Search PubMed⌕ Search

Biomedical subjects

T Agner

Publications and source records attributed to T Agner.

At least 55 records · Page 3Linked to original sources

Efficacy of topical corticosteroids on irritant skin reactions.

Topical corticosteroids are frequently used in the treatment of irritant contact dermatitis (ICD). The efficacy of this treatment has, however, not been thoroughly established, and experimental studies on the topic have provided conflicting results. The aim of the present study was to evaluate the effect of potent topical corticosteroids on experimentally-induced irritant skin reactions in a double-blind, vehicle-controlled study. 16 healthy volunteers had sodium lauryl sulfate patch tests symmetrically applied to the upper arms. After removal of patch tests, a potent topical corticosteroid (betamethasone-17-valerate) was applied to the irritant skin reaction on one arm, while the corresponding vehicle was applied to the irritant skin reaction on the opposite arm 2x daily for 7 days. Reactions were evaluated by measurement of transepidermal water loss (TEWL) and erythema. After 7 days, statistically significant lower values of TEWL and erythema were found in corticosteroid-treated, compared to the vehicle-treated, skin reactions. The results indicate that topical corticosteroids improve healing of ICD.

Administration, Topical↗

A single-blind study of podophyllotoxin cream 0.5% and podophyllotoxin solution 0.5% in male patients with genital warts.

OBJECTIVE: To evaluate the efficacy-safety ratio of a new topical podophyllotoxin cream 0.5% compared with podophyllotoxin solution 0.5% (Condyline) in male patients with genital warts. METHODS: In an observer-blinded controlled study a total of 136 and 133 wart lesions were treated with podophyllotoxin cream 0.5% and podophyllotoxin solution 0.5%, respectively. The preparations were applied twice daily for 3 days, repeated with 4 days intervals for a minimum of two and a maximum of four treatment cycles. RESULTS: At the conclusion of the study (8 weeks after completion of therapy) a significant reduction in mean wart area was observed in both the cream group (87.7, SD 8.4 to 20.6, SD 2.7) and in the solution group (92.3, SD 7.5 to 21.5, SD 2.8) (p < 0.01). At the same time all treated warts had completely cleared in 63% of patients in both study groups. Mild to moderate side effects occurred to the same extent in both podophyllotoxin cream and podophyllotoxin solution recipients. CONCLUSION: We conclude that podophyllotoxin 0.5% administered in a cream formulation does not give additional clinical benefits when compared with podophyllotoxin solution 0.5% in male patients with external genital warts.

Administration, Topical↗

Skin thickness in patients with osteoporosis and controls quantified by ultrasound A scan.

In order to study a possible association between skin thickness and osteoporosis, we measured skin thickness by A mode ultrasound scanning in 20 females with osteoporosis and 20 age- and sex-matched controls. Bone mineral content (BMC) of the lumbar spine and the forearm was measured by dual-photon absorptiometry. BMC of the lumbar spine was significantly reduced in the osteoporotic group as compared to controls (p < 0.002). No difference in skin thickness was found between osteoporotic patients and controls. A statistically significant correlation between skin thickness on the forearm and BMC of the forearm was found (p < 0.02), but was opposed by a lack of correlation between skin thickness and BMC of the lumbar spine. We found a correlation between skin thickness and body weight (p < 0.002), which to our knowledge had not been reported earlier.

Absorptiometry, Photon↗

Effect of systemic treatment with cholesterol-lowering drugs on the skin barrier function in humans.

The intercellular lipids of stratum corneum are predominantly formed by cholesterol, ceramides and free fatty acids. Cholesterol synthesis is inhibited by statins, cholesterol-lowering drugs (lovastatin, pravastatin, simvastatin). The present study was undertaken to examine the effect of these drugs on skin barrier function. Knowledge about the effect on epidermis of systemic inhibition of cholesterol synthesis may improve our understanding of the skin barrier function. Seventeen statin-treated subjects were compared to controls. All were patch-tested with sodium lauryl sulphate (SLS), and the skin was evaluated after 24 h and after 7 days by measurement of transepidermal water loss (TEWL), erythema and visual scoring. After 24 h as well as after one week erythema was significantly less pronounced in the statin-treated group than in controls (p < 0.001). No significant differences in TEWL were found between the groups at any time. The results imply a decreased bioavailability of SLS in the statin-treated group, while no evidence for an altered permeability barrier to water was found.

