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Biomedical subjects

J B Schmidt

Publications and source records attributed to J B Schmidt.

At least 55 records · Page 3Linked to original sources
PubMed1986

[Parameters of cellular and humoral immunity in patients with severe acne].

Severe forms of acne, characterized by predominance of inflammatory reactions and persistence of the disease for years, still present therapeutic problems. The purpose of our study was to investigate the role of the immune system in severe persisting forms of acne by means of determination of cellular and humoral immunobiological parameters. The study was performed on 52 patients (47 males and 5 females) having suffered from severe acne for six years on an average, including papulopustular acne grade IV resistant to therapy, nodulocystic acne, conglobate acne, and acne tetrade. The results were compared with those of 52 healthy controls of the same age showing no inflammatory diseases, who were tested on the same day. In 56% of the acne patients, one or more parameters showed pathological values, while in nodulocystic and conglobate acne there were similar results with regard to cellular defects and acute phase reactants. The lymphocytic proliferation induced by mitogens was significantly decreased in 35% of the acne patients. We assume that the immunodeficiency observed in these patients may be mainly secondary; however, it may contribute to the perpetuance of the disease and its resistance to therapy.

Acne Vulgaris↗
PubMed1986

[Topical cimetidine treatment of acne].

We present first results of topically applied cimetidine in acne. Ten patients suffering from papulopustular and comedone acne administered 2% cimetidine in indifferent lotion on their face twice a day. Clinical controls were performed every two weeks; sebum was monthly determined. After treatment of 13 weeks on the average, the clinical success was generally good. Comedones responded best, followed by papules. Pustules were hardly reduced. There was no significant reduction of SER and the lipid fractions at the end of treatment. Low concentration or insufficient penetration might be possible explanations. The efficient reduction of comedones might be an antiandrogenic effect due to modulation of the keratinization in the follicle excretory duct. Immune-modulatory effects of cimetidine and effects on the skin vessels are other possible explanations for the clinical efficacy of topical application of cimetidine in acne.

Acne Vulgaris↗
PubMed1986

[Steroid hormone receptors in normal skin].

Hormonal influences modulate various skin functions. Despite of skin manifestations indicative of increased androgenic influence, many cases show normal hormone serum levels. The target organ sensitivity of skin may be figured out by hormone receptor analysis. Our study presents data from 60 volunteer patients regarding estrogen (ER), androgen (AR), and gestagen (PgR) receptor analysis in normal skin. The highest percentages of AR and ER were found in the face of male and female patients followed by the lower extremities. Equal AR levels in both sexes indicate equal androgenic stimulability at the cellular level in both sexes. ER levels were higher in female than in male patients. PgR was negative in 14 cases. Nor could we prove any receptors in the youngest group of patients. Our results correspond with the clinical observation of different hormonal stimulability in various skin regions.

Adolescent↗
PubMed1986

[The concept of the causal therapy of hirsutism].

Extended hormonal diagnosis allows causative treatment in hirsutism. By means of inhibition of the pituitary/gonadal axis and the androgenic metabolism at the cellular level, the androgenic action in hirsutism is extensively treated. Cyproterone acetate allows differentiated treatment according to the various grades of hirsutism by modification of dosage and application. Individual treatment according to the specific grade of hirsutism is also possible by different modes of application of medroxyprogesterone acetate. Intralesional application is a new interesting aspect of treatment. There have also been reported good results with spironalactone. Cimetidine may be another helpful alternative in cases of contraindicated hormonal treatment.

Cimetidine↗
PubMed1986

Does cyclosporin A influence sex hormone level?

Cyclosporin A is an effective immunosuppressive substance which is extensively applied in various conditions. A well known side effect of high dose Cyclosporin A treatment is the occurrence of hypertrichosis, often referred to as hirsutism. The purpose of the study was therefore to investigate ovarian, adrenal and pituitary hormones as possible mediators of increased hair growth. In 5 female and 11 male patients who had developed hair overgrowth during Cyclosporin A treatment serum androgens (testosterone, dehydroepiandrosterone-sulfate, androstendione), sex hormone binding globuline (SHBG), prolactin (HPRL), 17-hydroxyprogesterone (17-OHP), 17 beta-estradiol (17 beta-E) and cortisol (F) were determined by standard radioimmunoassay methods. The same number of age matched patients with Azathioprine treatment served as control. Both patient groups received additive cortisone treatment of the same dosage. No significant differences of serum androgens were noted between Cyclosporin A treated patients and controls. In addition, normal prolactin levels were defected. 17-OHP was in the low normal range and cortisol below normal due to the additive cortisone treatment. SHBG was within normal range. The findings thus indicate that increased hair growth caused by Cyclosporin A seems not to be caused by an action of the substance on the hormonal level.

