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Biomedical subjects

J Austad

Publications and source records attributed to J Austad.

At least 19 recordsLinked to original sources

Clobetasol propionate followed by calcipotriol is superior to calcipotriol alone in topical treatment of psoriasis.

BACKGROUND: Although potent, topical corticosteroids offer effective and rapid healing of psoriatic lesions. Their long term use is limited because of the risk of side effects. Calcipotriol is safe for long-term treatment, but its initial efficacy is lower than with topical corticosteroids. OBJECTIVES: To investigate whether 2 weeks of treatment with clobetasol propionate 0.05% ointment bd followed by 4 weeks of treatment with calcipotriol 50 microg/g bd would offer therapeutic advantages over 6 weeks of continuous treatment with calcipotriol. METHODS: Forty-nine patients with moderate to severe plaque psoriasis were recruited from five centres in Norway. In a randomised, double-blind, right- versus left-side comparison, ointments were applied to two symmetrically-located areas. RESULTS: Two weeks of treatment with clobetasol propionate produced a significantly greater decrease in total symptom score (combined scores of erythema, induration and scaling) than calcipotriol treatment (P < 0.0001). This improvement on the clobetasol propionate-treated side of the body was maintained throughout a subsequent 4-week treatment period when calcipotriol was applied to both sides of the body (P < 0.0001). The superiority of the clobetasol propionate followed by calcipotriol treatment was maintained during a 4-week, treatment-free, observation period. Treatments were well tolerated with no rebound effect. CONCLUSIONS: Clobetasol propionate ointment bd for 2 weeks followed by treatment with calcipotriol ointment bd for 4 weeks was superior to calcipotriol ointment alone in the treatment of plaque psoriasis.

Administration, Topical↗

[Treatment of psoriasis in general practice].

Psoriasis is a chronic skin disease which affects about 2% of the population. Several new treatment modalities have been introduced in recent years. This article focuses on topical treatment of mild and moderate psoriasis that can be successfully treated at home. It is important that general practitioners who treat most of these patients are familiar with the best treatment procedures. Phototherapy and systemic therapy, mainly by dermatologists, are described in brief.

Family Practice↗

[Nevus flammeus in small children treated pulsed dye laser].

We report the results of treating 30 children less than 7.5 years old for port wine stains of the face and neck using pulsed dye laser with a wave length of 585 nm. The children were given a general anaesthetic. In five children the stains disappeared completely and in 21 there was marked improvement (> 75% lighter). The younger age group, 7 months to 4 years, required fewer treatment sessions (mean 3.7) than the older age group, 4 to 7 years (mean 5.1 sessions), indicating the benefit of early treatment. No side effects were seen except for transient hyperpigmentation.

Child↗

[Dermatomyositis and cancer. A retrospective study].

In a retrospective study, the files of 19 patients with dermatomyositis examined at our departments from 1970 to 1993 were reviewed. The parameters studied were age, sex, muscle enzyme values, muscle biopsies, electromyographical findings and interval from onset of dermatomyositis until first visit to the department. Out of 19 patients with dermatomyositis, 18 were adults and in nine of these the condition was associated with cancer (three out of three men, six out of 15 women). Electromyographical findings were pathological in 17 investigated patients and myositis was indicated in 13 out of 15 biopsies. Muscle enzyme values were elevated in seven out of nine patients with cancer and in three out of nine without. Out of five patients with dysphagia, four patients had cancer. The risk of cancer is increased in patients with dermatomyositis. Factors indicating a poor prognosis regarding the association between dermatomyositis and cancer in our study were old age, male sex and dysphagia.

Adult↗

[New treatment of psoriasis with the vitamin D analogue calcipotriol].

A new topical treatment for psoriasis was introduced in 1992 when the vitamin D analogue calcipotriol was registered in Norway. This is a new therapeutic principle for psoriasis. Calcipotriol induces differentiation and inhibits proliferation of the keratinocytes. Application twice daily for 6-8 weeks gives a 60-70% improvement in plaque type psoriasis. No serious side effects have been reported when using up to 100 grams of the ointment weekly.

Administration, Topical↗

Blue rubber bleb nevus syndrome with manifestations in the vulva.

The blue rubber bleb nevus syndrome (BRBNS) is a rare vascular disorder, manifesting with hemangiomas which are usually located in the gastrointestinal tract and/or in the skin. These lesions can cause local, sometimes severe bleedings or cosmetic problems. This report describes a young woman with BRBNS manifestations on the buttocks and in the vulva, the latter giving rise to symptoms specific to this location. The blood-filled blebs were successfully treated by argon laser. As far as we know, manifestations of this disease in the female genital tract have not previously been described.

Adult↗

Efficacy and skeletal side effects of two years' acitretin treatment.

In this prospective study, 51 patients suffering from psoriasis and ichthyosis were treated with acitretin for 2 years. The average dose was 0.5 mg/kg/day. We have evaluated the efficacy and side effects, focusing on skeletal side effects. X-ray examinations were done before treatment and after 1 and 2 years. Forty-five patients completed the study. Acitretin had a good clinical effect, with 75% improvement in 35 of the patients. Apart from the well-known side effects affecting the mucous membranes, one patient developed biopsy- proven toxic hepatitis. In 2 patients we observed unusual skeletal calcifications located in the forearms and in the hip. These were considered to be caused by the drug. In this study, which included patients up to 71 years, only radiographs of the pelvis and the forearms were of value as routine follow-up films.

Acitretin↗

Hereditary haemorrhagic teleangiectasia: unsuccessful treatment with the flashlamp-pulsed dye laser.

In seven patients with hereditary haemorrhagic teleangiectasia (HHT) only one patient had lasting benefit from treatment with the flashlamp-pulsed dye laser. In seven other patients who had received other treatment before, none had any observable effect of this laser. The flashlamp-pulsed dye laser therefore does not seem to be effective in the treatment of nasal teleangiectasias.

Humans↗

An open, parallel groups, study of the importance of thoroughness of application in the treatment of psoriasis with a dithranol cream (Micanol).

Earlier studies have suggested that the rate of healing is somewhat slower for the new microencapsulated dithranol formulation, Micanol, than for petrolatum or paraffin based formulations. The less smeary Micanol formulation may need more vigorous application. A population of 29 patients with chronic, stable plaque-type psoriasis was divided into two groups, both receiving short contact treatment. One group received standard patient information while the other received information stressing the importance of being thorough when rubbing the dithranol cream into the lesions. Regarding composite sign severity score, there was a significant difference (about 50%) in favour of the extra information group after 6 weeks. This result suggests that thoroughness of application is an important factor for the rate of healing in short contact treatment of psoriasis with Micanol.

Administration, Topical↗

[Dermatological laser treatment].

This article reviews the different lasers used in dermatology. Special emphasis is placed on the treatment of naevus flammeus ("portwine stain") where lasers are the treatment of choice. Argon laser and pulsed dye laser are the main lasers used in vascular skin diseases, and the article focuses on these two types. Copper vapour laser, neodymium-YAG-laser and CO2-laser are also presented. Information is provided about the availability of laser technology in the different health regions in Norway.

Adult↗

Hereditary hemorrhagic teleangiectasia--argon laser.

In 20 patients with hemorrhagic hereditary teleangiectasias (HHT) only 15 were treatable with argon laser. In the others septal perforation or continued bleeding made initial treatment inadequate. The laser treatment had to be repeated in all patients, due to multiplicity of lesions. Nine patients regarded the outcome very favourably with minimal bleeding episodes. In four of them the effect lasted more than one year.

Adult↗