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Biomedical subjects

A Ingber

Publications and source records attributed to A Ingber.

At least 19 recordsLinked to original sources
PubMed2003

[Cutaneous leishmaniasis].

Leishmaniasis is a vector-borne disease caused by an obligate intracellular protozoa, Leishmania, which resides in macrophages. The parasite is transmitted by an infected female sandfly. The incidence of cutaneous leishmaniasis approaches 2 million new cases per year with 90% of the cases occurring in the "Old World", while the "New World" accounts for the rest. Infection may be restricted to the skin with development of characteristic ulcers, or may affect the mucous membranes in its mucocutaneous form. The clinical diagnosis is verified by the presence of amastigotes in slit-skin smears. Therapeutic modalities include systemic treatments such as the pentavalent antimony compound sodium stibogluconate, liposomal formulations of amphotericin B, oral ketoconazole or itraconazole, as well as topical paromomycin sulphate, local heat, freezing with liquid nitrogen, or photodynamic therapy. An effective vaccine is not available.

Amphotericin B↗
PubMed2002

Nail involvement in pemphigus vulgaris.

BACKGROUND: Involvement of the nail unit in pemphigus vulgaris (PV) is thought to be rare. OBJECTIVES: To determine the frequency of nail changes among patients with PV. METHODS: Nail changes were recorded in patients with PV and were analysed retrospectively. Biopsies were taken from the nail bed and nail matrix for histological and immunofluorescence observations. Microscopic (potassium hydroxide) examination and fungal culture were performed. RESULTS: Nail changes were present in 30 of 64 (47%) patients with PV. Sixteen patients had onychomycosis and 14 had nail changes due to PV. These included onychomadesis, discoloration, deformity, onychorrhexis, onycholysis, subungual haemorrhage, subungual hyperkeratosis and paronychia. Onychomycosis affected fingernails and toenails, but changes due to PV occurred only in fingernails, most commonly on the thumb and index finger. No connection was found between the patient's occupation and nail involvement, and there was no correlation with the severity or duration of PV. In a control group of 64 patients of similar sex and age, only two had non-specific fingernail changes. CONCLUSIONS: Nail changes in PV may be more frequent than previously thought.

Adolescent↗
PubMed2001

Investigation of the threshold for allergic reactivity to chromium.

Allergy to chromium is relatively common, often in association with exposure to cement or in leather manufacture. However, in certain locations, there appears to be a relatively large cohort of chromium-sensitive individuals whose allergy cannot be explained by these common sources. In particular, this group include Israeli housewives with persistent hand eczema and concomitant patch test positivity to chromium. The causation of their allergy has been linked with relatively high levels of chromium contamination in household products. To provide further information in respect of the definition of safe levels for such products, we examined 17 chromium-allergic individuals to determine their threshold for reaction under closed patch test and repeated open application test (ROAT) conditions. The data derived indicated that, on normal skin, the patch test threshold was 10 ppm chromium; in the presence of an irritant (sodium lauryl sulfate) the threshold was closer to 1 ppm, 2/17 subjects giving 1+ reactions at this concentration. In the more realistic exposure conditions of the ROAT, 8/14 individuals failed to react to 50 ppm, whilst 3/15 reacted to 5 ppm. Interestingly, there was very poor correlation between patch test sensitivity and ROAT sensitivity. To ensure the large majority of chromium-allergic individuals do not suffer elicitation of their allergy, as well as to limit the development of new chromium-sensitive subjects, it is recommended that household products adhere to a previously published standard of a maximum limit of 5 ppm, with an ultimate target of 1 ppm contamination by chromium.

Adult↗
PubMed2001

The efficiency of humectants as skin moisturizers in the presence of oil.

BACKGROUND/AIMS: The research on the treatment of "dry skin syndrome" is hampered by the lack of a suitable animal model. Formerly, we developed a validated guinea pig in vivo model in which the dry skin syndrome persists at least for 1 week. We can, therefore, compare the pharmacological effectiveness of known and potential moisturizers for the treatment of dry skin syndrome. Our aim is to study whether the moisturizing efficiency of humectants depends on the solvents in which they are dissolved. METHODS: "Dry skin syndrome" was induced on the shaved skin on one side of guinea pigs by daily application of 2% sodium lauryl sulphate in deionized water (SLS) for 3 days. The other shaved side was used as control. After ascertaining skin dryness, that side was treated for 6 days with glycerol or 1,2-hexanediol in different solvents: water, or medium chain triglycerides (MCT) or mixtures of MCT with isopropyl alcohol in different proportions. Measurement of the in vivo moisturizing effect was carried out by a Comeometer CM 825; erythema was measured by a Mexameter MX 16. RESULTS: Treatments with glycerol (1M) in water reversed the skin dryness shown by both instruments. When dissolving glycerol in MCT, no moisturizing effect was found, probably because glycerol does not dissolve in the oil. No moisturizing effect was found with different combinations of glycerol in the mixtures of MCT and isopropyl alcohol. No moisturizing effect was found using another polyol moisturizer: 1,2 hexanediol (1M) dissolved in MCT oil. Glycerol or 1,2-hexanediol abolished the erythema only when they were dissolved in water alone. CONCLUSION: Polyol moisturizers such as glycerol or 1,2-hexanediol do not act in the presence of oils against the sodium lauryl sulphate-induced dry skin in our guinea pig model. Since in an oil-in-water (O/W) emulsion, the water evaporates within several minutes, one has to question the ability of moisturizing emulsions to treat dry skin. In such instances, one cannot draw conclusions about the moisturizing efficiency of the preparation merely from the presence of the humectant. One has to study the effect of the finished preparation.

