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Biomedical subjects

I Effendy

Publications and source records attributed to I Effendy.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Amantadine-induced livedo reticularis].

A 63-year old women developed livedo reticularis during treatment with amantadine. This reversible side effect of amantadine has been most often seen in women and is frequently associated with persistent ankle edema. We discuss the signs and symptoms, pathogenesis and treatment of amantadine-induced livedo reticularis.

Adult↗
PubMed1998

[Corymbiform nevus cell nevus].

There is a wide morphological variety in the appearance of melanocytic nevi. We report a case of a 77-year-old woman with a pedunculated, lobulated intradermal nevus on her trunk. For this grape-like clinical variant, we propose the term "corymbiform nevus".

Aged↗
PubMed1998

Coping with acne vulgaris. Evaluation of the chronic skin disorder questionnaire in patients with acne.

The present study investigated how patients with acne vulgaris cope with their disease. By means of questionnaires, relations and interactions between acne and psyche were evaluated. In addition to the evaluation of a specific questionnaire for patients with chronic skin disorders (CSD), assessing psychosocial impairment by the disease, depression and social anxiety were investigated in patients with acne. The study included 50 patients with acne. The CSD showed significant correlations with Beck's depression inventory, the interaction-anxiety questionnaire and the health locus of control scale. The CSD revealed significant differences compared to a control group of 33 patients with healthy skin. Furthermore the patients' attitudes towards triggering factors and disease-related limitations in everyday life are presented. The results of the study demonstrate that patients with acne suffer from emotional distress and psychosocial problems caused by their disease; however, impairment is not correlated with the objective severity of acne.

Acne Vulgaris↗
PubMed1997

Short-term immunotherapy: a prospective, randomized, double-blind, placebo-controlled multicenter study of molecular standardized grass and rye allergens in patients with grass pollen-induced allergic rhinitis.

BACKGROUND: Short-term immunotherapy (STI) can be beneficial for patients who are noncompliant with long-term specific immunotherapy. OBJECTIVE: The efficacy and tolerance of STI with seven preseasonal injections of molecular standardized allergens from grass and rye pollen has been investigated in a double-blind, placebo-controlled multicenter study with 87 patients at 12 German University hospitals. METHODS: Symptoms of the eyes, nose, and bronchi and use of symptomatic drugs were documented daily in diaries by patients with allergic rhinitis to grass and/or rye pollen and without bronchial asthma. Patients were monitored by skin prick test titration and measurement of levels of specific IgE and IgG4. RESULTS: The median nasal score for the 10 weeks with the strongest symptoms during the grass pollen season was significantly lower (p = 0.014) with 35.0 for STI (n = 41) versus 69.0 for placebo (n = 40); the overall symptom score was 54.0 for STI versus 97.5 for placebo (p = 0.020). Only STI-treated patients exposed to less than 40 pollen grains per cubic meter per week showed a significantly lower nasal symptom score of 39.0 versus 75.0 for placebo (p = 0.006); these patients also had fewer nasal symptoms and less use of topical nasal drugs (p < 0.001). The threshold dose in skin prick tests was significantly higher, being 9.06 histamine equivalent for skin prick test (HEP) for STI-treated patients who received the maximum dose (n = 22) versus 4.33 HEP for placebo (p = 0.005). Specific IgE levels were significantly higher, being 55.9 SU/ml for STI versus 39.2 SU/ml for placebo after seven injections (p = 0.006) and level of specific IgG4 was 5.36% for STI versus 1.28% for placebo (p < 0.001). No severe systemic reactions were observed. CONCLUSION: STI with seven preseasonal injections with molecular standardized allergens is effective and well tolerated.

Adolescent↗
PubMed1997

Acute irritant contact dermatitis: recovery time in man.

Our understanding of the details of the recovery time of acute irritant contact dermatitis (ICD) is limited. We examined skin reactivity to a model surfactant, sodium lauryl sulfate (SLS), on previous acute ICD and normal sites over time with visual grading and noninvasive instruments. Acute ICD was induced on the upper arms of 18 volunteers (aged 30 to 51 years) by occluded application of 1% SLS for 24 h. Previous ICD and normal sites were provoked by occluded application of 2% or 7.5% SLS 30 min daily 4 consecutive days. Skin reactivity was assessed daily by visual erythema scoring (VES), transepidermal water loss (TEWL), skin color reflectance (SCR) and electrical capacitance (EC). Skin function of previous ICD sites assessed by VES, TEWL, SCR, and EC did not normalize until 2 weeks later; all parameters of previous ICD returned to normal after 3 weeks. While skin reactivity to 2% and 7.5% SLS showed no differences between previous ICD and normal sites at 4 weeks, differences of irritant reactivity especially 7.5% SLS between previous ICD and normal sites were significant at 3 weeks post-provocation. Our results demonstrate that irritation evaluated with irritant provocation was long-lasting, even though skin functional parameters assessed by various bioengineering instruments returned to normal. Complete recovery of skin function including irritability after acute ICD induced by 1% SLS was achieved approximately 4 weeks later. The date were generated with a model surfactant; it remains to be determined whether similar responses will be noted with chemicals of different physiochemical properties.

