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ID PMID Title PublicationDate abstract
7048503 [Anti-DNA determination using Crithidia luciliae. Specificity and clinical usefulness in s 1982 Apr The authors determined the existence of native anti-DNA antibodies by the crithidia lucilae (anti-DNA-CL) test in 44 patients suffering from systemic lupus erythematosus (SLE), 48 with rheumatoid arthritis (RA), 12 with scleroderma, 8 with polymyositis and/or dermatomyositis, 12 with mixed connective tissue disease, 53 with chronic liver disease and 100 blood donors in order to establish the specificity of the test in SLE, its possible correlation with the degree of clinical activity and the presence or absence of neuropathy, and its possible use in the therapeutic control of the disease. The presence of anti DNA-CL was specific to SLE. It was seen at significant titres only in patients with active disease. Anti DNA-CL antibodies capable of activating complement were seen more frequently and at higher titres in cases with active nephritis. In longitudinal studies it was seen that clinical activity or inactivity were associated with parallel oscillations in anti DNA-CL titres. These data confirmed the specificity of the method and its usefulness in the diagnosis and therapeutic control of the process.
6983716 Health care for rheumatic disorders in a Swedish county. 1982 Utilization of rheumatological care by individual patients was studied in a Swedish county at all levels of the health care system. Calculated per population at risk, 0.6--0.8% per year were seen for rheumatoid arthritis. Of these, 35--81% were patients at the rheumatology department, varying according to distance of residence from the university hospital. The number of patients with other inflammatory diseases was, however, larger in primary care than in the specialist department. Only a minor part of the total care for rheumatic disorders (Chapt. XIII of ICD) in the county was provided by the rheumatology department. Back disorders constituted the largest diagnostic group of rheumatic disorders in primary care. During a period of one year a total of 12--14% of the population had contact with primary care, of the district hospital and/or the rheumatology department, because of rheumatic disorders. The results show the value of epidemiological studies to follow the development of and to define the future objectives of rheumatological care.
7457941 A light and electron microscopic study of the region of cartilage resorption in the embryo 1980 Nov It has long been known that uncalcified cartilage of embryonic chick long bones is removed to make way for invading marrow. However, no one has clearly established which cells are responsible for this erosion. Using the light and electron microscopes, we have studied the cartilage-marrow interface, which we presume to be the region of resorption. Here, we found two types of mononuclear cells in intimate contact with cartilage matrix. 1. The predominate cell type had a euchromatic nucleus with a nucleolus and a cytoplasm containing extensive profiles of rough endoplasmic reticulum; also, processes extended from these cells into the adjoining cartilage matrix. 2. Macrophages containing many lysosomal vesicles, which often became swollen, were found on or near the surface of cartilage. In addition, a few cells with an intermediate appearance were present. A decrease in the amount of sulfated material in a 25-30 micrometer zone of cartilage in advance of the interface and an alteration in the orientation, and in some cases the integrity, of collagenous fibers were associated with the presence of the above mentioned cells. These alterations in cartilage were not due to the synthesis of sulfated or of collagenous material. The above evidence, although not conclusive, suggests that these mononuclear cells are responsible for cartilage resorption. In this respect, the removal of avian uncalcified cartilage is similar to the resorption of uncalcified articular cartilage which occurs in rheumatoid arthritis.
308215 alpha 1-antitrypsin deficiency in early childhood. 1978 Jul Among 200,000 infants screened for alpha 1-antitrypsin (alpha 1-AT) deficiency, 125 Pi Z, 48 Pi Z, 1Pi S-, and 2 Pi Z- children were followed up prospectively. Eleven percent of the Pi Z infants had neonatal cholestasis, and at 2 years of age three of them had cirrhosis. About 50% of the asymptomatic Pi Z and Pi Z- subjects occasionally had serum alanine aminotransferase (ALAT) levels above normal, and in 15% of them the levels were probably permanently increased during the first two years of life. Two previously healthy Pi Z children had transient symptoms of liver disease at age 2 years in connection with severe infections. The Pi SZ children had no significant clinical liver disease and only two had abnormal serum ALAT levels. Among Pi Z children up to 2 years of age the following diseases were also encountered: eight had recurrent bronchitis with wheezing, two had persistant cough (both had cirrhosis), one had severe pneumonia, one was mentally retarded, three had urinary tract infections, six had pronounced eczema, one had allergic shock, and three had congenital malformations. Among the Pi SZ children one had recurrent bronchitis, one had eczema, and one had juvenile rheumatoid arthritis. Three children, two Pi Z and one Pi SZ, have died. The Pi Z- and Pi S- subjects were healthy. In conclusion a variety of significant symptoms were observed in about 30% of the Pi Z children compared with 6% of the Pi SZ children during the first two years of life.