Animals↗
PubMed2001

Intermittent low dose itraconazole treatment for onychomycosis--long term follow-up.

Eighty-seven patients with toenail onychomycosis were treated with intermittent low-dose itraconazole, 200 mg day(-1) for one week every four weeks; this regimen was repeated six times. A total of 77 patients (88.5%) showed microscopical and cultural cure after 6 months of treatment. A three-year follow-up showed a relapse rate of 6.5% occurring only during the first year after treatment.

Adult↗
PubMed2000

Skin toxic effects of polyethylene glycol-coated liposomal doxorubicin.

OBJECTIVES: To record the profile of toxic effects of polyethylene glycol-coated liposomal doxorubicin hydrochloride (Doxil) to the skin, and to evaluate whether the long circulation pattern and enhanced accumulation of liposomes in specific skin sites will result in any unique presentations. DESIGN: Patients were accrued in the frame of dose-range-finding studies that examine the toxic effects and antitumor activity of Doxil therapy in metastatic breast and prostate cancers. All patients receiving Doxil were instructed to report any skin eruption or discomfort. Skin examination was performed on a regular basis at every cycle of Doxil therapy and after specific complaints. SETTING: Outpatient day care unit of the oncology institute of a secondary-referral medical center. PATIENTS: Sixty patients (45 women and 15 men). MAIN OUTCOME MEASURES: A basic severity scale of I through IV was adopted for toxic effects to the skin, based on National Cancer Institute common toxicity criteria. RESULTS: The following 4 patterns of skin eruptions were encountered: hand-foot syndrome (n = 24), diffuse follicular rash (n = 6), intertrigolike eruption (n = 5), and new formation of melanotic macules (n = 3). Another major toxic effect of Doxil was stomatitis, which was found to be the dose-limiting factor for the maximal single dose. Alopecia and extravasation injuries did not occur. CONCLUSIONS: The profile of toxic effects of Doxil to the skin reflects its unique pharmacokinetics and tissue distribution. These skin reactions vary significantly from those associated with doxorubicin in non-liposome-encapsulated form.

Antineoplastic Agents↗
PubMed2000

Textile dermatitis in Israel: a retrospective study.

BACKGROUND: The diagnosis of contact dermatitis caused by clothing may be difficult because of its clinical polymorphism. Data in the literature suggest that textile dermatitis is more common than previously thought. OBJECTIVE: Our purpose was to study our patients suspected of having textile contact dermatitis from 1991 to 1997. METHODS: The records of the patients with positive reactions to allergens from the Textile Colors and Finish series in 3 contact dermatitis clinics were reviewed. All the patients were clinically evaluated and patch tested with the European Standard series and the Textile Colors and Finish series (Chemotechnique Diagnostics, Malmö, Sweden). RESULTS: Twenty-two of the 55 patients (40%) had positive patch tests to the textile dye allergens. Four of them had occupationally related textile dermatitis. The most frequent allergens were Disperse Blue 124, Disperse Blue 85, Disperse Red 17, and Disperse Blue 106. Erythematosquamous lesions were the most common forms of textile dermatitis (56%), followed by pustular lesion (16%) and hyperpigmented patches (8%). CONCLUSIONS: The relatively high percentage of positive results (40%) was attributable to the selected cohort of patients. In our series, positive reactions to the allergens Disperse Blue 124, 85, and 106 were common findings. Clinically, pustular allergic contact dermatitis, triggered by textile dyes was observed along with the more frequent erythematosquamous clinical form.

Adolescent↗
PubMed2000

Improving screening for melanoma by measuring similarity to pre-classified images.

A new method that can dramatically improve the sensitivity and especially the specificity of skin naevi screening for melanoma by physicians is introduced. The method is based on measuring the similarity to previously classified naevi images. As more naevi are being classified, the power of the method is enhanced. Thus physicians can benefit from experience accumulated by others and the screening can be performed effectively by physicians with less experience.

Dysplastic Nevus Syndrome↗
PubMed1999

Maggot therapy for the treatment of intractable wounds.

