摘要:

SUMMARYIn senescence, marked changes occur on the surface of the skin and in the stratum corneum. One of the most important features is the reduced quantity of hydrolipid emulsion on the skin surface. This has to be taken into account when developing skin care for the elderly. In photoaged skin especially, tretinoin ameliorates the morphological, biochemical and functional state of the skin surface and of the stratum corneum.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb16123.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYOver the past 10 years, oral cyclosporin A (CyA) has been used to treat a range of inflammatory and immunologically mediated dermatological conditions, but only psoriasis has been shown to be responsive in double‐blind, controlled trials. Thirteen patients with severe atopic dermatitis were treated for up to 31 months. Ten patients had a good response, one patient a moderate response and two a slight response. In two of these patients, CyA was withdrawn after more than 2 years of continuous treatment because of increasing plasma creatinine levels. Cyclosporin A appears to be useful in the treatment of severe, therapy‐resistant atopic dermatitis, but careful monitoring of side‐effects and dose adjustments are req

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb02881.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYNo difference was found between groups of senescent subjects and younger adults in the control of skin temperature, heat radiation and transcutaneous oxygen pressure. Although capillary numbers decline in elderly skin, transcutaneous oxygen pressure at 43°C in elderly skin is no lower than in young subjects. Topical tretinoin (0.05%) increases heat radiation from the skin, but there is no correlation with an improvement in superficial wrinkles. No conclusion is possible regarding the effects of topical tretinoin on transcutaneous oxygen diffusion due to a wide variability in results; sometimes it is increased and sometimes it is decreased. In different regions of the skin, such as the face and thigh, increased skin radiation and skin contact temperature are not associated with increased transcutaneous oxygen diffusion

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb16124.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYThis is a review of the side‐effects of cyclosporin A (CyA) in patients with severe psoriasis; renal dysfunction and hypertension are discussed elsewhere. In particular, paraesthesia, hypertrichosis, gingival hyperplasia and gastrointestinal disorders may occur, but are generally transient, mild‐to‐moderate in severity and only rarely require discontinuation of CyA. Infections are not a problem. As expected with an immunosuppressive drug, there is the possible risk of tumour development, particularly squamous cell carcinomas. However, these skin malignancies developed almost exclusively in patients previously treated with PUVA and/or methotrexate. The few lymphoproliferative disorders regressed spontaneously on discontinuation of the drug. Whether the isolated cases of solid tumours were CyA‐related is not known. Apart from a raised serum creatinine, an important indicator of renal dysfunction, the laboratory abnormalities included hypomagnesaemia, hyperkalaemia, increased uric acid, changes in liver function tests, and fluctuations in the serum cholesterol and triglyceride levels. Although most of these changes were not clinically relevant, laboratory monitoring of patients with psoriasis treated with CyA is es

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb02882.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYSolar keratoses are premalignant epidermal lesions that rarely transform to squamous cell carcinoma and occur even in temperate European climates much more frequently than has been previously supposed. Some lesions of solar keratosis may spontaneously regress due to immune rejection, but immunological influences do not appear to be responsible for keeping them from progressing to frank malignancy. Their frequency, accessibility and various morphological forms provide the basis of excellent models for carcinogenesis.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb16125.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYWe report our experience of the initial effects of a publicity campaign directed at early presentation of malignant melanoma in Leicestershire. The campaign resulted in a dramatic increase in workload and, at the pigmented lesion clinic, the numbers of new patients rose from 12.3 to 54.5 per clinic. There was a large rise in the number of new melanomas presenting in Leicestershire: from 1.02 per week before the campaign to 1.88 per week in the immediate postpublicity period. This was statistically significant (P<0.001), Although there was also an apparently encouraging rise in the percentage of thinner ‘good prognosis’ tumours, it was not possible to isolate this statistically from a pre‐existing

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb08239.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYThere is a wealth of new knowledge regarding mechanisms of carcinogenesis and their interaction with senescence and environmental insults, particularly on the effects of UV irradiation on the skin. Innovations and advances in tissue culture techniques now permit in vitro studies of keratinocytes and other benign and malignant skin‐derived cells. The ageing processes and cutaneous neoplasia, therefore, can now be studied at the cellular level. New insights regarding the interrelationship of ageing, environment and cutaneous neoplasia are close at hand. Depletion in the number of Langerhans cells and suppression of their function in ageing and UV‐exposed skin may allow tumour cells to overcome the host's defence system. The potential increase in UV irradiation due to depletion of the ozone layer may increase the incidence of skin tumours. Carcinogenesis involves three distinct steps: initiation, promotion, and malignant conversion. The mechanism has been studied in mice, where it is suggested the c‐ras oncogene may play an important

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb16126.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYSerum creatinine and blood pressure were measured in patients who had severe psoriasis and who were treated with cyclosporin A (CyA) in initial doses of 1.25mg (n = 34), 2.5 or 3 mg (n = 314), or 5 (n = 215) mg/kg/day. Of the 563 patients involved, 201 were treated for more than 3 months, and 100 received CyA continuously for 12 months or more. Sixty‐eight additional patients were included as controls and received placebo (n = 42) or etretinate (n = 26). At doses of 2.5 and 5 mg/kg/day, CyA induced slight but significant dose‐dependent increases in serum creatinine and blood pressure. Creatinine increases of 5o% or or more over baseline values were detected in 4% of the patients receiving 2.5 mg/kg/day and in 13% of those receiving 5 mg/kg/day. After an initial rise during the first weeks of treatment, mean creatinine level remained stable over 1 year provided that the CyA dose was reduced whenever creatinine levels increased by 30% or more over baseline. The incidence of hypertension was 10.6% and did not vary whether the CyA dose was 2–5 or 5 mg/kg/day. The first elevated blood pressures were recorded early after starting CyA therapy (median: i month). However, 3 months after stopping treatment, the increases in creatinine as well as in blood pressure were reversible and the levels did not significantly differ from baseline v

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb02883.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYAs average life expectancy is increasing, the ageing of skin presents a growing problem for dermatologists. When considering ageing it is important to distinguish between the effects of true biological ageing and environmental factors, such as exposure to sun. Epidermal changes associated with ageing involve the flattening of its underside, a reduction in the number of Langerhans cells and of melanocytes, and a decline in the number of melanosomes synthesized, leading to reduced pigmentation. Dermal changes involve a reduction in the collagenous and elastic fibres, fibroblasts, mast cells and macrophages, and dilation of the lymphatic channels. The number of hair follicles declines with age, but their structure remains unchanged. Ageing does not affect the sebaceous glands, but some changes occur in the exocrine sweat glands.

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb16127.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

SUMMARYCyclosporin A (CyA) has multiple effects on the kidney. The drug can cause changes in either the tubular or vascular system which may be either functional or structural, reversible or irreversible and frequent or seldom. Functional changes to the tubules and vessels are common, occur at low doses and are reversible, while structural changes to the tubules and vessels are rare, occur at high doses and are not always reversible. The changes of importance are vascular. By harnessing two strategies to restrain the development of side‐effects‐limiting the dose and restricting the functional changes‐it is possible to avoid irreversible damage to the kidney in patients treated wit

ISSN:0007-0963    

DOI:10.1111/j.1365-2133.1990.tb02884.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY