Decline of plasma concentrations of etretinate and its main metabolite after treatment.
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Biological Availability↗
Biomedical subjects
A Lassus
Publications and source records attributed to A Lassus.
Pharmacokinetics of 8-methoxypsoralen in serum and suction blister fluid.
Micronized 8-methoxypsoralen (8-MOP), with a smaller crystal size, produced significantly higher serum level profiles than nonmicronized 8-MOP. Furthermore, the absorption of the micronized drug was more rapid, resulting in peak serum levels within 1 h in 75% of the patients. Our blister fluid studies suggest, however, that reduction of the photosensitizer concentration is slower in skin than in serum. This implies that despite markedly reduced 8-MOP serum level after 2 h the skin remains sufficiently sensitized up to that point of time.
Blister↗
HLA antigens in patients with chronic biologically false-positive seroreactions for syphilis and systemic lupus erythematosus.
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Adult↗
Allergic contact eczema from topical corticosteroids.
Epicutaneous tests with topical steroids in therapeutic and ten-fold therapeutic concentrations in ethanol were performed in 105 patients selected on the basis of unresponsiveness of their eczema to topical corticosteroids or because topical steroids had provoked eczema around treated psoriatic lesions. Five patients showed allergic test reactions to one or several steroids. One of the two clobetasol-17-propionate sensitive patients reacted to the weak concentration only. The problem related to the instability of many steroids in ethanolic solution is discussed. After one month of storage in a refrigerator, the chromatographic purity of several test substances fell to 95-75%.
Administration, Topical↗
Light and electron microscopy of psoriatic skin before and during retinoid (Ro 10-9359) and retinoid-PUVA treatment.
Eight patients with psoriasis (pustular, erythrodermic or severe plaque type) were treated successfully with retinoid (Ro 10-9359) or with retinoid followed by PUVA (RePUVA). The histological changes in recovering skin were examined during 14 weeks. Treatment resulted in normalization of keratinocyte differentiation with fine structural changes suggesting decreased metabolic activity and a reduction of mitoses. There was an increase in the number of keratohyalin granules and of tonofilaments and desmosomes and a decrease in leukocytes in the epidermis. The different cell organelles were studied in detail, but the exact mechanism of retinoid action remains unsolved. Although the treatments were clinically highly effective, total normalization of the histological and electron microscopical picture was not achieved.
Animals↗
Ultrahistopathology of balanitis circinata.
Penile lesions from six patients with balanitis circinata were examined with the light and electron microscopes. The epithelium showed slight parakeratosis, acanthosis, and elongation of rete ridges. Neutrophil pustules occupied the upper epidermis. Prickle cells formed a spongiform net around the pustules. The most prominent features detected by the electron microscope were the small-to-medium-sized pustules in the upper epidermis. The thin flattened keratinocytes formed a sponge-like trabecular network. Neutrophils were not found inside the keratinocytes. Chlamydia were not present in the lesions, which indicates that balanitis circinata is due to some reactive mechanism. The fine structure of balanitis circinata resembles that of pustular psoriasis.
Adult↗
A double-blind cross-over evaluation of ketoprofen and indomethacin in Reiter's disease.
A double-blind cross-over study to compare the effect of 200 mg ketoprofen per day with that of 100 mg indomethacin per day was carried out in 50 patients with seronegative polyarthritis associated with Reiter's disease. Treatment was withdrawn in 3 cases, in 2 because of sideeffects due to indomethacin, in one owing to an intercurrent disorder. Treatment was discontinued in 3 other cases because of an exacerbation of the arthritis, in 2 cases during the ketoprofen period and in one during the indomethacin period. In the remaining 44 cases no statistically significant difference was observed between the beneficial effects of ketoprofen and indomethacin on the arthritis during the two 8-week periods of treatment. Initially ketoprofen had a slightly superior effect on pain, while during the second period indomethacin had a better effect on pain, morning stiffness and limitation of joint movement. Ketoprofen caused fewer and less serious sideeffects than indomethacin.
Adult↗
The effect of etretinate on fibronectin in psoriatic skin.
The distribution of fibronectin in psoriatic skin was studied in 6 patients during treatment with oral etretinate using indirect immunofluorescence technique. In untreated lesions fibronectin was clearly visualized in the dermo-epidermal junction (DEJ) and in the walls of papillary capillaries, and showed a reticular or fibrillar pattern in the dermis. In the horny layer there was some fluorescence which we regarded largely as unspecific. In all patients a transient accentuation of fibronectin accumulation in DEJ was seen after 3-7 days of treatment. Except for some decrease in the amount and intensity of capillary fluorescence, no other notable changes occurred in the fibronectin distribution during 4 weeks of treatment.
