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Biomedical subjects

H S Zackheim

Publications and source records attributed to H S Zackheim.

At least 37 records · Page 2Linked to original sources
PubMed1994

6-Thioguanine treatment of psoriasis: experience in 81 patients.

BACKGROUND: Despite recent innovations a considerable number of patients with psoriasis cannot be successfully treated by current therapies. OBJECTIVE: Our purpose was to summarize our 18-year experience with the antimetabolite 6-thioguanine in the management of patients with psoriasis. METHODS: We retrospectively studied 81 patients who were treated with 6-thioguanine. A variety of schedules were used to find the optimal schedule. Forty-eight percent of the patients either had been treated with methotrexate or were excluded from receiving methotrexate because of liver or kidney disease. RESULTS: Forty-nine percent of patients with plaques were effectively maintained with 6-thioguanine for a median of 33 months. Four of five patients with palmoplantar pustular psoriasis experienced substantial benefit. The most common side effect was myelosuppression. CONCLUSION: 6-Thioguanine is an effective therapy for psoriasis and should be considered for patients who have failed to respond to other systemic agents.

Adult↗
PubMed1994

The use of methotrexate for treatment of psoriasis in patients with HIV infection.

The use of methotrexate (MTX) has been contraindicated for treatment of severe psoriasis in HIV infection on the basis of six previously reported cases in which MTX appeared to potentiate opportunistic infections and accelerate HIV disease. We describe three HIV-infected patients who were given MTX for severe psoriatic arthritis. In two patients opportunistic infections did not develop. On the basis of survival data, it is not clear that use of MTX adversely affected the natural course of their HIV disease.

AIDS-Related Opportunistic Infections↗
PubMed1994

Topical carmustine (BCNU) for patch/plaque mycosis fungoides.

This article summarizes experience with topical carmustine (BCNU) solution in 172 patients with patch/plaque stage mycosis fungoides. At 36 months 92% of stage-T1 (less than 10% skin involvement) and 64% of stage-T2 (10% or more skin involvement) patients were either in complete or partial remission. The most frequent side effect was an erythematous reaction which was followed by a benign-type telangiectasia in some patients. No secondary skin cancers were seen. Bone marrow depression was uncommon. Topical BCNU is an effective treatment for patch/plaque stage mycosis fungoides.

Administration, Topical↗
PubMed1994

Treatment of cutaneous T-cell lymphoma.

A review of current therapy for cutaneous T-cell lymphoma (CTCL) (mycosis fungoides and erythrodermic CTCL) is presented. Treatments for mycosis fungoides limited to the skin include topical steroids, mechlorethamine (nitrogen mustard) and carmustine (BCNU), electron beam radiation, low-dose methotrexate, and interferon-alpha (IFN). Treatments for erythrodermic CTCL include low-dose methotrexate, IFN, extracorporeal photopheresis, and single agent or combination chemotherapy. Treatment for systemic CTCL includes IFN, single or combination chemotherapy, and combined modalities. Newer therapies are reviewed. Whereas prognosis for patients with disease limited to the skin is generally good, that for those with nodal or visceral lymphoma is mostly unfavorable. Controversial issues relating to total skin versus local treatment, prolonged maintenance versus intermittent therapy, and aggressive versus conservative treatment of early stage disease are discussed. The UCSF approach to treatment of CTCL and lymphomatoid papulosis is presented.

Carmustine↗
PubMed1993

Lack of effect of supplemental dietary selenium on time to development of radiation-induced cutaneous tumors in rats.

Sprague-Dawley 8-week-old male rats received a single dose of 1425 cGy to the skin of the back using a 6 meV electron beam. Three days later they were randomized into three groups receiving supplemental dietary selenium as sodium selenite at levels of 0 ppm, 1 ppm, and 2 ppm selenium. Cutaneous tumors first appeared 33 weeks after irradiation and the experiment was terminated at 63 weeks. A wide variety of epithelial and connective tissue tumors developed. There was no significant difference in the time to development of epithelial or connective tissue tumors between the three groups. Thus, under the conditions of this experiment an inhibitory effect of dietary selenium on radiation-induced skin tumors was not evident.

Animals↗
PubMed1993

Lymphomatoid papulosis followed by Hodgkin's lymphoma. Differential response to therapy.

BACKGROUND: The association of lymphomatoid papulosis (LyP) with Hodgkin's lymphoma or other lymphomas is well recognized. However, the issue as to whether this represents an independent association or a transformation of one proliferative process to the other remains unresolved. OBSERVATION: A woman with LyP subsequently developed Hodgkin's lymphoma. Combination chemotherapy resulted in apparent cure of the lymphoma but had only a transient effect on the LyP. A literature review revealed a similar difference in response to chemotherapy or radiation therapy in most patients who had LyP and associated lymphoma. CONCLUSIONS: The differential response to therapy in patients with LyP and associated lymphoma suggests that there are biological differences between LyP cells and associated lymphoma cells even though in some patients the immunophenotype and genotype were reported to be identical. However, alternative explanations are possible. In this article we also review studies on other cases of LyP associated with Hodgkin's lymphoma.

Female↗
PubMed1990

Topical carmustine (BCNU) for cutaneous T cell lymphoma: a 15-year experience in 143 patients.

One hundred forty-three patients with cutaneous T cell lymphoma were treated with topical carmustine (BCNU). A complete response was obtained in 86% of those with limited extent (less than 10%) plaques (T1 stage), in 48% of those with extensive (greater than or equal to 10%) plaques (T2 stage), and in 21% of those with erythroderma. The median time to achieve complete response was 11.5 weeks. Favorable results were obtained in patients with less than 5% involvement treated locally. Mild hematopoietic depression occurred in less than 10% of patients. Erythematous reactions were common, but no secondary cutaneous malignancies occurred. Differences in freedom from relapse or in survival between T2-stage patients with and those without clinical adenopathy were not statistically significant. The 5-year overall survival rate was 77%; the median survival time was 9.4 years.

Administration, Cutaneous↗