (96 #E1'6 'D,D/ E+D 'D0&() 'D4'&9) 'D0J J(/J 9BJ/'* E+D GD'E 'D*A'- 'D(FJ 'DE-E1 'DE'&D DD5A1) H*,1J G0G 'D*,1() (H'37) 41J-) 2,',J) #H .'A5 D3'F (D'3*JCJ 4A'A (6:7 (BH) 9DI 'D"A). 'D'F6:'* 'DE$B* DD/E 3HA J8G1 'D*:J1'* 'D,D/J). A-5 C4'7'* 'D,D/( S k i n s c r a p p i n g s ) : *3*./E 9'/) D*4.J5 'D"A'* 'DA71J) *#.0 'DC4'7) EF 'DA1H) #H 'DEF'7B 'DE:(FJ) 'D#B/'E #H 'DEF'7B 'D#.1I H0DC J*E CE' JDJ: JF8A 'D,D/ (H'37) 'DC-HD +E J*1C -*I J,A.
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'D4CD 1BE 9 : 'D*F8J1 'D.'1,J 'C47 'DEF7B) (H'37) 'DEC47) #H -'A) 'D41J-) 'D2,',J) 9DI 41J-) F8JA) H#6A FB7) H'-/) EF E1C( 1 0 % @ 2 0 % EF K O H #H S M S . 'D.JH7 H'D#(H': *8G1 (4CD #,3'E (J6'HJ) H*F9C3 6/ #16J) 'D.D'J' H'D4H'&(. H%+('* 'D*4.J5 H'D*#C/ EF 'DF*J,) J*E 9'/) (H'37) 219 'DC4'7) 9DI H37 .'5 E+D H37 л ",'1 3'(H1HJ/╗ . 'D5H1) 'D/EHJ) ( B l o o d p i c t u r e ) : *(/J (96 #E1'6 'D,D/ *:J1'* /EHJ) ,G'2J) #H EH69J) D0DC A%F 5H1) 'D/E B/ *3'9/ AJ 'DH5HD %DI 'D*4.J5 HD' J9FJ 0DC #F CD 'D-'D'* 'D,D/J) AJ -',) %DI B'&E) EF 'D'.*('1'* 'D*J 1(E' *,9D 'DE1J6 J5D %DI AB/'F +B*G ('D7(J(. B/ *8G1 5H1) 'D/E AJ (96 'D#E1'6 'D,D/J) E' JDJ: A17 'DE9/D'*( N e u t r o p h i l i a ) : *-/+ AJ 'D#E1'6 'D,D/J) 'D*'DJ): 1 . 'D'F*'F E+D 'D-E1) @ 'D/ED. 2 . '671'('* 'D*G'(J) E+D 'D(+1J) #H 'D5/'A 'D'D*G'(J '-E1J'* 'D,D/ 'D/(JD) 'DF.1) ( P y o d e r m a g a n g r e n o s u m ) . 3 . 'D.('+) 'D,G'2J) H'(J6'6 'D/E ( L e u k e m i a ) . 4 . 'D'1*C'3 DDE9'D,) 'D,G'2J) ('D3*J1H&J/'*. A17 'D-E6J'* ( E o s i n o p h i l i a ) 4'&9 AJ 'D-'D'* 'D*'DJ): 1 . 'D#E1'6 'D'3*41'&J) .'5) 'D1(H H'D#C2JE'. 2 . 'D-3'3J) DD79'E #H 'D/H'!. 3 . 'D%5'() 'D7AJDJ): /J/'F ( E9HJ) @ ,G'2J)) 'D,1(. 4 . #E1'6 'DCHD',JF 'DH9'&J): 'D*G'( 'D41'JJF 'D9/J/ 'D9B/J @ 'D*G'( 'D,D/ H'D96D'*. 5 . 'D"A'* 'DAB'9J): 'D#C2JE'* 'D.DBJ) 'DAB'9 H'D/'! 'DAB9'FJ. 6 . -E'EJ 'DHDJ/ ( E r y t h e m a n e o n a t a r u m ) . 7 . 'D.('+) .'5) /'! GH/ ,CF2 H'(J6'6 'D/E ('D-E6J'*. A17 DDEA'HJ'* ( L y m p h o c y t o s i s ) JECF #F JD'-8 AJ 'D-'D'* 'D*'DJ): 1 . 'D'F*'F'* 'DAJ1H3J) .'5) 'D7AH- H/'! H-J/'* 'DFHI 'D'F*'FJ. 2 . 'D'F*'F'* 'D,1+HEJ): 'D*/1F 'D2G1J ( 'D%A1F,J) 'D-EI 'DE'D7J) H-EI 'D*JAH&J/. 319) 'D*+BD " E S R "
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Boyd AS, Neldner KH. The isormorphic response of Koebner. Int. J. Dermatol 1990; 29: 131140 .3 Committee on Provocative Food Testing. Identification of food allergies. Ann Allergy 1973; 31: 375-92 .4 Caplan RM. Medical uses of Wood's lamp. J Am Med Assoc 1967; 202: 123 5 .5 Pepys J. Skin tests. Br J Hosp Med 1984; 32: 120-4 .6 Dutz W, Kohout E. Dermatologic diagnosis by using the hemocytometer and the dental broach. Int J Dermatol 1982; 21: 410-11 .7 Diagnosis. London: Royal College of Obstetricians and Gynaecologists, 1984: 147-58 .8 Eady RAJ, Rodeck CH. In: Rodeck CH, Nicolaides KH, eds. Prenatal Elias S. Use of fetoscopy for the prenatal diagnosis of hereditary skin disorders. In: Gedde-Dahl T, Jr, Whepper .9 Farmer ER, Hood AF, eds. Pathology of the Skin. London: Prentice Hall International, 1990 .10 Gosden CM, Ross A, Eason PJ. In: Sandler M, ed. Amniotic Fluid and its Clinical Significance. New York: Marcel Dekker, 1981: 37-103 .11 Harrison PV. A guide to skin biopsies and excisions. Clin Exp Dermatol 1980; 5: 235-43 .12 KD, eds. Prenatal Diagnosis of Heritable Skin Diseases. Current Problems in Dermatology. Basel: Karger, 1987: 1-13 .13 Kaback MM. In: Rodeck CH, Nicolaides KH, eds. Prenatal Diagnosis. London: Royal College of Obstetricians and Gynaecologists, 1984: 1-12 .14 Lehman CW. A double blind study of sublingual provocative food testing: a study of its efficacy. Ann Allergy 1980; 45: 144-9 .15 McKee PH. Pathology of the Skin. Philadelphia: Lippincott, 1989 .16
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Marks R, Dawber RPR. Skin surface biopsy: an improved technique for the examination of the horny layer. Br J Derm 1971; 84: 117-23 .17 Mills OH, Kligman AM. The follicular biopsy. Dermatologica 1983; 167: 57 63 .18 Polani PE. Incidence of developmental and other genetic abnormalities. Proc Roy Soc Med 1973; 66: 1118-19 .19 Patrick AD. Inherited metabolic disorders. Br Med Bull 1983; 39: 378-85 .20 Serup J. Quantification of weal reactions with laser Doppler flowmetry. Allergy 1985; 40: 233-7 .21 Seltzer JM. Correlation of allergy test results obtained by IgE RAST and prick- puncture methods. Ann Allergy 1985; 54: 25-30 .22 Boyd AS, Neldner KH. The isomorphic reponse of Koebner. Int J Dermatol 1990; 29: 401-10 .23 Rothman S. Physiology and Biochemistry of the Skin. Chicago: University of Chicago Press, 1954 .24 Caplan RM. Medical uses of Wood's lamp. J Am Med Assoc 1967; 202: 123-5 .25 Gilchrest BA, Fitzpatrick TB, Anderson RR et al. Localization of melanin pigment on the skin with Wood's lamp. Br J Dermatol 1977; 96: 245-8 .26 Gottlieb PM, Stupniker S, Askovitz J. The reproducibility of intradermal skin tests: a controlled study. Ann Allergy 1960; 18: 949-60 .27 Lever WF, Schaumburg-Lever G. Histopathology of the Skin 7thedn. Philadelphia: Lippincott, 1990 .28 McKee PH. Pathology of the Skin. Philadelphia: Lippincott, 1989 .29 Pepys J. Skin tests. Br J Hosp Med 1984; 32: 120-4 .30
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Ahlstedt S, Eriksson N, Lindgren S et al. Specific IgE determination by RAST compared with skin and provocation tests in allergy diagnosis with birch pollen. Timothy pollen and dog epithelium allergens. Clin Allergy 1974; 4: 131-140 .31 Ackerman AB. Histologic Diagnosis of Inflammatory Skin Diseases. Philadelphia: Lea & Febiger, 1978 .32 Farmer ER, Hood AF, eds. Pathology of the Skin. London: Prentice Hall International, 1990 .33 Harrison PV. A guide to skin biopsies and excisions. Clin Exp Dermatol 1980; 5: 235-43 .34 Eady RAJ. Fetoscopy and fetal skin biopsy for prenatal diagnosis of genetic skin disorders. Semin Dermatol 1988; 7: 2-8 .35 Eady RAJ, Rodeck CH. In: Rodeck CH, Nicolaides KH, eds. Prenatal Diagnosis. London: Royal College of Obstetricians and Gynaecologists, 1984: 147-58 .36 Gosden CM, Ross A, Eason PJ. In: Sandler M, ed. Amniotic Fluid and its Clinical Significance. New York: Marcel Dekker, 1981: 37-103 .37 Auerbach AD, Adler B, Chaganti RSK. Prena t a l a n d p o s t n a t a l d i a g n o s i s a n d c a r r i e r d e t e c t i o n o f F a n c o n i a n e m i a b y a c y t o g e n e t i c m e t h o d . P e d i a t r i c s 1 9 8 1 ; 6 7 : 1 2 8 - 3 5 . 3 8 'DA5D 'D.'E3 E('/& 71B E9'D,) 'D#E1'6 'D,D/J)
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,19) 'D#7A'D 'D169 0 . 0 5 ( F5A 'D941) ED H'D#7A'D 'DC('1 J97I 'DDB'- (,19) E6'9A) 0 , 1 ( 941) ED . 'D'1*C'3 'DEH69J J-/+ 9'/) (9/ 'DDB'- (-H'DJ 2 @ 6 #3'(J9 9DI 4CD -7'7) 5:J1) B/ **6.E ((7! H*A12 E'/) BJ-J) -J+ **1C (9/G' B1-) 37-J) HF/(). 'DE1',9 G r a c e y D R . T u b e r c u l o s i s i n t h e w o r l d t o d a y . M a y o Clin Proc 1988; 63: 1251-5 .1 Capewell S, France A, Uzel N et al. The current value of tuberculin testing and .2 BCG vaccination in children. Br J Dis Chest 1986; 80: 254-65 .3 Rieder HL, Cauthen GM, Kelly GD et al. Tuberculosis in the United States. J .4 Am Med Assoc 1989; 262: 385-9 .5 Sehgal VN, Srivastava MD, Khurana VK et al. An appraisal of epidemiologic, .6 clinical, bacteriologic, histopathologic and immunologic parameters in cutaneous .7 tuberculosis. Int J Dermatol 1987; 26: 521-6 .8 Grosset JH. Present status of chemotherapy for tuberculosis. Rev Infect Dis 1989; 11 (Suppl. 2): 34752. .9 Goette DK, Jacobson KW, Doty RD. Primary inoculation tuberculosis of the skin. Arch Dermatol 1979; 114: 567-9 .10 Ramesh V, Misra RS, Jain RK. Secondary tuberculosis of the skin: clinical features and problems in laboratory diagnosis. Int J Dermatol 1987; 26: 578-81 .11 Kennedy C, Knowles GK. Miliary tuberculosis presenting with skin lesions. BrMed J 1975; 3: 356 .12 Duhra P, Grattan CE, Ryatt KS. Lupus vulgaris with numerous tubercle bacilli. Clin Exp Dermatol 1988; 13: 31-3 .13 Ramesh V, Misra RS, Jain RK. Secondary tuberculosis of the skin: clinical features and problems in diagnosis. Int J Dermatol 1987; 26: 578-81 .14
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Voyce MA, Hunt AC. Congenital tuberculosis. Arch Dis Child 1966; 41:299-300 .15 Hassoun PM. Erythema induratum and active pulmonary tuberculosis. Am JMed 1988; 84: 784-5 .16 Grosset JH. Present status of chemotherapy for tuberculosis. Rev Infect Dis1989; 11 (Suppl. 2): 347-52 .17 Sensi P . A p p r o a c h e s t o t h e d e v e l o p m e n t o f n e w a n t i t u b e r c u l o s i s d r u g s . R e v I n f e c t D i s 1 9 8 9 ; 1 1 ( S u p p l . 2 ) : 4 6 7 - 7 0 . 1 8 M a r u y a m a , C . : S t u d i e s o n t r e a t m e n t o f s k i n t u b e r c u l o s i s w i t h e x t r a c t s f r o m t u b e r c l e b a c i l l i . J a p . . J . D e r m . ( s e r . B ) 7 4 : 7 0 - 8 8 ( J a n . ) 1 9 6 4 . 1 9 'DA5D 'D+'EF E16 'D,0'E ( L e p r o s y ) GH E16 ,G'2J 'F*'FJ E2EF *-/+G 'DE*A71'* 'D,0'EJ). 'D9H'ED 'DEOGJ&): 'D#7A'D 0H *916 9'DJ DD'F*'F. 3H! 'D*:0J). 3H! 'D-'D) 'D5-J) ( 'D5-) 'D9'E)) . 'D3CF :J1 'DEF'3(. 'DE3*HI 'DE*/FJ DD-J') H'D*1(J). 71B 'D9/HI : 1 . @ E('41) 9F 71JB ED'E3) 'D#4.'5 'DE5'(JF. 2 . @ 'D'F*'F EF 4.5 D4.5. 3 . @ 'D*E'3 E9 'D"A'* 'D%F*'FJ) 'DE*B1-). 4 . @ EA12'* 'D#:4J) 'DE.'7J) 'DE.EH,). 5 . @ 'D-41'* E+D: 'D51'5J1 @ 'D(B @ 'DA1'4 H7AJDJ'* 'D,D/. 'D#FE'7 'D31J1J) : 1 . @ 'D,0'E 'D,0'EJFJ ( L e p r o m a t o u s l e p r o s y ) . 2 . @ 'D,0'E 'D/1FJ ( T u b e r c u l o i d l e p r o s y ) . 3 . @ 'D,0'E 'D-/J( B o r d e r l i n e l e p r o s y ) . 'D,0'E 'D,0'EJFJ ( L e p r o m a t o u s l e p r o s y ) %F *4.J5 'D,0'E J(BI :'E6'K %DI #F *(/# 'D"A'* 'D,D/J) 'DE4.5) ('D8GH1 #H (9/E' **8'G1 'D5A'* 'DEEJ2) DG. 'DE8'G1 'D('C1) *CHF 'D#91'6 AJ 'D(/'J) E*FH9) HDJ3* 0'* /D'D) E-//) *3'9/ E('41) 9DI 'D*4.J5. *(/# 'D"A'* 'D+'FHJ) (E8'G1 4(JG) DD9/J/ EF 'D#E1'6 E+D 'D-EI H'D#DE 'D96DJ H'D*FEJD ('D,D/. 'DE8'G1 'D,D/J) :
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2 . @ E6'/'* 'DGJ3*'EJF. 3 . @ 'D#/HJ) 'DE6'/) DDED'1J'. 4 . @ %0' '3*E1 G0' 'D'1*C'3 (9/ CD G0G 'DH3'&D J,( %JB'A 'D/'(3HF. 'D-'D'* 'DE9*/D) H'D4/J/): 1 . @ 'JB'A 'D/H'!. 2 . @ EG/&'*. 3 . @ E6'/'* 'DED'1J'. 4 . @ E6'/'* 'DGJ3*'EJF. 5 . @ 'D3*J1HJ/'*. 'DE1',9 L a r a C B . L e p r o s y i n c h i l d r e n : g e n e r a l c o n s i d e r a t i o n s ; i n i t i a l a n d e a r l y s t a g e s . W P R / L E P / 2 4 G e n e v a : W H O , 1 9 6 1 . 1 . K a p l a n G , C o h n Z A . R e g u l a t i o n o f c e l l m e d i a t e d i m m u n i t y i n l e p r o m a t o u s l e p r o s y . L e p r R e v 1986; 57: 199-207. 2. Neill MA, Hightower AW, Broome CV. Leprosy in the United States. J Inf Dis 1985; 152: 1064-9. 3. McDougall AC, Archibald GC. Lepromatous leprosy presenting with swelling of the legs. Br Med J 1977; i: 23-4. 4. Duncan ME, Melsom R, Pearson JMH et al. A clinical and immunological Study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy. Int J Lepr 1983; 51: 7-17. 5. Drutz DJ, Chen TSN, Lu W-H. The continuous bacteraemia of lepromatous leprosy. New Engl J Med 1972; 287: 159-64. 6. Dabholkar VR, Gaitonde BB. A study of autonomic functions in leprosy. Leprosy in India 1982; 54: 303-17. 7. Bryceson ADM, Pfaltzgraff RF. Leprosy 3rd edn. Edinburgh: Churchill Livingstone, 1990. 8. Pearson JMH. Dapsone resistant leprosy. Lepr Rev 1983; (Special Issue): 85S-89S. 9. Pedley JC, Harman DJ, Waudby H et al. Leprosy in peripheral nerves: histopathological findings in 119 untreated patients in Nepal. J Neurol Neurosurg Psych 1980; 43: 198-204. 10. Ridley DS. Reactions in leprosy. Lepr Rev 1969; 40: 77-81. 11.
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Ridley DS, Jopling WH. Classification of leprosy according to immunity, a five-group system. Int J Lepr 1966; 34: 255-73. 12. Ellard GA. Rationale of multidrug regimens recommended by a WHO Study Group on chemotherapy of leprosy for control programmes. Int J Lepr 1984; 52:394-401. 13. Duncan ME, Melsom R, Pearson JMH et al. A clinical and immunological Study of four babies of mothers with lepromatous leprosy, two of whom developed leprosy in infancy. I n t J L e p r 1 9 8 3 ; 5 1 : 7 - 1 7 . 1 4 . 'DA5D 'D*'39 #F*'F'* 'D,D/ ('DDHD(JJ'* T r e p o n e m a l s k i n i n f e c t i o n s 'D'A1F,J ( 'D2G1J) 'D.DBJ C o n g e n i t a l s y p h i l i s 'DE8'G1 'D,D/J) DD'A1F,J 'D.DBJ *EJD DD8GH1 .D'D 'D#3'(J9 #H 'D#4G1 'D#HDI EF 'D-J'). JF*BD 'D#A1F,J EF 'D#E %DI 'D,FJF 9(1 'DE4JE) D0DC J9*(1 'DE16 E'B(D 'D-ED #C+1 EE' GH .DBJ. 'DE8'G1 'D,D/J) DD'A1F,J 'D.DBJ 'D('C1 : 1 . @ 'D3E)( S t i g m a t a ) 'DE16 'D,D/J 'D'A1F,J 'D.DBJ JECF *4.J5G (3GHD) AJ -'D H,H/ 'D3E) HGJ EF 'D#EH1 'DG'E) 'D*J *3'9/ 9DI 'D*4.J5 HGJ *H,/ 9F/ 'D#7A'D 'D5:'1 F',E) 9F "A'* E.1() *$/J %DI 'D*F/( H*1C "+'1 ('D,D/. G0G 'D*:J1'* E91HA) ('3E +D'+J HE' J3EI G*4JF3HF2 *1'J/( H u t s h i n s o n ' s t r i a d ) HJ4ED : 'D#FA 'D31,J. "A'* ,D/J) ( F/('* 49'9J) 'D4CD) . B1-'* H*C+A'* 'DB1FJ) 'D9JFJ). #3F'F G*4JF3HF H*8G1 'D#3F'F (4CD л 'D1-I 'D*H*J)╗ ( M a l b e r y m o l e s ) . 2 . @ AB'9'* 'DE16 'D'A1F,J: JCHF 'D%F/A'9 'DAB'9J E*F'81 HB/ J*H,/ AJ 'D1'-*JF H'D#.E5JF HJ-*HJ 9DI 3'&D BJ-J E5DJ J-*HJ 9DI 'DDHD(J'* H#.J1'K A%F 'DB4H1 'D-E1'! 'D:'EB) *:7J 'DEF7B) 'DE5'(). 3 . @ 'DH1E 'DBF(J7J ( 'DDBEJ) 'DE37- ( C o n d y l o m a l a t a ) : B/ *5J( G0G 'D"A) 'D'*5'D 'D,D/J @ 'DE.'7J.
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'DE1-D) 'D+'FHJ): **8'G1 ('F/A'9 D7'.J #H D7'.J -DBJ #H D7'.J 4'&C E9EE %5'() 'D#:4J) 'DE.'7J) (4CD 'D#H1'E 'DEBEE) ( 'DBF(J7J)) H(B9 E.'7J) *4(G 'DE8'G1 'D#.1I DDHD(J'* 'DE3*H7F) (-) 'D5H* 'D"D'E 'D98EJ) 'DDJDJ) 4'&9) HGJ #91'6 EEJ2). 'DE1-D) 'DC'EF) 'DE*'.1): G0G 'DE1-D) **8'G1 (*.1( 'D98E H'D#F3,). H'D%5'() 'D,G'2J) DDBD( H'D#H9J) H'D,G'2 'D95(J. 'DE1',9 B o o t J M, Oranje AP, Menke HE et al. congenital syphilis in the Netherlands: diagnosis & clinical features. Genitourin Med 1989; 65: 300-3 1. Bradlaw RV. The dental stigmata of prenatal syphilis. Oral Surg Oral Med Oral Pathol 1953; 6: 147-58 2. Browne SG. Yaws. Int J Dermatol 1982; 21: 220-3 3. Bengali FS. Involvement of aortic valve and ascending aorta in congenital syphilis. Br J Vener Dis 1961; 37: 257-67 4. Dunlop EMC, Wink RB. Incidence of corneal changes in congenital syphilis. Br J Vener Dis 1954; 30: 201-9 5. Feign D, Glenn M, MacBride-Stewart G et al. Yaws in the Solomon Islands. J Trop Med Hyg 1990; 93: 52-7 6. Harter CA, Benirschke K. Fetal syphilis in the first trimester. Am J Obstet Gynecol 1976; 124: 705-11 7. Hackett CJ, Loewenthal LJA. Differential Diagnosis of Yaws. Monograph Series, No. 45. Geneva: WHO, 1960 8. Mascola L, Pelosi R, Blount JH et al. Congenital syphilis revisited. Am J Dis Child 1985; 139: 57-80 9. Medina R. Pinta. An Endemic Treponematosis in the Americas. WHO INT/VDT/204.65 10. Noordhoek GT, Cockayne A, Schouls LM et al. A new attempt to distinguish serologically the subspecies of Treponema pallidum causing syphilis and Yaws.J Clin Microbiol 1990; 28: 1600-7 11.
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Robinson RCV. Congenital syphilis. Arch Dermatol 1969; 99: 599-610 12. Willcox RR. Njovera: an endemic syphilis of Southern Rhodesia. Lancet 1951; i: 558-60 13. Whittet HB, Quiney RE. Nasal manifestation of yaws. J Laryngol Otol 1988; 102: 1147-9 14. Hackett CJ, Loewenthal LJA. Differential Diagnosis of Yaws. MonographSeries, No. 45. Geneva: WHO, 1960 15. Mascola L, Pelosi R, Blount JH et al. congenital syphilis revisited. Am J Dis Child 1985; 139: 57-80 16. Noordhoek GT, Cockayne A, Schouls LM et al. A new attempt to distinguish serologically the subspecies of Treponema pallidum causing syphilis and Yaws 17. WHO. Treponemal infections. Technical Report Series No. 674. Geneva: WHO,1982 18. WHO. Expert Committee on Venereal Diseases and Treponematoses. Sixth Report. Technical Reports Series No. 736. Geneva: WHO, 1986 1 9 . 'DB1-) 'DE/'1J) T r o p i c a l u l c e r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2 . @ 'D4CD 'D4/J/ ( O R O Y A ) : 'DE8'G1 'D,D/J) GJ AB7 "A) .AJA) *F,E 9F D/: 'D-41'* AJ EH69 'DD/:). G0' 'D4CD -'/ J*DHG "A'* ,D/J) +$DHDJ) 0'* 3J1 E2EF. 'DE8'G1 'D,G'2J) : -EI H/9+. AB1 /E B/ JCHF 4/J/. FB5 'DC1J'* 'D(J6. "A'* +$DHDJ) B1E2J) E*9//) *-/+ (9/ 'D4A'! EF 'D#91'6 'D*J 8G1* AJ (/'J) 'DE16 #H (9/ 'D7H1 'D-EHJ (4G1 #H 4G1JF. 71B 'DE9'D,) : 1 . @ 'DHB'J) 2 . @ 'D(F3DJF 3 . @ 'D3*J1HJ/'* /'.D'K. 'DE1',9 A d r i a a n s B , H a y R J , D r a s a r B e t a l . T h e i n f e c t i ous aetiology of tropical ulcer - a study of the role of anaerobic bacteria. Br J Dermatol 1987; 1616: 31-7 1. Robinson DC, Adriaans B, Hay RJ et al. The epidemiology and clinical features of tropical ulcer. Int J Dermatol 1988; 27: 49-53 2. J Clin Microbiol 1990; 28: 1600-7 3. Wilkinson M, Agett P, Cole TJ. Zinc and acute tropical ulcers in Gambian children and adolescents. Am J Clin Nutr 1985; 4 1 : 4 3 - 5 1 4 . 'DA5D 'D9'41 #F*'F'* 'D,D/ 'DA71J) F u n g a l s k i n i n f e c t i o n s 'D'F*'F'* 'DA71J) 'D37-J) S u p e r f i c i a l f u n g a l i n f e c t i o n s 39A) 'D1#3 T i n e a c a p i t i s 3A9) 'D1#3 GJ #F*'F A71J J4CD E4CD) H'39) 'D'F*4'1 *5J( 'DA1H) HGJ (4CD 1&J3J E16 'D#7A'D 'D5:'1. 'D0CH1 #C+1 %5'() EF 'D%F'+ HB/ JCHF 3(( 0DC J9H/ %DI B51 'D491 D/I 'D0CH1 'D0J B/ J$/J D3GHD) H5HD 'D#(H': 'DA71J) %DI A1H) 'D1#3. F'/1'K E' J5'( 'D('D:JF HJ9*B/ #F 3(( 0DC GH A17 'D-EH6 'D/3E) AJ 'DA1H) 'D0J J4CD E1C('K E+(7'K DDA7H1 'D,D/J). DB/ +(* EF0 9/) 3FH'* #F (96 'D-EH6 'D/3E) 'DE4(9) EF 491 'D('D:JF ( H*4*B EF 'D2GE) E+(7) DDA7H1 'D,D/J).
