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PubMedDate not supplied

Ofloxacin versus cephalexin in the treatment of skin, skin structure, and soft-tissue infections in adults.

A multicenter study was conducted to compare the safety and efficacy of oral ofloxacin with that of cephalexin in microbiologic eradication of skin and skin-structure pathogens and the clinical treatment of skin and skin-structure infections. The subjects, 335 adult patients with acute localized infections of the skin, skin structure, or soft tissue, were randomly assigned to receive 400 mg of ofloxacin orally every 12 hours or 500 mg of cephalexin orally every six hours for 10 days. At admission, 398 aerobic pathogens were isolated, the most common being Staphylococcus aureus (160 isolates), Streptococcus pyogenes (49), coagulase-negative staphylococci (30), Staphylococcus epidermidis (25), and Pseudomonas aeruginosa (10). Of 317 isolates tested against ofloxacin, 96% were susceptible, and of 325 tested against cephalexin, 85% were susceptible (P less than 0.001). Microbiologic and clinical outcome were evaluated in 73 ofloxacin-treated patients and in 65 cephalexin-treated patients. The causative pathogens were eradicated in 95% of the ofloxacin group and in 92% of the cephalexin group. In the ofloxacin group, 75% were clinically cured and 23% improved, and in the cephalexin group, 74% and 23%, respectively. Drug-related adverse experiences were reported by 14% of the 161 ofloxacin-treated patients and by 11% of the 162 cephalexin-treated patients; gastrointestinal disturbances were reported by 8% and 7% and nervous system effects by 6% and 1%, respectively (P less than 0.05). It is concluded that both ofloxacin and cephalexin are safe and effective in the treatment of skin and soft-tissue infections.

Adolescent↗
PubMed1989

[Improvement of skin moisture and skin texture with urea therapy].

A significant increase in skin moisture and an improvement in skin smoothness after application of a urea-containing cream was noticed in a large number of volunteers with healthy skin and in neurodermitis patients compared with untreated skin and with vehicle. The effect was shown after one application (short-term test) as well as after repeated application (long-term test). Regular application of preparation containing urea increases the moisture of a the skin and improves the skin's smoothness compared with its previous condition, with untreated skin, and with placebo preparations.

Adult↗
PubMedDate not supplied

Drug metabolism in skin. Comparative activity of the mixed-function oxidases, epoxide hydratase, and glutathione S-transferase in liver and skin of the neonatal rat.

Aryl hydrocarbon hydroxylase (AHH) activity in the skin of neonatal rats was compared to that in epidermis, dermis, and other body tissues. Following topical application of benzo[a]pyrene (BP) or the polychlorinated biphenyl mixture Aroclor 1254 there was induction of AHH in each tissue studied. There was a greater increase in the activity of skin enzyme as compared to other extrahepatic tissues. When whole-organ activity (pmol of 3-OH-BP per min per whole organ) was considered, skin represented 2%, 21%, and 27% or whole body activity in control, BP-treated, and Aroclor 1254-treated animals, respectively. Skin microsomes from control rats exhibited 2, 0.5, 24, and 6% of corresponding liver microsomal AHH, 7-ethoxycoumarin de-ethylase, NADPH-cytochrome c reductase, and epoxide hydratase activities, respectively. Glutathione S-transferase activity in skin cytosol was 15% of the corresponding hepatic activity. Following topical application of Aroclor 1254 there were increases in the activity of AHH and 7-ethoxycoumarin de-ethylase in the skin and the liver. Glutathione S-transferase (40-60%) and epoxide hydratase (83-94%) activities in neonatal rat liver were induced by skin application of Aroclor 1254.

7-Alkoxycoumarin O-Dealkylase↗
PubMed1984

Quantification of acrosclerosis: measurement of skin thickness and skin-phalanx distance in females with 15 MHz pulsed ultrasound.

