Search PubMed⌕ Search

Biomedical subjects

C W Lynde

Publications and source records attributed to C W Lynde.

34 records · Page 2Linked to original sources
PubMed1997

Prevalence and epidemiology of unsuspected onychomycosis in patients visiting dermatologists' offices in Ontario, Canada--a multicenter survey of 2001 patients.

BACKGROUND: Questionnaire studies have been used to determine the prevalence of onychomycosis in the United Kingdom and Europe. One disadvantage of this methodology is that the patient self-diagnoses the onychomycosis. There have been very few large studies involving clinical examination of the nails of subjects, followed by mycological confirmation of the onychomycosis. We therefore determined the prevalence of onychomycosis in patients visiting dermatologists' offices in Ontario, Canada. METHODS: In a prospective, multicenter study, the finger- and toenails of all new patients presenting to dermatologists' offices were examined by a board-certified dermatologist. If there was clinical suspicion of onychomycosis, then nail samples were obtained for mycological examination at a central laboratory. Patients referred specifically for the management of onychomycosis were excluded. RESULTS: Toenails appeared abnormal in 455 (22.7%) of 2001 patients. Mycologically-confirmed pedal onychomycosis was present in 182 (9.1%) of the 2001 patients. The estimated value of the prevalence of onychomycosis in Ontario is 6.86% (95% confidence interval (CI): 5.8-8.0%), when corrected for age and sex of the general population using census data. Onychomycosis increased with age (P < 0.0001). The odds of males having onychomycosis was 84.3% greater than females of the same age (P = 0.0003). The distribution of organisms in the 141 patients with pedal onychomycosis who were culture positive was: dermatophytes 131 (92.9%), Candida species 4 (2.8%) and non-dermatophyte molds 6 (4.3%). CONCLUSIONS: The prevalence of mycologically-confirmed toenail onychomycosis was 9.1%, with the estimated prevalence in Ontario being 6.86%. The majority of patients with abnormal-appearing nails were unaware they might have onychomycosis, that it is infectious and potentially treatable, suggesting that there is potential for increased public awareness and education.

Adolescent↗
PubMed1997

A higher prevalence of onychomycosis in psoriatics compared with non-psoriatics: a multicentre study.

There is some controversy about the prevalence of onychomycosis in patients with psoriasis compared to non-psoriatics. We therefore measured the prevalence of toenail onychomycosis in psoriatics and non-psoriatics attending dermatologists' offices. None of the patients had a referring diagnosis of onychomycosis. The prevalence of pedal onychomycosis in psoriatics (n = 561) was 13%. The odds of patients with psoriasis having onychomycosis was 56% greater than non-psoriatics of the same age and sex (P = 0.02). In the psoriatics, when the toenails were clinically abnormal, the prevalence of onychomycosis was 27%. The odds of developing onychomycosis increased with age (P < 0.0001) and the odds of men developing onychomycosis was 2.5 times that of women (P = 0.0001). The duration of psoriasis did not significantly affect the odds of developing onychomycosis. The fungal organisms recovered from psoriasis subjects with onychomycosis were similar to those in the normal population with onychomycosis (P = 0.58).

Female↗
PubMed1993

Comparative study of the efficacy and safety of loratadine syrup and terfenadine suspension in the treatment of chronic allergic skin diseases in a pediatric population.

The safety and efficacy of loratadine (Sch 29851, CAS 79794-75-5) syrup (5 or 10 mg QD) was compared to terfenadine (CAS 50679-08-8) suspension (30 mg b.i.d.) in a randomized, third party blind, parallel-group, multicenter trial. Two hundred thirty-six children ages 6-12 years, with chronic allergic skin disorders were treated for 14 days. The predominant skin condition was atrophic dermatitis (88% of the efficacy population). Evaluation of efficacy was based on investigator and patient assessment of symptoms, overall condition of the disease, and therapeutic response to treatment. After 7 and 14 days of treatment, and in the endpoint analysis (last valid study visit for all patients) the decreases from baseline in mean total sign/symptom scores, and all individual symptoms, did not differ significantly (p > 0.05) between treatments. Itching improved 54% in the loratadine group and 58% in the terfenadine group in the endpoint analysis. Forty-five percent of patients treated with loratadine and 46% of terfenadine-treated patients treated had complete or marked relief of their symptoms at endpoint. The efficacy of loratadine increased during the study, suggesting that patients did not develop tolerance to the medication over the 14-day course of therapy. Mild to moderate treatment-related adverse experiences were reported in 7/113 patients (6%) treated with loratadine and 11/119 patients (9%) treated with terfenadine. Single daily doses of 5 mg or 10 mg loratadine syrup were comparable to terfenadine suspension 30 mg twice daily for improving the symptoms of chronic allergic skin disorders in children. Loratadine was safe and well tolerated.

