Search PubMed⌕ Search

Biomedical subjects

A I Lauerma

Publications and source records attributed to A I Lauerma.

At least 37 records · Page 2Linked to original sources
PubMed1995

Topical cis-urocanic acid suppresses both induction and elicitation of contact hypersensitivity in BALB/C mice.

Cis-urocanic acid, converted from trans-urocanic acid in stratum corneum by ultraviolet B irradiation, has been shown to impair contact hypersensitivity induction. To study whether topical cis-urocanic acid also alters contact hypersensitivity elicitation, as well as immediate hypersensitivity and acute irritation, we treated mice with 1% topical cis-urocanic acid or vehicle prior to induction or elicitation of hypersensitivity to contact allergen oxazolone or respiratory allergen trimellitic anhydride or prior to acute irritation from croton oil. Topical cis-urocanic acid suppressed both induction and elicitation of contact hypersensitivity to oxazolone. However, no effect by cis-urocanic acid on induction or elicitation of trimellitic anhydride allergy or croton oil irritation was seen. The possible efficacy of topical cis-urocanic acid as a treatment of inflammatory skin diseases responsive to ultraviolet B irradiation may be worthwhile to investigate.

Administration, Topical↗
PubMed1994

Topical FK506: suppression of allergic and irritant contact dermatitis in the guinea pig.

Topical FK506 has recently been shown to have an anti-inflammatory effect in vivo in humans. In this study its effects in contact dermatitis were studied in the guinea pig model. Topical FK506 suppressed both irritant and allergic patch-test reactions. The most prominent suppressive effect was seen when skin sites were pretreated with FK506. Topical FK506 did not impair the induction of contact allergy as assessed by challenges, although it suppressed local lymph node cell accumulation during contact allergy induction. Topical FK506 may hold promise as a treatment for skin disorders that respond to oral FK506 or cyclosporin A.

Administration, Topical↗
PubMed1994

Topical FK506--clinical potential or laboratory curiosity?

Cyclosporine A (CsA) is an immunosuppressant that is efficacious in several inflammatory skin disorders. Its use is, however, limited due to systemic side-effects. Topical forms of CsA have been tried but they do not seem to be effective presumably due to insufficient penetration to skin. Tacrolimus (FK506) is another immunosuppressant that has almost similar effects on the cellular level as CsA. FK506 is 10-100 times more potent than CsA and it has lower molecular weight. Recent studies suggest that topical FK506 penetrates human skin in amounts exceeding those of topical CsA. Topical FK506 also seems to suppress skin inflammation in man. These findings prompt for further clinical studies of efficacy and safety of topical FK506.

Administration, Cutaneous↗
PubMed1993

Contact allergy to corticosteroids.

Recent evidence shows that contact allergy to topical corticosteroids is more frequent than earlier believed. This review summarizes the current knowledge of this condition, including methods for clinical diagnosis.

Administration, Topical↗
PubMed1993

Contact hypersensitivity to hydrocortisone-free-alcohol in patients with allergic patch test reactions to tixocortol pivalate.

It has been suggested that contact allergy to hydrocortisone alcohol is a frequent phenomenon. A recent study showed that all patients with allergic patch reactions to tixocortol pivalate reacted to intradermal hydrocortisone sodium phosphate. We studied patients with positive patch test reactions to tixocortol pivalate but negative to hydrocortisone alcohol, with penetration enhancers in hydrocortisone alcohol patch tests and oral challenges with hydrocortisone alcohol. Additionally, prick and intradermal tests with hydrocortisone sodium succinate were used. Using penetration enhancers and oral challenges enabled detection of more contact allergies to hydrocortisone alcohol compared to conventional patch testing alone. 9/12 patients with allergic reactions to tixocortol pivalate reacted to intradermal hydrocortisone sodium succinate. No immediate reactions were seen in prick or intradermal tests, suggesting that hydrocortisone contact hypersensitivity is probably not associated with immediate allergy to hydrocortisone. The present study suggests that allergic patch test reactions to tixocortol pivalate are caused by hypersensitivity to hydrocortisone alcohol itself or to one of its metabolites in the skin.