The skin thickness of the extensor and flexor aspects of the forearm (TEF, TFF), and the skin-phalanx distance over the middle and proximal phalanges (DMP, DPP) were measured with a 15 MHz ultrasound (A-scan) apparatus. Twenty-two females with systemic sclerosis (acrosclerotic type) and 22 healthy females matched for age were studied. DMP, DPP, TEF and TFF measurements were all increased in systemic sclerosis (p less than 0.001, p less than 0.001, p less than 0.01, p less than 0.02). Standards for normal skin-phalanx distance and skin thickness in females were defined (mean +/- SD). DMP and DPP were not correlated to age in the controls. TEF and FEF decreased slightly with age, 0.078 and 0.062 mm/10 years of life respectively. DMP was increased in 18 (82%), DPP in 13 (59%), TEF in 7 (32%) and TFF in 5 (23%) patients with systemic sclerosis, as compared with standards defined. Noninvasive measurement of skin-phalanx distance of the digits and skin thickness of the forearm with high-frequency ultrasound is concluded to be proper for the diagnosis of acrosclerosis and for quantification of sclerodermatous skin changes during medical treatment.

Adult↗
PubMedDate not supplied

Radiosensitivity of irradiated mouse skin to a second course of single and multifractionated irradiation. I. Early skin reaction.

Six or 12 months after a single or multifractionated gamma ray irradiation of the skin from the hind legs of mice, the response of the skin to the test dose in single or multi-fractionated (4-16) exposures was studied, using an early skin reaction as an endpoint. The pre-irradiated skin was relatively radioresistant compared to the previously untreated control skin in either dorsal or ventral sides of the legs. The variation in the skin sensitivity depending on the site of irradiation is also discussed for the pretreated and the untreated skin.

Animals↗
PubMed1982

Skin cholesterol and skin apoprotein B in atherosclerosis.

In order to quantify the accumulation of apoprotein B in skin we determined the amount of apo B in the skin of atherosclerotic patients using a modified Hoff's method with extraction and electroimmunoassay. Skin biopsies were taken from the lower limbs of nineteen male patients with arteriosclerosis obliterans during revascularization and from the thoracic region of thirty male patients with ischemic heart disease during coronary bypass graft surgery and thirty one male patients with abnormalities of cardiac valves during valvuloplasty. A significant positive correlation between skin apo B and skin cholesterol was found in three groups. Our data support the hypothesis that cholesterol deposit in the skin of patients with atherosclerosis is derived from plasma lipoprotein B and that the content of skin lipids parallels with the development of atherosclerosis in man.

Apolipoproteins↗
PubMed1977

Human skin proteases: effect of separated proteases on vascular permeability and leukocyte emigration in skin.

The effect of human skin proteases on vascular permeability and leukocyte emigration in rabbit skin was investigated. The alkaline protease of human skin capable of hydrolysing trypsin substrate effectively increased vascular permeability. This effect was not inhibited by antihistamine, but almost totally so by Trasylol. The reaction was protracted. Leukocyte emigration in skin, primarily of PMN-cells at 12 hrs, and later a migration of mononuclear cells, also resulted. Swelling of the dermal fibres was noted. The alkaline protease of human skin capable of hydrolysing chymotrypsin substrate also increased vascular permeability, but this phenomenon was effectively inhibited by antihistamine and the reaction was of brief duration. The leukocyte emigration caused by this enzyme was remarkable. The acid proteases of human skin resembling cathepsin B1 and D also caused brief increased vascular permeability, which was effectively inhibited by antihistamine. The cellular reactions to these acid proteases were mild. The role of protease inhibitors in skin in the enzyme reactions is discussed.

Animals↗
PubMed1979

Diisopropylfluorophosphate-evoked inhibition of anaphylactic histamine release from human skin: decrease of the inhibition by storing the skin specimens.

Antigen-induced histamine release from human skin slices passively sensitized with reaginic serum in vitro was inhibited by DFP, suggesting involvement of serine esterase activation in the reaction. The magnitude of DFP-evoked inhibition of the histamine release was not the same in each skin sample and no correlationship was observed between the magnitude of the DFP-evoked inhibition of the histamine release and that of the histamine release in the absence of DFP. The magnitude of the histamine release in the presence of DFP was smaller in the fresh skin than in the stored skin, whereas that in the absence of DFP was greater in the former than in the latter. The inhibitory effect of cytochalasin B on the anaphylactic histamine release from fresh and stored human skin was the reverse of the effect of DFP. The present results indicate that the magnitude of anaphylactic histamine release from human skin does not match that of the activation of serine esterase in the reaction, suggesting the possibility that there may be some factor modulating the activation of serine esterase in the anaphylactic reaction in human skin.

Antigens↗
PubMed1993

The biology of skin grafts. Skin grafts as pharmacologic agents.

