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Biomedical subjects

P Elsner

Publications and source records attributed to P Elsner.

At least 145 records · Page 8Linked to original sources
PubMed1996

Evaluation of topical antipsoriatic treatment by chromametry, visiometry and 20-MHz ultrasound in the psoriasis plaque test.

The antipsoriatic effects of two topical antipsoriatic agents, betamethasone valerate (Betnovate) and calcipotriol (Daivonex), and a pure nanocolloid gel were assessed in 10 patients with chronic plaque-type psoriasis in a modified psoriasis plaque test. Three noninvasive bioengineering methods were applied to measure antipsoriatic effects: chromametry for objective evaluation of erythema; visiometry, a method for profilometry, and 20-MHz skin ultrasound for the measurement of skin thickness as a parameter of inflammatory infiltration and psoriatic hyperproliferation of the epidermis. Regarding inflammation parameters such as skin thickness (infiltration) and erythema (dilatation of vessels and hyperperfusion), the steroid preparation Betnovate proved to be significantly most effective in our study. Daivonex showed significant decreases in the skin roughness parameters, underlining its antiproliferative effect. The nanocolloid carrier was significantly effective in thickness reduction, this effect being most probably due to occlusion. 20-MHz ultrasound, chromametry and visiometry proved to provide multiparameter assessment of treated and untreated psoriatic skin and can be recommended as objective and reproducible measurements for further studies.

Administration, Topical↗
PubMed1996

Toxicology of topical local anesthetics.

Topical anesthesia of the skin, nowadays performed for various indications from pruritus over postherpetic neuralgia to minor surgery, has been under investigation for more than 30 years. Due to low water solubility, the active base form of most of the local anesthetics on the market is poorly absorbed through the skin. Hence, the most challenging target was to develop galenic preparations which provide a good skin penetration in order to reach the dermal nerve endings and thereby lead to sufficient local anesthesia. On the other hand good skin penetration also results in a distribution of the drug in the circulation. Since local anesthetic agents are known to have an impact on the heart and central nervous system, unwanted side effects following topical application onto the skin are worth discussing. This article reviews the current topical local anesthetics with particular accent on their pharmacological and toxicological data.

Administration, Topical↗
PubMed1996

Sensitizations to allergens of the European standard series at the Department of Dermatology in Zurich 1990-1994.

BACKGROUND: For planning and evaluation of preventive activities against contact dermatitis, it is important to detect trends in contact sensitization. OBJECTIVE AND METHODS: We performed a computer-aided analysis of the patch test results of 5,565 patients tested with the European standard allergens consecutively from 1990 to 1994 in our patch test clinic. RESULTS: The male/female ratio was 42.4/ 57.6%. Sixty-one percent of the patients were < 45 years. Hands, face and lower legs were the major localizations of eczema. The largest occupational groups were office workers (21%), houseworkers and cleaning personnel (18%) and pensioners (10%). The highest sensitization rates were found for nickel (18.5%) and fragrance mix (9.6%). An increase of sensitizations to fragrance mix and balsam of Peru in both sexes and a decrease in nickel and cobalt sensitizations for females and potassium dichromate reactions for males were observed. CONCLUSION: Our data show considerable changes in the frequency of contact sensitizations that warrant further analytic studies.

Adolescent↗
PubMed1996

Skin risk assessment of metalworking fluids: a survey among Swiss suppliers.

BACKGROUND: Metalworking fluids (MWF) are the most important cause of hand dermatitis in the metal industry. The substitution of noxious products by less aggressive MWFs is therefore an important measure to reduce the incidence of hand eczema in this type of industry. In order to do so, producers and suppliers have to evaluate the skin risk of such products by predictive allergenicity and irritancy testing. OBJECTIVE: The aim of the study is to evaluate if predictive testing is performed in MWF products that are currently offered in the Swiss market and what kind of tests are applied. METHODS: A questionnaire was sent to 11 Swiss MWF suppliers in order to collect information on the actual practice of skin risk testing. RESULTS: Nine of 11 suppliers returned the questionnaire. Five suppliers report some kind of allergenicity testing in some of the products. Seven companies test for irritancy by a single application method, but only two perform cumulative irritancy testing in some products. The methods of testing (animal, human, field studies) vary greatly among the different companies. CONCLUSION: It is concluded that the practice of predictive testing for sensitization and irritancy of MWF is unsatisfactory and does not allow the user to compare products based on their skin risk. Occupational dermatologists should strive for standardization of MWF testing including so far scarcely performed repeated insult tests.

