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[The use of Topisolone in dermatoses].

Topisolon (Desoximetasone) has been used under clinical conditions on 42 patients with acute and chronic dermatoses. This was a comparative trial on symetric areas. Topisolon with the test name A 41 304 has been compared to an 0,1% triamcinolon-acetonide ointment. Topisolon showed a quick onset of action. After 14 days of treatment a good result has been seen in 88% of the cases and in only 5% the effect has been moderate. The drug has been used in psoriasis vulgaris, atopic dermatitis, and lichen ruber. No side effects or irritations have been seen except one case of candidiasis. On five diabetics treated no influence on blood sugar level could be seen.

Acute Disease↗

[Dermatoses caused by atypical mycobacteria].

The authors discuss the main characteristics which enable a differential diagnosis to be made between the dermatoses due to atypical mycobacteria. Persistent bacteriological and epidemiologic studies are likely to result in a solution to the challenging problem presented by the conditions under consideration.

Diagnosis, Differential↗

[Advances in prophylaxis of occupational dermatoses].

The article deals with contemporary prophylactic methods for occupational dermatoses. The authors stress importance of etiologic approach to creation of prophylactic measures complex at various industrial enterprises.

Dermatitis, Occupational↗

[Occupational dermatoses due to polyurethane drugs].

Twenty cases of occupational dermatoses caused by isocyanates, especially diphenylmethane diisocyanate (MDI), isophorone diisocyanate (IPDI), toluene diisocyanate (TDI) and tri-isocyanate-triphenylmethane are reported. The handling of patch test substances is described. Personal in test laboratories have to be considered as persons at risk. Findings give some evidence for cross-sensitization between MDI and the corresponding diamine diaminodiphenylmethane. Moreover, it is supposed that MDI may give rise to cross-sensitization to p-phenylene diamine and chemically related compounds.

Asthma↗

Frequency of bullous pemphigoid-like antibodies as detected by western immunoblot analysis in pruritic dermatoses.

BACKGROUND AND DESIGN: Ninety-seven patients suffering from a pruritic dermatosis were screened for the detection of bullous pemphigoid (BP) antibodies (ab) using the Western immunoblot (WB) analysis technique. RESULTS: Twenty-four patients (25%) reacted at least twice with the BP antigen on WB analysis at a 1/10 dilution: seven had typical BP, four had papular BP, 10 had pruritus and prurigo of unknown origin, two had eczema, and one had lichen planus. This corresponds to 13% of BP-type ab in patients who did not fulfill criteria for BP. Therefore, we did the following: (1) tested a control group of 24 subjects; (2) assessed the reproducibility of the WB method by retesting the same serum samples on different epidermal extracts; and (3) estimated the BP ab titer. None of the 24 control subjects had detectable BP ab, and reproducible results were obtained in all groups when serum samples were retested at the 1/10 dilution. Although 86% (6/7) of patients with BP had BP ab titers of 1/100 or greater, only 60% (6/10) of the group with pruritus and prurigo and 33% (1/3) of the group with eczema reached such titers. CONCLUSION: These results indicate that due to its sensitivity, the WB method can detect low titers of BP ab in patients with pruritic dermatoses who did not fulfill criteria for BP, and therefore we question the specificity of this method.

Adult↗

OCCUPATIONAL DERMATOSES IN ONTARIO, 1955 TO 1962.

In Ontario in 1962, with a compensationeligible labour force of 1,814,000, 10 out of each 1000 workers received compensation for some occupational dermatosis, as defined here; 36 out of each 1000 workers received compensation for some cause. Contact dermatitides made up 5042 of 7448 cases of occupational disease for which compensation and/or medical aid was paid in 1955 and 1956. In eight years, 1955 to 1962 (inclusive), of a total of 534,557 "compensation only" cases, 7023 received payment for contact dermatitis. The average yearly cost of compensation of a worker with a contact dermatitis was estimated at $1113; the annual total cost, at $900,000. The average cost of an occupational dermatosis was $368; the annual total cost, $10 million. Occupational dermatoses account for almost one-third of all compensation costs. The cost of "medical aid only" is excluded from all of these estimates. In contact dermatitis, primary irritants (chemicals) are still the main causative agents. Skin sensitizers, the epoxy resins particularly, have become more prominent in recent years. There is no all-purpose barrier cream or protective clothing. Proper personal hygiene remains the most effective preventive agent in industry.

