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PubMed2005

Treatment costs of three nail lacquers used in onychomycosis.

OBJECTIVE: To assess the daily treatment costs and the average cost-effectiveness of three topical onychomycosis therapies - amorolfine 5% and ciclopirox 8% nail lacquers and tioconazole 28% nail solution - when used as indicated in France, the UK, Germany and Italy. METHODS: The quantity of drug required and nail size measurements were investigated and, knowing the cost per bottle of each study drug, used to calculate the average treatment cost per patient. Using the prevalence of infection data, the weighted average total treatment cost per patient and hence the weighted average daily treatment cost and cost per patient cured, were calculated. RESULTS: Amorolfine was consistently more cost-effective in terms of weighted average daily treatment cost and cost per patient cured than ciclopirox and tioconazole, when all therapies were used as indicated to treat onychomycosis. In France, for example, the weighted average daily treatment cost of amorolfine was found to be euro 0.23 and euro 0.40 when used once and twice a week, respectively; the cost per patient cured for amorolfine was euro 84. By comparison, the weighted average daily treatment cost of ciclopirox was found to be euro 0.81; the cost per patient cured was euro 252. CONCLUSIONS: When used as indicated, amorolfine 5% nail lacquer is more cost-effective than ciclopirox 8% and tioconazole 28% for onychomycosis of toenail, fingernail or both in males and females in France, UK, Germany and Italy.

Adult↗
PubMed2006

The use of topical PUVA for palmoplantar dermatoses.

Palmoplantar dermatoses have a tendency to be chronic and are frequently recalcitrant to treatment. We summarize our experience with paint PUVA in the treatment of 125 patients with palmoplantar dermatoses between the years 1996 and 2000. The dominant clinical picture of the lesions was hyperkeratosis in 84, pustulosis in 11 and exudative dermatitis in the remaining 30 patients. The treatment was applied thrice weekly on alternate days. The affected skin was painted with methoxsalen 0.1% solution, and exposed 30 minutes later to UVA radiation, starting at 0.25 J/cm(2), with increments of 0.25-0.50 J/cm(2) every third treatment. Complete response was considered if all signs disappeared, and partial response if improvement occurred in more than 75% of each of the clinical findings of scaling erythema, fissuring, pustule formation and infiltration. Sixty-nine percent of the patients had a good response (i.e. a complete or partial response), which was achieved in 78.5% of the exudative dermatitis lesions, but in only 46.7% of the pustular lesions. The average time to achieve good response was 13 weeks (range 1-42), with an average total dose of 50 J/cm(2) (range 0.50-366). Maintenance therapy every 1-4 weeks was recommended for all responding patients, but only 58 consented and were treated for an average period of 10 additional weeks. Side effects were minor and transient, mainly mild first-degree superficial skin burns in 10 patients, and patchy hyperpigmentation in three patients, which resolved after a few weeks.

Administration, Cutaneous↗
PubMed1994

Dermatological toxicity from chemotherapy containing 5-fluorouracil.

5-Fluorouracil (5-FU) is an antimetabolite frequently used in the treatment of cancer. The most common adverse reactions are acute gastrointestinal effects and bone marrow suppression while neurological, ocular and dermatological toxicities are unusual. Several cutaneous manifestations can be found. They are hyperpigmentation, maculo-papular eruption and palmar-plantar erythrodysesthesia (PPES) promptly reversed with discontinuation of 5-FU. The etiopathogenesis of such manifestations is still unknown particularly as regards PPES, but it has been postulated that the local drug accumulation secondary to different scheduling (continuous infusion instead of bolus infusion), the total amount of drug, alcoholism, local trauma, increased blood flow could be responsible for them. In this study we have reported 10 cases of dermatological toxicity (1 of these had PPES) observed from January '91 to December '93 in 81 patients treated with bolus injection of 5-FU containing combination chemotherapy.

Adult↗
PubMed1998

Papular-purpuric gloves and socks syndrome associated with acute parvovirus B19 infection: case report and review.

The papular-purpuric gloves and socks syndrome (PPGSS) was first described in 1990. This syndrome is characterized by fever, acral pruritus, edema, petechiae, and oral erosions. Subsequently, parvovirus B19 has been implicated, in most cases, as the causative agent of this syndrome. To date, with two exceptions, all published cases of PPGSS have been from Europe and the Middle East and have been mainly reported in the dermatology literature. Herein, we report what we believe to be only the second case of documented parvovirus B19-associated PPGSS occurring in the United States. The patient presented with the typical clinical syndrome, and the diagnosis of acute parvovirus B19 infection was documented by serial serologies that demonstrated development of IgM antibody to virus during the acute phase of infection and seroconversion to IgG antibody in the convalescent period. We then review the existing literature on this unusual syndrome and its association with parvovirus B19.

Acute Disease↗
PubMed2004

A method for assessing occupational dermal exposure to permanent hair dyes.

Hairdressers have an increased risk of developing occupational skin diseases due to exposure to skin irritants and sensitizers. In the present work a method of assessing dermal exposure to permanent hair dyes was developed. The sampling performance characteristics of hand wash sampling with bag rinsing were studied for five hair dye compounds. The effect of residence time, sample load and different matrices were studied. Thirty volunteers were exposed to a reference solution of these compounds and to commercial hair dye products. The sampling efficiency after 5 min residence time was between 70 and 90% for the dye components in the hair dye products. Sampling efficiency decreases with increasing residence time, making the time of sampling an important factor. Hand wash sampling should be performed as soon as possible after the work task of interest. We conclude that the sampling efficiency is adequate for measurements of dermal exposure to permanent hair dyes. Hand wash sampling with bag rinsing is a useful tool for field studies of dermal exposure assessment in hairdressers.