Acute Disease↗
PubMed1996

CHILD syndrome in a boy.

CHILD syndrome (congenital hemidysplasia with ichthyosiform nevus and limb defects) occurs, as a rule, exclusively in girls because the underlying X-linked gene exerts a lethal effect on male embryos. In this report the characteristic manifestations of CHILD syndrome are described in a 2-year-old boy with a normal chromosome constitution 46,XY. This exceptional case is best explained by the assumption of an early somatic mutation and thus compatible with the concept of X-linked dominant male-lethal inheritance of this trait.

Child, Preschool↗
PubMed1996

[The sodium lauryl sulfate test. A noninvasive functional evaluation of skin hypersensitivity].

The purpose of this study was to determine whether 24 hour patch testing with 0.5% sodium lauryl sulphate (SLS) could reliably predict skin susceptibility to an irritant when compared with the alkali resistance test (ART), a widely used method employing sodium hydroxide. After having given informed consent, 40 patients (age range from 20 to 60 years) with an active irritant contact dermatitis (ICD), 40 patients in whom ICD had cleared, as well as 40 healthy volunteers serving as controls were tested. The skin responses to SLS were assessed both visually and by measurement of transepidermal water loss (TEWL) as an indicator of stratum corneum integrity. SLS significantly increased the erythema scores and TEWL in patients with healed ICD, and the increase of TEWL was even more pronounced in patients with active ICD. By contrast, a decrease in alkali resistance was found in patients with active ICD only but not in patients with healed ICD. The data obtained indicate that the SLS test, unlike ART, may provide a non-invasive tool predicting a possible constitutional skin susceptibility or indicating a subclinically impaired epidermal barrier function. However, because of the relatively high interindividual variation, a cut-clear statement concerning the skin susceptibility cannot be made by this test. On the other hand, the ART seems only to be useful for following and documenting the healing period following ICD.

Adult↗
PubMed1996

Differential irritant skin responses to topical retinoic acid and sodium lauryl sulphate: alone and in crossover design.

Topically applied all-trans retinoic acid (RA) is often associated with skin irritation. A detailed quantification of RA-induced functional changes in stratum corneum is, however, still limited. Using non-invasive bioengineering techniques of measurements of transepidermal water loss (TEWL), stratum corneum hydration and cutaneous blood flow (CBF), we quantified the irritant effects of 0.05% and 0.1% RA in ethanol on normal skin compared with 1% sodium lauryl sulphate (SLS) in water as a model irritant in a 24-h occlusive patch-test assay. Additionally, in order to document data possibly related to the mechanism of action, skin responses to both compounds applied in tandem was also investigated over 18 days. The extent of the irritant response to 0.05 and 0.1% RA, respectively, were similar, implying analogous irritation potency. While RA caused more intense scaling than SLS, other skin responses to RA were significantly weaker than those due to SLS. An increase in TEWL, on day 7, in RA-exposed sites indicates a secondary delayed impairment of the stratum corneum (SC) barrier. In a tandem-design assay, pretreatment with RA appeared to reduce the irritant effects of SLS on SC hydration and CBF. In contrast, pre-exposure to SLS showed a synergestic response in erythema, scaling and TEWL. Our results demonstrate that RA, like SLS, is capable of impairing SC water barrier function, which may be responsible, in part, for the irritation associated with its topical use. However, the distinctive biological responses to these compounds suggest a different mode of action of RA and SLS. In addition, the precise reason for the unique results observed in the tandem-design assays is not clear.

Administration, Topical↗
PubMed1996

Effects of calcipotriol on stratum corneum barrier function, hydration and cell renewal in humans.