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e l s u n s h a m p o o ) #H 4'E(H( N i z o r a l ) J3*9ED E1) CD JHEJF) JA1C (G 'D,D/ 'DE5'( HJ*1C DE/) 1(9 3'9) 9DI 'D,D/ +E J:3D. B/ J97J 0DC F*J,) 7J() H3GHD) AJ 'D'3*9E'D .'5) 9DI 'DEF'7B 'DH'39) #H *DC 'DEF'7B EF 'D,D/ 'D*J J59( 'DH5HD %DJG' (H'37) 'DE5'( DE/) #3(H9JF 3J2JD 0DC :'D('K E98E 'D"A'*. J,( 'D'G*E'E ('DEF'7B 'D*F'3DJ) H'D9JHF (3(( %EC'FJ) 'D*.1J4 'DEH69J. 'D'2HD'* 'DEH69J) E+D " 'D'JCHF'2HD ( P e v a r y l s p r a y ) " HE6'/'* 'DA7H1 'D#.1I A9'D) #J6'K DCFG' :'DJ) 'D+EF. 'DE3*-61'* 'D10'0J) #H 'D4'E(H #3GD '3*./'E'K EF 'DC1JE'* #H 'DE1'GE. E1) #H E1*JF JHEJ'K J7(B 'D/H'! GH CD E' J7D( 9'/) DE/) #3'(J9. 'D3*J1HJ/'* 'DB41J) EH69J'K B/ *-3F 'D-'D) E$B*'K HDCF D'JF5- (G' #(/'K. 9D', -'D'* 'DA4D AJ 'DE9'D,) 'DEH69J) J9H/ 3((G %DI E9'H/) 'D9/HI 3H'! ('D'F*'F 'D0'*J #H EF E5'/1 #.1I.
( 1 / 1 0 9 )
'D9D', ('3*9E'D 'D'JCHF'2HD 3*J1'* ( P e v a r y l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e v a r y l s a c h e t s ) 9(H) H'-/) JA1C (E-*HJ'*G' 'D,D/ E1*JF #3(H9J'K DE/) 4G1 H'-/ +E E1) H'-/) #3(H9J'K DE/) 3 4GH1 #H #C+1. J,( #.0 'D-J7) H'D-01 DEF9 'D'F*'F 'D0'*J #H 'DE*C11 EF 'DE*E'3JF. 'DA7'1 'D491J 'D9BJ/J P i e d r a 'F*'F A71J J5J( 'D491) HJ$/J %DI *4CJD 9BJ/'* 37-J) 9DI 'D491) 'DE5'(). #C+1 E' *5J( G0' 'DFH9 'DA*J'* 'D5:J1'* HB/ J-/+ 'F*4'1 DDE16 (JF #A1'/ 'D9'&D) #H 'D#4.'5 'DED'E3JF DGE. G0' 'DFH9 J-/+ AJ 'D(D/'F 'DE/'1J) HJ5J( 'DB1H/ ('D%6'A) DD%F3'F. 'DE8'G1 'D31J1J) : JH,/ FH9'F EF 'DA7'1: 'DA7'1 'D491 'D3H/'! ( B l a c k p i e d r a ) H'D(J6'!( W h i t e p i e d r a ) 'DF,EJ) 'D4CD ( A s t e r o i d ) . #FH'9 'DA7H1 'D*J *3(( 'DE16 GJ: ( P i e d r a h o r t a e & T r i c h o s p o r o n b e i g e l i i ) .
( 1 / 1 1 0 )
A7'1 'D491 'D3H/'!: J*EJ2 G0' 'DFH9 (H,H/ 9BJ/'* 3H/'! ED*5B) HB'3J) **#DA EF C*D) 'D.D'J' 'DA71J) 9DI ,09 'D491) -J+ J3(( 0DC %DI *A** H*B5A 'D491. J*1H'- -,E 'D9B/ E' (JF 'DFH9 'D/BJB %DI 1 / EDE #H #C+1. A7'1) 'D491 'D#(J6 " W h i t e p i e d r a " 9BJ/'* (J6'! #H 1E'/J) A'*-) @ 71J) 9DI ,09 'D491). 'DA7H1 *FEH /'.D H.'1, ,3E 'D491). E+D 'DFE7 'D#3H/ A%F 'D491 B/ J69A HJ*C31. 'D,D/ D' J5'( HD' J-/+ HE6'F (#49) HH/. 'D'F*'F'* 'D,G'2J) 'DF',E) 9F 'D(HJ:'! 'D491J) B/ *5J( (96 'D#E'CF E+D 'DC(/ H'D7-'D H'DBD( H#-J'F'K J-/+ 9BJ/'* ,D/J) 9EJB). 'D4CD 1BE 8 1 : A7'1 'D491 'D#(J6 71B 'D*4.J5 : 'DE3-'*: .JH7 A71J) E,G1J'K H'D#(H': H'D.D'J' 'D*C'+1J) JECF %8G'1G'. 'D219: 'DA7H1 (7J&) 'DFEH AJ 'DE2'19 H*8G1 3H/'! H9'*E) H*CHF 9'/) E*CHE) AJ 'DE1C2. AJ 219 'DA7H1 'D491J) *CHF 'DE3*9E1'* 0'* FEH 31J9 H0'* DHF C1JEJ HEFCE4) +E *5(- EF7HJ) (9EB ( 0'* 4BHB 9EJB)) . 71B 'DE9'D,): 'D96HJ'* 'DE3(J) 'DF,E'&J) *CHF EB'HE) (4CD E/G4 DD#/HJ) 'DE6'/) DDA7H1 E+D E,EH9) 'D"2HD'*. -DB #H *B5J1 'D491 GJ 71JB) :'D('K A9'D) DDE9'D,). HDEF9 *C1'1 'D9/HI A%F E6'/'* 'DA7H1 E+D -E6 'D(F2H&JC E1GE #H E-DHD 1 / 2 0 0 0 EF (J1CDH1'J/ 'D2&(B B/ J7(B 9DI 'DA1H) (9/ '3*./'E 'D4'E(H .
( 1 / 1 1 1 )
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e r p e s S i m p l e x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'D#91'6 B/ *CHF .AJA) ,/'K HAJ (95 'D#-J'F .7J1) HB/ *CHF B'*D) 9F/ 'DHD/'F. B/ JCHF 'D'F*'F (/'&J (3J7 9F/ 'D#4.'5 'D0JF D/JGE #6'/ E9'/D) DDAJ1H3'* #H E*C11. 'D4CD 1BE 8 7 ' : 9B(HD 4AHJ 'D4CD 1BE 8 7 ( : 9B(HD 4AHJ 'D4CD 1BE 8 9 : 9B(HD 'D4A) H'DD3'F 'D4CD 1BE 8 8 ' : E6'9A'* 'D#C2JE' ('DG1(3 'D4CD 1BE 8 8 (: E6'9A'* 'D#C2JE' ('DG1(3 'D9B(HD 'D(3J7 'DHD'/J N e o n a t a l h e r p e s s i m p l e x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i n c e n t s a n g i n a ) " #H 'DBD'9 'DAEHJ( A p h t h o u s s t o m a t i t i s ) #H 'DE16 'DAB'9J 'DE*B1- ( U l c e r a t i n g b u l l o u s d i s e a s e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3 . .DD H8JAJ DD.D'J' 'DDEA'HJ) 'D*'&J) " T . C e l l " EEJ2 DD/'! 9F/ 'D('D:JF HGH 9'/) E8G1 E*#.1 9F/ 'D#7A'D 'D5:'1. 4 . #6/'/ 'DAJ1H3: " H I V " H,H/ #6/'/ 'D@ " H I V " EF 'DFH9 " I g G " 9F/ 'D169 JE+D ((3'7) 'D#6/'/ 'DEC*3() EF 'D#E (4CD E*FBD HD'J9*(1 /DJD'K D'F*'F" H I V " . 71B 3J1 'DE16: (96 'D#7A'D 'DE5'(JF J-/+ D/JGE 'D%J/2 ( A I D S ) AJ 'D3F) 'D#HDI EF 9E1GE AJ E98E 'D-'D'* J*1BJ 'D'F*'F ((7! 4/J/. E9'D,) 'F*'F" H I V " AJ 'D7AHD): E9'D,) 'D%.*D'7'*. E9'D,) 'D#F*'F 'D,1+HEJ 'D+'FHJ 0'* 'D1&) 'DE*CJ3 'DC'1JFJ'J. 'DE9'D,) ('D#/HJ) 'DE6'/) DDAJ1H3'* -'DJ'K D'*4AJ 'D'F*'F. 'D/H'! 'D1&J3J GH" R e t r o v i r , A Z T , ( A z i d o t h y m i d i n e ) Z i d o v o d i n e " 1:E 'D*-3F AJ (96 'D-'D'* DCFG J,( EH'2F) 'DAH'&/ E9 'D"+'1 'D,'F(J) DD/H'! H*4ED: AB1 'D/E. FB5 'DC1J'* 'DE9*/D) @ 'D*G'( 'D96D'* @ 'D5/'9 @ 'D*,D7 @ AB/'F 'D0'C1) ( 'D*HG'F) 'D-EI @ 'D7A- H*5(: 'D#8'A1. J97I 'D@" Z i d o v u d i n e " 9'/) AEHJ'K DA*1'* 7HJD) AJ (96 'D-'D'* 'DEB'HE) B/ 3,D* E3*HJ'* #6/'/" H I V " AJ 'DE5D #H 'D3'&D 'D/E':J 'D4HCJ" C S F " JECF #F JF.A6 (4/) HB/ *5(- EGED) 'D*1CJ2. 'D*31J( 'DH1J/J 'D7HJD 'D#E/ ('D9D', ( Z i d o v u d i n e ) B/ J$/J D*-3F 'D40H0'* 'D*7H1J) 'D95(J) 9F/ 'D#7A'D. D'JH,/ DB'- #H E9'D,) FH9J) DD@" H I V " -'DJ'K %D' #F ,GH/'K C+J1) ,'1J) AJ 9/) E1'C2 /HDJ) D%J,'/ E9'D,) 4'AJ). 'DHB'J): 'DHB'J) EF 'F*B'D 'DAJ1H3 'D@ " H I V " GH 0H #GEJ) C(J1) H'D.7H) 'D1&J3J) GJ *,F( 'D*E'3 (JF EA12'* 'DE5'(JF H'D#:4J) 'DE.'7J) #H 'D,D/ 'DEE2B. 'DA5D 'D+'FJ 941 'D'F*'F'* 'D7AJDJ) 'D,D/J) P a r a s i t i c s k i n i n f e s t a t i o n s 'DE8'G1 'D,D/J) D'F*'F'* 'D#H'DJ / H-J/'* 'D.DJ) / S k i n m a n i f e s t a t i o n s d u e t o P r o t o z o a /'! 'DD'J4E'FJ'
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( L e i s h m a n i a s i s ) GH E16 7AJDJ *3((G 7AJDJ'* 'DD'J4E'FJ) 'DE/'1J) 'D*J *F*BD (H'37) 0('() 'D1ED 'DA'5/)( P h l e b o t o m u s s a n d f l y ) 'D*J *9*(1 'DCD'( E3*H/9' DG'. JC+1 'DE16 AJ EF7B) 41B 'DE*H37 H'D41B 'D#H37 #E' AJ "3J' H#A1JBJ' A%F 'DA&1'F 'DB'16) B/ *CHF GJ E5/1 'D9/HI. 'D/'! 0H +D'+) #4C'D E.*DA) GJ: 'DD'J4E'FJ) 'D,D/J). 'DD'4E'FJ) 'D,D/J) 'DE.'7J) H'DD4E'FJ' 'D-4HJ). /'! 'DD'J4E'FJ' 'D,D/J: ( C u u t a n e o u s l e i s h m a n i a s i s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r i e n t a l s o r e " 'D"A) 'D(/'&J) GJ -7'7) 9DI 'DEF'7B 'DEC4HA) E+D 'DH,G H'D#71'A. 'D-7'7) **6.E (9/ 9/) #3'(J9 D*4CD DHJ-) E/H1) H#.J1'K %DI B1-'* *F*- EA12'* D2,) H*4CD B41) ED*5B) 3EJC) (FJ) 'DDHF.
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'D'F*'F 'D,1+HEJ 'D+'FHJ DDB1-'* 4'&9 E3(('K *.1( #F3,) #C+1 H*4HG'* ,D/J) H*DC H'-/) EF 'D5A'* 'DEEJ2) D"A) 'DB1-) 'DE/'1J) GJ 3J1G' 'DE2EF 'D7HJD HFH9 'D"A'*. G0G 'D"A'* *4CD B1-'* E1*A9) HE/H1) (J6'HJ) 'D4CD B/ *4AI (9/ 9/) 4GH1 E3(() F/('* E4HG). 'D4CD 'DE,G6 A b o r t i v e t y p e : (96 'D"A'* ,'A) -J+ **-HD 'D-7'7) %DI 9BJ/) B/ **6.E -,E'K (/HF *B1-. 'D4CD H-J/ 'DF'C3" A b o r t i v e t y p e " : GH F'C3 -J+ J-/+ 'D'F*'F E1) +'FJ) (9/ 4A'! 'D"A) 'D(/&J). 'D4CD 'DEF*41" D i s s e m i n a t e d t y p e " : "A'* E*9//) B/ *5J( 'D#71'A. 'D4CD 1BE 1 1 8 : /'! 'DD'J4E'FJ' 'D,D/J 'DE,G6 'D4CD 1BE 1 1 9 : /'! 'DD'J4E'FJ' 'D,D/J ( H-J/ 'DF'C3) 'D4CD 1BE 1 2 0 : /'! 'DD'J4E'FJ' 'D,D/J ( 'D4CD 'DEF*41) 'DE8'G1 'D,D/J) 'DE.*DA): /'! 'DD'J4E'FJ' 'D,D/J 'DF',E 9F 'DD'J4E'FJ' 'D7AJDJ) / 'D5:1I / " L . i n f a n t u m " : 'D169 'DE5'(HF (G0' 'D7AJDJ B/ J5'(HF (E16 'DD'J4E'FJ' 'D-4HJ (JFE' 'D('D:JF 9'/) J5'(HF ('D"A'* 'D,D/J) AB7. 'D/'! 'DD'J4E'FJ' 'D,D/J 'DF',E 9F 'DD'J4E'FJ' 'DC(1I: " L . M a j o r " G0' 'D4CD E3*H7F AJ 'DEF'7B 'D17() AJ 'D(/'H) .'5) (JF 19') 'D-JH'F. 'D"A'* 'D,D/J) GJ 9BJ/) /EDJ) 'D4CD -E1'! *8G1 9DI EC'F 'D/.HD -J+ (9/ #3(H9JF **4CD B41) E1C2J) J*DHG' 'DB1-) 0'* G'E4 #-E1 E1*A9 *C(1 .D'D 2 @ 3 4GH1 'D*'DJ) -J+ *5D %DI B71 3 @ 6 3E HB/ *8G1 9/) "A'* 9B/J) +'FHJ) ( *'(9)) B1J('K EF 'D"A) 'D(/&J). 'D4A'! 'D9AHJ -*I (/HF 9D', 9'/) J-/+ .D'D 6 #4G1 E.DA'K H1'&G F/(). /'! 'DD'J4E'FJ' 'D,D/J 'DF',E 9F 'DD'J4E'FJ' 'DE/'1J)" L . t r o p i c a " : /H1 'D-6'F) #C+1 EF 2 4G1 *8G1 'D"A) (4CD 9BJ/) (FJ) 5:J1) **6.E */1J,J'K %DI DHJ-) (B71 1 @ 2 3E AJ -H'DJ 6 4GH1 E4CD) *B1- 37-J 6-D E9 B41) ED*5B). 'D"A'* 'D+'FHJ) ( 'D*'(9)) BDJD) (G0' 'DFE7.
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/'! 'DD'J4E'FJ' 'D,D/J 'DF',E 9F 'DD'J4E'FJ) 'D#+JH(J) " L . E t h i o p i a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u c o c u t a n e o u s L e i s h m a n i a s i s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*B1- 'DD3'F HE.'7J) 'D9JF H'DE.'7J) 'D*F'3DJ). '9*D'D 9B/ DEAJ) F'-J). 'D*4.J5 'D*A1JBJ: 'DB1-) 'DE/'1J) /'! 'D491J'* 'D(H:J) 'D*/1F 'D/'! 'D9DJBJ / 'DJH2" Y a w s " / H / 'D# A1F,J 'D2G1J/ 71B E9'D,) 'DD'J4E'FJ': E98E 'DB1-'* :'D('K E' *4AI 9AHJ'K .D'D 3F) H'-/). 9D', /'! 'DD'J4E'FJ' 'D,D/J H'D,D/J 'DE.'7J GJ FA3G' (JFE' J-*', 'D#.J1 E9'D,) E4//) #C+1 (3(( 'D'.*D'7'* 'D#C+1 4/) H'DE.1(). 'D#F*EH'F 'D.E'3J" P e n t a v a l e n t a n t i m o n y " J3*9ED DDB1-'* 'D*J *3(( *F/('K H*4HG'* AJ 4CD 'DH,G #H 9DI #3AD 'D3'B #H AHB 'DEA5D #H 9DI 'D#:4J) 'DE.'7J) #H 'D:6'1JA #H 'DB1-) 'D*J B/ *CHF F',E) 9F 7AJDJ DD'J4E'FJ' 'D(1'2JDJ). " D3H! 'D-8 AI (96 -'D'* /'! 'DD'J4E'FJ' B/ *4'G/ E9'D,) ('D3*J1HJ/'* 'DB41J) EH69J'K HG0G *:J1 'D5H1 'D31J1J) H*,9D 'D"A'* E.*D7) 'D*J *5(- #.J1'K #C+1 %2E'F'K H*FB5 '3*,'(*G' DDE9'D,) 'DFH9J)" . DD('D:JF F97J 6 3E3 EF 'D(F**H3*'E ( P e n t o s t a n ) 96DJ'K CD JHE DE/) 941) #J'E G0' 9'/) J97J F*'&, ,J/) HJ$/J D4A'! 31J9 DDB1-'* HJECF *9/JD 'D,19) -3( 9E1 'DE1J6. DB/ 3,D 'D/C*H1 'D8H'G1J F*'&, ,J/) ('3*9E'D E1C('* GJ/1H'JE*JF -(*'F JHEJ'K DD('D:JF DE/) 4G1 H'-/. FJH3*J(H2'F ( N e o s t i b o s a n , B a y e r ) GH #J6'K /H'! A9'D. 'D,19) 'DJHEJ): GJ 5 / ED: / CD: ,19) EF 2 0 0 @ 3 0 0 ED: JECF %97'!G' JHEJ'K DD#7A'D 'DC('1 H'D('D:JF DE/) 1 6 JHE #+(* #FG A9'D #J6'K. 'D#/HJ) 'D#.1I E+D" 'DCDH1HCJF" H'DA$'/JF ( F o u a d i n ) H'DE6'/'* 'D-JHJ) E+D " 'D**1'3CDJF " H,/* %FG' A9'D). 'D(F*'EJ/JF 'J2H+JHF'*( P e n t a d i n e i s o t h i o n a t e ) : DE9'D,) 'DD'J4E'FJ' 'DE/'1J) (,19) 4 ED:/ CD: E1) H'-/) #3(H9J'K DE/) 7HJD) -3( 'D-',). 'DE1J6 'DE5'( (/'! 'DD'J4E'FJ' 'D,D/J B/ J-*', %DI E9'D,) DA*1) #7HD.
