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Biomedical subjects

B Przybilla

Publications and source records attributed to B Przybilla.

At least 127 records · Page 7Linked to original sources
PubMed1991

Photopatch testing with different ultraviolet A sources can yield discrepant test results.

A photopatch test series consisting of 27 substances was tested in 81 patients with suspected photosensitivity disorders. Irradiation was performed using the following light sources: TL-K 40W/09 bulbs (UVA'; lambda max. at 355 nm), UVASUN 5000 (UVA''; lambda max. at 375 nm), and TL 20 W/12 bulbs (UVB; lambda max. at 315 nm). One day after applying 4 sets of the test substances (D1), one test series each was exposed to 10 J/cm2 of UVA' or UVA'', or a combination of 40 mJ/cm2 UVB and 10 J/cm2 UVA''; the fourth series was left nonirradiated (control). Photopatch test reactions (PPTR) were defined as positive if there was at least an indurated erythema on D3 or later between D3 and D21 (late-onset reactions) exclusively at the irradiated, but not at the control site. At least one positive PPTR was found in 35 patients (43%), 7 of whom exhibited late-onset reactions only; in 2 cases the tests could not be read because of skin irritation. On D3, there were 44 positive reactions with UVA', only 10 of which were also demonstrable with UVA''. Twenty-one late-onset PPTR were found with UVA' and 17 with UVA''. Late-onset reactions elicited by UVA' or UVA'' mostly were concordant; divergent positive or negative results were found only in a few cases. Compared with the results obtained with UVA' or UVA'' alone, combined irradiation with UVB and UVA'' occasionally led to divergent positive as well as negative results. When photopatch test results are interpreted, it should be considered that testing with different UVA sources may yield divergent results.

Adolescent↗
PubMed1990

Demonstration of quinolone phototoxicity in vitro.

The 'first-generation' quinolones cinoxacin, nalidixic acid, oxolinic acid, pipemidic acid and rosoxacin and the newly developed quinolones ciprofloxacin, enoxacin, fleroxacin, norfloxacin and ofloxacin were screened in vitro at 10(-5), 10(-4) and 10(-3) M concentrations for ultraviolet (UV)-induced phototoxic effects in a photohemolysis test. At 10(-3) M, photodependent effects of norfloxacin could not be evaluated, as hemolysis occurred without irradiation. All other compounds with the exception of ciprofloxacin were found to be phototoxic at 10(-3) M and some also at 10(-4) M. Hemolysis was UV dose dependent and for all compounds most prominent after exposure to UVA-rich radiation except for fleroxacin which was most active in the UVB range. Besides fleroxacin, also oxolinic acid, pipemidic acid and rosoxacin induced hemolysis with irradiations rich in UVB. It is concluded that quinolones have to be regarded as potentially phototoxic substances. Therefore intense light exposure should be avoided during treatment with these agents.

Dose-Response Relationship, Radiation↗
PubMed1990

Efficiency of acitretin in combination with UV-B in the treatment of severe psoriasis.

Compared with the antipsoriatic retinoid etretinate, the new aromatic retinoid acitretin represents an important advance due to its rapid elimination kinetics. Since in psoriasis vulgaris retinoids are used predominantly in combination regimens, we investigated the therapeutic efficacy of acitretin and UV-B compared with placebo and UV-B in a double-blind, randomized multicenter trial in 82 patients with severe psoriasis. They were treated with 35 mg of the study medication during the first 4 weeks of therapy and 25 mg thereafter, concomitantly with UV-B irradiation in increasing energy doses. Forty patients who underwent therapy with acitretin and UV-B and 38 patients who underwent therapy with placebo and UV-B were evaluated for efficacy. The target variables--psoriasis severity index and total UV-B dose--were reported at intervals of 2 weeks over a maximum period of 8 weeks. At the end of treatment, the psoriasis severity index decrease was 79% in the acitretin and UV-B group and 35% in the placebo and UV-B group. The response rate, defined as greater than or equal to a 75% decrease of the psoriasis severity index, was 60% for the combination treatment and only 24% for the control treatment. This treatment response was achieved with markedly lower cumulative UV-B energy. The median cumulative UV-B energy applied to reach 75% clinical improvement was 11.8 J/cm2 vs 6.9 J/cm2. Side effects showed a similar pattern in both groups. Our data show that the acitretin dramatically improves the results of UV-B treatment in patients with severe psoriasis. In addition, it markedly decreases the effective cumulative UV-B dose, thereby reducing the potential long-term hazards of UV irradiation. We conclude that the acitretin plus UV-B combination treatment represents a highly effective therapeutic regimen in severe psoriasis.

