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Biomedical subjects

D Taplin

Publications and source records attributed to D Taplin.

At least 37 records · Page 2Linked to original sources

Permethrin 5% dermal cream: a new treatment for scabies.

Permethrin 5% dermal cream (Burroughs Wellcome Co.) was compared in an investigator-blinded, randomized study against lindane 1% lotion (Kwell) for the treatment of microscopically confirmed scabies. Eleven of twenty-three patients treated with permethrin cream were cured in 2 weeks (48%). Only two patients had scabies 1 month following a single treatment with this product, giving a cure rate of 91%. One of these two patients was considered to have a reinfestation. Only three of twenty-three (13%) patients treated with 1% lindane lotion (Kwell) were free of scabies 2 weeks after a single treatment and fifteen of twenty-three (65%) were cured at 1 month. The unusually high percentage of treatment failures (35%) following lindane therapy may have been related to extensive use of this agent for head lice and scabies in this village during the preceding 5 years. The higher cure rate at 1 month seen with permethrin cream was significant (p less than 0.025). Permethrin 5% dermal cream offers a new, cosmetically elegant alternative to lindane therapy and was effective in a community in which lindane demonstrated an unacceptable level of treatment failures.

Administration, Topical↗

Permethrin 1% creme rinse for the treatment of Pediculus humanus var capitis infestation.

Permethrin 1% creme rinse (NIX) was tested as a treatment for Pediculus humanus var capitis (head lice) in a placebo-controlled, double-blinded, randomized study. As a positive control, a third arm of the study included nonrandomized, but investigator-blinded, treatment with 1% lindane shampoo (Kwell). At 14 days after treatment, 97% of patients treated with permethrin were free of lice compared to 6% of placebo-treated patients (P less than 0.001) and 43% of the lindane-treated group. Permethrin was 70% ovicidal compared to 14% for placebo (P less than 0.001) and 45% for lindane. No adverse experiences were noted during this study. Permethrin 1% demonstrated high pediculicidal and ovicidal activities, which in combination with its low mammalian toxicity, residual activity, and cosmetic properties, make it an excellent treatment for pediculosis capitis.

Adolescent↗

Comparative efficacy of treatments for pediculosis capitis infestations.

Ovicidal activity and killing times were evaluated for six pediculicides, using viable eggs and recently fed head lice from infested children. Lice were continuously exposed to the products until death, and elapsed time was recorded. Eggs were immersed for ten minutes, rinsed, and dried. Four synergized pyrethrin products (RID, R&C Shampoo, A-200 Pyrinate Shampoo, A-200 Pyrinate Liquid) killed all lice in ten to 23 minutes, and 23% to 32% of treated eggs hatched; 0.5% malathion lotion (Prioderm Lotion) killed lice within five minutes and was highly ovicidal, with only 5% of eggs hatching. One percent lindane shampoo (Kwell Shampoo) was the slowest-acting pediculicide, requiring approximately three hours to kill all lice; 30% of the eggs hatched after treatment. The in vitro results for RID, Prioderm Lotion, and K well Shampoo were validated by clinical trials.

Child↗

Recovery of Staphylococcus aureus from multiple body sites in menstruating women.

Because we suspected the number of women harboring Staphylococcus aureus perivaginally to be higher than previously reported, we undertook an examination of normal, healthy volunteers. Of 97 young women, 26% yielded S. aureus from the external labia at the time of menstruation. Toxin associated with toxic shock syndrome was recovered from 5 of 25 subjects with positive genital cultures. Approximately one-half of the women with positive genital cultures yielded positive cultures from the posterior cervical fornix. These 12 women with positive vaginal cultures formed a distinct subgroup that was characterized by positive labial and tampon cultures, higher incidence of previous streptococcal infections, and more frequent vaginal insertion of their own fingers or those of a partner. Tampons were used by all but one woman in the group with positive labial cultures and all but one woman in the group with positive vaginal cultures. We concluded that the presence of S. aureus in the vagina involves mechanisms other than the use of tampons. Insertion of fingers and perhaps some aspect of immunological status appear to play a role.

Adolescent↗

Eradication of scabies with a single treatment schedule.

A single application (16 to 20 hours) of 1% gamma benzene hexachloride (GBH) lotion, when applied to a total island population of 178 persons in which seventy-four clinically had scabies, resulted in a cure rate of over 98%. Re-examination of the population at 10 and 21 weeks revealed only one remaining individual still having scabies. On a neighboring island, only those with clinical evidence of scabies were treated (140 persons). Applications of 1% GBH lotion were applied with the same methods used on the first island. When the population was re-examined at 10 weeks, the prevalence of scabies was reduced by only 50%. Successful eradication of scabies from a population should include treatment of all contacts, whether clinically infected or not. Treatment of the entire population at risk at one time is preferable. Coexistent pyoderma should be treated, and a second treatment for scabies may be needed when the pyoderma has cleared.