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'DD'J4E'FJ' 'DF'C3) B/ J3*,J( DD-BF 'DEH69J #H 'D'97'! 'D,G'2J DD#F*EH'F'*. 'D*41( 'DEH69J (@ 1 @ 2 EDE 5H/JHE 3*J(H:DHCHF'* ( S o d i u m s t i b o g l u c o n a t e ) DD"A'* 'DEA1/). +D, :'2 +'FJ #HC3J/ 'DC1(HF ( C o 2 s n o w ) D9D', 'DB1-'* 'D5:J1) **,E/ H*,1A *-* *./J1 EH69J. "A'* 'D*F/( 'D4/J/ B/ *-*', ,1'-) *5FJAJ) ( *,EJDJ)) . F-F F3*./E 'DDJ21" C O 2 " D%9'/) 37- H%2'D) 'DD4E'FJ' 'D,D/J). AJ 'DE1C2 'D7(J 3,DF' F*'&, E4,9) .'5) 'D"A'* 'DE.*D7) ('D*F/( . 'D4CD 1BE 1 2 1 : 'DD'J4E'FJ' 'D,D/J) ( F/()) 'D4CD 1BE 1 2 2 : 'DD'J4E'FJ' 'D,D/J) ( F/() E9'D,) ('DJ21) /'! 'DD'J4E'FJ' 'D-4HJ V i s c e r a l l e i s h m a n i a s i s J91A ('3E 'DC'D' "2'1 #H -EJ /E /E" D u m - D u m F e v e r " : 'DE16 EF*41 ,/'K AJ "3J' H,FH( #H1H(' -HD 'DE*H37 #A1JBJ' H'DE,*E9'* 'DABJ1) H'D1JAJ). 'D5H1) 'D31J1J): 'D-EI EEJ2) H#-J'F'K E4.5) DDC'D' "2'1. *1*A9 'D-1'1) AJ HB* 'D951 H*F.A6 B1( 'DE3'! H*1*A9 #C+1 -H'DJ EF*5A 'DDJD. 6.'E) C(/J) 7-'DJ). G2'D HF-HD. AB1 /E HFB5 'DC1'* 'D/EHJ) 'D(J6'!. E8'G1 -4HJ) 6.'E) C(/J) 7-'DJ). E8'G1 ,D/J): ,D/ (DHF 1E'/J :1J( .'5) 9DI 'DJ/JF H'D#8'A1 H'D,(G) H'D.7 'DF'5A DD(7F D0DC 3EJ " 'D/'! 'D#3H/ " . /'! 'DD'J4E'FJ' 'D,D/J E'(9/ 'DC'D' "2'1 P o s t k a l a a z a r l e i s h m a n i a s i s 'DE8'G1 'D31J1J): 8GH1 9BJ/'* (DHF GD'E 'D*A'- E-'7) (F/('* .'5) 9DI 'DH,G -J+ *8G1 9/) 3FH'* (9/ 'D4A'! EF 'D"A) 'D(/&J). B/ *8G1 (B9 F'B5) 'D5(': .'5) 9DI 'DH,G H'D9FB H'D37H- 'D('37) EF 'D3'9/ H'D,'F( 'D/'.DJ DDA./JF J4(G 'D,0'E 'D,0'EJFJ. "A) 9B/J) H-(J() B/ *8G1 9DI 'D,D/ HF'/1'K E'*CHF -DJEJ) 9DI 'D#,A'F H'D4A'G HA*-'* 'D#FA. 'DE1',9 B r y c e s o n A . T h e r a p y i n m a n . I n : P e t e r s W . K i l l i c k - K e n d r i c k R , e d s . T h e 1
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L e i s h m a n i a s e s i n B i o l o g y a n d M e d i c i n e V o l 2 . L o n d o n : A c a d e m ic Press, 1987: 848-907 2 Ho M, Koech DK, Iha DW et al. Immunosuppression in Kenyan visceral leishmaniasis. Clin Exp Immunol 1983; 51: 207-14 3 Kumar PV, Sadeghi E, Torabi S. Kala azar with disseminated dermal leishmaniasis. Am J Trop Med Hyg 1989; 40: 150-3 4 Rashid JR, Chunge CN, Oster CN et al. Post kala-azar dermal leishmaniasis occurring after long cure of visceral leishmaniasis in Kenya. E Afr Med J 1986; 63: 365-71 5 WHO. The leishmaniases. Report of WHO Expert Committee. Technical Report Series 701. Geneva: World Health Organization, 1984 6 Ballou WR, McClain JB, Gordon DM et al. Safety and efficacy of high dose sodium stibogluconate therapy of American cutaneous leishmaniasis. Lancet 1987; ii: 12-16 7 Bryceson A. Therapy in man. In: Peters W. Killick-Kendrick R, eds. The Leishmaniases in Biology and Medicine Vol 2. London: Academic Press, 1987: 848-907 8 El-On J, Weinrauch L, Livshin R et al. Topical treatment of recurrent cutaneous leishmaniasis with ointment containing paromomycin and methylbenzathonium chloride. Br Med J 1985; 291: 704-5 9 Kumar PV, Sadeghi E, Torabi S. Kala azar with disseminated dermal leishmaniasis. Am J Trop Med Hyg 1989; 40: 150-3 10 Montalban CK, Martinez-Fernandez R, Calleja JL et al. Visceral leishmaniasis (kala-azar) as an opportunistic infection in patients infected with the human immunodeficiency virus in Spain. Rev Infect Dis 1989; 1 1 : 6 5 5 - 6 0 1 1 /'! 'DE+B(J'* 'D%F3'FJ H u m a n T r y p a n o s o m i a s i s ( /'! 4':'3) C h i g a s d i s e a e
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/'! 'DE+B(J'* 'D,FH( #E1JCJ( S o u t h A m e r i c a n t r y p a n o s o m i a s i s ) : GH /'! ,G'2J *3(( 'DE+B(J'* 'DC1H2J) 71B 'D'F*'F: @ 'D'F*'F 'DE('41: 'D'F*'F EF 'D-JH'F'* 'DE5'() EF 'DE3*H/9'* 'D-JH'FJ) E+D 'DB77 'DCD'( H'DA&1'F 'DB'16). @ 'D'F*'F :J1 'DE('41: EF %F3'F %DI %F3'F (H'37) " 'D(B 'DEB(D " ( K i s s i n g b u g s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l e e p i n g s i c k n e s s /'! 'DE+B(J'* 'D'A1JBJ 'D9'ED 'DF'BD DD7AJDJ GH 0('() 'D*3J @ *3J 'D*J 9F/E' *D/: 'D%F3'F A%FG' *-BF ('DE+B(J'* 'D7AJDJ'* 'DEH,H/) AJ ://G' 'DD9'(J) /'.D 'D,D/ ( 'DE+B(J'* 'D1H/J3J) H'DE+B(J'* 'D,'E(J)) . 'D5H1 'D31J1J): 'DE1-D) 'D-'/): **EJ2 G0G 'DE1-D) (@: #91'6 (FHJ) 4/J/) -EJ H'D*G'( 9B/ DEAJ) 'D*G'( #H9J) DEAJ) 37-J F'-J HH0E) 9'(1) *EJ2 G0G 'DE1-D). 'DE8'G1 'D,D/J): 'DB1-) ( C h a n c r e ) : GJ 9B/) *8G1 EC'F 'DD/:) *CHF -E1'! @ E$DE). H**1'AB E9 'D*G'( #H9J) DEAJ) H9B/ DEA'HJ) F'-J). -C) HH0E) E$DE): *5J( 'DJ/JF H'DB/EJF H'D9JFJF H*(/H 'DEA'5D E*H1E). 'DE1-D) 'DE*#.1): *-/+ (9/ 7H1 E2EF -J+ JCHF GF'C '671'( /E':J J-/+ */1J,J'K E$/J'K %DI 5H1) 31J1J) GH " E16 'DFHE" . D' JH,/ E8'G1 ,D/J) AJ G0G 'DE1-D). 'D*4.J5:
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-BF 'D3'&D 'D/E':J 'D4HCJ DA#1): GH DJ3 '.*('1 1H*JFJ HF'/1'K E'J3*9ED AJ 'DEE'13) 'D31J1J). 71B 'DE9'D,): E4'1C) 'D3DAHF'EJ/'* ( ,19) 'D('D: 3 :/ JHE) H'D(J1JEJ+'EJF ( D a r a p r i m ) *97I (,19) 1 ED:/ CD: JHEJ'K DE/) 4G1 H'-/. J,( ED'-8) #F 'D/'1'(1JE GH EF E9'C3'* -E6 'DAHDJC D0DC JF5- (%97'! AHDJC #3J/ E9 'D9D',. 'D@" R o v a m y c i n e " EECF #F J97J F*'&, ,J/). 'D@" S p i r a m y c i n " / ,19) 'D('D: 2 : / JHE/ HGH A9'D #J6'K. G0G 'D#/HJ) *.A6 E9/D -/H+ 'D'671'('* 'DB'*D) . 9F/E' *97J 'D#/HJ) 'DEF'3() DD#E 'D-'ED A%F *DC *3J71 9DI 'D#91'6 'D(FHJ) E+D 'D-EJ H*-3F 'D"A) 'D9JFJ) 9F/E' *41C E9 'D3*J1HJ/'* 'DB41J). 'DE1',9 M c C a b e R E , R e m i n g t o n J S . T o x o p l a s m a g o n d i i . In: Mandell GL, Douglas RG. 1. Bennett JE, eds. Principles and Practice of Infectious Disease 2nd edn. New York: John Wiley, 1983: 1540-9. 2. Beverley JKA. Congenital toxoplasma infections. Proc Roy Soc Med 1960; 53:111-13. 3. Topi GC, D'Alessandro L, Catricata C et al. Dermatomyositis - like syndrome due to toxoplasma. Br J Dermatol 1979; 101 : 5 8 9 - 9 1 . 4 . 'D/'! 'D-JH'FJ Z o o n o s i s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'DE1',9 A l e x a n d e r J O D . S c a b i e s . I n : A r t h r o p o d s a n d H u m a n S k i n . Berlin: Springer-Verlag, 1984: 227-92. 1 Bartley WC, Mellanby K. The parasitology of human scabies (women and children). Parasitology 1944; 35: 207-8. 2 Van Neste DJJ. Human scabies in perspective. Int J Dermatol 1988; 27: 10-15. 3 Alexander JOСD. Scabies. In: Arthropods and Human Skin. Berlin: Springer-Verlag, 1984; 227-92. 4 Funaki B, Elpem DJ. Scabies epidemiology, Kauai, Hawaii, 1981-1985. IntJDermatol 1987; 26:5902. 5 Dahl MV. The immune system in scabies. ln: Orkin M, Maibach HI, eds. Cutaneous Infestations and Insect Bites. New York: Marcel Dekker, 1985:75-83. 6 Van Neste DJJ. Human scabies in perspective. Int J Dermatol 1988; 27: 10-15. 7 Bean SF. Bullous scabies. J Am Med Assoc 1974; 230: 878. 8 Hurwitz S. Scabies in babies. Am J Dis Child 1973; 126: 226-8. 9 Clayton TM. Treatment of scabies by T.E.T.M.S. Br Med J 1943; 1: 443-5. 10 Cubela V, Yawalkar SJ. Clinical experience with crotamiton cream and lotion in the treatment of infants with scabies. Br J Clin Pract 1978; 32: 229-31. 11 Ginsburg CM, Lowry W, Reisch JS. Absorption of lindane (gamma benzene hexachloride) in infants and children. J Pediatr 1977; 91: 998-l000. 12 Hewitt M, Barrow GI, Miller DC et al. Mites in the personal environment and their role in skin disease. Br J Dermatol 1973; 89: 401-9. 13 Alexander JOСD. Reactions to Dipterous biting flies. In: Arthropods and Human Skin- Berlin: Springer-Verlag, 1984: 115-33. 14
(2/46)
Matusow RJ. Oral inflammatory responses to a sting from Portugese man-oX war. J Am Dent Assoc 1980; 100: 73-5. Hoeffler DF. Swimmers itch. Cutis 1977; 19: 461-7. 15 Bernhardt MJ, Mandojana RM. Sea bathers eruption. Clin Dermatol 1987; 5: 101-2. 16 Hoeffler DF. Swimmers itch. Cutis 1977; 19: 461-7. 17 Kettle DS. Medical and Veterinary Entomology. London: Croom Helm, 1984. 18 Medley S. A dog bite wound infected with Pasteurella pneumotropica. Med J Australia 1977; 2: 224-5. 19 Brenner DJ, Hollis DG, Fanning GR et al. Capnocytophaga canimorsus sp. nov. (Formerly CDC group DF-2), a cause of septicaemia following dog bite, and C. cynadegmi sp. nov., a cause of local wound infection following dog bite. J Clin 20 Stawiski MA. Insect bites and stings. Emerg Clin North Am 1985; 3 (4): 785-808. 21 Burns DA. The investigation and management of arthropod bites acquired in the home. Clin Exp Dermatol 1987; 12: 114-20. Microbiol 1989; 27: 231-5. 22 Warrell DA. Animal poisons - scorpion stings. In: Manson-Bahr PEC, Bell DR, eds. MansonСs Tropical Diseases 19th edn. London: BalliEre Tindall, 1987: 889-90. 23 Alexander JOСD. Scorpion stings. In: Arthropods and Human Skin. Berlin: Springer-Verlag, 1984: 199-207. 24 Medley S. A dog bite wound infected with Pasteurella pneumotropica. Med J Australia 1977; 2: 224-5. 25 Gueron M, Yaron R. Cardiovascular manifestations of severe scorpion sting. Clinicopathologic correlations. Chest 1970; 57: 156-62. 26
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(2/58)
Broadbent V. Children's worms. Br Med J 1975; i: 89. Pearson RD, Irons RP, Irons RP Jr. Chronic pelvic peritonitis due to the pinworm Enterobius vermicularis. J Am Med Assoc 1981; 245: 1340-1 3 Burke JA. Strongyloidiasis in childhood. Am J Dis Child 1978; 132: 1130-6. von Kuster LC, Genta RM. Cutaneous manifestations of strongyloidiasis. Arch Dermatol 1988; 124: 1826-30. 4 Katz R, Ziegler J, Blank H. The natural course of creeping eruption and treatment with thiabendazole. Arch Dermatol 1975; 91: 420-4. 5 Beaver PC, Jung RC, Cupp EW, eds. Clinical Parasitology, Philadelphia: Lea & Febiger, 1984: 340. 6 Davis A. Recent advances in Schistosomiasis. Quart J Med 1986; 58: 95-110. El-Zawahary M. Schistosomal granuloma of the skin. Br J Dermatol 1965; 77: 344-5. 7 Gonzalez E. Schistosomiasis, cercarial dermatitis and marine dermatitis. Dermatol Clin 1989; 7: 291-300. 8 Mahmoud AAF, ed. Schistosomiasis. In: Clinical Tropical Medicine and Communicable Diseases. London: Bailliere Tindall, 1987. 9 Mahmoud AAF. Praziquantel for the treatment of helminthic infections. In: Stollerman GH, ed. Advances in Internal Medicine 32. Chicago: Year Book Medical Publishers, 1987: 419-34. 10 Torres VM. Dermatological manifestations of Schistosomiasis mansoni. Arch Dermatol 1976; 112: 1539-42. 11 World Health Organization. Atlas of the global distribution of Schistosomiasis. Parasitic Diseases Programme. WHO, 1987, Geneva. 351 12 Baird JK, Wear DJ. Cercarial dermatitis. The swimmers itch. Clin Dermatol 1987; 5: 88-91. 13
(2/59)
Bernhardt MJ, Mandojana RM. Sea bathers eruption. Clin Dermatol 1987; 5: 101-2. 14 Hoeffler DF. Swimmers itch. Cutis 1977; 19: 461-7.Medical Letter. Drugs for parasitic infections. Med Let 1988; 30: 15-24. 15 Fujita WH, Barr RJ, Gottschalk HR. Cutaneous amoebiasis. Arch Dermatol 1981; 117: 309-10. 16 Martinez-Palomo A. The pathogenesis of amoebiasis. Parasitol Today 1987; 3: 111-18. 17 Knight R. The chemotherapy of amoebiasis. J Antimicrob Chemother 1980; 6: 577-93. 18 Fouts AC, Kraus SJ. Trichomonas vaginalis. Reevaluation of its clinical presentation and laboratory diagnosis. J Infect Dis 1980; 141: 137-52. 19 Honigberg B. Trichomonads of importance in human medicine. In: Kreier JP, ed. Parasitic Protozoa 2. New York: Academic Press, 1978: 275-86. 20 Lossick JG. Treatment of Trichomonas vaginalis infection. Rev Infect Dis 1982; (Suppl.): S801-8. 21 Foulkes JR. Human trypanosomiasis in Africa. Br Med J 1981; 283: 1172-4. 22 Greenwood BM. African trypanosomiasis. In: Weatherall DJ, Ledingham JGG, Warrell DA, eds. Oxford Textbook of Medicine 2nd edn. Oxford: Oxford University Press, 1987. 23 Gallerano RH, Marr JJ, Sosa RR. Therapeutic efficacy of allopurinol in patients with chronic Chagas' disease. Am J Trop Med Hyg 1 9 9 0 ; 4 3 : 1 5 9 - 6 6 . 2 4 'DA5D 'D.'E3 941 'D-3'3J) H'DEF'9) 'D31J1J) A l l e r g y a n d c l i n i n c a l i m m u n o l o g y 'D-3'3J) GJ *:J1 FH9J EC*3( AJ B'(DJ) 'DE6JA DD*A'9D E9 E3*6/ E'. HGH *A'9D EF'9J J9*E/ 9DI E1C('* 6/ @ E3*6/.
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'D.D'J' 'D*'&J): *3'GE AJ CD EF 'D'3*,'() 'DEF'9J) 'D.DHJG H'D.DJ7). 'D.D'J' 'D('&J): *F*, E,EH9'* #6/'/ " :DH(HDJF'*" EF'9J) E.*DA): " I g E , I g G H I g M , I g A H" I g D " . 'D*A'9D 'D#D1,J B/ J92I %DI 9H'ED /'.DJ) 'DEF4# #H.'1,J) 'DEF4#. ' @ 'DE3*6/" A n t i g e n " : GH E'/) :1J() JECFG' #F *+J1 '3*,'() EF'9J). HG0' B/ J$/J %DI: *4CJD 'D#6/'/ " A n t i b o d i e s " . *:J1 A9'DJ) 'D.D'J' 'DDEA'HJ) 'DE91HA) ('3E 'D'3*,'() 'DE*H'37) ('D.D'J' " C e l l m e d i a t e d r e s p o n s e " 'D5A'* 'DCJE'HJ) DDE3*6/'*: B/ *CHF 'DE3*6/'* 5:J1) 'DH2F 'D,2J&J #H C(J1) 'DH2F 'D,2J&J . 1 @ 'DE3*6/'* C(J1) 'DH2F 'D,2J&J ( H i g h m o l e c u l a r w e i g h t a n t i g e n s ) : **4CD EF 'D#-E'6 'D#EJFJ) H'D((*J/'* 'D*J JECFG' #F *+J1 H*-16 *CHJF 'D#6/'/. 2 @ 'DE3*6/'* 5:J1) 'DH2F 'D01J( L o w m o l e c u l a r w e i g h t a n t i g e n s ) : G0G 'D#FH'9 D'*3*7J9 #F *-16 *4CJD 'D#6/'/ E'DE *1*(7 E9 (1H*JF G0G *91A ('3E ( 'DFH'4() H a p t e n s HJECF #F *+J1 'D#6/'/ 'D.DJ7) H u m o r a l #H 'DFE7 'DE*#.1 ( 'DE*H'37 ('D.D'J' : D e l a y e d c e l l t y p e ) EF 'D-3'3J) 'D*J *CHF FH9J) DDFH'4(. 'DE3*6/'* 'D*J *-33 'D#4.'5 (4CD #C+1 4JH9'K DD-3'3J) 'D'3*G/'AJ) ( A n a p h y l a c t i c ) #H 'DFE7 'DE*#.1 HG0' J91A ('3E E3*R'1, " 'D1J',JF" #H EHD/ 'D'1,JG( A l l e r g e n ) . 'D#6/'/ ( A n t i b o d i e s ) : GJ ,DH(HDFJ'* EF'9J) E5DJ) **4CD '3*,'() D*-1J6 'DE3*6/. H'D#6/'/ **4CD EF B(D 'D.D'J' 'D(D'2EJ) H**#DA EF 3D'3D 9/J/) EF (HDJ ((*'J/'*. 'DH-/) 'D1&J3J) DD6/ GJ ,2J& 'D,DH(HDJF 'DEF'9J ( I g ) . JH,/ 9/) ,DH(HDJF'* EF'9J) AJ 'DEA12'* 'D.'1,J) E+D 'DBF') 'DE9HJ) H'D71B 'D*FA3J). A4D #J ,2! EF ,G'2 'DEF'9) B/ J$G( DD*-33 #H %DI 'D'D*G'( #H %DI 'D#E1'6 'D.(J+). 'D*A'9D'* 'DEF'9J) 'DE.*DA):
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'D'F/A'9 'D6J'&J E*9// 'D#4C'D ( P o l y m o r p h o u s l i g h t e r u p t i o n ) 'D*G'( ,D/ 'F*'FJ ( I n f e c t i v e d e r m a t i t i s ) 3 @ 'D#4C'D :J1 'DE5FA) EF 'D'C2JE': 'D*G'( 'D,D/ 'D95(J: " 'D-2'2 'DE2EF 'D(3J7" ( N e u r o d e r m a t i t i s , L i c h e n s i m p l e x c h r o n i c u s ) 'D#C'D 'D9BJ/J " N o d u l a r P r u r i g o . " *5FJA 'D#C2JE' -3( 'D3J1 H'D5H1) 'D31J1J): 'D#C2JE' 'D-'/). 'D#C2JE' *-* 'D-'/). 'D#C2JE' 'DE2EF). 'DE1',9 L o n g l e y J , B r a v e r m a n I M , E d e l s o n R L . I m m u n o l o g y a n d t h e S k i n : A n n N Y A c a d S c i 1 9 8 8 1 B o s J D , Z o n n e v e l d I , D a s P K e t a l . T h e s k i n i m m u n e s y s t e m ( S I S ) : d i s t r i b u t i o n a n d i m m u n o p h e n o t y p e o f l y m p h o c y t e s u b p o p u l a t i o n s i n n o r m a l human skin. J Invest Dermatol 1987; 88: 569-73 2 Bruynzeel-Koomen C. IgE on Langerhans cells: new insights into the pathogenesis of atopic dermatitis. Dermatologica 1986; 172: 181-3 3 Kim KM, Mayumi M, Iwai Y. IgE receptor-bearing lymphocytes in allergic and non-allergic children. Pediatr Res 1988; 24: 254-7 4 Streilein JW. Skin-associated lymphoid tissues (SALT): Origins and functions. J Invest Dermatol 1983; 80: 12s-15s 5 Zola H. The surface antigens of human B-lymphocytes. Immunology Today 1987; 8: 308-15 6 Chernielewski J, Vaigot P, Prunieras M. Epidermal Langerhans cells - a cycling cell population. J Invest Dermatol 1985; 84: 424-6 7 Wolff K, Stingl G. The Langerhans cell. J Invest Dermatol 1983; 80: 17s-21s 8 Weaver CT, Unanue ET. The costimulatory function of antigen-presenting cells. Immunology Today 1990; 11: 49-55 9 Quinti I, Brozek C, Wood N et al. Circulating IgG auto-antibodies to IgE in atopic syndromes. J Allergy Clin Immunol 1986; 77: 586-94 10
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Cronin E. Contact Dermatitis. Edinburgh: Churchill Livingstone, 1980 11 Sampson HA. Role of immediate food hypersensitivity in the pathogenesis of atopic dermatitis. J Allergy Clin Immunol 1983; 71: 473-80 12 Rudzki E, Grzywa A. Immediate reactions to Balsam of Peru, cassia oil and ethyl vanillin. Contact Derm 1976; 2: 360-1 13 Cronin E. Studies in contact dermatitis. 18. Dyes in clothing. Trans St John's Hosp Derm Soc 1960; 54: 156-64 14 Reynolds CW, Ortaldo JR. Natural killer activity: the definition of a function rather than a cell type.Immunology Today 1987; 8: 172-4 15 Maibach HI, Epstein WL. Plant dermatitis: fact and fancy. Postgrad Med 1964; 35: 571-4 16 Mitchell JC, Dupuis G, Geissman TA. Allergic contact dermatitis from sesquiterpenoids of plants. Br J Dermatol 1972; 87: 235-40 17 Mitchell JC, Geissmann TA, Dupuis G et al. Allergic contact dermatitis caused by Artemisia and Chrysanthemum species. J Invest Dermatol 1971; 56: 98-101 18 Mitchell JC, Rook AJ. Diagnosis of contact dermatitis from plants. Int J Dermatol 1977; 16: 257-66 19 Rothenborg HW, Menne T, St3/4lin K-E. Temperature dependent primary irritant dermatitis from lemon perfume. Contact Derm 1977; 3: 37-48 20 Powell SM, Barrett DK. An outbreak of contact dermatitis from Rhus verniciflua (Toxicondendron vernifluvum). Contact Derm 1986; 14: 288-9 21 Dahlquist I, Fregert S. Formaldehyde releasers. Contact Derm 1978; 4: 173 22 Menne T, Hjorth N. Routine patch testing with paraben esters. Contact Derm 1988; 19: 189-91 23
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G w y n n C M , M o r r i s o n S m i t h J , L e o n G L . R o l e o f I g G 4 s u b c l a s s i n c h i l d h o o d a l l e r g y . L a n c e t 1 9 7 8 ; i : 9 1 0 - 1 1 . 1 S v e n s s o n A , E d m a n B, M"ller H. A diagnostic tool for atopic dermatitis based on clinical criteria. Acta Derm Venereol 1985; 92 (Suppl. 114): 33-40. Br J Dermatol 1971; 84: 605-7. 2 Braathen LR. T-cell subsets in patients with mild and severe atopic dermatitis. Acta Derm Venereol 1985; 114 (Suppl.): 133-6. 3 Jensen JR. Reduction of active natural killer cells in patients with atopic dermatitis estimated at the single cell level. Acta Derm Venereol 1985; 114 (Suppl.): 105-8. 4 Rajka G. Essential Aspects of Atopic Dermatitis. Berlin: SpringerVerlag, 1989. 5 Svensson A, Edman B, M"ller H. A diagnostic tool for atopic dermatitis based on clinical criteria. Acta Derm Venereol 1985; 92 (Suppl. 114): 33-40. 6 Rajka G. Essential Aspects of Atopic Dermatitis. Berlin: SpringerVerlag, 1989. 7 Walker RB, Warin RP. The incidence of eczema in early childhood. Br J Dermatol 1956; 68: 1182. 8 Blumenthal MN, Yunis E, Mendell N et al. Preventive allergy: genetics of IgE mediated-diseases. J Allergy Clin Immunol 1986; 78: 962-67. 9 Rajka G. Essential Aspects of Atopic Dermatitis. Berlin: SpringerVerlag, 1989. 10 Taylor B, Wadsworth J, Wadsworth M et al. Changes in the reported prevalence of childhood eczema since the 1939-45 war. Lancet 1984; ii: 1255-7. 11 Wuthrich B, Baumann E, Fries RA et al. Total and specific IgE (RAST) in atopic twins. Clin Allergy 1981; 11: 147-54. 12 Cookson WOCM, Hopkin JM. Dominant inheritance of atopic immunoglobulin-E responsiveness. Lancet 1988; i: 86-7. 13
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'A6D E5/1 DAJ*'EJF " /" GH #49) 'D4E3 D0' *91J6 ,D/ 'D7AD JHEJ'K D#49) 'D4E3 AJ 'D5('- DG A'&/G G'E). 71JB) 'D*79JE (E5D .'5 (F'! 9DI F*J,) '.*('1'* 'D-3'3JG B/ JCHF 0' A'&/) DDE5'(JF ('D-3'3J) 'D'3*41'&J) @ 'D1(H H-EI 'DB4. 'DE1',9 A n d e r s s o n , J B . A n d L e s s o f , M H . : D i a g n o s i s a n d t r e a t m e n t o f f o o d a l l e r g i e s . P r o c e e d i n g s o f t h e n u t r i t i o n s o c i e t y , 4 2 , 2 5 7 ( 1 9 8 3 ). 1 Atkins FM, Steinberg SS, Metcalfe DD. Evaluation of immediate adverse reactions to foods in adult patients II. A detailed analysis of reaction patterns during oral food challenge. J Allergy Clin Immunol 1985; 75: 356-63. 2 Bock SA, Lee W-Y, Remigro LK. Studies of hypersensitivity reactions to foods in infants and children. J Allergy Clin Immunol 1978; 62: 327-34. 3 Sampson HA. The role of food allergy and mediator release in atopic dermatitis. J Allergy Clin Immunol 1988; 81: 635-45. 4 Barnetson R StC, Merrett TC. Food allergy and atopic eczema. Proc Nutr Soc 1983; 42: 247-56. 5 Jackson PG, Lessof MH, Baker RWR. Intestinal permeability in patients with eczema and food allergy. Lancet 1981; i: 1285-6. 6 Hausen BM, Hjorth N. Skin reaction to topical food exposure. Dermatol Clin 1984; 2: 567-78, 7 Sampson HA, Joli PL. Increased plasma histamine concentrations after food challenges in children with atopic dermatitis. N Engl J Med 1984; 311: 372-6. 8 Eagle, R. :Eating and allergy. Futura, London. 110 (1979) 9 Barnetson R StC, Merrett TC. Food allergy and atopic eczema. Proc Nutr Soc 1983; 42: 247-56. 10
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Carini C. IgE immune complexes in food allergy; significance, pathogenicity and clinical consideration. Clin Allergy 1987; 17: 485-97. 11 Barnetson R StC, Merrett TC. Food allergy and atopic eczema. Proc Nutr Soc 1983; 42: 247-56. Atopic Dermatitis 12 Jackson PG, Lessof MH, Baker RWR. Intestinal permeability in patients with eczema and food allergy. Lancet 1981; i:1285-6. 13 Sampson HA. The role of food allergy and mediator release in atopic dermatitis. J Allergy Clin Dermatol 1989; 81: 635-45. 14 Barnetson R StC, Merrett TC. Food allergy and atopic eczema. Proc Nutr Soc 1983; 42: 247-56. 15 Carini C. IgE immune complexes in food allergy; significance, pathogenicity and clinical consideration. Clin Allergy 1987; 17: 485-97. 16 Gwynn CM, Morrison Smith J, Leon GL. Role of IgG4 subclass in childhood allergy. Lancet 1978; i: 910- 17 Satyawan I, Oranje AP, van Joost Th. Perioral dermatitis in a child due to rosin in chewing gum. Contact Derm 1990; 22:182-3. 18 Sampson HA. Role of immediate food hypersensitivity in the pathogenesis of atopic dermatitis. J Allergy Clin Immunol 1983; 71: 473-80. 19 Sampson HA, Joli PL. Increased plasma histamine concentrations after food challenges in children with atopic dermatitis. N Engl J Med 1984; 311: 3 7 2 - 6 . 2 0 'DA5D 'D+'EF 941 'D*G'('* 'D,D/ 'D*.14J) 'D#HDJ) P r i m a r y i r r i t a n t d e r m a t i t i s J.*DA 'D*G'( 'D,D/ 'D*.1J4J 9F 'D*G'( 'D,D/ 'D*-33J. 'D'C2JE' 'D*.1J4J) *-/+ (3(( EH'/ *7(B DDE1) 'D#HDI #H DA*1) B5J1) B/ *$/J %DI #0J) .DHJ) %0' 7(B* (*1CJ2 E9JF HDE/) C'AJ).