Anti-Inflammatory Agents↗
PubMed1993

Intradermal testing in the diagnosis of allergic contact dermatitis. A reappraisal.

Contact hypersensitivity may be diagnosed with patch testing or intradermal testing. Although these methods have been used earlier in parallel, patch testing has gradually become the only method in routine diagnosis of contact allergy. Recent findings in corticosteroid contact hypersensitivity have shown that patch testing is not always an optimal method, especially when poor penetrants are used. Therefore, a reappraisal of intradermal testing is presented, based on the literature. Studies employing both patch and intradermal testing are reviewed and the advantages and disadvantages of intradermal tests as compared to patch tests in contact allergy diagnostics are discussed. We find that it might be worthwhile to evaluate whether contact allergy to compounds other than corticosteroids may be easier to detect with intradermal than patch test.

Adrenal Cortex Hormones↗
PubMed1993

Cyclosporine in the treatment of palmoplantar pustulosis. A randomized, double-blind, placebo-controlled study.

BACKGROUND AND DESIGN: Palmoplantar pustulosis (PPP) is an inflammatory skin disease characterized by pustule formation, erythema, induration, and scaling of the affected skin of the palms and soles. Palmoplantar pustulosis is usually resistant to treatment. In a double-blind study (phase 1) of 4 weeks, 40 patients with PPP were randomized to receive oral cyclosporine, 2.5 mg/kg per day, or placebo. An open-label dose-finding phase 2 with cyclosporine doses of 1.25, 2.5, and 3.75 mg/kg per day was performed in the following 3 months. The patients were then followed for at least 2 months after termination of cyclosporine treatment. Response to treatment was judged by the number of fresh pustules. Patients displaying a reduction of 50% or greater in the number of pustules, compared with baseline, were defined as responders. RESULTS: Of the patients who completed phase 1, 17 of 19 patients in the cyclosporine group and four of 15 in the placebo group were classified as responders (P < .001). Cyclosporine, but not placebo, significantly reduced formation of new pustules (P = .001). In the subsequent open phase, a daily cyclosporine dose of 1.25 mg/kg appeared to be an effective treatment of PPP in approximately half of the treated patients. Many patients relapsed after initial success with cyclosporine. However, only one patient studied totally failed to respond to cyclosporine treatment. At the end of phase 3, most of the studied parameters had returned to pretreatment levels. The most common side effect was headache in the 2.5 mg/kg per day dosage group; no significant side effects were observed in the 1.25 mg/kg per day dosage group. CONCLUSIONS: Low-dose cyclosporine treatment (1.25 to 2.5 mg/kg per day) is effective in PPP.

Adolescent↗
PubMed1991

Systemic hydrocortisone/cortisol induces allergic skin reactions in presensitized subjects.

To determine whether systemic hydrocortisone can elicit allergic skin reactions in patients with contact hypersensitivity to hydrocortisone, we studied four patients with contact hypersensitivity to hydrocortisone and hydrocortisone-17-butyrate and two patients with contact hypersensitivity to hydrocortisone-17-butyrate but not to hydrocortisone. Open oral provocation with 100 or 250 mg hydrocortisone in patients with hydrocortisone contact hypersensitivity elicited cutaneous reactions at sites of previous allergic dermatitis caused by hydrocortisone in two patients and at sites of earlier allergic patch test reactions caused by hydrocortisone in the other two patients. Provocations in two patients with contact hypersensitivity to hydrocortisone-17-butyrate but not to hydrocortisone remained negative. To determine whether the adrenal cortical hormone cortisol, which is identical to hydrocortisone, could induce similar skin reactions, one patient with hydrocortisone contact hypersensitivity underwent adrenocorticotropic hormone stimulation tests; as a control, one hydrocortisone-sensitive patient underwent analogous provocations with placebo. After an 8-hour infusion with the adrenocorticotropic hormone analog tetracosactide, a similar skin reaction to that seen with oral hydrocortisone was observed, whereas provocations with placebo remained negative. We conclude that both oral hydrocortisone and intrinsic cortisol are able to induce allergic skin reactions in presensitized subjects.