6699057 The surgical treatment of instability of the upper part of the cervical spine in children 1984 Mar In a retrospective review of the cases of thirteen skeletally immature children and adolescents (four to eighteen years old) with instability of the upper part of the cervical spine (occiput to fifth cervical vertebra), we determined the efficacy of posterior arthrodesis and halo-cast immobilization in the management of this condition. The patients were divided into two groups: those with congenital vertebral anomalies alone (fusion or structural defects, or both) and those with cervical anomalies and systemic disorders (dwarfism, juvenile rheumatoid arthritis, Down syndrome, and cerebral palsy). Two patterns of instability were found: instabilities at intervertebral joints adjacent to vertebral fusions, and instabilities located in vertebral defects. For all patients treatment included a posterior arthrodesis with external immobilization by a halo cast, and in two patients internal fixation with wire was also used. Solid arthrodesis was obtained in the twelve patients who were treated with autogenous grafts (iliac cancellous bone in eleven and rib bone in one), and a non-union developed in a child who was treated with bank-bone rib segments. Posterior cervical arthrodesis with wire fixation carries some risk of neural injury and often is not applicable in children with anomalous vertebrae. Spine fusion using delicate exposure, decortication using an air-drill, and placement of autogenous cancellous iliac grafts with external immobilization by a halo cast minimizes the risk of neural damage and is a reliable way to obtain a solid arthrodesis.
6358364 Development of a micro enzyme-linked immunosorbent assay for antibodies against liver-spec 1983 Nov 11 Guinea pig antisera raised against human and rabbit liver-specific membrane lipoprotein (LSP) have been used to develop a rapid, reproducible and sensitive solid-phase, enzyme-linked immunosorbent assay (ELISA). The ELISA was used in a series of cross-inhibition experiments to define and quantitate the antigenic specificities of these antisera. The results confirm previous findings that LSP contains both liver-specific and liver non-specific antigens. In addition, it is shown that both human and rabbit LSP contain liver-specific antigens that are species-specific, as well as others that are species cross-reactive. Binding to human LSP was detected by the ELISA with 11 of 13 anti-LSP-positive (by radioimmunoassay) sera from patients with HBsAg-negative chronic active hepatitis. Similar binding was also found with 10 of 11 sera from patients with systemic lupus erythematosus and with 7 of 14 with rheumatoid arthritis --all of which were negative for anti-LSP by radioimmunoassay. It is suggested that immune complexes in these sera might bind to IgG-Fc receptors in LSP and that caution should be exercised in the interpretation of data from ELISA-based studies of anti-LSP in human sera.
6183336 Hanganutziu-Deicher antibodies in infectious mononucleosis and other diseases. 1982 Dec An enzyme immunoassay (EIA) was developed for the detection of heterophile, Hanganutziu-Deicher (H-D) antibodies in sera of patients with infectious mononucleosis (IM) and various other diseases. The EIA with a high m.w. glycoprotein (HMWGP) isolated from bovine erythrocyte stromata was shown to detect H-D antibodies directly, in spite of higher titers of Paul-Bunnell (P-B) antibodies in the IM sera. Absorption and inhibition studies of IM sera demonstrated H-D specificity of the antibodies combining with HMWGP in the EIA. The H-D antibodies were found in sera of 56% Caucasians and 27% of Japanese suffering from IM. The vast majority of the H-D antibodies in IM sera was of IgM class. Sera of patients with various other diseases also gave positive results: rheumatoid arthritis, 22%; syphilis, 19%; cancer of the gastrointestinal tract, 13%; and lepromatous leprosy 9.7%. The incidence of positive results in control sera from apparently healthy subjects was less than 4%. Results of this study confirmed our previous observation that whereas P-B antigens appear in immunogenic form in only IM, the H-D antigen is expressed as an immunogen in various diseases including IM.
