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[Urea as a single drug in dry skin].

Preparations containing urea were found to be effective in the treatment of ichthyosis vulgaris and so we were encouraged to test their use in other dry skin conditions. Urea creams are well applied to dry skin which is not inflamed. In the treatment of psoriasis, which requires a stronger water-binding substance, a combination of sodium chloride and urea in equal concentrations is optimal. Urea creams can be used in the prophylactic treatment of hand eczema and also as a prophylactic against infection, but not in the treatment of already existing infections. In psoriasis and ichthyosis urea is effective in creams substitution therapy. Though urea creams provided relief from itching in neurodermatitis, their use after treatment of eczema with fat-containing salves caused burning sensations. In our experience creams with a urea concentration of 5%-10% offer possibility for treating dry skin.

Administration, Topical↗

[Antilymphocytic antibodies in human diseases as a factor decreasing the functional activity of T-suppressors].

157 sera from adults and children with rheumatoid arthritis, rheumatic fever, myocarditis, neurodermatitis, bronchial asthma, wound infections, second degree obesity without symptoms of diabetes were examined. 60% of sera contained high concentrations of antibodies possessing cytotoxicity against thymus cells, but not against bone marrow cells. Sera of healthy children and adults contained no cytotoxic antibodies. Sera cytotoxic against mouse thymus cells inhibited the suppressing activity of mouse splenocytes in experiments on syngeneic transfer, reducing the ability of human lymphocytes to form T-RFC. The latter phenomenon is associated with the decline in the number of T-theophylline-sensitive lymphocytes, known as T-suppressors.

Adult↗

[Structural-functional characteristics of the surface of the blood mononucleocytes in children suffering from chronic dermatoses. I. The correction of the glycocalyx structure by UV irradiation of the blood and in the course of treatment with an autotransfusion of UV-irradiated blood].

In children suffering from chronic dermatoses (psoriasis and neurodermatitis), the glycocalix of blood mononuclears displays an Alcian blue dye sorption by 23-25% less than that in healthy children. The UV irradiation of their blood (254 nm), in addition to a course of UV-irradiated blood autotransfusion, resulted in an elevated sorption capacity of the mononuclear glycocalix up to the normal. A possible involvement of these changes in immunocompetent cell glycocalix in the pathogenesis of chronic dermatoses is discussed, as well as the significance of glycocalix normalization in the medicinal effect of UV-irradiated blood autotransfusion.

Absorption↗

[Electrophysiological research on pain and itching in the clinic].

To study the central mechanisms of pain and itching, the authors performed electroencephalographic (EEG) examination in acupuncture-treated patients with diffuse neurodermatitis (n = 43) and trigeminal neuralgia (n = 25). The most characteristic EEG finding was increased synchronization of the cortical rhythm. The revealed EEG features point to the functional involvement of the thalamocortical system in the development of pain and itching. Changes of clinical and electrophysiological parameters in the course of acupuncture treatment is an additional evidence of the morphofunctional unity of the development of pain and itching.

Acupuncture Therapy↗

Double-blind paired comparison clinical trial of halcinonide and hydrocortisone.

Fifty patients with a diagnosis of psoriasis, eczematous dermatitis, atopic dermatitis, or neurodermatitis and with bilateral symmetric lesions of equal severity participated in this study. A double-blind paired comparison technique was used in which halcinonide-neomycin-amphotericin ointment was applied to the lesions on one side of the body and hydrocortisone ointment to similar lesions on the other side according to a randomized schedule. The halcinonide-containing combination was statistically superior (p less than 0.05) to hydrocortisone ointment in the treatment of psoriasis patients. No statistically significant difference between the two drugs was obtained for the three other indications studied. No side effects with either ointment were observed. Halcinonide as formulated in this combination is an effective and safe corticosteroid.

Administration, Topical↗

[Effect of autologous blood in the hypo-osmotic state on the immune system of the body].

The analysis of the immune status of patients under neurodermatitis after autologous blood treatment has been performed. It has been found that positive therapeutic effect correlates with a number of immunologic parameters: the lysozyme content raises, the metabolic activity of neutrophilic cells increases, a number of T-lymphocytes grows to a certain degree, the balance of T-lymphocyte subpopulation normalizes.

Blood Transfusion, Autologous↗

[Topical treatment of various dermatosis with difluocortolone valerianate. (ointment) Double blind comparative study].

The trial preparation, diflucortolone valerate, was tested clinically in the form of fatty ointment on 27 patients: 4 with psoriasis, 4 with neurodermatitis, 4 with contact dermatitis, 2 with actinodermatitis, 10 with eczema, 2 with cutaneous reticulosis and 1 with radiodermitis. In 89% of the cases the results were good; in 11% were they regular.

Adolescent↗

Lennert's lymphoma presenting as prurigo nodularis.

Lennert's lymphoma is a peripheral T-cell lymphoma that only rarely involves the skin. We present the case of a forty-two-year-old man who experienced severe pruritus for ten months. He was repeatedly diagnosed as having neurodermatitis and prurigo nodularis before subtle hematologic clues suggested, and subsequent examination of bone and lymph node biopsy specimens confirmed, the diagnosis of Lennert's lymphoma. This report describes the case and presents a brief review of Lennert's lymphoma.

Adult↗

Hypnosis in dermatology.

BACKGROUND: Hypnosis is an alternative or complementary therapy that has been used since ancient times to treat medical and dermatologic problems. OBJECTIVE: To describe the various uses for hypnosis as an alternative or complementary therapy in dermatologic practice. METHODS: A MEDLINE search was conducted from January 1966 through December 1998 on key words related to hypnosis and skin disorders. RESULTS: A wide spectrum of dermatologic disorders may be improved or cured using hypnosis as an alternative or complementary therapy, including acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo. CONCLUSION: Appropriately trained clinicians may successfully use hypnosis in selected patients as alternative or complementary therapy for many dermatologic disorders.

Complementary Therapies↗

Comparative efficacy of halcinonide and fluocinonide creams in psoriasis and eszematous dermatoses.

The clinical efficacy of halcinonide and fluocinonide creams was compared in the treatment of 392 patients with corticosteroid-responsive dermatoses, including psoriasis, and various eczematous dermatoses such as atopic dermatitis, eczematous dermatitis, and neurodermatitis. The severity of the condition treated was moderate or severe in most of the patients. Usually, the creams were applied three times daily for two to three weeks. In psoriasis, halcinonide was superior to fluocinonide (P less than 0.05). There was no significant difference between halcinonide and fluocinonide in the treatment of the eczematous dermatoses. Both creams were well tolerated, each being associated with local side effects (such as burning sensation, dryness, erythema, and pruritus) in 4.9 per cent of patients.

Administration, Topical↗

Thought Field Therapy clinical applications: utilization in an HMO in behavioral medicine and behavioral health services.

Thought Field Therapy (TFT) is a self-administered treatment developed by psychologist Roger Callahan. TFT uses energy meridian treatment points and bilateral optical-cortical stimulation while focusing on the targeted symptoms or problem being addressed. The clinical applications of TFT summarized included anxiety, adjustment disorder with anxiety and depression, anxiety due to medical condition, anger, acute stress, bereavement, chronic pain, cravings, depression, fatigue, nausea, neurodermatitis, obsessive traits, panic disorder without agoraphobia, parent-child stress, phobia, posttraumatic stress disorder, relationship stress, trichotillomania, tremor, and work stress. This uncontrolled study reports on changes in self-reported Subjective Units of Distress (SUD; Wolpe, 1969) in 1,594 applications of TFT, treating 714 patients. Paired t-tests of pre- and posttreatment SUD were statistically significant in 31 categories reviewed. These within-session decreases of SUD are preliminary data that call for controlled studies to examine validity, reliability, and maintenance of effects over time. Illustrative case and heart rate variability data are presented.

Adult↗

[Arthrogenic ear canal tumor].

We report our findings in two female patients (aged 56 and 64 years) who complained about slight hearing loss that varied during jaw movements. In both cases a polypoid tumor of the external auditory meatus was found that almost completely disappeared with mouth opening. CT showed a bony defect of the anterior wall of the external auditory canal in both patients. Biopsies from the tumor-like lesions were done, revealing a chronic inflammatory hyperplasia of the connective tissue in one case and a rheumatic granuloma in the other. Review of medical histories showed that the first patient suffered from a recurrent neurodermatitis and the second had experienced a chronic polyarthritis for many years. From these findings and on the basis of a literature review, we conclude that these pseudotumors represent a chronic inflammatory hyperplasia of the periarticular tissue which herniated through a persistent "foramen of Huschke." This foramen is formed during embryological development of the two tympanic tubercles, but normally closes before the age of 5 years. However, in a few rare cases is may persist to allow herniation of synovial tissue.

Arthritis, Rheumatoid↗

Topical progesterone in treatment of vulvar dystrophy: preliminary report of five cases.

Topical progesterone was used in five cases of chronic vulvar dystrophy which were confirmed by biopsy. Good results were obtained in three of the cases through the sole use of topical progesterone. In one case, topical testosterone was substituted for the progesterone, and it was not as effective. The concomitant use of estrogen vaginal cream was required in order to achieve maximum results in another case due to the presence of senile vaginitis. The apparent failure of the progesterone preparation to achieve satisfactory results in a diabetic patient could possibly be explained by the presence of neurodermatitis.

Administration, Topical↗

Hospital management of a patient with factitial dermatitis.

A 64-year-old male with a 40-year history of dermatologic disorders is presented. The patient carries diagnoses of neurodermatitis and suspected myosis fungoides on which has been superimposed a factitial dermatitis requiring increasingly extended hospitalizations. Given a very disturbed home life and personality style, the patient showed no incentive for change, and his family and caregivers became increasingly frustrated and distraught. An operant behavioral approach proved helpful to staff in standardizing care and setting realistic expectations. This led to a reversal of a downward course and to a coordinated discharge.