Adult↗
Treatment of uncomplicated genital Chlamydia trachomatis infections in males.
The treatment of chlamydial urethritis in males depends on the susceptibility of Chlamydia trachomatis to different antimicrobial agents. Tetracyclines seem to be the drugs of choice; long-acting tetracyclines are recommended, as these are more convenient for the patient. Both lymecycline and doxycycline produce clinical and bacteriological cure in approximately 90% of cases, when used in adequate doses. Erythromycin is the alternative treatment in patients who should not be given tetracyclines. Trimethoprim/sulfamethoxazole is effective in patients with chlamydial urethritis, but it seems to be ineffective in those with Chlamydia-negative urethritis. The importance of treating sexual partners should not be overlooked.
Anti-Bacterial Agents↗
A clinical evaluation of the effects of an aromatic retinoid (Tigason), combination of retinoid and PUVA, and PUVA alone in severe psoriasis.
Eighty ambulatory adult patients with severe psoriasis were included in our 14-week study to compare the clinical effects of treatment with an aromatic retinoid (Tigason), combination treatment with aromatic retinoid plus PUVA (RePUVA), and PUVA alone. RePUVA was given by two different modifications: either 4 weeks of pretreatment with retinoid followed by 6 weeks of PUVA treatment, or 10 weeks of retinoid treatment with concomitant PUVA treatment during the last 6 weeks. The latter modification of RePUVA proved to be significantly more effective than the other treatments (P less than 0.01) as regards complete remission. With respect to the number of patients with good or excellent improvement (75-100% improvement) there was no marked difference between RePUVA and PUVA treatments. Retinoid alone proved to be the least effective, showing, however, a good to excellent result in 65% of patients. Besides the increase in efficacy, another advantage achieved by RePUVA was a highly significant (P less than 0.001) reduction of total UVA doses to about one third as compared to PUVA therapy.
Adult↗
Hyperpigmentation and hypopigmentation of the skin after long term PUVA therapy. Light and electron microscopic observations on three patients.
An electron microscopic study was performed to demonstrate the pathological changes induced by long term PUVA treatment in recalcitrant psoriasis. Three patients developed mottling (hyperpigmentation and hypopigmentation) during two to three years of treatment. Three different types of morphological changes were found: disarrangement of keratinocytes, clustering and stimulation of melanocytes and homogenization of papillary dermis. Furthermore, the superficial blood vessels were loaded with the same type of amorphous granular substance. These changes might be specific to PUVA treatment or they might occur only in patients with previous treatment with, e.g., arsenic, methotrexate, anthralin + UVB or a combination of these.
Adult↗
PUVA treatment and skin cancer: A follow-up study.
Altogether 525 PUVA-treated psoriatics were re-examined. The mean follow-up period since the beginning of PUVA therapy was 2.1 years (range 1-3.6 years). In 107 cases (20%) the total UVA dose was below 100 J/cm2 and in 20 (4%) over 1000 J/cm2. During PUVA treatment or at re-examination of 14 of the 525 patients (3%) were found to have skin lesions suspected of being malignant. A total of 23 biopsies were taken and in one case a basal-cell carcinoma was histologically verified. This had almost certainly been present before the beginning of the PUVA therapy. Two other patients, both previously treated with methotrexate, had reversible lesions with Bowenoid histology. Both these patients had received a total UVA dose of more than 1000 J/cm2. The incidence of skin carcinomas in the present PUVA treated series was lower than that in hospitalized psoriatics treated with regimens other than PUVA and was not higher than the incidence in the age-matched general population in Finland.
Adult↗
Clinical trial of a potent non-halogenated topical steroid, Budesonide.
In a double-blind, randomized multi-centre study, 116 patients with psoriasis have been treated for 1-3 weeks with budesonide ointment (Preferid, Draco/Tika; a subsidiary of AB ASTRA), a new non-halogenated topical steroid. In a series of 11 patients a 0.025% budesonide ointment was significantly superior to placebo. In a second series, of 54 patients, a 0.025% fluocinolone acetonide ointment (Synalar, ICI). In a third series, of 51 patients, a 0.010% budesonide ointment was compared with 0.025% fluocinolone acetonide ointment. No statistically significant difference between these two preparations was found to exist. No adverse reactions were observed.
Administration, Topical↗
Mixed connective tissue disease: a follow-up study of 12 patients with special reference to cold sensitivity and skin manifestations.
