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PubMed2003

A review of thalidomide's history and current dermatological applications.

Once abandoned because of devastating teratogenic effects, thalidomide has reemerged as an alternative treatment in many dermatologic diseases. In 1998, thalidomide became FDA approved for the acute treatment and suppression of the cutaneous manifestations of erythema nodosum leprosum (ENL). ENL is a systemic disorder that typically occurs after several years of antileprosy treatments, usually for lepromatous leprosy. Off-label uses for thalidomide include: aphthous stomatitis, Behçet disease, pyoderma gangrenosum, chronic discoid lupus erythematosus, systemic lupus erythematosus, lichen planus, prurigo nodularis and sarcoidosis. This review examines the background, pharmacokinetics, mechanism of action, side-effects, and indications of thalidomide.

Dermatologic Agents↗
PubMed1977

Utilization of physician services for dermatologic complaints. The United States, 1974.

The National Ambulatory Medical Care Survey provides data on the "who," "for what complaint," and "to whom" for office visits to office-based physicians. In 1974, complaints referable to the skin accounted for 44 million physicians visits. This represents 7% of the 634 million visits to physician offices made during this period. Dermatologists accounted for 34% of all visits for skin complaints. General and family practitioners accounted for 40% of such encounters. Office visits prompted by dermatologic complaints were frequently less than 16 minutes long. Each office-based dermatologist accounted for an average of 5,600 patient visit per year. According to the dermatologist's diagnosis, 31% of these visits were prompted by acne; warts accounted for an additional 8%.

Acne Vulgaris↗
PubMed1992

Why 100 patients failed to keep an outpatient appointment-audit in a dermatology department.

Failure to keep outpatient appointments is common at all clinics and various explanations may be offered. One hundred attending patients who had failed to keep their previous dermatology clinic appointment were asked the reason for their non-attendance. Many and varied reasons were given but illness (28%), and problems related to appointments (33%) were prominent. They were also asked how they had obtained a further appointment. Stricter follow-up of non-attenders by the hospital including informing the GP, and subsequent GP action if necessary, may improve attendance figures.

Adolescent↗
PubMed1992

[Neurologic manifestations of Behçet disease. Review of the caseload of the Neurology and Dermatology services at the Santa Maria Hospital].

Neurological involvement in a series of patients with Behçet's disease, evaluated at the Departments of Neurology and Dermatology, St. Maria Hospital is reported. Meningoencephalytic or encephalytic were the most common clinical forms, while headache, cerebellar and pyramidal signs were the most prevalent symptoms/signs. On follow-up (range 2-13 years) the majority of the patients had either a progressive or a remitting-progressive course. Magnetic ressonance imaging was the most valuable method of detecting central nervous system lesions.

Adult↗
PubMed1992

Paediatric dermatology.

The format of this collection of skin conditions allows for only a brief discussion of the aetiology and appearance of each entity. Most of them are common skin conditions. Referring to a dermatology reference book will make this presentation more valuable.

Adolescent↗
PubMed1992

[Prescriptions for individually prepared dermatologic agents. I].

The present paper reports the results of a survey of contemporary medical prescriptions of solutions, suspensions and emulsions used in dermatological practice. The obtained results were compared with the district prescription lists from Slovakia. The analysis of contemporary prescription was carried out in 27 districts in the years 1987 and 1989. The results show that 112 drugs are prescribed in the preparation of solutions. Most solutions are composite and 90% of solutions are hydrophilic. An analysis of suspensions revealed that in hydrophilic suspensions the liquid media water-glycerol or spirit-water prevail, and in hydrophobic suspensions nearly always plant oils are used. Emulsions are represented in topical extemporaneous preparations in a smaller amount than solutions and suspensions; it is 0.7% in the set under study.

Czechoslovakia↗
PubMed2003

Difficulties in diagnosing and treating tinea in adults at the Department of Dermatology in Bialystok (Poland).

In the years 1981-2000, the department of dermatology at the Medical University of Bialystok, Poland, carried out a retrospective study of common difficulties in the diagnosis and treatment of tinea. The aim of this study was to assess the incidence of incorrect diagnosis and therapy of tinea and tinea incognito (TI) in the patients hospitalized at the institution over a 19-year period. Tinea was identified in 814 patients (4.3% of all patients). TI was diagnosed in 318 patients (39.1% of all patients with tinea). The most diagnostic-therapeutic problems were observed in the patients with tinea pedis, tinea cutis glabrae superficialis, intertrigo candidamycetica, tinea profunda cutis glabrae and tinea profunda barbae. The most common clinical isolates were T. rubrum, T. mentagrophytes, and Candida albicans. A high percentage of TI was present in comparison with all other tinea conditions.

