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Biomedical subjects

K Hersle

Publications and source records attributed to K Hersle.

At least 19 recordsLinked to original sources

Cryosurgery of eyelid basal cell carcinomas.

One hundred and twenty-one patients have been treated for eye lid basal cell carcinomas with cryosurgery during the last 7 years. The condition resolved completely after treatment in all patients with no recurrences observed so far. Most patients have been followed for more than 2 years. Complications were few and minor. In 14 cases conjunctival overgrowth was noted. We conclude that this treatment modality is excellent, cost-effective and easily tolerated as compared with other methods.

Adult

Changes in laboratory variables induced by isotretinoin treatment of acne.

During a trial of isotretinoin (0.5 mg/kg body weight/day for 3 months) in 90 patients with severe acne, the leucocyte (WBC) count, and particularly the number of neutrophils, decreased significantly. In patients with a good response the mean WBC count fell by 24% and the neutrophils by 33%, whereas in those with a poor response these variables decreased by 8% and 14%, respectively. The serum ALAT, ASAT, cholesterol and triglyceride levels increased significantly. Patients with a poor response (n = 35) received a higher dosage (0.75 mg/kg) for an additional 3 months, and during this period there was a further decrease in the WBC and neutrophil counts and an increase in the triglyceride level. In the other patients, who initially responded well, the dosage was decreased to 0.1 or 0 mg/kg during the second 3-month period, which resulted in reversion of the laboratory variables to the pre-treatment levels. The observed changes were clearly both dose-dependent and reversible.

Acne Vulgaris

Terfenadine in chronic urticaria: a comparison with clemastine and placebo.

Terfenadine, a new specific and peripherally acting antihistamine, was compared with clemastine and placebo in a prospective, randomized, double-blind, double-dummy, crossover study of the treatment of chronic urticaria. Sixty patients with chronic urticaria participated in this multicenter trial. The treatment time was two weeks per drug treatment, totalling six weeks. Terfenadine proved more effective than clemastine and was associated with significantly less sedation. Few adverse reactions were noted.

Adult

Treatment of recurrent genital herpes simplex infections with oral acyclovir.

A total of 113 patients with recurrent genital herpes were enrolled in a multicentre cross-over study. Two consecutive recurrences were treated with either oral acyclovir 200 mg or matching placebo five times daily for five days. Acyclovir significantly reduced the time to crusting and healing and the duration of new lesions and symptoms. Acyclovir was not found to have any clinically significant effect on the haematological or biochemical parameters measured, or to have caused adverse events and was well tolerated. Early self-initiated treatment may abort a recurrent attack of genital herpes without progression to the ulcerative or crusting stage.

Acyclovir

Long-term ketoconazole treatment of chronic acral dermatophyte infections.

Ketoconazole 200-400 mg was given once daily for a maximum period of 12 months to 31 patients with chronic (mean duration, 12 years) dermatophyte infections of the hands and/or feet. Griseofulvin had previously been withdrawn due to intolerance or lack of effect. All skin and nail infections improved clinically. Fifty percent of the patients with skin infections and 26% of those with nail infections became clinically clear and culture-negative. Six months later, relapses had occurred in 8 of 12 patients (67%) with cleared skin lesions, and in 2 of 5 (40%) with cleared nail infections. Ketoconazole was discontinued in one patient due to headache and in another due to asymptomatic transient elevation of hepatic laboratory tests. Ketoconazole is an alternative when a replacement for griseofulvin is required, provided the degree of disability justifies the risk of drug toxicity.

Female

Oral lichen planus: hypersensitivity to dental restoration material.

67 patients with oral lichen planus of the atrophic-erosive or reticular plaque type were examined. Dental amalgam in contact with mucosal lesions was present in 64 patients, and gold fillings in 33. Patch testing with a standard procedure was performed with components of dental fillings. 11 patients (16%) reacted to at least one of the mercury compounds compared to 8% in a reference group. Most positive reactions were caused by elemental mercury and ammoniated mercury. No patient reacted to gold or copper. Readings at days 10-14 did not increase the number of responders. 13 patients were patch tested with palladium; all were negative. It is not clear whether in the mercury-positive patients allergy to dental amalgam is a causative or aggravating factor, or merely on epiphenomenon.