Biometry↗

[Specific dermatoses of pregnancy].

A heterogenic group The dermatoses specifically associated with pregnancy are generally benign, even if they lead to great discomfort. Some of them require appropriate management because of the risk of maternal or foetal complications. Pruritus of pregnancy Corresponds to intra-hepatic cholestasis of pregnancy, present in 1 to 2% of pregnant women, it may place the foetus at risk of delayed growth, prematurity or even death in utero. Treatment relies on cholestyramine. Pemphigoid gestationis or herpes gestationis This is an autoimmune disease of pregnancy occurring in multiparous women between the 28th and 32nd week of amenorrhoea (once out of 5 times within the first 7 days postpartum). Diagnosis is confirmed by histological examination of a bullous lesion. The disease usually regresses spontaneously after delivery, generally within a period of 1 to 17 months. Relapses, earlier on and more severe than during the initial episode, occur in 50 to 70% of subsequent pregnancies. Treatment is essentially based on corticosteroids: local Class II for the pauci-bullous and/or limited forms and general corticosteroid therapy for the severe forms. Polymorphic dermatitis of pregnancy This regroups various and similar entities described during pregnancy. They start during the third trimester of pregnancy, their clinical aspects are similar, their histology is non specific, the biological explorations are normal, direct immunofluorescence is negative, the progression is favourable for the mother and the child and the pathogenesis is unknown. Impetigo herpetiformis This exceptional dermatosis affects the primiparous woman in 80% of cases and the eruption usually appears during the 3rd trimester of pregnancy, or even after delivery. Relapses are constant during subsequent pregnancies.

Dermatitis↗

Vulvar dermatoses.

Dermatologic manifestations of vulvar disease can be confusing, the cause ambiguous, and the course of treatment long. Without a specific complaint, the vulva is often overlooked during a routine pelvic examination, and is often simply "the means to go through" in order to perform the routine Pap smear. The clinician must develop an awareness of the importance of dermatologic manifestations related to the vulva. A systematic approach is necessary to determine the pathogenesis and clinical behavior of vulvar conditions. This article will focus on identification of the various classifications of vulvar dermatoses, the causes of these conditions, differential diagnoses, accurate assessment, and management of cutaneous vulvar conditions.

Female↗

[New German legislation on occupational dermatoses (author's transl)].

According to the new German legislation on occupational dermatoses of January 1, 1977, a person suffering from an occupational dermatosis can be idemnified only in case that occupational disease "has compelled him to abstain from all activities that have caused or might be responsible of, the appearance, the aggravation or the recurrence of that disease".

Dermatitis, Occupational↗

[Dermatoses in pregnancy].

A number of immunological, endocrine, metabolic and vascular changes with various influences on the skin occur in the organism during pregnancy. The specific dermatoses of pregnancy are a heterogenous group of diseases with a different impact on both mother and child. Their clinical characteristics, diagnostic criteria and therapeutic options are discussed in the present review.

Female↗

[Dermatoses specific for pregnancy period].

The study presents dermatoses specific to the pregnancy period, like intrahepatic cholestasis of pregnancy, pruritic urticarial papules and plaques of pregnancy (PUPPP), impetigo herpetiformis, gestational pemphigoid, papulous and papulo-pustulous dermatitis.

Adult↗

[The pathogenesis of inflammatory dermatoses, especially psoriasis].

