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Miconazole lacquer compared with gel in treatment of denture stomatitis.

An open, randomized, controlled study with two parallel treatment groups was done to evaluate the efficacy and safety of a single application of a miconazole 55 mg/g denture lacquer applied once on the mucosal denture surface, as compared with those of a commercially available miconazole 2% gel applied four times daily for 2 wk, in the treatment of Candida-associated denture stomatitis. The efficacy variables were Candida cultures on the Oricult plates taken from the palatal mucosa and the denture surface, erythema of the palatal mucosa, and smears for leukocyte migration into the palatal epithelium taken on entering the study and on days 3, 7, 14, 21, 28, and 35 after commencement of therapy. On entering the study, all patients had positive cultures of yeast in the samples from the palatal mucosa. Within the first 3 days, all gel patients and 88% of the lacquer patients had fewer than 10 colonies. The gel was statistically significantly more efficient than the lacquer on days 7 and 14. In the samples from the denture surface, all patients had more than 100 yeast colonies at inclusion and, on day 3, approximately 80% in both treatment groups had fewer than 10 colonies. From day 7 onward, the gel was statistically significantly more efficient than the lacquer. The reddening of the palatal mucosa was not statistically significantly different in the treatment groups at any of the examinations, but smears for the determination of leukocyte migration indicated that the gel was statistically significantly more efficient than the lacquer on day 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗

In-vitro permeability of the human nail and of a keratin membrane from bovine hooves: penetration of chloramphenicol from lipophilic vehicles and a nail lacquer.

Lipophilic vehicles and especially nail lacquers are more appropriate for topical application on the nail than aqueous systems because of their better adhesion. This work has, therefore, studied the penetration through the human nail plate of the model compound chloramphenicol from the lipophilic vehicles medium chain triglycerides and n-octanol and from a lacquer based on quaternary poly(methyl methacrylates) (Eudragit RL). The results were compared with data obtained with a keratin membrane from bovine hooves. If the swelling of the nail plate or the hoof membrane is not altered by use of lipophilic vehicles, the maximum flux of the drug is independent of its solubility in the vehicle and is the same as that from a saturated aqueous solution. These vehicles are not able to enter the hydrophilic keratin membrane because of their non-polar character and so cannot change the solubility of the penetrating substance in the barrier. If the concentration of the drug in the nail lacquer is sufficiently high, the maximum flux through both barriers equals that from aqueous vehicles or even exceeds it because of the formation of a supersaturated system. Penetration through the nail plate follows first order kinetics after a lag-time of 400 h. The course of penetration through the hoof membrane is initially membrane-controlled and later becomes a matrix-controlled process because of the membrane's greater permeability. Chloramphenicol is dissolved in the lacquer up to a concentration of 31%. The relative release rates from these solution matrices are independent of the drug concentration but they decrease on changing to a suspension matrix. These results show that drug flux is independent of the character of the vehicle and that penetration of the drug is initially membrane-controlled and changes to being matrix-controlled as the drug content of the lacquer decreases.

1-Octanol↗

Health complaints and work conditions among lacquerers in the Danish furniture industry.

In the present work, morbidity rates were based upon 418 replies to postal inquiries sent to 478 members of the carpenters/cabinet makers trade union in the Arhus area of Denmark. Lacquerers, when compared with former lacquerers and non-lacquerers, have an excess of neurophysiological symptoms and symptoms from the respiratory tract. The statistical association between exposure to lacquers and lung symptoms persists after checking for differences in age, smoking habits, and exposure to dust. Organic solvents are an important component of lacquers. Far too little is yet known of solvents' long-term effects on the human body. Most of our present knowledge concerns the short-term toxic effects on the nervous system. This study further points out a relation between lung symptoms and exposure to organic solvents, and it is suggested that further research into this association must be carried out.

Age Factors↗

Perianal contact dermatitis caused by nail lacquer allergy.

BACKGROUND: Allergy to nail cosmetics is relatively infrequent compared with other cosmetics. Allergic contact dermatitis from nail lacquer typically affects the eyelids, cheeks, sides of the neck, hands and periungual areas, and less frequently another areas. OBJECTIVE: We report on a patient who developed nail lacquer-related allergic contact dermatitis in an infrequent location, namely the perianal area. METHODS: A patient with perianal and eyelid pruritus and dermatitis was patch tested with the TRUE tests, cosmetic series, personal cosmetics, plastic and glue series, and personal nail lacquers. RESULTS: A +2 positive allergic response was observed at the sites of the toluenesulfonamide-formaldehyde resin and at the sites the patient's nail lacquers at days 2 and 4. CONCLUSION: Nail lacquer allergy may be observed at distant sites, and the perianal area may be involved more frequently than was previously thought.

