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Biomedical subjects

L E Millikan

Publications and source records attributed to L E Millikan.

At least 19 recordsLinked to original sources
PubMed1996

A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: a multicenter trial.

BACKGROUND: Adapalene is a new synthetic retinoid analogue developed for the topical treatment of acne vulgaris. OBJECTIVE: The study was designed to compare the efficacy and safety and adapalene gel 0.1% with tretinoin gel 0.025% in the treatment of grade II to II facial acne vulgaris. METHODS: Three hundred twenty-three patients were enrolled in this investigator-masked, randomized, parallel group, multicenter trial. Patients applied the test materials to the entire facial area daily, for a period of 12 weeks. Efficacy and cutaneous tolerance were assessed at baseline and weeks 2,4,8, and 12. Efficacy was determined by investigator counts of noninflammatory open and closed comedones, and inflammatory papules and pustules, as well as global improvement. Cutaneous tolerance was evaluated by erythema, scaling, and dryness, along with burning and pruritus. RESULTS: Staring at weeks 2 and 4, adapalene gel produced numerically greater lesion reductions than did tretinoin gel for all lesion types. At week 12, the mean percent reduction in the different lesion counts was as follow: 49% versus 37% for total lesions (p<0.01); 46% versus 33% for noninflammatory lesions (p=0.02); 48% versus 38% for inflammatory lesions (p=0.06) in adapalene and tretinoin gel treatment groups, respectively. Cutaneous side effects were limited to a mild "retinoid dermatitis" occurring in both treatment groups; however, patients treated with adapalene gel tolerated this therapy significantly better than those treated with tretinoin gel. Laboratory test evaluations (hematology, blood chemistries, urinalysis) were performed in 54 patients before and after 3 months of treatment. No clinically significant changes were observed. CONCLUSION: Adapalene gel 0.1% applied once daily was significantly more effective in reducing acne lesions and was better tolerated than tretinoin gel 0.025% in the treatment of acne vulgaris.

Acne Vulgaris↗
PubMed1996

Treating pruritus. What's new in safe relief of symptoms?

In several cutaneous disorders, pruritus is both the primary symptom and the cause of perpetuating factor. Therefore, one focus of therapy should be on treating pruritus and thereby preventing or aiding in the resolution of skin lesions. Several treatment options are available, including nonpharmacologic methods; use of emollients, tar preparations, and other topical agents; ultraviolet B therapy; and use of oral antihistamines or corticosteroids. A new topical tricyclic agent is now available that adds a promising therapeutic approach.

Administration, Topical↗
PubMed1995

MaltaDerm '94.

Explore the source record for details and available documents.

Dermatology↗
PubMed1995

The antipruritic effect of 5% doxepin cream in patients with eczematous dermatitis. Doxepin Study Group.

BACKGROUND AND DESIGN: Eczematous dermatitis is commonly characterized by intense pruritus. Current treatment modalities for this condition, regardless of its cause, are primarily directed at blunting the cutaneous inflammatory response and thereby providing relief of pruritus. To expand on our previous findings in atopic dermatitis, the present multicenter double-blind trial was conducted to evaluate the safety and antipruritic efficacy of 5% doxepin hydrochloride cream in patients with lichen simplex chronicus (n = 136), nummular eczema (n = 87), or contact dermatitis (n = 86). A total of 309 patients with moderate to severe pruritus were randomly assigned to apply either doxepin cream (n = 154) or vehicle cream (n = 155) to eczematous areas four times per day for a period of 7 days. Efficacy was assessed using a pruritus severity rating scale, a Physician's Global Evaluation for pruritus relief, and a Visual Analogue Scale for pruritus relief. RESULTS: Twenty-four hours after initiation of treatment, and continuing throughout the remainder of the study, patients treated with doxepin cream experienced significantly greater pruritus relief than did vehicle-treated patients as determined by all efficacy parameters (P < .002). Sixty percent of doxepin-treated patients experienced pruritus relief within 24 hours. The response rate increased to 84% by conclusion of the study. As judged by significant changes (P < or = .05) occurring in at least one assessment of efficacy, doxepin cream provided pruritus relief in all forms of eczematous dermatitis that were examined. The study medication was well tolerated. The two most common adverse effects, stinging at the site of application and drowsiness, were usually transient and mild to moderate in severity. CONCLUSION: Topical application of doxepin provides significant antipruritic activity with a favorable safety profile, suggesting a role for doxepin cream in the symptomatic treatment of pruritus associated with eczematous dermatitis.

Administration, Cutaneous↗
PubMed1994

Dermatologists.

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Administration, Cutaneous↗
PubMed1994

Dermatologic diseases of eastern Africa.

The countries of eastern Africa are deprived of the most basic of care for their skin disease. Diagnostic tools and treatment modalities that are commonplace in developed countries are at a bare minimum in these third world nations. In addition, there is a dearth of trained dermatologic specialists, especially in the arid areas of Kenya and Tanzania. The International Foundation for Dermatology was founded in 1987 in an attempt to address this vacuity in medical care. During the last 6 years, they have launched a campaign concentrated on the activation of Regional Training Centers in Africa, where students will enter a 2-year training program and graduate with the title of "Dermatology Officer" possessing those skills required to treat 80% of common skin diseases. It is hoped that this will lead to an increased awareness of skin pathology in general and the specific need for trained specialists in underserved areas. However, a lack of health care specialists is only part of the problem. Better nutrition, clean water, and the education of tribal communities are impending future goals, difficult to attain in a nation burdened with economic and political strife.