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H o l s t R , M " l l e r H . O n e h u n d r e d t w i n p a i r s p a t c h t e s t e d w i t h p r i m a r y i r r i t a n t s . B r J D e r m a t o l 1 9 7 5 ; 9 3 : 1 4 5 - 9 2 J a c kson EM, Goldner R, eds. Irritant Contact Dermatitis. New York: Marcel Dekker, 1990 3 Kligman AM, Wooding WM. A method for the measurement and evaluation of irritants on human skin. J Invest Dermatol 1967; 49: 78-94 4 Fregert S. Manual of Contact Dermatitis, 2nd edn. Copenhagen: Munksgaard, 1981 5 Symposium on Skin Cleansing. Trans St John's Hosp Dermatol Soc 1965; 51: 133-256 6 Van der Valk PGM, Crijns MC, Nater JP et al. Skin irritancy of commercially available soap and detergent bars as measured by water vapour loss. Dermatosen 1984; 32: 87-90 7 Wood DCF, Bettley FR. The effect of various detergents on human epidermis. Br J Dermatol 1971; 84: 320-5 8 Zesch A. Adverse reactions of externally applied drugs and inert substances. Dermatosen 1988; 36: 128-33 9 De Groot AC. Patch Testing. Test concentrations and vehicles for 2800 allergens. Amsterdam: Elsevier, 1986 10 Fisher AA. Contact Dermatitis, 3rd edn. Philadelphia: Lea and Febiger, 1986 11 Hurkmans JFGM, Bodde HE, van Driel LMJ et al. Skin irritation cause d b y t r a n s d e r m a l d r u g d e l i v e r y s y s t e m s d u r i n g l o n g - t e r m ( 5 d a y s ) a p p l i c a t i o n . B r J D e r m a t o l 1 9 8 5 ; 1 1 2 : 4 6 1 - 7 1 2 'DA5D 'D*'39 941 'C2JE' 'D*E'3 9F/ 'D#7A'D -/J+J 'DHD'/) N e o n a t a l C o n t a c t D e r m a t i t i s #3('( 'D*G'( 'D,D/ ('D*E'3 9F/ 'DHDJ/:
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"A'* 'D,D/ *8G1 AJ 9E1 4 4GH1 %DI 9 4GH1 9'/). 'D"A'* **CHF EF H'-/ #H 9/) 'F/A'9'* 9DI 4CD 9BJ/'* #1,H'FJ) :'E6) H-J/) 'D4CD 9'/) (J6'HJ) E-H1G' 'D7HJD JH'2J 4BHB 'D,D/. H*3*E1 D(69) #3'(J9 HB/ **1C H1'&G' *F/('* 6EH1J) (9/ 'D4A'!. 71B 'DE9'D,) 'D9D', E+D E' J7(B AJ E9'D,) -'3J) 'D-A'&8. 'DE1',9 P r a t t A G . P e r i a n a l d e r m a t i t i s o f t h e n e w b o r n . A m J D i s C h i l d 1 9 5 1 ; 8 2 : 4 2 9 - 3 2 1 P r a t t A G , R e e d W T . I n f l u e n c e o f t y p e o f f e e d i n g o n p H o f s t o o l , p H o f s k i n a n d t h e i n c i d e n c e o f p e r i a n a l d e r m a t i t i s in the newborn infant. J Pediatr 1955; 46: 539-43 2 Tanino J, Steiner M, Benjamin B. The relationship of perianal dermatitis to fecal pH. J Pediatr 1959; 54: 793-800 3 Boisits EK, McCormack JJ. In: Maibach H, Boisits EK, eds. Neonatal Skin. New York: Marcel Dekker, 1982: 191-204 4 Brookes DB, Hubbert RM, Sarkany I. Skin flora of infants with napkin rash. Br J Dermatol 1971; 85: 250-3 5 Brown BW. Fatal phenol poisoning from improperly laundered diapers. Am J Public Health 1970; 60: 901-2 6 Caplan RM. The irritant role of feces in the genesis of perianal itch. Gastroenterol 1966; 50: 19-23 7 Gall LS. Normal fecal flora of man. Am J Clin Nutr 1970; 23: 1457-65. Honig PJ, Gribetz B, Leyden JL et al. Amoxicillin and diaper dermatitis. J Am Acad Dermatol 1988; 19: 275-9 8 John Radcliffe Hospital Cryptorchidism Study Group. Effect of corticosteroid creams on descent of testes in infants. Br Med J 1990; 301: 214-15 9 Jordan WE, Blaney TL. In: Maibach H, Boisits EK, eds. Neonatal Skin. New York: Marcel Dekker, 1982: 205-221 10
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Pratt AG, Reed WT. Influence of type of feeding on pH of stool, pH of skin and the incidence of perianal dermatitis in the newborn infant. J Pediatr 1955; 46: 539-43 11 Zimmerer RE, Lawson KD, Calvert CJ. The effects of wearing diapers on skin. Pediatr Dermatol 1986; 3: 95-101 12 Bonifazi E, Garofalo L, Lospalluti M et al. Granuloma gluteale infantum with atrophic scars: clinical and histological observations in eleven cases. Clin Exp Dermatol 1981; 6 : 2 3 - 9 1 3 'DA5D 'D941HF 'D*G'( ,D/ EF7B) 'D-A'&8 D i a p e r D e r m a t i t i s ( N a p k i n d e m a t i t i s ) GH *#C2E AJ 'DFH'-J 'DE:7') ('D-A'&8 F*J,) D9H'ED C+J1) #GEG': 'D*:7J) 'DE3*E1) 'D17H() H'D*97JF AJ EF7B) 'D-A'&8 B/ *3(( -'D) :J1 AJ2JHDH,J) -J+ %F 'D,D/ D' JECF *-ED 0DC. *.E1 'DEA12'* H'F7D'B 'D'EHFJ' B/ JCHF D*DC 'D9H'ED #+1 G'E. CE' %F 'D#7A'D 0H 'D*:0J) 'D,J/G H'DH2F 'D2'&/ EF 'D9H'ED 'DEGJ&) HGE #C+1 *916'K DD%5'() ('D*G'( 'D,D/ (EF7B) 'D-A'&8. 'DE3(('*: 1:E #F *DC 'D9H'ED 'DAJ2JHDH,J) H'DE-16) *D9( /H1'K EGE'K AJ 'DE3(('* %D' %F 'DE$+1'* 'D*J JECF #F *G& 'DI -/H+ 'D"A) 'D,D/J) AJ 'D16J9 DJ3 ('D61H1) #F *CHF GJ FA3G' 9F/ 'D".1. 'D9H'ED 'DE$G(): 1 @ *97JF 'DF'-J) 'DE:(FJ): G0' J$/J 'DI *:JJ1 'D-'D) 'DAJ2JHDH,J) 'DE+'DJ) DG0G 'DEF7B). 2 @ *:7J) 'DF'-J) 'DE:(FJ): 'D*:7JG 'DE3*E1) DD,D/ JECF (-/ 0'*G' #F *3(( -E'EJ F',E) 9F A17 'D*91B H*1'CE 'DA6D'* 9DI 'DF'-J) 'DE:(FJ). 3 @ 'DE'!: GH 9'ED E.14 EGE .'5) 9F/E' JCHF E-*H'G EF 'D#ED'- #H 'DCDH1JF #9DI EF 'DE9/D CE' %F '3*./'E 'DE'! 'DEDH+ DG /H1 G'E C0DC.
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J,( /'&E'K ED'-8) #F 'D,D/ 'DE*"CD JGJ! %DI 'D'E*5'5 'D,D/J DD3*J1H&J/'* 'DB41J) EF 'DE3*-61'* 'DEH69JJ) 'DE7(B) AJ F'-J) 'D-A' 8 #H -'D'* 'D*:7J) DG0' 'DEHB9. 'E*5'5 'D3*J1H&J/'* 'DB41J) B/ J3(( *#+J1'* ,'F(J) E+D 9/E F2HD 'D.5J*JF .'5) 9F/ 'D./, #H 'D#7A'D 'DD0JF JHD/HF B(D 'DEH9/. ED'-8): 1 @ 'E*5'5 'D3*J1HJ/'* 'DB41J) EF 37- 'D,D/ #C+1 E' JCHF EF 9DI EF'7B +F'J' 'D,D/ .'5) EF7B) 'D-A'&8 @ 'DA.0JF @ 'D%(7 H'DH,G. %0 #F 'D'E*5'5 DG0G 'DE1C('* EF EF7B) 'D-A'&8 #C+1 (-H'DJ #1(9JF E1) EF 'E*5'5G 9DI ,D/ 'D#J/J. D0' A%F 'D*#+J1'* 'D,'F(J) H'D,G'2J) B/ *CHF #4/ 9DI *DC 'DEF'7B. 2 @ 'D'E*5'5 JCHF #319 H#C+1 9DI 'DEF'7B 'DE*3D.) EF 'D,D/. 3 @ 'D'E*5'5 EF 37- 'D,D/ 'D#7A'D JCHF #C+1 EF 'D('D:JF. 'DE1',9 H e r p e t i f o r m n a p k i n d e r m a t i t i s : n a p k i n d e r m a t i t i s s i m u l a t i n g a n a c u t e h e r p e s s i m p l e x i n f e c t i o n . B r J D e r m a t o l 1986;114: 746-7 1 Keswick BH, Seymour JL, Milligan MC. Diaper area skin microflora of normal children and children with atopic dermatitis. J Clin Microbiol 1987; 25: 216-21 2 Zimmerer RE, Lawson KD, Calvert CJ. The effects of wearing diapers on skin.Pediatr Dermatol 1986; 3: 95-101 3 Stein H. Incidence of diaper rash when using cloth and disposable diapers. J Pediatr 1982; 101: 720-3 4 Buckingham KW, Berg RW. Etiologic factors in diaper dermatitis: the role of feces. Pediatr Dermatol 1986; 3: 107-12 5 Jordan WE, Lawson KD, Berg RW et al. Diaper dermatitis: frequency and severity among a general infant population. Pediatr Dermatol 1986; 3: 198-207 6
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Munz D, Powell KR, Pai CH. Treatment of candidal diaper dermatitis: a double blind controlled comparison of topical nystatin with topical plus oral nystatin. J Pediatr 1982; 101: 1022-5 7 Berg RW, Buckingham KW, Stewart RL. Etiologic factors in diaper dermatitis: The role of urine. Pediatr Dermatol 1986; 3: 102-6 8 Buckingham KW, Berg RW. Etiologic factors in diaper dermatitis: The role of feces. Pediatr Dermatol 1986; 3: 107-12 9 Campbell RL, Bartlett AV, Sarbargh FC et al. Effect of diaper types on diaper dermatitis associated with diarrhoea and antibiotic use in children and day-care centres. Pediatr Dermatol 1988; 5: 83-7 10 Jordan WE, Lawson KD, Stewart R et al. Diaper dermatitis: Frequency and severity among a general infant population. Pediatr Dermatol 1986; 3: 198, 2 0 7 1 1 'DA5D 'D-'/J H'D941HF -3'3J) EH'/ 'D*,EJD C o s m e t i c D e r m a t i t i s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A d a m s R M , M a i b a c h H I . A f i v e - y e a r s t u d y o f c o s m e t i c r e a c t i o n s . J A m A c a d D e r m a t o l 1 9 8 5 ; 1 3 : 1 0 6 2 - 9 1 D e G r o o t A C . A d v e r s e R e a c t i o n s t o C o s m e t i c s . G r o n i n g e n , T h e N e t h e r l a n d s : S t a t e U n i v e r s i t y o f G r o n i n g e n , 1 9 8 8 2 N a t e r J P , d e G r o ot AC. Unwanted Effects of Cosmetics and Drugs Used in Dermatology, 2nd edn. Amsterdam: Elsevier,1983 3 Bardazzi F, Misciali C, Borrello P et al. Contact dermatitis due to antioxidants. Contact Derm 1988; 19: 385-6 4 Cronin E. Contact Dermatitis. Edinburgh: Churchill Livingstone, 1980: 264-5 5 Nater JP, de Groot AC. Unwanted Effects of Cosmetics and Drugs Used in Dermatology, 2nd edn. Amsterdam: Elsevier,1983 6 De Groot AC. Labelling cosmetics with their ingredients. Br Med J 1990; 300: 1636-8 7 De Groot AC, Beverdam E. Tjong Ayong C et al. The role of contact allergy in the spectrum of adverse effects caused by cosmetics and toiletries. Contact Derm 1988; 19: 195-201 8 Suyai T, Takahashi Y, Takagi T. Pigmented cosmetic dermatitis and coal tar dyes. Contact Derm 1977; 3: 249 9 Nakayama H, Harada R, Toda M. Pigmented cosmetic dermatitis. Int J Dermatol 1976; 15: 673-5 10 Koch SE, Mathias T, Maibach HI. Chloracetamide: an unusual cause of cosmetic dermatitis. Arch Dermatol 1985; 121: 172-3 11 Taylor JS. Adhesives, gums and resins. In: Fisher AA. Contact Dermatitis, 3rd edn. Philadelphia: Lea and Febiger, 1986: 667-74 12 Calnan CD. Unusual hydroxycitronellal perfume dermatitis. Contact Derm 1979;5: 123 13 Dooms-Goossens A, Dubelloy R, Degreef H. Contact and systemic contact-type dermatitis to spices. Dermatol Clin 1990; 8: 89-93 14
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Larsen WG. Perfume dermatitis. J Am Acad Dermatol 1985; 12: 1-9 15 Shelley WB, Hurley HJ. The allergic origin of zirconium deodorant granulomas. Br J Dermatol 1958; 70: 75-101 1 6 'DA5D 'D+'FJ H'D941HF -3'3J) 'D#D(3) C l o t h i n g d e r m a t i t i s 'D-1'1) H'D17H() EF 'D9H'ED 'DG'E) 'DE+J1) DD-3'3J) HDG0' 'D3(( EF 'D61H1J 'D-A'8 9DI /1,) -1'1) ,3E 'D7AD (H69G' 'D7(J9J 3H'! AJ 'D5JA #H AJ 'D4*'! HD'J9FJ 0DC C*E ,D/ 'D7AD .'5) AJ A5D 'D4*'! EE' B/ JH/J 0DC %DI 'D*GJ&) D2J'/) 'D-3'3J) F*J,) D2J'/) 'D*91B HC0DC *$G( DD'D*G'('* 'D,D/J) 3H'! 'DA71J) #H 'D,1+HEJ). 'D4CD 1BE 1 8 6 # : -3'3J) 'DED'(3 'D4CD 1BE 1 8 6 (: -3'3J) 'DED'(3 'D4CD 1BE 1 8 6 , : -3'3J) 'DED'(3 'DE'/) 'DE$1,) #H 'DE+J1) DD-3'3J) AJ 'D#D(3) %E' #F *CHF FA3 FH9 'DBE'4 #H 'DEH'/ 'DCJE'HJ) #H 'D#5(': #H 'DE9'/F E+D 'D3-'('* #H *DC 'D*J AJ 'D#-2EG H:J1G'. 'D#BE4): 'DB7F: 9'/) D'J+J1 'D-3'3J) HGH #BD #FH'9 'D#BE4G 'DEGJ&) DD-3'3J). 'D5HA: 9'ED EGE AJ %+'1) 'D-3'3J) D0DC JD'-8 %F (96 #FH'9 'D-3'3J) *2/'/ AJ A5D 'D4*'! F*J,) D'3*9E'D 'DED'(3 'D5HAJG HF*J,) #J6'K D,A'A 'D,D/. HJ,( ED'-8) %F (B'J' EH'/ 'D:3JD 'D*J *9DB AJ 'DED'(3 F*J,) 9/E 47AG' ,J/'K B/ *CHF 9'ED'K EGE'K DD-3'3J) HJ,( 'D'F*('G DG0G 'DED'-8G %0 F5'/A (96 #FH'9 'D-3'3J) 'D,D/J) 'D*J 51A* DG' 'D9/J/ EF 'D9D','* /HF A'&/) H9F/E' *E 'D*1CJ2 9DI 47A 'DED'(3 '.*A* G0G 'DE4CDG FG'&J'K (%0F 'DDG. 'D-1J1: F'/1'K E'J$/J %DI 'D-3'3J). 'D(HDJ3*1 H'DF'JDHF: EH'/ 'DF'JDHF H'D'C1JDC HE'/) 'D3('F/C3 'DE3*9ED) AJ 5F9 -A'&8 'D'7A'D H'D#-2E) DG' ,EJ9'K #+1 G'E AJ -/H+ 'D-3'3J). H'D3(( 'D#HD 'DE$+1 B/ JCHF E'/) 'DBE'4 #H 'D'5(':.
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(2/126)
Epstein E, Maibach HI. Ethylenediamine allergic contact dermatitis. Arch Dermatol 1968; 92: 476-7 5 Frosch PJ, Kligman AM. A method for appraising the stinging capacity of topically applied substances. J Soc Cosmet Chm 1977; 28: 197-209 6 Christophersen J, Mennщ TM, Tanghof P et al. Clinical patch test data evaluated by multivariate analysis. Contact Derm 1989; 21: 291-9 7 Kirton V, Wilkinson DS. Sensitivity to cinnamic aldehyde in a toothpaste. Contact Derm 1975; 1: 77-80 8 Berger C, Muscleman M, Meekness Brand?o F et al. Thin layer chromatography search for Disperse Yellow 3 and Disperse 9 Orange 3 in 52 stockings and pantyhose. Contact Derm 1984; 10: 154-7 10 Cronin E. Formal in textile dermatitis. Br J Dermatol 1963; 75: 267-73 11 Cronin E. Studies in contact dermatitis: XVIII. Dyes in clothing. Trans St John's Hosp Derm Soc 1968; 54: 156-64 12 Fregert S, Greenberger B, Grandson K et al. Allergic contact dermatitis from chromate in military textiles. Contact Derm 1978; 4: 223-4 13 Hjorth N, M"ller H. Phototoxic textile dermatitis (`Bikini dermatitis'). Arch Dermatol 1976; 112: 1445-7 14 Jordan WP. Clothing and shoe dermatitis. Postgrad Med 1972; 52: 143-8 15 Lundkofoed M. Contact dermatitis from formaldehyde in fabric softeners. Contact Derm 1984; 11: 254 16 Dahl MV. Allergic dermatitis from footwear. Minnesota Med 1975; 58: 871-4 17 De Groot AK, Gerkens F. Contact urticaria from a chemical textile finish. Contact Derm 1989; 20: 63-4 18 Farli M, Gasperini M, Giorgini S et al. Clothing dermatitis. Contact Derm 1986; 14: 316-17 19
(2/127)
Fisher AA. How to obtain shoes free of common sensitizers. Cutis 1973; 12: 678 20 Fisher AA, Kanof NB, Bionchi EM. Free formaldehyde in textiles and paper. Arch Dermatol 1962; 36: 753-6 21 Foussereau J, Dallara JM. Purity of standardized textile dye allergens - a thin layer chromotography study. Contact Derm 1986; 14: 303-6 22 Hatch KL, Maibach HI. Textile chemical finish dermatitis. Contact Derm 1986; 14: 1-13 23 HODGSON G. & HELLIER F. (1946) J. roy. Army. Med. Corps. 87, 110 24 Hatch KL, Maibach HI. Textile fiber dermatitis. Contact Derm 1985; 12: 1-11 25 Hjorth N, M"ller H. Phototoxic textile dermatitis (`Bikini dermatitis'). Arch Dermatol 1976; 112: 1445-7 26 Jordan WP. Clothing and shoe dermatitis. Postgrad Med 1972; 52: 143-8 27 Lundkofoed M. Contact dermatitis from formaldehyde in fabric softeners. Contact Derm 1984; 11: 254 28 Hatch KL, Maibach HI. Textile chemical finish dermatitis. Contact Derm 1986; 14: 1-13 29 Hatch KL, Maibach HI. Textile fiber dermatitis. Contact Derm 1985; 12: 1-11 30 Cronin E. Studies in contact dermatitis. 18. Dyes in clothing. Trans St John's Hosp Derm Soc 1960; 54: 156-64 31 Cronin E. Contact Dermatitis. Edinburgh: Churchill Livingstone, 1980 32 Hodgson CA, Hellier FF. Dermatitis caused by shirts in B.L.A. J Roy Arm y M e d C o r p s 1 9 4 6 ; 8 7 : 1 1 0 - 1 7 3 3 E p s t e i n E , M a i b a c h H I . E t h y l e n e d i a m i n e a l l e r g i c c o n t a c t d e r m a t i t i s . A r c h D e r m a t o l 1 9 6 8 ; 9 2 : 4 7 6 - 7 3 4 O s m u n d s e n P . E . ( 1 9 6 8 ) B r . J . D e r m 8 1 , 7 8 9 3 5 O s m u n d s e n P . E . ( 1 9 7 0 ) B r . J . D e r m 8 3 1 , 2 9 6 3 6
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Wilkinson DS. Nursing and Management of Skin Diseases 4th edn. London, Faber & Faber, 1977. 4 Calnan CD. Nickel dermatitis. Br J Dermatol 1956; 60: 229-36. 5 Christensen OB, Moller H. Nickel allergy and hand eczema. Contact Derm 1975; 1: l29-35. 6 Cronin E. Clinical prediction of patch test results. Trans St John's Hosp Derm Soc 1972; 58: 153-62. 7 Edman B. Sites of contact dermatitis in relationship to particular allergens. Contact Derm 1985; 13: 129-35. 8 Fisher AA. Metal dermatitis - some questions and answers. Cutis 1977; 19: 156, 158, 164, 165 and 169. 9 Fregert S. Occupational dermatitis in a 10-year material. Contact Derm 1975; 1: 96-107. 10 Husain SL. Contact dermatitis in the West of Scotland. Contact Derm 1977 ; 3 : 3 2 7 - 3 2 . 1 1 M e n n щ T , B r a n d r u p F , T h e s t r u p - P e d e r s e n K e t a l . P a t c h t e s t r e a c t i v i t y t o n i c k e l a l l o y s . C o n t a c t D e r m 1 9 8 7 ; 1 6 : 2 5 5 - 9 . 1 2 M o l l e r H . I n t r a d e r m a l t e s t i n g i n d o u b t f u l c a s e s o f c o n t a c t a l l e r g y t o m e t a l s . C o n t a c t D e r m 1 9 8 9 ; 2 0 : 1 2 0 - 3 . 1 3 'DA5D 'D1'(9 H'D941HF 'D*-33 'DF('*J ( #C2JE' 'DF('*'*) P l a n t D e r m a t i t i s GF'C 'D9/J/ EF 'DF('*'* 'DE.*DA) 'D*J B/ *3(( 'D-3'3J) 'D,D/J) E+D: F('*'* E'F3HFJ' @ 'D*J3EJ' @ 'D*JC H'D,H2 'D#3H/ 'D#A1JBJ H:J1G'. 'D-4'&4 H#H1'B 'D#4,'1 H'D2GH1 C0DC B/ *3(( 'D-3'3J). 'D*G'( 'D,D/ 'DEGFJ ('DF('*'* J-/+ 9F/ 9E'D 'D-/'&B 9E'D 'D:'('* H:J1GE.
