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[Cutaneous side effects of gold therapy. Clinical and histologic results].

Based on our own observations in 40 patients and a review of the literature the clinical and histological aspects of dermatitis caused by gold therapy are discussed. There is a broad spectrum of cutaneous side effects following gold therapy. In most of the patients a nonspecific dermatitis can be observed. The skin lesions may also mimic lichen planus, pityriasis rosea or various forms of eczema, obscuring early diagnosis. Histologically four types of reactions can be differentiated including a dermatitis type, vasculitis type, a lichenoid and an urticarial type.

Arthritis, Rheumatoid↗

Short-term treatment of dandruff with a combination of propylene glycol solution and shampoo.

Many studies now indicate an association between the lipophilic dimorphic yeast Pityrosporon ovale and dandruff. Propylene glycol has been proved effective in the treatment of pityriasis versicolor, Pityrosporon folliculitis, and seborrheic dermatitis. The patients in this study found treatment with a combination of propylene glycol, ethanol, and water, used with a shampoo, to be effective, easy to use, and cosmetically attractive. No side effects were observed by the patients.

Adult↗

Parapsoriasis and related conditions.

Classification of parapsoriases is revised into a simple practical table. Pityriasis lichenoides (guttate parapsoriasis) is not a type of parapsoriasis. The clinical features of small patch and large plaque parapsoriasis are described in detail. Six clinical varieties of large plaque parapsoriasis and three clinical varieties of exfoliative dermatitis including Sézary syndrome have been clearly recognized as distinctive categories. Histopathology is useful for the diagnosis of parapsoriasis and mycosis fungoides. Sézary cell count is not significant for the diagnosis of Sézary syndrome.

Dermatitis, Exfoliative↗

Antibacterial efficacy of Fabry's tinctura on the resident flora of the skin at the forehead. Study of bacterial population dynamics in stratum corneum and infundibulum after single and repeated applications.

The in-vivo antibacterial activity of Fabry's tinctura (FT), a 3 w% salicylic acid, 1 w% phenoli liquefacti containing 50 v/v% isopropanol used in dermatology for the treatment of erythrasma, pityriasis versicolor, acne vulgaris a.o. on the human resident skin flora was assessed by a new test method in comparison to 60 v/v% isopropanol. The test method consists of a detergent scrub method (DSM) in combination with the cyanoacrylate method (CAM) thus allowing the quantitative determination of bacterial densities in two depth compartments of human skin, separately for bacterial genera. The most important innovation of this test method is that its arrangement, especially the separate evaluation of the genera of the resident flora, makes it possible to examine the ability of an antimicrobial agent to invade different depth compartments by its bioactivity against the resident flora and to measure short-and-long-term efficacies under physiological conditions. Our findings in 120 volunteers indicate that compared to 60% isopropanol FT is able to reduce bacterial density in superficial and deep skin compartments immediately after a single application equally well, but for a significantly longer period. In repeated applications, 60% isopropanol does not produce a cumulative or long-lasting effect, but it causes an abundant rebound growth of Propionibacterium spp. in the lower skin compartment. FT, however, shows a cumulative antibacterial effect at the surface and in the depth persisting up to four days after the last application. It is concluded that by its salicylic acid and phenolic content FT is an effective drug for the topical antimicrobial therapy of skin diseases.

1-Propanol↗

Skin diseases in children in Singapore.

Singapore has developed over the past 3 decades with improvement in housing, nutrition and general health. The pattern of skin diseases has changed from conditions like pyodermas and malnutrition to predominantly eczemas. The paediatric cases seen at Middle Road Hospital consist of 13% of general dermatology cases (509 of 37,964 total new cases in 1986). About 2.7% (138) of the children were below 1 year, 32.5% (1630) were below 1-4 years and 64.5% (3251) were below 14 years of age. The ten most common dermatoses (1986) follow a similar trend in most of the developed towns of Asia. This includes eczemas 32.0% (1603 cases); 14.5% (730) of atopics, non-specified eczemas 9.6% (481), hand eczema 4.1% (209), contact dermatitis 1.7% (90), discoid eczema 1.15% (57), seborrhoeic 0.7% (36). The remaining are viral warts 6.8% (342), scabies 3.2% (302), acne 3.7% (180), pyoderma 3.5% (175), dermatophytes 3.3% (169), urticaria 2.6% (134), pityriasis rosea 0.1% (51) and vitiligo 0.09% (46).

Adolescent↗

[Clotrimazol therapy of skin mycoses].

Clinical evaluation of a 1% clotrimazole cream and solution on 236 in and out patients with different clinical manifestations of mycotic infections was done. Clotrimazole, both cream and solution, is an effective and well tolerated agent in the treatment of infections due to dermatophytes and yeasts. Best results were recorded with patients suffering from pityriasis versicolor and erythrasma, and interdigital erosion.

Administration, Topical↗

Dermatological manifestations of toxic agents.

A great variety of cutaneous disorders can be seen as reactions to toxic substances. To limit the extent of this review, cutaneous manifestations known to have an immunological mechanism are simply listed with pertinent references. The report has been focused to cover the cutaneous manifestations of toxic agents of non-immunological and unknown mechanisms. Entities discussed include acne, alopecia, dermatitis caused by spider bites, pityriasis rosea, and chemically-induced scleroderma.

Humans↗

[Cutis "trunci variata." A new genetic dermatosis].

A maculo-hypochromic condition is not rarely seen in brown-skinned adolescents and young adults, that may spread over the skin of the trunk, specially the lumbar, sacral and epigastric regions assuming a considerable psychologic important. It is generally confused with pityriasis versicolor or its hypochromic sequelae. The histologic and genetic study of the condition remains undone. It is provisionally considered among genodermatoses and the name cutis trunci variata is being proposed for it.

Adolescent↗

Efficacy and tolerance of fenticonazole versus miconazole cream.

On the basis of a randomized scheme, 40 patients affected by pityriasis versicolor, candidiasis or dermatophytosis were treated with fenticonazole 2% cream or with miconazole 2% cream. Clinical healing was obtained in 16 patients and there were four improvements in those treated with fenticonazole. In those treated with miconazole there were 14 clinically healed and five improvements. Only in two cases treated with miconazole and in one with fenticonazole, microscopic and cultural analysis had not become negative by the end of treatment. Both drugs were well tolerated. At the end of the study it was concluded that fenticonazole 2% cream is an effective antimycotic with an equal or even higher activity than miconazole.

Adolescent↗

[Folliculitis granulomatosa perforans profunda: an independent perforating dermatosis?].

A peculiar perforating dermatosis was observed in two adolescent male patients consisting of a persistent, disseminated, asymptomatic, follicular, discretely hyperkeratotic papular eruption. Histologically a massive granulomatous panfolliculitis was present with partial destruction of the pilary complex and occasional perforation of hairs through the infundibular wall. Aggregations of keratin fragments were scattered throughout the corium. These histological findings clearly separate the condition from perforating folliculitis, pityriasis rubra pilaris and Kyrle's disease. Differentiation from the perforating type of keratosis pilaris is more difficult.

Adolescent↗

Taxonomy of Exophiala werneckii and its relationship to Microsporum mansonii.

Study of the neotype culture of Exophiala werneckii (Cladosporium werneckii), as well as additional isolates, has shown that the yeast-like and hyphal conidiogenous cells are annellides. E. werneckii cannot be accommodated in Cladosporium, a genus characterized by catenulate holoblastic coanidia. E. werneckii and the dematiaceous hyphomycete that Castellani misidentified as Microsporum mansonii (Cladosporium mansonii) are two entirely different fungi. M. mansonii is considered to be a synonym of the Malassezia furfur since both names were used to describe in tissue the etiologic agent of pityriasis versicolor.

Cladosporium↗

Clinical results of photochemotherapy. The Cleveland Clinic experience.

PUVA therapy has proved to be beneficial for dermatologic conditions such as psoriasis, vitiligo, and mycosis fungoides. Attempts have been made to treat other diseases with the modality; five patients with pityriasis rubra pilaris were treated, with only a partial response noted in one. A poor to fair response was seen in treating a small group of patients with cystic acne, atopic dermatitis, and neurodermatitis. As might be expected, no response was seen in one patient with Darier's disease. At present, photochemotherapy must be viewed with cautious optimism. Strict adherence to a rational treatment approach and close longterm follow-up observations are essential for determining the safety of this modality.

Evaluation Studies as Topic↗

Tinea versicolor: treatment and prophylaxis with monthly administration of ketoconazole.