Africa, Eastern↗
PubMed1994

Superficial fungal infections in the tropics.

Cutaneous dermatophyte infections are limited to the superficial layers of the epidermis. Tropical and subtropical regions of the world provide warm and humid climates and therefore a favorable environment for organisms causing superficial dermatophyte infections. This article deals with cutaneous dermatophyte infections, with particular emphasis on those occurring in tropical regions of the world. History, causative organisms, diagnosis, and treatment are discussed.

Child↗
PubMed1994

Deep fungal infections in the tropics.

Although tropical deep fungal infections are uncommonly identified in North America, these disorders are a diagnostic and therapeutic challenge to the clinician. Presented in this article is information on the management of patients suffering from mycetoma, chromomycosis, African histoplasmosis, or keloidal blastomycosis.

Africa↗
PubMed1994

Myiasis.

Myiasis is not an uncommon parasitic infestation in the tropics and subtropics, and with the increase in international travel, cases also are encountered outside the endemic regions in both Europe and North America. This article reviews the ecology, classification, pathophysiology, pathology, and treatment of myiasis.

Ecology↗
PubMed1993

Lepromin responses in recipients of a candidate antileprosy bacterin vaccine (WHO-IMMLEP Mycobacterium leprae killed preparation) in the USA.

BACKGROUND: Identification of the nine-banded armadillo as a potential source of massive numbers of Mycobacterium leprae led to the development of a candidate bacterin vaccine for possible immunoprophylaxis. METHODS: Volunteers were from a leprosy-hypoendemic, nonBCG-using area (USA). They had been vaccinated intradermally 3 years earlier with a candidate antileprosy bacterin vaccine of irradiated and autoclaved Mycobacterium leprae obtained from experimental nine-banded armadillos. They were tested for dermal responsiveness to standard lepromin A. RESULTS: Values for induration and erythema appeared slightly greater for the vaccinated group; however, the differences were not statistically significant, indicating no appreciable 'anamnestic' effect on either Fernandez (early) or Mitsuda (late) reactions after 3 years. CONCLUSIONS: Because previous studies had demonstrated that administration of this bacterin produced no humoral changes, it now appears less probable that laboratory methods will be of much help in assessing even possible effectiveness of such vaccination.

Bacterial Vaccines↗
PubMed1993

Treatment of gonococcal infections with a single 250 mg intramuscular injection of trospectomycin sulphate vs ceftriaxone sodium.

Trospectomycin sulphate is a new, more potent analog of spectinomycin, which is active in vitro against penicillin-sensitive and penicillin-resistant strains of Neisseria gonorrhoeae. This study was designed to determine the bacteriologic and clinical efficacy as well as safety of a single intramuscularly administered 250 mg dose of trospectomycin sulphate in the treatment of uncomplicated gonorrhoea (cervical, urethral, pharyngeal and anal). Ceftriaxone sodium was used as a comparator antibiotic in a single 250 mg intramuscular dose. Seventy-four patients (36 women and 38 men) were evaluable in the trospectomycin treated group and 40 patients (22 women and 18 men) in the ceftriaxone treated group. The overall bacteriologic cure rate was 98.6% (73/74) for trospectomycin and 95% (38/40) for ceftriaxone. Bacteriologic failures were observed among women 1/36 (2.8%) treated with trospectomycin and 2/22 (9.1%) treated with ceftriaxone. The overall clinical success rate (clinically cured plus clinically improved) was 90.5% for trospectomycin and 100% for ceftriaxone. Adverse events were reported rarely in both groups. Less than 10% of patients complained of pain and/or tenderness at the injection site for both drugs; one patient developed a generalized, pruritic rash which occurred three days after administration of trospectomycin and resolved within six days. In conclusion, a single dose of 250 mg i.m. trospectomycin appears to be at least as effective and safe as a single dose of ceftriaxone in the treatment of uncomplicated gonorrhoea.

Adolescent↗
PubMed1993

Mite infestations other than scabies.

Scabies is clearly the primary medical problem involving mites. However, regionally, there is a broad variety of other dermatoses associated with mite exposure, which in some areas vastly exceed the incidence of scabies. Also, scabies is characterized by a cyclical occurrence that is unusual in other mite infestations and mite-associated dermatoses. Many of these have seasonal or regional characteristics, which will be discussed. The clinical aspects of mite infestation will primarily be dealt with, and the basic anatomy and biology of the mites will be ignored.

Animals↗
PubMed1993

Papular urticaria.

The diagnosis of papular urticaria has evolved over the years and has many synonyms. Its most common present day usage relates to a cutaneous reaction presumably from an apparent exposure to insects. The evolving science in this area is allowing a better understanding of potential sources including newer tools to look at antigens from insect proteins injected after bites from flying insects and some other environmental arthropods. Insight to etiology is important and can be partially determined by clinical history and clinical pattern of symptoms. The usual approach in practice is to treat symptomatically first while investigating etiologies. Increasing appreciation of the role of environmental mites and ectoparasites has allowed us more precision in diagnosis to specifically treat the cause. The primary challenge in therapy often relates to the achievement of the goal of symptom relief. This is often difficult because of the chronicity of the syndrome when the patient is seen by a specialist. Both the search for etiology and symptomatic relief often need to be aggressive to achieve the desired therapeutic benefit for the patient.

Animals↗