[Action of spironolactone and potassium canrenoate].
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Biomedical subjects
Publications and source records attributed to H Zaun.
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We examined the clinical and histological effects of etretin in pustulosis palmo-plantaris (PPP) in a multicentre study. 30 patients with PPP were treated with etretin in a double-blind study. After a 4-week interval of either etretin (50 mg/day) or placebo (randomized), all patients received etretin during a second period of 20 weeks (the dosage was individually varied). The effect of etretin was verified clinically and by immunhistochemical methods. The number of pustules in a 4 cm2 reference area diminished within the first 4 weeks from 8.5 to 1.9 (etretin group) and from 9.0 to 6.2 (placebo group). Within a maximum of 24 weeks 16% of the patients showed a complete remission, 44% a pronounced improvement, and 22% little improvement. The state of 2% of the patients deteriorated. Immunhistologically, the number of granulocytes was reduced in the inflammatory infiltrate and in the pustules. Etretin is therefore a retinoid, which is easily controlled and effective in PPP.
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We discuss the promising results of recent pharmacological and clinical studies on non-cicatricial alopecia: (1) The development of effective antiandrogens for topical application will provide some possibilities of 'causal' treatment of androgenetic alopecia in male patients. (2) Further investigations on patients treated with minoxidil may lead to new insight of the factors regulating the follicular functions. (3) Our preliminary experiences with the various therapeutic modes of alopecia areata, based on the autoimmune pathogenesis of this disease, supply the foundation for effective therapeutic regimens for practical use.
According to morphologic differences or provoking factors, variants of hemorrhagic pigmentary dermatoses (HPD) have been reported under numerous names. Common characteristics of these disorders are grouped petechiae, eczematoid dermatitis and, in older lesions, hyperpigmentation due to hemosiderin deposits; these symptoms are usually seen on the lower extremities. Today, we suppose a uniform pathogenesis of the clinically varying types of HPD.
Different types of brachyonychia were observed in a mother and her daughter. The mother presented a unilateral racket thumb-nail (localized brachyonychia "en raquette" of Basset). In the case of the daughter the thumbs and three middle fingers of both hands were involved, the nails of the little fingers being normal (generalized brachyonychia "en raquette" of Basset). Also, the daughter's toe-nails were short and wide. There was a family history of short nails "on all fingers" occurring in the two sisters of the mother's father. We believe that localized and generalized types of racket nails are variants of the same inherited anomaly. As far as we know, this is the first report of brachyonychia of the toe-nails.
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Our experience with the treatment of psoriasis with systemic glucocorticosteroids is reviewed. The results have been completely disappointing. Oral glucocorticoids are not up to the standards of a useful antipsoriatic drug when the therapeutic advantages versus the side effects are compared.
In addition to the 1968 report on two patients suffering from Duhring's disease (DD) associated with hydrarthrosis by Zaun, we now present a third case of the same combination of signs. In all three patients, painful joint swelling regularly preceded the manifestation of cutaneous eruptions. Joint pains and swelling did not respond to usual antirheumatic treatment, but always remitted together with the skin eruptions under medication of sulphones.
Naftifine, an allylamine derivative, represents a new class of antimycotic agents. During a multicentric, double blind, intraindividual, contralateral comparison study, 126 patients with dermatophytosis or candidosis were examined with regard to antimycotic efficacy and local tolerance of Naftifine cream or Clotrimazole cream. After treatment with Naftifine for 7 days, 63.5% of the patients were mycologically cured, whereas 56% were cured with the help of Clotrimazole. After 2 weeks, the healing rate amounted to 84% under both drugs. At that time, 95% of the patients showed negative cultures on both corresponding body sites. Regarding the improvement of the clinical symptoms and the frequency of relapses occurring 4 weeks after the end of treatment as well as local side effects, there was no substantial difference between both drugs. The "responder-rate" towards Naftifine, however, was higher by the end of treatment. The local tolerance of both drugs was excellent or good on more than 90% of the patients.
Modes of action of antiandrogens, their side effects as well as indications for their application to androgen-dependent skin conditions. Particular attention is paid to the possibilities for topical medication with antiandrogenic active substances.
The investigation of patients with leg ulcers, treated with a concentrated benzoylperoxide solution, revealed a sensitization to the substance in nearly half of the probands. Therefore and because of the probable promotion of neoplastic epidermal proliferation, benzoylperoxide-containing solutions should be used for the treatment of leg ulcers in selected cases only.
Two children with abnormally long eyelashes and bushy brows ("trichomegaly") present at birth and associated with pigmentary degeneration of the retina and general growth retardation are described. This combination of findings has been observed previously in three cases. Mental retardation, sparse scalp hair, endocrinologic deficiencies and (in one of our cases) koilonychia may be found in addition, but not necessarily.
By means of a new test kit (Multitest), intracutaneous tests have been performed on several groups of patients in order to evaluate the degree of cellular immunity. This test system affords the simultaneous application of seven quantitatively and qualitatively standardized antigens. In comparison to healthy people, patients suffering from malignant melanoma showed a slightly higher immunity reaction whereas patients with atopic dermatitis revealed a significantly lesser degree of reactivity to the recall-antigens. Chemotherapy with Dacarbazine did not change the amount of reactivity to the Multitest. This paper discusses the advantages of the new test kit as well as the difficulties of recall-antigen testing with regard to the evaluation of cellular immunity.
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An unusual case of circumscribed mucinosis without thyroid dysfunction or paraproteinemia is reported. The lesions were localized symmetrically on the upper lip sparing the philtrum. Histopathologie findings suggest that the mucinous deposits are caused by a disturbance of the vascular circulation.