ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00055.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00056.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractBackgroundToday's standard treatment of zoster in immunocompetent patients is oral acyclovir. Other therapies are no longer customary because of their insufficient efficacy and frequent side effects. The positive results obtained with an orally administered enzyme combination led to the assumption that this might represent an alternative therapy. The purpose of our study was therefore to determine whether the enzyme combination differs from acyclovir with regard to efficacy and tolerance.Patients and MethodsIn a double‐blind, controlled multicenter trial immunocompetent patients with zoster were randomly assigned to receive one of the two test drugs for 7 days. Parameters of pain and skin lesions were measured over 14–21 days. Forty‐four patients were enrolled in the enzyme group (ET) and 46 in the acyclovir group (AT).ResultsThere were no significant differences with respect to anamnestic and clinical data at entry into the study. Neither were there significant differences regarding the statistically evaluated parameters of efficacy: “segmental pain on day 7” (P= 0.496) and “vesicle duration” (P= 0.803). Paracetamol use and total pain over 14 days also failed to show any notable differences between the two groups. The beginning of crust formation and the duration of skin lesions showed a very similar frequency distribution. Side effects occurred in four patients in the ET group and in three in the AT group.ConclusionsOur trial suggests that the therapy of zoster with an orally applied enzyme combination is a valid alternative to the therapy us

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00057.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractObjectivesTo investigate the therapeutic efficacy of acitretin + PUVA compared to placebo + PUVA in terms of improvement assessed by the Psoriasis Severity Index (PSI) and total UVA dosage.DesignDouble‐blind, randomized, parallel, multicenter study over 8 weeks.IndicationGeneralized chronic plaque or exanthematic type of psoriasis severe enough to require PUVA treatment.TargetsDecrease ofPSIat the end of the study; response defined as improvement ofPSI≥ 75% with respect to baseline, total UVA dosage applied and UVA dosage applied up to response.Statistical methods PSIchanges (baseline up to end of treatment) in the two groups were compared at the 5% significance level using the Kolmogoroff‐Smirnoff test (2‐tailed). In addition, descriptive statistics for comparison of response rates (Chi2test) and total UVA dosage as well as UVA dosage applied up to response (life‐table analysis by Kaplan‐Meier) were performed.ResultsPatientsForty patients (36 males. 4 females) in the placebo + PUVA and 43 patients (32 males, 11 females) in the placebo + PUVA group were investigated for efficacy. Twenty‐three patients of the acitretin + PUVA group and 25 patients of the placebo + PUVA group ceased treatment prematurely.PSIThe median PSI decrease was 24 (89%) score points in the acitretin + PUVA group and 21 (83%) in the placebo + PUVA group (P>0.05, Kolmogoroff‐Smirnoff test). The response rate was 34 out of 40 (85%; 95% CI 70‐94%) in the acitretin + PUVA group and 26 out of 43 (60%; 95% CI 44–75%) in the placebo + PUVA group (P= 0.013. Chi2test: descriptive).Complete remissionThe clinical outcome as assessed by the investigator was complete remission in 28 patients of the acitretin + PUVA group and 19 patients of the placebo + PUVA group. Premature discontinuation of treatment due to complete remission was possible in 16 patients of the acitretin + PUVA group and 11 patients of the placebo + PUVA group. UVA dosage The total UVA dose applied was 77.6 J/cm2(SEM = 9.2 J/cm2) in the acitretin + PUVA group and 73.0 I/cm2(SEM = 7.2 J/cm2) in the placebo + PUVA group. The median UVA dose up to response was 52.0 J/cm2in the acitretin + PUVA group and 74.5 J/cm2in the placebo + PUVA group.TolerabilityIn both treatment groups, adverse events were frequent. Mucocutaneous adverse events, such as dry lips, mouth and nose and dryness and scaling of the skin, were the most common complaints in both groups, but more pronounced in the acitretin + PUVA group. Treatment of adverse events included mainly indifferent ointments, non‐steroidal, anti‐inflammatory drugs and anti‐puritic agents and tranquilizers. Treatment had to be discontinued due to adverse events in three patients of each group. In the acitretin + PUVA group, the reasons were acral‐bullous photodermatosis due to PUVA, increased liver enzymes and increased triglycerides, respectively. In the placebo + PUVA group, one patient developed sensori‐neural loss of hearing, one stomach pain, nausea and colics of the upper abdomen and one increased triglycerides, cholesterol and liver enzymes.ConclusionsDifference in improvement of the PSI was not statistically significant between the acitretin + PUVA and the placebo + PUVA groups. However, the response rates (75% PSI decrease) and complete remission as assessed by the investigator for acitretin + PUVA was superior to PUVA alone. The UVA‐saving effect could not be confirmed although the UVA dose applied up to response was less in the acitretin + PUVA group. Overall, acitretin was found to enhance the therapeutic efficacy of PUVA in

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00058.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractA case of a young female patient with hydroa vacciniforme is reported. Blisters, bullae and papules healing with scarring appeared on light‐exposed areas and were accompanied by fever, malaise and photophobia. The patient improved with use of high protection sunscreens and per os hydroxychloroquine (200 mg/day

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00059.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractCase reportsThree cases of acyclovir‐resistant ano‐genital HSV infection.Management reviewAcyclovir‐resistant mucocutaneous herpes simplex virus (HSV) infections are increasingly seen in patients with advanced HIV disease. The primary mechanism of resistance is deficiency of virus specific thymidine kinase. Foscarnet, a pyrophosphate analogue, which directly inhibits HSV DNA polymerase is an effective therapeutic alternative to acyclovir, and is commonly used. Topical trifluridine recently has been useful as a non‐toxic alternative to foscarnet. Management of recusrrent episodes of acyclovir‐resistant HSV infection following successful inital or induction therapy with foscarnet requires development of a clear strategy for effective suppressiv

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00060.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00061.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0926-9959    

DOI:10.1111/j.1468-3083.1993.tb00062.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY