Search PubMed⌕ Search

Biomedical subjects

J Berth-Jones

Publications and source records attributed to J Berth-Jones.

At least 55 records · Page 3Linked to original sources
PubMed1996

Clinical aspects: preliminary experience with a novel oral formulation of cyclosporin (Neoral).

Cyclosporin has been shown to be highly effective in psoriasis, atopic dermatitis and numerous other dermatoses. Despite the effectiveness of cyclosporin, the response varies somewhat between individuals. Some may not respond, and often this is linked with unpredictable absorption of the traditional formulation. Cases of atopic dermatitis and psoriasis previously resistant to cyclosporin have responded well to a new microemulsified formulation, Neoral, and formal trials are now underway to investigate its use in these indications. Preliminary data from a clinical trial using the new formulation in chronic plaque psoriasis suggest that this has similar efficacy and tolerability to the traditional formulation in this condition, and that repeated short courses of therapy may be well tolerated.

Chemistry, Pharmaceutical↗
PubMed1996

Six area, six sign atopic dermatitis (SASSAD) severity score: a simple system for monitoring disease activity in atopic dermatitis.

The Six Area, Six Sign Atopic Dermatitis severity score has proved to be a simple and effective system for recording and monitoring disease activity in atopic dermatitis. The score is obtained by grading six signs (erythema, exudation, excoriation, dryness, cracking and lichenification), each on a scale of () (absent), 1 (mild), 2 (moderate), or 3 (severe), at each of six sites; arms, hands, legs, feet, head and neck, trunk. The maximum score is 108.

Dermatitis, Atopic↗
PubMed1996

A new microemulsion formulation of cyclosporin (Neoral) is effective in the treatment of cyclosporin-resistant dermatoses.

Cyclosporin is a highly effective treatment for severe psoriasis and atopic dermatitis. However, both inter- and intrapatient gastrointestinal absorption of the conventional formulation of cyclosporin (Sandimmun) are very variable, ranging from 20 to 50%. Variations in bioavailability may explain isolated resistance to therapy. Neoral is a novel microemulsion formulation of cyclosporin which has been developed to enhance and standardize its absorption. We report the first experience with Neoral in patients with psoriasis and atopic dermatitis refractory to Sandimmun.

Adult↗
PubMed1995

Prevalence of atopic dermatitis in Leicester: a study of methodology and examination of possible ethnic variation.

A study was undertaken to investigate and compare various methods of estimating the prevalence of atopic dermatitis (AD), and to investigate a possible ethnic difference in our local community. Preschool children attending routine child health surveillance clinics and Social Services day nurseries were examined by a trained observer, and their parents were interviewed. In addition, general practice records from a health centre were scrutinized. Three hundred and twenty-two children aged 1-4 years were examined, and the point prevalence of AD was 14% [95% confidence interval (CI) 10-18]. There was no apparent ethnic difference in prevalence. Twenty-seven per cent (95% CI 22-32) of parents reported that their children had suffered from 'eczema' at some time. General practitioners' records contained a diagnosis of 'eczema' in 32% (95% CI 28-36) of 446 children aged 1-4 years. It is clear that methodology must be carefully standardized if comparisons are to be made between different studies. Accurate estimations of the prevalence of AD can probably only be obtained by examination of a population sample by a trained observer. However, the estimates obtained in this study are high, and would tend to support existing evidence that the prevalence of AD is rising.

Asia↗
PubMed1995

Nodular prurigo responds to cyclosporin.

Nodular prurigo is a distressing disease which is difficult to treat. Two patients with severe nodular prurigo were treated with cyclosporin for periods of 36 and 24 weeks, respectively, using doses of 3-4.5 mg/kg per day. In both cases there was a reduction in the severity of pruritus after 2 weeks of treatment. In one patient there was a considerable, although incomplete response, and in the other almost complete resolution of the disease was achieved. The improvement was maintained throughout the treatment period, and the drug was generally well tolerated, although in one patient there was a rise in serum creatinine during treatment, which later returned to normal.

Adult↗
PubMed1995

Novel cycle changes in scalp hair are caused by etretinate therapy.

The scalp hair of 15 patients, who were treated with etretinate for at least 6 months, was investigated, with the aims of confirming the previously described reduction in the duration of anagen and establishing the mechanism of etretinate alopecia. An increase in hair shedding rate and an increase in plucked telogen count, both of which continued for 6 months of treatment, were found, whereas there was no significant increase in the proportion of new, or regrowing, anagen hairs in a cut sample (NAH). The sustained decrease in the duration of anagen was confirmed, and it was further shown that this decrease was progressive. This would appear to be the main cause of the observed increased shedding associated with etretinate treatment. In relation to the mechanism of the alopecia, it was concluded that an arrest at the onset of anagen and a follicular anchorage defect in telogen were causes. The evidence for an arrest at the onset of anagen was a failure of NAH to rise on treatment, and a large increase in NAH on stopping treatment. The evidence for a follicular anchorage defect was a rise in shed rate very early in treatment, and an observed shed rate greater than expected, on the basis of plucked telogen results, later in treatment. These pathogenic mechanisms have never been described previously in drug-induced alopecia, or in the majority of hair disorders in general. However, it would seem highly unlikely that these mechanisms are exclusive to etretinate therapy.

Adult↗
PubMed1995

Cryotherapy of common viral warts at intervals of 1, 2 and 3 weeks.

We studied the efficacy, and time to clearance, of more frequent cryotherapy of viral warts, by randomizing 225 patients to receive treatment at 1-, 2- or 3-weekly intervals. The mean times to clearance of warts in each group were 5.5, 9.5 and 15 weeks in the weekly, 2-weekly and 3-weekly groups, respectively (P < 0.01). Cure rates after 3 months correlated with frequency of treatment (P < 0.05). After 3 months, 43% (66% of non-defaulters) had cleared in the group treated weekly, 37% (47%) of the group treated every 2 weeks, and 26% (30%) of those treated every 3 weeks. The mean numbers of treatments needed to achieve clearance were similar in each group (5.5, 4.75 and 5 treatments). After 12 treatments, cure rates were similar for all three groups: 43% for the weekly-treated group (3 months), 48% for the 2-weekly group (6 months), and 44% for the 3-weekly group (9 months). Percentage cure is related to the number of treatments received, and independent of the interval between treatments. A more rapid cure may, therefore, be achieved by more frequent treatment.

Adolescent↗
PubMed1994

Assessment of epidermal dendritic cell markers and T-lymphocytes in psoriasis.

Epidermal dendritic and T-cell counts have been performed in lesional and non-lesional skin from 35 psoriatic patients. The aims were to investigate absolute changes and interrelationships between these cellular elements in psoriasis and to explain apparent discrepancies between these results and reports in the literature. In non-lesional skin, the most frequently expressed dendritic cell marker was CD1a. HLA-DR+ and alpha-mannosidase+ dendritic cells were approximately 50 per cent and S100+ cells were 25 per cent as frequent. T-lymphocytes were rare, CD4+ cells predominating. In lesional psoriatic epidermis, there was a definite increase (approximately two-fold) in the absolute number of CD1a+ dendritic cells. This differs from the conclusions from the majority of previous studies. However, when cell counts were expressed per unit area of vertical section, there was a decrease in CD1a+ cells in lesional skin, which is an explanation for this discrepancy. There was a greater increase in absolute HLA-DR+ cell counts, so that the numbers of cells expressing CD1a and HLA-DR were similar in lesional skin. S100 expression increased proportionately with CD1a+, but there was no absolute increase in alpha-mannosidase+ cells, which might represent a separate sub-population of dendritic cells. The greatest cellular increase was in T-lymphocytes, particularly CD8+. In lesional skin, direct correlations have been demonstrated between epidermal thickness, HLA-DR+ dendritic cells and T-lymphocytes, particularly CD8+ cells. We would suggest that the present method of quantification is of value for the analysis of absolute changes in epidermal infiltrates, particularly psoriasis, and could be applied to other epidermal pathologies.