Twenty-two patients with tinea versicolor (pityriasis versicolor) were treated with a single 400 mg dose of ketoconazole and evaluated one month later. All patients were found to be clinically cured when examined with Wood's light and microscopic techniques approximately one month after the initial dose. Hypopigmented macules persisted for several months in most patients. Prophylaxis with single monthly doses of 400 mg of ketoconazole has resulted in one recurrence to date, with follow-up for four to fifteen months (mean of 8.2 months) in twenty patients. No side effects from ketoconazole were reported by any of the patients.

Adolescent↗

Prevalence of skin diseases in old age.

The prevalence of skin disorders was studied in an elderly population comprising 584 individuals. The mean age was 80 years (range 55-106). The prevalence of pityriasis of the scalp and asteatosis was high, 44.3% and 28.9%, respectively. Psoriasis vulgaris was found in 2.9%, vitiligo in 1.2%, and contact dermatitis in 3.8% of the group.

Aged↗

Seborrhoeic dermatitis and napkin dermatitis.

Seborrhoeic dermatitis is described clinically and histologically with emphasis upon the vague definition of the disease. The relationship between pityriasis asteatosa and psoriasis is discussed. Napkin dermatitis is subdivided into infantile seborrhoeic dermatitis and true napkin dermatitis. The relationship between the former and psoriasis is unsettled. The role of microorganisms is stressed. Granuloma gluteale infantum is a condition caused by potent topical steroids and C. albicans.

Adrenal Cortex Hormones↗

[Oral treatment with retinoids-mechanisms of action and clinical experiences in erythematosquamous and other dermatoses].

Retinoids possess regulatory influences on growth and differentiation of epithelial tissues. They induce a population of keratinozytes with normal pattern of differentiation, they have antiproliferative properties, and they show antineoplastic effects by inhibition of malignant transformation of cells in vitro. Also the dermis undergoes distinct alterations under oral administration of retinoids. By stimulating T-lymphocytes and by inhibition of neutrophil migration retinoids seem to develop immunmodulating and antiinflammatory effects. The aromatic retinoid Etretinate is therapeutically used in severe forms of psoriasis and in various genodermatoses with disorders of keratinization as for example ichthyosis, dyskeratosis follicularis Darier, and pityriasis rubra pilaris.

Acne Vulgaris↗

[Human papillomavirus and oncogenesis (author's transl)].

Various types of human papillomavirus (HPV) are responsible for different warts. Characteristic of HPV infections is a lowered cell-mediated immunity (CMI), especially defective in cases of epidermodysplasia verruciformis induced by HPV5. The malignant transformation seems to be related with the type of HPV, and not with the grade of CMI defect and duration of the infection. A life-long infection with HPV3 in cases of EV does not induce a malignant transformation in spite of heavily depressed CMI. The oncogenic potential has seemingly HPV5 responsible for red plaques and pityriasis versicolor-like lesions characteristic of EV. Malignant transformation, although rare, may also occur in long-lasting cases of genital warts (Buschke-Loewenstein-disease) and juvenile larynx-papilloma. The most important problem is an early diagnosis and prophylaxis of genital cancers in women. This was made possible by cytological and virological studies of cervical dysplasia. In the condylomatous and non-condylomatous lesions of the colli uteri virus particles have been found using the immunoperoxidase technique and immunserum against disrupted viral particles, i.e. against the common HPV antigen. However, the type of HPV can not be determined by this method. Using the same immunsera virus particles were found also in the bowenoid genital papules. The best model for human oncogenesis remains EV. The clinical and pathological morphology, virological and immunological studies on the non-specific and HPV-type specific humoral and cellular immunity are presented in detail.

Animals↗

[Ketoconazole. 3 years' experience with a new orally active broadspectrum antimycotic].

Ketoconazole is an orally high effective broad-spectrum antimycotic of the imidazole series. It is very well tolerated and stands out by its long-lasting therapeutic serum levels, lack of development of resistant fungi, simple administration and low toxicity. Own experience has shown its high efficacy in pityriasis versicolor, mycoses due to dermatophytes, skin and mucous membrane candidoses and chronic mucocutaneous candidosis syndromes. Its effect in systemic mycoses is promising. Consistent follow-up of laboratory data did not suggest any changes due to ketoconazole even after more than one year of treatment.

Administration, Oral↗