Anal Canal↗

Lacquer cracks following laser treatment of choroidal neovascularization in pathologic myopia.

BACKGROUND: Lacquer cracks are breaks in the retinal pigment epithelial-Bruch's membrane-choriocapillaris complex and are manifestations of pathologic myopia. Progressive posterior segment elongation, uveal scleral thinning, and retinal pigment epithelial degeneration are thought to create a predisposition for crack formation in these eyes. In turn, choroidal neovascularization (CNV) may develop within the cracks to produce disciform scarring of the macula. This study examined lacquer cracks as a possible consequence of laser photocoagulation of CNV. METHODS: From the files of two retinal referral practices, five patients were located in whom lacquer cracks developed or expanded after laser photocoagulation for macular CNV in pathologic myopia. The mean age of the patients was 54.8 years. Four patients were treated with krypton red laser and one with an argon laser. Laser settings were available for only one of the patients. RESULTS: After laser photocoagulation, lacquer cracks were noted to expand in one or two directions from the laser scar between 10 days and 3 months of the treatment. The cracks also served as a pathway for progressive or recurrent neovascularization. CONCLUSIONS: Although lacquer cracks occur spontaneously in pathologic myopia, expansion, elongation, or simple development of a crack may occur as a result of laser photocoagulation of CNV. The new cracks also serve as a potential risk for recurrent neovascularization. This potential adverse complication should be considered in the management of CNV in pathologic myopia with laser treatment.

Adult↗

Miconazole lacquer in the treatment of denture stomatitis: clinical and microbiological findings in Chinese patients.

OBJECTIVE: To investigate the efficacy of a miconazole lacquer in producing mycological and clinical cure of Candida-associated denture stomatitis in a Chinese cohort and to study the microbiology of the conditions. DESIGN: A cross-sectional study of the clinical and microbiological features of the condition and its response to treatment with the lacquer. SUBJECTS AND METHOD: Twenty-one Chinese adults with palatal erythema; 15 denture wearers matched for age and sex as controls for microbiology. Clinical examination, impression for culture, photograph of palate to monitor response to treatment, and lacquer application on upper denture base on days 0, 7 and 14. Impression and photograph repeated on day 21; impression cultures quantified by image analysis. Palatal impression in controls; dummy impression as control for impression culture procedures. MAIN OUTCOME MEASURES: Severity of lesion, incidence and type of microorganism at presentation and during treatment; qualitative and quantitative assessment of yeast growth; the latter by statistical analysis of pixel units of yeast colonies; correlation of clinical and mycological cure. RESULTS: Out of the 21 lesions (16 Newton's stage I and 5 stage II), 57% had yeasts at presentation, 10% coliforms and 33% no significant growth. Clinical cure in 3 weeks in 71%, mycological cure in 75% in 7 days; clinical and mycological cure coincided only in 43%. Polymicrobial growth of yeasts and coliforms throughout the course in some. CONCLUSIONS: Miconazole lacquer was a viable treatment option for Candida-associated denture stomatitis in this adult, Chinese cohort; microbiology comprised yeasts, mainly C. albicans and coliforms, especially Klebsiella and Enterobacter species; the pathogenic role of the latter is questionable.

Adult↗

In vitro transungual permeation of ciclopirox from a hydroxypropyl chitosan-based, water-soluble nail lacquer.

Commercial antimycotic nail lacquers are commonly based on water-insoluble resins. The present study was aimed at evaluating a novel, experimental nail lacquer (P-3051, Polichem SA, Lugano, Switzerland) based on the water-soluble film-forming agent hydroxypropyl chitosan (HPCH). The in vitro permeation of ciclopirox (CPX) from P-3051 and from a commercial, water-insoluble lacquer based on a vinyl resin (Penlac, Aventis Pharma), was investigated using thin membranes obtained from bovine hooves, an accepted model for human nails. Similar CPX permeation fluxes at steady state through the membranes, but significantly different lag times were observed for P-3051 and Penlac, when these were tested as dry films. The formulations thus appeared to influence only the time required by CPX to saturate the membrane, and not the final drug concentration gradient in the membrane. Permeation experiments performed on the same membranes and on hairless mouse skin with P-3051 and with a similar, HPCH-free vehicle (ERV), both tested in liquid form, disproved the possibility that HPCH might act as a permeation enhancer for CPX in either substrate. The possible reasons for the greater efficiency of the HPCH vehicle in terms of CPX transfer from the vehicle itself to the keratin membrane are discussed. This effect might be tentatively attributed to a particular affinity of HPCH for the membrane, resulting in intimate contact and strong adhesion of the HPCH lacquer to the keratin substrate.

