Biomedical subjects
Publications and source records attributed to M Schewach-Millet.
Double-blind clinical studies of pairs of lesions were initiated to evaluate several components of Solcoderm treatment. The superiority of Solcoderm over plain nitric acid was as evident with plastic as with wooden applicators. A mixture of oxalic and nitric acid had effects similar to Solcoderm, while acetic and nitric acid was similar in effect to plain nitric acid.
Over 300 patients with basal cell epithelioma have been treated with Solcoderm during the past 4 years. The treatment is simple and effective for small superficial lesions and particularly useful in patients with periocular or multiple lesions.
25 patients with 29 histologically confirmed periocular basal cell epitheliomas were treated by topical application of Solcoderm, a solution of organic and inorganic acids and ions. The cure rate of the 29 lesions, which were followed for a mean period of 32 months, was 80%. The overall cure rate following second Solcoderm treatment of the 6 recurrent lesions was 96.7%. The cosmetic and functional results were excellent and there were no serious complications and side effects.
Long-standing disseminated lesions of pityriasis versicolor (PV) were found in 101 patients. As they had failed to respond to various topical agents, we treated them with 200 mg/day of ketoconazole. All of them were under clinical and mycological surveillance at weekly intervals. In successive mycological examinations during the course of therapy, an increased ratio of filaments/spores was observed, and the last positive examinations invariably showed the presence of only a few filaments and no spores. The mean duration of therapy, until a negative mycological smear was obtained, was 2.2 weeks. Side effects were insignificant, and did not necessitate interrupting treatment except in one patient, who developed an allergic eruption after a single 200-mg dose of the drug. The transient minor disturbances in liver function tests noted in six patients were considered drug related, but ketoconazole administration was continued in all these patients, and the values normalized gradually during treatment. We conclude that ketoconazole is a well-tolerated and highly effective drug in the systemic therapy of disseminated PV.
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The sun protection factors (SPF) of 35 commercially available sunscreen preparations were tested on human skin under various conditions. Five distinct groups of products, ranging from minimal (SPF 2 to less than 4) to ultra sun protection (SPF 15 to greater than 19) were evaluated. Claimed SPF values were not always consistent with those obtained in our tests. Substantivity studies of a randomly selected group of sunscreen preparations during the hot, highly humid Israeli summer showed mean SPF reductions of 47 and 60%, respectively, following exercise-induced sweating or a 20-min swim. Judicious selection and use of an appropriate sunscreen preparation according to individual skin type or life-style, as well as the introduction of strict testing and labeling regulations, are essential measures for reducing the risk of sun-induced skin cancer and malignant melanoma in Israel.
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Distinct differences between topical acid preparations can be detected by simple preclinical and clinical pharmacologic models designed to evaluate potential utility in the treatment of superficial skin tumors. The models distinguish a tissue-dissolving (ulcerating) effect from a tissue-fixation (mummifying) effect, as reflected by a distinct and lasting discoloration of hair in vitro or the skin surface in vivo. Double-blind clinical comparison of the response to different preparations of matched pairs of small superficial skin tumors in 33 subjects demonstrated for greater utility for nitric acid preparations of appropriate strength (6 to 7N), with added oxidizable organic acids, over the mineral acid alone. The nitrate reduction products generated in such preparations markedly speed up discoloration in the models and apparently contribute to the improved clinical utility of the topical treatment by enhancing the speed and intensity of tissue fixation, but not tissue erosion. The architecture of lesions eradicated by such mixtures is generally adequately preserved for histologic diagnosis of the extruded tissue.
A family with a four-generation history of steatocystoma multiplex is presented. The subject described had unusually large tumors on his scalp and forehead which were successfully excised and closed with skin grafts.
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