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Biomedical subjects

J B Schmidt

Publications and source records attributed to J B Schmidt.

At least 37 records · Page 2Linked to original sources
PubMed1993

When applied to facial skin, does estrogen ointment have systemic effects?

We examined cytological vaginal smears of 17 women before and after three months of dermal estrogen (1 g of 0.01% estradiol ointment or 0.3% estriol ointment once daily), applied to the face for dermatological indications. The mean age was 57.1 +/- 7.6 years (range from 46 to 66). Seven women had estrogenic smears (more than 10% superficial cells) before therapy. Nine women were treated with 0.01% estradiol ointment and 8 were treated with 0.3% estriol ointment. Both groups had gynecological examinations including cervical and vaginal smears before and after treatment and also monthly measurements of serum follicle-stimulating hormone, prolactin and estradiol levels. Serum hormone levels and the appearance of vaginal smears showed no significant change during treatment.

Aged↗
PubMed1991

Hormonal parameters in androgenetic hair loss in the male.

Alopecia in the male is considered as a genetically determined disorder. Increased local androgen metabolism and androgen receptor binding in the balding areas confirm the importance of the target organ hair follicle as regulative of androgen influences. In our study the hormonal parameters of 65 male patients with male pattern hair loss with a mean age of 24.31 years were compared with those of 58 age-matched controls. Determinations of the androgens, sex-hormone-binding globulin, the hypophyseal hormones luteinizing hormone, follicle-stimulating hormone and prolactin, 17 beta-estradiol and cortisol were performed by standard radioimmunoassay. Significant differences in serum levels of androstenedione, cortisol, 17 beta-estradiol and luteinizing hormone were noted between hair loss patients and control subjects. Suprarenal stimulation as well as hypophyseal feedback mechanisms therefore seem to be involved in male pattern alopecia.

17-alpha-Hydroxyprogesterone↗
PubMed1991

Hormone studies in females with androgenic hairloss.

Reports on hormone analysis in androgenic hairloss in the female show partly contradicting results. Elevated as well as normal-range androgen levels have been found. The present study aimed at the investigation of a possibly more differentiated hormonal constellation by hormone analysis and additional determination of the hypophyseal level by the thyrotropin-releasing hormone (TRH) test. In 46 female patients with androgenic hairloss blood sampling for hormone analysis was performed. Determination of the androgens testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), 17-hydroxy-progesterone acetate (17-OHP) and free testosterone (FT), of sex-hormone-binding globulin (SHBG), estradiol (E2), cortisol (F) and the hypophyseal luteinizing hormone (LH) and follicle-stimulating hormone (FSH) was performed by standard radioimmunoassay methods. The TRH-test is based on feedback mechanisms between the hypothalamic TRH which stimulates hypophyseal TSH and PRL release. Thus, even mild forms of hypothyroidism or hyperprolactinaemia can be detected. The control group for the TRH test consisted of 45 volunteer females without hairloss or any other hormonal or menstrual disturbances. Statistical analysis was performed according to the Wilcoxon two-sample test. The results of the study show no significant elevation of androgens in females with androgenic hairloss, but a more complex condition with involvement of the glandula suprarenalis and the hypophyseal level. Significantly elevated TSH levels prior to and after TRH stimulation in the hairloss group indicate that hypothyroidism may be an important hormonal disturbance in androgenic hairloss. Interactions between hypothyroidism and androgen metabolism are possible at various links.(ABSTRACT TRUNCATED AT 250 WORDS)

17-alpha-Hydroxyprogesterone↗
PubMed1991

[Hyperprolactinemia and hypophyseal hypothyroidism as cofactors in hirsutism and androgen-induced alopecia in women].

A more comprehensive hormonal diagnosis than has previously been performed shows that androgen-dependent diseases of hair growth are due to more varied hormonal disturbances than elevated androgen serum levels alone. In 46 female patients with androgenic hair loss and 27 patients with hirsutism, the levels of the androgens testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulphate and 17-hydroxyprogesterone and of sex hormone-binding globulin, cortisol, oestradiol and the hypophyseal hormones follicle-stimulating hormone and luteinizing hormone were determined and compared with the hormone levels of 27 female patients without endocrine disorders. Of the androgens, only androstenedione showed a slightly significant elevation in hirsutism. Cortisol was elevated significantly in androgenic hair loss, and with a low degree of significance in hirsutism. In view of the complex hormonal interactions of thyroxin, prolactin and androgens and thyroid hormones the thyrotropin-releasing hormone (TRH)-stimulation test was performed in 38 female patients with androgenic hair loss and 27 with hirsutism, and the results were compared with those recorded in 45 female control persons. The test is based on feedback mechanisms between hypothalamic TRH and hypophyseal TSH and prolactin and peripheral thyroid hormones. Baseline concentrations of TSH prior to stimulation were significantly elevated in hirsutism, while in androgenic hair loss both baseline and stimulated TSH levels were significantly elevated; thus, hypothyroidism is a significant finding in both clinical pictures. In the case of prolactin, both baseline and stimulated levels were highly significantly elevated in hirsutism, while in androgenic hair loss the stimulated levels were significantly elevated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Hormone receptors in pubic skin of premenopausal and postmenopausal females.

