Human phenotypes. The atopic and seborrheic: Part II.
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Biomedical subjects
Publications and source records attributed to H Ely.
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The use of transcutaneous electric nerve stimulation is new to dermatologists but has a long history. A list of published applications includes use in therapy for postherpetic neuralgia, increased peripheral circulation, itching, varicose ulcers, ischemic ulcers, diabetic neuropathy, leprous neuritis, would healing, increased survival of skin flaps, Raynaud's phenomenon, scleroderma, esophageal dysmotility, and glossodynia.
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This article presents numerous alternative therapies for stubborn dermatologic conditions. Agents include hypertonic saline, mexiletine, alpha-acetoxymandelic acid, deladumone, emulsified steroids, activated charcoal, azelaic acid, silymarin, and dexamethasone. Several surgical tips are also included for the practitioner's consideration.
The conditions treatable with PTX are limited only by our understanding of disease pathogenesis. Surely the reader will think of new applications. I would caution at this point that PTX is not the primary treatment for any cutaneous condition but may be a valuable therapeutic adjunct.
Two patients with idiopathic livedo vasculitis responded favorably to therapy with pentoxifylline. One patient had responded to fibrinolytic therapy with phenformin and ethylestrenol before phenformin was taken off the market. Pentoxifylline (Trental) has multiple mechanisms of action, including stimulation of prostacyclin synthesis, decreased aggregation of platelets, increased deformability of red blood cells, increased mobility of neutrophils, and increased fibrinolysis. All of these factors may contribute to its successful use in the treatment of idiopathic livedo vasculitis.
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