435402 N-alkaline phosphatase: a potential disease marker for lymphoproliferative disorders. 1979 Apr A characteristic alkaline phosphatase (orthophosphoric monoester hydrolase, alkaline pH optimum, EC 3.1.3.1) was detected in the sera of most patients with infectious mononucleosis, acute and chronic lymphatic leukaemia, non-Hodgkin's lymphoma, Burkitt's lymphoma and nasopharyngeal carcinoma. The enzyme was also present in the sera of nine out of 26 patients with cancer of the cervix. N-APase in these cases counted 30-100% of the total alkaline phosphatase activity. N-APase was absent from the sera of healthy individuals and of patients with acute and chronic granulocytic leukaemia, breast cancer, colon cancer, rheumatoid arthritis, ulcerative colitis, systemic lupus erythematosis, hepatitis and obstructive jaundice. Only three of 22 patients with Hodgkin's disease showed n-apase activity in the serum. In infectious mononucleosis the presence of N-APase activity was well correlated with the clinical course. In 13 cases studied, the clinical improvement was associated with the decrease or disappearance of N-APase activity. N-APase activity could not be detected in white cells of acute myeloid leukaemic patients, nor in the cells of myeloid blastic crisis of chronic granulocytic leukaemia. It was present in the cells of lymphoid blastic crisis of chronic granulocytic leukaemia.
68546 Evaluation of 125I-DNA for detecting anti-DNA antibodies in the diagnosis of systemic lupu 1977 Apr 23 A 125I-DNA preparation for the detection of human anti-DNA antibodies (ADA) was evaluated as a diagnostic test for systemic lupus erythematosus (SLE). A normal range of 0-25 U/ml was established. Serum ADA level greater than 110 U/ml were diagnostic in clinically active SLE and levels greater than 45 U/ml were found in 75% of patients with inactive disease. This value was significantly greater than that found in rheumatoid arthritis, renal disease caused by non-immune mechanisms, post-streptococcal glomerulonephritis and a miscellaneous group of disorders comprising connective tissue diseases, auto-immune disorders and chronic active hepatitis. Anti-nuclear factor (ANF) titres greater than 1/160 and LE cells were found in 85% of these patients. In inactive disease the ADA levels ranged between 25 and 98 U/ml, ANF titres varied from 1/40 to 1/640, and LE cells were detected in only 20% of the cases. In 3 patients investigated during the course of the disease, the ADA levels correlated best with clinical improvement. Two patients with apparent active lupus nephritis showed intermediate ADA levels, which were probably caused by antigen-antibody formation and immune complex deposition in the kidneys.
973643 Steroid myopathy in connective tissue disease. 1976 Oct In eight women with polymyositis (three patients), systemic lupus erythematosus (SLE) (three patients), rheumatoid arthritis (one patient) and shoulder-hand syndrome (one patient), weakness developed during high dose prednisone therapy. These women were studied using serial functional and manual muscle tests, determination of serum glutamic oxaloacetic transminase (SGOT), creatine phosphokinase (CPK) and serum aldolase levels, and urinary excretion of creatine. Insidious onset of weakness was characteristic. Myalgias were seen in five patients and unusual sudden weakness in two. Weakness was always most severe in the pelvic girdle muscles; there was a lesser involvement of shoulder girdle and distal muscles. Serum muscle enzyme levels were normal in all cases, but urinary creatine excretion was invariably increased and proved to be the most sensitive laboratory indicator for clinical diagnosis and for monitoring patient improvement. Serial urinary creatine excretion and serum enzyme studies were of value in differenting steroid myopathy from a flare of myositis in patients with connective tissue disease. Diagnosis and effective management were achieved by the use of readily available laboratory and clinical procedures without resorting to muscle biopsy.
