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At least 397 records · Page 22Linked to original sources
PubMed1986

Low-dose etretinate in the maintenance of remission of palmoplantar pustular psoriasis.

Twenty patients with palmoplantar pustular psoriasis were treated initially for 4 weeks with 70 mg etretinate daily. This led to clinical improvement and a significant fall in pustule count. The patients were then allocated randomly to 30 mg etretinate daily or placebo for a further 12 weeks. There was a rapid deterioration in the clinical condition and a rise in pustule count in the placebo group. The etretinate-treated group still showed clinical improvement and a significantly lower pustule count after 12 weeks. Clinical side-effects were few and adverse effects on liver function and serum lipids were not found.

Clinical Trials as Topic↗
PubMed1986

Acropustulosis of infancy.

Acropustulosis of infancy is a syndrome characterized by recurrent pruritic acral vesicopustules. It occurs primarily in black male infants and hitherto has been described mainly in the North American literature. We describe four cases seen in London. This entity, therefore, should be recognized in the U.K., particularly in the differential diagnosis of infantile scabies.

Foot Dermatoses↗
PubMed1988

An evaluation of itraconazole in the management of onychomycosis.

At present the reported use of itraconazole, a new oral triazole antifungal, has been confined to short-term treatments. This investigation is an appraisal of itraconazole in the treatment of three different forms of onychomycosis. Six patients with nail infections due to Candida albicans not associated with paronychia affecting a total of 20 nails received itraconazole (100 mg daily) for a mean period of 5.9 months. Complete remission was achieved in all cases. Twenty six patients with dermatophyte onychomycosis affecting a total of 45 finger and 80 toe-nails were treated with itraconazole (100-200 mg daily). In 24 cases the causative organism was Trichophyton rubrum. Remission was achieved in 64% of finger and 73% of toe-nails in 5 and 9.4 months, respectively. Treatment failures were experienced in patients with finger-nail infections due to T. violaceum (I) and those concurrently receiving phenytoin and phenobarbitone (3). Three patients with infections due to Hendersonula toruloidea failed to respond to treatment. Adverse effects were experienced by four patients (abdominal discomfort 3, diarrhoea I), but none were serious enough to lead to abandonment of treatment. No persistent changes were seen in serum biochemical values. This study suggests that itraconazole is potentially effective in the long-term treatment of superficial fungal infections such as onychomycosis, and comparative studies with alternatives such as griseofulvin should now be carried out.

Adult↗
PubMed1988

Acitretin and etretinate in the treatment of palmoplantar pustulosis: a double-blind comparative trial.

Sixty patients with palmoplantar pustulosis were treated in a double-blind trial with either acitretin (etretin, Ro 10-1670) or with etretinate. The study consisted of 4 weeks of therapy with three 10 mg capsules/day followed by 8 weeks of therapy with a varying number of capsules given daily according to therapeutic response. At the end of the 12-week treatment period, the mean number of pustules (+/- SEM) had decreased from 57.8 (+/- 8.6) to 3.9 (+/- 1.6) in the acitretin group and from 57.1 (+/- 14.1) to 5.7 (+/- 2.7) in the etretinate group. With regard to influence on erythema, infiltration, scaling, and area involved, similar improvements were obtained in both treatment groups. Adverse reactions of the hypervitaminosis A type were observed with almost the same frequency and severity in both treatment groups. The mean number of 10 mg capsules used daily was comparable in the two groups: 2.82 (range 1.23-4.67) for acitretin and 2.77 (range 1.60-4.82) for etretinate. It can be concluded that acitretin and etretinate do not significantly differ with regard to efficacy and overall safety in the treatment of patients with palmoplantar pustulosis.

Acitretin↗
PubMed1989

Treatment of dermatophyte infection of the finger- and toe-nails with terbinafine (SF 86-327, Lamisil), an orally active fungicidal agent.

We report on the use of a new orally active fungicidal agent, terbinafine (SF 86-327, Lamisil) in the treatment of patients with dermatophyte onychomycosis. Twenty patients with toe-nail, and 10 with finger-nail infection received 250 mg of terbinafine daily: finger-nail infections were treated for 6 months and toe-nail infections for 12 months. All 24 patients who completed the course of therapy achieved mycological cure, as did two subjects who dropped out of the trial. All but two patients had clinically normal nails at the end of the study period. The mean time for mycological cure was 12.5 weeks for finger-nail infection, and 24 weeks for toe-nail infections. The time for a clinical cure with normal nails was 20.5 weeks for finger-nail infection, and 44 weeks for toe-nail infection. An exacerbation of pre-existing dyspepsia occurred in three of the six patients who did not complete the trial but there were no other significant adverse reactions.

Administration, Oral↗
PubMed1989

Thallium poisoning: a dermatological perspective.