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B/ *-/+ 'D#C2JE' #J6'K EF (96 'DH1H/ E+D 2G1) 'D1(J9 @ #2G'1 " C h r y s a n t h e m u m " H2GH1 " P r a i r i e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e a w e e d D e r m a t i t i s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5 @ 'D3*J1H&J/'* 'DB41J) AEHJ'K #H 96DJ'K ( D e p o t M e d r o l 4 0 m g . ) B/ J-*', DG AJ 'D-'D'* 'D4/J/) H'D"A'* 'DEF*41). 6 @ E6'/'* 'DGJ3*'EJF *3*./E DEF9 'D-C). 7 @ 'DAB'9'* B/ *A*- H*3*./E CE'/'* (1EF:F'* 'D(H*'3JHE 1 / 9 0 0 0 D*,AJAG'. 8 @ 'D9D', (71JB) 'D*79JE 'D*-33J ( D e s i n s t i z a t i o n ) . 'DE1',9 R E F ERENCE Kligman AM. Poison ivy (Rhus) dermatitis. Arch Dermatol 1958; 77: 149-80 Malten KE. Tracing back a positive to epoxy resins. Contact Derm 1977; 3: 217. Malten KE. Tracing back a positive to epoxy resins. Contact Derm 1977; 3: 217. Holst R, Kirby J, Magnusson B. Sensitization to tropical woods giving erythema multiforme-like eruphons. Contact Derm 1976; 2: 295 Woods B. Irritant plants. Trans St JohnСs Hosp Dermatol Soc 1962; 48: 75-82. Maibach HI, Epstein WL. Plant dermatitis: fact and fancy. Postgrad Med 1964; 35: 571-4. Mitchell JC, Dupuis G, Geissman TA. Allergic contact dermatitis from sesquiterpenoids of plants. Br J Dermatol 1972; 87: 235-40. Mitchell JC, Geissmann TA, Dupuis G et al. Allergic contact dermatitis caused by Artemisia and Chrysanthemum species. JInvest Dermatol 1971; 56: 98-101. Mitchell JC, Rook AJ. Diagnosis of contact dermatitis from plants. Int J Dermatol 1977; 16: 257-66. Rothenborg HW, Menne T, St3/4lin K-E. Temperature dependent primary irritant dermatitis from lemon perfume. Contact Derm 1977; 3: 37-48. Maibach HI, Epstein WL. Plant dermatitis: fact and fancy. Postgrad Med 1964; 35: 571-4. Mitchell JC, Dupuis G, Geissman TA. Allergic contact dermatitis from sesquiterpenoids of plants. Br J Dermatol 1972; 87: 235-40.
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Mitchell JC, Geissmann TA, Dupuis G et al. Allergic contact dermatitis caused by Artemisia and Chrysanthemum species. J Invest Dermatol 1971; 56: 98-101. Powell SM, Barrett DK. An outbreak of contact dermatitis from Rhus verniciflua (Toxicondendron vernifluvum). Contact Derm 1986; 14: 288-9. Rook A. Plant dermatitis. Br Med J 1960; 2: 1771-4. Rudzki E, Grzywa A. Immediate reactions to Balsam of Peru, cassia oil and ethyl vanillin. Contact Derm 1976; 2: 360-1 Thune PO, Solberg YJ. Photosensitivity and allergy to aromatic lichen acids and compositae oleoresins and other plant substances. Contact Derm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'DE1C('* 'D96HJ) *3*./E CE(J/'* H9H'ED E6'/) DD,1'+JE @ AJ 'D2JH* @ 'D/G'F'* H5F'9) 'D#BE4) @ 5F'9) 'DH1B HAJ *(7JF 'D#-0J). #-J'F'K 'DE1C('* 'D96HJ) *3*./E CE'/) -'A8) AJ 'DE-'DJD 'DE9/) DD-BF E+D .D'5'* 'D,'E':DH(JF H'D#6/'/ #H AJ 'DEB49'* 'DC1JE'* 'DE7G1'* 'D,D/J) 'DB71'* 'D9JFJ) HE-'DJD 'D9/3'* 'DD'5B). (H1'* AFJD 'D2&(B ( M e r f e n ) E'2'D J3*9ED (C+1) AJ 'DE(J/'* DDA7H1. '3*J'* AFJD 'D2&(B J3*./E AJ (96 B'*D'* 'DF7A 'DEG(DJ) 'D*J B/ *3(( '1*C'3 #1,J. 3DA'J/ 'D2&(B 'D#-E1 ( C i n n a b a r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E-DHD (HAJ/HF @ 'JH/'JF AJG AB7 1 % JH/ HGH E-33 F'/1. 'DE1',9 1 B u r r o w s D . A d v e r s e c h r o m a t e r e a c t i o n s o n t h e s k i n . I n : B u r r o w s D , e d . C h r o m i u m : M e t a b o l i s m a n d T o x i c i t y . B o c a R a t o n , F l o r i d a : C R C P r e s s , 1 9 8 3 : 1 3 7 - 6 3 2 H a m bly EM, Wilkinson DS. Contact dermatitis to butyl acrylate in spectacle frames. Contact Derm 1978; 4: 115 3 Kirton V, Wilkinson DS. Sensitivity to cinnamic aldehyde in a toothpaste. Contact Derm 1975; 1: 77-80 4 Calnan CD. Nickel dermatitis. Br J Dermatol 1956; 60: 229-36 Christensen OB, M?ller H. Nickel allergy and hand eczema. Contact Derm 1975; 1: l29-35 5 6 Shelley WB, Hurley HJ. The allergic origin of zirconium deodorant granulomas. Br J Dermatol 1958; 70: 75-101. 7 Volden C, Kiokan H, Kauli G et al. Phototoxic and contact toxic reactions to the exocarp of sweet oranges: a common cause of cheilitis? Contact Derm 1983; 9: 201-4. 8 Cronin E. Clinical prediction of patch test results. Trans St JohnСs Hosp Derm Soc 1972; 58: 153-62. 9 Edman B. Sites of contact dermatitis in relationship to particular allergens. Contact Derm 1985; 13: 129-35. 10 Fisher AA. Metal dermatitis - some questions and answers. Cutis 1977; 19: 156, 158, 164, 165 and 169. 11 Fregert S. Occupational dermatitis in a 10-year material. Contact Derm 1975; 1: 96-107. 12 Husain SL. Contact dermatitis in the West of Scotland. Contact Derm 1977; 3: 327-32. 13 MennщЖT, Brandrup F, Thestrup-Pedersen K et al. Patch test reactivity to nickel alloys. Contact Derm 1987; 16: 255-9. 14 Meller H. Intradermal testing in doubtful cases of contact allergy to metals. Contact Derm 1989; 20: 120-3.
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15 Berger C, Muslmani M, Menezes Brandao F et al. Thin layer chromatography search for Disperse Yellow 3 and Disperse Orange 3 in 52 stockings and pantyhose. Contact Derm 1984; 10: 154-7. 16 Cronin E. Formalin textile dermatitis. Br J Dermatol 1963; 75: 267-73. 17 Cronin E. Studies in contact dermatitis: XVIII. Dyes in clothing. Trans St JohnСs Hosp Derm Soc 1968; 54: 156-64. 18 De Groot AK, Gerkens F. Contact urticaria from a chemical textile finish. Contact Derm 1989; 20: 63-4. 19 Farli M, Gasperini M, Giorgini S et al. Clothing dermatitis. Contact Derm 1986; 14: 316-17. 20 Fisher AA, Kanof NB, Bionchi EM. Free formaldehyde in textiles and paper. Arch Dermatol 1962; 36: 753-6. 21 Fisher AA. The notorious poison ivy family of Anacardiaceae plants. Cutis 1977; 20: 570-95. 22 Mitchell JC, Rook AJ. Diagnosis of contact dermatitis from plants. Int J Dermatol 1977; 16: 257-66. 23 Rothenborg HW, Menne T, Stlin K-E. Temperature dependent primary irritant dermatitis from lemon perfume. Contact Derm 1977; 3: 37-48. 24 Powell SM, Barrett DK. An outbreak of contact dermatitis from Rhus verniciflua (Toxicondendron vernifluvum). Contact Derm 1986; 14: 288-9. 25 Rook A. Plant dermatitis. Br Med J 1960; 2: 1771-4. Rudzki E, Grzywa A. Immediate reactions to Balsam of Peru, cassia oil and ethyl vanillin. Contact Derm 1976; 2: 360-1. 26 27 Thune PO, Solberg YJ. Photosensitivity and allergy to aromatic lichen acids and compositae oleoresins and other plant substances. Contact Derm 1980; 6: 64-71. 28 Cronin E. Contact Dermatitis. Edinburgh: Churchill Livingstone, 1980.
(2/144)
Edman B. Sites of contact dermatitis in relationship to particular allergens. Contact Derm 1985; 13: 120-35. 29 30 Hodgson CA, Hellier FF. Dermatitis caused by shirts in B.L.A. J Roy Army Med Corps 1946; 87: 110-17. 31 Epstein E, Maibach HI. Ethylenediamine allergic contact dermatitis. Arch Dermatol 1968; 92: 476-7. 32 Frosch PJ, Kligman AM. A method for appraising the stinging capacity of topically applied substances. J Soc Cosmet Chm 1977; 28: 197-209. 33 Christophersen J, MennE TM, Tanghof P et al. Clinical patch test data evaluated by multivariate analysis. Contact Derm 1989; 2 1 : 2 9 1 - 9 . 'DA5D 'D3'/3 H'D941HF 'D*-33 'D,D/J 'DF',E 9F 'DE.14'* 'D#.1I S k i n S e n s i t i z a t i o n d u e t o O t h e r I r r i t a n t s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i g . 1 9 5 . a , b , c , d . " T h e y o u n g e s t w e l d e r " : 1 0 y e a r s o l d c h i l d m i s u s e d a s a m e t a l w e l d e r w i t h o u t t h e m i n i m a l p r o t e c t i v e s a f e t y m e a s u r e s . 1 9 5 '( , / '5:1 DD'-E E9'/F: 3H! '3*9D'D 'D'7A'D 'D2JH*:
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e r m a c i l , S t e r r S t r i p " H(D'3*1 " B a n d A I D . 'DE1',9 R a e s a e n e n L , L e h t o M , R e u n a l a T . D e c r e a s e d m o n o c y t e p r o d u c t i o n o f i n t e r l e u k i n - 1 a n d i m p a i r e d l y m p h o c y t e p r o l i f e r a t i o n i n a t o p i c d e r m a t i t i s . A r c h D e r m a t o l R e s 1 9 8 7 ; 2 7 9 : 2 1 5 - 1 8 . 1 Zesch A. Adverse reactions of externally applied drugs and inert substances. Dermatosen 1988; 36: 128-33. 2 Hezemans-Boer M, Toonstra J, Meulenbelt J et al. Skin lesions due to exposure to methyl bromide. Arch Dermatol 1988; 124: 917-21. 3 Hostynek JJ, Patrick E, Younger B et al. Hypochlorite sensitivity in man. Contact Derm 1989; 20: 32-7. 4 Jackson EM, Goldner R, eds. Irritant Contact Dermatitis. New York: Marcel Dekker, 1990. 5 Middleton JD. The mechanism of action of surfactants on the isolated stratum corneum. J Soc Cosmet Chem 1969; 20:399-412. 6
(2/149)
Pryce DW, White J, English JSC et al. Soluble oil dermatitis: a review. J Soc Occup Med 1989; 39: 93-8. 7 Rycroft RJG. Soluble Oil as a Major Cause of Occupational Dermatitis. Cambridge: University of Cambridge, 1982 (dissertation). 8 Verbeck SJA, Buise-van Unnik EMM, Malten KE. Itching in office workers from glass fibres. Contact Derm 1981; 7: 354. 9 Fisher AA. Contact Dermatitis, 3rd edn. Philadelphia: Lea and Febiger, 1986. 10 Foussereau J, Benezra C, Maibach HI. Occupational Contact Dermatitis. Copenhagen: Munksgaard, 1982. 11 Fregert S. Manual of Contact Dermatitis, 2nd edn. Copenhagen: Munksgaard, 1981. 12 Caron GA, Calnan CD. Studies in contact dermatitis XIV. Resorcin. Trans St JohnСs Hosp Dermatol Soc 1962; 48: 149-56. 13 Correia S, Menezes Brand?o F. Contact dermatitis of the feet. Dermatosen 1986; 34: 102-5. 14 Sugai T, Yamamoto S. Decrease in the incidence of contact sensitivity to formaldehyde. Contact Derm 1980; 6: 154. 15 Cronin E. Studies in contact dermatitis: XIX. Nylon stocking dyes. Trans St JohnСs Hosp Derm Soc 1968; 54: 165-9. 16 Dahl MV. Allergic dermatitis from footwear. Minnesota Med 1975; 58: 871-4. 17 Fisher AA. How to obtain shoes free of common sensitizers. Cutis 1973; 12: 678. 18
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DD#7A'D 'D#C(1 JECF '3*9E'D 'DGJ/1HCH1*J2HF DH-/G #H E4'1C) E9 -E6 'D5A5'A. ( D e x a l o c a l , L o c o s a l o n ) JECF *7(JBG (D7A HB/ J97J F*'&, ,J/). 'D-'D'* 'DE.*D7) ('F*'F ,1+HEJ #H A71J +'FHJ JECF E9'D,*G' ('3*./'E 'DE6'/'* 'D,1+HEJ) 'DEH69J) E+D " M u p e r a c i n " C1JE #H E6'/ A71J EH69J E+D 'D'J*1'CHF'2HD C1JE . /'! D'JFJ1 ( #-E1J) D'JF1) L e i n e r ' s d i s e a s e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i g . 2 0 8 L e i n e r ' s d i s e a s e J*EJ2 'DE16 ('DE8'G1 'D*'DJ): 1 @ 'D*G'( ,D/ 2GEJ E9EE. 2 @ %3G'D 4/J/ E9F/. 3 @ G2'D 4/J/ HF-HD. 4 @ 'F*'F'* EH69J) H,G'2J) E*C11). 5 @ /'! D'JFJ1 'D9'&DJ E9 3H! H8JA) C 5 J9*(1 E16'K .71'K B/ JG// -J') 'D7AD. 'DE9'D,): E98E 'D-'D'* 4/J/) *-*', %DI '3*4A'!. *H'2F 'D3H'&D H'D4H'1/. (D'2E' 7'2,). 3*J1HJ/'* H5'/'* -JHJ). %6'A'* :0'&J) DDAJ*'EJF B 'DE1C( (E' AJG 'D(JH*JF EGE. 'DE1',9 B o n i f a z i E . I n f a n t i l e s e b o r r h e i c d e r m a t i t i s : p a t h o g e n e t i c c o n s i d e r a t i o n s a n d n o s o l o g i c a l a s p e c t s . P e diatr Dermatol News 1988; 7: 16-21 1
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Yates VM, Kerr Rei, Mackie R. Early diagnosis of infantile seborrheic dermatitis and atopic dermatitis-clinical features. Br J Dermatol 1983; 108: 6338 2 Prince GE. Erythroderma desquamativa of the newborn infant. J Pediatr 1955; 47: 475-80 3 Miller ME, Koblenzer PJ. Leiner's disease and deficiency of C5. J Pediatr 1972; 80: 879-80 4 Evans DIK, Holzel A, MacFarlane H. Yeast opsonization defect and immunoglobulin deficiency in severe infantile dermatitis (Leiner's d i s e a s e ) . A r c h D i s C h i l d 1 9 7 7 ; 5 2 : 6 9 1 - 5 5 'DA5D 'D+'EF H'D941HF #FH'9 #.1I EF -3'3J) 'D,D/ 'D'C2JE' 'D'F*'FJ) I n f e c t i v e D e r m a t i t i s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'D'C2JE' 'D1CH/J) ( S t a s i s D e r m a t i t i s ) GJ #C2JE' .'1,J) 'DEF4# *1*(7 ('671'('* H9'&J) E9 B5H1 H1J/J HGJ #C+1 4JH9'K 9F/ 'D#9E'1 'DC(J1). 'DE8'G1 'D,D/J) 9'/) *8G1 9DI #3AD 'D3'B AJ 'DH,G 'D/'.DJ AHB 'DC9( 'D#F3J. 'D4CD 1BE 2 1 9 : #C2JE' 1CH/J) *8G1 'D"A) (4CD -E'EJ #H H0EJ #H E21B (3(( 'D'-*B'F 'DEH69J HB/ **1'AB E9 -C) .AJA) *-22 *B1- HA17 *5(:. 'DE1',9 P a r i s h W E , W e l b o u r n E , C h a m p i o n R H . H y p e r s e n s i t i v i t y t o b a c t e r i a i n e c z e m a . I V : C y t o t o x i c e f f e c t o f a n t i b a c t e r i a l a n t i b o dy on skin cells acquiring bacterial antigens. Br J Dermatol 1976; 95: 493-506 1 Parish WE, Welbourn E, Champion RH. Hypersensitivity to bacteria in eczema. Titre and immunoglobulin class of antibodies to staphylocci and micrococci. Br J Dermatol 1976; 95: 285-93 2 Weismann K, Hjorth N. Microbial eczema of the feet. Br J Dermatol 1982; 107: 330-7 3 Welbourn E, Champion RH, Parish WE. Hypersensitivity to bacteria in generalized eczema. I: Bacterial culture, skin tests, and immunofluorescent detection of immunoglobulins and bacterial antigens. Br J Dermatol 1976; 94: 619-25 4 Bendl BJ. Nummular eczema of stasis origin: a morphological pattern of diverse etiology. Int J Dermatol 1979; 18: 129-35 5 Calnan CD, Meara RH. Discoid eczema - dry type. Trans St John's Hosp Dermatol Soc 1956; 37: 26-8 6 Cowan MA. Nummular eczema - a review, follow-up and analysis of 325 cases. Acta Derm Venereol 1961; 41: 453-60 7 Rollins TG. From xerosis to nummular dermatitis. J Am Med Assoc 1968; 206: 637 8 Ashton RE, Griffiths WA. Juvenile plantar dermatosis - atopy or footwear? Clin Exp Dermatol 1986; 11: 529-34 9
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Graham RM, Verbov JL, Vickers CFH. Juvenile plantar dermatosis. Clin Exp Dermatol 1987; 12: 468 10 Jones SK, English JSC, Forsyth A et al. Juvenile plantar dermatosis - an eight year follow-up of 102 patients. Clin Exp Dermatol 1987; 12: 5-7 11 Mackie RM. Juvenile plantar dermatosis. Semin Dermatol 1982; 1: 67-75 M"ller H.Atopic winter feet in children. Acta Derm Venereol 1972; 52: 401-5 12 Shrank AB. Aetiology of juvenile plantar dermatosis. Br J Dermatol 1979; 100: 641-6 13 Stankler L. Juvenile plantar dermatosis in identical twins. Br J Dermatol 1978; 99: 585-6 14 Hersle K, Mobacken H. Hyperkeratotic dermatitis of the palms. Br J Dermatol 1982; 107: 195-202 de Boer EM, Bruynzeel DP, Van Ketel WG. Dyshidrotic eczema as an occupational dermatitis in metal workers. Contact Derm 1988; 19: 184-8 15 Duhra P, Ryatt KS. Haemorrhagic pompholyx in bullous pemphigoid. Clin Exp Dermatol 1988; 13: 342-3 16 Burton JL. Venous `stasis' ulcers, stasis dermatitis and mothers' political ambitions for their offspring: Reply Br J Derm 1990; 122: 715-16 17 Fraki JE, Peltonen L, Hopsu-Havu VK. Allergy to various components of topical preparations in stasis dermatitis and leg ulcers. Contact Derm 1979; 5: 97-100 18 Breit R. Allergen change in stasis dermatitis. Contact Derm 1977; 3: 309-11 19 Ryan TJ. Venous stasis ulcers, stasis dermatitis and mothers' political ambitions for their offspring. Br J Dermatol 1990; 122: 715 (letter) 20
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HB/ J*1'AB 0DC E9 'D-C). 'D*.1J4 #J6'K J$/J %DI 8GH1 E+D G0G 'D.7H7 'D%-E1'1J). 'DE9'D,): 'D'E*F'9 9F *F'HD 'D79'E 'DE*HB9 #H 'D/H'! 'DE*GE. ( A t a r a x - H y d r o x y z i n e ) J9*(1 EF 'D9D','* 'DA9'D) AJ CD #FH'9 'D41I. E6'/'* 'DGJ3*'EJF 'D,JD 'D,/J/ 3*1J2JF ( Z y r t e c - C e t r i z i n e ) #J6'K 0H BJE). 'D3*J1H&J/'* EH69J'K D'JF5- (GE' /'&E'K. 'D3*J1H&J/'* AEHJ'K #H .D'DJ'K A9'D) (4CD E$B* HF'/1'K E' *3*9ED 9F/ 'D169 H'D#7A'D. -'51'* H 2 E+D 'D3JEJ*/JF ( C i m e t i d i n e ) B/ *,1( AJ 'D-'D'* 'DE9F/) H'DE2EF). 'D3'J(1HG(*'/JF ( P e r i a c t i n ) B/ *97J DD#7A'D 'DC('1 HDJ3 DD#7A'D 'D5:'1. HG0' 'D/H'! B/ JCHF A9'D .'5) ('DE4'1C) E9 ( H y d r o x a z i n e ) #-J'F'K. E4'1C) E6'/JF DDGJ3*'EJF EF E,EH9*JF E.*DA*JF B/ *CHF 61H1J 9F/ 'D#7A'D 'DC('1 AJ (96 'D-'D'* 'D*J D'*3*,J( DD9D','* 'D*BDJ/J). 'D41I 'DH1'+J 'D9'&DJ H e r i d o f a m i l i a l u r t i c a r i a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*9HJ6 'D(D'3EJ 'DE,E/) 'D-'HJ)9DI E+(7)" C 1 " #3*1J2 B/ *CHF A9'D). #(3JDHF #EJFHC'(1HJC #3J/ H'D@" D a n a z o l " #F/1H,JF 69JA J+(7 'D,HF'/H*1AJF 'DF.'EJ CD'GE' #+(* #FG A9'D C/H'! HB'&J. 'D41I 'D5(':J U r t i c a r i a p i g m e n t o s a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s t e o p o r o s i s ) H*5D(. ED'-8):
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'DE16J J,( #F JF*(GH' D9/E A1C 'D,D/ (4/) .'5) #+F'! #H (9/ 'D-E'E ('DE'! 'D3'.F -J+ #F G0' JF47 'D.D'J' 'D(/FJ) AJ 'D,D/ H'D71B 'D*FA3J) EE' B/ J$/J %DI HG, HG(H7 6:7 H*4F, B5('* H-*I EH* EA',& . 'DE9'D,): -'51'* H 1 H'D3J1HG(*'/JF B/ *(/J (96 'D*-3F. -'51'* H 2 J9*B/ #F DG' *#+J1 (3J7 9DI *.AJA 'D#91'6 AJ 'D41I 'D5(':J. 'DE8'G1 'D,G'2J) JECF #F *9'D, CD 9DI -/). 'DE1',9 G o l l h a u s e n R , K l i g m a n A M . H u m a n a s s a y f o r i d e n t i f y i n g s u b s t a n c e s , w h i c h i n d u c e n o n - a l l e r g i c c o n t a c t u r t i c a r i a : t h e N I C U - t e s t . C o n t a c t D e r m 1 9 8 5 ; 1 3 : 9 8 - 1 0 6 1 D e G r o o t A K , G e r k e n s F . C o n t a c t u r t i c a r i a f r o m a c h e m i c a l t e x t i l e f i n i s h . C o n t a c t D e r m 1 9 8 9 ; 2 0 : 6 3 - 4 2 J u h l i n L . R e c u r r e n t u r t i c a r i a : c l i n i c a l i n v e s t i g a t i o n o f 3 3 0 p a t i e n t s . B r J D e r m a t o l 1 9 8 1 ; 1 0 4 : 3 6 9 - 8 1 3 M i c h a e l s s o n G , J u h l i n L . U r t i c a r i a i n d u c e d b y p r e s e r v a t i v e s a n d d y e a d d i t i v e s i n f o o d a n d d r u g s . B r J D e r m a t o l 1 9 7 3 ; 8 8 : 5 2 5 - 3 2 4 P a r i s h W E . P o s s i b l e r e l e v a n c e o f c h a n g e s i n m a s t c e l l s a n d n e u t r o p h i l s t o p e r p e t u a t i o n o f c h r o n i c u r t i c a r i a I n : C h a m p i o n 5 R H , G r e a v e s M W , K o b z a B l a c k A e t a l . , e d s . T h e U r t i c a r i a s . E d i n b u r g h / N e w Y o r k : C h u r c h i l l L i v i n g s t o n e , 1 9 8 5 : 7 0 - 8 5 6 K o b z a B l a c k A , G r e a v e s M W , C h a m p i o n R H e t a l . U r t i c a r i a . B r J D e r m a t o l 1 9 9 1 ; 1 2 4 : 1 0 0 - 8 7 L a g u n o f f D . T h e m e c h a n i s m o f h i s t a m i n e r e l e a s e f r o m m a s t c e l l s . B i o c h e m P h a r m a c o l 1 9 7 2 ; 2 1 : 1 8 8 9 - 9 6 8 M a c D o n a l d S M , L i c h t e n s t e i n L M , P r o u d L M e t a l . S t u d i e s o f I g E - d e p e n d e n t h i s t a m i n e r e l e a s i n g f a c t o r s : h e t e r o g e n e i t y o f I g E . J I m m u n o l 1 9 8 7 ; 1 3 9 : 5 0 6 - 1 2 9 P a r i s h R P C h a m p i o n R H . U r t i c a r i a . L o n d o n : W . B . S a u n d e r s , 1 9 7 4 1 0
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P a r i s h W E P o s s i b l e r e l e v a n c e o f c h a n g e s i n m a s t c e l l s a n d n e u t r o p h i l s t o p e r p e t u a t i o n o f c h r o n i c u r t i c a r i a . I n : C h a m p i o n R H , G r e a v e s M W , B l a c k A K , P y e R J , e d s . T h e U r t i c a r i a s . E d i n b u r g h : C h u r c h i l l - L i v i n g s t o n e , 1 9 8 5 : 7 0 - 8 5 1 1 C a r i n i C . I g E i m m u n e c o m p l e x e s i n f o o d a l l e r g y ; s i g n i f i c a n c e , p a t h o g e n i c i t y a n d c l i n i c a l c o n s i d e r a t i o n . C l i n A l l e r g y 1 9 8 7 ; 1 7 : 4 8 5 - 9 7 1 2 H e a v e y D J , K o b z a - B l a c k A , B a r r o w S E e t a l . P r o s t a g l a n d i n D 2 a n d h i s t a m i n e r e l e a s e i n c o l d u r t i c a r i a . J A l l e r g y C l i n I m m u n o l 1 9 8 6 ; 7 8 : 4 5 9 - 6 1 1 3 M i c h a e l s s o n G , J u h l i n L . U r t i c a r i a i n d u c e d b y p r e s e r v a t i v e s a n d d y e a d d i t i v e s i n f o o d a n d d r u g s . B r J D e r m a t o l 1 9 7 3 ; 8 8 : 5 2 5 - 3 2 1 4 T h o m p s o n H L , B u r b e l o P D , S e g u i - R e a l B e t a l . L a m i n i n p r o m o t e s m a s t c e l l a t t a c h m e n t . J I m m u n o l 1 9 8 9 ; 1 4 3 : 2 3 2 3 - 7 1 5 F r e e m a n R G , S p i l l e r R , K n o x J M . H i s t o p a t h o l o g y o f e r y t h e m a t o x i c u m n e o n a t o r u m . A r c h D e r m a t o l 1 9 6 0 ; 8 2 : 5 8 6 - 9 1 6 H a r r i s R , S c h i c k B . E r y t h e m a n e o n a t o r u m . A m J D i s C h i l d 1 9 5 6 ; 9 2 : 2 7 - 3 3 K e i t e l H G , Y a d a v V . E t i o l o g y o f t o x i c e r y t h e m a . A m J D i s C h i l d 1 9 6 3 ; 1 0 6 : 3 0 6 - 9 1 7 L e v y H L , C o t h r a n F . E r y t h e m a t o x i c u m n e o n a t o r u m p r e s e n t a t b i r t h . A m J D i s C h i l d 1 9 6 2 ; 1 0 3 : 6 1 7 - 1 9 1 8 W a k e e l R A , G a v i n M P , K e e f e M . S e v e r e t o x i c e r y t h e m a c a u s e d b y d i l t i a z e m . B r M e d J 1 9 8 8 ; 2 9 6 : 1 0 7 1 1 9 H a s a n T , J a n s e n C T . E r y t h r o d e r m a : a f o l l o w - u p o f 5 0 c a s e s . J A m A c a d D e r m a t o l 1 9 8 3 ; 8 : 8 3 6 - 4 0 2 0 Z o o n J J , M a l i J W H . T h e i n f l u e n c e o f e r y t h r o d e r m a o n t h e b o d y . A r c h D e r m a t o l 1 9 5 7 ; 7 5 : 5 7 3 2 1 H a r r i s D W S , S p e n c e r M - J , T i d m a n M J . P a p u l o - e r y t h r o d e r m a - c l i n i c a l a n d u l t r a s t r u c t u r a l f e a t u r e s . C l i n E x p D e r m a t o l 1 9 9 0 ; 1 5 : 1 0 5 - 6 . 1 3 2 2
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U v n a s B . C h e m i s t r y a n d s t o r a g e f u n c t i o n o f m a s t c e l l g r a n u l e s . J I n v e s t D e r m a t o l 1 9 7 8 ; 7 1 : 7 6 - 8 0 2 3 V e l l a B r i f f a D , E a d y R A J , J a m e s M P e t a l . P h o t o c h e m o t h e r a p y ( P U V A ) i n t h e t r e a t m e n t o f u r t i c a r i a p i g m e n t o s a . B r J D e r m a t o l 1 9 8 3 ; 1 0 9 : 6 7 - 7 5 2 4 P o y n a r d T , N a t a f C , M e s s i n g B e t a l . S e c r e t o r y d i a r r h e a a n d p r o s t a g l a n d i n D 2 o v e r p r o d u c t i o n i n s y s t e m i c m a s t o c y t o s i s . N e w E n g l J M e d 1 9 8 2 ; 3 0 7 : 1 8 6 . ( L e t t e r ) 2 5 O m e r o d A D , H e r r i o t R , D a v i d s o n R J L e t a l . A d u l t m a s t o c y t o s i s , a n i m m u n o p h e n o t y p i c a n d f l o w c y t o m e t r i c i n v e s t i g a t i o n . B r J D e r m a t o l 1 9 9 0 ; 1 2 2 : 7 3 7 - 4 4 2 6 R a s m u s s e n J E . X a n t h e l a s m o i d e a : a n u n u s u a l c a s e o f u r t i c a r i a p i g m e n t o s a . A r c h D e r m a t o l 1 9 7 6 ; 1 1 2 : 1 2 7 0 - 1 2 7 S u t t e r M C , B e a u l i e u G , B i r t A R . H i s t a m i n e l i b e r a t i o n b y c o d e i n e a n d P o l y m y x i n B i n u r t i c a r i a p i g m e n t o s a . A r c h D e r m a t o l 1 9 6 2 ; 8 6 : 2 1 7 - 2 1 2 8 S o t e r N A , A u s t e n K F , W a s s e r m a n S I . O r a l d i s o d i u m c r o m o g l y c a t e i n t h e t r e a t m e n t o f s y s t e m i c m a s t o c y t o s i s . N e w E n g l J M e d 1 9 7 9 ; 3 0 1 : 4 6 5 - 9 2 9 'DA5D 'D+D'+HF 'D'F/A'9'* 'D/H'&J) D r u g R e a c t i o n s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(96 E+(7'* *4CJD 'D4-HE E+D ( T r i p a r a n o l ) *$/J %DI '671'( AJ 'D*B1F. 'D#8'A1: 'D/JCDHE'J3JF B/ J3(( *48J 'D#8'A1. 'D491: 'DE9'D,) 'DCJE'HJ) E+D 'DEJ+H*1C3'* B/ *3(( *3'B7 9'E DD491 . A17 *F'HD 'DAJ*'EJF A B/ J-+ *3'B7 491. 'DE1',9 K o r k i j W , S o l t a n i K . F i x e d d r u g e r u p t i o n . A b r i e f r e v i e w . A r c h D e r m a t o l 1 9 8 4 ; 1 2 0 : 5 2 0 - 4 . 1 H u r w i t z S . C u t a n e o u s d i s o r d e r s o f t h e n e w b o r n . I n : C l i n i c a l P e d i a t r i c D e r m a t o l o g y . P h i l a d e l p h i a ; W B S a u n d e r s , 1 9 8 1 ; 1 4 - 1 5 . 2 M e y r i c k T h o m a s R H , M u n r o D D . F i x e d d r u g e r u p t i o n d u e t o p a r a c e t a m o l . B r J D e r m a t o l 1 9 8 6 ; 1 1 5 : 3 5 7 - 9 . 3 H u g h e s B R , H o l t P J A , M a r k s R . T r i m e t h o p r i m a s s o c i a t e d f i x e d d r u g e r u p t i o n . B r J D e r m a t o l 1 9 8 7 ; 1 1 6 : 2 4 1 - 2 . 4 F e i n s t e i n A , S o f e r E , T r a u H e t a l . U r t i c a r i a a n d f i x e d d r u g e r u p t i o n i n a p a t i e n t t r e a t e d w i t h g r i s e o f u l v i n . J A m A c a d D e r m a t o l 1 9 8 4 ; 1 0 : 9 1 5 - 1 7 . 5 C o m m e n s C . F i x e d d r u g e r u p t i o n . A u s t J D e r m a t o l 1 9 8 3 ; 2 4 : 1 - 8 . 6 A l a n k o K , S t u b b S , R e i t a m o S . T o p i c a l p r o v o c a t i o n o f f i x e d d r u g e r u p t i o n . B r J D e r m a t o l 1 9 8 7 ; 1 1 6 : 5 6 1 - 7 . 7 G u i n J D , H a y n i e L S , J a c k s o n D e t a l . W a n d e r i n g f i x e d d r u g e r u p t i o n : A m u c o c u t a n e o u s r e a c t i o n t o a c e t a m i n o p h e n . J A m A c a d D e r m a t o l 1 9 8 7 ; 3 : 3 9 9 - 4 0 2 . 8 A l a n k o K , S t u b b S , R e i t a m o S . T o p i c a l p r o v o c a t i o n o f f i x e d d r u g e r u p t i o n . B r J D e r m a t o l 1 9 8 7 ; 1 1 6 : 5 6 1 - 7 . 9 A n d e r s e n K E , M a i b a c h H I . A l l e r g i c r e a c t i o n t o d r u g s t o p i c a l l y . C l i n T o x i c o l 1 9 8 0 ; 1 6 : 4 1 5 - 6 5 . A n g e l i n i C , V e n a C A , M e n e g h i n i C L . C o n t a c t a l l e r g y t o a n t i v i r a l a g e n t s . C o n t a c t D e r m 1 9 8 6 ; 1 5 : 1 1 4 - 1 5 . 1 0 B a n d m a n n H - J , C a l n a n C D , C r o n i n E e t a l . D e r m a t i t i s f r o m a p p l i e d m e d i c a m e n t s . A r c h D e r m a t o l 1 9 7 2 ; 1 0 6 : 3 3 5 - 7 . 1 1
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B e c k M H , B u r r o w s D , F r e g e r t S e t a l . A l l e r g i c c o n t a c t d e r m a t i t i s t o e p o x y r e s i n i n o s t o m y b a g s . B r J S u r g 1 9 8 5 ; 7 2 : 2 0 2 - 3 . 1 2 B u r r y J N , H u n t e r C A . P h o t o c o n t a c t d e r m a t i t i s f r o m J a d i t . B r J D e r m a t o l 1 9 7 0 ; 8 2 : 2 2 4 - 9 . 1 3 C a l n a n C D . D i e t h y l d i t h i o c a r b a m a t e i n a d h e s i v e t a p e . C o n t a c t D e r m 1 9 7 8 ; 4 : 6 1 . 1 4 C a l n a n C D , C r o n i n E . F a l s e p o s i t i v e r e a c t i o n t o m e r c a p t o b e n z o - t h i a z o l e f r o m r u b b e r i n e y e d r o p b o t t l e . C o n t a c t D e r m 1 9 8 1 ; 7 : 2 8 3 - 4 . 1 5 C a l n a n C D , F r a i n - B e t l W , C u t h b e r t J W . O c c u p a t i o n a l d e r m a t i t i s f r o m c h l o r p r o m a z i n e . T r a n s S t J o h n ' s H o s p D e r m a t o l S o c 1 9 6 2 ; 4 8 : 4 9 - 7 4 . 1 6 C l a r k E W , B l o n d e e l A , C r o n i n E e t a l . L a n o l i n o f r e d u c e d s e n s i t i z i n g p o t e n t i a l . C o n t a c t D e r m 7 : 8 0 - 3 . 1 7 C o l v e r C B , I n g l i s J A , M c V i t h e E e t a l . D e r m a t i t i s d u e t o i n t r a v e s i c a l m i t o m y c i n C : a d e l a y e d - t y p e h y p e r s e n s i t i v i t y r e a c t i o n ? B r J D e r m a t o l 1 9 9 0 ; 1 2 2 : 2 1 7 - 2 4 . 1 8 C o o p m a n S , D o o m s - C o o s s e n s A . C r o s s - r e a c t i o n s i n t o p i c a l c o r t i c o s t e r o i d c o n t a c t d e r m a t i t i s . C o n t a c t D e r m 1 9 6 0 ; 1 9 : 1 4 5 - 6 . 1 9 C r o n i n E . C o n t a c t D e r m a t i t i s . E d i n b u r g h : C h u r c h i l l L i v i n g s t o n e 1 9 8 0 : 1 9 2 - 2 7 8 . 2 0 C r o n i n E . C o n t a c t D e r m a t i t i s . E d i n b u r g h : C h u r c h i l l L i v i n g s t o n e , 1 9 8 0 : 8 0 5 - 1 3 a n d 8 3 2 - 8 . 2 1 C u r l e y R K , M a c f a r l a n e A W , K i n g C M . C o n t a c t s e n s i t i v i t y t o t h e a m i d e a n a e s t h e t i c s l i d o c a i n e , p r i l o c a i n e , a n d m e p i v a c a i n e . A r c h D e r m a t o l 1 9 8 6 ; 1 2 2 : 9 2 4 - 6 . 2 2 D a h l q u i s t I , F r e g e r t S , C r u v b e r g e r B . D e t e c t i o n o f f o r m a l d e h y d e i n c o r t i c o i d c r e a m s . C o n t a c t D e r m 1 9 8 0 ; 6 : 4 9 4 . 2 3 S h o s s R G , R a y h a n z a d e h S . T o x i c e p i d e r m a l n e c r o l y s i s f o l l o w i n g m e a s l e s v a c c i n a t i o n . A r c h D e r m a t o l 1 9 7 4 ; 1 1 0 : 7 6 6 - 7 0 . 2 4
( 3 / 3 4 )
R o u j e a u J - C , G u i l l a u m e J - C , F a b r e J - P e t a l . T o x i c e p i d e r m a l n e c r o l y s i s ( L y e l l s y n d r o m e ) . I n c i d e n c e a n d d r u g e t i o l o g y i n F r a n c e 1 9 8 1 - 1 9 8 5 . A r c h D e r m a t o l 1 9 9 0 ; 1 2 6 : 3 7 - 4 2 . 2 5 R e v u z J , R o u j e a u J - C , G u i l l a u m e J - C e t a l . T r e a t m e n t o f t o x i c e p i d e r m a l n e c r o l y s i s . C r e t a i l ' s e x p e r i e n c e . A r c h D e r m a t o l 1 9 8 7 ; 1 2 3 : 1 1 5 6 - 8 . 2 6 L y e l l A . T o x i c e p i d e r m a l n e c r o l y s i s ( t h e s c a l d e d s k i n s y n d r o m e ) . B r J D e r m a t o l 1 9 7 9 ; 1 0 0 : 6 9 - 8 6 . 2 7 H e i m b a c h D M , E n g r a v L H , M a r v i n J A . T o x i c e p i d e r m a l n e c r o l y s i s . A s t e p f o r w a r d i n t r e a t m e n t . J A m M e d A s s o c 1 9 8 7 ; 2 5 7 : 2 1 7 1 - 5 . 2 8 B a r n e s R L , W i l k i n s o n D S . E p i d e r m a l n e c r o l y s i s f r o m c l o t h i n g i m p r e g n a t e d w i t h p a r a f f i n . B r M e d J 1 9 7 3 ; i v : 4 6 6 - 7 . 2 9 D e G r o o t A C , C o n e m a n s J M H . C o n t a c t a l l e r g y t o f u r a z o l i d o n e . C o n t a c t D e r m 1 9 9 0 ; 2 2 : 2 0 2 - 5 . 3 0 D e s c h a m p s D , C a r n i e r R , S a v o y e J e t a l . A l l e r g i c a n d i r r i t a n t c o n t a c t d e r m a t i t i s f r o m d i e t h y l - b e t a c h l o r o e t h y l a m i n e . C o n t a c t D e r m 1 9 8 8 ; 1 8 : 1 0 3 - 5 . 3 1 V a n D i j k E , N e e r i n g H , V i t ? n y i B E J . C o n t a c t h y p e r s e n s i t i v i t y t o s e s a m e o i l i n p a t i e n t s w i t h l e g u l c e r s a n d e c z e m a . A c t a D e r m V e n e r e o l 1 9 7 3 ; 5 3 : 1 3 3 - 5 . 3 2 D o h n W . B e i t r a g z u r F r a g e d e r C h l o r a m p h e n i c o l - K o n t a k t a l l e r g i e n . H a u t a r z t 1 9 6 5 ; 1 6 : 1 7 4 - 7 . 3 3 A l l e r g e n i c i t y p r e d i c t i o n a n d p h a r m a c o p o e i a l r e q u i r e m e n t s . C o n t a c t D e r m 1 9 8 3 ; 9 : 1 7 5 - 8 5 , a n d 3 5 2 - 9 . 3 4 D o o m s - G o o s e n s A , D e g r e e f H , C o o p m a n S . C o r t i c o s t e r o i d c o n t a c t a l l e r g y : a r e a l i t y . I n : F r o s c h 3 5 P J , D o o m s - C o o s s e n s A , L a c h a p e l l e J - M e t a l . , e d s . C u r r e n t T o p i c s i n C o n t a c t D e r m a t i t i s . B e r l i n : S p r i n g e r , 1 9 8 9 : 2 3 3 - 7 . 3 6
( 3 / 3 5 )
D o o m s - C o o s s e n s A , D e g r e e f H , V a n h e e J e t a t . C h l o r o c r e s o l a n d c h l o r a c e t a m i d e : a l l e r g e n s i n m e d i c a t i o n s , g l u e s a n d c o s m e t i c s . C o n t a c t D e r m 1 9 8 1 ; 7 : 5 1 - 2 . 3 7 F i s h e r A A . C o n t a c t D e r m a t i t i s , 3 r d e d n . P h i l a d e l p h i a : L e a a n d F e b i g e r , 1 9 8 6 : 1 4 1 - 2 5 7 . 3 8 F i s h e r A A . U n n e c e s s a r y a d d i t i o n o f e t h y l e n e d i a m i n e h y d r o c h l o r i d e t o ' g e n e r i c ' n y s t a t i n c r e a m s . J A m A c a d D e r m a t o l 1 9 8 9 ; 2 0 : 1 2 9 - 3 0 . 3 9 F r e g e r t S , M ? l l e r H . P h o t o c r o s s - s e n s i t i z a t i o n a m o n g h a l o g e n - h y d r o x y b e n z o i c a c i d d e r i v a t i v e s . J I n v e s t D e r m a t o l 1 9 6 4 ; 4 3 : 2 7 1 - 4 . 4 0 F r e g e r t S , T r u l s o n L , Z i m e r s o n E . C o n t a c t a l l e r g i c r e a c t i o n s t o d i p h e n y l t h i o u r e a a n d p h e n y l i s o t h i o c y a n a t e i n P V C a d h e s i v e t a p e . C o n t a c t D e r m 1 9 8 2 ; 8 : 3 8 - 4 2 . 4 1 G e l f a r b M , L e i d e r M . A l l e r g i c e c z e m a t o u s c o n t a c t d e r m a t i t i s . R e p o r t o f a c a s e c a u s e d b y s e n s i t i z a t i o n t o u n d e c y l e n i c a c i d a n d i t s z i n c s a l t . A r c h D e r m a t o l 1 9 6 0 ; 8 2 : 6 4 2 - 3 . 4 2 G e l l i n G A , M a i b a c h H I , W a c h s C N . C o n t a c t a l l e r g y t o t o l n a f t a t e . A r c h D e r m a t o l 1 9 7 2 ; 1 0 6 : 4 3 G o h C L . C o n t a c t s e n s i t i v i t y t o p r o f l a v i n e . I n t J D e r m 1 9 8 6 ; 2 5 : 4 4 9 - 5 1 . 4 4 C o l a M , F r a n c a l a n c i S , B r u s i C e t a t . C o n t a c t s e n s i t i z a t i o n t o a c y c l o v i r . C o n t a c t D e r m 1 9 8 9 ; 2 0 : 4 5 C ? r a n s s o n K , L i d щ n S . C o n t a c t a l l e r g y t o s o r b i c a c i d a n d u n g u e n t u m M e r c k . C o n t a c t D e r m 1 9 8 1 ; 2 7 7 . 4 6 H a r r i s G L , M a i b a c h H I . A l l e r g i c c o n t a c t d e r m a t i t i s p o t e n t i a l o f 3 p y r i d o s t i g m i n e b r o m i d e t r a n s d e r m a l d r u g d e l i v e r y f o r m u l a t i o n s . C o n t a c t D e r m 1 9 8 9 ; 2 l : 1 8 9 - 9 3 . 4 7 H a n n u k s e l a M , P i r i l ? V , S a l o O P . S k i n r e a c t i o n s t o p r o p y l e n e g l y c o l . C o n t a c t D e r m 1 9 7 5 ; 1 : 4 8 H a u s e n B M , H e e s c h B , K i e l U . S t u d i e s o n t h e s e n s i t i z i n g c a p a c i t y o f i m i d a z o l e d e r i v a t i v e s . A m J C o n t a c f D e r m 1 9 9 0 ; 1 : 2 5 - 3 3 . 4 9
( 3 / 3 6 )
