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Biomedical subjects

J D Guin

Publications and source records attributed to J D Guin.

At least 19 recordsLinked to original sources
PubMed1992

Aquagenic urticaria.

Aquagenic urticaria is a rare form of physical urticaria characterized by small follicular wheals with an erythematous flare upon exposure to water. We describe typical lesions in a seven-year-old boy with aquagenic urticaria, cholinergic urticaria, and symptomatic dermatographism, who responded to treatment with ultraviolet B and oral antihistamines.

Child↗
PubMed1991

Pathogenesis of onychoschizia (lamellar dystrophy).

Onychoschizia or lamellar dystrophy of the nails is common, especially in adult women, but little information is available about its cause. Most theories involve environmental factors, but supportive experimental data are scarce. Therefore we studied the in vitro nail changes produced by several organic solvents, detergents, water, other polar materials, and both acidic and basic solutions. Challenged and control fingernail clippings were examined grossly, microscopically, and by scanning electron microscopy at regular intervals. There was a progressive increase in severity with prolonged wetting and drying. By 3 weeks, scanning electron microscopy demonstrated unattached individual cells in empty spaces in which separation was more prominent. Basic solutions caused some softening, but layering (peeling) was seen only after repeated hydration and dehydration. Although other factors may influence onychoschizia, the typical changes can be produced in normal nails after a 21-day challenge of repeated exposure to water followed by dehydration. These findings suggest a probable cause for the condition and a logical approach to management.

Adult↗
PubMed1991

Making your own videotapes for patient instruction.

Producing your own videotapes can be both fun and clinically helpful. They are extremely effective for patient instruction and for obtaining informed consent. This article discusses the production, presentation, and effective use of videotapes in office practice.

Humans↗
PubMed1990

Magnolia grandiflora dermatitis.

A patient is described who had allergies to several sesquiterpene lactone-containing plants, but the reaction to Magnolia grandiflora was extremely severe. The condition was a chronic lichenified dermatitis that was unresponsive to treatment but cleared with protective measures. Primary allergy to Magnolia is rarely reported, even though some studies of cross-reactivity suggest that sensitivity is far from rare.

Clobetasol↗
PubMed1989

Bioequivalence (bioavailability) of generic topical corticosteroids.

A new, quantitative modification of the vasoconstrictor assay was used to measure bioavailability of generic topical corticosteroid products in two categories: betamethasone valerate 0.1% cream and triamcinolone 0.1% cream. Betamethasone valerate products could be separated into two distinct categories, and triamcinolone acetonide products could be grouped into three categories of activity. A survey of local pharmacies showed that generic substitution would be made for the prescribed brand of betamethasone valerate in 58% of cases and for the prescribed triamcinolone acetonide 75% of the time. Because of the prevalence of generic substitution of products that may not have equivalent bioavailability, some standardization of the bioavailability of topical products is needed.

Administration, Topical↗
PubMed1989

Erythroderma from systemic contact dermatitis: a complication of systemic gentamicin in a patient with contact allergy to neomycin.

A patient who was sensitive to potassium dichromate and neomycin showed a universal exfoliative erythroderma following intravenous gentamicin therapy. When his ear canals were later treated with a neomycin-containing topical medication, he reacted so severely that the skin of his ears was temporarily depigmented. Withdrawal of aminoglycoside antibiotics along with use of a topical steroid preparation under occlusion brought the eruption under control. Since approximately half of the persons with contact allergy to neomycin will also react to gentamicin, it seems unwise to treat such patients with other intravenous aminoglycosides that are closely related chemically. In our patient, multiple patch tests to other aminoglycosides caused positive reactions to all reagents containing a deoxystreptamine ring, but there was no reaction to streptomycin, which lacks that structure.

Aged↗
PubMed1988

The tanning salon: an area survey of equipment, procedures, and practices.

Because so little data are available on practices and procedures used by tanning salons, we studied, as customers, salons in a major city in Arkansas, the state where the practice began. We measured both ultraviolet A (UVA) and ultraviolet B (UVB) output at multiple reference points and found UVB always to be present, but at lower-than-expected levels. The highest irradiance was always at the umbilicus and the lowest was on the face. We evaluated compliance with accepted safety principles and federal guidelines and regulations; too often we found no eye protection and sometimes we found inadequate limits of exposure time. Persons with skin types I and II were sometimes promised a safe, effective UVA tan that would protect against sunburn. From our experience we concluded that if the industry is to continue, there is need for closer supervision and regulation.

Equipment and Supplies↗
PubMed1988

Isolation, via activity-directed fractionation, of mercaptobenzothiazole and dibenzothiazyl disulfide as 2 allergens responsible for tennis shoe dermatitis.

Although contact dermatitis from shoes is common, the causative allergen is frequently not known. Reliance cannot be placed on standard screening trays because such testing can be negative when testing to shoe materials is positive. Furthermore, the relevance of positive screening tests is almost never proven by extracting that allergen from the patient's shoes. We present a case of insole dermatitis to tennis shoes in which we directly isolated the causative allergens by step-by-step patch-test monitoring of active fractions. Chromatographic separation of the active fractions led to the isolation of 2 allergens, mercaptobenzothiazole (Captax) (MBT) and its dimer, dibenzothiazyl disulfide (Altax) (DBTD). Patch tests to DBTD were noticeably more potent than those to MBT. In what might be considered an obvious case of contact sensitivity to MBT, the actual allergen is DBTD. Using this method, unknown shoe allergens can be isolated, identified, and added to the shoe test tray of potential allergens.

