ISSN:1018-8665    

DOI:10.1159/000247000

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Etretinate (Tigason®, Tegison®) and its active metabolite acitretin (Neotigason®, Soriatane®) are known teratogens. Pregnancy should be avoided during treatment and until 2 years after treatment discontinuation. The question is discussed whether a dose or a blood concentration of the drug below which there is no teratogenic risk can be determined. Animal experimental and human pharmacokinetic data are reviewed. An evaluation of the outcomes of pregnancies which occurred in mothers exposed to etretinate or acitretin was performed. A threshold dose in human therapy below which there is no risk of congenital malformation cannot be determined based on animal experimental data. With regard to pharmacokinetics, there are currently no data suggesting that blood levels of the drug below the detection limit of 2 ng/ml are associated with a teratogenic risk. The most useful information is given by reports in women who were exposed to either retinoid before or during pregnancy. The data indicate that the risk of spontaneous abortion or congenital malformation is high when the drug is administered during the first trimester of pregnancy. After treatment discontinuation, the risk is low since the number of abnormalities seems not to exceed those observed in a general population. There are currently no available data which suggest that the pregnancy warnings are inappropriate in terms of duration of contracept

ISSN:1018-8665    

DOI:10.1159/000246811

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Pruritus at the site of active acne has not been described before as a complication of acne therapy. We report 8 cases seen over a 3-year period at our department with localized itching mainly at the active acne sites, within 2–6 weeks of starting effective acne therapy. Seven had oral tetracyclines (oxytetracycline, Vibramycin or Minocin) with or without topical antibiotics or benzoyl peroxide. Only 1 patient received oral isotretinoin. The severity of itch was mild to moderate in most cases with the severest reaction in the isotretinoin-treated patient. All cases resolved within 4 weeks, 7 with non-sedative antihistamine therapy (terfenadine), and 1 resolved spontaneously upon cessation of antibiotic therapy. The pathogenesis of this localized itch is presumed to be related to the change in pH of the micro-environment of the acne follicle providing an optimal environment for the production of histamine or histamine-like products by Propionibacterium acnes. This report highlights the self-limiting nature of pruritus during effective anti-acne therapy. Increased awareness of this uncommon complication helps prevent the unnecessary discontinuation of effective acne therap

ISSN:1018-8665    

DOI:10.1159/000246812

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: Since soluble intercellular adhesion molecules 1 (sICAM-1) retain their ability to bind to their ligand, they can interfere in cell-mediated immunosurveillance. Objective: We studied the impact of various cytokines on ICAM-1 release of several tumor cell lines. Methods: Two melanoma cell lines (M19, M26), 1 B lymphoblastoid cell line (Daudi), 1 erythroleukemia cell line (K562), 1 Sézary-cell-derived cell line (SeAx), 1 cell line derived from a mycosis fungoides lesion (MyLa) and normal peripheral blood mononuclear cells (PBMC) were grown in the presence of interferon γ (IFN-γ), IFN-α, interleukin-2 (IL-2), IL-6 and tumor necrosis factor α (TNF-α) in various concentrations. ICAM-1 release into the supernatant was measured after 24 and 48 h using an enzyme-linked immunosorbent assay (ELISA). Results: PBMC and the B lymphoblastoid cell line did not shed detectable amounts of sICAM-1. In all other cell lines, ICAM-1 shedding was found with and without cytokine stimulation. In all cell cell lines except the CTCL-derived one, ICAM-1 shedding was marginally affected by IFN-α, IL-2 and IL-6. TNF-α and IFN-γ enhanced the shedding in a time- and dose-dependent manner. In the SeAx line, IL-2 and IFN-γ inhibited ICAM-1 release. By contrast, TNF-α and IL-6 enhanced it. The CTCL-derived MyLa responded to IFN-α with a dose-dependent increase in ICAM-1 shedding. All other cytokines had marginal influence. Conclusion: Cytokine-modulated ICAM-1 shedding shows quantitative and qualitative differences in the investigated cell lines. This might have implications for the pathophysiology of cutaneous malignancies and their susceptibility to immu