H a u s e n B M , W o l l e n w e b e r E , S e n f f H e t a l . P r o p o l i s a l l e r g y ( 1 ) O r i g i n , p r o p e r t i e s , u s a g e a n d l i t e r a t u r e r e v i e w . C o n t a c t D e r m 1 9 8 7 ; 1 7 : 1 6 3 - 7 0 . 5 0 H j o r t h N , T r o l l e - L a s s e n C . S k i n r e a c t i o n s t o o i n t m e n t b a s e s . T r a n s S t J o h n ' s H o s p D e r m a t o l S o c 4 9 : 1 2 7 - 4 0 . 5 1 H o l d i n e s s M . A r e v i e w o f c o n t a c t d e r m a t i t i s a s s o c i a t e d w i t h t r a n s d e r m a l t h e r a p e u t i c s y s t e m s . C o n t a c t D e r m 1 9 8 9 ; 2 0 : 3 - 9 . 5 2 J e l e n C , T e n n s t e d t D . C o n t a c t d e r m a t i t i s f r o m t o p i c a l i m i d a z o l e a n t i f u n g a l s : 1 5 n e w c a s e s . C o n t a c t D e r m 1 9 8 9 ; 2 1 : 6 - 1 1 . 5 3 J o r d a n W P . C r o s s - s e n s i t i z a t i o n p a t t e r n s i n a c r y l a t e a l l e r g i e s . C o n t a c t D e r m 1 9 7 5 ; 1 : 1 3 - 1 5 . 5 4 D o o m s - G o o s s e n s A , D e g r e e f H . C o n t a c t a l l e r g y t o p e t r o l a t u m s . ( I ) S e n s i t i z i n g c a p a c i t y o f d i f f e r e n t b r a n d s o f y e l l o w a n d w h i t e p e t r o l a t u m s . ( I I ) A t t e m p t s t o i d e n t i f y t h e n a t u r e o f t h e a l l e r g e n s . 5 5 J o n e s S K , K e n n e d y C T C . C o n t a c t d e r m a t i t i s f r o m t i o c o n a z o l e . C o n t a c t D e r m 1 9 9 0 ; 2 2 : 1 2 2 - 3 . 5 6 K a t z B E , F i s h e r A A . B a c i t r a c i n : a u n i q u e t o p i c a l a n t i b i o t i c s e n s i t i z e r . J A m A c a d D e r m a t o l 1 9 8 7 ; 1 0 1 6 - 2 4 . 5 7 K i n n u n e n T , H a n n u k s e l a M . S k i n r e a c t i o n s t o h e x y l e n e g l y c o l . C o n t a c t D e r m 1 9 8 9 ; 2 1 : 1 5 4 - 8 . 5 8 K l i g m a n A M . L a n o l i n a l l e r g y : c r i s i s o r c o m e d y ? C o n t a c t D e r m 1 9 8 3 ; 9 : 9 9 - 1 0 7 . 5 9 L a c h a p e l l e J M , L a m y F . O n a l l e r g i c c o n t a c t d e r m a t i t i s t o v i r g i n i a - m y c i n . D e r m a t o l o g i c a 1 9 7 3 ; 3 2 0 - 2 . 6 0 L a r s e n W G . A l l e r g i c c o n t a c t d e r m a t i t i s t o t h e p e r f u m e i n M y c o l o g c r e a m . J A m A c a d D e r m a t o l 1 : 1 3 1 - 3 . 6 1 L e v i n e B B . S t u d i e s o n t h e m e c h a n i s m o f t h e f o r m a t i o n o f t h e p e n i c i l l i n a n t i g e n . I . D e l a y e d a l l e r g i c c r o s s - r e a c t i o n s a m o n g p e n i c i l l i n C a n d i t s d e g r a d a t i o n p r o d u c t s . J E x p M e d 1 9 6 0 ; 1 1 2 : 6 2
( 3 / 3 7 )
L e y d e n J J , K l i g m a n A M . C o n t a c t d e r m a t i t i s t o n e o m y c i n s u l f a t e . J A m M e d A r s o c 1 9 7 9 ; 2 4 2 : 6 3 L o v e l l C R , S t a n i f o r t h P . C o n t a c t a l l e r g y t o b e n z a l k o n i u m c h l o r i d e i n p l a s t e r o f P a r i s . C o n t a c t D e r m 1 9 8 1 ; 7 : 3 4 3 - 4 . 6 4 M e n e g h i n i C L , R a n t u c c i o F , L o m u t o M . A d d i t i v e s , v e h i c l e s a n d a c t i v e d r u g s o f t o p i c a l m e d i c a m e n t s a s c a u s e s o f d e l a y e d - t y p e a l l e r g i c d e r m a t i t i s . D e r m a t o l o g i c a 1 9 7 1 ; 1 4 3 : 1 3 7 - 4 7 . 6 5 M e n n щ T , H j o r t h N . R o u h n e p a t c h t e s t i n g w i t h p a r a b e n e s t e r s . C o n t a c t D e r m 1 9 8 8 ; 1 9 : 1 8 9 - 9 1 . 6 6 N a t e r J P , d e G r o o t A . C . U n w a n t e d E f f e c t s o f C o s m e t i c s a n d D r u g s u s e d i n D e r m a t o l o g y , 2 n d e d n . A m s t e r d a m : E l s e v i e r , 1 9 8 5 : 4 4 - 1 0 8 a n d p a s s i m . 6 7 N e u m a n n R A , K n o b l e r R M , L i n d e m a y r H . T i a p r o f e n i c a c i d i n d u c e d p h o t o s e n s i t i v i t y . C o n t a c t D e r m 1 9 8 9 ; 2 0 : 2 7 0 - 3 . 6 8 P a t r u n o C , A u r i c c h i o L , M o z z i l l o R e t a t . A l l e r g i c c o n t a c t d e r m a t i t i s d u e t o t r o m a n t a d i n e h y d r o c h l o r i d e . C o n t a c t D e r m 1 9 9 0 ; 2 2 : 1 8 7 . 6 9 P u i g L , A b a d i a s M , A l o m a r A . E r y t h r o d e r m a d u e t o r i b o s t a m y c i n . C o n t a c t D e r m 1 9 8 9 ; 2 1 : 7 0 R a j k a C , P a l l i n 0 . S e n s i t i z a t i o n t o l o c a l l y a p p l i e d A n t a s t e n e . A c t a D e r m V e n e r e o l 1 9 6 4 ; 4 4 : 7 1 R e i t a m o S , L a u e r m a A I , F ? r s t r ? m L . D e t e c t i o n o f c o n t a c t h y p e r s e n s i t i v i t y t o t o p i c a l c o r t i c o s t e r o i d s w i t h h y d r o c o r t i s o n e - l 7 - b u t y r a t e . C o n t a c t D e r m 1 9 8 9 ; 2 1 : 1 5 9 - 6 5 . 7 2 R e y n o l d s N J , H a r m a n R R M . A l l e r g i c c o n t a c t d e r m a t i t i s f r o m c h l o r h e x i d i n e d i a c e t a t e i n a s k i n s w a b . C o n t a c t D e r m 1 9 9 0 ; 2 2 : 1 0 3 - 4 . 7 3 T a k a h a s h i M , M a t s u o I , O h k i d o M . C o n t a c t d e r m a t i t i s d u e t o h o n e y b e e r o y a l j e l l y . C o n t a c t D e r m 1 9 8 3 ; 9 : 4 5 2 - 5 . 7 4 S a l o O P , P i r i l ? V , V i l j a n e n E . S e n s i t i v i t y t o t o p i c a l d e q u a l i n e . A c t a A l l e r g o l 1 9 6 8 ; 2 3 : 4 9 0 - 6 . 7 5
( 3 / 3 8 )
S c h w a r t z B K , G l e n d e n n i n g W E . A l l e r g i c c o n t a c t d e r m a t i t i s f r o m h y d r o x y p r o p y l c e l l u l o s e i n a t r a n s d e r m a l e s t r a d i o l p a t c h . C o n t a c t D e r m a t i t i s 1 9 8 8 ; 1 8 : 1 0 6 - 7 . 7 6 S h e l l e y W B , H e a t o n C L . M i n o c y c l i n e s e n s i t i v i t y . J A m M e d A s s o c 1 9 7 3 ; 2 2 4 : 1 2 5 - 6 . 7 7 B r i g g s G G , F r e e m a n R K , Y a f f e S J . D r u g s i n P r e g n a n c y a n d L a c t a t i o n . B a l t i m o r e : W i l l i a m s & W i l k i n s , 1 9 8 6 . 7 8 L e n z W . M a l f o r m a t i o n s c a u s e d b y d r u g s i n p r e g n a n c y . A m J D i s C h i l d 1 9 6 6 ; 1 1 2 : 9 9 - 1 0 6 . 7 9 M i l l e r M E , S e a l s J , K a y e R e t a l . A f a m i l i a l , p l a s m a - a s s o c i a t e d d e f e c t o f p h a g o c y t o s i s . L a n c e t 1 9 6 8 ; i i : 6 0 - 3 . 8 0 V u j a s i n J , P e t r o v i c D . B i o t i n i n s o m e e r y t h e m a t o - s q u a m o u s d e r m a t o s e s o f b a b i e s . D e r m a t o l o g i c a 1 9 5 2 ; 1 0 5 : 1 8 0 - 3 . 8 1 S h o n o M , H a y a s h i K , S u g i m o t o R . A l l e r g i c c o n t a c t d e r m a t i t i s f r o m c r o c o n a z o l e h y d r o c h l o r i d e . C o n t a c t D e r m 1 9 8 9 ; 2 1 : 2 2 5 - 7 . 8 2 T e n n s t e d t D , L a c h a p e l l e J - M . A l l e r g i c c o n t a c t d e r m a t i t i s t o 5 - f l u o r o u r a c i l . C o n t a c t D e r m 1 9 8 7 ; 2 7 9 - 8 0 . 8 3 V a l s e c c h i R , C a i n e l l i T . C o n t a c t d e r m a t i t i s f r o m i b u p r o x a m . A c a s e w i t h c r o s s - r e a c t i v i t y w i t h k e t o p r o f e n . C o n t a c t D e r m 1 9 9 0 ; 2 2 : 5 1 . 8 4 V a n K e t e l W C . S y s t e m i c c o n t a c t - t y p e d e r m a t i t i s b y d e r i v a t i v e s o f a d a m a n t a n e . D e r m a t o s e n 1 9 8 8 ; 2 3 - 2 4 . 8 5 W a s i l e w s k i C . A l l e r g i c c o n t a c t d e r m a t i t i s f r o m n y s t a t i n . A r c h D e r m a t o l 1 9 7 0 ; 1 0 2 : 2 1 6 - 1 7 . 8 6 C r o t t y R Q . E r y t h r o d e r m a d e s q u a m a t i v u m ( L e i n e r ' s d i s e a s e ) . A r c h D e r m a t o l 1 9 5 5 ; 7 1 : 5 8 7 - 9 0 . 8 7 D e n T a n d t W , E g g e r m o n t E , B o u r g e o i s N . E r y t h r o d e r m a d e s q u a m a t i v u m . A c t a P a e d i a t r B e l g 1 9 6 7 ; 2 1 : 4 3 3 - 5 0 . 8 8
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E v a n s D I K , H o l z e l A , M a c F a r l a n e H . Y e a s t o p s o n i z a t i o n d e f e c t a n d i m m u n o g l o b u l i n d e f i c i e n c y i n s e v e r e i n f a n t i l e d e r m a t i t i s ( L e i n e r ' s d i s e a s e ) . A r c h D i s C h i l d 1 9 7 7 ; 5 2 : 6 9 1 - 5 . 8 9 N y h a n W L . I n b o r n e r r o r s o f b i o t i n m e t a b o l i s m . A r c h D e r m a t o l 1 9 8 7 ; 1 2 3 : 1 6 9 6 - 8 . 9 0 'DA5D 'D-'/J H'D+D'+HF E8'G1 #E1'6 FB5 'DEF'9) 'D#HDJ) M a n i f e s t a t i o n s o f p r i m a r y i m m u n o - d e f f i c i e n c y d i s e a s e s 9/) E8'G1 31J1J) *-/+ (3(( 9H2 'D,DH(HDJF'* 'DEF'9J). HB/ *CHF *DC 'DE8'G1 :J1 FH9J) #H FH9J) **9DB (FE7 E9JF EF 'D,DH(HDJF'* 'DEF'9J). 'DE8'G1 'D,D/JG :J1 'DFH9J): *-/+ (3(( 9/) 9H'ED E.*DA) GJ (4CD 1&J3J: 'D'F*'F'* H'D*B1-'*. 'D/E'ED 'DE*C11) #H 'D.1','*. 'DBH('! 'DAB'9J) E9 9FJ('* 1'&B). 'D*B1-'* 'D,D/J) B/ *$/J %DI 'F*'F +'FHJ ('DAJ1H3'* E+D 'D9B(HD 'D(3J7 HAJ1H3 'D-D# 'DF7'BJ @ CDG' *$/J %DI .DD AJ 'DDEA'HJ'* 'D*'&J). 'D+"DJD 'DAJ1H3J). 'D"A'* 'D-HJ5DJ) 'DAB'9J). 'D8GH1 'D-HJ5DJ DD*F'01 A17 I g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'D#C2JE': GJ E8G1 EEJ2 D'671'('* 9H2 'DEF'9) E-//) E+D *F'01 " HJ3CH* 'D/1J." H:J'( :'E':DH(JF 'D/E @ 9H2 I g A 'D'F*B'&J @ 9H2 I g M 'D'F*B'&J H1F- *H39 'D#H9J) 'D491J) A t a x i a t e l e n g e c t a s i a . 'D0&() 'D-E'EJ): JH,/ E9/D E*2'J/ DD0&() 'D-E'EJ) 'D,G'2J) 9F/ 'DE16J 'DE5'(JF (9H2 I g A 'D'F*B'&J H'D"A'* 'D,D/J) *4(G *B1J('K 'D0&() 'D-E'EJ) 'DB1J5J). 'D*F'01'* 'DE*1'AB) E9 #E1'6 9H2 'DEF'9J) S y n d r o m e s a s s o c i a t e d w i t h i m m u n o - d e f f i c i e n c y d i s e a s e s 1 @ :J'( ,'E':DH(JF 'D/E ( /'! (1H*HF) GH 9H2 EF'9J F'/1 @ J5J( 'D0CH1 @ J-/+ C5A) E1*(7) ('D,F3 EBGH1) .D'D 6 4GH1 'D#HDI JCHF 'D7AD 9'/) E-EJ (H'37) 'D#6/'/ 'D"*JG DG EF #EG #+F'! 'D-ED. 'DE8'G1 'D31J1J): #C2JE' D' JECF *A1JBG' 9F 'D#C2JE' 'D'3*41'&J) B/ *8G1 9F/ 'D16J9 E9 E3*HJ'* EF.A6) EF I g E 'D,'&D. 'D#7A'D 'DE5'(HF JCHF 9F/GE '3*9/'/ DCJ JCHF D/JGE "A'* 'F*'FJ) BJ-J) *5J( .'5) 'D#0F 'DH37J 'D,JH( H'D1&*JF. 'D'F*'F'* 'D,D/J) 'DBJ-J) #J6'K 4'&9) H*4ED 'D/E'ED H'D.1','* H'D*G'( 'DF3J, 'D.DHJ. G0G 'D#4C'D EF 'D'F*'F'* :'D('K E' *-/+ ('D9FBH/J'* 'DE0G() H'D9B/J'* E,EH9) A . #E1'6 1&HJ) E2EF) FB5 3E9 A4D 'DFEH 2 @ 9H2 I g A 'D'F*B'&J 'DE8'G1 'D31J1J): -E'B ( V a r i c e l l a ) B'*D. H1E -(J(J E2EF ('DE(J6'* 'D(J6. 'C2JE' *#(*J) #H '3*41'&JG H1(H. 'F*'F'* ,1+HEJ) E*C11) AJ 'D71B 'D*FA3J). B/ *CHF '671'('* 'DEF'9) 'D0'*J) '.*D'7'K D9H2 I g A .'5) 'D0&() 'D-E'EJ) 'D,G'2J) ( S L E ) 'D*G'( 'DEA'5D 'D1+H'FJ @ 'D*G'( 'D,D/ H'D96D'* AB1 'D/E 'D.(J+ 'D(GB H(1A1J) FB5 'D5AJ-'* 'D#3'3J). 'D'1*C'3'* 'D*#BJ) 'D*'DJ) DFBD 'D/E #H %97'! 'D,DH(HDJF'* 'DEF'9J) *F,E 9F H,H/ 'D@ I g E H#6/'/ I g A . 3 @ 9H2 I g M 'D'F*B'&J 'DE8'G1 'D31J1J): #C2JE'. +"DJD AJ1H3J) 6.E).
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'F*'F'* ('D1&HJ'* H'DECH1'* 'D3-'&J). 4 @ *F'01 A17 I g M GH E16 H1'+J E1*(7 ('D,F3 J5J( 'D0CH1 (4CD E3J71. 'DE8'G1 'D9'E): 'D'F*'F'* 'D,1+HEJ) 'DE*C11) .'5) 'D*G'( 'DDH2*JF 'D*G'( 'D#0F 'DH37J H0'* 'D1&) .'5) #+F'! 'D3F) 'D#HDI #H 'D+'FJ) EF 'D-J'). 'DE8'G1 'D,D/J): +"DJD AJ1H3J) C+J1). E8'G1 'D#:4J) 'DE.'7J): 'D*G'( 'DAE 'D*G'( 'DD+) H*B1- AEHJ J-/+ (4CD +'FHJ DFB5 'D9/D'*. 5H1) 'D/E: J1*A9 I g M HJF.A6 I g A , I g G H I g E HFB5 'D9/D'* . 5 @ 9H2 'D*#J'* ( *F'01 /J ,H1, @ 931 *5F9 'D*JEH3) G0' 'D*F'01 J9C3 'D*7H1 'D4'0 AJ 'DBH) 'D:D5EJ) #H 'D.J4HEJG ( B r a n c h i a l p o u c h e s ) 'D+'D+ H'D1'(9 ( 'D(D9HEJ)) . 'DE8'G1 'D31J1J): 'DE8'G1 'D,D/J): 'D#7A'D 'DE5'(HF JCHF D/JGE "A) ,D/J) " *4(G 'D*G'( 'D,D/ 'D2GEJ" H'D#C2JE' 'D*#(*J) H'D7AH- 'DD7'.J) 'D-7'7J). /'! 'DE(J6'* 'DAEHJ 'DE3*E1 GH E8G1 4'&9 9F/ 'D#7A'D 'D0JF *9/H' 'DE1-D) 'DHDJ/J). 'DE8'G1 'D9'E): :J'( 'D:// E,'H1'* 'D/1B. *4HG'* BD(J) HAJ 'D#H9J) 'DC(J1). *4HG'* AJ 'D1#3 H'D9FB HFB5 *5(: 'D*JEH3 *$/J %DI .DD .D'J' T .DBJ. 6 @ 9H2 'DEF'9) 'DE.*D7) 'D4/J/ J4J1 G0' 'DE57D- %DI *F'01 J(/J 9/) '671'('* H1'+J) EEJ2) (FA3 'DE8'G1 'D31J1J) H'DEF'9J). G0' 'D*F'01 J*8'G1 ('671'('* '3*BD'(J) E9 9H2 'D'/FJH2JF /J'EJF'F H(JH1JF FJCDJH2J/ AH3AH1JD'2 9H2 AJ 'D(1H*JF'* 'D1'(7 DD@ D N A H.DD AJ %F*', 'D'F*1DHCJF @ 2 . 'DEH* 4'&9 AJ 'D#4G1 'D#HDI EF 'D9E1. 'DE8'G1 'D31J1J): J8G1 'DE1J6 9H2 4/J/ H'6- AJ H8'&A CD EF 'DDEA'HJ'* 'D*'&J) H'D('&J). 'DE8'G1 AJ 'D#:4J) 'DE.'7J): /'! 'DE(J6'* 'D,G'2J H'D,D/J 'DE.'7J GJ 'D*8'G1'* 'D#C+1 4JH9'K 'F*'F'* 'DA7H1 'D,D/J) B/ *-/+ HB/ *(/H (4CD 'D*G'( ,D/ -A'8J E2EF.
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'D#-E1J) 'D3E'CJ) E9 -'5) H:J'( 491 'D-',(JF H'D,AFJF #H 931 *5F9 'D#/E) ( E c t o d e r m a l d y s p l a s i a ) . "A'* *4(G 'F-D'D 'D(41) 'DF.1J 'D3EJ. 'F*'F'* AJ1H3J) **8'G1 (*B1-'* 'D,D/ .'5) AJ F'-J) 'D9,'F #H 'D:4'! 'DE.'7J DDAE H'DD3'F. 'F*'F'* 'D-D# 'DF7'BJ 'D4/J/) B/ *-/+. 'DE8'G1 'D9'E): 'F*'F'* E*C11) .'5) 0'* 'D1&). 'F*'F'* AJ1H3J) F',E) 9F 'D-E) 'DE6.E) DD.D'J' ( C y t o m e g a l i c v i r u s ) 'D-5() H'D*CJ3 'D1&HJ 'DC'1JFJ. 'D%3G'D 'DE2EF ( (3(( 'D1H*' AJ1H3 :'D('K #H 'DCHE(JDH('C*1 #H 'D7AJDJ'* E+D 'D,J'1/ J'D'E(J') . 'DE9'D,): 219 FBJ 'D98E GJ 'DE9'D,) 'DA9'D) AB7 . 7 @ *F'01 'DDEA'HJ'* 'D@" B a r e " G0' 'D*F'01 JH1+ (5(:) ,3EJ) EBGH1) J*5A (.DD AJ *F4J7 'DE3*6/'* 'D*H'AB 'DF3,J AJ 'D.D'J' T H B H'DH-J/'* 3H'! EF 'DFE7 I #H I I . 'DE3*6/'* 5FA I EGE) .'5) EF #,D 3EJ) 'D.D'J' 'DAJ1H3J) HCD'K EF 'D5FA I H I I E7DH() D%J,'/ E3*6/'* 'DDEAHJ'* T H:'D(' J-/+ 'DEH* ('C1'K AJ 'D#7A'D. 'DE8'G1 'D31J1J): 2J'/) 'DEJD D'F*'F'* 'DE(J6'*. 'F*'F 'D1&) (9/) 96HJ'* .'5) 'DE*CJ3 'D1&HJ 'DC'1JFJ. %3G'D 4/J/. 'F*'F /E HEJD 4/J/ DD'F*'F'* 'DAJ1H3J) (E' AJG' 'D9B(HD 'D(41J HAJ1H3 CHC3'C3J H4DD 'D#7A'D. 8 @ *F'01: #HEF O m e n n ' s GH *F'01 9'&DJ (5A) ,3EJ) EBGH1) #:D( 'D*8'G1'* ,D/J) HJ(/J '671'( J9C3 *C'+1 'DDEA'HJ'* 'D*'&J) H9DI -3'( 'DDEA'HJ'* 'D('&J). 'DE16 0H 3J1 31J9 HB'*D E9 A4D FEH H'F*'F E*C11. 'DE8'G1 'D,D/J): 7A- E*B41 H%-E1J) ,D/J) E*EH,). 'DE8'G1 'D9'E): 6.'E) C(/J) 7-'DJ) H'9*D'D 9B/ DEAJ) E9EE). %3G'D E2EF. B/ J-/+ DEAHE' AJ (96 'D-'D'*. A17 'DDEA'HJ'* H'D-E6'*. 6J'9 'D.D'J' 'D('&J) HE3*HJ'* E*F'B5) EF CD 'D,DH(HDJF'* 'DEF'9J) E'9/' I g E . 'DE9'D,):
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E3*HJ'* 'D#5F'A 'D+D'+) EF 'D,DH(JF'* 'DEF'9J) E2/'/) E9 E3*HI I g E 2'&/ #H 7(J9J. 'DE9'D,): 'D9F'J) 'D5-J) ('D,D/. J,( '3*B5'! A17 'D-1'1) ('F*('G D%8G'1 EHB9 'D'F*'F H'D96HJ'* 'DE3$HD). J,( '.*J'1 'DE6'/'* 'D-JHJ) ('F*('G HJ,( #F *CHF 'DE9'D,) E1C2). 'DE9'D,) 'DE3*E1) ('DE6'/'* ('D*1'J E+H(1JF @ 3DA'EJ+HC3'2HD ( B a c t r i m , s e p t r i n f o r t ) #H 'D*1JEJ*H(1JE DH-/G GH 'D.7 'DE9J'1J DDE9'D,) 'D"F. 'DE9'D,) 'DE3*E1) (E6'/'* 'DA7H1 E+D 'DCJ*HCHF'2HD D'J(/H #FG' A9'D) AJ 'DHB'J) EF 'D14'4J'* DCF J$ED #F J97J 'D%J*1'CHF'2HD A'&/) E' HGH *-* 'D*BJJE H#+(* #FG A9'D ,/'K. 'D'F*1AJ1HF *-* 'D,D/. ,'E',DH(HDJF B/ JCHF 0H F*'&, ,J/). FBD 'D/E B/ JCHF E7DH('K DE9'D,) AB1 'D/E. 'D3*J1H&J/'* 'DB41J) ,G'2J) DD%F3/'/ 'DE9HJ. 219 FBJ 'D98E. 1 9 @ *F'01 4H'4E'F S c h w a c h m a n s y n d r o m e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
( 3 / 5 2 )
/'! 'DE(J6'* 'DE3*E1 AJ 'DAE H'D#8'A1. 5 @ 9H2 C 1 r H C 1 s 'DE8'G1 GJ: E8'G1 4(G 'D0&() 'D-E'EJ) 'D,G'2J). 'D*G'( CDJ) :4'&J. 'F*'F'* 1&HJ) H.1','* C(/J). 6 @ 9H2 C 4 'DE8'G1 'D31J1J): 0&() -E'EJ) ,G'2J) #H *F'01 'D0&() 'D-E'EJ) 'D,G'2J). E8'G1 E+D (1A1J) GJFHC @ 4HFD'(F #H *F'01 3,H,1F. 'F*'F'*. 7 @ 9H2 C 2 J(/H #FG #4J9 E*EE) H*(JF -'DJ'K #FG J*1'AB E9 *FH9 AJ 'D#E1'6 DCF 'D#4.'5 'DE5'(HF JCHFHF #5-'! *E'E'K. 'DE8'G1 'D31J1J): B/ *4(G 'DE8'G1 #E1'6' E.*DA) E+D: #E1'6 'D:1'!: E+D 'D0&() 'D-E'EJ) 'D,G'2J). 'D0&() 'D-E'EJ) 'DB15J) 'D*G'( 'DCDJ) 'D:4'&J 'D*G'( 'DEA'5D 'D1+H'FJ H'D*G'( 'D,D/ H'D96D. (1A1J) GJFHC @ 4HFD'JF. /'! C1HF. (1A1J) FB5 'D5AJ-'* 'D#3'3J). 'F*'F'* ,1+HEJ) B/ *-/+ #J6'K .'5) ('D1&HJ'* H'DE3*/ JE'* 'DF2DJ) H'D3'&J'*. 8 @ 9H2 C 3 'D'F*'F'* GJ 'DE.'71 'D1&J3J) D9H2 C 3 'D*G'( 'D3-'J' ('D3-'&J'* H0'* 'D1&) ('D1&HJ'* GJ 'DE4'CD 'D1&J3J). 'D5H1) 'D31J1J): *4(G *DC 'D.'5) (FB5 ,'E',DH(JF 'D/E. 7AH- -7'7J) D7'.J) 9'(1) E*1'AB) E9 'F*'F'*. E8'G1 #.1I E+D 'D0&() 'D-E'EJ) 'D,G'2J) H'D*G'( 'DCDJ) 'D:4'&J. 9 @ 9H2 'DE*EE) 'D'F*G'&J) ( C 5 , C 6 , C 7 , C 8 , C 9 ) 'DE8'G1 'D31J1J): 'D*G'( 3-'J' ('D3-'&J'* E*C11. 'F*'F'* EF*41) ('DECH1'* 'D(FJ). 'F*'F'* ,D/J) H.1','* *E* ,D/J) AJ (96 'D-'D'*. #E1'6 'D:1'!: 'D0&() 'D-E'EJ) 'D,G'2J) H'D0&() 'D-E'EJ) 'DB15J) H/'! 3,H:1JF 'D/'! 'D1+H'FJ 'D4('(J @ *5D( 'D#5'(9 @ 8'G1) 1JFH @ H'D*G'( 'DAB'1 'DEB37 ( 'DD'5B) . 'DE1',9 B r e s t e i E P , K l i n g b e r g W G , V e l t r i R W e t a l . O s t e o g e n e s i s i m p e r f e c t a t a r d a i n a c h i l d w i t h h y p e r - I g E s y n d r o m e . A m J D i s C h i l d 1 9 8 2 ; 1 3 6 : 7 7 4 - 6 1
( 3 / 5 3 )
G i l s o n I H , B a n e t t J H , C o n a n t M A e t a l . D i s s e m i n a t e d e c t h y m a t o u s h e r p e s v a r i c e l l a - z o s t e r v i r u s i n f e c t i o n i n p a t i e n t s w i t h a c q u i r e d i m m u n o d e f i c i e n c y s y n d r o m e . J A m A c a d D e r m a t o l 1 9 8 9 ; 2 0 : 6 3 7 - 4 2 2 G r e t z u l a J , P e n n e y s N S . C o m p l e x v i r a l a n d f u n g a l s k i n l e s i o n s o f p a t i e n t s w i t h a c q u i r e d i m m u n o d e f i c i e n c y s y n d r o m e . J A m A c a d D e r m a t o l 1 9 8 7 ; 1 6 : 1 1 5 1 - 4 3 M i l l e r M E , S e a l s J , K a y e R e t a l . A f a m i l i a l , p l a s m a - a s s o c i a t e d d e f e c t o f p h a g o c y t o s i s . L a n c e t 1 9 6 8 ; i i : 6 0 - 3 4 P a l l e r A S . D i s o r d e r s o f t h e i m m u n e s y s t e m . I n : S c h a c h n e r L A , H a n s e n R C , e d s . P e d i a t r i c D e r m a t o l o g y . N e w Y o r k : C h u r c h i l l - L i v i n g s t o n e , 1 9 8 8 : 1 2 9 - 3 0 5 P a t r i z i A , M a s i n a M , T a s s o n i P e t a l . E r y t h r o d e r m a i n i n f a n c y : a s i g n o f i m m u n o d e f i c i e n c y ? J A m A c a d D e r m a t o l 1 9 8 7 ; 1 7 : 6 9 4 - 5 6 H i l l H R , O c h s H D , Q u i e P G e t a l . D e f e c t i n n e u t r o p h i l g r a n u l o c y t e c h e m o t a x i s i n J o b ' s s y n d r o m e o f r e c u r r e n t ` c o l d ' a b s c e s s e s . L a n c e t 1 9 7 4 ; i i : 6 1 7 - 1 9 7 D o n a b e d i a n H , G a l l i n J I . T h e h y p e r i m m u n o g l o b u l i n E r e c u r r e n t i n f e c t i o n ( J o b ' s ) s y n d r o m e . M e d i c i n e 1 9 8 3 ; 6 2 : 1 9 5 - 2 0 8 8 D o n a b e d i a n H , G a l l i n J I . T h e h y p e r i m m u n o g l o b u l i n E r e c u r r e n t i n f e c t i o n ( J o b ' s ) s y n d r o m e . M e d i c i n e 1 9 8 3 ; 6 2 : 1 9 5 - 2 0 8 9 B u c k l e y R H , S a m p s o n H A . T h e h y p e r i m m u n o g l o b u l i n E s y n d r o m e . I n : F r a n k l i n E D , e d . C l i n i c a l I m m u n o l o g y U p d a t e . N e w Y o r k : E l s e v i e r 1 9 8 1 : 1 4 7 - 6 7 1 0 B u c k l e y R H , B e c k e r W G . A b n o r m a l i t i e s i n t h e r e g u l a t i o n o f h u m a n I g E s y n t h e s i s . I m m u n o l R e v 1 9 7 8 ; 4 1 : 2 8 8 - 3 1 4 1 1 M a w h i n n e y J , K i l l e n M , F l e m i n g W A e t a l . T h e h y p e r i m m u n o g l o b u l i n e m i a E s y n d r o m e : a n e u t r o p h i l c h e m o t a c t i c d e f e c t r e v e r s i b l e b y h i s t a m i n e H 2 r e c e p t o r b l o c k a d e . C l i n I m m u n o l I m m u n o p a t h o l 1 9 8 0 ; 1 7 : 4 8 3 - 9 1 1 2
( 3 / 5 4 )
M o r g a n G , H e n d r i c k s e W , H a r v e y B A M e t a l . T r e a t m e n t o f t h e h y p e r - I g E s y n d r o m e w i t h c i m e t i d i n e . I n : V o s s e n J , G r i s c e l l i C , e d s . P r o g r e s s i n I m m u n o d e f i c i e n c y R e s e a r c h a n d T h e r a p y I I . A m s t e r d a m , E l s e v i e r , 1 9 8 6 : 2 1 7 - 2 0 1 3 Z a c h a r y C B , A t h e r t o n D J . H y p e r - I g E s y n d r o m e . C l i n E x p D e r m a t o l 1 9 8 6 ; 1 1 : 4 0 3 - 8 1 4 E v a n s D I K , H o l z e l A , M a c F a r l a n e H . Y e a s t o p s o n i z a t i o n d e f e c t a n d i m m u n o g l o b u l i n d e f i c i e n c y i n s e v e r e i n f a n t i l e d e r m a t i t i s ( L e i n e r ' s d i s e a s e ) . A r c h D i s C h i l d . 1 9 7 7 ; 5 2 : 6 9 1 - 5 1 5 N y h a n W L . I n b o r n e r r o r s o f b i o t i n m e t a b o l i s m . A r c h D e r m a t o l 1 9 8 7 ; 1 2 3 : 1 6 9 6 - 8 1 6 P a l l e r A S . D i s o r d e r s o f t h e i m m u n e s y s t e m . I n : S c h a c h n e r L A , H a n s e n R C , e d s . P e d i a t r i c D e r m a t o l o g y . N e w Y o r k : C h u r c h i l l - L i v i n g s t o n e , 1 9 8 8 : 1 2 9 - 3 0 1 7 S v e j c a r J , H o m o l k a J . E x p e r i m e n t a l e x p e r i e n c e s w i t h b i o t i n i n b a b i e s . A n n P a e d i a t r 1 9 5 0 ; 1 7 4 : 1 7 5 - 9 3 1 8 N y h a n W L . I n b o r n e r r o r s o f b i o t i n m e t a b o l i s m . A r c h D e r m a t o l 1 9 8 7 ; 1 2 3 : 1 6 9 6 - 8 1 9 P a l l e r A S . D i s o r d e r s o f t h e i m m u n e s y s t e m . I n : S c h a c h n e r L A , H a n s e n R C , e d s . P e d i a t r i c D e r m a t o l o g y . N e w Y o r k : C h u r c h i l l - L i v i n g s t o n e , 1 9 8 8 : 1 2 9 - 3 0 2 0 S v e j c a r J , H o m o l k a J . E x p e r i m e n t a l e x p e r i e n c e s w i t h b i o t i n i n b a b i e s . A n n P a e d i a t r 1 9 5 0 ; 1 7 4 : 1 7 5 - 9 3 2 1 S u p e r M , T h i e l S , L u J e t a l . A s s o c i a t i o n o f l o w l e v e l s o f m a n n a n b i n d i n g p r o t e i n w i t h a c o m m o n d e f e c t o f o p s o n i s a t i o n . L a n c e t 1 9 8 9 ; i i : 1 2 3 6 - 9 2 2 M i l l e r M E , N i l s s o n U R . A f a m i l i a l d e f i c i e n c y o f t h e p h a g o c y t o s i s e n h a n c i n g a c t i v i t y o f s e r u m r e l a t e d t o a d y s f u n c t i o n o f t h e f i f t h c o m p o n e n t o f c o m p l e m e n t ( C 5 ) . N e w E n g l J M e d 1 9 7 0 ; 2 8 2 : 3 5 4 - 8 2 3 V u j a s i n J , P e t r o v i c D . B i o t i n i n s o m e e r y t h e m a t o - s q u a m o u s d e r m a t o s e s o f b a b i e s . D e r m a t o l o g i c a 1 9 5 2 ; 1 0 5 : 1 8 0 - 3 2 4
( 3 / 5 5 )
B r e s t e i E P , K l i n g b e r g W G , V e l t r i R W e t a l . O s t e o g e n e s i s i m p e r f e c t a t a r d a i n a c h i l d w i t h h y p e r - I g E s y n d r o m e . A m J D i s C h i l d 1 9 8 2 ; 1 3 6 : 7 7 4 - 6 2 5 H i l l H R , O c h s H D , Q u i e P G e t a l . D e f e c t i n n e u t r o p h i l g r a n u l o c y t e c h e m o t a x i s i n J o b ' s s y n d r o m e o f r e c u r r e n t ` c o l d ' a b s c e s s e s . L a n c e t 1 9 7 4 ; i i : 6 1 7 - 1 9 2 6 K a r o l R A , E n g J , C o o p e r J B e t a l . I m b a l a n c e s i n s u b s e t s o f T l y m p h o c y t e s i n a n i n b r e d p e d i g r e e w i t h O m e n n ' s s y n d r o m e . C l i n I m m u n o l I m m u n o p a t h 1 9 8 3 ; 2 7 : 4 1 2 - 2 7 2 7 D r e s k i n S C , G o l d s m i t h P K , G a l l i n J I . I m m u n o g l o b u l i n s i n t h e h y p e r i m m u n o g l o b u l i n E a n d r e c u r r e n t i n f e c t i o n s y n d r o m e . J C l i n I n v e s t 1 9 8 5 ; 7 5 : 2 6 - 3 4 2 8 B l u m R , G e l l e r G , F i s h L A . R e c u r r e n t s e v e r e s t a p h y l o c o c c a l i n f e c t i o n s , e c z e m a t o i d r a s h , e x t r e m e e l e v a t i o n s o f I g E , e o s i n o p h i l i a a n d d i v e r g e n t c h e m o t a c t i c r e s p o n s e s i n t w o g e n e r a t i o n s . J P e d i a t r 1 9 7 7 ; 9 0 : 6 0 7 - 9 2 9 D o n a b e d i a n H , G a l l i n J I . T h e h y p e r i m m u n o g l o b u l i n E r e c u r r e n t i n f e c t i o n ( J o b ' s ) s y n d r o m e . M e d i c i n e 1 9 8 3 ; 6 2 : 1 9 5 - 2 0 8 3 0 W a l s h G A , R i c h a r d s K L , D o u g l a s S D e t a l . I m m u n o g l o b u l i n E a n t i - S t a p h y l o c o c c u s a u r e u s a n t i b o d i e s i n a t o p i c p a t i e n t s . J C l i n M i c r o b i o l 1 9 8 1 ; 1 3 : 1 0 4 6 - 8 3 1 B u c k l e y R H , I n : S t i e h m E R , e d . I m m u n o l o g i c D i s o r d e r s i n I n f a n t s a n d C h i l d r e n . P h i l a d e l p h i a : W B S a u n d e r s , 1 9 8 9 : 3 2 0 - 6 3 2 K a m e i R , H o n i g P J . N e o n a t a l J o b ' s s y n d r o m e f e a t u r i n g a v e s i c u l a r e r u p t i o n . P e d i a t r D e r m a t o l 1 9 8 8 ; 5 : 7 5 - 8 2 3 3 H i l l H R , O c h s H D , Q u i e P G e t a l . D e f e c t i n n e u t r o p h i l g r a n u l o c y t e c h e m o t a x i s i n J o b ' s s y n d r o m e o f r e c u r r e n t ` c o l d ' a b s c e s s e s . L a n c e t 1 9 7 4 ; i i : 6 1 7 - 1 9 3 4
( 3 / 5 6 )
M o r g a n G , H e n d r i c k s e W , H a r v e y B A M e t a l . T r e a t m e n t o f t h e h y p e r - I g E s y n d r o m e w i t h c i m e t i d i n e . I n : V o s s e n J , G r i s c e l l i C , e d s . P r o g r e s s i n 3 5 I m m u n o d e f i c i e n c y R e s e a r c h a n d T h e r a p y I I . A m s t e r d a m , E l s e v i e r , 1 9 8 6 : 2 1 7 - 2 0 3 6 W a l s h G A , R i c h a r d s K L , D o u g l a s S D e t a l . I m m u n o g l o b u l i n E a n t i - S t a p h y l o c o c c u s a u r e u s a n t i b o d i e s i n a t o p i c p a t i e n t s . J C l i n M i c r o b i o l 1 9 8 1 ; 1 3 : 1 0 4 6 - 8 3 7 M i l l e r M E , S e a l s J , K a y e R e t a l . A f a m i l i a l , p l a s m a - a s s o c i a t e d d e f e c t o f p h a g o c y t o s i s . L a n c e t 1 9 6 8 ; i i : 6 0 - 3 3 8 B r e s t e i E P , K l i n g b e r g W G , V e l t r i R W e t a l . O s t e o g e n e s i s i m p e r f e c t a t a r d a i n a c h i l d w i t h h y p e r - I g E s y n d r o m e . A m J D i s C h i l d 1 9 8 2 ; 1 3 6 : 7 7 4 - 6 3 9 Z a c h a r y C B , A t h e r t o n D J . H y p e r - I g E s y n d r o m e . C l i n E x p D e r m a t o l 1 9 8 6 ; 1 1 : 4 0 3 - 8 4 0 M o r g a n G , H e n d r i c k s e W , H a r v e y B A M e t a l . T r e a t m e n t o f t h e h y p e r - I g E s y n d r o m e w i t h c i m e t i d i n e . I n : V o s s e n J , G r i s c e l l i C , e d s . P r o g r e s s i n 4 1 I m m u n o d e f i c i e n c y R e s e a r c h a n d T h e r a p y I I . A m s t e r d a m , E l s e v i e r , 1 9 8 6 : 2 1 7 - 2 0 4 2 G l o v e r M T , A t h e r t o n D J , L e v i n s k y R J . S y n d r o m e o f e r y t h r o d e r m a , f a i l u r e t o t h r i v e a n d d i a r r h e a i n i n f a n c y : a m a n i f e s t a t i o n o f i m m u n o d e f i c i e n c y . P e d i a t r i c s 1 9 8 8 ; 8 1 : 6 6 - 7 2 4 3 A r c h e r E , C h u a n g T - Y , H o n g R . S e v e r e e c z e m a i n a p a t i e n t w i t h D i G e o r g e ' s s y n d r o m e . C u t i s 1 9 9 0 ; 4 5 : 4 5 5 - 9 4 4 D i G e o r g e A M . C o n g e n i t a l a b s e n c e o f t h e t h y m u s a n d i t s i m m u n o l o g i c c o n s e q u e n c e s : o c c u r r e n c e w i t h c o n g e n i t a l h y p o p a r a t h y r o i d i s m . B i r t h D e f e c t s 1 9 6 8 ; 4 : 1 1 6 - 2 3 4 5 B a s t i a n J F , W i l l i a m s R A , O r n e l a s W e t a l . M a t e r n a l i s o i m m u n i s a t i o n r e s u l t i n g i n c o m b i n e d i m m u n o d e f i c i e n c y a n d f a t a l g r a f t - v e r s u s - h o s t d i s e a s e i n a n i n f a n t . L a n c e t 1 9 8 4 ; 1 : 1 4 3 5 - 7 4 6
( 3 / 5 7 )
W e i n b e r g K , P a r k m a n R . S e v e r e c o m b i n e d i m m u n o d e f i c i e n c y d u e t o a s p e c i f i c d e f e c t i n t h e p r o d u c t i o n o f i n t e r l e u k i n - 2 . N e w E n g l J M e d 1 9 9 0 ; 3 2 2 : 1 7 1 8 - 2 3 4 7 G e l f a n d E W , D o r s c h H M . D i a g n o s i s a n d c l a s s i f i c a t i o n o f s e v e r e c o m b i n e d i m m u n o d e f i c i e n c y d i s e a s e . B i r t h D e f e c t s 1 9 8 3 ; 1 9 : 6 5 - 7 2 4 8 S c h u u r m a n H J , H u b e r J , Z e g e r s B J M e t a l . P l a c e n t a l d i a g n o s i s o f t h e b a r e l y m p h o c y t e s y n d r o m e . N e w E n g l J M e d 1 9 8 5 ; 3 1 3 : 7 5 7 - 8 4 9 P a l l e r A S . D i s o r d e r s o f t h e i m m u n e s y s t e m . I n : S c h a c h n e r L A , H a n s e n R C , e d s . P e d i a t r i c D e r m a t o l o g y . N e w Y o r k : C h u r c h i l l - L i v i n g s t o n e , 1 9 8 8 : 1 2 9 - 3 0 5 0 S o o t h i l l J F , H a r v e y B A M . D e f e c t i v e o p s o n i z a t i o n : a c o m m o n i m m u n i t y d e f i c i e n c y . A r c h D i s C h i l d 1 9 7 6 ; 5 1 : 9 1 - 9 5 1 D e G r o u c h y J , T u r l e a u C . C l i n i c a l A t l a s o f H u m a n C h r o m o s o m e s . N e w Y o r k : J o h n W i l e y , 1 9 8 4 5 2 B u c k l e y R H , S a m p s o n H A . T h e h y p e r i m m u n o g l o b u l i n E s y n d r o m e . I n : F r a n k l i n E D , e d . C l i n i c a l I m m u n o l o g y U p d a t e . N e w Y o r k : E l s e v i e r 1 9 8 1 : 1 4 7 - 6 7 5 3 D r e s k i n S C , G o l d s m i t h P K , G a l l i n J I . I m m u n o g l o b u l i n s i n t h e h y p e r i m m u n o g l o b u l i n E a n d r e c u r r e n t i n f e c t i o n s y n d r o m e . J C l i n I n v e s t 1 9 8 5 ; 7 5 : 2 6 - 3 4 5 4 B u c k l e y R H , I n : S t i e h m E R , e d . I m m u n o l o g i c D i s o r d e r s i n I n f a n t s a n d C h i l d r e n . P h i l a d e l p h i a : W B S a u n d e r s , 1 9 8 9 : 3 2 0 - 6 5 5 M a w h i n n e y J , K i l l e n M , F l e m i n g W A e t a l . T h e h y p e r i m m u n o g l o b u l i n e m i a E s y n d r o m e : a n e u t r o p h i l c h e m o t a c t i c d e f e c t r e v e r s i b l e b y h i s t a m i n e H 2 r e c e p t o r b l o c k a d e . C l i n I m m u n o l I m m u n o p a t h o l 1 9 8 0 ; 1 7 : 4 8 3 - 9 1 5 6 M i l l e r M E , K o b l e n z e r P J . L e i n e r ' s d i s e a s e a n d d e f i c i e n c y o f C 5 . J P e d i a t r 1 9 7 2 ; 8 0 : 8 7 9 - 8 0 5 7
( 3 / 5 8 )
O c h s H D , D a v i s S D , M i c k e l s o n E e t a l . C o m b i n e d i m m u n o d e f i c i e n c y a n d r e t i c u l o e n d o t h e l i o s i s w i t h e o s i n o p h i l i a . J P e d i a t r 1 9 7 4 ; 8 5 : 4 6 3 - 5 5 8 A u e r b a c h A D , M i n Z , G h o s h R e t a l . C l a s t o g e n - i n d u c e d c h r o m o s o m a l b r e a k a g e a s a m a r k e r f o r f i r s t t r i m e s t e r p r e n a t a l d i a g n o s i s o f F a n c o n i a n e m i a . H u m G e n e t 1 9 8 6 ; 7 3 : 8 6 - 8 5 9 G l u c k m a n E , B e r g e r R , D u t r e i x J . B o n e m a r r o w t r a n s p l a n t a t i o n f o r F a n c o n i a n e m i a . S e m i n H e m a t o l 1 9 8 4 ; 2 1 : 2 0 - 6 6 0 J o u a n H , L e D i e s t F , N e z e l o f C . O m e n n ' s s y n d r o m e : p a t h o l o g i c a r g u m e n t s i n f a v o r o f a g r a f t - v e r s u s - h o s t p a t h o g e n e s i s . H u m P a t h o l 1 9 8 7 ; 1 8 : 1 1 0 1 - 8 6 1 B a l d i n i M G . N a t u r e o f t h e p l a t e l e t d e f e c t i n t h e W i s k o t t - A l d r i c h s y n d r o m e . A n n N e w Y o r k A c a d S c i 1 9 7 2 ; 2 0 1 : 4 3 7 - 4 4 6 2 B l a e s e R M , S t r o b e r W , W a l d m a n n T A . I m m u n o d e f i c i e n c y i n t h e W i s k o t t - A l d r i c h s y n d r o m e . B i r t h D e f e c t s : O r i g i n a l A r t i c l e S e r i e s 1 9 7 5 ; X I ( I ) : 2 5 0 - 4 6 3 K w a n S - P , K a n d k u y l L A , B l a e s e M e t a l . G e n e t i c m a p p i n g o f t h e W i s k o t t - A l d r i c h s y n d r o m e w i t h t w o h i g h l y l i n k e d p o l y m o r p h i c D N A m a r k e r s . G e n o m i c s 1 9 8 8 ; 3 : 3 9 - 4 3 6 4 M a u e r A M . X - l i n k e d r e c e s s i v e d i s o r d e r s : c h r o n i c g r a n u l o m a t o u s d i s e a s e a n d W i s k o t t - A l d r i c h s y n d r o m e . J I n v e s t D e r m a t o l 1 9 7 3 ; 6 0 : 5 2 2 - 8 6 5 P e a c o c k e M , S i m i n o v i t c h K A . L i n k a g e o f t h e W i s k o t t - A l d r i c h s y n d r o m e w i t h p o l y m o r p h i c D N A s e q u e n c e s f r o m t h e h u m a n X - c h r o m o s o m e . P r o c N a t l A c a d S c i U S A 1 9 8 7 ; 8 4 : 3 4 3 0 - 3 6 6 R o s e n F S . T c e l l : B c e l l c o l l a b o r a t i o n - t h e r e s p o n s e t o p o l y s a c c h a r i d e a n t i g e n s . S e m i n I m m u n o l 1 9 8 9 ; 1 : 8 7 - 9 1 6 7
( 3 / 5 9 )
S t a n d e n G R , L i l l i c r a p D P , M a t t h e w s N e t a l . I n h e r i t e d t h r o m b o c y t o p e n i a , e l e v a t e d s e r u m I g A a n d r e n a l d i s e a s e : i d e n t i f i c a t i o n a s a v a r i a n t o f t h e W i s k o t t - A l d r i c h s y n d r o m e . Q u a r t J M e d 1 9 8 6 ; 5 9 : 4 0 1 - 8 6 8 A m m a n n A J , H o n g R . D i s o r d e r s o f t h e T - c e l l s y s t e m . I n : S t i e h m E R , e d . I m m u n o l o g i c a l D i s o r d e r s i n I n f a n t s a n d C h i l d r e n . P h i l a d e l p h i a : W B S a u n d e r s , 1 9 8 9 : 2 8 0 - 5 6 9 E p s t e i n W L , R e e d W , B o d e r E e t a l . D e r m a t o l o g i c a s p e c t s o f a t a x i a t e l a n g i e c t a s i a . C u t i s 1 9 6 8 ; 4 : 1 3 2 4 - 3 2 7 0 P e t e r s o n R D A , F u n k h o u s e r J D . A t a x i a t e l a n g i e c t a s i a : a n i m p o r t a n t c l u e . N e w E n g l J M e d 1 9 9 0 ; 3 2 2 : 1 2 4 - 5 7 1 N y h a n W L . I n b o r n e r r o r s o f b i o t i n m e t a b o l i s m . A r c h D e r m a t o l 1 9 8 7 ; 1 2 3 : 1 6 9 6 - 8 7 2 T h o e n e J , B a k e r H , Y o s h i n o M e t a l . B i o t i n - r e s p o n s i v e c a r b o x y l a s e d e f i c i e n c y a s s o c i a t e d w i t h s u b n o r m a l p l a s m a a n d u r i n a r y b i o t i n . N e w E n g l J M e d 1 9 8 1 ; 3 0 4 : 8 1 7 - 2 3 7 3 B o n i l l a M A , G i l l i o A P , R u g g e i r o M e t a l . E f f e c t s o f r e c o m b i n a n t h u m a n g r a n u l o c y t e c o l o n y - s t i m u l a t i n g f a c t o r o n n e u t r o p e n i a i n p a t i e n t s w i t h c o n g e n i t a l a g r a n u l o c y t o s i s . N e w E n g l J M e d 1 9 8 9 ; 3 2 0 : 1 5 7 4 - 8 0 7 4 K o s t m a n n R . I n f a n t i l e g e n e t i c a g r a n u l o c y t o s i s ; a r e v i e w w i t h p r e s e n t a t i o n o f t e n n e w c a s e s . A c t a P a e d i a t r S c a n d 1 9 7 5 ; 6 4 : 3 6 2 - 8 7 5
( 3 / 6 0 )
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