Administration, Oral↗
PubMed1991

Screening for corticosteroid contact sensitivity. Comparison of tixocortol pivalate, hydrocortisone-17-butyrate and hydrocortisone.

3 corticosteroids have so far been tried as markers for corticosteroid contact sensitivity: hydrocortisone, tixocortol pivalate and hydrocortisone-17-butyrate. The present study compared these steroids for screening in addition to a standard patch test series. Of 727 patients, 28 (3.9%) reacted to tixocortol pivalate and 10 (1.4%) to hydrocortisone-17-butyrate; hydrocortisone gave an allergic reaction in 2 of 521 (0.4%) patients. Serial dilutions suggested that tixocortol pivalate, not marketed in Finland, caused allergic reactions which could possibly be cross-reactions to hydrocortisone. In contrast to previously published data, frequent cross-reactions occurred with hydrocortisone-17-butyrate and tixocortol pivalate. All allergic reactions to other corticosteroids found by testing with tixocortol pivalate concurred with reactions to hydrocortisone-17-butyrate. The study suggests that the most effective choice for routine testing for corticosteroid contact sensitivity would be both tixocortol pivalate and hydrocortisone-17-butyrate.

Administration, Topical↗
PubMed1990

Langerhans cells but not monocytes are capable of antigen presentation in vitro in corticosteroid contact hypersensitivity.

Corticosteroids suppress delayed-type hypersensitivity (DTH) reactions in vivo and impair lymphoid cell functions in vitro. In contact hypersensitivity (CHS) to corticosteroids, however, the corticosteroids are capable of inducing DTH responses in vivo. The present study examined the capacity of corticosteroids to induce in vitro proliferation of T lymphocytes from patients with CHS to corticosteroids. With peripheral blood mononuclear adherent cells as antigen-presenting cells (APC) and hydrocortisone-17-butyrate (H-17-B) as hapten, no proliferation responses were detected of T lymphocytes from patients with CHS to H-17-B. However, when epidermal Langerhans cells (LC) were used as APC, weak proliferation responses were observed.

Administration, Topical↗
PubMed1989

Contact allergies in patients with familial benign chronic pemphigus (Hailey-Hailey disease)

To determine whether patients with familial benign chronic pemphigus have an increased risk for the development of contact allergies to topical therapy, we performed epicutaneous tests in 15 patients with this disease. Nine had positive patch test reactions of which seven were allergic to compounds used in local treatments. Allergic reactions in more than one patient were seen to neomycin sulfate (three patients), bacitracin (two), and hydrocortisone-17-butyrate and betamethasone-17-valerate (two). Although no comparable control group was similarly studied, the frequency of sensitization appears to be increased in patients with familial benign chronic pemphigus.

Administration, Topical↗
PubMed1989

Detection of contact hypersensitivity to topical corticosteroids with hydrocortisone-17-butyrate.

We showed earlier that most patients with contact dermatitis due to corticosteroids show cross-reactions when patch tested with hydrocortisone-17-butyrate (H-17-B). To test whether H-17-B could be used for detecting topical corticosteroid allergy, we screened patients undergoing routine patch testing with H-17-B. Patients with clearly allergic or doubtful/mildly irritant patch test reactions to H-17-B, and with a history suggesting topical corticosteroid allergy, were further tested with a large panel of steroid preparations. 20 out of 4039 patients (0.5%) showed definite allergic test reactions to corticosteroids. A further 165 patients with clinically suspected corticosteroid allergy were directly tested with a panel of steroid preparations; 14 patients showed positive patch test reactions. Altogether, 33 out of 34 patients with corticosteroid allergy had positive test reactions to H-17-B. Inclusion of 1.0% H-17-B in ethanol in the standard patch test series improves the diagnosis of topical corticosteroid hypersensitivity.

Administration, Topical↗