Adult↗
PubMed1950

Antihistaminic drugs in dermatology.

From the results of treatment of 1,770 patients with dermatologic diseases (1,458 as reported in the literature and 312 observed by the author) it is concluded that antihistaminic preparations are of great value in allergic diseases where it is hypothecated that liberated histamine is the offender, as in acute edematous types of urticaria, erythema multiforme, and some cases of allergic pruritus. The indiscriminate use of these drugs is to be avoided. Antihistaminic drugs are palliative-they do not cure. They often prolong the disease. They give temporary relief from swelling and pruritus. They develop no specific immunity and do not replace immunizing efforts. They do not replace or interfere with epinephrine or ephedrine.

Anti-Allergic Agents↗
PubMed1951

The topical and systemic use of cortisone in dermatology.

Part I of this report deals with the topical use of cortisone in a variety of skin diseases. Fifteen patients with chronic discoid lupus erythematosus, four patients with necrobiosis lipoidica diabeticorum, four with psoriasis, one with lichen planus and one with granuloma annulare were treated with cortisone ointment. All the patients with chronic discoid lupus erythematosus had some degree of improvement. In two patients with chronic lupus erythematosus, complete clearing of the eruption occurred. In four patients with necrobiosis lipoidica diabeticorum remarkable involution resulted. Patients with psoriasis, lichen planus and granuloma annulare were not benefited. Part II deals with the systemic use of cortisone. Eight patients with severe serum sickness-like penicillin reaction responded dramatically to parenterally administered cortisone. In two cases of pemphigus vulgaris and one case of Sulzberger-Garbe disease, the disease was kept in remission with cortisone administered intramuscularly as well as orally. Partial improvement resulted in a case of localized myxedema associated with malignant exophthalmus. Two patients with exfoliative dermatitis due to therapy with heavy metals responded dramatically to cortisone. No beneficial effects were noted in patients with chronic urticaria and atopic dermatitis.The systemic use of ACTH and cortisone in dermatology at present should be confined to patients with known fatal or hopelessly incapacitating diseases and to patients with extreme hypersensitivity reactions which may be protracted or life-endangering, and which can be controlled or cured with a relatively small total dosage of the agents in a short time.

Administration, Topical↗
PubMedDate not supplied

[Report of courses on "Occupational dermatology" and "Occupational skin and respiratory allergies" organized by the Nordic Institute for Advanced Training in Occupational Health (NIVA)].

The Nordic Institute of Advanced Training in Occupational Health (NIVA), has been organising courses for around 10 years, aimed to the constant up-date of Occupational Medicine. The courses "Occupational dermatology" and "Occupational skin and respiratory allergies", held in 2001 and 2002, analysed some occupational medicine aspects such as allergic contact dermatitis in metal workers, latex disease, allergies in odontoiatric workers, correct patch test performing. The courses has underlined the importance of the cooperation between occupational physician and dermatologist or other specialists, and the project of a standard questionnaire monitoring the exposure to allergic substances. This article is a summary of an extended publication available on the following URLs: http://www.unibs.it/medlav http://www.gimle.fsm.it.

Allergy and Immunology↗
PubMed2004

Pityriasis rosea: roles of the dermatology nurse.

Pityriasis rosea, a self-limited exanthematous disease of unknown etiology, is a fairly common exanthem encountered by dermatology nurses and nurse practitioners. Their special roles in diagnosis, symptomatic relief, care for patients with atypical rash, patient education, and counseling are described.

Dermatology↗
PubMedDate not supplied

The IFRA: working towards the continually-improved safety of fragrance ingredients and the importance of a partnership with the dermatological community.

The relationship between the fragrance industry and the dermatological community in the past has not always been perceived as one of partnership. IFRA, the International Fragrance Association, has started a series of initiatives to underline the industry's commitment to market safe products that limit any unavoidable risk to the minimum while at the same time enabling the consumer to choose from a variety of fragranced products. This article describes current projects and future initiatives.

Consumer Product Safety↗
PubMed1992

Lasers in dermatology.

The author gives a resume of the use of the different types of laser in dermatology and outlines the indications and usage for each one. Special emphasis is put on recent changes.

Dermatology↗
PubMed2004

[Contact sensitization to pharmaceutic aids in dermatologic cosmetic and external use preparations].

