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Biomedical subjects

A Sakuntabhai

Publications and source records attributed to A Sakuntabhai.

23 records · Page 2Linked to original sources
PubMed1993

Response of psoriasis to twice weekly PUVA.

In the U.K., PUVA treatment for psoriasis is usually given three times weekly, with the starting dose of UVA chosen according to the skin type of the patient. Observations on the time-course and dose-response characteristics of PUVA erythema suggest that larger doses of UVA could be used safely, provided that the frequency of PUVA treatment is reduced. We have examined this by treating 100 patients with chronic plaque-type psoriasis with a PUVA protocol in which treatment using oral 8-methoxypsoralen was given twice weekly, with the starting dose of UVA based on each patient's minimal phototoxic dose, and with weekly UVA dose increments calculated as a percentage of the dose used in the previous treatment. Clearance of psoriasis was achieved in 92% of patients. The median number of treatments required for clearance was 12, and the median cumulative UVA dose for clearance was 52J/cm2. Although erythema occurred at some stage during the course of PUVA in 48% of patients, in only 16% of cases was the erythema of sufficient intensity to result in more than one treatment being missed. These results compare favourably with previous studies in which treatment was given three or four times weekly. Thus, twice weekly PUVA treatment for psoriasis is at least as effective as treatment given more frequently, and may be safer, as lower cumulative UVA doses are required for clearance. It also allows for more efficient operation of a PUVA unit and is more convenient for patients.

Adolescent↗
PubMed1993

Clinical and histopathological features of secondary syphilis.

Fifty-four patients with secondary syphilis were studied in regard to the clinical manifestations, response to treatment and histopathology of the skin lesions. The correlation between the skin lesions and histopathology, between the duration of skin lesions and VDRL titer, between type of skin lesions and VDRL titer were also determined. The clinical manifestations varied from macular, maculopapular, papular, papulosquamous and urticarial lesions. The hair loss usually occurred on the scalp, but the eyebrows or even total body hair loss could occur. The response to treatment was good, only one patient relapsed. The histopathology was related to the clinical manifestations, there was sparse inflammatory cell infiltration in the dermis in macular lesions, but more dense infiltration as well as more epidermal change in papular and papulosquamous lesions. There were significant correlation between the duration of skin lesions and VDRL titer, but no correlation between types of skin lesions and VDRL titer.

Adolescent↗
PubMed1993

Intralesional steroid injection after nerve block anesthesia in the treatment of orofacial granulomatosis.

BACKGROUND: The facial disfigurement produced by orofacial granulomatosis causes enormous embarrassment. None of the many therapies recommended is reliably successful. Oral corticosteroids cause significant side effects and repeated injections of small quantities of triamcinolone are painful. We have injected large volumes of triamcinolone after numbing the lips using nerve block anesthesia. OBSERVATIONS: Nine patients (six males and three females, aged 10 to 47 years) with orofacial granulomatosis were investigated. No evidence of an allergic cause was found using patch or contact urticaria tests. Eating chocolate produced lip swelling in one man, and his lip shrank in size after avoiding this for 12 months. Five patients, aged 10 to 24 years, were treated with high-volume intralesional triamcinolone injections (3 to 10 mL of 10 mg/mL) after first numbing the lips using infraorbital nerve branch and mental nerve block. After 6 weeks, the lip size returned to normal in four patients and was reduced in a fifth. One patient was injected on four occasions over a 2-year period; in four other patients treated once, lip size remained reduced for over 10 months. CONCLUSION: Intralesional triamcinolone reduces lip swelling in patients with orofacial granulomatosis. Numbing the lips by nerve block anesthesia before triamcinolone injection enables adequate volumes and repeated injections to be given painlessly.

Adolescent↗
PubMed1991

Topical steroid induced chronic demodicidosis.

We report a 39-year-old female patient who developed pruritic erythematous telangiectatic patches with scaly follicular papules on the neck and upper chest for 4 years. Ten per cent potassium hydroxide preparation of skin scrapings revealed Demodex folliculorum. Histology showed three Demodex mites in one of the hair follicles. She was treated with a topical steroid without improvement. The skin lesions and Demodex mite disappeared after a single application of 1 per cent gamma benzene hexachloride but twice daily application of 1 per cent gamma benzene hexachloride for 2 weeks was needed to prevent recurrence.

Administration, Topical↗