Absorption↗

Comparative efficacy and safety of amorolfine nail lacquer 2% versus 5% once weekly.

Altogether 157 patients with onychomycosis affecting not more than 80% of the surface area of nail with intact lunula and matrix were treated once weekly for up to 6 months with amorolfine nail lacquer (2 or 5%) in a double-blind randomized design. Clinical examinations were carried out before, monthly during, and 1 and 3 months after therapy. Mycological examinations were performed before, 1 and 3 months after therapy. One hundred patients were evaluated. According to the overall assessment by the investigators, which was based on the clinical response and mycological findings, there was cure in 12%, improvement in 55% and failure in 33+ of the 2% group. The corresponding figures in the 5% group were: cure in 38%, improvement in 32% and failure in 30%. The difference in the number of cures was statistically significant in favour of the 5% nail lacquer. The most common pathogens isolated were Trichophyton rubrum in 59% of cases and Trichophyton mentagrophytes in 22%. Three months after the end of the treatment the mycological culture was negative in 55% of the 2% group and in 60% of the 5% group. Both concentrations were well tolerated. Only three patients (2%) experienced mild local adverse events. No systemic side-effects occurred and no patient discontinued treatment due to an adverse event. In conclusion, the 5% nail lacquer was more effective than the 2% nail lacquer when used once weekly for up to 6 months for the treatment of mild to moderate onychomycosis, and both concentrations were well tolerated.

Administration, Topical↗

Comparative efficacy and safety of amorolfine nail lacquer 5% in onychomycosis, once-weekly versus twice-weekly.

Amorolfine is a new topical antifungal of the phenylpropyl morpholine class which is highly active both in vitro and in vivo against yeasts, dermatophytes and moulds responsible for superficial fungal infections. Human pharmacological studies have established that amorolfine has a persistent antifungal effect in the nail bed and in the skin without being systemically absorbed. This has been confirmed by clinical work showing that amorolfine is effective in treating dermatomycoses and onychomycoses when administered as cream or nail lacquer. It is ineffective when given orally for systemic mycoses or bacterial infections in animals. In earlier studies a 5% concentration of amorolfine nail lacquer was found to produce a better cure rate in onychomycosis than a lower concentration of 2%. From data available on the penetration of amorolfine and on the persistence of mycologically relevant tissue concentrations, it appeared likely that once- or twice-weekly application of nail lacquer should suffice to produce a satisfactory therapeutic effect in onychomycosis. The aim of this investigation was to assess the efficacy and tolerability of 5% amorolfine nail lacquer given once versus twice weekly to patients with onychomycosis of finger nails and toe nails.

Administration, Topical↗

Multifocal brain damage due to lacquer sniffing: the first case report of Thailand.

The first patient of multifocal brain damage due to lacquer sniffing was reported in Thailand. He was a 24-year-old man who had a 5 year history of lacquer sniffing (toluene abuse). He had difficulty in walking and had tremor for 1 year which became progressively worse and he was finally confined to bed. Examination revealed marked cerebellar signs of both upper and lower extremities with scanning speech. Five of his friends who were lacquer abusers also had similar symptoms and were confined to bed. Investigations showed marked atrophy of both cerebellar hemispheres, vermis, brainstem and less atrophy of both cerebral hemispheres in both computerized brain scanning and magnetic resonance imaging. Diffuse toxic demyelination of white matter and excess iron deposition over both thalami, basal ganglia and cerebral cortex were demonstrated on magnetic resonance imaging. Brainstem evoked response showed abnormal response of both sides. Nerve conduction velocity, electromyographic study and electroencephalogram were normal. Psychometric tests revealed dull normal or below average IQ-test of 82. He was admitted for 2 months with gradual recovery of neurological deficits. After six months of abstinence from lacquer and daily physical rehabilitation. This report of toluene abuse is not only public health problem but also reflects the socioeconomic status as well as political unawareness of this condition in the Thai community.

Adult↗

[Effect of urea nail lacquer on nail quality. Clinical evaluation and biophysical measurements].

