Use of thalidomide in dermatological indications.

The resurgence of interest in thalidomide in the last decade has been remarkable. Thalidomide has established its own niche market particularly for the dermatological manifestations associated with HIV, Behçet's disease, graft-versus-host disease and systemic lupus erythematosus. To a large extent this has resulted from initial empirical uncontrolled studies in conditions resistant to other drug therapies. Appropriate trials are now being published for most of the prevalent indications. Thalidomide produces partial inhibition of tumour necrosis factor-alpha production in vivo but recent data reveals that it can also act as a co-stimulatory molecule for T cell activation in vitro, resulting in increased production of interleukin-2 and interferon-gamma. Hence in addition to monocyte inhibitory activity, thalidomide can exert a co-stimulatory or adjuvant-like effect on T cell responses. The unraveling of the molecular basis of thalidomide's therapeutic effects would suggest that an expansion of the use of thalidomide and its analogues in other conditions is highly likely. It remains imperative, however, that physicians using this fascinating drug are familiar with its risks and adverse effects.

Dentistry in Greece--focus in the problems-prospect.

In this article the level of preventive dentistry performed by dentists in Greece is being discussed. Several items like the composition of the dental curricula, the intake of students and the structure of the health system in Greece are discussed. Furthermore some suggestions for future policy are given.

Behçet's disease.

Behçet's disease is a systemic vasculitis of unknown aetiology characteristically affecting venules. Onset is typically in young adults with recurrent oral and genital ulceration, uveitis, skin manifestations, arthritis, neurological involvement, and a tendency to thrombosis. It has a worldwide distribution but is prevalent in Japan, the Middle East, and some Mediterranean countries. International diagnostic criteria have been proposed, however diagnosis can be problematical, particularly if the typical ulcers are not obvious at presentation. Treatment is challenging, must be tailored to the pattern of organ involvement for each patient and often requires combination therapies.

Papulonecrotic tuberculide and stenosis of the abdominal aorta.

Papulonecrotic tuberculide (PNT) is a rare form of skin tuberculosis affecting predominantly young adults, with a history of immunity to Mycobacterium tuberculosis. We report a case of a young Caucasian female with PNT who was also documented to have a stenotic segment in the abdominal aorta. The difficulty in clarifying and treating the primary disease and the association between a tuberculous infection and Takayasu's arteritis are discussed.

Retroviral activity in Behçet's syndrome and systemic lupus erythematosus detected by a PCR-based reverse transcriptase assay.

The objective of this study was to assess retroviral activity in Behçet's syndrome (BS) and systemic lupus erythematosus (SLE) patients. Serum and peripheral blood mononuclear cells (PBMC) were obtained from patients and normal volunteers and PBMC cultured with and without phytohaemagglutinin stimulation. Reverse transcriptase (RT) activity in serum and culture supernatants was measured using a sensitive polymerase chain reaction-based assay. An RT activity above the levels in normal controls was detected in a minority of patients with BS (2/15) and SLE (1/13) and was typically present in all three types of sample. Elevated levels of RT activity were not detected in follow-up samples from the two BS patients. Our findings indicate that elevated RT activity is present in only a minority of patients with BS and SLE. Simultaneously elevated activity in all three sample types implicates PBMC as the source of this retroviral activity.