[Indications for the treatment of psoriasis vulgaris in practice].
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Biomedical subjects
Publications and source records attributed to H Tronnier.
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The addition of an anti-infective to a topical glucocorticoid preparation for superinfected atopic eczema is still controversial. To address this question in the context of the topical glucocorticoids of the non-halogenated double-ester type 0.25% prednicarbate cream was compared to the identical preparation incorporating the same amount of the disinfectant didecyldimethylammoniumchloride in patients suffering from atopic eczema carrying Staphylococcus aureus at a density of more than 10(6) colony-forming units per cm2. One of the preparations was used twice daily over 5 days according to a random plan in a blind fashion. Thereafter treatment was based on either prednicarbate cream or the corresponding vehicle according to clinical needs. Clinical and microbiological evaluation were scheduled for days 0, 6 and 34. Various clinical parameters were addressed individually as well as over all improvement using scores. A total of 143 patients was recruited. The patients of both groups improved rapidly with respect to clinical and microbiological findings. Essentially, there was no difference between the groups. Hence, the addition of an anti-infective to a topical prednicarbate preparation is not to be generally recommended.
In order to investigate the effect of a gel containing isoprenaline and a gel containing clemastine hydrogen fumarate on histamine-induced skin reactions compared with placebo, a histamine solution was injected intradermally in four given fields on the backs of 12 healthy volunteers 15 min and 60 min after application of the gel preparations. The study was controlled by a non-treated field on the volunteers' backs. The main points of interest in this study included the size of the erythema reaction, the capillary blood flow and onset and intensity of itching. With respect to the size of the erythema reaction, both clemastine hydrogen fumarate and isoprenaline proved more effective than placebo in most cases. This superiority was, in some cases, statistically significant. There were no statistically significant differences between the gel preparations for the other parameters investigated. Clemastine hydrogen fumarate is regarded as a classical antihistamine, whereas a possible effect on the superficial circulation of the skin is being discussed for isoprenaline.
One patient showed tinnitus during hyposensitization 5 min after injection, resolving without any therapeutical approach within the next 30 min. Moderate increase of dosage did not lead to new symptoms. The question of allergy in the pathomechanism of diseases of the inner ear is discussed.