Adult

Severe oral lichen planus: remission and maintenance with vitamin A analogues.

Twenty-five patients with chronic oral lichen planus, usually of the atrophic-erosive type, were treated for 2 months with Etretinate 0.6 mg/kg b.w./day, followed for 4 months by Etretinate 0.3 mg/kg/day, or 0.1% Tretinoin in an adhesive base. Complete resolution or improvement was seen in 85% of the lesions after first treatment. The number of patients with oral soreness and pain was significantly reduced (p less than 0.001). During the second treatment, the improvement was maintained or even increased in about 70% of the patients, irrespective of the mode of treatment. Treatment was discontinued in one patient owing to moderately increased serum transaminase levels. The number of drug-related drop-outs was significantly lower than in a previous study utilizing an etretinate dose of about 1 mg/kg/day (p less than 0.05). Other adverse effects were minor and tolerable. Retinoids offer an effective mode of therapy for severe oral lichen planus.

Adult

Hyperkeratotic dermatitis of the palms.

Thirty two adult patients who presented with a sharply marginated, hyperkeratotic dermatitis of the palms (HDP), but with no skin lesions elsewhere, have been re-examined approximately 10 years later. Topical treatments had had limited effect. The morphological appearance and localization had remained unchanged, except in two individuals who were free from symptoms. One had developed psoriasis. The incidence of atopic disease and psoriasis in first degree relatives did not differ from that in control subjects. Mycological cultures and patch tests were negative. Serum IgE was normal. Skin biopsies in nine patients all revealed a chronic spongiotic dermatitis.

Adult

Severe oral lichen planus: treatment with an aromatic retinoid (etretinate).

A double-blind study of twenty-eight patients with severe oral lichen planus treated with etretinate (75 mg daily) or a placebo for 2 months, showed that the oral retinoid had a marked beneficial effect. Nine non-responders who had received only placebo then entered an open cross-over study and they responded well to etretinate. Etretinate thus provided effective symptomatic relief for severe oral lichen planus, but side-effects were common, and six patients stopped treatment because of them.

Adult

Uses of dextranomer absorbent pads after cryosurgery of cutaneous malignancies.

Secretion from wounds after cryosurgery of cutaneous malignancies may be excessive and may constitute a problem in management. It was found possible to collect and quantitate such discharges by use of highly hydrophilic dextranomer beads (Debrisan). They were applied in convenient, small "tea-bag" pads. The amount and duration of postoperative oozing was approximately proportional to the sizes of the lesions and more impressive in sites of sparse subcutaneous tissue. The absorbent pads also proved to be effective and safe for use as postoperative dressings.

Bandages

Once daily application of diflorasone diacetate ointment compared with betamethasone valerate ointment twice daily in patients with eczematous dermatoses.

The clinical efficacy of 0.05% diflorasone diacetate applied once daily, for eczematous dermatoses, was compared with the twice daily application of betamethasone valerate. Both agents were supplied as ointments. Sixty patients were randomized to one of the two treatment regimens. The investigators were unaware of the regimen used. Evaluations were made at 1 and at 3 weeks. There were no statistically significant differences in eight parameters studied at any time during the study. No side-effects were reported.

Administration, Topical

Basal cell carcinoma in children. Case report.

Clinical and pathoanatomic features of two children with basal cell carcinoma, an extremely uncommon disease in childhood, are reported. Clinically these lesions had a benign appearance, similar to a foreign body granuloma and an intradermal naevus, respectively, but histological examination showed a picture typical of basal cell carcinoma. The tumours were radically treated and no recurrence occurred during an observation time of 12 and 42 months, respectively.

Adolescent