Adult↗

Skin barrier properties in patients with recessive X-linked ichthyosis.

Patients with X-linked recessive ichthyosis (RXLI) were studied as a model of the effect of disturbed epidermal lipid composition on skin barrier function. Thirteen patients with RXLI and 15 age- and sex-matched controls were patch-tested with sodium lauryl sulphate (SLS) 0.5% for 24 h. Basal skin properties and skin response to SLS were studied by measurement of transepidermal water loss (TEWL), electrical capacitance and erythema index. No statistically significant difference in basal TEWL was found between the two groups. The skin response to SLS was found to be statistically significantly increased in controls compared to ichthyosis patients, when evaluated by TEWL. When evaluated by erythema index a statistically significant increase in redness was found in controls, but not in ichthyosis patients. Electrical capacitance, reflecting skin hydration, was significantly reduced in RXLI patients as compared to controls. The water permeability barrier in RXLI patients was not found to be impaired, and skin reactivity was found to be decreased in RXLI patients as compared to controls.

Adult↗

Guidelines for measurement of cutaneous blood flow by laser Doppler flowmetry. A report from the Standardization Group of the European Society of Contact Dermatitis.

The report reviews individual-related variables (age, sex, race, anatomical site), intra- and inter-individual variation (temporal, physical and mental activity, food and drugs), and environment-related variables (air convection, temperature). Technical variation, instrument validation including a standard reactive hyperemia experiment, and a standard operating procedure are discussed and included in the guidelines.

Adolescent↗

Sodium lauryl sulphate penetration in an in vitro model using human skin.

Because of their ability to impair the skin barrier function, detergents constitute a major risk factor for the development of irritant contact dermatitis. Sodium lauryl sulphate (SLS) is a commonly used detergent for experimental studies within the area of irritant contact dermatitis. In the present study, penetration of S35-labelled SLS was studied in an in vitro model using human cadaver skin. The investigations showed that SLS is capable of permeating the skin barrier when applied under occlusion. SLS could be detected in the dermis and the amount of SLS found here was shown to depend on the dose of SLS applied on the skin. Penetration of SLS continued after removal of the SLS applied as a patch test on the skin surface. Considerable inter-individual variation in the penetration of SLS was demonstrated between different donors.

Adult↗

[Toxic epidermal necrolysis].

A case of severe toxic epidermal necrolysis is described, stressing the importance of multiorgan system involvement of the disease. A possible pathogenetic mechanism involving tumor necrosis factor is discussed.

Adult↗

Skin barrier function and dermal inflammation. An experimental study of transepidermal water loss after dermal tuberculin injection compared with SLS patch testing.

The reaction of the skin water barrier to dermal inflammation was studied in 15 healthy volunteers. Dermal inflammation was induced either by injection of tuberculin (Mantoux test) or by a 24-h sodium lauryl sulphate (SLS) patch test on the volar forearm. Measurement of transepidermal water loss (TEWL) was used for evaluation of the skin barrier function. Inflammation was quantified by assessment of blood flow by laser-Doppler flowmetry. Measurement from uninvolved skin in the test region > 7 cm distant from the test sites served as control. Measurements were performed twice, separated by an interval of 6 days. Throughout the study, TEWL values were higher in the SLS test sites than in the Mantoux reactions, although the blood flow was significantly increased in Mantoux reactions compared with SLS test sites. This indicates that the impaired skin barrier function caused by SLS is due to a direct cytotoxic effect, and cannot be explained by the inflammatory response alone. At control sites, blood flow and TEWL were significantly higher on the arm with the Mantoux test than the arm with the SLS patch test. The significant inflammation caused by the Mantoux reaction may cause functional alterations in the clinically normal skin > 7 cm distant from the test area.

