[Acute photodermatosis (sun allergy)].
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Biomedical subjects
Publications and source records attributed to H Tronnier.
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Growth and quality of hair was studied after treatment with Pantogar, another prescription (Verum-2) and placebo for four months in 60 patients with diffuse effluvium capillorum and agnogenic structural alternations of hair. Efficacy was assessed by measurements of swelling, dye-binding and thickness for hair-quality and evaluation of hair-density and trichograms for hair-growth. Statistical analysis of swelling properties and trichogram data indicated that Pantogar was effective, the second preparation improved quality of hair and retarded hair loss. Placebo was ineffective judged by the used parameters. Tolerance of the treatment was good and adverse effects could not be substantiated.
In an open multi-center study on 1,286 patients aged 60 years and more, we tested the efficacy and compatibility of prednicarbate (Dermatop) in various vehicles. The eczemas and erythematosquamous dermatoses of 857 patients (66.6%) disappeared within three weeks treatment. In 142 patients (11%), it took more than 3 weeks (62 day at the most) to achieve a complete healing. A very good or good tolerance was observed in 97.1% of the patients. Only in 1.5% the study had to be broken off because of a change for the worse. Prednicarbate, therefore, is especially suitable in the treatment of eczemas and chronic erythematosquamous dermatoses of aged skin.
The process of involution of aging skin is essentially caused by functional changes progressing as a consequence of the chronic influence of exogenous noxae. Reasonably, prophylaxis should avoid actinic damages, and skin care should be adapted to the changes due to age, which means providing a substitute for cutaneous lipids and stabilizing the hydration of the horny layer. Placebo-controlled studies proved that topical treatment with 0.05% tretinoin can result in the regression of degenerative and precancerous changes of the senile skin caused by chronic exposure to UVB. However, long-term results remain to be seen.
Nowadays, cosmetic preparations are developed and tested with the same care as pharmacons by serious producers, whose proficiency includes solid knowledge on the physiology and pharmacology of the skin. Since the law restricts the use of effective substances, these products are often introduce on the market under fantasy names and vague declarations of their effects. In this field, the dermatologist calls for more openness and clarity, especially with regard to the effectiveness of the preparation and its compatibility with the so-called "problem skin". A declaration of allergologically relevant components of cosmetics is necessary to protect the allergic consumer from recurrences of his contact dermatitis. This will contribute to a further reduction of the already small number of allergic side effects of cosmetics. A close cooperation between dermatologists and the cosmetic industry will be useful for both sides and doubtlessly to the advantage of the user of these products.
A female infant showing linear skin lesions arranged in an irregular way with bullae, vesicles, and erythema, which had predominantly affected her extremities since her birth, was examined by us at the age of one week. Histologic and immunofluorescence findings confirmed the preliminary diagnosis of incontinentia pigmenti. Electron microscopic investigations were additionally made. In the course of the disease, we observed the characteristic development of a warty and a pigmented stage. The disease was complicated by epileptic seizures, motor disturbances, and ocular defects. EEG, CT, and ultrasound revealed anomalies. Since her mother reports on similar skin lesions during her own childhood, we suspect an X-chromosomal genetic defect.
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Thirty-four patients suffering from various skin infections caused by gram-positive and gram-negative pathogens were treated with enoxacin (400 to 800 mg/day) for 8 to 14 days. A marked abatement of clinical symptoms, accompanied by eradication of the causative pathogens was observed in all 34 patients. Enoxacin was well tolerated. The minimal erythema dose of UVA light was reduced by a mean of 45% in three of the twenty patients receiving the 800 mg daily dosage of enoxacin. No positive reactions could be provoked in a subsequently applied photopatch test, allergic reactions were not observed. These mild reactions seen in a small percentage of patients appear to indicate further specific tests to determine a possible photosensitization effect of enoxacin.
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Photo-patch and other photo-skin-tests are essential for many scientific and clinical studies. There are relatively simple techniques of handling that can be carried out even in practice, but also rather complicate procedures. Testing must be strictly adjusted to the specific problem in order to avoid false results. For clinical concerns, photo-skin-testing has to be done with UVA light, because most of the pathological light reactions are induced by UVA. As the role of visible light has not been investigated yet, we are doing some experiments employing a special unit emitting the action spectrum of visible radiation only.
A new combination of beta-carotene (25 mg) and canthaxanthin (35 mg) was clinically investigated in 74 patients with various photodermatoses and 111 patients with pigmentation disorders. The photoprotective action of this combination was ascertained in clinical experiments. Serum levels were determined in 20 patients; the absence of increased retinol levels could be confirmed. In 23 patients, ophthalmological controls did not reveal any abnormalities. In 65 of the 74 patients with photodermatoses, a satisfactory protective action was recorded. 85 of the 111 patients with depigmentations and hyperpigmentations experienced a marked decrease of the disturbing contrast between their lesions and the surrounding skin.
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Clinical experiments could demonstrate that beta-carotene and canthaxanthin (Carotinoid-N), orally applied, decreases ultraviolet sensitivity such as manifests itself by erythematous reactions. The dosage administered was 4 dragees daily (1 dragee contains 25 mg beta-carotene and 35 mg canthaxanthin) for two weeks and 2 dragees daily for another two weeks. There was no induction of melanin production observed. In vitiligo, administration of Carotinoid-N failed to induce repigmentation, but the contrast between vitiliginous white patches and the surrounding pigmented skin was markedly reduced by carotinoids deposited in the skin. In addition, sun protection was afforded. Carotinoid-N induced a photoprotecting action in patients with pronounced ultraviolet sensitivity or with polymorphic light eruptions (PLE). In some cases, however, we recommend an additional pretreatment with ultraviolet light ("ultraviolet hyposensitization"). With acne-lesions, the common sun lotions and creams should be avoided: only preparations without emulsifiers may be made use of.
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The effects of ultraviolet irradiation on granulocyte chemotaxis and nitroblue tetrazolium reduction activities were studied in healthy volunteers. An increase of polymorphonuclear chemotaxis takes place after five irradiations, while the nitroblue tetrazolium reduction activity remains practically unchanged.
The erythema effectiveness curve (EEC) has been remeasured with frequency-doubled tunable dye lasers in the wavelength range from 250 to 320 nm. The EEC has been determined from the response of the skin of adult white males after application of a 5 mJ/cm2 radiant exposure. Additionally, minimal erythema doses have been measured. The results confirm earlier observations but give curves with a smaller half bandwidth. In the range from 290 to 310 nm, the EEC has been measured after application of 8-methoxypsoralen and of 3-carbethoxypsoralen.