Acitretin↗
PubMed1990

Food allergy and atopic eczema.

As a contributing factor, certain foods can provoke skin lesions in some patients with atopic eczema. In newborns with an increased risk of atopy, exclusive breastfeeding during the first months of life and delayed introduction of solid food seem to inhibit or to retard the manifestation of atopic disease. The pathomechanism of provocation of eczema by food has not yet been elucidated. The frequent finding of specific immunoglobulin E (IgE) antibodies to the offending food items suggests that immediate type allergic reactions may be involved. Furthermore, other allergic or nonimmunologic (pseudo-allergic) mechanisms have to be considered. History taking, skin tests, and radioallergosorbent test (RAST) may provide some information with regard to eliciting food, but these procedures usually are not sufficient to obtain a conclusive diagnosis. Oral challenge tests have to be performed in a controlled manner in order to identify food items that are not tolerated and thus have to be avoided. As most of the patients react only to one or two food items and as these often differ from one patient to another, undirected exclusion diet regimens are unnecessary and unethical. Furthermore, such diets bear the risk of malnutrition and of anaphylactic reactions after reintroduction of allergenic food. Dietary recommendations in atopic eczema have to be based on a careful allergological workup of the individual patient.

Dermatitis, Atopic↗
PubMed1990

[UV exposure in the workplace. Apropos the establishing of threshold limit values].

Although UV exposure is present at many workplaces, it has not gained much attention. Particularly with regard to UVA, the UV threshold limit values for acute effects used to date are insufficient, and there are no obligatory limits to prevent the sequels of chronic UV exposure. More precise threshold limit values have been published only preliminarily (DIN-Standard No. 5031, part 10). There is a need for regulations governing the supervision of occupational UV exposure and the individual protection of exposed persons.

Dose-Response Relationship, Radiation↗
PubMed1990

[Subcutaneous dirofilariasis: infection with Dirofilaria repens].

A female patient resident in Germany is described, who had developed dirofilariasis presenting as a hard subcutaneous nodule at the glabella. Dirofilaria repens was isolated after surgical removal of the skin lesion. She was treated with diethylcarbamazine (Hetrazan) for 4 weeks. Exposures related to infection with Dirofilaria repens are discussed.

Animals↗
PubMed1989

Reproducibility of patch test results: comparison of TRUE Test and Finn Chamber test results.

To evaluate the reproducibility of patch test results, duplicate patch test series comprising 12 allergens were simultaneously applied to either side of the back in 63 patients by the use of a newly developed patch test system, TRUE Test. When a positive test result occurred on only one side of the back, it was regarded as nonreproducible. For evaluation of the concordance of test reactions between the TRUE Test and the Finn Chamber test, the same 12 allergens mixed in petrolatum were also applied to the upper back according to the Finn Chamber technique. The reproducibility of TRUE Test results was compared with the reproducibility of the Finn Chamber test in 76 other patients. The concordance of positive reactions between the two tests was 57%, somewhat lower than in recently published studies. The percentage of nonreproducible positive results was more than twice as high with Finn Chambers, (22 of 58 positive reactions, or 37.9%) as with the TRUE Test (5 of 28 reactions, or 17.9%). However, this difference in reproducibility in the two test systems was not significant as determined by the chi 2 test (p less than 0.05).