Dermatitis, Occupational↗
PubMed1993

Irritant contact dermatitis in warehouse employees.

A detailed survey of skin complaints amongst 114 airline employees working in a new warehouse revealed 26 cases of skin problems which originated during the 2 1/2 year operation. A clinical survey of broadly the same population confirmed 14 cases from 98 employees as chronic irritant contact dermatitis of the hands. The work involved the reception, unpackaging, inspection, repackaging and dispatch of aircraft parts. The source of the skin irritation was not to be found in the work itself. Rather, the presence among the employees of two severe cases of non-occupational eczema, combined with the idea that incoming aircraft parts from foreign countries might be 'dirty' in some way, had caused a heightened perception of a risk of skin disease, and the frequency of hand washing had increased as a result. Over-frequent hand washing in a few employees had resulted in precisely what the warehouse staff had been trying to avoid.

Aircraft↗
PubMed1995

A descriptive study of health problems on car mechanics' hands.

The purpose of the present study was to investigate occupational health problems relating to the hands of car mechanics. A descriptive study was performed among all car mechanics in 22 car repair shops using a self-administered questionnaire. In total, 172 car mechanics returned the questionnaire (92%). Fourteen per cent reported occurrence of white fingers, 24% reported occurrence of paresthesias in hands or arms, 41% reported that dry skin on their hands was often a problem, 46% reported occurrence of hand eczema, and 28% had experienced more than 20 cuts on the hands in the past year. A significant relationship was found between the occurrence of hand eczema and employment for less than 14 years as a car mechanic. This was also found for occurrence of white fingers and cuts on the hands. Further surveillance of the working environment among car mechanics seems to be required.

Automobiles↗
PubMed1986

The enigma of juvenile plantar dermatosis.

Juvenile plantar dermatosis, which is sometimes accompanied by palmar changes, is a chronic condition. It is characterized by shiny redness, anhidrosis, and fissuring of the skin. Microscopically, focal inflammatory changes at the junctions of sweat-gland ducts and acrosyringia are seen. The pathogenesis is unknown. We surmise that individual susceptibility, bacterial colonization, and the use of man-made leather substitutes and fibers are the main causative factors.

Adolescent↗
PubMed1996

Idiopathic palmoplantar hidradenitis.

Idiopathic plantar hidradenitis (IPH) is a recently described condition primarily affecting healthy children who develop tender lesions localized to the plantar or lateral aspects of the feet with histologic findings similar to those seen in neutrophilic eccrine hidradenitis (NEH), although with certain notable exceptions including the absence of syringosquamous metaplasia and the presence, in most cases, of neutrophilic abscesses adjacent to eccrine coils. Since its original description, three additional patients have been reported, one with palmoplantar lesions, extending the disease's clinical spectrum to include palmar as well as plantar surfaces. We report on a healthy 8-year-old girl with tender, erythematous nodules on palms and soles and review the literature on this subject.

Abscess↗
PubMed1984

A retrospective study of thick split-thickness plantar skin grafts to resurface the palm.

Both the function and appearance of thick split-thickness plantar skin grafts to resurface palmar skin defects are examined in this retrospective study. If defects in the hand are covered by grafts from hair-bearing donor sites, these grafts will show increased pigmentation and contrast clearly with the surrounding skin, particularly in the case of patients with heavy skin pigmentation. To avoid this pigmentation, we have used the thick split-thickness skin grafts taken from the plantar region of the foot. The most important aspect of the method is the removal of split-thickness skin with a thick dermal layer. Since 1975, we have used this method in 64 patients and conducted follow-ups on 41 of them. The results of follow-ups indicate that this method is quite successful and useful, especially in patients with dark skin. In general, there was no excessive pigmentation of the grafted skin; color and texture of grafted skin matched the surrounding skin; function recovery is good owing to similar skin structure; thick split-thickness skin with a thick dermal layer prevents contracture of grafted skin; grafted skin withstands trauma; donor site need not be grafted; and the scar at the donor sites is hidden and produced no morbidity. It must be noted, however, that one-third of all patients were lost to follow-up, and the results in these patients are not known.

Adolescent↗
PubMed2001

Dermal exposure, handwashing, and hand dermatitis in the rubber manufacturing industry.

Skin diseases, such as hand dermatitis, are thought to be a common problem in the rubber manufacturing industry, as workers are exposed to a wide range of chemicals with known irritant and sensitizing potential. We conducted a cross-sectional survey of a representative sample of rubber manufacturing workers (N = 202), selected from nine different rubber companies. Prevalence of hand dermatitis ("major" and "minor" dermatitis) and skin injuries was assessed on the basis of a diagnosis by a dermatologist. We investigated the possible relations between actual skin exposure, handwashing practices, and hand dermatitis. Prevalence of major hand dermatitis (7%) was comparable with that in the general population; however, minor signs of dermatitis were more common among the surveyed population (28%), as were traumata of the skin (17%). Dermal exposure to cyclohexane-soluble agents at work was related to the occurrence of major hand dermatitis, but not to the occurrence of minor hand dermatitis. Moderate and frequent handwashing especially with industrial surfactants containing scrubbing particles were found to be strongly associated with the occurrence of minor dermatitis [odds ratio = 4.27 (95% confidence interval = 0.90-20.27) and odds ratio = 6.38 (95% confidence interval = 1.33-30.17, respectively)].

Administration, Cutaneous↗