Adult↗
PubMed1994

Mutations of keratin 9 in two families with palmoplantar epidermolytic hyperkeratosis.

The hereditary palmoplantar keratodermas are a heterogeneous group of diseases unified by thickening of the stratum corneum of the palms and soles with consequent painful fissuring, discomfort on pressure, and resultant disability. One of the histologic patterns underlying palmoplantar hyperkeratosis is that of epidermolytic hyperkeratosis. Because that histologic pattern has been found in its generalized form to be due to keratin gene mutations, we assessed the inheritance of the form localized to the palms and soles. In each of two families studied, the mutant gene causing the disease is linked strongly to the chromosome 17 cluster of genes encoding type I keratins, and mutations are present in the conserved helix initiation region of keratin 9 in affected members of both kindreds. These data, as well as those generated recently by others, indicate that keratin gene mutations may underlie not only the generalized phenotype but also this more localized phenotype of epidermolytic hyperkeratosis and suggest one mechanism by which skin diseases can achieve their characteristic localization.

Base Sequence↗
PubMed1994

Value of a second freeze-thaw cycle in cryotherapy of common warts.

A study of open, randomized, parallel-group design was performed to investigate the impact of a second freeze-thaw cycle on the cure rate, at 3 months, from cryotherapy of common warts on the hands and feet. Cryotherapy was performed at 3-week intervals, and subjects were randomized to receive either one or two freeze-thaw cycles. In addition, all subjects used keratolytic wart paints throughout the study, and plantar warts were pared prior to freezing. Three hundred subjects were recruited. At 3 months, 124 were cured, 83 were not cured, and 93 had defaulted. Among those who did not default the cure rate was 57% from the single freeze technique, and 62% from the double freeze technique, a difference of 5% (P = 0.53, 95% CI-8.1-18.6). Separate analyses for subjects with warts on the hands and on the feet demonstrated no effect of double freezing on hand warts. In contrast, for plantar warts, the cure rate was 41% from single freezing and 65% for double freezing, a difference of 24% (P = 0.04, 95% CI 2.9-44.4). The use of a double freeze-thaw cycle confers little or no advantage over a single freeze in the treatment of hand warts, but may be considerably more effective for plantar warts.

Adult↗
PubMed1994

Pemphigoid nodularis: a report of two cases.

Pemphigoid nodularis is a rare variant of bullous pemphigoid characterized by the development of pruritic hyperkeratotic nodules. These nodules may be the presenting feature of the disease, and may precede the development of bullae by several years. The condition appears to be more common in females than males, and is often resistant to treatment. We report two definite cases and one possible case of pemphigoid nodularis, and review the literature relating to this disorder.

Aged↗
PubMed1994

High dose topical calcipotriol consistently reduces serum parathyroid hormone levels.