Allergens↗
PubMed1989

Reproducibility of patch tests.

Patch tests with a series of 39 substances were performed in 41 patients on one side of the upper aspect of the back. Testing was repeated on the contralateral side of the back 1 week later (sequential testing). In 35 other patients, duplicate patch test series were simultaneously applied on both sides of the back (concomitant testing). If a positive reaction to a test substance was obtained at only one side of the back, the result was regarded as nonreproducible. Of all positive reactions, 40.0% were nonreproducible at sequential testing and 43.8% were nonreproducible at concomitant testing. Weakly positive reactions were far more often nonreproducible than stronger reactions.

Adult↗
PubMed1989

Preventive effect of an E. coli-filtrate (Colibiogen) in polymorphous light eruption.

During the administration of Colibiogen, a commercially available E. coli-filtrate, there was a significant (P less than 0.01) increase of the test dose of UVA necessary to elicit skin lesions in nine patients with polymorphous light eruptions. Control tests performed in the same manner without the drug indicate that this was due to treatment. Colibiogen appears to be of value in the treatment of polymorphous light eruption (PLE).

Adult↗
PubMed1989

Ultraviolet A inhibits histamine release from human peripheral leukocytes.

Irradiation of human peripheral leukocytes with ultraviolet A (UVA) induced a significant and dose-dependent reduction of anti-IgE or Ca-ionophore-stimulated histamine release without consistent influence upon C5a-induced release reactions. This effect was equally demonstrable in atopics and controls. In the presence of the radical scavenger superoxide dismutase, the UVA-induced inhibition of anti-IgE-induced histamine release was abolished. Under the conditions used, UVB exposure did not result in relevant changes of in vitro histamine release.

Antibodies, Anti-Idiotypic↗
PubMed1989

[Olmstedt syndrome--associated with primary sclerosing cholangitis and immune deficiency of uncertain origin].

The Olmstedt syndrome is an erythrokeratodermia of unknown aetiopathogenesis, which mostly becomes manifest in early childhood. Skin lesions involve palms, soles and the periorificial regions. Up to now only 6 cases have been reported. We present a new case of a 45-year-old woman who had started developing the characteristic skin lesions at the age of 30. Remarkably, primary sclerosing cholangitis and an immunodeficiency of an unknown origin were present in this patient. Systemic treatment with glucocorticosteroids cleared the periorificial lesions temporarily, whereas the palmoplantar keratoses hardly responded to therapy. An attempt at treatment with retinoids was precluded by the presence of hepatic disease.

Candidiasis, Vulvovaginal↗
PubMed1989

[Urea in combination with dithranol in treating psoriasis vulgaris].

Dithranol (anthralin) is one of the basic compounds used in the treatment of psoriasis vulgaris. However, in outpatients its use is largely restricted as it may cause discoloration of skin, clothes, and bedding as well as significant skin irritation. The combination of dithranol with urea results in a better benefit/side-effect ratio. Even at relatively low dithranol concentrations (0.1%/0.2%) combined preparations have been found to be effective over several weeks of application. The therapeutic results of such treatment are comparable to those of topical glucocorticosteroid preparations.

Administration, Topical↗
PubMed1988

[Ambulatory external treatment of psoriasis vulgaris: comparison of the effectiveness of a dithranol and a glucocorticoid-containing preparation].

In a comparative study, 20 ambulatory patients suffering from chronic psoriasis vulgaris with plaques were treated with preparations containing either dithranol (0.1/0.2%) plus urea (17%) or desoximetasone (0.25%). In the two groups, 7 and 8 courses, resp., could be evaluated. Both modalities led to significant improvement of the skin lesions. During the course of treatment, there were no significant differences between the two regimens with regard to both the area of skin involvement and the scores of semiquantitative evaluation of infiltration, erythema, and scaling.

Administration, Topical↗