BACKGROUND: Urea is a well-known humectant. The aim of our study was to evaluate the in vivo effect of 10% urea lacquer on nail quality. METHODS: 60 healthy probands with brittle nails were included in a randomized, controlled study. The nail lacquer was applied once (n=30) or twice daily (n=30) on one hand for 28 days, while the other hand served as untreated control. Assessments included clinical evaluations and bioengineering measurements. RESULTS: Application of the nail lacquer was well-tolerated and led to a significant clinical improvement of nail surface morphology, nail plate consistency, reflection of the nail plate surface, appearance of the cuticle and the nail fold. Sonographic nail density was slightly increased. No relevant changes were found in nail thickness and transonychial water loss. CONCLUSIONS: Nail lacquer containing urea improves the cosmetic appearance of fingernails.

Adult↗

In vivo study on the effectiveness of a lacquer containing CaF2/NaF in treating dentine hypersensitivity.

The purpose of this double-blind study was to evaluate the effectiveness of a commercially available fluoride lacquer (Bifluorid 12) containing CaF2 (6%) and NaF (6%) in reducing dentine hypersensitivity. A fluoride lacquer containing only NaF (6%) served as a control. Twenty-five adult patients complaining about at least two hypersensitive teeth participated in this study. In each patient and at each appointment, one tooth was treated with Bifluorid 12, while the other was treated with the control substance. Sensitivity levels were determined before and after the application of each lacquer at baseline as well as at 1, 2 and 3 weeks after the start of study. The final evaluation of hypersensitivity was performed at 4 weeks, and follow-ups were undertaken at 6 and 12 months. A reproducible air blast stimulus and a visual analogue scale were used for evaluation. Results demonstrated a distinct reduction of hypersensitivity after 1, 2 and 3 weeks in the Bifluorid 12 group. Initially, no obvious effects could be observed in the control group. However, a clear alleviation could be observed after 2 and 3 weeks with the control. After 4 weeks, the overall sensitivity scores were comparably low, without any significant differences between the two fluoride lacquers. In both groups, the effects of treatment were seen over the 12-month observation period. Bifluorid 12 was considered at least comparable to the control. It is concluded from this study that Bifluorid 12 is effective in the initial reduction of dentine hypersensitivity. The combination of CaF2/NaF can be recommended for clinical use.

Adult↗

Indocyanine green angiographic findings of lacquer cracks in pathologic myopia.

Lacquer cracks are thought to represent healed mechanical breaks in the retinal pigment epithelium, Bruch's membrane, and choriocapillaris complex. In this study, we analyzed the indocyanine green (ICG) angiographic features of lacquer cracks and compared them with findings using fluorescein angiography. Complete ophthalmologic examinations, fluorescein angiography, and ICG angiography were performed in 29 consecutive patients (37 eyes) with lacquer cracks. Fluorescein angiograms of the cracks revealed linear hyperfluorescence in all 37 eyes. Using ICG angiography, we observed linear hypofluorescence in all 37 eyes. In 15 of 37 eyes, the length of the hypofluorescent lesion detected by ICG angiography was longer than the hyperfluorescent lesion observed by fluorescein angiography. In 17 of 37 eyes, more lacquer cracks were observed by ICG angiography than by fluorescein angiography. These findings indicate that ICG angiography can detect the development of the lesion more precisely, and may provide useful information for diagnosing pathologic myopia.

Adolescent↗

Primary structure of a Japanese lacquer tree laccase as a prototype enzyme of multicopper oxidases.

The cDNA library of the Japanese lacquer tree (Rhus vernicifera) was constructed by the reverse transcription of mRNA. A cDNA encoding laccase was amplified by PCR using primers based on the N-terminal amino acid sequences of the purified laccase and its peptide fragments formed by digestions with chymotrypsin and trypsin, and subcloned. The laccase cDNA clone contained a single, large open reading frame of 1599 nucleotides, encoding a protein of 533 amino acids with a calculated molecular mass of 58981 Da. The lacquer laccase was found to have 42 to 62% identity with other plant laccases and 20 to 24% identity with microorganism laccases at the deduced amino acid level. Differing from microorganism laccases the lacquer laccase utilizes a Met residue in addition to one Cys and two His residues to construct the type 1 Cu site. The secondary structure of the lacquer laccase was predicted to mainly consist of the beta-structure (28.7%) and loop and random structures (67.0%). The alpha-helix content was predicted to be only 4.3%. The location of these secondary structures was assumed to be very similar to those of ascorbate oxidase and fungal laccase, the crystal structures of which have been determined.

Amino Acid Sequence↗

Pharmacokinetics of the combination pyrimethamine with sulfadoxine and mefloquine (FANSIMEF) in Chinese volunteers and the relative bioavailability of a lacquered tablet.