From April 2001 to December 2002, a group of 514 patients (178 men, 336 women, average age 42.8 years) suffering from chronic eczema were tested by means of epicutaneous tests for contact hypersensitivity to selected auxiliary substances of dermatological external and cosmetic preparations. In 194 patients, the principal diagnosis was atopic eczema. Of the preservatives, the most frequently sensitizing agents were Thiomersal in 13.6%, phenylmercuric acetate in 7.8%, formaldehyde in 5.6%, Bronopol in 5.1%, chlorohexidine in 3.3%, dibromodicyanobutane/phenoxyethanol in 2.9%, chloroacetamide in 2.1%, Kathon CG and parabenes in 1.9%, imidazolidinyl urea and diazolidinyl urea in 1.4%, glutaraldehyde in 1.2%, DMDM-hydantoin in 1.0%, dichlorophen in 0.8%, sorbic acid, phenoxyethanol and triclosan in 0.6%, benzalkonium chloride, Quaternium-15 and chlorocresol in 0.4% and chloroquinaldol in 0.2% of the group of patients. Of antioxidizing agents, it was dodecyl gallate in 2.3%, butylhydroxyanisol in 1.2%, propyl gallate in 0.6%, butylhydroxytoluen in 0.4% of the group o patients and of emulsifiers, alcohols lanae in 5.1%, triethanolamine in 1.6% and propylene glycol in 0.4% of the group of patients. A complete list of contained substances in drug information sheets of both pharmaceutical and cosmetic preparations seems necessary particularly for patients suffering from eczema. The results of the test can serve as feed-back information for the manufacturers of both pharmaceutical and cosmetic preparations.

Adolescent↗
PubMedDate not supplied

Topical immunomodulators in dermatology.

Topical immunomodulators are agents that regulate the local immune response of the skin. They are now emerging as the therapy of choice for several immune-mediated dermatoses such as atopic dermatitis, contact allergic dermatitis, alopecia areata, psoriasis, vitiligo, connective tissue disorders such as morphea and lupus erythematosus, disorders of keratinization and several benign and malignant skin tumours, because of their comparable efficacy, ease of application and greater safety than their systemic counterparts. They can be used on a domiciliary basis for longer periods without aggressive monitoring. In this article, we have discussed the mechanism of action, common indications and side-effects of the commonly used topical immunomodulators, excluding topical steroids. Moreover, newer agents, which are still in the experimental stages, have also been described. A MEDLINE search was undertaken using the key words "topical immunomodulators, dermatology" and related articles were also searched. In addition, a manual search for many Indian articles, which are not indexed, was also carried out. Wherever possible, the full article was reviewed. If the full article could not be traced, the abstract was used.

Administration, Topical↗
PubMed2004

Dermatology research within the Department of Defense.

Dermatologists in the US Department of Defense have made numerous research contributions over the past several decades. This article focuses on research performed during the past few years. Space does not permit a complete discussion of all research activities of the numerous Department of Defense investigators, and this review concentrates on the work of a few physicians who have made an impact in 4 areas of dermatologic research.

Alopecia↗
PubMed2004

Vibration anesthesia: a noninvasive method of reducing discomfort prior to dermatologic procedures.

In some dermatologic and cosmetic procedures, local anesthesia is not sufficient for relieving pain; often patients are averse to injections. We propose vibration anesthesia, the use of vibration delivered with commercially available inexpensive massagers to reduce discomfort. We find the analgesic effect of vibration helpful in minimizing pain in patients undergoing injections of botulinum toxin type A treatment for hyperhidrosis, injection of filler substances such as Restylane and Juvederm, laser therapy for leg veins, nail-fold injections, Q-switched laser treatment of tattoos, incision and drainage of abscesses, and cautery of facial warts, as well as facilitating anesthetic injections for needle-phobic patients. We expect that additional uses will be found as experience with this modality grows. Although the use of vibration anesthesia generally does not eliminate pain completely, it can serve to make the injection or procedure much more tolerable.

Anesthesia↗
PubMedDate not supplied

Combination therapy in clinical and cosmetic dermatology: the marriage of device and drug.

The first generations of lasers used in clinical and cosmetic dermatology achieved their effects by means of epidermal and dermal ablation. While effective in removing some of the stigmata of photodamage including pigmentary changes and rhytides, vascular abnormalities associated with such conditions as melasma and rosacea, were not sufficiently effective. The new generation of laser and non-laser light devices (eg, intense pulsed light or IPL) offer excellent results in the management of clinical and cosmetic conditions, including significant changes in improvement in vascular conditions such as rosacea and actinic damage and stimulating dermal collagen production, without significant injury to the epidermis. The combination of light therapies and topical agents adds to the efficacy of these procedures, particularly in post-procedural maintenance. Light-based therapies have been an important addition to the anti-acne armamentarium as they are effective and do not add to the increasing bacterial resistance problem.

Acne Vulgaris↗