Adult↗

Time course of occlusive effects on skin evaluated by measurement of transepidermal water loss (TEWL). Including patch tests with sodium lauryl sulphate and water.

The time course for transepidermal water loss (TEWL) for a period of 3 h after removal of occlusive patch tests with sodium lauryl sulphate (SLS), water and empty chambers was studied in healthy volunteers. Patches were applied to the upper arm for 24 h. TEWL was measured immediately after removal of the patches, and every 30 min up to 3 h. For SLS and water patches, TEWL remained significantly increased for 3 h, as compared to normal adjacent skin, while for empty chamber patches, TEWL was only significantly increased for 30 min. A significant decrease from 0 to 30 min and from 30 to 60 min was observed for all patches, and for water patches, a significant decrease in TEWL was found from 60 to 180 min, while SLS patches remained constant. The prolonged increase in TEWL observed after SLS exposure is a well-known occurrence. The prolonged increase in TEWL after exposure to water is interpreted as transient damage to the water barrier of the skin.

Adult↗

The relation between lichen planus and hepatitis C: a case report.

A case of simultaneous occurrence of lichen planus (LP) and hepatitis C in the same patient is presented. The patient had received treatment with interferon alpha for her chronic liver disease, and the association between LP, hepatitis C and interferon alpha treatment is discussed.

Female↗

An experimental study of irritant effects of urea in different vehicles.

The properties of urea as an irritant were investigated. Seventeen healthy volunteers were patch tested with 20% urea using petrolatum and water, respectively, as vehicles. Irritant effects of urea were assessed by clinical evaluation of patch test reactions as well as by various non-invasive methods. The inflammatory response was quantified by laser Doppler flowmetry measuring the superficial blood flow, and by ultrasound A-scan reflecting the edema formation. Impairment of the barrier function was indicated by measurement of transepidermal water loss (TEWL). It is concluded that 20% urea in petrolatum applied under occlusion for 24 h elicits significant inflammation (i.e. increase in blood flow and skin thickness) and causes impairment of the skin barrier (i.e. increased TEWL). The irritant impact of urea on the skin depends upon the vehicle used, the irritant effect being intensified when urea is dispensed in petrolatum compared with water.

Adult↗

Noninvasive measuring methods for the investigation of irritant patch test reactions. A study of patients with hand eczema, atopic dermatitis and controls.

The aim of the study was to assess the susceptibility of clinically normal skin to a standard irritant trauma under varying physiological and patophysiological conditions. Evaluation of skin responses to patch tests with sodium lauryl sulphate (SLS) was used for assessment of skin susceptibility. The following noninvasive measuring methods were used for evaluation of the skin before and after exposure to irritants: measurement of transepidermal water loss by an evaporimeter, measurement of electrical conductance by a hydrometer, measurement of skin blood flow by laser Doppler flowmetry, measurement of skin colour by a colorimeter and measurement of skin thickness by ultrasound A-scan. The studies were carried out on healthy volunteers and patients with eczema. In the first studies the standard irritant patch test for assessment of skin susceptibility was characterized and validated. SLS was chosen among other irritants because of its ability to penetrate and impair the skin barrier. The implications of use of different qualities of SLS was investigated. The applied noninvasive measuring methods were evaluated, and for quantification of SLS-induced skin damage measurement of TEWL was found to be the most sensitive method. Application of the standard test on clinically normal skin under varying physiological and patophysiological conditions lead to the following main results: Seasonal variation in skin susceptibility to SLS was found, with increased susceptibility in winter, when the hydration state of the stratum corneum was also found to be decreased. A variation in skin reactivity to SLS during the menstrual cycle was demonstrated, with an increased skin response at day 1 as compared to days 9-11 in the menstrual cycle. The presence of active eczema distant from the test site increased skin susceptibility to SLS, indicating a generalized hyperreactivity of the skin. Taking these sources of variation into account healthy volunteers and patients with hand eczema and atopic dermatits were studied and compared. In healthy volunteers increased baseline TEWL and increased light reflection from the skin, interpreted as "fair" skin, was found to be associated with increased susceptibility to SLS. Hand eczema patients were found to have fairer and thinner skin than matched controls. Increased susceptibility to SLS was found only in patients with acute eczema. Patients with atopic dermatitis had increased baseline TEWL as well as increased skin susceptibility as compared to controls. Skin susceptibility is thus influenced by individual- as well as environment-related factors. Knowledge of determinants of skin susceptibility may be useful for the identification of high-risk subjects for development of irritant contact dermatitis, and may help to prevent the formation of the disease.