A great variety of skin manifestations and the frequent occurrence of cold sensitivity, vascular symptoms with peripheral painful ulcerations, headache of migraine type, and muscle and joint symptoms are described in a series of 12 patients with an overlap syndrome compatible with mixed connective tissue disease (MCTD). The patients have been followed up for an average of 7 years. The peripheral symptoms on the extremities in particular were exacerbated by exposure to cold and caused much inconvenience and early disability for the patients. In addition to the symptoms generally connected with MCTD, some of the patients presented signs of other diseases of autoimmune type as well. For instance 2 of the patients presented autoimmune thyroiditis and one patient developed myasthenia gravis and cold agglutinin syndrome.
Adolescent↗
One-week treatment of chlamydia-positive urethritis with doxycycline and tetracycline chloride in males.
65 patients with chlamydia-positive urethritis were treated with doxycycline and 59 with tetracycline chloride 1 g/day for one week. All steady sexual partners of these patients were treated with the same regimen during the same period. At control visits 2 and 3 weeks after the beginning of the treatment, all re-examined doxycycline-treated patients and all except 4 tetracycline-treated patients showed clinical cure and were free from signs of urethritis in the microscopical examination of Gram-stained smears from the urethra. Isolation of C. trachomatis was positive in 7 of the doxycycline-treated and 10 of the tetracycline-treated patients at the first control visit and in one more tetracycline-treated patient at the second control visit. The study stresses the importance of attempts to isolate C. trachomatis in cases without clinical or microscopical evidence of nongonococcal urethritis at control visits after short-term treatment with tetracyclines. The present investigation indicates that this is true also in cases in which all steady sexual partners are treated simultaneously.
Adult↗
Fine structure of the intercellular space of psoriatic epidermis during retinoid (RO 10-9359) and retinoid-PUVA treatment.
The enlarged intercellular space in the lower malpighian layers of untreated psoriasis contains a fine granular and a coarse granular substance. Both types of this substance increase in amount during 2-6 weeks of retinoid (RO 10-9359) therapy. Retinoid stimulates the formation of these substances, which previously have been termed "mucus". After glutaraldehyde-osmium tetroxide fixation their mucoid nature cannot be ascertained more specific cytochemical techniques being needed for this. A darker, more homogeneous substance in the upper spinous intercellular spaces increases in amount during retinoid therapy. Large amounts of keratinosome-derived lamellae are observed at the boundary of the stratum intermedium and the stratum corneum. Even after 14 weeks of treatment with retinoid or retinoid plus PUVA, at clinical remission, the histological and electron microscopical pictures still show some psoriatic changes, i.e. enlarged intercellular spaces with fine or coarse granular substance.
Adult↗
Treatment of Darier's disease with an oral aromatic retinoid (Ro 10-9359): a clinical and light and electron microscopic study.
An aromatic retinoid (Ro 10-9359) cleared 6 of 8 patients with Darier's disease in 4-6 weeks. After discontinuing the treatment, remission was maintained for up to 5 months. In 2 severe cases continuous treatment proved necessary in order to maintain the improved state. Acantholysis, various types of dyskeratosis and acanthosis with downward proliferation of rete ridges were seen by light microscopy before treatment. Electron microscopy revealed a decreased number of desmosomes and other cellular attachments and conspicuous microvillous changes of cell surface in separated basal cells. Keratinization in epidermal cells was premature and characterized by abnormal aggregations of keratinization products. Under the influence of retinoid there seemed to appear a new generation of basal cells better able to form intercellular attachments, after which the progress of keratinization in the entire epidermis shifted towards normal, and acanthosis decreased.
Administration, Oral↗
Trioxsalen bath plus UVA treatment of psoriasis. Plasma concentration of the drug and clinical results.
Forty-five patients with psoriasis were treated with trioxsalen bath plus UVA. Good or excellent results were obtained in 34 (67%) of the 51 treatments. Trioxsalen plasma concentrations were determined at different stages of the treatment in 10 patients 1 hour after trioxsalen bath, and in 11 patients undergoing treatment for vitiligo 2 hours after ingestion of 0.6 mg trioxsalen per kilogram body weight. The determinations were performed using the glass capillary, gas chromatography, mass spectrometry method, reaching a sensitivity of greater than or equal to 25 pg/ml. The trioxsalen plasma concentrations varied between 12.5 and 0.27 ng/ml after oral ingestion and between approximately 9 ng/ml and less than 25 pg/ml after bath application.
Adolescent↗