136418 [Considerations regarding the influence of intrauterine and early postnatal diseases and n 1976 Oct Malnutrition, infectious and toxic stress, hormonal and enzymatic deficiencies as well as graft versus host reactions during the last trimester of pregnancy and during the first six months of life lead to persistent depressions of cell mediated immunity. The subsequent imbalance between the cell mediated and humoral system of immunity leads to differences in disease prevalence in poor and rich populations. Particularly leprosy, tuberculosis, viral disease as for instance frequently fatal measles and diseases due to complexes between humoral antibody and bacterial components as for example acute rheumatic fever occur with increased frequency in B (+) T (-) populations. Desturbances of immune surveillance due to suppression of specific cell mediated immune function leads to an increased frequency of neoplasia, particularly B-cell lymphoma and gastrointestinal tumors. Populations in which the T-cell system can mature without interference show a trend towards diseases in which excessive T-cell response plays a major role, as for instance rheumatoid arthritis, Sjögren syndrome, terminal ileitis, autoimmune angiopathies, multiple sclerosis and possibly also disseminated lupus erythematodes.
2931519 Modulation of macrophage-lymphocyte interactions by the antiarthritic gold compound, auran 1985 Jun Auranofin (AF), a new oral gold agent effective for treating rheumatoid arthritis (RA) was evaluated for its ability to alter macrophage and lymphocyte functions of immune mediated chronic inflammation. AF (2 microM) inhibited antigen presentation by splenic macrophages to sensitized (DNFB) lymph node cells in vitro and also inhibited production of IL-2 and IL-1 by lymphocytes and macrophages, respectively. When AF suppressed Con-A induced mitogenesis in vitro, there were no inhibitory effects on Con-A induced suppressor T cell functions. AF administered orally to normal mice did not affect antigen presentation. DNFB contact sensitivity or Con-A induced mitogenesis. High concentrations of topical AF inhibited local immune responses to contact sensitizing agents and enhanced the induction of antigen specific suppressor T cells. Optimally, in vitro or in vivo AF inhibited macrophage and helper T cell functions with impairing the induction of suppressor T cells. After chronic treatment, similar effects could contribute to the efficacy of AF in humans with RA.
6505967 Hyperparathyroidism and hypergastrinemia revisited. 1984 Dec The prevalence of hypergastrinemia was determined in 38 consecutive patients with proved primary hyperparathyroidism. Uncorrected serum calcium levels ranged from 2.6 to 4.0 mmol/L and parathyroid hormone levels from 260 to 8750 ng/L (normal less than 600 ng/L). Preoperative serum gastrin levels were grossly elevated (1000 to 4000 ng/L) in three patients (normal median 63 ng/L; range 30 to 120 ng/L). Two patients were achlorhydric. After parathyroidectomy (adenomatous hyperplasia) in the third patient, the serum gastrin level decreased from 4000 to 3000 ng/L, with a negative response to both a secretin challenge and a meal test. The latter patient was subsequently shown to have an adrenal ganglioneuroma and islet cell hyperplasia, neither containing gastrin, and at 4-year follow-up she still has no symptoms from the hypergastrinemia. Eight patients had a modest hypergastrinemia. Serum gastrin levels returned to normal in three of the four patients after parathyroidectomy. The fourth patient had rheumatoid arthritis, which can be associated with hypergastrinemia. The mean plasma gastrin level before operation (100.3 +/- 26.1 ng/L) was similar to the postoperative value (67.0 +/- 18.5 ng/L). There was no correlation between parathyroid hormone and gastrin levels nor between serum calcium and gastrin levels. The three patients with duodenal ulcers did not have elevated gastrin levels. Therefore it would appear that routine screening of patients with primary hyperparathyroidism adds little to their clinical management.
6416064 Prostaglandins and the mechanism of action of anti-inflammatory drugs. 1983 Oct 31 Aspirin and a large number of nonsteroidal anti-inflammatory drugs act primarily through the inhibition of prostaglandin synthesis by inhibiting the enzyme cyclooxygenase. Other groups of biologically active polyunsaturated fatty acid derivatives including the leukotrienes, are generally not inhibited by this class of drugs in the same concentration ranges. Inhibition of the vasodilator prostaglandins, prostaglandin E2 and prostacyclin, as well as the leukotrienes, may reduce their inflammatory effects in several disease states. In addition, prostaglandin synthesis is also inhibited by glucocorticoids even though their mode of action may involve other effects as well. Prostaglandin E2 stimulates the osteoclastic reabsorption of juxtaarticular bone; its inhibition by nonsteroidal anti-inflammatory agents may, therefore, retard the process of bone erosion in rheumatoid arthritis and in other inflammatory processes. Inhibition of prostaglandin synthesis by these drugs accounts for many of their major toxic effects, including gastritis, which is the most common side effect; precipitation or aggravation of renal failure; fluid retention; hyperkalemia; antiplatelet effects with hemorrhagic phenomena; and aggravation of asthma and rhinosinusitis. Inhibition of prostaglandin synthesis can, therefore, account for most of the therapeutic as well as toxic effects of the nonsteroidal anti-inflammatory agents. Inhibition of pathways of synthesis of other important mediators, such as leukotrienes, are currently under investigation and may provide another approach for the development of new therapeutic agents.