Data Collection↗
PubMed1996

Prevention of hand eczema in the metal-working industry: risk awareness and behaviour of metal worker apprentices.

BACKGROUND: In the metal-working industry, occupational hand eczema is very common and often due to contact with cutting fluids. Since it can be avoided by adequate protective measures, prevention plays an important role. However, the effectiveness of prevention depends heavily on the employees' awareness of this health risk. OBJECTIVE: The study aimed to collect information on the attitude of metal worker apprentices towards the risk of occupational skin disorders and skin protection since it is believed that their attitude at the beginning of the education will guide their future risk behaviour. METHODS: By means of a questionnaire, 79 metal worker apprentices were interviewed about their awareness of dermal risk factors and their risk behaviour at work. RESULTS: The apprentices are very badly informed about skin diseases and skin care. Most of them are not concerned about developing occupational skin problems, and they declared having obtained very little information about this subject. CONCLUSION: Considering this finding, it seems urgent to intensify health and safety education already at the beginning of the apprenticeship.

Adolescent↗
PubMed1996

Irritancy testing in occupational dermatology: comparison between two quick tests and the acute irritation induced by sodium lauryl sulphate.

To reduce the incidence of irritant contact dermatitis, the development of screening methods to identify subjects with increased susceptibility to irritants is essential. In a pilot study on the comparison between two quick, non-invasive irritancy tests (dimethyl sulfoxide (DMSO) and sodium hydroxide (NaOH) with the time-consuming patch testing with sodium lauryl sulphate (SLS), no correlation between the "quick tests" and SLS patch testing was observed. In the present paper the results of irritancy testing in 181 metal worker trainees are presented. Experimental irritant contact dermatitis reactions were induced on the medial third of the volar forearm using SLS 0.5%, applied for 23 h and as "quick tests" DMSO 90% and 95% and a solution of 0.2% mol/l NaOH applied for 5 min. Assessment of skin irritability was made by visual scoring and measurement of transepidermal water loss. Except for a statistically significant relationship between the irritations by DMSO 90% and 95%, correlations between the different techniques were weak or non-existent. This is most probably due to different pathophysiological pathways for the irritant reactions. We therefore propose to use a spectrum of different tests in occupational dermatology for predicting the individual's risk of irritant contact dermatitis.

Adolescent↗
PubMed1996

Fragrance contact dermatitis: a worldwide multicenter investigation (Part I).

OBJECTIVE: The aim of this study was to determine the prevalence of responses to selected fragrance materials in patients with suspect fragrance allergy and to evaluate risk factors and associations with such responses. The validity of using specific fragrance ingredients versus a mixture of fragrances was evaluated in terms of predicting allergy to different fragrance ingredients. METHODS: One hundred sixty-seven subjects were evaluated in seven centers worldwide with a fragrance mix, the eight ingredients in the fragrance mixture, six other well-known fragrance allergens, balsam of Peru, and 15 lesser studied fragrance materials. RESULTS: The age of the patients was 44.9 +/- 17.5 years (mean +/- SD). More than 85% were women. A relatively high proportion gave a past history of atopic disease. Facial eruptions (40%) and hand involvement (26.7%) were the most common topographic sites. All but 4 of the 35 fragrance materials produced a positive response in > 1%. A reaction to fragrance mix occurred in 47.3%. Seven of the 34 ingredients tested produced an allergic response in more than 10% of those tested. Men were more likely than women to exhibit a positive response to five fragrance ingredients. White persons were more likely to react to perfume mix (52.8% versus 25.3%) and certain ingredients in the mix than Asian persons. Allergy to benzyl salicylate was more common in Japan than in Europe or the United States. CONCLUSION: The age at which patients with perfume allergy present for evaluation is similar to that of other contactants. Atopic individuals may be overrepresented in this group of patients. Face involvement is likely. White persons are more likely to react to fragrance mix, whereas in Asian patients benzyl salicylate was a more frequent allergen. Fragrance mix corrected with 85.6% of positive responses to fragrance ingredients. The addition of ylang ylang oil, narcissus oil, and sandalwood oil to fragrance mix would be expected to pick up 94.2% with positive responses to fragrance materials; adding balsam of Peru increases this to 96%.