The dermatological findings in five patients with thallium poisoning are described. Cutaneous involvement consisted mainly of an acneiform eruption, pellagra-like dyssebacea, crusted eczematous lesions and dry scaling of the distal parts of the extremities. Alopecia was not evident initially but later became apparent. The patients also had gastrointestinal and neurological symptoms and signs.

Alopecia↗
PubMed1992

Prevalence of dermatophyte onychomycosis in the United Kingdom: results of an omnibus survey.

A computer omnibus survey to determine the prevalence of onychomycosis in the United Kingdom was carried out in the early part of 1990. A total population of 9332 adults, aged 16 years and over, was interviewed face-to-face, and a questionnaire completed, which consisted of questions and photographs of various nail dystrophies, including onychomycosis. The results in the population surveyed revealed a prevalence of dermatophyte nail infection of 2.8% in men and 2.6% in women. In the group aged 16-34 years, the prevalence rate was 1.3%; this increased to 2.4% in the group aged 35-50 years, and to 4.7% in those aged 55 years or over. Of those found to have onychomycosis, 27% had sought advice from a chiropodist and less than 12% had consulted a specialist. These results suggest that nearly 1.2 million people in the UK have a fungal nail infection and the majority had not sought medical advice, although over 80% stated that they would do so if they were aware that their nail disorder was of fungal origin. A similar proportion would wish to be treated if an effective treatment was available.

Adolescent↗
PubMed1992

Short-duration therapy with terbinafine for dermatophyte onychomycosis: a multicentre trial.

Terbinafine, an orally active antifungal agent, is effective in the treatment of dermatophyte onychomycosis when given for 12 months in the case of toenail infection (TN) and 6 months for fingernail infection (FN). The rapid response and short mycological cure time indicate a potential for a reduced treatment duration. In this multicentre double-blind placebo-controlled trial, 112 patients with mycologically proven dermatophyte onychomycosis were given 250 mg/day of terbinafine for 3 months. Twenty-seven patients were excluded, leaving 85 fully evaluable [average age 44 (range 19-78) years; 55 men; 75 TN, 10 FN]. Forty-nine of the TN patients and seven of the FN patients received terbinafine. At the end of the follow-up period, the TN mycological cure rate with active treatment was 82% (37/45), but no patient taking placebo maintained mycological cure (P less than 0.001). Of the FN patients treated with active drug, 71% (5/7) achieved mycological cure at the end of follow-up. Minor side-effects occurred in 41% of the placebo-treated group compared with 33% of those taking terbinafine. These adverse events were mainly gastrointestinal. Two patients taking terbinafine discontinued treatment--one with tonsillitis and another with diarrhoea. In conclusion, 3-month treatment with terbinafine is effective, well tolerated and safe in dermatophyte onychomycosis. Short-duration therapy for this indication represents a major therapeutic advance.

Adult↗
PubMed1992

Treatment of onychomycosis with terbinafine.

An open multicentre trial was conducted by 40 dermatologists in Switzerland involving 188 patients with onychomycosis of either the toenails or fingernails. Of these patients, 145 who had positive microscopy and culture of dermatophyte infection were evaluable: of the dermatophytes identified at the initial visit, 80% were Trichophyton rubrum and 12.4% were T. mentagrophytes. Only the most affected nail was evaluated during the observation period. Daily dosage was 250 mg of terbinafine (Lamisil) orally for up to 6 months. The cure rate (negative microscopy and culture) at the end of treatment was 77% for toenails and 100% for fingernails. A follow-up investigation was made 6 months after the end of treatment: of the 88 patients examined with onychomycosis of the toenail and the 14 with fingernail onychomycosis, 90.9% and 85.7%, respectively, remained free of recurrence. Of the 26 patients who had shown improvement, but not cure, by the end of the treatment period, 15 were clinically and mycologically cured at the time of the follow-up investigation. Terbinafine was generally well tolerated; the most frequent drug-related adverse events were mild-to-moderate gastrointestinal disturbances. Changes in liver or renal biochemical tests were not considered clinically relevant.

Adult↗
PubMed1992

Epidermolysis bullosa simplex (Dowling-Meara). A clinicopathological review.