17-alpha-Hydroxyprogesterone↗
PubMed1986

[Inhibition of ovulation with 35 micrograms of ethinyl estradiol and 2 mg of cyproterone acetate (Diane 35)].

In the study reported here the ovulation inhibition dose for cyproterone acetate was determined. Experiments showed that the ovulation inhibition dose is 1 mg of cyproterone acetate, administered daily. Results proved that the cyproterone acetate dose cannot be reduced when cyproterone acetate is combined with ethinyl estradiol. However, the objective of this study was to determine whether it is possible to reduce the estrogen dose to 35 micrograms when the common combination of 2 mg cyproterone acetate and ethinyl estradiol is being used. After a control menstruation cycle, 2 mg cyproterone acetate and 35 micrograms ethinyl estradiol were administered daily to six women with normal menstruation. Drug administration began on Day 5 and ended on Day 25. During the control cycle, the first treatment cycle, and the third treatment cycle, LH, FSH, 17 beta estradiol, progesterone, testosterone, prolactin, and SHGB were examined daily. Cervix score and karyopyknosis index were determined at the same time. In addition, antithrombin III was examined during the control cycle and during the third treatment cycle. Present results show that ovulation inhibition is possible with dose reduction of ethinyl estradiol to 35 micrograms, combined with 2 mg of cyproterone acetate. Increase in SHBG and reduction in testosterone serum level point to an additional antiandrogenic effect of cyproterone acetate, aside from its cellular effect. The combined preparation discussed here does not bring about any changes in antithrombin III values. Results permit the conclusion that ovulation inhibition is insured with a reduction of the daily estrogen dose from 50 micrograms to 35 micrograms.

Adult↗
PubMed1986

Androgen receptor in hirsutism and acne.

Hyperandrogenism may result in acne and hirsutism. On the other hand, acne and hirsutism may occur without elevated androgen serum levels. An important point of androgen action is the target organ sensitivity at the receptor level. In the present study, androgen receptor (AR) determinations by saturation analysis were performed in 36 hirsute as well as in 11 female and 52 male acne patients. A small group of endocrine healthy patients served as control group. For AR analysis, the predilection sites of the disease were chosen. In acne, also nonlesional skin served as control. 26% of the hirsute patients were AR-positive, with mean AR levels of 68 fmol/mg protein. Male acne patients were 50% AR-positive in acne lesions and 60% positive in their nonlesional skin. The mean AR levels were 25 and 38 fmol/mg protein, respectively. The control group was 27% AR-positive, with mean AR levels of 15 fmol/mg protein. Female acne patients were 3/11 positive in lesional and 1/11 positive in nonlesional skin. The mean AR levels were 25 and 35 fmol/mg protein, respectively. The female control group was in 3/13 cases AR-positive, with a mean level of 8 fmol/mg protein. Comparison of the AR levels indicates hirsutism as the mostly androgen-dependent dermatosis. No correlation between AR and androgen serum levels was demonstrated. This finding suggests that androgen action at the target organ level in both dermatoses may be independent of peripheral serum levels of hormones.

Acne Vulgaris↗
PubMed1986

Response of multiple syringomas to isotretinoin.

Two female patients with multiple syringomas were treated for 5/6 months with cumulative doses of 9 and 11 g isotretinoin respectively. Clinically, the appearance of the lesions in both patients improved from the third month on. After therapy, the lesions were flattened, softened, and skin coloured. Histologically, a marked reduction of size and numbers of syringomas was observed, and the contents of cystic lesions seemed reduced 6 months after therapy. Ultrastructurally, changes in the cystic and ductal epithelium correspond with the keratin modulating efficacy of the drug, but also point at a drug-induced change in intracellular lipid composition.

Adenoma↗
PubMed1986

[Marghescu-Braun-Falco syndrome].

A 32-year-old male patient with congenital poikilodermia syndrome is presented. The case history details of blister formation in the past and the association of the characteristic symptoms prompted us to make the diagnosis of Marghescu-Braun-Falco Syndrome in a male patient.

