Methotrexate: anti-inflammatory or antiproliferative?
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Biomedical subjects
Publications and source records attributed to E F Sherertz.
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The format of the 4-week dermatology elective rotation at the University of Florida is presented. A 20-item case example slide test was given as a pre-test and as a post-test to 12 internal medicine residents and 41 fourth-year medical students during the elective. Results indicate that the residents (48% correct) and students (46% correct) did not differ in their recognition abilities for common dermatoses at the beginning of the elective. Both groups improved their scores significantly at the end of the dermatology elective (residents, 87% correct; students, 82% correct). These results indicate the usefulness of a dermatology elective program in improving dermatologic skills and of a clinical pre- and post-test approach for the crude assessment of such acquired knowledge for both rotating students and residents. This feedback can be helpful in modifying teaching programs for dermatology educators.
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Squaric acid diethylester and squaric acid dibutylester have been used in contact sensitization therapy of alopecia areata. This study investigated the application of these esters or squaric acid alone to hairless mouse and human skin in vitro to determine squaric acid flux from the various preparations. Measurable amounts of squaric acid were delivered through skin by squaric acid itself, but flux was lower than for that delivered by the two esters. These results support the proposal by Noster that the esters combine with a protein to form an antigen while squaric acid can not and that this explains why the esters are active in contact sensitization and the acid is not. We suggest that the results of previous studies showing that the diethyl ester of squaric acid was a less effective sensitizer than the dibutyl ester may have been due to decomposition of the ethyl ester to squaric acid.
A case of procainamide-induced lupus erythematosus with prominent cutaneous features is presented. The patient subsequently showed typical lesions of lichen planus, which has been associated with spontaneously occurring lupus erythematosus, but not previously reported with drug-induced lupus or as a result of procainamide therapy. A review of the immunologic alterations induced by procainamide raises questions about possible mechanisms causing the lupus and lichen planus.
Acanthosis nigricans is well recognized in its clinical association with several types of insulin-resistant syndromes, and skin involvement is usually unresponsive to local treatment or management of diabetes. A young woman with a lipodystrophic form of diabetes, hypertriglyceridemia, and severe generalized acanthosis nigricans was placed on a diet with fat supplementation in the form of omega-3-fatty-acid-rich fish oil. She was observed to have striking improvement in the appearance and extent of acanthosis nigricans while receiving this regimen. This occurred despite continued therapy with niacin (nicotinic acid), an agent associated with acanthosis nigricanslike skin changes.
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Three members of a family with numerous ectodermal abnormalities are described. These anomalies primarily include patchy alopecia beginning in childhood, premature cataracts, widespread keratosis pilaris, and psoriasis. The alopecia and premature cataracts appear to follow an autosomal dominant inheritance pattern with incomplete penetrance and appear to be linked. Psoriasis also occurs in several members of this family and probably represents a separate but possibly related genodermatosis. This kindred has features of both keratosis follicularis spinulosa decalvans and ichthyosis follicularis, and the disorder seems to fit into the group of follicular hyperkeratosis disorders.
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Values for experimental permeability coefficients of 5-fluorouracil (5-FU) in 7 single- and 4 two component vehicles were determined from flux measurements through hairless mouse skin in diffusion cells and from solubility data. Theoretical partition coefficients of 5-FU between vehicle and skin were determined from solubility parameters of drug, vehicle, and skin, and from this theoretical permeability coefficients were estimated. Comparison of theoretical with experimental values for the permeability coefficients showed a good correlation for vehicles with solubility parameters between 12-18 (cal/cm3)1/2. For vehicles or mixtures of vehicles with solubility parameters in the range of 8-12 (cal/cm3)1/2, increases in flux and permeability coefficients were seen compared with theoretical predictions, possibly due to the similarity in solubility parameters of the vehicles to that of skin (10 cal/cm3)1/2. There was an inverse relationship between 5-FU solubility in the vehicles and flux or permeability coefficient that corresponded approximately to the point where the solubility parameters of drug and vehicle were the same.
Clinical and in vitro evidence suggest that pretreatment of skin with a drug or vehicle can influence topical drug delivery. In this study, hairless mouse skin in diffusion cells was treated for 48 h with topical applications of vehicle alone (oleic acid (OA), isopropyl myristate, octanol (OCT), dimethylformamide, propylene glycol (PG), ethylene glycol (EG), formamide), or mixtures of OA and PG, or with 5-fluorouracil (5-FU) suspensions in each of these vehicles. Twenty-four hours after removing the initially applied agent, a standard suspension of theophylline in PG was applied to the skin surface and the flux of theophylline was determined over the next 48 h. Skin pretreatment with vehicle alone increased theophylline flux 1.6-(EG) to 122-fold (OCT) over control experiments in which the skins were not pretreated. Pretreatment with nonpolar vehicles with lower solubility parameters (OA, OCT, or mixed vehicles containing one of these) had the greatest effect on subsequent theophylline flux. Pretreatment with 5-FU in various vehicles caused a subsequent increased theophylline flux similar to the effect of vehicle alone, except for pretreatment with 5-FU in vehicles which did not have much effect themselves. In those instances, theophylline fluxes up to 16-fold over the effect of those vehicles alone were observed.
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