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Biomedical subjects

L C Guenther

Publications and source records attributed to L C Guenther.

11 recordsLinked to original sources
PubMed2002

Topical tazarotene therapy for psoriasis, acne vulgaris, and photoaging.

Psoriasis, acne vulgaris and photoaging are common conditions. Tazarotene is a pro-drug of tazarotenic acid, a receptor-selective retinoid, which has shown efficacy in the treatment of these disorders. In the treatment of acne vulgaris, it has greater comedolytic activity than the currently available topical retinoids. In psoriasis, tazarotene normalizes keratinocyte differentiation, reverses keratinocyte hyperproliferation and has better anti-inflammatory effects than any of the currently available topical retinoids. It is most commonly used as combination therapy with a topical corticosteroid or phototherapy in psoriasis, or with an antibiotic in acne.

Acne Vulgaris↗
PubMed2001

One-year followup on the impact of a sun awareness curriculum on medical students' knowledge, attitudes, and behavior.

BACKGROUND: A one-week sun awareness curriculum was developed at the University of Western Ontario to educate first-year medical students on skin cancer risks and prevention. OBJECTIVE: To assess the retention of knowledge, attitudes, and behavioral practices one year after receiving education in sun awareness. METHOD: Three surveys were administered: before, immediately after the sun awareness teaching, and one year later. Actual practiced behavior in the past year was compared with the intended behavior. RESULTS: Half as many sunburns were reported in the year following the sun awareness curriculum compared with the previous year. Medical students demonstrated a good retention of the knowledge learned a year earlier. However, many students still believed that a tanned appearance looks healthy. While there was intent to adopt more healthy behavior after the curriculum, the actual behavior practiced varied. CONCLUSIONS: An undergraduate medical curriculum on sun awareness can be effective in improving the knowledge, attitudes, and behaviors of future physicians.

Adult↗
PubMed2000

A comparison of tazarotene 0.1% gel once daily plus mometasone furoate 0.1% cream once daily versus calcipotriene 0.005% ointment twice daily in the treatment of plaque psoriasis.

BACKGROUND: Both tazarotene (a retinoid prodrug) and calcipotriene (a synthetic analog of vitamin D3) are effective in the treatment of plaque psoriasis, but no reports in the literature directly compare the efficacy and tolerability of these 2 drugs. Tazarotene is commonly used in conjunction with a topical corticosteroid. In this study, tazarotene was used with mometasone furoate (a synthetic corticosteroid), and the 2-drug regimen was compared with calcipotriene monotherapy. OBJECTIVE: This study was conducted to compare the efficacy and tolerability of tazarotene 0.1% gel once daily plus mometasone furoate 0.1% cream once daily with those of calcipotriene 0.005% ointment twice daily in the treatment of plaque psoriasis. METHODS: In this multicenter, investigator-blinded, parallel-group study, adult patients with chronic, stable plaque psoriasis affecting 5% to 20% of their body surface area were randomly allocated to receive up to 8 weeks of treatment with either tazarotene 0.1% gel once daily (in the evening) plus mometasone furoate 0.1% cream once daily (in the morning) or calcipotriene 0.005% ointment twice daily. Patients were assessed at baseline and at weeks 2, 4, and 8 of treatment. Patients who demonstrated complete clearance of plaque psoriasis after 2 or 4 weeks of treatment and those whose psoriasis had improved > or = 50% after 8 weeks of treatment entered a 12-week posttreatment follow-up phase during which they applied only moisturizer. Patients were reassessed after 4, 8, and 12 weeks of posttreatment follow-up. Physician-rated measures of efficacy included global improvement, plaque elevation, scaling, erythema, and percentage of body surface area involvement. Patient-rated assessments included efficacy of study treatment compared with previous therapies, comfort of treated skin, outlook for long-term control of psoriasis, and overall impression of treatment. RESULTS: Of 120 patients with moderate to severe psoriasis enrolled from 3 centers, 106 (88%) completed the study. No significant differences in baseline clinical variables were observed between the 2 groups. Twenty-seven patients (45%) in the tazarotene plus cortico-steroid group achieved marked improvement (> or = 75% global improvement) after 2 weeks of treatment compared with 15 patients (26%) in the calcipotriene group (P < or = 0.05). Between-group comparisons of the percentage of patients achieving complete or almost complete clearance (> or = 90% global improvement) did not reach statistical significance at any time point. When compared with the calcipotriene regimen, the tazarotene plus corticosteroid regimen resulted in significantly greater efficacy on trunk lesions in reducing plaque elevation (at the end of treatment and at week 4 of the posttreatment phase, P < or = 0.05), scaling (week 4 of treatment and week 4 of the posttreatment phase, P < or = 0.05), erythema (week 4 of treatment and at the end of treatment, P < or = 0.05), and percentage of body surface area involvement (weeks 2 and 4 of treatment, P < or = 0.01). In addition, the tazarotene plus corticosteroid regimen was significantly more effective in reducing the percentage of body surface area involvement in upper limb lesions (weeks 2 [P < or = 0.05] and 4 [P < or = 0.01] of treatment). Forty-two of 55 patients (76%) in the tazarotene plus corticosteroid group rated their medication as more or much more effective than previous therapies compared with 30 of 52 patients (58%) in the calcipotriene group (P < or = 0.05). Although adverse events (burning, pruritus, irritation, and erythema) occurred in a significantly greater proportion of patients who received tazarotene plus corticosteroid than in those who received calcipotriene (P < or = 0.05), 47 of 55 patients (85%) in both groups rated the comfort of their treated skin as "somewhat comfortable" or better and both groups had similar discontinuation rates due to treatment-related adverse events (3% and 5%, respectively). CONCL

Administration, Topical↗
PubMed1996

Proliferating cell nuclear antigen (PCNA); prognostic value in the clinical recurrence of primary basal cell carcinoma.