BACKGROUND: Fly maggots have been known for centuries to help debride and heal wounds. Maggot therapy was first introduced in the USA in 1931 and was routinely used there until the mid-1940s in over 300 hospitals. With the advent of antimicrobiols, maggot therapy became rare until the early 1990s, when it was re-introduced in the USA, UK, and Israel. The objective of this study was to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds and ulcers in long-term hospitalized patients in Israel. METHODS: Twenty-five patients, suffering mostly from chronic leg ulcers and pressure sores in the lower sacral area, were treated in an open study using maggots of the green bottle fly, Phaenicia sericata. The wounds had been present for 1-90 months before maggot therapy was applied. Thirty-five wounds were located on the foot or calf of the patients, one on the thumb, while the pressure sores were on the lower back. Sterile maggots (50-1000) were administered to the wound two to five times weekly and replaced every 1-2 days. Hospitalized patients were treated in five departments of the Hadassah Hospital, two geriatric hospitals, and one outpatient clinic in Jerusalem. The underlying diseases or the causes of the development of wounds were venous stasis (12), paraplegia (5), hemiplegia (2), Birger's disease (1), lymphostasis (1), thalassemia (1), polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were examined daily or every second day until complete debridement of the wound was noted. RESULTS: Complete debridement was achieved in 38 wounds (88.4%); in three wounds (7%), the debridement was significant, in one (2.3%) partial, and one wound (2.3%) remained unchanged. In five patients who were referred for amputation of the leg, the extremities was salvaged after maggot therapy. CONCLUSIONS: Maggot therapy is a relatively rapid and effective treatment, particularly in large necrotic wounds requiring debridement and resistant to conventional treatment and conservative surgical intervention.

Adult↗
PubMed1998

Low-dose low-molecular-weight heparin (enoxaparin) is beneficial in lichen planus: a preliminary report.

BACKGROUND: Low-dose heparin devoid of anticoagulant activity inhibits T-lymphocyte heparanase activity, which is crucial in T-cell migration to target tissues. OBJECTIVE: The purpose of this study was to assess the efficacy of low-dose enoxaparin (Clexane), a low-molecular-weight heparin, as monotherapy in lichen planus. METHODS: Included in the study were 10 patients with widespread histopathologically proven lichen planus (LP) associated with intense pruritus of several months' duration. Patients were given 3 mg enoxaparin, subcutaneously once weekly; three patients received four injections, and seven patients received six injections. RESULTS: In nine patients the itch disappeared within 2 weeks. Within 4 to 10 weeks in eight of these patients, there was complete regression of the eruption with residual postinflammatory hyperpigmentation; in one patient, there was marked improvement. In one patient, no effect was observed. Of the four patients who also had oral LP, only one showed improvement. No side effects were observed in any of the patients. CONCLUSION: These findings indicate that enoxaparin may be a simple, effective treatment for cutaneous LP.

Adult↗
PubMed1998

Safety of solar phototherapy at the Dead Sea.

BACKGROUND: Climatotherapy at the Dead Sea is effective for patients with psoriasis, atopic dermatitis, vitiligo, and other diseases. Although impressive improvement has been reported for patients with psoriasis, with a clearance rate of more than 80% after a 4-week stay, questions regarding the safety of this treatment have arisen. OBJECTIVE AND METHODS: We compare the mean UVB radiation intensities absorbed by psoriatic patients undergoing a 4-week climatotherapy under supervision at the DMZ Rehabilitation Clinic of Ein-Bokek (The Dead Sea, Israel), with similar climatotherapy studies in Sweden and Switzerland. We also compare the climatotherapy radiation dosages with the UVB intensities absorbed by psoriatic patients in radiation cabins at seven university clinics. RESULTS: According to our individually computerized DMZ protocol, a psoriasis patient with skin type IV is exposed during a 4-week climatotherapy to a mean 3.11 J/cm2 (148 MED) of UVB, similar to that in Sweden and Switzerland. The range of the in-clinic annual phototherapy in the seven medical centers studied varied from 1.17 to 37.80 J/cm2 (56 to 1800 MED). CONCLUSION: When all relevant factors are taken into account, the mean UVB exposure dose at the Dead Sea is one of the lowest reported for clearance of psoriatic plaques.

Humans↗
PubMed1998

Detergents and bleaches are sources of chromium contact dermatitis in Israel.

Total chromium levels were determined in 38 detergents and 12 bleaches on the market in Israel (45 locally produced, 5 imported). The samples were analyzed by Zeeman-corrected graphite furnace atomic absorption spectrophotometry. Chromium levels were higher than 5 ppm in 28 (56%) of the 50 products, from 1 to 5 ppm in 16 (32%), and lower than 1 ppm in only 6 (12%). Among the 5 imported products, only 1 had a chromium level below 1 ppm and the other 4 (1 from Germany, 3 from the USA) had high levels. Since a most 90% of the detergents and bleaches examined contained chromium levels higher than 1 ppm, it is concluded that these consumer products may be the cause of the high incidence of chromium sensitivity in Israel.

Anti-Infective Agents, Local↗