ISSN:1018-8665    

DOI:10.1159/000246813

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: Primary localized cutaneous nodular amyloidosis (PLCNA) is a rare disease, and its pathogenesis of amyloid deposition is still unknown. Objective: The purpose of this study was to know the origin of amyloid in PLCNA. Methods: Water-soluble amyloid fibrils were isolated from the skin and resolved on SDS-PAGE, then subjected to immunoblot analysis. Results: The major amyloid fibril protein was a 29-kD peptide which reacted with both anti-λ- and anti-K-light-chain antibodies. Conclusion: Amyloids in this particular case of PLCNA are derived from the polyclonal immunoglobulin light chain and some cases of PLCNA could be reactive diseases rather than neoplastic ones

ISSN:1018-8665    

DOI:10.1159/000246814

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: There is an increased risk for agricultural workers to acquire skin problems, but data so far published are still very scarce. Objective: To individualize skin disorders that involved this class of workers. Methods: Between 1990 and 1992, 426 agricultural workers, authorized to use pesticides, were examined. The control group consisted of 100 nonagriculture workers, who were age and sex matched. Results: Some common dermatological diseases, such as vitiligo, psoriasis and seborrheic dermatitis, had an incidence overlapping with that found in the controls. Irritant plant dermatoses (2.5%), episodes of acute systemic intoxication from pesticides (6.8%), onychopathies due to chronic trauma (16%), contact dermatitis of the hands (12%), chilblains (7%) and Favre-Racouchot syndrome (2.5%) showed a higher prevalence in the study group. Conclusion: Farmers were affected mainly by diseases caused by the direct action of chemical agents, either natural or industrial, in addition to climatic and physical agents.

ISSN:1018-8665    

DOI:10.1159/000246815

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: Eosinophilic pustular folliculitis (EPF) is a cutaneous inflammatory follicular disorder of unknown etiology. The diagnosis is established on the basis of clinical and histopathologic features. In only a few instances has EPF been described in children. Objective and Methods: We describe the clinical and histopathologic features of a recurrent follicular eosinophilic pustular eruption involving the scalp in 2 children. Previously reported cases of EPF in childhood below 14 years of age are reviewed. Results: Two patients (9-month-old and 6-month-old boys) presented recurrent crops of follicular pustules on the scalp of 4 and 5 months’ evolution. The lesions resolved spontaneously without scarring. Histopathologic examination revealed an acute follicular inflammatory infiltrate with abundant eosinophils. Scraping from the lesions showed abundant eosinophils in 1 case. A peripheral eosinophilia was also detected in both patients. Conclusion: EPF in children below 1 year of age seems to represent a unique disorder bearing distinctive clinical (constant involvement of the scalp), evolutive (self-healing recurrent crops) and prognostic (the lesions may last until 3 years of age) features. A possible relationship between this disorder and other idiopathic pustular dermatoses of early childhood (especially with infantile acropustulosis) is suggeste

ISSN:1018-8665    

DOI:10.1159/000246816

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: Infants under evaluation for atopic dermatitis (AD) at our clinic undergo a battery of examinations that include urinalysis and urine culture tests with antibiograms. The prevalence of cases with significant bacteriuria and leukocyturia (SBL) appeared to be unexpectedly high. Objective: This study attempts to establish whether infants with AD should be suspected of having a higher prevalence of urinary tract infections (UTI). Methods: A retrospective analysis of urine and urine culture tests was performed in 131 infants (84 males and 47 females) aged 1–24 months with untreated AD and in 1,327 control subjects (621 male, 706 female) aged 1–24 months. Results: SBL was present in 27.5% of cases versus 3% of controls (p < 10––5). After routine treatment for AD and antibiotic treatment on the basis of a urine antibiogram, the recurrence rate of SBL, evaluated monthly over a 6-month period, was only 8.3%. Conclusion: Infants with AD might be at a greater risk for developing UTI, and when treated for AD this risk might be