6307054 Premature ovarian failure: a search for circulating factors against gonadotropin receptors 1983 Aug 1 Nine patients with premature ovarian failure, one of whom had the associated autoimmune disorders rheumatoid arthritis, Hashimoto's thyroiditis, and vitiligo, were examined for the presence of a serum factor which would interfere with gonadotropin-receptor interaction in a bovine testicular membrane system. Sera from nine premenopausal and nine postmenopausal women served as control subjects. Mean displacement of radiolabeled follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from receptors was not significantly different among the three groups. However, the greatest interference with FSH-receptor interaction was detected in the patient with both premature ovarian failure and autoimmune diseases. No differences in mean serum levels of IgG, IgM, and IgA were found among the premature ovarian failure and the two control groups, nor were immunoglobulin levels different in the otherwise unique subject (premature ovarian failure and autoimmunity). Our study suggests that anti-gonadotropin receptor factors are unlikely to be involved in the majority of patients with premature ovarian failure. However, an anti-FSH receptor factor, possibly an antibody, may be present in some patients, particularly those who have concomitant autoimmune disorders.
7172508 Radiometric ligand binding assay for C-reactive protein. Complexed C-reactive protein is n 1982 Oct A radiometric ligand binding assay for human C-reactive protein (CRP) was established using pneumococcal C polysaccharide (CPS) coupled to magnetizable cellulose particles as the solid phase ligand. Competition for binding to the solid phase between 125I-CRP and unlabelled CRP permitted detection of 30 micrograms/l of CRP and the precise assay of concentrations up to 3000 micrograms/l. Identical results were obtained when the assay was used to quantitate isolated pure CRP and pure CRP added to normal human serum. However in vitro addition of known ligands for CRP to acute phase serum resulted in lowering of the apparent CRP concentration in this assay and addition of as little as 1 microgram/l of free CPS or 1 mg/l of lecithin was demonstrable in this way. A combination of the ligand binding assay and the standard electroimmunoassay for CRP was therefore used to test acute phase sera for the presence of CRP complexed in vitro. No evidence of complexed CRP was detected among sera containing between 1-319 mg/l of CRP from patients with Hodgkin's disease (10), rheumatoid arthritis (10), Crohn's disease (19) and various microbial infections (11), including six with subacute bacterial endocarditis. Since it is likely that CRP does form complexes with its ligands in the plasma these results suggest that complexed CRP is rapidly cleared from the circulation.
7204444 Hemodynamics of the femoral head. 1981 Mar We have determined the pressure-flow relationships of the canine femoral head during venous tamponade of the hip capsule. Intra-osseous pressures were determined before and after infusion of the joint with saline solution to a pressure of sixty-five centimeters of water. Femoral head blood flow was simultaneously determined by the indicator-dilution technique utilizing isotopically labeled microspheres. In puppies, pressure in the femoral head rose 248 per cent while flow dropped by 60 per cent after inflation of the capsule. In adults, no statistically significant change in either pressure or flow was seen. Thus, in the immature animal, venous tamponade results in increased pressure and decreased blood flow. In the mature animal, venous tamponade does not alter intra-osseous pressures or blood-flow rates due to the intact intramedullary venous drainage of the adult femoral head. CLINICAL RELEVANCE: In the immature individual, venous tamponade may well be involved in the development of Legg-Perthes disease. A bout of nonspecific synovitis may elevate intracapsular pressure sufficiently to obstruct venous outflow. This creates an increase in intra-osseous pressure and a decrease in femoral head blood flow. Hemodynamic changes of this magnitude have not been shown to induce Legg-Perthes disease; however, a strong suspicion exists that such alterations may be linked to the disease. In the adult, venous tamponade probably is not involved in the pathogenesis of avascular necrosis. The maintenance of intramedullary venous drainage of the epiphysis into the metaphysis may account for the fact that vascular necrosis of the femoral head rarely develops in adult patients with osteoarthritis or rheumatoid arthritis plus an inflammatory synovitis of the hip.