Colorimetry↗

Dopaminergic inhibition of glycoprotein hormone alpha-subunit in normal subjects.

The pituitary glycoprotein hormones thyrotropin (TSH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) consist of two noncovalently linked subunits, alpha and beta. In addition to producing intact hormone, the pituitary releases free alpha-subunit, which is stimulated by gonadotropin-releasing hormone (GnRH) and thyrotropin-releasing hormone (TRH). However, little is known about the dopaminergic regulation of free alpha-subunit in vivo. The effect of dopamine (DA), metoclopramide (MTC), and the specific DA D-1 receptor agonist, fenoldopam, on circulating alpha-subunit levels was studied in normal men and women. Normal women received 4-hour infusions of either glucose (n = 6) or DA at rates of 0.04 (n = 6), 0.4 (n = 6), and 4.0 micrograms/kg.min (n = 6). After 3 hours, 10 mg MTC was administered intravenously (IV). The high dose of DA significantly lowered alpha-subunit levels (P less than .05). No response to MTC was observed in any of the groups. Six women received glucose or DA infusion (4.0 micrograms/kg.min) for 18 hours. DA significantly reduced basal alpha-subunit levels compared with control infusion (P less than .05). MTC administration after 17 hours induced a significant increase in alpha-subunit levels on the day of DA infusion compared with control (P less than .05). In a third study, nine normal males received fenoldopam (0.5 microgram/kg.min) or placebo infusions for 4 hours. Fenoldopam did not affect basal alpha-subunit levels, but the alpha-subunit response to a GnRH/TRH bolus was significantly increased during fenoldopam compared with control (P less than .05). The results suggest that alpha-subunit release may be modulated by the dopaminergic system in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

Menstrual cycle and skin reactivity.

The hypothesis was tested that a cyclic variation exists in skin reactivity to irritant stimuli. Twenty-nine healthy women with regular menstrual cycles were challenged with sodium lauryl sulfate as an irritant patch test at day 1 and at days 9 through 11 of the menstrual cycle. The skin response to the applied irritant stimulus was evaluated by visual scoring and also quantified by measurements of transepidermal water loss, edema formation, and blood flow in the skin. The skin response to challenge with sodium lauryl sulfate was found to be significantly stronger at day 1 than at days 9 through 11 in the menstrual cycle as evaluated by visual scoring (p less than 0.05) as well as by measurement of transepidermal water loss (p less than 0.05) and edema formation (p less than 0.005).

Adult↗

Skin susceptibility in uninvolved skin of hand eczema patients and healthy controls.

Basic physiological characteristics were examined in the uninvolved skin of 39 patients with hand eczema and in 39 healthy controls. Susceptibility to sodium lauryl sulphate (SLS)-induced irritant dermatitis was evaluated by the application of a single 24-h SLS patch test to the upper arm. Transepidermal water loss (TEWL) was measured by an evaporimeter, skin thickness by ultrasound A-scan, blood flow by laser-Doppler flowmetry and skin colour by a chroma meter using the L*a*b* system of the Commission Internationale de l'Eclairage (CIE). No difference in basal TEWL values was found between patients and controls. A decreased skin thickness was found in those with hand eczema as compared to the controls. The hand eczema patients had significantly increased L* and decreased b*-values compared to controls, indicating a more 'fair' skin. Susceptibility to SLS was increased only in patients with acute eczema, indicating that the presence of an active eczema increases the reactivity to irritants of distant uninvolved skin.

Acute Disease↗