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Biomedical subjects

P Elsner

Publications and source records attributed to P Elsner.

At least 127 records · Page 7Linked to original sources
PubMed1997

Foreign body granuloma of the penis caused by occupational glass fibre exposure.

We report a patient who presented with the suspected diagnosis of syphilis. Clinical findings included a penile ulcer, positive history of syphilis more than 20 years ago, and positive syphilis serology (TPHA, FTA-Abs). A biopsy showed a plasma-cell rich inflammation with granuloma formation. Since a birefractory structure was observed in the biopsy possibly corresponding to a foreign body, the patient's occupational exposure was investigated. Working in the fiber reinforced plastics industry, he was heavily exposed to glass fibre that was even detected on the inside of his underwear. Taking the serological pattern into account that was not consistent with active syphilis, a penile ulcer following a foreign body reaction was diagnosed. This case report demonstrates the difficulties of differentiating foreign body granuloma of the genital region from venereal diseases with granuloma formation.

Biopsy↗
PubMed1997

Daytime serum levels of melatonin after topical application onto the human skin.

The hormone melatonin is produced in the pineal gland and secreted into the blood in a circadian rhythm. Due to its antioxidative and immunomodulatory effects it might play a role as a topical drug in dermatology. In this study we investigated the penetration kinetics of melatonin applied to the skin of 6 healthy volunteers aged 26-34 years (M/F = 2/4). First the individual physiologic daytime melatonin serum levels were determined by radioimmunoassay. Then 3 of the participants were treated once topically on their scalp with 20 mg melatonin dissolved in 70% ethanol, while the other 3 individuals received 100 mg. The application was performed at 9.00 a.m., and blood samples were collected repeatedly for a total of 8 h. Physiologic daytime melatonin levels in the 6 individuals were 16.8 +/- 10.0 pg/ml. The 3 individuals treated with 20 mg melatonin displayed peak serum levels of 762, 918 and 3,440 pg/ml, respectively, those treated with 100 mg melatonin showed peak levels of 1,136, 3,360 and 4,230 pg/ml lasting throughout the entire observation period of 8 h. These findings indicate that melatonin might accumulate in the stratum corneum with prolonged release into the blood system from this depot.

Administration, Topical↗
PubMed1997

Training workers at risk for occupational contact dermatitis in the application of protective creams: efficacy of a fluorescence technique.

BACKGROUND: In spite of promising experimental data demonstrating the efficacy of protective creams (PC), their practical value is still viewed with scepticism. Lack of protection could be caused simply by uneven or spotty application of these products. How precisely workers apply PC at the workplace can be monitored and quantified by a recently developed fluorescence technique. OBJECTIVE: The goal of the present study was to use this technique to teach workers in high-risk occupations the proper use of PCs and to compare the benefit of this method with the use of an instructive videotape. METHODS: Fifty healthy metal workers were recruited to self-apply a fluorescent preparation 6 weeks after being taught either by a fluorescence test or by a 20-min videotape. The application was evaluated under Wood's light examination. RESULTS: The performance of the fluorescence group had improved significantly over the initial test (p < 0.001) and was significantly better than that of the videotape group (p < 0.001). CONCLUSION: Our results indicate that this method may become a useful adjunct to improve the daily application of PC as a preventive measure.

Administration, Cutaneous↗
PubMed1997

Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). Influence of the application time point.

BACKGROUND: In a previous study, we reported a significant and dose-dependent suppression of UV-induced erythema in human skin by a topically applied melatonin preparation. OBJECTIVE: The present double-blind randomized study was designed to examine the influence of the application time point of topical melatonin on this antierythema effect. METHODS: Defined small areas on the lower back of 20 volunteers were treated with 0.6 mg/cm2 melatonin dissolved in a nanocolloid gel carrier either 15 min before or 1, 30 or 240 min after UV irradiation with twice the individual minimal erythema dose delivered by a Multiport Solar UV Simulator (UVA and UVB). The erythemata induced were evaluated by visual scoring and chromametry 24 h after irradiation. RESULTS: Treatment of the skin with melatonin 15 min before UV irradiation proved to almost completely suppress the development of an UV-induced erythema. In contrast, no significant protective effects of melatonin were observed when it was applied after UV irradiation. CONCLUSION: Topically applied melatonin has a clear-cut protective effect against UV-induced erythema. Free radical scavenging of UV-generated hydroxyl radicals and interference with the arachidonic acid metabolism are possible mechanisms of the melatonin action.

Administration, Topical↗
PubMed1997

'Patient's delay'--analysis of the preclinical phase of occupational dermatoses.