BACKGROUND: Skin grafting is commonly used to treat nonhealing wounds. However, how skin grafts help to heal wounds is not entirely known. Why epithelium from grafted skin is able to migrate and cover these wounds, while epithelium at the edge of nonhealing wounds is unable to, is a long unanswered biologic question. OBSERVATIONS: The recent use of cultured epithelial allografts has rekindled interest in the biology of skin grafts. Replaced, even in chronic wounds, by recipient epithelium, cultured epithelial allografts appear to work by providing a potent stimulus to healing imparted by the graft itself. Based on this, we have reassessed how skin autografts help to heal wounds and hypothesize that, in a similar fashion, autografts may work not only by replacing tissue but also by providing a stimulus for healing. CONCLUSIONS: We suggest that skin grafts may work not only as tissue replacement but as pharmacologic agents that provide a stimulus for healing. We believe that, someday, it may be possible to augment the stimulatory properties of donor skin to speed healing of the recipient wound.

Culture Techniques↗
PubMed1996

[Skin flaps and expanded full-thickness skin grafts. Indications in the repair of burn sequelae].

The great majority of sequelae of deep burns concern the skin. Their correction essentially raises problems of replacement of scarred skin by good quality skin. Sequelae of burns logically constitute one of the best indications for progressive mechanical skin expansion by prosthesis, which allows for considerable improvement of the aesthetic results. This improvement is related to the use of skin replacement tissues with the same quality as the original tissue. Local expanded flaps and expanded full-thickness skin grafts are the two essential techniques used. The authors review the general rules concerning the use of expansion prostheses, then describe the various indications for expanded flaps and expanded full-thickness skin grafts in the sequelae of burns of the face, neck, thorax and limbs. The main indications are illustrated by clinical cases.

Burns↗
PubMed1985

Skin AVA and capillary dilatation and constriction induced by local skin heating.

In conscious sheep, total femoral blood flow and flow through arteriovenous anastomoses (AVAs) and capillaries (CAP) in skin of the hindleg were measured employing electromagnetic and radioactive microsphere techniques. Core temperature (Tc) was manipulated using intravascular heat exchangers and hindleg skin temperature (Tsk) was manipulated by immersion in temperature controlled water. With Tc set 1 degree C above normal, AVA flow was highest at the lowest Tsk tested (34 degrees C); AVAs progressively constricted as Tsk was increased from 34 to 40-41 degrees C, then dilated again as Tsk reached the highest levels tested (42-44 degrees C). Skin CAP flow was not altered by Tsk of 34 to 42 degrees C but was increased at a Tsk of 44 degrees C. Therefore total skin blood flow followed essentially the same pattern as AVA flow; total femoral flow also followed this pattern. When Tc was set 0.5 degrees C below normal, AVA flow was low at all levels of Tsk. It is concluded that Tc plays a dominant role in control of skin blood flow, however, once Tc is at a level requiring increased heat loss, Tsk exerts an extremely potent influence on the nature and magnitude of changes in skin blood flow. The pattern of flow changes appears to reflect principally a negative feedback mechanism aimed at maintaining Tsk at approximately 40 degrees C; this may contrast with mechanisms associated with sweating and/or active vasodilatation in other species.

Animals↗
PubMed1994

Surfactant-induced skin irritation and skin repair. Evaluation of the acute human irritation model by noninvasive techniques.

BACKGROUND: Although the induction of irritant dermatitis by surfactants has been extensively studied in recent years, our understanding of the repair phase of irritant dermatitis is limited. OBJECTIVE: We investigated qualitative and quantitative differences in surfactant-induced irritant skin reactions from short-term exposure to three structurally different surfactants. METHODS: Sodium lauryl sulfate (SLS), dodecyl trimethyl ammonium bromide (DTAB), and potassium soap were the model irritants. Surfactant solutions (0.5%) were applied for 24 hours to the volar aspect of the forearm of 11 volunteers. Irritant reactions were assessed until complete healing was indicated by visual assessment and by various aspects of skin function, that is, transepidermal water loss (TEWL), erythema (skin color reflectance), and stratum that is, transepidermal water loss (TEWL), erythema (skin color reflectance), and stratum corneum hydration (electrical capacitance). RESULTS: SLS and DTAB induced similar degrees of erythema, whereas SLS induced significantly higher TEWL increase. Although both erythema and TEWL were highest 1 hour after exposure to surfactants, skin dryness was a symptom with delayed onset, justifying the long observation period in this study. Minimum hydration values were measured as late as 7 days after surfactant exposure. Dryness was significantly more pronounced in areas exposed to SLS than in areas exposed to DTAB. Complete repair of the irritant reaction induced by either SLS or DTAB was achieved 17 days after surfactant exposure. Stratum corneum hydration was the last feature to return to baseline values. Potassium soap did not significantly influence any skin function. CONCLUSION: We emphasize the importance of extended periods needed before a patient with irritant contact dermatitis can be reexposed to irritant substances. The evaluation of the irritation potential of diverse surfactants depended significantly on the feature (erythema vs hydration and TEWL) measured.