The skin contains a variety of cell types and mediators, which together constitute the skin's immune system and play a key role in protecting the human body against dangers from outside. Dysregulation of the skin's immune system, however, frequently occurs and can result in undesirable inflammatory processes in the skin. A typical example of an undesirable inflammation in the skin is the chronic inflammatory skin disease psoriasis. In the pathogenesis of psoriasis, both genetic and environmental factors play a key role. In psoriasis, the complex interactions between T-lymphocytes, antigen-presenting cells, keratinocytes and pro-inflammatory cytokines and chemokines are disturbed. The two most widely accepted hypotheses are: (a) psoriasis is a T-cell mediated autoimmune disease, and (b) psoriasis is the result of a too finely adjusted system for regulating inflammation in the skin. The result of both mechanisms is a chronic inflammatory reaction fuelled by pro-inflammatory type-I cytokines that lead to the psoriasis-skin phenotype. With the development ofbiologicals, it has become feasible to target specific molecules in the immune process, for example type-I cytokines and the molecules present on pathogenic T-cells. This approach has already proved successful in the treatment of rheumatoid arthritis and Crohn's disease, creating novel therapeutic options for psoriasis and other inflammatory dermatoses.

Autoantibodies↗

[Study of the sorption capacity of red blood cell membranes for the assessment of the pattern of endogenous intoxication in dermatoses].

The parameters of the sorption capacity of red blood cell membranes and the level of small and medium molecular weight substances were studied in 53 patients with chronic dermatoses. The plasma accumulation of small and medium molecular weight substances contributes to the altered sorption capacity of red blood cell membranes and to the occurrence of resistance to long used drugs. Biological blood clearance should be performed to enhance the efficiency of therapeutic measures.

Adsorption↗

[The safety of the antihistamines in dermatoses of pregnancy].

Pregnancy is frequently complicated by dermatoses, in which antihistamines may be potentially used. In fact, none of these drugs currently used has been classified by FDA on the basis of controlled human and animal studies as completely negative from the point of view of untoward effects in pregnancy. Based on the information available to date, in this paper we have attempted to provide rational guidelines for the gestational use of H1-receptor antagonists.

Female↗

The use of 308-nm excimer laser for dermatoses: experience with 34 patients.

Targeted phototherapy has been utilized in the past few years for the treatment of various dermatoses. In this article, we summarize the experience of using 308-nm excimer laser at Henry Ford Hospital, Detroit, MI, for the treatment of psoriasis, vitiligo, palmoplantar psoriasis, and hand dermatitis. A total of 34 patients were treated between January 2003 and February 2005. Of the 28 patients with psoriasis, over 80% had greater than 75% improvement after an average of 12 treatments. While the number of patients was small, excimer laser showed promising results for palmoplantar psoriasis. Possibly due to patient selection bias, we have not had the same success as other studies for the treatment of vitiligo with this modality.

Adult↗

[A comparative study of the quantitative distribution and ultrastructure of Langerhans cells in the epidermis of patients with chronic benign dermatoses and mycosis fungoides].

Using histoenzymatic assay for ATPase activity and electron microscopy, Langerhans' cells (LC) in biopsy specimens taken from skin lesions of 20 patients with chronic benign dermatoses (CBD) and of 28 patients suffering from mycosis fungoides (MF) were identified. In the early lesions of MF the reduction of the number of cell dendrites, disappearance of normal arrangement and the reduced absolute quantity of LC were observed on comparison with patients with CBD. Ultrastructurally, the destroyed forms of LC were predominantly observed in MF lesions, while in cases of CBD most of the LC were functionally active. The authors suggest that the examination of functional activity, quantitative distribution and ultrastructural features of LC should be used as an early morphologic test for differential diagnosis of early signs of MF and CBD this being of vital importance for an adequate and due treatment.

Adenosine Triphosphatases↗

The invisible dermatoses.

The central tenet of invisible dermatology is that visible lesions represent a late stage of development. The eye is an unreliable instrument for judging the normalcy of skin. In chronic widespread dermatoses, the uninvolved skin is at least physiologically abnormal. Recently healed skin is always abnormal. Recognition of occult changes will have a substantial impact on the prevention and treatment of diseases of the skin.

Humans↗