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Biomedical subjects

P Duschet

Publications and source records attributed to P Duschet.

33 records · Page 2Linked to original sources

Treatment of herpes zoster. Recombinant alpha interferon versus acyclovir.

Sixty-four patients received systemic alpha-interferon (10 million units subcutaneously daily) and 63 received systemic acyclovir (5 mg/kg body weight intravenously thrice daily) in a randomized study of acute herpes zoster. Start of healing, complete healing, development of new skin lesions in the primarily affected and in other dermatomes, and degree and duration of pain were evaluated. Both drugs proved equally clinically efficient without statistically different findings between the two groups; herpes zoster neuralgia was not prevented by either interferon or acyclovir therapy. Minor clinical side effects occurred slightly more frequently during interferon treatment and included fever and nausea. Transient and moderate leukopenia was observed in nearly all patients in the interferon group.

Acyclovir↗

Persistent light reaction. Successful treatment with cyclosporin A.

A 53-year-old male patient who had suffered for several years from severe persistent light reaction possibly due to tribromsalan photosensitivity was treated with cyclosporin A after long-term low-dose administration of corticosteroids which had to be discontinued. PUVA therapy was impracticable due to the extraordinarily high UVA sensitivity. When cyclosporin A blood concentrations between 100 and 200 ng/ml were reached, the patient was nearly free from symptoms; the excellent clinical response was also documented by phototesting performed prior to and during therapy. Cyclosporin A may be a valuable therapeutic alternative to systemic corticosteroids for severe cases of persistent light reaction which cannot be controlled by photoprotective measures.

Anti-Infective Agents↗

[Lichen ruber planus--lupus erythematosus/overlap syndrome].

Lichen planus/lupus erythematosus/overlap syndrome (OS) comprises those dermatoses which show the clinical, histologic, and immunopathologic characteristics of both diseases. On account of this heterogeneity, the diagnosis of OS may be difficult. About 35 cases have been reported on in the literature so far. We are going to discuss the clinical, histologic, and immunofluorescence findings in OS in detail.

Biopsy↗

[Chronic lichenoid keratosis].

A 34-year-old female patient presented with the classical features of keratosis lichenoides chronica, a very rare dermatosis. Typical hyperkeratotic papules in a linear and reticular pattern were located on the upper extremities and the trunk. The nails and the perionychial areas showed marked vegetating lesions. After administration of a combined retinoid-PUVA therapy impressive remission was observed. The clinical picture, the differential diagnosis, in particular from lichen ruber planus, and the therapeutic aspects are discussed.

Administration, Oral↗

[Dowling-Degos disease: unsuccessful therapeutic trial with retinoids].

A patient with the typical features of Dowling-Degos disease (reticulate pigmented anomaly of the flexures) is described; the clinical picture and differential diagnosis are discussed. Systemic retinoids were used for treatment, but no essential improvement could be observed.

Administration, Topical↗

Erythromelanoderma with eosinophilic spongiosis and epidermal intercellular antibodies. Differentiation from pemphigus.

A patient with figurated, erythematous skin lesions which histologically showed eosinophilic spongiosis and an epithelial intercellular staining with IgG, but no acantholysis, developed erythromelanoderma. This case and a review of the pertinent literature indicate that the diagnosis of pemphigus does not seem to be justified even in the presence of eosinophilic spongiosis and epidermal intercellular antibodies, when the clinical signs of this disease and the typical histological feature, i.e., acantholysis, are lacking.

Aged↗

Lymphomatoid papulosis: remission following intravenously administered acyclovir.

In a 54-year-old male patient suffering from Hodgkin's disease, lymphomatoid papulosis occurred. Complete clearing of the skin lesions was observed immediately after intravenously administered acyclovir. The patient had numerous relapses of his skin eruption with complete responses after each course of intravenously applied acyclovir. This striking therapeutic effect parallels reports of regression of mycosis fungoides and chronic generalized lymphadenopathy after acyclovir application. The mode of action of acyclovir in these disorders is not known. They all are characterized by involvement of the T cell system, and in all these diseases, a virus etiology has been proved or is suggested. Thus, a specific effect of acyclovir on T lymphocytes or selectively on helper T cells is discussed. Alternatively, the virustatic effect of acyclovir could be responsible for the therapeutic success.

Acyclovir↗

[Leg ulcers in congenital dyserythropoietic anemia].

We report on an 18-year-old male patient suffering from leg ulcers due to congenital dyserythropoetic anemia and thrombocytosis. Based on this case, we discuss the importance of hematologic disorders for the development of leg ulcers as well as the pathogenetic mechanisms involved.

Adolescent↗

[Hyperkeratosis lenticularis perstans (Flegel's disease)].

Hyperkeratosis lenticularis perstans (Flegel's disease) is a rare form of dermatosis, which can only be diagnosed microscopically. A typical case is reported; histological differential diagnosis and treatment with systemic retinoids are discussed.

Aged↗

[Urticarial vasculitis].

Knowledge of urticarial vasculitis is very important, because its therapy and prognosis are different to other clinically similar diseases, eg idiopathic urticaria. We present a 72-year-old female patient suffering from recurrent urticaria associated with slight fever, arthralgia, occasional abdominal pain, as well as highly elevated erythrocyte sedimentation rate. Histologic examination of involved skin revealed leucocytoclastic vasculitis. Corticosteroid treatment led to clinical improvement. Courses of urticarial vasculitis may vary to a high degree; the clinical spectrum of urticarial vasculitis may turn to ranges from chronic idiopathic urticaria to systemic lupus erythematosus. Clinical hallmarks of urticarial vasculitis are slowly (within 72 hours) regressing wheals, arthralgia, as well as highly elevated erythrocyte sedimentation rate.

Aged↗