BACKGROUND: In order to cure diseases effectively it is important that they are detected in their early stages so that medical precautions can be taken. With job-related disorders it is conceivable that anxiety concerning the workplace, as well as other factors of a demanding nature, may lead to a further delay of diagnosis and treatment. OBJECTIVE: The study was carried out for the purpose of gathering information about the patients' reactions in the preclinical phase of job-related eczema. METHODS: 79 patients suffering from a job-related skin disease were questioned. The patients were divided up into groups according to their respective delay and the results evaluated in line with the method of logistic regression. RESULTS: The average delay was 8.6 months. Fear of losing their job was mentioned by most participants as the reason for the postponement of seeking medical care. People with a long delay were mainly men, senior and Swiss citizens, those with a higher education and those with a longer professional training. CONCLUSION: Patient delay in occupational dermatology highly depends on the support of employers and on the counseling of workers on job-related skin disease and their insurance protection.

Adolescent↗
PubMed1997

Occupational dermatoses in cheese makers: frequent association of irritant, allergic and protein contact dermatitis.

BACKGROUND: Few data are available on occupational dermatoses in cheese makers. OBJECTIVE: The purpose of the present study was to investigate occupationally related skin diseases in cheese makers. METHOD: In a retrospective study we analyzed 400 patients with occupational dermatoses which presented for expert opinion evaluation at our institution (1990-1995). RESULTS: Four patients with hand eczema acquired in cheese dairies were identified. All patients had a decreased alkali resistance. Atopy was a further risk factor in 2 patients. Three out of 4 patients were patch test positive for occupationally related substances and demonstrated also immediate skin test reactions to various milk products. Therefore, these patients had concurrent allergic contact and protein contact dermatitis. CONCLUSION: The diagnosis of concurrent allergic and protein contact dermatitis has to be considered in occupational dermatoses related to cheese making.

Adolescent↗
PubMed1997

Petrolatum prevents irritation in a human cumulative exposure model in vivo.

BACKGROUND: Protective creams (PCs) have been studied in different models indicating a protective effect of some products. In order to compare PCs in different studies, a generic reference standard should be available. OBJECTIVE: The purpose of this study was to investigate if petrolatum prevents epidermal barrier disruption induced by various irritants in a repetitive irritation test (RIT) and to assess its potential as a standard reference product. METHODS: White petrolatum was evaluated against a set of 4 irritants [10% sodium lauryl sulphate (SLS), 1% sodium hydroxide (NaOH), 30% lactic acid (LA) and undiluted toluene (TOL)] in the RIT. Twenty subjects were tested on the paravertebral skin of the midback. Irritation was assessed by visual scoring, transepidermal water loss and colorimetry. RESULTS: Petrolatum was very effective against SLS, NaOH and LA irritation, and it provided a moderate protection against TOL. CONCLUSION: Petrolatum can be recommended as a standard reference substance against which PCs may be compared as it is effective against water-soluble and water-insoluble irritants in a standardized test procedure.

Adolescent↗
PubMed1997

Generalized drug reaction due to papaya juice in throat lozenges.

We report the case of a 55-year-old woman without a history of atopic disease or drug allergy who developed a maculopapular symmetric exanthematous rash about 2 days after taking throat lozenges containing papaya juice. Patch tests gave negative reactions to the European standard series but were positive for papaya juice. A solution of 1% papain in water showed a weak and probably irritant reaction, while a 0.1% solution was negative. To our knowledge this is the first case report of systemic contact dermatitis to papaya without papain hypersensitivity.

Drug Eruptions↗
PubMed1997

Contact dermatitis caused by triglycidyl isocyanurate.

A case of a 31-year-old color paint factory worker who developed contact dermatitis of the face and forearms on exposure to triglycidyl isocyanurate is reported. Patch testing showed a positive allergic reaction to only 5% triglycidyl isocyanurate in methyl ethyl ketone. A face mask that had not been regularly cleaned probably promoted the patient's sensitization by its occlusive effect.

Adult↗
PubMed1997

Self-application of a protective cream. Pitfalls of occupational skin protection.

OBJECTIVES: To determine if a protective cream (PC) is adequately applied to the hands by workers in several occupations and to quantify what areas are covered or missed. DESIGN: Prospective diagnostic study. SETTINGS: Metalworking factory, construction sites, and university hospital. PARTICIPANTS: One hundred fifty healthy volunteers (50 from each setting) were recruited for a questionnaire interview and typical self-application of a PC. INTERVENTION: None. MAIN OUTCOME MEASURE: Percentage of sufficient cover with PC as assessed with fluorescence under Wood light. RESULTS: Many areas were skipped when viewed under Wood light. The application of PC was incomplete, especially on the dorsal aspects of the hands. CONCLUSION: Individuals should be made aware of the most commonly missed regions to ensure complete skin protection. This simple method is a useful adjunct to quantify self-application and in worker education.