Various functions of the skin are hormone-dependent. Recently hormonal involvement in aging processes of the skin has attracted increasing interest. The rapid onset of aging of the skin from the climacterium on seems to be correlated with the decrease of estrogens. In order to evaluate hormonal stimulability of the skin a study of hormone receptors was performed in pre- and postclimacteric women. Pubic skin of a total of 106 females was obtained during gynecologic operations for determination of estrogen receptors (ER), androgen receptors (AR) and gestagen receptors (PgR) by saturation analysis. In the preclimacteric group consisting of 62 females with a mean age of 39.6 +/- (SD) 6.5 years the operations were performed in the luteal phase of the menstrual cycle. The results were compared with those of 44 postmenopausal females with a mean age of 63.2 +/- 9.4 years. AR concentrations were significantly lower in the skin of postmenopausal women. 47.4% positive findings with a mean receptor level of 15.3 +/- 33.3 fmol/mg protein were to be found against 85.2% positive AR with a mean level of 31.4 +/- 20.3 fmol/mg protein in the ovulatory cycling females. These findings were of high significance. In addition, diminished PgR in the postmenopausal group were noted for incidence and mean receptor levels. PgR were positive in 18.4% with a mean level of 34.2 +/- 72.8 fmol/mg protein versus 36.3% with a mean receptor level of 34.2 +/- 72.8 in the ovulatory group. In contrast, no significant differences between ER of premenopausal and postmenopausal skin became evident. Results of hormone receptor determinations in the premenopausal and postmenopausal group with regard to the aging process are interpreted.

Adult↗
PubMed1990

Endocrine parameters in acne vulgaris.

Hormonal parameters (see below) were determined in 78 male acne patients of both sexes (mean age 21.2 +/- 3.8 years; (mean +/- S.D.) and compared with 63 controls (25.0 +/- 4.2 years). In a female group consisting of 60 patients acne (23.2 +/- 5.0 years) and 28 controls (26.1 +/- 5.7 years) of age, blood sampling was performed in the luteal phase of the menstrual cycle. Testosterone (T), dehydroepiandrosterone-sulfate (DHEAS), androstenedione (A), free testosterone (FT) and 17-hydroxy-progesterone (17-OHP) were determined by standard radioimmunoassay methods. In addition, sex hormone binding globulin (SHBG), follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), 17 beta-estradiol (E2) and cortisol (F) were evaluated. Moreover, the counts of acne lesions in the face were performed in 34 males and females patients in order to investigate possible correlations between hormones and acne lesions. The results in the male group revealed a significant elevation only for F but not for the other hormones. However, the female acne group significantly elevated levels of T, DHEA and F and a decrease of E became apparent. In addition, the correlation between both free and total T and acne lesions were found in the total of males and females. In the female group, free T and total A were found to correlate with acne lesions. The evaluation of these results indicates that androgens play a more important role in female than in male acne at the hormonal and at the peripheral level in skin. Another interesting finding was the significant increase of F in both male and female acne subjects, thus stressing the role of suprarenal involvement.

17-alpha-Hydroxyprogesterone↗
PubMed1989

[Hypothyroidism and hyperprolactinemia as a possible cause of androgenetic alopecia in the female].

31 female patients suffering from androgentic alopecia were examined by means of the TRH test with regard to hypothyroidism and hyperprolactinemia. Before, as well as 20 and 40 minutes after, application of thyroxine releasing hormone (TRH), the serum concentrations of the hypohyseal thyroxine stimulating hormone (TSH) and prolactin (PRL) were measured by radioimmunoassay (RIA). In 7 of the patients (23%), we found increased TSH levels after stimulation with TRH--indicative of hypothyroidism. In 9 of the patients (29%), we observed increased PRL levels after TRH stimulation, indicating prolactinemia. TSH and PRL can interact with androgen metabolism at various levels. Thyroxine may influence the unbound, metabolically active testosterone via the sex hormone binding globulin (SHBG). Prolactine, which is stimulated by TRH, promotes the suprarenal cortisol and androgen production. In 48% of the patients, we found either hypothyroidism or hyperprolactinemia. This suggests that both conditions may contribute to the clinical picture of female androgenetic alopecia, as they interfere with the androgen metabolism.