Adult↗
PubMed2004

Treatment of full-thickness skin defect with concomitant grafting of 6-fold extended mesh auto-skin and allogeneic cultured dermal substitute.

The aim of this clinical study was to evaluate an allogeneic cultured dermal substitute (CDS) as a biological dressing for highly extended mesh auto-skin grafting. The subjects were five patients with extensive deep burn wounds. Allogeneic CDS was prepared by seeding fibroblasts on a spongy matrix of hyaluronic acid and atelo-collagen. Six-fold extended auto-skin graft was applied to the debrided wound, on which allogeneic CDS was placed. A conventional ointment-gauze dressing was used to protect the CDS. The CDS was applied repeatedly at intervals of 5-7 days. In all cases, the wounds were closed by successful take of mesh auto-skin graft and prompt epithelization from the grafted skin. The skin on the grafted area had a cicatrix appearance, but was soft and thin, maintaining good quality. The application of 6-fold extended auto-skin graft in conjunction with allogeneic CDS is an effective method for treatment of extensive severe burn wounds.

Adult↗
PubMed2002

A randomised trial of skin photography as an aid to screening skin lesions in older males.

OBJECTIVES: We have previously shown that photographs assist in detection of change in skin lesions and designed the present randomised population based trial to assess the feasibility of photographs as an aid to management of skin cancers in older men. SETTING: 1899 men over fifty, identified from the electoral roll in two regions in New South Wales (NSW), Australia, were invited by mail to participate. METHODS: A total of 973 of 1037 respondents were photographed and randomised into intervention (participants given their photographs) or control groups (photographs withheld by investigators). At one and two years from the time of photography, all participants were advised to see their primary care practitioner for a skin examination. Those in the intervention group were examined with their photographs and those in the control group without their photographs. RESULTS: The results indicated that the practitioners were more likely to leave suspicious lesions in place for follow up observation (37% v 29%) (p=0.006) and less likely to excise benign non pigmented lesions (20 v 32%). There was little difference in excision rates for benign pigmented lesions (21% v 23%). Lesions excised were more likely to be non-melanoma skin cancer (58% v 42%) from patients who had photographs compared to those without photographs (p=0.005). The use of skin photography resulted in a substantial savings due to the reduced excision of benign lesions. CONCLUSIONS: These results suggest that it would be feasible to conduct a large scale randomised trial to evaluate the value of photography in early detection of melanoma and that such a trial could be cost effective due to the reduced excision of benign skin lesions.

Australia↗
PubMed1992

Scaling, dry skin and gender. A bioengineering study of dry skin.

Dry skin and scaling was studied in a group of 72 healthy volunteers by using subjective self-assessment and by clinical assessment by a dermatologist, as well as application of noninvasive bioengineering techniques to measure scaling and epidermal hydration. The study revealed that 67% of the volunteers had subjective complaints, while only 5.6% had definite clinical signs of dry skin at the time of examination. Subjective complaints were more common in women than in men (p < 0.001), though neither clinical nor objective measurements showed any sex difference, which suggests that other factors may play a role in the way men and women perceive dry skin. Subjective and clinical scores were correlated (p < 0.02), though neither was significantly correlated to objective measurements. Grading of skin scaling on D-squame tapes correlated with densitometry of the tapes (p < 0.001), as did the electrical capacitance (p < 0.001). Both clinical and objective methods can identify dry skin. However, the study showed that in healthy persons a number of irrational factors play a role in the use of moisturizers, and while these factors cannot be measured, they must be taken into account. Healthy, but dry skin is a vaguely defined clinical entity, which may explain the generally poor correlation between the two methods. This underlines the need for several methods to be used simultaneously in order to elicit complementary information.

Adult↗
PubMed2005

Enhancing the care and treatment of skin of color, part 2: understanding skin physiology.