Administration, Cutaneous↗
PubMed1996

Suppression of UV-induced erythema by topical treatment with melatonin (N-acetyl-5-methoxytryptamine). A dose response study.

Oxygen-centred free radicals play an important role in the pathogenesis of acute and chronic UV-induced skin damage as well as in skin aging. In this double-blind randomized study the efficacy of topically applied melatonin (N-acetyl-5-methoxytryptamine), a potent free radical scavenger, in the suppression of UV-induced erythema was assessed. A group of 20 healthy volunteers were irradiated with 0.099 J/cm2 UVB on four 5-cm2 areas on the lower back and topically treated with various concentrations of melatonin (0.05, 0.1, 0.5%) in a nanocolloid gel as carrier or with carrier alone. The UV-induced erythema was examined 8 and 24 h after irradiation by visual scoring and chromametry. A distinct dose response relationship was observed between the topical dose of melatonin and the degree of UV-induced erythema. Significant differences (P < 0.05) were found in redness (chromameter a-value and visual scoring) 8 h after irradiation between the areas treated with melatonin at 0.5% and those treated with melatonin at 0.05% or with the carrier. These results might open a new approach in the prevention and control of free radical-influenced skin diseases.

Administration, Topical↗
PubMed1996

Outcome of job change in patients with occupational chromate dermatitis.

Patients with allergic contact dermatitis due to dichromate are reputed to have a bad prognosis. Based on the Swiss Law on Accidents Insurance, the Swiss National Accidents Insurance Organization (SNAIO) may issue a declaration of medical inability (DMI) in cases of severe occupational dichromate dermatitis. With such a DMI, an employee is not allowed to perform any further work in contact with dichromate or cement. In this study, we reviewed medical records from 88 construction workers with DMI due to occupational dichromate dermatitis, between 1986 and 1989. Follow-up was performed by standardized questionnaire. 63 patients (72%) healed in the first few years after DMI. These patients mostly changed industry and strictly avoided all contact with cement or chromium salts. A few retired early. The outcome of our study is favorable in comparison to studies from other countries without the DMI mechanism. We conclude that strict allergen avoidance enforced by authorities, and financial support in the case of job change, are important factors in improving the prognosis in occupational dichromate dermatitis.

Adult↗
PubMed1996

Efficacy of 4 commercially available protective creams in the repetitive irritation test (RIT).

Protective creams (PCs) play their part in the prevention of occupational contact dermatitis, even though efficacy data are frequently lacking. 4 different commercially-available PCs were evaluated against a set of 4 standard irritants (10% sodium lauryl sulfate (SLS), 1% sodium hydroxide (NaOH), 30% lactic acid (LA) and undiluted toluene (TOL)) in the repetitive irritation test (RIT) in humans described by Frosch and Kurte. 20 subjects were tested on the paravertebral skin on the mid-back. Irritation was assessed by visual scoring, transepidermal water loss (TEWL) as an indicator of epidermal barrier function, and colorimetry as a parameter of inflammation. Very different protective effects of the PCs on irritation by chemical substances were detectable. All products were very effective against SLS irritation. No PC provided significant protection against toluene. 3 products showed a partially protective effect against all ionic irritants, while the 4th showed less protection against SLS and NaOH, and even amplification of inflammation by TOL. Considering the range of PC effects from good protection to increased irritation, depending on the irritant, the need for careful selection of PCs for specific workplaces is stressed.

Administration, Topical↗
PubMed1996

Human skin irritation studies of a lecithin microemulsion gel and of lecithin liposomes.

Soybean lecithin microemulsion gels offer promising features for the possible use as matrices in transdermal therapeutic systems. In order to assess the skin irritancy potential of the gel, acute and cumulative irriation tests were performed in human subjects in vivo using as comparison an unilamellar soybean lecithin liposome preparation and the solvent isopropyl palmitate (IPP). Acute irritation was tested in 151 volunteers in a 48-hour patch test, whereas cumulative irritation was assessed in a 21-day human repeated insult patch test in 20 volunteers. In the acute irritation test, discrete irritation (erythema only) developed with the gel in 2 subjects (1.3%), with the liposomes in 3 subjects (2.0%), and with IPP in 2 subjects (1.3%). For the assessment of cumulative irritation, the IT50 (irritation time of 50% of the test population) was calculated. IT50 was 13 days for the gel, 14 days for the liposomes and 17 days for IPP. This study shows a very low acute and a low cumulative irritancy potential for the soybean lecithin microemulsion gel making it a candidate matrix for transdermal therapeutic systems also under toxicological aspects.

Adolescent↗