Calcipotriol, a vitamin D analogue utilized for psoriasis, has irritation as its most frequent reported adverse event. However, studies on its irritant properties in humans have produced conflicting data. This study evaluates the effect of calcipotriol on stratum corneum barrier function, hydration and cell turnover in healthy volunteers, compared with sodium lauryl sulphate (SLS) as a model irritant. Calcipotriol 0.005% ointment and 1% aqueous SLS solution were applied for 60 min once daily for 2 weeks (5 consecutive days weekly) on untreated and on dansyl-chloride-labelled skin. Irritant responses were documented by visual scoring and by measurement of the transepidermal water loss (TEWL) and stratum corneum hydration (electrical capacitance), until day 18. Stratum corneum turnover time (SCTT) was the time in days between staining (day 0) and the disappearance of dansyl fluorescence. SLS caused more erythema, scaling, and a significant TEWL increase for 18 days. In contrast, calcipotriol induced erythema, and slightly but significantly increased TEWL on day 11 only, as compared with the vehicle control (P < 0.05). SLS, but not calcipotriol, caused skin dryness from day 4 to day 18. The shortest SCTT was obtained at SLS-exposed sites (11.2 +/- 0.7 days: mean +/- SD). Calcipotriol significantly shortened SCTT (16.3 +/- 1.1 days) when compared with its vehicle. Compared with the skin irritation induced by SLS, under these test conditions, calcipotriol is a far weaker irritant on normal human skin. In addition, calcipotriol accelerates stratum corneum turnover to a significantly greater extent than its vehicle.

Adult↗
PubMed1996

Effects of all-trans retinoic acid and sodium lauryl sulphate on the permeability of human skin in vitro.

Recent in vivo investigations have shown that pretreatment with topical all-trans retinoic acid (RA) may diminish the skin response to sodium lauryl sulphate (SLS). This study evaluated the permeation of SLS through human skin after pretreatment with RA, and vice versa, by in vitro methods. The permeability coefficient of SLS (3.24 +/- 0.21 x 10(3) cm/h) and the 24-h cumulative amount of SLS (3.41 +/- 0.6% of dose applied) permeating RA-pretreated skin did not differ significantly from those across untreated skin (control) (P > 0.05). In contrast, the permeability coefficient of RA (0.23 +/- 0.05 x 10(3) cm/h) and its 24-h cumulative amount (0.37 +/- 0.05% of dose applied) penetrating SLS-pretreated skin were significantly greater than those permeating untreated skin (P < 0.05). Thus, an increase in RA penetration was induced by SLS pretreatment; however, pretreating the skin with RA did not inhibit the percutaneous permeation of SLS. Based on previous in vivo findings where RA reduced skin reactions to SLS, one would speculate that RA pretreatment may decrease SLS penetration. However, these penetration data do not necessarily uphold this presumption. Perhaps, other interactions between the substances and the skin, e.g. at cellular levels, may be responsible for the differing skin responses.

Adult↗
PubMed1995

Nail incorporation kinetics of terbinafine in onychomycosis patients.

Patients with toe-nail onychomycosis were treated with terbinafine (250 mg daily, n = 20) for either 6 or 12 weeks in a randomized double-blind study. Plasma and distal nail clippings were taken before initiation of therapy and 1, 6, 12, 18, 24, 36 and 48 weeks thereafter. Analytical data of terbinafine extracted from nail clippings or plasma were obtained by high-performance liquid chromatography (HPLC). Nail extracts and isolated HPLC terbinafine peaks were analysed using a combined gas chromatography-mass spectroscopy system (GC-MS) for unequivocal identification of the drug. Terbinafine could be detected in the distal nail in the majority of the patients within 1 week of starting therapy. Maximum terbinafine levels of 0.52 and 1.01 micrograms/g were measured after 18 weeks in the 6- and 12-week treatment groups, respectively. While plasma levels decreased rapidly after termination of therapy terbinafine was detected in the nails as long as 30 weeks (6 weeks treatment) and 36 weeks (12 weeks treatment) after termination of therapy at a range of 0.28-0.19 microgram/g. The drug concentrations measured at all time points are well above the minimum inhibitory concentration (MIC) for dermatophytes and other fungi. These data suggest that the drug reaches the nail plate rapidly and persists there for several months after cessation of active treatment.

Antifungal Agents↗
PubMed1995

Surfactants and experimental irritant contact dermatitis.