659966 Human plasma prekallikrein (Fletcher factor) clotting activity and antigen in health and d 1978 Jul Human plasma prekallikrein (Fletcher factor) clotting activity and antigen levels have been examined in various clinical conditions. Prekallikrein antigen was measured by a newly developed, specific, and sensitive radioimmunoassay. The assay had no demonstrable cross-reactivity with human urinary kallikrein nor, in the species tested, animal plasma prekallikrein. This assay was able to measure plasma kallikrein after its biological functions had been inactivated by plasma inhibitors. Normal human pooled plasma contained approximately 50 microgram/ml prekallikrein. Quantitative measurement of plasma prekallikrein was possible for concentrations as low as 0.3% of that of normal pooled plasma. A good correlation (correlation coefficient = 0.71) existed between titers of plasma prekallikrein measured by Fletcher factor clotting assays and radioimmunoassays among 40 normal subjects. Both prekallikrein clotting activity and antigen were significantly reduced in plasmas of patients with advanced hepatic cirrhosis or DIC. Prekallikrein activity and antigen were mildly decreased in plasmas or serums of patients with chronic renal failure and nephrotic syndrome but were normal in those of patients under treatment with warfarin or suffering from SLE, rheumatoid arthritis, sarcoidosis, or HANE. Human cord serum contained a lower titer of prekallikrein antigen than adult serum. Strenuous physical exercise did not significantly change plasma prekallikrein levels.
1268776 Clinical and laboratory findings in primary generalized and multiple-myeloma-related amylo 1976 May 22 Thirty-four patients with primary generalized amyloidosis (PGA) and 14 with multiple-myeloma-related amyloidosis (MRA) were studied. The commonest clinical manifestations in PGA were nephrotic syndrome, hepatomegaly and congestive heart failure, and in MRA, low back pain, plasmacytoma and rheumatoid-arthritis-like syndrome. Eight patients with PGA had limited clinical expression of the disease, such as involvement of only kidneys, joints, parotid glands or gastrointestinal tract; in one patient amyloidosis was limited to lymph nodes. Low serum concentrations of total protein and albumin were common. M components were detected in the serum of 91% of patients with PGA and 92% of patients with MRA: 70% of the M components in PGA and 25% of those in MRA had lambda light chains. Bence Jones proteinemia was detected in 56% of the patients with PGA and in 77% of those with MRA. The serum concentration of immunoglobulins was decreased substantially in more than two thirds of the patients with PGA. Proteinuria (greater than 250 mg/24 h) was observed in 78% of patients with PGA and in 93% of patients with MRA. Bence Jones proteinuria was noted in 75 and 77% of patients, respectively. Plasmacytic infiltration of the bone marrow was found in 90% of the patients with PGA. The mean survival time of the patients with PGA was 28 months and of those with MRA, 29 months from the time of diagnosis.
1200715 D-penicillamine in dermatology: influence on enzymatic activities of human skin in vitro. 1975 Nov 14 By in vitro assay, 6 important enzymatic activities of human skin homogenates were determined following an incubation with D-penicillamine in concentrations between 10(-4) and 10 mg/ml, i.e. 67 X 10(-5) and 67 mM/l. The following enzymatic activities were recorded: lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G-6-PDH), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), alkaline phosphatase (AP), acid phosphatase (AcP), and "leucine aminopeptidase" (LAP). A dose-dependent activation by D-penicillamine occurred in the case of G-6-PDH- and AcP-activities, a dose-dependent inhibition by D-penicillamine was found with AP- and GAPDH-activities. LDH- and LAP-activities remained unchanged in the presence of D-penicillamine in concentrations up to 10 mg/ml (67 mM/l). From the data of pharmacokinetic studies in rats it may be concluded that concentrations of D-penicillamine which influence enzymatic activities may easily be reached in vivo, under the conditions of treating rheumatoid arthritis and Morbus Wilson. The biochemical actions of D-penicillamine are briefly discussed with secial regard to dermatological therapy and dermatological unwanted side-effects.