[Cutting oils and skin diseases].
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Biomedical subjects
Publications and source records attributed to L P Durocher.
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This paper presents a simple method for evaluating the extent of impairment in occupational dermatosis based on the portion (P) of the anatomic area involved (A) and the coefficient of physiologic disturbance (C). A percentage value is assigned to each anatomic area on the basis of its functional importance. The coefficient of physiologic disturbance is the average of four factors (stiffness, dehydration, thickening, and pruritus or pain). The formula (P X A). C gives the final percentage of impairment.
Forty adult out-patients with erythematous squamous dermatoses of the scalp were treated in this 21-day double-blind study with an alcohol base lotion containing either 0.05% betamethasone-17,21-dipropionate, 2% salicylic acid, 0.05% betamethasone-17,21-dipropionate + 2% salicylic acid or their respective placebo. The four treatments were assigned randomly to the patients according to a 2 x 2 orthogonal factorial design. Changes in severity of redness, scaling, pruritus and size of lesions were evaluated. Since very few patients presented with excoriation and lichenification, these symptoms could not be ascertained. Results were assessed for significance by covariance analysis where initial status was used as regressor. A potentiation of the betamethasone-17,21-dipropionate activity by salicylic acid was observed for scaling. An additive effect was noted for redness and pruritus. According to the physician's global evaluation, patients treated with the combination drug showed a better evolution than those treated with placebo. The results suggest that addition of a keratolytic agent enhances the corticosteroid effect in the treatment of erythematous squamous dermatoses.
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It is important to differentiate worsening of a cutaneous eruption following topical therapy from lack of response to the medication. A study to determine the origin of contact dermatitis secondary to topical therapy was conducted among 87 patients with this kind of contact dermatitis. Sixteen patch tests with chemical compounds known to be allergenic were done. The following eight chemical compounds were responsible for 86.5% of the positive reactions observed: neomycin, ethylenediamine, mercury, benzocaine, iodochlorhydroxyquin, peruvian balsam, nitrofurazone and cinchocaine. More than half of the reactions were to neomycin, ethylenediamine and mercury. It is easier to diagnose this condition if one knows the composition of the topical medications one prescribes and the allergenic potency of their ingredients.
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