Surface-active agents (surfactants) are characterized by the possession of 2 different moieties, both polar and non-polar regions on the same molecule. Surfactants are broadly classified as anionic, cationic, amphoteric, or non-ionic, according to the nature of the hydrophile yielded in aqueous solution. In currently marketed household, personal, and industrial cleaners, anionic surfactants are the most common class because of their relative ability to solubilize fats and oils, lower the surface tension of aqueous solutions, or form microemulsions. Many surfactants elicit irritant reactions when applied to the skin, partially due to their relative ability to solubilize lipid membranes. Hence, surfactants have become important implements in skin irritation investigations. In general, the physicochemical properties of surfactants are a crucial factor in eliciting skin irritation. Anionic surfactants are broadly accepted as potent irritants to human and animal skin. Cationic surfactants are reputedly at least equally irritating, but more cytotoxic than anionic, while the irritation potential of non-ionic surfactants is considered the lowest. Such classification of innumerable surfactants is convenient and held in high practical esteem. however, the categorization does not permit the exact determination of irritation and cytotoxicity potential of each surfactant. Ranking of surfactant skin irritancy and cytotoxicity obtained by both in vitro and in vivo assays provides a helpful orientation for future work.

Animals↗
PubMed1995

Baseline transepidermal water loss in patients with acute and healed irritant contact dermatitis.

To examine the skin barrier function of patients with acute and healed irritant contact dermatitis (n = 80) baseline transepidermal water loss (TEWL) was quantitatively measured using an evaporimeter. Healthy subjects served as controls (n = 40). Test areas were the forearm and the thigh. A significant increase in TEWL was observed in the patients with acute and with healed irritant contact dermatitis (ICD) as compared to healthy volunteers (P < or = 0.01). TEWL values in both test areas were comparable and markedly correlated (P < or = 0.01) with each other in every group. Thus, it is possible that basal TEWL depends more on the intrinsic skin barrier function of the subjects rather than the 2 anatomical regions examined. TEWL at the forearm with acute ICD was significantly higher (P < or = 0.01) than that of the group with healed ICD, but not for TEWL at the thigh suggesting that ICD may aggravate the barrier function of the adjacent uninvolved skin. It is assumed, that increased basal TEWL in patients with ICD may reflect a constitutional deviation of epidermal barrier function. This event seems to be comparable with the well-known symptom of atopic individuals. Using a detailed atopic scoring system in such a study may clarify the question of whether a proportion of patients with hand ICD may indeed be atopic individuals.

Acute Disease↗
PubMed1995

Functional changes in human stratum corneum induced by topical glycolic acid: comparison with all-trans retinoic acid.

The effects of topical glycolic acid and all-trans retinoic acid on stratum corneum barrier function and hydration of human skin were investigated in 6 healthy volunteers utilizing non-invasive techniques. In addition, changes in stratum corneum turnover time induced by the substances were examined using the dansyl chloride fluorescence test. Twelve percent glycolic acid in water and 0.1% retinoic acid in ethanol, respectively, were applied for 60 min once daily, over a period of 2 weeks (5 consecutive days weekly) on dansyl chloride-labelled skin and on untreated skin. During a 10-day application period, both glycolic acid and retinoic acid similarly induced a significant increase in TEWL. However, after discontinuing treatment, TEWL in retinoic acid-exposed skin remained increased. Glycolic acid significantly reduced stratum corneum hydration from day 11 to day 18 (p < 0.05), while retinoic acid induced skin dryness after 9 days of treatment, which persisted until day 18 (p < 0.005). Whereas glycolic acid rapidly induced an intense erythema implying a direct non-specific inflammatory response, the retinoic acid-exposed skin gradually developed erythema. Retinoic acid caused scaling to a greater extent than did glycolic acid, even after treatment cessation. Both glycolic acid and retinoic acid significantly decreased stratum corneum turnover time and stratum corneum turnover time50 (the time in days from labelling until approximately 50% of fluorescence disappeared), compared with the vehicle controls. However, glycolic acid shortened stratum corneum turnover time (12.8 +/- 0.9 days) as well as stratum corneum turnover time50 (7.3 +/- 0.7 d) significantly more than did retinoic acid (15.8 +/- 0.7 d and 9 +/- 0.8 d, respectively). While ethanol (vehicle of retinoic acid) slightly but significantly decreased stratum corneum turnover time (p < 0.05), water (vehicle of glycolic acid) did not. This study showed that both glycolic acid and retinoic acid induced certain functional changes in stratum corneum, mirroring their irritation potential. However, changes at retinoic acid-exposed sites appeared longer-lasting, implying a distinct mode of action. An increase in stratum corneum turnover induced by the substances may be, in part, linked with their irritation properties.

Adult↗