Adult↗
PubMed1988

[1 percent clindamycin phosphate solution versus 5 percent benzoyl peroxide gel in papulopustular acne].

In a multicenter study, 60 patients suffering from mainly moderate papulopustular acne were treated to pically either with 1% clindamycin phosphate in alcoholic solution or with 5% benzoyl peroxide gel, 30 patients each. During the treatment period of 9 weeks, clinical controls with lesion counts were performed every 3 weeks and after a 3 weeks follow-up. The therapeutic efficacy according to the reduction of papules and pustules was 72% in the benzoyl peroxide group and 73% in the clindamycin group, the latter showing significantly less side effects. On account of its good therapeutic results, we consider topical treatment with clindamycin phosphate an important alternative to systemic antibiotic or topical benzoyl peroxide therapy in acne.

Acne Vulgaris↗
PubMed1988

[Effect of topical glucocorticoids on endogenous cortisol production].

In a randomized double blind study, we investigated the systemic effects of 3 different ointments containing corticoids. Every 7 patients out of a total of 21 patients suffering from various skin diseases were daily treated with 40 g of one of the 3 corticoid preparations over 8 days (group A: 0.05% clobetasol-17-propionate; group B: 0.25% fluocortolone trimethyl acetate; group C: 0.25% fluocortolone trimethyl acetate + 0.25% fluocortolone capronate). The plasma cortisol levels were determined by radioimmune assay. In group B and C, we did not observe any effect on the pituitary-adrenal axis, whereas in group A the plasma cortisol levels were extremely low already after 1 day of corticoid application. This adrenal suppression did not return to normal within 4 days after discontinuation of the corticoid. Our results suggest that highly potent topical corticoids are capable of adrenal suppression even without occlusive dressing and even in healthy persons.

Administration, Topical↗
PubMed1987

[Endocrine constellation in androgenetic alopecia in the female].

The mechanisms which induce androgenetic alopecia in females are only poorly understood at the molecular biological level. In predisposed, mainly centroparietal areas, androgenic stimulation of genetically predisposed hair follicles is considered to cause transformation from terminal to vellus hair follicles. However, reports on serum androgen levels in androgenetic alopecia in the female show broad variations. In the present study serum androgens, gonadotropins, oestradiol and sex hormone binding globulin were determined in the luteal phase of the menstrual cycle in 25 patients with female pattern androgenetic alopecia by radioimmunosorbent assay. In 16 of these patients skin slices from the alopecic areas were punch biopsied under local anaesthesia for determination of cytosol- and nuclear androgen receptor (AR). Mean values of all serum hormone levels were within the normal range. Cytoplasmatic AR was positive in 75% of cases, with a mean level of 22 fmol/mg protein. In 50% of cases nuclear AR was demonstrated, with a mean level of 119 fmol/mg DNA. No correlation was found between serum androgen levels and AR. Highly positive AR levels indicate a high androgen stimulability in female androgenetic alopecia. These findings support the concept of AR as regulators of genetically determined hair follicles in androgenetic alopecia.

17-alpha-Hydroxyprogesterone↗
PubMed1987

Nuclear and cytosol androgen receptor in androgen dependent dermatoses in female patients.

Determination of cytosol and nuclear androgen receptor (AR) was performed in females with androgen dependent dermatoses. 34 patients with acne, hirsutism and androgenetic alopecia were punch biopsied on day 21 of the menstrual cycle under local anesthesia within correspondent predilection sites. The tissue was snap frozen in liquid nitrogen and stored until receptor assays were performed. Overall evaluation of both, cytosol and/or nuclear AR was positive in 76% of all cases. In 86% of (10 out of 14) females with androgenetic alopecia, in 80% (8 out of 10) of patients with acne and 60% (6 out of 10) of hirsute females cytosol and/or nuclear AR were positive. No significant differences of cytosol androgen receptor levels became evident between the dermatoses. In contrast, nuclear androgen receptor levels showed a trend towards distinct differences with highest levels in hirsutism, followed by androgenetic alopecia and acne. Androgen stimulability thus seems to be superior in the first and minor in the latter. Comparison with previous studies on cytosol androgen receptor in androgen dependent dermatoses shows significantly higher number of positive results by additive nuclear receptor determination. Additional nuclear androgen receptor assay, thus gives a more complete picture of local hormone action.

Acne Vulgaris↗
PubMed1987

Parenteral and oral cyproterone acetate treatment in severe hirsutism.