Adult↗
PubMed1985

Medroxyprogesterone acetate therapy in hirsutism.

In a pilot study, 26 hirsute females were treated with medroxyprogesterone acetate (MPA). We used an ointment containing 0.2% MPA in 13 patients, subcutaneous injection of MPA into the hairy areas of the face in five patients and intramuscular injection of low doses of MPA in 13 patients, each for an average duration of 16 weeks. The best clinical result was achieved by subcutaneous injection, the next most successful was the intramuscular injection, and the least successful was the topical application. Hair diameter measurements, carried out in 12 patients, were found to be reduced by 33% on average. Serum androgen levels, measured monthly, remained unaffected by topical treatment, but were decreased by intralesional and intramuscular injection. The clinical improvement with topical therapy despite the lack of effect on serum androgen levels supports the idea that MPA works partly at the cellular level. The intralesional and systemic injection of MPA may exert an effect both by systemic androgen suppression and a local action.

Administration, Topical↗
PubMed1985

Sebum suppression by benzoylperoxide.

Sebum excretion rate (SER) was determined by thin-layer chromatography and based on densitometric data in 9 male and 5 female patients suffering from acne during treatment with 10% benzoylperoxide (BPO). BPO was applied to the forehead (treatment area), whereas gel only was applied to the chest (control area) for 6 weeks. SER decreased in 10/14 subjects, no change was found in 1 subject and 3 patients exhibited an increase in SER. Suppression varied between 12 and 86%. Concomitant SER reduction in control and treatment areas was noted in 6 patients. When treatment and control areas of individual patients were considered for data evaluation, SER decrease was noted in only 4 out of 14 subjects. Similar results were obtained when free fatty acids, triglycerides and squalene data were analyzed. Combined, these data suggest that BPO may affect SER in some patients. The present experiments indicate the importance of adequate controls in such studies.

Acne Vulgaris↗
PubMed1985

Steroid hormone levels in serum and skin receptor concentrations in hirsutism.

In 36 women androgen (AR), estrogen (ER) and progesterone (PgR) receptor were determined by dextran coated charcoal assay and subsequent Scatchard plot analysis in skin slices obtained from hirsute areas under local anesthesia. The biopsies were performed between day 18-21 of the menstrual cycle. Concomitantly venous blood was sampled in these and additional 14 patients for radioimmunoassay estimation of serum levels of testosterone (T), dehydroepiandrosterone sulfate (DHEA-S), androstenedione (A), estradiol (E2) and prolactin (PRL). However, it should be noted that all receptors and hormones were not examined in all patients. The incidence of ER-positive patients was smaller (i.e. 17%) than previous findings in acne and normal skin, while 26% of the examined patients were AR-positive. This result was similar to findings in acne, whereas the receptor levels are three times higher than in acne lesions. This suggests a greater androgen sensitivity of hirsute areas compared to acne lesions. Two out of 10 examined patients were PgR-positive. T was elevated in 63%, DHEA-S in 50% and A in 37% of examined patients. Lack of correlation between hormone serum levels and corresponding receptors concentration indicates a direct involvement of hormone action at the cellular level. The data combine to suggest that greater target organ sensitivity was responsible for hirsutism in those patients with normal androgen serum levels, while the absence of receptors in skin samples may characterize patients with idiopathic hirsutism.

Adult↗
PubMed1985

The levels of androgen in serum in female acne patients.

Twenty six female acne patients aged between 27 and 42 years were investigated. Blood samples were taken and radioimmunoassayble testosterone, androstenedione and DHEA-S were determined. Seven out of 26 patients (27%) had normal androgen serum levels. In 19 patients one or more androgen serum levels were elevated. DHEA-S (23%) alone and testosterone, androstenedione plus DHEA-S (15%) showed the greatest incidences of elevated levels. Testosterone and androstenedione, respectively, were elevated in 3 patients whereas DHEA-S alone was elevated in 6 patients. 71% with normal androgen serum levels and 72% of patients with elevated androgens presented with premenstrual or menstrual exacerbation of acne. In addition, patients with elevated testosterone, androstenedione or with all measured androgens elevated had menstrual disorders and premenstrual formation of therapy resistant big nodules in the chin area. Present data combine to suggest that the determination of androgens is of importance for the evaluation of acne patients.

Acne Vulgaris↗