The clinicopathological features of 22 cases of the Dowling-Meara form of epidermolysis bullosa simplex (DM-EBS) (11 males, 11 females; aged 5 days-46 years) were reviewed using data collected over a 10-year period. All cases presented clinically within the first 5 days of life. Early blisters were often large (up to 5 cm in diameter), and were mostly acral and particularly periungual. Some cases presented with more widespread erosive skin changes, and two neonates with extensive skin involvement died as a result of overwhelming sepsis. After the neonatal period a different pattern of blistering occurred with more proximal haemorrhagic, herpetiform clusters of blisters. Central healing with recurrent blistering at the margins of these areas was frequently noted. Other physical signs included varying degrees of intra-oral blistering, nail shedding, nail dystrophy, minor scarring, palmo-plantar keratoderma, a lack of seasonal variation and improvement during later childhood. The underlying pathological mechanism in DM-EBS is basal cell cytolysis, or rarely acantholysis, in association with tonofilament (TF) clumping. TF clumping was found in lesional, perilesional and some non-lesional skin, suggesting that the tonofilament abnormality may be of primary aetiological significance in DM-EBS. TF clumping may be due to specific keratin abnormalities because the altered TF were found in a distribution similar to the known distribution of the basal cell keratins, K5 and K14. The level of blistering was invariably very low within the epidermal basal layer and often less than 0.5 microns above the basement membrane. We conclude that DM-EBS is a distinct, and probably under-recognized genodermatosis which tends to have a good prognosis. However, the disease can occasionally be severe, especially during the neonatal period, when it may be confused with junctional or severe recessive dystrophic EB. Electron microscopy is the best means for demonstrating the characteristics cytoskeletal disorder and confirming the diagnosis.

Adolescent↗
PubMed1992

Lymphoproliferative responses to human papillomaviruses in patients with cutaneous warts.

In vitro lymphoproliferative responses of peripheral blood mononuclear cells (PBMC) from patients with cutaneous warts, caused by infection with human papillomavirus type 1 (HPV-1) or type 2 (HPV-2), were assayed during the course of treatment. Purified HPV-1 and HPV-2 were used as antigens, as well as herpes simplex virus (HSV) and concanavalin A (Con A). All patients had normal percentages of subsets within the PBMC population and normal lymphoproliferative responses to Con A, and those with a clinical history of HSV infections had positive lymphoproliferative responses to HSV. Responses to both HPV antigens were poor. Only 10 of 100 assays of PBMC from 26 patients showed a stimulation index greater than 2. Addition of interleukin 2 made little difference in most cases. No correlation of clinical status of warts, i.e. improving, unchanged or resolved, with lymphoproliferation was found. When the PBMC were depleted of plastic-adherent cells and enriched for T cells, some samples which had not shown a lymphoproliferative response to HPV-1 or HPV-2 became positive; this response was abolished when the adherent cells were re-added. Thus it is possible that the adherent cell population from a proportion of patients contains cells which suppress lymphoproliferation, or that an immunoregulatory network is present so that lymphoproliferation does not take place in vitro without prior activation and cloning of T cells.

Adolescent↗
PubMed1993

Successful treatment of sporotrichosis with oral fluconazole: a report of three cases.

We report three cases of sporotrichosis successfully treated with oral fluconazole. A verrucous lesion on the toe was cured after 126 days, and a lesion on the left foot resolved after 91 days' treatment. A case of lymphangitic-type sporotrichosis required 174 days of treatment to achieve a cure, and a higher dose (400 mg daily) was necessary in this case. Any side-effects were insignificant. We conclude that this new bis-triazole compound can be successfully used as an alternative treatment for sporotrichosis when conventional drugs must be avoided.

Administration, Oral↗
PubMed1993

Mal de Meleda keratoderma with pseudoainhum.

Pseudoainhum is an infrequent complication in the autosomal-recessive keratodermas. We describe two related families in which the diagnosis of mal de Meleda keratoderma has been confirmed by mode of inheritance and ultrastructural findings. One family member, a 9-year-old girl, developed pseudoainhum which threatened the viability of her little fingers. This responded to treatment with etretinate. The treatment dilemma posed by keratoderma-induced pseudoainhum in children, i.e. the concern over the possible skeletal toxic effects of long-term etretinate treatment vs. the risks and outcome of surgery, is discussed.

Ainhum↗
PubMed1994

New types of human papillomaviruses and intracytoplasmic inclusion bodies: a classification of inclusion warts according to clinical features, histology and associated HPV types.

Two new types of intracytoplasmic inclusion bodies (ICBs) associated with distinct clinical features, and the presence of DNA of distinct types of human papillomaviruses (HPVs) are reported. One hundred and seven cutaneous warts containing ICBs were grouped into three categories according to distinct clinicopathological features: 67 were wart lesions with well-known granular (Gr)-ICB, 13 were punctate keratotic lesions with filamentous (Fl)-ICB and 31 were pigmented warts with homogeneous (Hg)-ICB. Molecular biological studies were performed in order to assess a specific association of each group of warts with distinct types of HPV. HPV-1 DNA sequences were detected in all the lesions with a Gr-ICB. Punctate keratotic lesions with Fl-ICB were associated with HPV-63, which was newly cloned from such a lesion. One of the samples also contained HPV-1 DNA. Pigmented warts with Hg-ICBs contained one of the related HPVs, i.e. HPV-4, HPV-60 or a novel type of HPV, HPV-65. Based on these associations, a classification of inclusion warts is proposed.

Adolescent↗