The oral single-dose pharmacokinetics and bioavailability of mefloquine (M) in combination with pyrimethamine (P) and sulfadoxine (S) from a single non-lacquered tablet (NL; M 250 mg, P 25 mg, S 500 mg) and two lacquered tablets (L; M 125 mg, P 12.5 mg, S 250 mg) were investigated in 6 healthy Chinese volunteers. The plasma concentrations of P and S were measured by high-performance liquid chromatography with UV detector over 11 days and the plasma concentrations of M were measured by gas chromatography with electron capture for 63 days. The pharmacokinetic evaluation of each of the three components was based on the assumption of an open linear one-compartment model. The model-independent pharmacokinetic parameters such as elimination half-life and total clearance of P and S in the present study were not appreciably different from those reported previously. The pharmacokinetic parameters of elimination half-life, total clearance and apparent volume of distribution of M were 11 days, 45.8 ml/h.kg, and 14.8 l/kg, respectively. Compared to previously published data on M in Thai patients, Caucasian, Brazilian and African subjects, it was found that the elimination half-life in Chinese subjects was similar to that in Thai patients, but different from Caucasian, Brazilian and African subjects. There were significant differences in total clearance and volume of distribution among Chinese subjects and Thai patients. The differences in pharmacokinetic behaviour of M between subject groups needs to be examined further. The relative bioavailability of P, S, and M in the lacquered and non-lacquered tablet formulations in the 6 subjects studied were not significantly different with values (mean +/- SD) of 0.98 +/- 0.06, 1.28 +/- 0.20 and 1.02 +/- 0.17, respectively.

Administration, Oral↗

Lacquer crack formation after photodynamic therapy.

PURPOSE: To report the occurrence of a lacquer crack after photodynamic therapy (PDT) of choroidal neovascularization (CNV) in a patient with pathologic myopia. METHODS: PDT was performed with verteporfin, which was activated by a diode laser light at 690 nm. RESULTS: The left eye of a 42-year-old woman was treated with PDT because of juxtafoveal CNV caused by pathologic myopia. No lacquer crack was present in the macula on either fluorescein or indocyanine green angiography before treatment. The CNV subsided after treatment. However, a large lacquer crack underlying a subretinal hemorrhage was formatted in the macula of the treated eye soon after PDT. CONCLUSIONS: Although the chorioretinal damage produced by PDT is minimal, it is enough to create, directly or indirectly, the basis for the formation of a lacquer crack in an eye with pathologic myopia.

Adult↗

Ciclopirox 8% nail lacquer in the treatment of onychomycosis of the toenails in the United States.

Ciclopirox 8% nail lacquer has recently become the first topical antifungal agent to be approved by the US Food and Drug Administration for the treatment of onychomycosis. This article reviews the results of the two pivotal clinical trials of this drug that have been performed in the United States as well as those that have been carried out in other countries. The two US studies were both double-blind, vehicle-controlled, parallel-group, multicenter studies designed to determine the efficacy and safety of ciclopirox nail lacquer in the treatment of mild-to-moderate onychomycosis of the toenails caused by dermatophytes. The combined results show a 34% mycologic cure rate, as compared with 10% for the placebo. Data from the ten studies conducted worldwide show a meta-analytic mean (+/- SE) mycologic cure rate of 52.6% +/- 4.2%. As expected for a topical agent, ciclopirox nail lacquer was found to be extremely safe, with mild, transient irritation at the site of application reported as the most common adverse event. Ciclopirox nail lacquer may also have potential for use in combination or adjunctive therapy. Further studies will help to better position this agent for the treatment of this widespread podiatric condition.

Administration, Topical↗

Ciclopirox nail lacquer and podiatric practice.

Ciclopirox 8% nail lacquer has recently been approved by the US Food and Drug Administration (FDA) for the management of mild-to-moderate dermatophytic onychomycosis not involving the lunula. Previously, the agents that were approved for the treatment of dermatophytic pedal onychomycosis--griseofulvin, itraconazole, and terbinafine--were administered orally. When ciclopirox nail lacquer is used, it is recommended that the infected nail undergo debridement by a health-care professional as frequently as monthly. It is important to be aware of the circumstances under which debridement of the mycotic nail may be considered medically necessary and therefore potentially eligible for reimbursement by third-party payers. For many nail presentations, nail debridement is an important component of a treatment protocol involving either the oral medications or the topical lacquer, as it serves to reduce the fungal load and ameliorate symptoms. With the availability of a new FDA-approved topical treatment alternative, it remains to be seen if podiatrists will embrace the definitive treatment of onychomycosis using the newer oral agents, the new nail lacquer, or both in combination with nail debridement to treat the disease.

Administration, Topical↗