Adult↗
PubMed1996

Occupational contact dermatitis toward sesquiterpene lactones in a florist.

Many plants and flowers can cause dermatitis in florists, growers, and others working in the industry. In the United States, Alstromeria, also called Peruvian Lily, has frequently been reported to cause hand eczema in floral workers. This interesting report details sesquiterpene lactone allergy in the occupational setting. Fortunately, in this case, it seems that resolution of the dermatitis was achieved fairly rapidly by avoiding the occupational situation. Unfortunately, for many of our patients with airborne compositae dermatitis, there is no way to avoid the allergen; therefore, many of these individuals develop severe, chronic recalcitrant dermatitis requiring aggressive therapy. Diagnosis of this condition is not always easy, as it appears that the sesquiterpene lactone mix allergen that we have commercially available misses a number of cases, at least in the United States. Better characterization of the allergens involved and better supply of allergenic extracts for testing is critical to improve our diagnostic ability.

Adult↗
PubMed1996

Skin problems in sugar artists.

Sugar artistry is a growing profession amongst bakers and confectioners and an increasingly common hobby in amateur cooks. The main work consists of manual manipulation of sugar which is formed into figures and objects for table and food decoration. The sugar must be warmed up to 50 degrees C in order to be liquid and malleable and so the artists suffer from diverse thermally induced skin problems on their hands. Such changes have not to date been reported in the dermatological literature. In this study we report our experience in 50 Swiss sugar artists who have suffered from skin problems. The study took the form of a questionnaire survey. The response rate was 30 out of 50. Twenty-six reported no chronic skin disorder. Four suffered from a palmar vesicular relapsing type of chronic eczema. The main skin problems on the hands during work with hot sugar were increased sweating, seen in 20 out of 30 (67%), and burning with erythema and blistering, seen in 12 out of 30 (40%). Most participants (83%) were highly irritated by the skin problems during their work, and applied a protective cream before working with sugar, or wore rubber gloves. Topical therapy with a preparation containing 10% aluminium chloride hexahydrate, used once daily for 3 weeks, evaluated in 14 participants, decreased sweating in 10 (71%) and reduced the thermally induced erythema in one (7%).

Aluminum Chloride↗
PubMed1995

[Exposure to solvents in scleroderma: disseminated circumscribed scleroderma (morphea) in a painter exposed to perchloroethylene].

We report on a 45-year-old painter who developed morphea-like scleroderma. He had been exposed to perchlorethylene for one year while operating a metal degreaser; the perchlorethylene concentration in the workplace ranged between 10 and 25 ppm. Whereas systemic scleroderma has frequently been attributed to solvent exposure in the past, this is only the third description of a morphea-like scleroderma suspected to be related to occupational contact with organic solvents.

Humans↗
PubMed1995

[Cowden's syndrome].

Multiple hamartoma and neoplasia syndrome, or Cowden's disease, is a genodermatosis inherited as an autosomal dominant trait with variable expressivity. We describe a woman with classic mucocutaneous features of the syndrome: facial papules, acral keratoses, oral mucosal papillomatosis, oral polyps and scrotal tongue. As a child she had strabismus. Her family history is positive for the disease, and a sister died of malignant melanoma. The check-up revealed chronic lymphocytic thyroiditis. A checklist for use in screening patients with Cowden's disease is proposed.

