ISSN:0954-6634    

DOI:10.3109/09546639509086844

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

From 1991 to 1992, 28 patients with chronic plaque psoriasis were treated with a new UVB treatment regimen guided by skin reflectance measurements. The severity of the disease, the efficacy of the treatment, the number of side-effects and the cumulative UVB dose were recorded. These data were compared in an open study with the data obtained from 18 patients with chronic plaque psoriasis, who were treated from 1988 to 1991 at our department with a UVB treatment regimen with regular dose increments. There was no difference in the severity of the disease at the beginning of the therapy or in the healing score between the two groups. The cumulative UV exposure was lower with the new treatment regimen (30 basic minimal erythema doses) compared with the old regimen (89 basic minimal erythema doses). The skin reflectance-guided UVB therapy achieved a response earlier (5 weeks) than the regimen with stepwise dose increments (9 weeks). This study indicates that skin reflectance-guided UVB phototherapy may enable the dermatologist to lower the cumulative UVB exposure dose without reducing the effect of UVB phototherapy in the treatment of psoriasis. The results of this open retrospective study emphasize the need to conduct a prospective double-blind controlled study in the future.

ISSN:0954-6634    

DOI:10.3109/09546639509086845

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The present study attempted to determine the effect of dietary supplementation with evening primrose seed oil (EPO) enriched withγ-linolenic acid (GLA, 18:3n-6) on the synthesis of proinflammatory 5-lipoxygenase (5-LOX) metabolites of arachidonic acid (AA, 20:4n-6) by human peripheral neutrophils in adults with atopic dermatitis (AD). After incubation of neutrophils with calcium ionophore A-23187 (10μM) the 5-LOX products were separated and quantified by reversed-phase high-performance liquid chromatography (RP-HPLC). The results demonstrated that neutrophils of AD patients without therapy generated significantly less LTB4(P<0.05) and 5-HETE (P0.01) and 5-HETE (P<0.05) was revealed in AD patients after 12 weeks of daily ingestion of 6 g EPO, equivalent to 0.48 g GLA per day, compared with untreated patients (LTB4609±173 pmol/107cells vs 390±84 pmol/107cells and 5-HETE 1463±418 pmol/107cells vs 946±129 pmol/107cells). In contrast the level of AA in the phospholipids of neutrophils was unaltered, whereas the level of dihomo-γ-linolenic acid (DGLA, 20:3n-6), an elongation product of GLA, was significantly elevated (P<0.01). The synthesis of 15-hydroxyeicosatrienoic acid (15-HETrE), an anti-inflammatory metabolite of DGLA, was not observed. The AA/DGLA ratio in the phospholipids of neutrophils decreased within 12 weeks of EPO treatment and was negatively correlated with the molar sum of 5-LOX metabolites in the indicated time interval (r= -0.88,n= 6). It is therefore reasonable to speculate that the availability of AA in membrane phospholipids of neutrophils is impaired in AD patients. Our results indicate that treatment with EPO probably improves the release of AA and consequently increases the generation of 5-LOX products to normal levels in neutrophils of patients with AD. The pathophysiological significance of these results remains to be clarified.

ISSN:0954-6634    

DOI:10.3109/09546639509086846

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

The effectiveness and safety of diflorasone diacetate 0.05% in an optimized cream vehicle (Psorcon Cream) and fluocinonide 0.05% cream (Lidex Cream) in the management of moderate-to-severe psoriasis was compared in a double-blind multicenter 2-week study enrolling 100 patients. A randomized bilateral-paired comparison study design was used. The efficacy results showed that the mean total scores (erythema, scaling, and induration) were significantly lower for diflorasone diacetate-treated sites than for the comparable fluocinonide-treated sites at days 7 and 14 (P<0.001). The comparative evaluations made by the investigators were also more favorable for diflorasone diacetate-treated sites than for fluocinonide-treated sites at day 14 (P<0.001), and the global evaluations of effectiveness done by the investigators favored the diflorasone diacetate-treated sites (P<0.001). More patients rated the improvement in their diflorasone diacetate-treated sites superior to that in their fluocinonide-treated sites (59% vs 20%) at day 14 (P<0.001). Patients also found diflorasone diacetate treatment to be more cosmetically acceptable than fluocinonide treatment (70% vs 44% rated treatment as good to excellent). No adverse experiences were reported following diflorasone diacetate treatment. These findings demonstrate that this cream formulation of diflorasone diacetate is an effective, well-tolerated, and cosmetically acceptable treatment for the management of moderate-to-severe psoriasis.