Administration, Topical↗

A comparative trial of three treatment schedules for the eradication of scabies.

A trial of three treatment schedules, consisting of 1% gamma benzene hexachloride (GBH) lotion applied head to toe and left on the body for 2, 6, or 12 to 24 hours was conducted on an island of 2,076 persons, approximately 70% of whom had clinical evidence of scabies. The island is situated off the north coast of the Republic of Panama. Examination at 1 month after therapy showed that both the 6-hour and 12- to 24-hour cure rate was high (96% and 98%). There was a significantly lower cure rate in the 2-hour group, in which only 82% were cured. Eleven to twelve percent of the subjects became infested in all groups, presumably due to contact with untreated persons with scabies on the island. A single 6-hour application of 1% GBH lotion appears to be adequate therapy for scabies if properly applied. The entire population at risk should be treated at the same time if possible to reduce or eliminate the risk of infestation. No adverse reactions to 1% GBH lotion were observed.

Administration, Topical↗

Malathion for treatment of Pediculus humanus var capitis infestation.

One hundred fifteen subjects took part in a double-blind study comparing the efficacy and safety of 0.5% malathion lotion (Prioderm lotion) and the alcoholic vehicle of the lotion as pediculicides in the treatment of head lice. The subjects, with a mean age of 9 years, had long-standing lice infestations and at least 20 viable ova. The subjects were treated with the test preparation, which was allowed to remain on the hair for 12 hours. Ovicidal and pediculicidal efficacy for the malathion lotion was significant; overall clinical evaluation by the investigators showed a significant number of moderate to marked therapeutic responses to malathion lotion. Only one adverse reaction (in the malathion lotion group) was reported, the stinging of pyodermal lesions in reaction to the alcoholic vehicle. Other concomitant scalp diseases were unchanged or improved at the end of the study.

Administration, Topical↗

Fatal Aeromonas hydrophila infection of the skin.

A 62-year-old woman developed a fatal Aeromonas hydrophila infection of the skin after dropping a crab trap on her leg. The area surrounding the punctures was erythematous and had several flaccid bullae. A biopsy specimen of the involved skin showed necrosis and suppuration in the dermis and subcutaneous fat. The A hydrophila sepsis resolved after treatment with gentamicin, but the patient developed secondary wound infections and died three months after injury.

Aeromonas↗

A community outbreak of scabies.

An elementary school in Broward County, Florida, reported an outbreak of scabies in January and February 1975. Investigation identified 23 cases of scabies in schoolchildren, with at least two cases in each grade. The first case had appeared as early as July 1974, but most occurred after December. There was little contact between students in different grades; most transmission was found to have taken place within families and in the community. An additional 28 cases were found in families and contacts; altogether, 51 cases in 24 families were identified on clinical or historical grounds. Infestation was more frequent in children who exchanged clothes with friends or relatives and in those who, on occasion, spent the night with other children.

Child↗

Superficial mycoses.

Twenty-five years ago many of the topical remedies for superficial mycoses were irritating, toxic, or allergenic. Total x-ray depilation of the scalp was the accepted mode of therapy for tinea capitis. The introduction of topical nystatin for candidiasis and tolnaftate for dermatophytosis were major advances, but tinea capitis, onychomycosis, and chronic tinea pedis still presented problems. Soon after its introduction in 1958, griseofulvin became the definitive form of therapy for all types of dermatophytosis and played a major role in abolishing large-scale epidemics of tinea capitis in some countries. Recently, haloprogin and the imidazole derivatives, miconazole and clotrimazole, which are topically active against dermatophytes and Candida albicans, have become available. Selective indicator media for isolating dermatophytes are useful diagnostic tools, but quicker methods of diagnosis which require little interpretation are still lacking. Epidemiologic studies in Vietnam again revealed the effects of climate and occlusion on the prevalence, incidence, and severity of superficial mycoses and led to renewed interest in host susceptibility, environment, and prevention of infections.

Administration, Topical↗

Bacterial pyodermas.

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Administration, Topical↗

Skin infections in eastern Panama. Survey of two representative communities.

A skin infection survey of 1,084 people was carried out in two jungle villages in eastern Panama. Bacterial pyoderma was the most prevalent infection, affecting 25% of boys, 15% of girls, and 11% of those over 10 years of age. Streptococcus pyogenes and Staphylococcus aureus were recovered from 84% of pyodermas cultured. Nearly 60% of the cutaneous staphylococcal isolates were resistant to penicillin. Hippelates flies were seen feeding on purulent skin lesions and may have been important in transmission. Scabies, ringworm, candidiasis, and cutaneous leishmaniasis were in comparison with pyoderma involving less than 1% of the population each. All of the ringworm infections were caused by Trichophyton rubrum.

Adolescent↗