Benzothiazoles↗
PubMed1988

Chronic fixed drug eruption caused by acetaminophen.

A case of chronic fixed drug eruption resembling parapsoriasis en plaques is reported, which presented with persistent, stable lesions that were present for seven months before the diagnosis was established. The patient's skin cleared totally with avoidance of acetaminophen and flared prominently with re-exposure. Distribution of the recurrence was different: some previous sites had apparently become refractory and remained clear, some involvement had recurred in the same site, and new areas of involvement had appeared, causing the eruption to "wander," as is often seen in acute fixed drug eruption due to acetaminophen.

Acetaminophen↗
PubMed1988

Mometasone furoate ointment and cream 0.1 percent in treatment of psoriasis: comparison with ointment and cream formulations of fluocinolone acetonide 0.025 percent and triamcinolone acetonide 0.1 percent.

Mometasone furoate (Elocon) is a newly formulated and unique medium-potency synthetic 17-heterocyclic corticosteroid. The efficacy and safety of the ointment and cream formulations (0.1 percent) of the corticosteroid, administered once daily, were compared with those of the ointment and cream formulations of fluocinolone acetonide 0.025 percent administered three times daily and triamcinolone acetonide 0.1 percent administered twice daily in four multicenter clinical studies. They were conducted involving psoriasis patients with chronic and moderate to severe disease. Evaluation of change in disease sign scores indicated that mometasone ointment, applied once daily, was significantly more effective (P less than 0.01) than fluocinolone ointment, applied three times daily, and triamcinolone ointment, applied twice daily. The cream formulation of mometasone was significantly more effective (p less than 0.001) than fluocinolone cream, applied three times daily, and equivalent to triamcinolone cream, applied twice daily. The incidence of local adverse experiences following treatment with the ointment or cream formulations of mometasone was minimal. Mometasone ointment and cream provide a highly effective once-a-day treatment for moderate to severe psoriasis with minimal risk of side effects.

Administration, Topical↗
PubMed1987

Wandering fixed drug eruption: a mucocutaneous reaction to acetaminophen.

Two patients are presented with a fixed drug eruption to acetaminophen characterized by recurring erythematous, circular plaques of the skin and oral mucosa along with multiple sites of deep (postinflammatory) hyperpigmentation clinically characteristic of fixed drug eruption. The involved sites did not necessarily flare with each exposure, nor did activity always appear in the same sites with each flare. Eventually some sites apparently became completely refractory. This caused the eruption to seem to "wander." Patch testing with 1% acetaminophen in alcohol (300 mg/30 ml alcohol) confirmed the causative agent in one patient. Although patch testing was negative in the other patient, oral reexposure caused a flare. Acetaminophen appears to be an uncommon cause of fixed drug eruption, with a tendency for lesions to appear at the same or at different sites in flares, perhaps because of a prolonged refractory period and the tendency to become completely refractory in some locations.

Acetaminophen↗
PubMed1987

Compositae dermatitis in childhood.

Compositae dermatitis occurred in a 9-year-old boy with a strong personal and family history of atopy. Positive patch test reactions were 2+ for dandelion (Taraxacum officinale), false ragweed (Ambrosia acanthicarpa), giant ragweed (Ambrosia trifida), short ragweed (Ambrosia artemisifolia), sagebrush (Artemisia tridentata), wild feverfew (Parthenium hysterophorus), yarrow (Achillea millifolium), and tansy (Tanacetum vulgare) and 1+ for Dahlia species and English ivy (Hedera helix). Patch tests were negative for another 30 plants, including cocklebur (Xanthium strumarium), dog fennel (Anthemis cotula, fleabane (Erigeron strigosus), sneezeweed (Helenium autumnale), and feverfew (Tanacetum parthenium). The eruption resembled atopic dermatitis morphologically but was prominent on the palms and face and dramatically spared the area of the boy's feet covered by his shoes. The condition has always been seasonal, worsening in summer, especially July, and it clears on avoidance of contact. This case is believed to represent a contact dermatitis to oleoresins of Compositae plants; inhalants as a cause of systemic aggravation are not likely to be important in this patient.

Child↗
PubMed1985

Double-blind treatment of seborrheic dermatitis with 2% ketoconazole cream.

Thirty-seven patients with seborrheic dermatitis were treated topically with a 2% ketoconazole cream or its vehicle control in a double-blind study. The subjects were studied for numbers of Malassezia ovalis (Pityrosporum ovale) cells in their scalp scale; changes in numbers of yeast cells and morphology of M. ovalis were tabulated along with clinical assessment of improvement. The 2% ketoconazole cream, but not the placebo cream, reduced the numbers of viable yeast cells on the scalp. The clinical effect of 2% ketoconazole cream was good (75%-95% improvement) or better in eighteen of twenty subjects; the placebo cream produced good results in only three of seventeen subjects treated. Results of this study are consistent with the view that M. ovalis plays a central role in the pathogenesis of seborrheic dermatitis.

Administration, Topical↗