Biomedical subjects

E A Olsen

Publications and source records attributed to E A Olsen.

At least 37 records · Page 2Linked to original sources

PubMed1992

Generalized papular xanthomatosis in mycosis fungoides.

Xanthomas can occur in association with underlying lymphoproliferative disease, or they can result from lipid deposition in damaged or altered skin. We report a case of generalized papular xanthomas that developed in a patient with Sézary syndrome. The xanthomas were composed of foamy histiocytes that were shown by immunoperoxidase staining to be of the monocyte/macrophage lineage. Electron microscopic studies revealed lipid vacuoles, lysosomes, and myelin figures but no Birbeck granules, features that are consistent with a non-X histiocytosis. Generalized papular xanthomatosis has not been previously described in a patient with cutaneous T-cell lymphoma.

Aged↗

PubMed1992

Effectiveness of various barrier preparations in preventing and/or ameliorating experimentally produced Toxicodendron dermatitis.

BACKGROUND: Despite extensive research on hyposensitization and prior application of topical barrier preparations, efforts to prevent Toxicodendron dermatitis have been only minimally successful. OBJECTIVE: Seven different barrier creams were evaluated for topical protection against experimentally produced Toxicodendron dermatitis in a randomized, double-blind study. METHODS: Twenty patients had the seven barrier creams randomly applied to eight test sites (one untreated area as control) on each forearm before application of the Toxicodendron extract. Development of Toxicodendron dermatitis was followed for 8 days, with measurements of erythema, induration, vesiculation, and global severity taken at each site on days 1, 2, 3, 4, and 7 after Toxicodendron application. RESULTS: The barrier creams Stokogard, Hollister Moisture Barrier, and Hydropel significantly reduced the erythema, induration, and global severity of Toxicodendron dermatitis and did not differ from each other. The percent reductions in global dermatitis severity per day of assessment for the seven barriers in order of effectiveness were as follows: Stokogard, 59%; Hollister Moisture Barrier, 52%; Hydropel, 48%; Ivy Shield, 22%; Shield Skin, 13%; Dermofilm, 13%; and Uniderm, -9%. During the 8-day period, a significantly greater number of test sites pretreated with Stokogard, Hollister Moisture Barrier, and Hydropel were free of dermatitis compared with control sites and sites treated with the other four barriers. CONCLUSION: The results indicate that Stokogard, Hollister Moisture Barrier, and Hydropel are effective in the prevention of Toxicodendron dermatitis.

Administration, Cutaneous↗

PubMed1992

Human test models for bioequivalence of topical corticosteroids: a review.

It would be useful to have a safe, reliable, reproducible, and inexpensive human test model to determine the potency of topical corticosteroids and the bioequivalence of generic agents. Existing human test systems include erythema or inflammation induced by irritants or other stimuli, experimentally induced cutaneous disease-like states, and bioassays in patients with psoriasis. None of these systems is currently reliable enough to warrant general use. Among the shortcomings of existing test systems are the difficulty of producing a uniform, steroid-responsive test condition, the requirement to use occlusion in several of the systems, and the lack of agreement among the results of different tests. Despite these shortcomings, some of the tests may prove useful in comparing innovator and generic topical corticosteroids and in screening the potency of new agents.

Administration, Topical↗

PubMed1992

Systemic steroids with or without 2% topical minoxidil in the treatment of alopecia areata.

BACKGROUND AND DESIGN: Thirty-two patients with mild to extensive alopecia areata, including 16 patients with alopecia totalis or universalis, entered a randomized, controlled trial of a 6-week taper of prednisone followed by either 2% topical minoxidil or vehicle applied three times daily for an additional 14 weeks. The results of this study were compared with an open trial of 48 patients with alopecia areata treated with a similar taper of prednisone with concomitant 2% topical minoxidil applied twice daily. Only terminal hair growth was considered and was quantitated as 1% to 24%, 25% to 49%, 50% to 74%, and 75% to 100%: only those with more than 25% terminal hair regrowth were considered to have had an objective response. RESULTS: At the end of 6 weeks of prednisone, 47% (15/32) of patients had more than 25% regrowth, including nine of 20 patients who had had at least 75% hair loss at baseline. Side effects of prednisone were primarily weight gain and mood changes/emotional lability. At 3 months, six of seven minoxidil-treated patients vs one of six vehicle-treated patients who had an objective response to prednisone maintained or augmented this hair growth: at the 20-week visit, these numbers were three of seven and zero of four patients, respectively. In the open trial, objective hair growth with prednisone was 30%, related to the extent of hair loss at baseline, and this growth persisted in more than 50% of patients at 6 months with the use of 2% topical minoxidil. CONCLUSIONS: A 6-week taper of prednisone offers potential for more than 25% regrowth in 30% to 47% of patients with alopecia areata with predictable and transient side effects. Two percent topical minoxidil three times daily appears to help limit poststeroid hair loss.

Administration, Cutaneous↗

PubMed1991

A double-blind, vehicle-controlled study of clobetasol propionate 0.05% (Temovate) scalp application in the treatment of moderate to severe scalp psoriasis.

The efficacy and safety of clobetasol propionate 0.05% scalp application was evaluated in 378 patients with moderate to severe scalp psoriasis in a double-blind vehicle-controlled parallel group study. After 2 weeks of twice-daily applications, 81% receiving active drug versus 22% receiving vehicle had clearing of 50% or greater. Complete clearing was seen in 26% with active drug and 1% with vehicle. Local side effects were primarily burning or stinging in 11% and 10% of patients treated on an active or a vehicle regimen, respectively. The morning cortisol levels of 168 patients were checked at baseline and again after 2 weeks of drug therapy. Subnormal morning plasma cortisol values were seen in 5% of the patients receiving active drug and in 5% receiving vehicle; 13% of those taking active drug versus 5% taking vehicle had a 50% or greater decrease in morning cortisol at the 2-week visit compared with baseline values. Clobetasol propionate 0.05% scalp application appears to be a safe and an effective treatment for scalp psoriasis.

Administration, Topical↗

PubMed1991

A double-blind, vehicle-controlled study evaluating masoprocol cream in the treatment of actinic keratoses on the head and neck.

This double-blind, vehicle-controlled, multicenter study evaluated the efficacy and safety of a new topical antineoplastic agent, masoprocol, in the treatment of actinic keratoses of the head and neck. Of the 113 patients who applied topical masoprocol twice a day for 14 to 28 days, there was a mean decrease in actinic keratoses from 15.0 to 5.4 and a median percent reduction from baseline actinic keratosis count of 71.4% at the 1-month follow-up visit. Comparable numbers for the vehicle-treated group were 13.4 to 11.1 actinic keratoses and 4.3% median percent reduction. Irritation, as manifested by erythema or flaking, occurred in 61.5% of topical masoprocol-treated patients versus 26.7% of those treated with vehicle and did not correlate with clinical response. Topical masoprocol appears to be useful in the treatment of actinic keratoses.

Administration, Cutaneous↗

PubMed1991

The pharmacology of methotrexate.

Methotrexate is a useful antimetabolite for the treatment of both benign and malignant proliferative disorders. When the pharmacokinetics and potential toxicity of this drug are understood, treatment regimens can be tailored to the underlying kinetics of the target population. With the appropriate knowledge of the importance of urinary excretion of methotrexate and factors that influence this and with the ready availability of leucovorin, toxicity can be avoided in all but the most unusual of circumstances.

Bone Marrow↗

PubMed1991

Central nervous system involvement by cutaneous T cell lymphoma.

Central nervous system disease in cutaneous T cell lymphoma is uncommon and is usually not considered in standard therapeutic regimens. We report three patients who had cutaneous T cell lymphoma with involvement of the central nervous system and review the cases of 28 such patients reported in the literature. Potential risk factors, the reliability of various diagnostic tests, and potential therapeutic modalities are discussed.

Aged↗

PubMed1991

Topical minoxidil in the treatment of androgenetic alopecia in women.

Twenty-eight women with mild to moderate androgenetic alopecia were randomly assigned to apply either 2 percent topical minoxidil or placebo (vehicle) to their involved scalp areas twice daily. At the end of thirty-two weeks, there was a statistically significant increase of nonvellus target area hairs in the minoxidil-treated versus the vehicle-treated group (p = 0.006). Investigator assessment of moderate regrowth showed better results in subjects who used 2 percent topical minoxidil solution than those who used vehicle (p = 0.007), although subjects discerned no difference between treatment groups. Two percent topical minoxidil appears to be effective in the treatment of female androgenetic alopecia.

Administration, Topical↗

PubMed1991

A double-blind controlled comparison of generic and trade-name topical steroids using the vasoconstriction assay.

Six generic formulations of five topical steroids were compared for bioequivalence with their trade-name counterparts using an in vivo vasoconstriction assay. Two of six generic formulations were found to show significantly less vasoconstriction than the respective trade-name topical steroids. The issue of generic equivalence of topical steroids is discussed, with particular emphasis on the vagaries of the vasoconstriction assay.

Administration, Topical↗

PubMed1990

Five-year follow-up of men with androgenetic alopecia treated with topical minoxidil.

Thirty-one men with androgenetic alopecia completed 4 1/2 to 5 years of therapy with 2% and 3% topical minoxidil. Hair regrowth with topical minoxidil tended to peak at 1 year with a slow decline in regrowth over subsequent years. However, at 4 1/2 to 5 years, maintenance of nonvellus hairs beyond that seen at baseline was still evident. Topical minoxidil appears to be effective in helping to maintain nonvellus hair growth in men with androgenetic alopecia.

Administration, Cutaneous↗

PubMed1990

Transdermal viprostol in the treatment of male pattern baldness.

Fifty-seven men were randomly assigned for treatment of androgenetic alopecia with viprostol, vehicle, or placebo twice daily for 24 weeks. Nonvellus hair growth was assessed subjectively by both patient and investigator and objectively through hair counts from macrophotographs of the target area. Nonvellus target area hair counts declined in all three treatment groups at the end of the 6-month study. Viprostol is not an effective hair growth promoter in androgenetic alopecia.

Administration, Cutaneous↗

PubMed1990

A controlled trial of clobetasol propionate ointment 0.05% in the treatment of experimentally induced Rhus dermatitis.

We studied the effectiveness of clobetasol propionate ointment 0.05% in experimentally induced Rhus dermatitis. Clobetasol rapidly decreased the vesiculation at each treated site, although the effect was most prominent at the site to which clobetasol was applied the earliest, that is, at 12 hours after exposure to Rhus extract. On the basis of this experimental model, clobetasol propionate ointment 0.05% may be effective therapy for naturally occurring Rhus dermatitis.

Adult↗

PubMed1990

Natural history of androgenetic alopecia.

Twenty-two men with patterns III-Va androgenetic alopecia were entered into a 10-month study aimed at establishing information on the natural progression of hair loss over a period of time typical of studies of hair growth promoters. The methodology employed was the same as that in published clinical trials of topical minoxidil, but the men refrained from application of either active drug or vehicle to their scalps. As one of the potential explanations for the observed 'placebo-effect' seen in non-vellus hair counts in the topical minoxidil trials was a learning curve of novice hair counters, we were particularly interested in evaluating this in our 'no-treatment' trial. To that end, both a novice (Observer I) and an experienced (Observer II) hair counter independently performed the hair counts. There was a mean decline in the number of vertex target area non-vellus hairs (-17.2 +/- 80.3 for Observer I and -26.6 +/- 63.5 for Observer II) at the end of 10 months; this was not significant. The novice's hair counts were lower than the experienced observer's counts at baseline, and the difference remained relatively constant during the study. Without the application of a placebo, there was no increase in hair growth, making it unlikely that the methods of hair counting led to the 'placebo-effect' seen in prior topical minoxidil studies.

Adult↗

PubMed1990

Sweating in ectodermal dysplasia syndromes. A review.

