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Biomedical subjects

H H Ibsen

Publications and source records attributed to H H Ibsen.

At least 19 recordsLinked to original sources

Efficacy, tolerability, and safety of calcipotriol ointment in disorders of keratinization. Results of a randomized, double-blind, vehicle-controlled, right/left comparative study.

BACKGROUND AND DESIGN: Disorders of keratinization are a heterogeneous group of diseases that have in common a defect in cornification. The bioactive form of vitamin D3 has been shown to modulate epidermal proliferation and differentiation. The purpose of the present study was to determine the effect of the synthetic vitamin D3 calcipotriol in a randomized, double-blind, placebo-controlled, right/left comparative study. The 67 patients included in the study were at least 12 years of age and had the following diseases: ichthyosis vulgaris (n = 9), X-linked ichthyosis (n = 8), congenital ichthyosis (n = 10), hereditary palmoplantar keratoderma (n = 20), keratosis pilaris (n = 9), and Darier's disease (n = 11). Calcipotriol ointment (50 micrograms/g) and placebo (vehicle of calcipotriol ointment) were applied to all patients twice daily for up to 12 weeks. The patients were allowed to use up to 120 g of calcipotriol ointment per week. RESULTS: At the end of the treatment regimen, calcipotriol ointment had an effect on the improvement of the ichthyoses, although to a variable degree. No therapeutic effect was detected in palmoplantar keratoderma or keratosis pilaris. Eight of 12 patients with Darier's disease had to be withdrawn because of skin irritation or a worsening of the disease. Skin irritation occurred in 18 cases (26%) only on the calcipotriol-treated side, and in one case (1%) only on the placebo-treated side. Nine cases (13%) had irritation on both sides. The amount of calcipotriol ointment used per week was lowest in palmoplantar keratoderma (mean, 11.8 g/wk; range, 2.1 to 25.6 g/wk) and highest in congenital ichthyosis (mean, 59.3 g/wk; range, 11.4 to 94.7 g/wk). There was no clinically significant change of serum calcium levels during the treatment period. CONCLUSION: Short-term treatment with calcipotriol ointment (50 micrograms/g) used in amounts up to about 100 g/wk is moderately efficacious, well-tolerated, and safe in adult patients with various ichthyoses.

Adolescent

[Cholesterol microemboli].

Cholesterol microemboli are caused by cholesterol crystals released from arteriosclerotic plaques in the major arteries. The clinical picture is illustrated by two case histories with symptoms in the form of myalgia, livedo reticularis and gangrene. The diagnoses were verified by demonstration of cholesterol crystals in the affected tissue. The pathogenesis is illustrated and, on the basis of the literature, it is emphasized that cholesterol microemboli are probably often overlooked clinically and that an increasing incidence must be anticipated on account of the increasing frequency of invasive procedures and treatments of arteriosclerotic vascular disease.

Aged

Familial hypotrichosis of the scalp. Autosomal dominant inheritance in four generations.

We describe a Danish family of four generations suffering from hypotrichosis of the scalp. Age at onset was 6-17 years and almost total scalp alopecia was reached by the age of 14-21 years. No associated ectodermal defects were present. Nine of 22 persons covering four generations were affected. Growth of the scalp hair slowly decreased and was accompanied by a gradual, diffuse hair loss without regional variation. A scalp biopsy was performed, revealing a non-scarring alopecia with features of androgenetic alopecia. The pedigree was compatible with autosomal dominant inheritance.

Adult

Psoriasis and polyneuropathy. Three case histories.

Neurophysiological examination of 3 psoriasis patients with symptoms of polyneuropathy revealed varying degrees of both sensory and motor nerve affection and indicated nerve fibre loss as well as demyelination. Previous reports have suggested a connection between peripheral nerves and psoriasis.

Adult

Occurrence of Ureaplasma urealyticus and Mycoplasma hominis in non-gonococcal urethritis before and after treatment in a double-blind trial of ofloxacin versus erythromycin.

The efficacy of ofloxacin, a new quinolone derivate, was tested against that of erythromycin in a prospective double-blind trial in patients with non-gonococcal urethritis (NGU) with special reference to the occurrence of Mycoplasma hominis and Ureaplasma urealyticum. 188 male NGU patients were randomized to treatment with either ofloxacin 200 mg b.i.d. or erythromycin 500 mg b.i.d. for seven days. Before treatment eight (4.3%) patients, five in the erythromycin group and three in the ofloxacin group, were M. hominis positive. At follow-up day 8 and 15 after start of treatment all five in the erythromycin group and two in the ofloxacin group were still positive. U. urealyticum was recovered in 16 patients (8.5%) before treatment. One patient was still positive in the erythromycin group when examined day 15, whereas all patients were negative in the ofloxacin group at both follow-up controls. Clinically, the efficacy of treatment day 15 was 77.4% in the erythromycin group and 84.3% in the ofloxacin group. The difference was not significant. Side-effects occurred in 38.5% in the erythromycin group and in 21.3% in the ofloxacin group. This difference is significant. Ofloxacin is effective in the treatment of NGU in males and is an alternative to conventional antibiotic treatment.