ISSN:0954-6634    

DOI:10.3109/09546639509086847

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

OBJECTIVE To determine the safety, efficacy, and acceptability of self-administered podofilox for treatment of genital warts when used in everyday circumstances.DESIGN Prospective cohort study.SETTING National convenience sample of 1361 patients enrolled through 453 physicians who frequently treat genital warts.PATIENTS Serial enrollment of patients being treated for the first time or who had completed another treatment with unsatisfactory results. After initial examination, patients used podofilox for up to four cycles (each consisting of 3 days of treatment, 4 days without). At the end of each week, patients completed a diary detailing response and symptoms. After 4 weeks, patients returned to the physician for reevaluation. Brief follow-up questionnaires were also obtained 8 and 12 weeks after initiating therapy.RESULTS At 4 weeks, the end of the main evaluation period, 53% of patients reported complete clearing, and another 28% clearing of at least half their warts. The most common side-effects were pain and burning, and redness and swelling. Side-effects were most frequent and most severe during the first week of use. Overall assessment by physicians and patients was favorable, with 65% and 70%, respectively, considering podofilox to be better than other treatments. Patient comments indicated that an advantage of podofilox treatment was that repeated physician visits were unnecessary.CONCLUSIONS In typical conditions of use among large numbers of subjects, podofilox is effective and well tolerated. The strongest virtue of self-treatment with podofilox may be that it offers a less costly and more flexible method of treatment, a benefit of particular interest for managed care settings.

ISSN:0954-6634    

DOI:10.3109/09546639509086848

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This study evaluated the short- and long-term effects of the modified Ingram regimen in widespread plaque psoriasis. A group of 22 patients were evaluated at regular intervals for 210 days using the psoriasis area and severity index (PASI) score and a psoriatic histological value (PHV). Of the 22 patients, 4 were lost to follow-up after day 70, 4 were withdrawn due to therapy failure, and 14 completed the final evaluation at day 210. This trial confirmed the effectiveness of the Ingram regimen in inducing remission in patients with widespread plaque psoriasis. A post-treatment steady-state was identified clinically and histologically.

ISSN:0954-6634    

DOI:10.3109/09546639509086849

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This investigation was carried out to compare the therapeutic efficacy and cosmetic acceptability of prednicarbate 0.25% ointment in the treatment of atopic dermatitis, and to monitor any local side-effects. A group of 51 patients suffering from atopic dermatitis were randomized to twice daily treatment with prednicarbate 0.25% ointment (n= 24) or vehicle control (n= 27) in a parallel group design with a 4-week treatment period. Prior to treatment, the groups were comparable in all clinically relevant aspects. Prednicarbate was shown to be statistically significantly superior to vehicle control in terms of efficacy. The number of adverse events was observed to be higher in the control group than in the prednicarbate group (15 and 2, respectively).

ISSN:0954-6634    

DOI:10.3109/09546639509086850

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

One of the more disabling cutaneous features of tuberous sclerosis is the angiofibromatous lesions, 'adenoma sebaceum' which occur in about 90% of patients. These are clinically manifested as smooth dome-shaped papules of variable erythema dependent on the degree of vascular ectasia within individual lesions. Increased vascularity produces more cosmetically disabling lesions. Seven patients with adenoma sebaceum, five male and two female (mean age 16.2 years, range 10–39 years), were treated using a pulsed dye laser at a wavelength of 585 nm. The average number of treatment sessions was 5.7 (range 2–10), the mean energy was 6.7 J/cm2(range 6.0–7.5 J/cm2) and the average number of pulses was 86.2 (range 27–200). Clinical assessment of treatment efficacy was as follows: excellent, one; very good, one; good, three; and fair, two. No serious adverse events were encountered. Treatment of angiofibromata with the pulsed dye laser is a useful and safe procedure for adults and children.

ISSN:0954-6634    

DOI:10.3109/09546639509086851

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

Certain calcium channel blockers such as diltiazem, nicardipine, and verapamil, but not nifedipine, are known to raise blood levels of cyclosporin A (CsA) upon concomitant administration. Isradipine, a newer calcium channel blocker purportedly free of interaction with CsA metabolism, was utilized for blood pressure control in a patient with Sézary's syndrome being treated with CsA. Unexpectedly, indirect evidence of a drug-drug interaction occurred with alterations in CsA blood levels dependent upon continuation/discontinuation of isradipine. Although a single case, this report underscores the necessity for monitoring CsA blood levels in patients being treated with other drugs in order to avoid deleterious side-effects secondary to altered CsA levels.

ISSN:0954-6634    

DOI:10.3109/09546639509086852

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

This review summarizes and criticizes 10 papers concerning the treatment of skin diseases with acupuncture. Despite a high success rate, the results are questioned because of the lack of objective evidence presented.

ISSN:0954-6634    

DOI:10.3109/09546639509086853

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor