PubMed Health⌕ Search

Biomedical subjects

E Lehmuskallio

Publications and source records attributed to E Lehmuskallio.

7 recordsLinked to original sources

Thermal effects of emollients on facial skin in the cold.

Ointments are traditionally used in Finland for protection against facial frostbite. Recent epidemiological reports showed unexpectedly, however, that the use of ointments is a statistically considerable risk factor for frostbite of the face and ears. The effects of 4 different emollients on facial temperature were studied in 46 acute cold exposures. The voluntary test persons sat in a cold chamber after emollients were applied thickly on half of the face, while the other half acted as an untreated control. Thermistors and an infrared scanner were used to measure skin temperature of symmetrical areas of the face. The thermal sensations on the corresponding sites were also recorded. Test emollients more often had an objectively cooling than a warming effect on facial skin. However, white petrolatum often produced a subjectively warming skin sensation. "Protective" ointments may cause a false sensation of safety, leading to increased risk of frostbite due to neglect of other protective measures.

Adult↗

Emollients in the prevention of frostbite.

47% of Finnish conscripts had had at least one frostbite of the head (42% on the ears, 23% on the face) at the age of 19. Non-medicated ointments are traditionally used in Finland for protection against facial frostbite without scientific evidence of their benefit. In studies on cold protecting emollients it was found that 21% of the male conscripts in Finland had used them in the cold. 84% of the users had experienced their effect as somewhat or clearly protective. However, in a controlled prospective epidemiological study of 913 cold injuries of the head, the use of cold protective ointments was associated with an increased risk of frostbite to the head (odds ratio 4.5 for ear frostbite, 5.6 for nasal frostbite and 3.3 for frostbite on other parts of the face). The thermal insulation provided by different emollients in the cold was minimal in in vitro experiments using a skin model. In in vivo studies with test subjects the skin on the applied half of the face cooled at least as quickly as the untreated half. However, when white petrolatum was applied, the subjective skin perception of a test persons was warming in the majority of the tests, in contrast to objective measurements. "Protecting" emollients seem to cause a false sensation of safety leading to an increased risk of frostbite probably mainly through neglect of efficient protective measures.

Adult↗

Thermophysical effects of ointments in cold: an experimental study with a skin model.

The use of emollients on the face is a traditional way to protect the skin against cold injuries in cold climate countries like Finland, but their preventive effect against frostbite has been questioned. The purpose of this investigation was to define the thermal insulation and occlusivity of ointments in cold by using a skin model with a sweating hot plate. The properties of four different emollients were studied in both dry and humid conditions simulating transepidermal water loss, sweating, and a combination of sweating and drying. The thermal insulation of ointments applied on a dry surface was minimal. Evaporation of water from an oil-in-water cream caused significant cooling for 40 min after its application. The diffusion of water through the applied emollients changed their thermal effects depending on their composition and on the amount of water. Low input of water increased and high input diminished slightly the thermal resistance of ointments. The minimal or even negative thermal insulation of emollients in varying conditions gives them at best only a negligible and at worst a disadvantageous physical effect against cold.

Cold Temperature↗

Cold protecting ointments and frostbite. A questionnaire study of 830 conscripts in Finland.

Application of ointments to the face is one of many measures used to avoid frostbite of the head in cold climates. A recent epidemiological study indicated, however, that the use of ointments in the cold may be a considerable risk factor in development of frostbite of the face and ears. A questionnaire on the use of protective ointments was completed by 830 young male conscripts divided into 4 groups by climatic home region on the south - north axis of Finland. Personal estimates of cold exposure, sensitivity to cold, smoking, and cumulative incidence of frostbite to the face and ears were reported. Twenty-one percent of the conscripts had used cold protective ointments, mostly at school age or earlier. In 25% of the conscripts' families some other member (mostly women and children) had used emollients in order to prevent cold injuries. Both the conscripts and their families living in southern Finland used protective ointments more often than those in northern Finland. Almost half (47%) of the conscripts had had frostbites of the head, 42% of the ears and 23% of the face. Those who had used ointments in the cold had a significantly higher cumulative incidence of frostbites on the face (p=0.0031), especially on the cheeks and chin. Their subjective experience concerning the protective effect of ointments in the cold was somewhat or clearly positive in 84% of respondents. The controversy between subjective experience and increased incidence of facial frostbite in ointment users needs further investigation.