OBJECTIVE: Calcipotriol is a vitamin D analogue which is an effective topical treatment for chronic plaque psoriasis. It has been reported to have no effect on systemic calcium homeostasis provided the manufacturer's guidelines are adhered to (maximum 100 g of calcipotriol ointment (50 micrograms/g) per week). However, there have been reports of hypercalcaemia in patients using topical calcipotriol even at recommended doses. The purpose of this study was to investigate the effects of topical calcipotriol in vivo using the recently developed 'intact' PTH assay as a more sensitive index of systemic calcium homeostasis. DESIGN AND PATIENTS: Seven patients with extensive psoriasis were recruited for the study. Each patient was admitted to hospital and applied 200 g of calcipotriol (50 micrograms/g) ointment over the first week followed by 300 g over the second week. In the third week of treatment, patients were treated with 2% crude coal tar which served as a biochemical washout phase. MEASUREMENTS: Serum total adjusted calcium was measured at baseline and three times a week during the study. Twenty-four-hour urinary calcium excretion was measured at baseline and twice a week throughout the study. Peak (0400 h) and trough (0900 h) PTH levels were measured at baseline and at the ends of weeks 2 and 3. RESULTS: Serum PTH levels were reduced in every patient after 2 weeks' treatment with calcipotriol and rose after withdrawal. Mean 0400 h PTH fell by 2.58 pmol/l (95% confidence interval 1.45-3.70) from 5.11 to 2.53 pmol/l (P < 0.01) and mean 0900 h PTH fell by 2.08 pmol/l (0.84-3.36) from 4.04 to 1.96 pmol/l (P < 0.01). Mean serum and urine calcium rose during treatment with calcipotriol and fell after withdrawal. Mean adjusted total calcium rose by 0.14 mmol/l (95% confidence interval 0.10-0.16) from 2.25 to 2.39 mmol/l (P < 0.01). Mean 24 hour urine calcium excretion rose by 2.09 mmol/24 h (0.51-3.26) from 3.40 to 5.49 mmol/24 h (P < 0.05). No patient developed hypercalcaemia at any stage of the study although hypercalcaemia was recorded transiently in three patients. CONCLUSION: Topical calcipotriol is likely to have a dose dependent effect on systemic calcium homeostasis.

Administration, Cutaneous↗
PubMed1994

Long-term use of topical calcipotriol in chronic plaque psoriasis.

BACKGROUND AND DESIGN: A multi-centre, open, prospective study of 12 months duration was performed to assess safety, efficacy and tolerability of topical calcipotriol in the long-term treatment of psoriasis. One hundred and sixty-seven adults with chronic plaque psoriasis who had previously responded to calcipotriol entered the study. Disease activity was monitored using the psoriasis area and severity index (PASI). Calcipotriol ointment 50 micrograms/g was applied twice daily until remission was attained. Treatment was then stopped but reinstituted in the event of relapses. RESULTS: Of the 167 recruited patients, 6 patients did not receive any treatment during the trial. A total of 39 patients were withdrawn: 15 due to inadequate control of their psoriasis, 9 due to irritant reactions, 7 due to defaulting and 8 for miscellaneous voluntary reasons. A further 24 patients either reached the study medication limit of 2,500 g or were considered to have completed the study a few weeks prior to the 12-month period. Accordingly, 98 patients were assessable after 12 months of therapy. Complete clearing was obtained in 26% of subjects, who then used the treatment intermittently. The remaining patients required continuous treatment for 12 months. The mean PASI fell from 8.1 (SD +/- 6.67, n = 167) at baseline to 3.90 (+/- 3.50, 136) at 2 months and 2.71 (+/- 2.12, 98) at 12 months. There was no rise in the mean serum total calcium. CONCLUSION: Calcipotriol ointment was safe, effective and well tolerated.

Administration, Topical↗
PubMed1994

Diphencyprone is not detectable in serum or urine following topical application.

Diphencyprone is a potent contact sensitizer in widespread use for treatment of alopecia areata. It is currently not known whether this compound is absorbed following topical application. This is important, since little is known regarding potential toxicity. We therefore analysed serum and urine samples following application of at least 0.5 ml of a 1% solution of diphencyprone to the scalp of patients under treatment for alopecia areata. Serum samples were obtained over 8 h following treatment and 24-h urine collections were performed. The threshold for detection was 2 ng, and the assay gave an accurate linear response for samples of serum and urine containing known concentrations of diphencyprone. Blood and/or urine samples were obtained from a total of 18 subjects. Diphencyprone was not detected in any sample of serum or urine from the subjects. These data suggest that diphencyprone is not absorbed following application to the skin.

Administration, Topical↗