ISSN:1018-8665    

DOI:10.1159/000246817

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: Genital warts are a well-recognized clinical entity and a disease of great antiquity that differ from skin warts both histologically and antigenically. It is a common sexually transmitted disease of high prevalence all over the world. Women are more likely to be unaware of such warts because it is harder for them to examine their genitalia. Objective: The purpose of this multicenter, double-blind, placebo-controlled study was to compare the clinical efficacy and tolerance of 0.3% and 0.5% podophyllotoxin in a cream emulsion (castor oil, BP as vehicle) to cure genital condylomata in women. Methods: Preselected (n = 80) Asian females (mean age 23.6 years), harboring 544 warts (mean 6.8 in number), ranging from 1 to 9 mm in size (mean 2.1 mm) with biopsy-proven diagnosis of condylomata acuminata were randomly allocated to three groups (30 + 30 + 20). At home the patients applied the given trial medication themselves (using the finger) twice a day, for 3 consecutive days per week, and if not cured the same course was extended to 3 more weeks, in total 24 topical applications for 4 weeks. The patients were examined on a weekly basis, and a total regression of warts (biopsy-proven) was evaluated as complete cure. Results: By the end of the study, the placebo group (20 patients, bearing 124 warts) did not show any regression or clinical efficacy, while 41/60 patients (68.3%) and 349/420 warts (83%) were cured in the 0.3% and 0.5% treatment groups (placebo vs. active groups p < 0.001). Patients using the 0.5% active medication had substantially more eliminated warts (205/349, 95.8%) than the 0.3% group (70%). Localized adverse symptoms were mild to moderate and were well tolerated by the patients with no dropout. Forty-three patients (53.8%) did not show any adverse reaction. The most frequent adverse symptoms were tenderness (23/80, 28.8%) and burning sensation (14/80, 17.5%). Among 41/80 (51.25%) cured patients 4 had a relapse after 16 weeks. Conclusion: Along with mild, tolerable side effects the study demonstrates that 0.5% podophyllotoxin cream is more efficacious than 0.3% (p < 0.01) and can be considered as a reliable home-based treatment.

ISSN:1018-8665    

DOI:10.1159/000246818

出版商:S. Karger AG    

年代:1994

数据来源: Karger

摘要:

Background: Evaluation techniques for determining the strength of action and the onset of activity of H1 receptor blockers have not yet been sufficiently standardized. Objective: The clinical efficacy of the H1 receptor blocker loratadine was to be measured upon a wheal response subsequent to an intracutaneous injection of 0.1 ml histamine (0.1%). Methods: In a pilot study, 10 patients were treated with the H1 receptor blocker loratadine for a period of 7 days. Various noninvasive measurement techniques, i.e. 20-MHz sonography, laser-Doppler flowmetry, chromatometry using the Lab* system and computer-assisted planimetry, were applied to provide a quantitative evaluation of the wheal and the marginal erythema. Using these quantification methods, the development of the urticarial reaction 20 min after injection and its decline were evaluated. Results: The urticarial reaction was reduced substantially under treatment with 10 mg loratadine over a period of 7 days. The methods we used could accurately quantify different aspects of the urticarial reaction noninvasively. Conclusions: All of the chosen measurement techniques are widely recognized. For objective assessment of the urticarial reaction with high-frequency ultrasound, we recommend the measurement of the distance between skin entrance echo and fascia since the demarcation of the wheal is often impossible by ultrasound. In order to improve comparison of results of various workgroups in the future, we therefore suggest the use of the selected combination of noninvasive procedures as a standard for evaluating the efficacy of H1 receptor blockers.

ISSN:1018-8665    

DOI:10.1159/000246819

出版商:S. Karger AG    

年代:1994

数据来源: Karger