Adolescent↗

Merthiolate hypersensitivity and vaccination.

Epicutaneous tests with 0.1% merthiolate in petrolatum showed hypersensitivity in 96 of 4647 eczema patients (2.0%) and in seven of 105 healthy recruits (7%). There was a marked preponderance of young age classes in the eczema group. Twelve of 41 merthiolate-positive patients tested reacted to mercury alone, three to thiosalicylic acid alone and one to both. The remaining 25 patients reacted to neither of the individual components although the merthiolate complex as a whole gave a positive test result. Forty-five of the merthiolate-positive patients were tested subcutaneously with 0.5 ml of a 0.01% merthiolate solution, i.e. a dose equal to that contained in one shot of tetanus toxoid, for example. Nine patients developed a local reaction at the site of the injection, and the area became eczematous in four cases. In one of the patients the eczema spread over the body, causing fever. Since merthiolate-sensitive patients also react to merthiolate administered intracutaneously, the vaccinator should avoid the use of a needle whose outer surface has been contaminated when the vaccine was aspirated from the bottle. However, even when this precautionary measure is taken, local reactions can be expected in such a high percentage of merthiolate-sensitive persons that merthiolate in vaccines should be replaced by another antibacterial agent.

Adolescent↗

The liver in sarcoidosis.

Neddle biopsies of the liver were performed in 121 cases of sarcoidosis. Granulomas compatible with sarcoidosis were seen in 24 percent of the cases. Liver function tests (serum alkaline phosphatase, serum aspartate aminotransferase, serum alanine aminotransferase, and bromsulphthalein clearance test) were performed on 325 patients with sarcoidosis and on 132 with non-sarcoid erythema nodosum (EN). Pathological findings were seen especially in patients with extensive EN, without any correlation with the disease responsible for the eruption. Hepatic granulomas were found more often in patients with sarcoid changes in lung parenchyma than in those with bilateral hilar adenitis only. There were no other definite correlations between hepatic granulomas and other clinical and laboratory findings. The incidence of pathological results in this study was clearly lower than, e.g., in the USA, thus reflecting the good prognosis of sarcoidosis in the Scandinavian countries.

Acute Disease↗

Frostbite of the face and ears: epidemiological study of risk factors in Finnish conscripts.

OBJECTIVE: To determine the incidence of and the risk factors for local cold injuries of the face and ears in peacetime military service. DESIGN: Prospective, controlled epidemiological study using a questionnaire. SETTING: Finnish defence forces, 1976-89. SUBJECTS: 913 young male conscripts with local frostbite of the head that needed medical attention and 2478 uninjured control conscripts. MAIN OUTCOME MEASURES: Type of activity, clothing, and other risk factors at the time of cold injury. Odds ratios were used to calculate risk. Controls were handled as one group. RESULTS: The mean annual incidence of frostbite was 1.8 per 1000 conscripts. Frostbite of the ear was most common (533 conscripts (58%)), followed by frostbite of the nose (197 (22%)) and of the cheeks and other regions of the face (183 (20%)). Most conscripts (803 (88%)) had mild or superficial frostbite. Risk factors included not wearing a hat with earflaps (odds ratio 18.5 for frostbite of the ear); not wearing a scarf (odds ratio 2.1 and 3.8 for frostbite of the ear and cheeks respectively); using protective ointments (odds ratio 3.3, 4.5, and 5.6 for frostbite of the cheeks, ear, and nose respectively); being extremely sensitive to cold and having hands and feet that sweat profusely (odds ratio 3.5 for frostbite of the nose); and being transported in the open or in open vehicles under windy conditions (odds ratio 2.2 for frostbite of the cheek). CONCLUSIONS: Wearing warm clothing, including a scarf and a hat with earflaps, helps to prevent frostbite. Each person's sensitivity to cold may also be important. The routine use of protective ointments should not be recommended.

Adult↗