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Biomedical subjects

D M Pariser

Publications and source records attributed to D M Pariser.

49 records · Page 3Linked to original sources
PubMed1990

Cutaneous candidiasis. A practical guide for primary care physicians.

Cutaneous candidiasis is a common fungal infection that can affect intertriginous or occluded areas, mucous membranes, the glabrous skin, and the nails. The diagnosis is confirmed by microscopic examination of a potassium hydroxide preparation, by Gram's stain or Polysciences Multiple Stain, or by culture when appropriate. Safe, simple, and effective treatment is available. Physical measures that promote dryness are helpful.

Administration, Cutaneous↗
PubMed1990

Superficial fungal infections. A practical guide for primary care physicians.

Clinicians who establish a proper diagnosis should have little difficulty managing dermatophyte infections. Diagnosis can be confirmed by direct microscopic examination with a potassium hydroxide preparation or by culture with the dermatophyte test medium. Safe, reliable antifungal therapy is available. Treatment will be more effective if antifungal therapy is not prescribed until fungal organisms have been identified and if topical steroids are not prescribed until fungal organisms have been excluded.

Antifungal Agents↗
PubMed1989

Cutaneous viral infections: herpes simplex and varicella-zoster.

Herpes simplex and varicella-zoster infections of the skin are commonly seen in primary care practice. For the patient to be managed most effectively, clinical diagnoses must be accurately made and supported by laboratory confirmation using the Tzanck smear and/or viral culture. Topical therapy and systemic acyclovir can be of help to most patients with these infections.

Acyclovir↗
PubMed1989

Diagnostic and therapeutic techniques. For evaluation and treatment of skin disorders.

Many infectious diseases of the skin can be diagnosed accurately and rapidly by simple bedside techniques. This article describes several of the more useful and commonly performed techniques for diagnosing superficial fungus infection, herpes simplex, zoster, and varicella as well as the techniques for identification of the ectoparasite-producing scabies and pediculosis in addition to techniques of skin biopsy. Also the therapeutic techniques of cryotherapy and curettage and electrode-siccation are discussed.

Diagnostic Tests, Routine↗
PubMed1987

Primary care physicians' errors in handling cutaneous disorders. A prospective survey.

This study analyzes the errors made by primary care physicians in handling skin disorders in patients seen prospectively over a 20-month period in a dermatologic practice. There were 319 errors in 260 patients. Eighty-eight percent of the errors were in diagnosis. There was a striking tendency to overdiagnose infectious dermatoses such as bacterial pyodermas, superficial mycoses, scabies, and herpes simplex and to underdiagnose inflammatory dermatoses such as contact dermatitis, nummular dermatitis, pityriasis rosea, and psoriasis. In 218 cases (68%) the error probably could have been prevented if the following diagnostic criteria were considered mandatory: positive culture or potassium hydroxide preparation for dermatophytosis or candidiasis, positive Tzanck smear or viral culture for herpes simplex, zoster, or varicella, and demonstration of ectoparasite for scabies. These findings have implications for the medical education of primary care physicians and for the practitioner who handles cutaneous disorders.

Diagnostic Errors↗
PubMed1980

Toxic hepatitis from oral methoxsalen photochemotherapy (PUVA).

A 59-year-old white woman with long-standing psoriasis, who had a damaged liver from methotrexate, developed a toxic hepatitis while on oral methoxsalen photochemotherapy (PUVA). Fever and marked elevation of liver enzymes occurred after the fifteenth PUVA treatment and spontaneously returned to normal within 5 days. One week later, following the next PUVA treatment, the same toxic hepatitis developed and again spontaneously resolved. Topical methoxsalen photochemotherapy with ultraviolet A (UVA) did not produce the toxic hepatitis and provided a suppression of the psoriasis on a maintenance basis.

Administration, Oral↗
PubMed1978

Mycosis fungoides involving the brain and optic nerves.

In a patient with long-standing plaque-stage mycosis fungoides, eye pain, a visual field defect, decreased acuity, and a swollen optic disc developed. A lymphomatous infiltrate consistent with mycosis fungoides was found in the brain at craniotomy and in the optic nerves at autopsy. Ten months elapsed between the presenting symptoms and death and during this period the patient's symptoms were controlled with prednisone therapy. The optic nerves as well as the brain can be involved with mycosis fungoides.

Brain↗
PubMed1976

Intravenous desensitization to mechlorethamine in patients with psoriasis.

Eight patients with psoriasis who had developed contact allergy to mechlorethamine hydrochloride (nitrogen mustard) were subjected to a regimen of intravenous infusion of small amounts of the drug in an attempt to produce desensitization. Although three of eight developed negative patch tests and were presumed to be desensitized, only one patient was able to use the drug therapeutically, and then only for a period of eight months, after which allergy recurred. The other two patients whose allergic contact dermatitis was abolished by the infusions were unable to use mechlorethamine therapeutically because of pruritus. Seven patients experienced some adverse reaction to the infusion. Intravenous desensitization of psoriatic patients who are allergic to mechlorethamine was not successful enough as a useful clinical procedure to allow them to once again use the drug therapeutically.

Administration, Topical↗
PubMed1975

Quinidine photosensitivity.

Photodermatitis occurring in three patients taking oral quinidine sulfate cleared when the drug was discontinued and recurred when it was readministered. The dermatitis was experimentally reproduced with long-wave ultraviolet light (UV-A, 320-400 nm) in these three patients, who also exhibited a decreased minimal erythema dose (MED) to hot quartz irradiation. Patients taking quinidine who had no dermatitis exhibited normal MEDs and normal response to UV-A. Normal subjects injected intradermally with quinidine and irradiated with UV-A showed no reaction. These observations indicate that the photosensitive dermatitis to quinidine that occurred in the three patients is idiosyncratic and that the UV-A is at least partially responsible for the development of the dermatitis that correlates with the absorption of quinidine in the UV-A range. Quinidine must be considered among the drugs that can produce photosensitive dermatitis.

Aged↗
PubMedDate not supplied

Efficacy and safety of twice-daily augmented betamethasone dipropionate lotion versus clobetasol propionate solution in patients with moderate-to-severe scalp psoriasis.

This 2-week, randomized, multicenter, investigator-blinded, parallel-group study was conducted to compare the efficacy and safety of augmented betamethasone dipropionate 0.05% lotion and clobetasol propionate 0.05% solution in the treatment of moderate-to-severe scalp psoriasis among 197 (193 assessable) healthy adult patients with at least 20% scalp-surface involvement. The patients received one of two treatments applied twice a day for 2 weeks. Signs and symptoms were evaluated at baseline, after 3 days (day 4), and after weeks 1 (day 8) and 2 (day 15) of treatment. As early as 3 days after treatment, scaling and induration were improved significantly faster by betamethasone dipropionate than by clobetasol propionate. Both treatments also reduced erythema and pruritus. Patients receiving betamethasone dipropionate had a significantly greater mean percent improvement in total sign/symptom scores (P < or = 0.015) at all visits and better mean global clinical response scores at the early visits (days 4 and 8) (P < or = 0.017). At the end of the study, only mild disease was present in both groups. Adverse events were reported by 34.0% and 36.4% of patients receiving betamethasone dipropionate and clobetasol propionate, respectively. All events were transient, most were mild and local, and no discontinuations resulted. The effects of treatment on the hypothalamic-pituitary-adrenal axis were not measured. In conclusion, augmented betamethasone dipropionate lotion and clobetasol propionate solution were equally effective, but betamethasone dipropionate lotion provided a faster onset of relief for scaling and induration, which may enhance patient compliance and patient satisfaction with treatment.

Administration, Topical↗