Cutaneous diseases in patients with skin of color frequently present differently than in individuals with white skin. Increased understanding of skin physiology including skin lipids and barrier function, as well as documentation of common issues such as ashy skin, has been the focus of researchers. New insights into the effects of UV radiation in skin of color and the increasing incidence of malignant melanoma heighten awareness of the need for new initiatives directed at education and further research, despite previous views about photoprotection for this population.

Black People↗
PubMed2003

Production of a monoclonal antibody, DF-5, that identifies cells at the epithelial-mesenchymal interface in normal human skin. APN/CD13 is an epithelial-mesenchymal marker in skin.

Epithelial-mesenchymal interactions play a critical role in skin development and differentiation, and similar interactions may also regulate the day-to-day proliferation and differentiation events of the epidermis that occur in normal adult skin. This study was directed at identifying molecules that are selectively located at the dermal-epidermal junction in normal adult skin as they may be involved in regulating these homeostatic events. To this end, monoclonal antibodies were raised against the crude cell membrane fraction of cultured human dermal fibroblasts. Screening of antibodies that recognized cell surface antigen on cultured human dermal fibroblasts was followed by determining which of these antibodies selectively localized cells at sites of epithelial-mesenchymal interactions. Antibody DF-5 fit these criteria and was further characterized. This antibody was found to recognize the cell surface ectopeptidase aminopeptidase N (APN), a molecule homologous to the cluster differentiation antigen CD13. Antibody DF-5 and anti-CD13 antibodies both identified cells at sites of epithelial-mesenchymal interactions in fetal, neonatal, and adult human skin, and the APN/CD13 enzyme activity was also identified at these sites. A second ectopeptidase, dipeptidyl peptidase IV (DPPIV) or CD26, presented a significantly different immunohistochemical and histochemical pattern in skin samples, confirming the specificity of the APN/CD13 studies. The function of APN/CD13 in skin has yet to be determined. Its invariant localization at sites of epithelial-mesenchymal interactions argues for a role particular to this region. It may play a role in regulating the activity of neuropeptides or other signaling peptides that are released in this region of skin or it may have an as yet undefined role in mediating communication between dermal and epidermal cells.

Adolescent↗
PubMed2003

Expression of the T-helper 2-specific chemokine receptor CCR4 on CCR10-positive lymphocytes in atopic dermatitis skin but not in psoriasis skin.

BACKGROUND: Atopic dermatitis (AD) and psoriasis are inflammatory skin diseases. AD is generally perceived as a T-helper (Th) 2-dominated disease whereas psoriasis is a Th1-dominated disease. The chemokine cutaneous T-cell attracting chemokine (CTACK) and its receptor CCR10 attract skin-homing lymphocytes to inflamed skin, suggesting that CCR10+ cells in AD and psoriasis should be of Th2 and Th1 type, respectively. The chemokine receptor CCR4 is expressed selectively on Th2 lymphocytes and its ligand thymus and activation-regulated chemokine (TARC) is upregulated in AD lesions, suggesting that the CCR10+ cells in AD lesions should also express CCR4. OBJECTIVES: To examine the coexpression of CCR10 and CCR4 on skin-invading lymphocytes in AD and psoriasis lesions as well as the Th1/Th2 cytokine expression of the CCR10+ lymphocytes. METHODS: Skin biopsies from AD and psoriasis patients were double stained with antibodies against CCR10-CCR4, CCR10-CCR5, CCR10-interleukin (IL)-2 and CCR10-IL-4. RESULTS: The CCR10+ cells in AD showed a mixed IL-2/IL-4 expression pattern, and a minor proportion expressed CCR4, whereas a large proportion of the CCR4+ cells did not express CCR10. In psoriasis the CCR10+ cells only expressed IL-2, and no CCR4 expression was detected. CONCLUSIONS: The CCR10+ lymphocytes invading the skin in AD and psoriasis have different Th1/Th2 profiles, as measured by both their cytokine and chemokine receptor expression. This suggests that the CCR10+ subpopulation of lymphocytes is made up of different Th1/Th2 subsets. However, the Th1/Th2 lymphocytes of AD and psoriasis were either CCR10+ or CCR10-, suggesting that both the Th1 and Th2 subpopulation can be subdivided further. CCR4 was found only in AD skin and on both CCR10+ and CCR10- cells, supporting the hypothesis of TARC and CTACK as being independent lymphocyte-attracting chemokines in AD.

Adult↗