Adult↗
PubMed1995

Assessment of skin irritancy by 2 short tests compared to acute irritation induced by sodium lauryl sulfate.

Irritant contact dermatitis is a very common disease that is preventable by protective measures. The development of screening methods to identify subjects with increased susceptibility to irritants is essential to reduce the incidence of this disorder in the workplace. On the outlook for such methods, 2 quick non-invasive tests for irritability of the skin were compared to reliable, but time-consuming, patch testing with sodium lauryl sulfate (SLS). In 20 healthy volunteers, 0.5% SLS was applied on the medial 1.3 of the forearm for 23 h in order to induce experimental irritant contact dermatitis. On the same part of the forearm, 3 concentrations of dimethylsulfoxide (DMSO) and a solution of 0.2 mol/l NaOH were applied for 5 min. Assessment of skin irritability was made by visual scoring and measurement of transepidermal water loss. No correlation between the "quick tests" and SLS patch testing was found, indicating that these tests assess different mechanisms of irritation.

Acute Disease↗
PubMed1995

Airborne irritant contact dermatitis from metal dust adhering to semisynthetic working suits.

2 workers at an aircraft factory were employed in a plasma sparying unit. Soon after they were equipped with new semisynthetic working suits, they started to complain of pruritic eruptions after heavy exposure to metal dust. They noted that the dust was not as easily blown off the clothes by pressurized air as previously. Clinical findings consisted of discrete macular and papular lesions, partly follicular, on the ventral and medial thighs. Atopy score, IgE level and a standard series of prick tests ruled out atopic disposition. Patch tests revealed no reactions. A diagnosis of occupational airborne irritant contact dermatitis from metal dust was therefore made. To elucidate the role of the working suit, extensive physical investigations of the physical properties of the textile were performed. Microscopic pictures at low magnification showed more dust particles on the semisynthetic working suit, compared to the former pure cotton suit. This impression could not be confirmed by particle count because of too uneven particle distribution at higher magnification. Hairiness of the 2 textiles was low and ruled out irritation by the semisynthetic textile itself. No difference in electrostatic properties between the 2 working suits could be established either. Both textiles showed high static electrical propensity. When use of the semisynthetic overall was discontinued, the patients reported no recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants, Occupational↗
PubMed1995

Contact hypersensitivity to corticosteroids in routine patch test patients. A multi-centre study of the Swiss Contact Dermatitis Research Group.

BACKGROUND: Contact hypersensitivity to corticosteroids is increasingly reported and has been identified as a problem of considerable clinical relevance. The prevalence of positive patch tests to corticosteroids ranges from 0.2 up to 5%. OBJECTIVE: The prevalence of positive patch tests to corticosteroids in Switzerland was determined in a multi-centre study of patients undergoing routine patch tests. METHODS: As representatives of corticosteroid groups, the following substances were used for screening: tixocortol pivalate and hydrocortisone for group A (hydrocortisone type), hydrocortisone butyrate for group D (hydrocortisone butyrate type) and budesonide for both groups B (triamcinolone type) and D. Patients positive for at least one corticosteroid were retested with the screening series and 12 corticosteroids commonly used in Switzerland. RESULTS: Among 3,016 consecutive patients, 65 individuals (2.2%) with a total of 106 positive reactions were found. Retesting showed a concordance of 70-98%, depending on the corticosteroid and the score of the positive reaction. In the subsequently tested corticosteroid series including 12 substances, 19 out of 56 screening-positive patients had a positive result to one or several corticosteroids. There were only few evident cross-reactive patterns in between the corticosteroids tested. CONCLUSIONS: Corticosteroids should be included in routine patch testing, because contact sensitization to a corticosteroid is of considerable practical importance. We confirm that as markers of corticosteroid sensitization tixocortol pivalate, budesonide and hydrocortisone butyrate may be suited, because there is no single corticosteroid which is a marker for all four corticosteroid groups. Patch test reactions of 2+ or higher have a better reproducibility than 1+ reactions.

Administration, Topical↗