Proliferating cell nuclear antigen (PCNA) is a nuclear protein which is correlated with the S-phase of the cell cycle and has been utilized by many investigators as a marker of cell proliferation. A previous immunohistochemical study revealed increased PCNA staining in clinically and histologically aggressive basal cell carcinoma and the present study evaluated the prognostic value of PCNA in clinical recurrence of primary basal cell carcinoma. Thirty patients with primary basal cell carcinoma (BCC) treated with shave biopsy followed by electrodesiccation in 1989 and have been regularly followed up for local recurrence were selected for this study. The histology of their primary BCC's was reviewed and the presence of PCNA in the tumor cells was studied immunohistochemically. Ninety-six percent of the non-recurrent BCC's had < 10% of tumor cells showing a positive staining for PCNA whereas 100% of the BCC's that recurred showed more than 30% of tumor cells staining positive for PCNA. In comparison, 88.9% of the non-recurring group showed non-aggressive histological features and only 66.7% of the recurring group was aggressive by microscopic appearance. In summary, the PCNA staining appeared to be superior to traditional histologic features in predicting clinical recurrence in primary BCC's and further prospective studies in a larger patient group are warranted.

Adult↗
PubMed1994

Usefulness of the dissecting microscope in the surgical management of skin cancers.

Dermatopathological examination of excised skin cancers serves the dual purposes of defining the nature of the malignancies and evaluating the resection margins for evidence of tumor involvement. Conventional histological techniques, including horizontal frozen sections as prescribed in Mohs micrographic surgery to evaluate resection margins, can often be tedious and not without many pitfalls. In this study, the use of a stereoscopic dissecting microscope is compared with routine microscopy in the examination of 54 skin specimens resected with the clinical diagnosis of cancer. Our results show that the dissecting microscope is more efficient and as accurate in diagnosing basal and squamous cell carcinomas, and in detecting tumor involvement of resection margins. The ability to visualize marginal surfaces in three dimensions allows for a thorough examination and quick localization and mapping of the involved sites. Tissue artifacts due to fixation, freezing, or sectioning are nonexistent. With the lower cost and ease of operation, we suggest that the dissecting microscope is a more superior instrument. Its usefulness in the surgical management of skin cancers should be emphasized and further validated.

Basal Cell Carcinoma↗
PubMed1990

Localized childhood vulvar pemphigoid.

Bullous pemphigoid is a disease primarily of the elderly and is uncommon in children. A distinct localized variant of this condition appears to occur in children and is limited to the vulva. Two children with localized disease are discussed.

Administration, Topical↗
PubMed1986

Cyclosporin A.

Cyclosporin A is a new immunosuppressive agent that selectively affects T helper cells without suppressing the bone marrow. Cyclosporin A has been used primarily to prevent rejection in organ transplantation and acute graft-versus-host disease. Studies suggest that it may be of benefit in psoriasis, pemphigus vulgaris, bullous pemphigoid, Behçet's disease, and collagen vascular disorders. Since cyclosporin A has a potentially important use in dermatology, and since a number of dermatologic side effects are seen as a consequence of its use, it is important that dermatologists be familiar with this drug.

Behcet Syndrome↗
PubMed1985

An evaluation of a 2% erythromycin ointment in the topical therapy of acne vulgaris.

Two hundred eight patients completed a 12-week, multicenter, double-blind, controlled study comparing a 2% erythromycin ointment to its vehicle. Patients were evaluated by inflammatory lesion counts and Cook acne severity grade at the initial visit and at weeks 2, 4, 8, 10, and 12. The 2% erythromycin ointment proved to be statistically more effective than the vehicle in reducing lesion counts and acne severity grade at weeks 4, 8, 10, and 12. The ointment caused few side effects and was well tolerated by most patients.

Acne Vulgaris↗
PubMed1985

Multicentric reticulohistiocytosis: a report of a case and a review of the pathology.

A case of multicentric reticulohistiocytosis (MR) in a 24-yr-old woman is presented. MR is a rare disorder characterized by progressive polyarthropathy and a papulo-nodular skin rash. The diagnosis was established by histological examination of biopsies of erythematous nodules on the fingers which showed circumscribed collections of large mononuclear cells and multinucleate giant cells in the reticular dermis. These were embedded in a fine network of mature fibrous tissue with a scanty lymphocytic infiltrate. Histochemical, immunopathological and ultrastructural investigations confirmed that the large mononuclear cells had the properties of macrophages. The histopathological features of MR are reviewed in the light of current knowledge of macrophage physiology, and evidence for lymphocyte-histiocyte interactions in the pathogenesis of this bizarre granulomatous disorder is presented.

Adult↗
PubMed1983

Inherited disorders of complement.

Isolated complement component deficiencies are uncommon. Deficiencies of all eleven components and two inhibitors of the classical pathway have been described. Complete absence of the components of the alternative pathway has not been described. The consequences of a single defect in complement are often predictable from an understanding of the biologic activities associated with activation of the complement system. Deficiency of C1 esterase inhibitor gives rise to the disease, hereditary angioedema; deficiency of the early components of the classical pathway are associated with lupus erythematosus; C3 and C3 inactivator deficiencies with pyogenic infections; C5 dysfunction with Leiner's disease; deficiencies of the terminal components with recurrent Neisseria bacteremia; and C9 deficiency with normal health. The complement system and its associated biologic activities are reviewed. The present knowledge of the inherited complement deficiencies and associated diseases, with particular emphasis on the dermatologic manifestations, genetics, and diagnosis, is summarized.

Angioedema↗