Child↗
PubMed1984

Multiple melanomas occurring in a patient with xeroderma pigmentosum.

Xeroderma pigmentosum (XP) is associated with an increased frequency of cutaneous malignancies including malignant melanoma. We report a patient who developed eleven primary melanomas and numerous highly atypical nevi in addition to the basal cell carcinomas and squamous cell carcinomas more commonly seen in patients with XP.

Adult↗
PubMed1984

Tumors of ceruminous glands.

Tumors of the ceruminous glands may involve the auricular and preauricular skin and thus should be included in the differential diagnosis of neoplasms involving these areas. A rational decision as to the management of ceruminous gland tumors depends on the precise histologic classification of these tumors and the extent of involvement. We present seven patients with tumors of the ceruminous glands: ceruminous adenoma in one, ceruminous adenocarcinoma in three, and adenoid cystic carcinoma in three. The literature is reviewed with respect to signs and symptoms, pathology, and therapy.

Adenocarcinoma↗
PubMedDate not supplied

Therapeutic options for the treatment of tinea capitis caused by Trichophyton species: griseofulvin versus the new oral antifungal agents, terbinafine, itraconazole, and fluconazole.

Tinea capitis is a relatively common fungal infection of childhood. Griseofulvin has been the mainstay of management. However, newer oral antifungal agents are being used more frequently. A multicenter, prospective, randomized, single-blinded, non-industry-sponsored study was conducted in centers in Canada and South Africa to determine the relative efficacy and safety of griseofulvin, terbinafine, itraconazole, and fluconazole in the treatment of tinea capitis caused by Trichophyton species. The regimens for treating tinea capitis were griseofulvin microsize 20 mg/kg/day x 6 weeks, terbinafine [> 40 kg, one 250 mg tablet; 20-40 kg, 125 mg (half of a 250 mg tablet); < 20 kg, 62.5 mg (one-quarter of a 250 mg tablet)] x 2-3 weeks, itraconazole 5 mg/kg/day x 2-3 weeks, and fluconazole 6 mg/kg/day x 2-3 weeks. Patients were asked to return at weeks 4, 8, and 12 from the start of the study. Griseofulvin was administered for 6 weeks and the final evaluation was at week 12. Terbinafine, itraconazole, and fluconazole were administered for 2 weeks and the patient evaluated 4 weeks from the start of therapy. At this time, if clinically indicated, one extra week of therapy was given. There were 200 patients randomized to four treatment groups (50 in each group). At the final evaluation at week 12, the number of evaluable patients were griseofulvin, 46; terbinafine, 48; itraconazole, 46; and fluconazole, 46. Patients who discontinued therapy or were lost to follow-up were griseofulvin, 1/3; itraconazole, 0/4; terbinafine, 0/4; and fluconazole, 0/4. The causative organisms were Trichophyton tonsurans and T. violaceum species. Patients were regarded as effectively treated at week 12 if there was mycologic cure and either clinical cure or only a few residual symptoms. Effective treatment was recorded in, intention to treat, griseofulvin (46 of 50, 92.0%), terbinafine (47 of 50, 94.0%), itraconazole (43 of 50, 86.0%), and fluconazole (42 of 50, 84.0%) (p=0.33). Adverse effects were reported only in the griseofulvin group (gastrointestinal effects in six patients). Discontinuation from therapy due to adverse effects occurred only in the griseofulvin group (nausea in one patient). For the treatment of tinea capitis caused by the Trichophyton species, in this study, griseofulvin given for 6 weeks is similar in efficacy to terbinafine, itraconazole, and fluconazole given for 2-3 weeks. Each of the agents has a favorable adverse-effects profile.

Adult↗