Behavior Therapy↗

Lichenoid dermatitis: a clinicopathologic and immunopathologic review of sixty-two cases.

We reviewed 62 cases (26 men and 36 women, median age 55 years) of previously diagnosed lichenoid dermatitis and correlated the histologic and immunodermatologic findings with the clinical diagnosis and course. The clinical diagnostic groups were contact dermatitis (6 cases), drug eruption (14), lupus erythematosus (6), lichen planus (3), cutaneous T cell lymphoma (3), chronic dermatitis or neurodermatitis (19), and miscellaneous dermatologic disorders (11). With the use of individual histologic features, a correlation with specific clinical conditions was possible, and the clinical groups of dermatitis, drug eruption, lupus erythematosus or lichen planus, and T cell infiltration could be selected histologically. Direct immunofluorescence studies were of most help in the diagnosis of lupus erythematosus and atypical lichen planus, but these studies should be performed in all cases involving lichenoid inflammation. Although previously the nonspecific term lichenoid dermatitis was used to classify the histologic features in these cases, we found that by careful correlation of histologic, immunodermatologic, and clinical features, we were often able to provide a specific diagnosis.

Adolescent↗

Acquired reactive perforating collagenosis. Report of six cases and review of the literature.

BACKGROUND: Reactive perforating collagenosis (RPC) is characterized by transepithelial elimination of altered collagen. Two types have been recognized: the childhood form and the adult form. OBJECTIVE: Our purpose was to review the associated disorders, evaluate the possible causes, and set criteria for the diagnosis of the disease. METHODS: The clinical and pathologic findings of six patients with the adult form of RPC are reviewed. The literature on this subject is compared with our findings. RESULTS: Pruritus was reported in all cases. Treatment of pruritus cleared the lesions in many patients. This is the first report of an association between RPC and hyperparathyroidism, hypothyroidism, liver disorders, and neurodermatitis. CONCLUSION: Various disorders can be associated with the adult form of RPC. Pruritus is the common factor among all types. Control of itching might be helpful for clearing the lesions. We propose the following diagnostic criteria for acquired RPC: (1) histopathologic findings of elimination of necrotic basophilic collagen tissue into a cup-shaped epidermal depression, (2) clinical presentation of umbilicated papules or nodules with a central adherent keratotic plug, and (3) onset of skin lesions after the age of 18 years.

Adrenal Cortex Hormones↗

Live-epikeratophakia for keratoconus.

PURPOSE: To assess the clinical feasibility of refractive live-epikeratophakia (L-EPI) for early keratoconus to cap, rather than reverse, the ectatic cornea. SETTING: Eye Department, Martin-Luther-Hospital, Bochum, Germany. METHODS: Twenty-seven consecutive cases with keratoconus stage I-II had L-EPI. Lenticules were obtained from eye-bank eyes. The lenticules were cut on the artificial anterior chamber bench of the Barraquer-Krumeich-Swinger set. Optical power was generated over refractive dies to achieve postoperative emmetropia. The lenticule was sutured into a peripherally undermined 7.0 mm trephination with a double-running torque suture. RESULTS: Re-epithelialization was complete within 4 to 6 days. In all but three cases that had corneal ulcers and experienced partial melting of tissue following severe neurodermatitis, all lenticules remained stable during the 10 year follow-up. The 1 month spherical equivalent remained almost stable over the entire follow-up. There was no sign of progression of keratoconus as induced myopia or astigmatism indicated by keratometry readings. Mean best spectacle-corrected visual acuity (BSCVA) was 0.45 (n = 27) preoperatively and 0.19 (n = 25) at 1 week, 0.39 (n = 26) at 1 month, 0.53 (n = 20) at 6 months, 0.58 (n = 13) at 1 year, and 0.64 (n = 8) at 2 years. Preoperative BCVA was achieved or improved in 13 eyes at 1 month. Postoperative astigmatism was < or = 3.25 diopters. Neither rejection nor lenticule opacification was observed. CONCLUSIONS: Live-epikeratophakia is a safe and minimally invasive extraocular procedure suitable for keratoconus stage I-II. Progression of keratoconus may be arrested. If unsuccessful, the procedure is complementable and there is no interference with a later penetrating keratoplasty.

Cornea↗

Bronchial asthma: information on phytotherapy with essential fatty acids. Interactions between essential fatty acids and steroid hormones.

The pharmacological treatment of bronchial asthma is based on the inhalation of bronchodilative beta2 agonists and steroid hormones. In view of the therapeutic successes obtained with evening primrose oil in the treatment of neurodermatitis in children, the question arises whether this phytotherapeutic substitution therapy could at least partly replace symptomatic pharmacotherapy in bronchial asthma. It is shown that this will only be successful if one dispenses with the anti-inflammatory effect of the treatment with steroid hormones.

Asthma↗