Double-Blind Method

[Epididymitis caused by amiodarone].

A case of epididymitis developed in a 33 year old man after treatment with the anti-arrhythmic agent, amiodarone, for approximately 18 months. No signs of bacterial infection or anatomical abnormalities were found. Amiodarone as the cause of epididymitis has only previously been described on a few occasions. We stress the importance of considering this adverse effect of amiodarone therapy as a differential diagnosis in the etiology of epididymitis.

Adult

Epididymitis caused by treatment with amiodarone.

Epididymitis is described in a man aged 33 who had been treated with the antiarrhythmic agent, amiodarone. No signs of bacterial infection or anatomical abnormalities were found. Amiodarone as the cause of non-infectious epididymitis has been reported. This additional case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.

Adult

Plasma concentrations of complement split product C3d and immune complexes after procainamide induced production of antinuclear antibodies.

Seventeen patients treated with procainamide for cardiac ventricular arrhythmias were followed for up to 40 weeks. Immunological data as a clue to developing the systemic lupus erythematosus (SLE)-like syndrome was emphasized. Ten patients developed antinuclear antibodies (IgG or IgM), but no increase in the plasma concentration of the complement split product C3d or immune complexes, measured by two different methods, was demonstrated. This finding is in contrast to the high levels of both C3d and immune complexes in SLE. The discrepancy may be caused by a lack of immune complex mediated complement activation by the procainamide induced antibodies, or may be due to a difference in severity of disease. The acetylator phenotype of the patients was determined but due to the low frequency of fast acetylators no comparison of the immunological response of the two phenotypes could be done.

Aged

Ichthyosis of steroid sulphatase deficiency. Clinical study of 76 cases.

A detailed clinical study of 76 males with steroid sulphatase deficiency confirmed the ichthyosis of this disorder to be identical with the classical descriptions of recessive X-linked ichthyosis. The appearance of regular ichthyotic scaling seems in most instances to be heralded by a general peeling of the skin. This characteristic feature was registered between age 1 and 3 weeks in 19 of 21 young boys followed due to a placental steroid sulphatase deficiency. Later on, polygonal scales giving a 'dirty' appearance were most pronounced on the distal parts of the body and extensor aspects of the extremities. The ichthyosis aggravates through childhood into adult age.

Adolescent

Lipoprotein electrophoresis in recessive X-linked ichthyosis.

Recessive X-linked ichthyosis (RXLI) is consistently associated with steroid sulphatase deficiency, and a definite diagnosis can be made by measurement of the activity of this enzyme, e.g. in cultured skin fibroblasts and leucocytes. Demonstrating an increased electrophoretic mobility of plasma low-density lipoprotein in RXLI patients has been proposed as a simpler method for the diagnosis of this condition. Our findings in 7 RXLI patients and 7 normal controls confirmed that a discrimination between patients and controls can be obtained by routine lipoprotein electrophoresis. However, due to variation in the results of repetitive performances further studies are needed to evaluate the overall reliability of this diagnostic approach.

Blood Protein Electrophoresis

Steroid sulphatase deficiency disease.

Seventy-six ichthyotic male patients with a biochemically confirmed diagnosis of steroid sulphatase deficiency are reported. Ascertainment was based on either a previous diagnosis of placental steroid sulphatase deficiency (21 probands and 15 secondary cases), or ichthyosis with steroid sulphatase deficiency (29 probands and 11 secondary cases). The ichthyotic phenotype of the first group was indistinguishable from that of the other group, and completely fitting the classic description of recessive X-linked ichthyosis. A prominent skin peeling in early infancy was found to be a characteristic feature of this syndrome. Maldescent of the testis was registered in 9 patients; and testis cancer had been diagnosed in 2 males with normally descended gonads. This high proportion of patients with gonadal abnormalities strongly indicates a relation with the steroid sulphatase deficiency. Corneal opacities, not affecting visual acuity, were seen in 14 out of 28 males by slit-lamp examination.

Adolescent

Familial right ventricular dilated cardiomyopathy.

Cardiomyopathy of unknown cause occurred in three of six siblings. The course of the illness was marked by life threatening supraventricular and ventricular arrhythmias, sinoatrial block, atrioventricular block, and embolism (in one patient). The disease was characterised by right ventricular dilatation. Two of the three patients died aged 32 and 48. No new cases of the disease were found when a further 33 family members from three generations were investigated.

Adult