In the present study a parenteral treatment regimen with cyproterone acetate was compared with the high dose peroral administration in patients with severe hirsutism. Two groups consisting of 10 patients each performed treatment with either 100 mg cyproterone acetate perorally for the first 10 days of the menstrual cycle or received a monthly implant of 300 mg cyproterone acetate intramuscularly applied on the first day of each cycle. In addition, contraception was performed with Diane in both patient groups. 9 treatment cycles were followed by a posttreatment period of 3 months. Hair parameters and serum androgens were monitored regularly. No significant differences of testosterone, androstenedione, dehydroepiandrosterone-sulfate and prolactin serum levels became evident between both cyproterone acetate regimens. Measurements of facial hair diameters revealed a better reduction for the parenteral application. Also the improvement of dermatological parameters was more prominent in the parenteral treatment group. The good effects of a medium dose parenteral application against higher dose peroral treatment thus was documented. The lack of significant differences of androgenic suppression in both regimens turns up the question if different metabolism at the cellular level may be responsible for that phenomenon.

Administration, Oral↗
PubMed1987

Efficacy of topically applied 17 alpha-propylmesterolone in acne patients.

A new substance--17 alpha-propylmesterolone--was tested in the treatment of acne. 8 male and 5 females patients applied a 3% alcoholic solution of the substance twice daily on the face for a mean period of 13 weeks. Besides clinical controls with acne grading also the determinations of the sebum excretion rate (SER) and separation of the lipid fractions was done before onset of treatment, after 14 days and then monthly. Concomitantly, the levels of several hormones (serum testosterone, prolactine, follicle stimulating hormone, luteinizing hormone and estradiol) were determined. Clinical results were moderate to excellent in most of the patients. In two patients no therapy effects became apparent after 8 weeks. SER was decreased in all patients to values between 70 and 4% of pretreatment values. Sebaceous gland lipids and epidermal lipids were both inhibited effectively. Hormonal parameters showed no significant difference of pretreatment and posttreatment values. For the first time positive effects of a topical new antiandrogen--17 alpha-propylmesterolone--could be demonstrated. The interesting finding of decrease of dermal and epidermal lipids suggests that not only sebaceous glands but also overstimulated epidermal structures may be inhibited by this antiandrogen.

Acne Vulgaris↗
PubMed1987

[Dandruff--an atopic sign?].

Dandruff is a sign of low specificity but high sensitivity for atopic constitution. Of 32 (40%) patients consulting the clinic for other reasons than dandruff, atopic dermatitis, or seborrheic dermatitis, 13 had raised IgE PRIST values of greater than 120 IU/ml. In only 6 (19%) of these patients was screening for atopy completely negative (family and personal history, total and specific IgG, prick test).

Adult↗
PubMed1987

[An effective topical antiandrogen--17 alpha-propylmesterolone--in acne].

17 alpha-Propylmesterolon, a new topically active antiandrogen, was administered to 25 patients with papulopustular or comedo acne and severe seborrhoea. The patients were supplied with a 3% solution of 17 alpha-propylmesterolone in 70% alcohol and were advised to apply it to the face twice daily for a mean duration of 14 weeks. Clinical follow-ups and thin-layer-chromatography determination of the sebum secretion rate (SER) and the lipid fractions were performed monthly. At the end of the treatment period 72% of the patients had improved. Comedo acne was reduced by 2 grades, papulopustular acne by 1.8 grade. The mean reduction of seborrhoea was 2 grades. SER was reduced in 62.5% of the patients to 76.4 +/- 8.8% of pretreatment values. In addition to sebaceous gland lipids, epidermal lipids were also inhibited effectively. This finding is in accordance with the marked reduction of comedones. Thus, in addition to sebaceous gland inhibition, epidermal structures may also be the target of the antiandrogen.

Acne Vulgaris↗
PubMed1986

[Immunoglobulin A in the sebaceous glands. Light and electron microscopy immunomorphologic detection].

This paper presents evidence for the presence of immunoglobulin A in human sebaceous glands. Light- and electron-microscopic immune cytochemistry techniques revealed secretory IgA in normal sebocytes and within pilosebaceous ducts. The secretory process corresponds to the well-established production of IgA at the site of other internal body surfaces. Basal and suprabasal sebocytes contain IgA in linear extracellular, as well as aggregated intracellular patterns. However, maximal diffuse concentrations are present at the opening of the pilosebaceous duct. This distribution pattern indicates an antimicrobial protective character of IgA, corresponding to similar functions on mucous membrane surfaces. Thus, another important humoral factor contributing to the complex system of skin-associated lymphoid tissue is postulated.

Acne Vulgaris↗