Ectodermal dysplasia syndromes are currently classified based on constellations of clinical features, a major one of which is the presence or absence of normal sweating. The evaluation of sweating in these disorders has not been performed in a standardized manner, as is shown here in this literature review of a sampling of ectodermal dysplasia syndromes. Accurate evaluation of sweating is important not only in enabling more effective diagnosis and classification of patients with these syndromes, but also in aiding genetic counseling by potential detection of carrier states. A review of the variety of sweat tests currently in use is presented.

Ectodermal Dysplasia↗

PubMed1989

Interferon alfa-2a in the treatment of cutaneous T cell lymphoma.

Twenty-two patients with Stages Ia to IVa cutaneous T cell lymphoma were entered into a controlled trial of interferon alfa-2a (Roferon-A). Patients initially received either 3 million IU interferon alfa-2a, or their dosage was escalated to 36 million IU intramuscularly daily for a 10-week induction period. At the end of induction, 14/22 (64%) of patients had an objective antitumor response: three patients had a complete response, ten patients had a partial response (greater than or equal to 50% resolution of clinical disease), and one patient had a minor response. Responders included those with Stages Ia to IVa cutaneous T cell lymphoma, and remissions have lasted at least 4 to 27.5 months. Three patients progressed from a partial to complete response with further treatment, for an overall complete response rate of 27%. Acute flu-like side effects were generally minor and transient. Malaise/fatigue, depression, anorexia, and weight loss were common chronic dose-related side effects and the most frequent reasons for dose reduction or discontinuation of drug. Leukopenia was the most common laboratory side effect and was also dose-related. Recombinant human leukocyte interferon alfa-2a is an effective and well-tolerated single-agent therapy for early and advanced cutaneous T cell lymphoma.

Adult↗

PubMed1989

Comparative study of systemic interferon alfa-nl and isotretinoin in the treatment of resistant condylomata acuminata.

This study evaluated the effectiveness of systemic interferon alfa-nl versus isotretinoin in the treatment of condylomata acuminata. Patients were randomly assigned interferon alfa-nl, 5 million units, subcutaneously daily for 2 weeks then twice weekly for 4 weeks, or isotretinoin, 1 mg/kg by mouth daily for 6 weeks. Seventeen otherwise healthy men with histologically confirmed condylomata acuminata refractory to standard treatment completed 6 study weeks. Five of nine men (56%) treated with interferon alfa-nl had an objective clinical response (greater than or equal to 50% clearance of baseline disease), with one patient clearing completely. None of the patients treated with isotretinoin alone had an objective response (p = 0.009). Those whose clearing was incomplete with interferon alone were then assigned to interferon therapy three times weekly in combination with daily isotretinoin for 6 weeks, and those receiving isotretinoin were switched to interferon three times weekly for 6 weeks. There was continued clearing in all patients in the combination treatment group but in only three of seven in the sequential treatment group. Side effects were common and generally predictable for each drug but were generally not exacerbated when interferon and isotretinoin were used in combination. Parenteral interferon alfa-nl is an effective alternative treatment modality for patients with refractory condylomata acuminata.

Adult↗

PubMed1989

A double-blind, placebo-controlled trial of acitretin for the treatment of psoriasis.

Acitretin, the active metabolite of etretinate, has the clinical advantage of a much shorter terminal elimination half-life. We report the results of a double-blind, placebo-controlled trial of acitretin (Soriatane) in 15 patients with moderate to severe psoriasis. Patients received 25 mg or 50 mg daily of acitretin or placebo in a double-blind fashion for 8 weeks and then were given 25 to 75 mg acitretin daily during an open study. Only two placebo patients completed the double-blind phase; one patient's psoriasis worsened, and one showed no significant change. All 15 patients then completed at least 8 weeks with 25 to 75 mg acitretin daily, with a moderate change in erythema, scaling, and induration (mean 28% to 37% improvement) but with minimal change in the percentage of body surface area involved. Prolonged treatment (greater than or equal to 20 weeks) with acitretin resulted in further significant improvement and a 44% reduction of involved surface area from baseline.

Acitretin↗