The cost of psoriasis treatment at the Dead Sea.
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Biomedical subjects
Publications and source records attributed to L Weinrauch.
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Strains of Leishmania mexicana isolated from Belizian patients were found to be highly susceptible to paromomycin sulphate (PR) treatment. This drug at 100 micrograms ml-1 destroyed 85-99.5% of in vitro cultivated Leishmania promastigotes within 4 days of exposure to the drug. Leishmania promastigotes inoculated into the base of the tail of Balb/c mice caused the development of local lesions several weeks after infection. These lesions were totally cleared of parasites after 20 days of topical treatment with PR ointment, comprised of 15% paromomycin sulphate and 12% methylbenzethonium chloride in soft white paraffin. Similar results were also obtained with L. braziliensis infections. Isoenzyme analysis was found to be the method of choice for parasite strain identification. Excreted factor serotyping was only partially effective and promastigote agglutination gave negative results.
BACKGROUND: Many studies have been performed during the past decade to find an effective topical therapy for cutaneous leishmaniasis (CL). OBJECTIVE: Our purpose was to evaluate the effect of paromomycin ointment (P-ointment) containing 15% paromomycin sulfate and 12% methylbenzethonium chloride on Belizean patients with New World CL. METHODS: Fifty-three patients were treated twice daily for 14 to 21 days with P-ointment. RESULTS: Sixty-eight percent of the patients healed, 6% had a delayed cure, and 26% did not respond. No toxic effects from the ointment were observed. CONCLUSION: Topical paromomycin is as efficacious in the treatment of New World CL as other currently accepted modalities that are potentially more toxic.
BACKGROUND: A controlled study of the efficacy of topical paromomycin sulfate (PR) and methylbenzethonium chloride (MBCl) in cutaneous leishmaniasis (CL) has not yet been performed. OBJECTIVE: The therapeutic effect of an ointment containing 15% PR and either 12% or 5% MBCl (15/12 or 15/5 P-ointment) on patients suffering from Old World CL was examined in a randomized, double-blind, cross-over study. METHODS: Thirty-nine patients with Old World CL caused by Leishmania major were treated topically, twice daily, for 10 to 20 days with 15/12 or 15/5 P-ointment and 10 to 20 days with a placebo ointment to achieve a total of 30 days of treatment in all groups. RESULTS: In the P-ointment-treated groups, 74.2% (29 of 39 patients) of the patients were cured versus 26.6% (4 of 15 patients) in the placebo-treated group. Little difference was found between the 15/12 and 15/5 P-ointment groups. CONCLUSION: In most of the patients treated with the active ingredients, total elimination of the parasites was achieved within the first 10 days of treatment.
We have used a histochemical technique to study mast cells (MC) in skin biopsies of 8 patients suffering from pemphigus vulgaris (PV) and from 4 control volunteers. The MC were stained for 30 min with 0.5% toluidine blue, pH 0.5, counted and then restained for 5 days under the same conditions. This staining method allows the identification of two groups of MC, one that stains promptly (30 min) and one that stains after longer incubation times (5 days). After 30 min of staining, a slight increase was found in the number of MC in PV sections, in comparison with normal controls. However, when the 30 min stained sections were reincubated under the same conditions for 5 days, a significant increase in the number of MC in PV was found in comparison with 5-day-stained normal skin sections (p less than 0.005) and in comparison with 30-min-stained PV sections (p less than 0.005). The MC were distributed throughout the dermis and were concentrated in the upper dermis near hair follicles and vessels. The possible importance of the increased numbers of MC in PV is discussed.
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HLA antigens of two Jewish families with alopecia areata were studied. There was no linkage between the disease and the HLA complex.
Neutrophil chemotaxis in patients with psoriasis vulgaris and psoriatic arthritis was investigated before and after 6 weeks of treatment with zinc sulphate (50 mg elementary zinc three times daily). In patients with active psoriasis vulgaris, a significant increase in neutrophil random migration and directed chemotaxis was demonstrated (10.2 +/- 3.1 and 14.1 +/- 4.1 mu, respectively, greater than that of control patients), while in patients with psoriatic arthritis the values were within the normal range (5.8 +/- 3.2 and 1.1 +/- 4.1 mu, respectively, greater than that of control patients). Although the zinc sulphate treatment had little or no effect on the course of either disease, it restored both the random migration and directed chemotaxis to normal values in psoriasis vulgaris patients. These results support the contention that zinc sulphate modifies neutrophil inflammatory potential; however, the lack of a clinical benefit suggests that neutrophils play only a secondary role in the pathogenesis of psoriasis.
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Two cases of perioral psoriasis are described. A brief review of various dermatologic conditions that should be included in the differential diagnosis is included.
Cutaneous leishmaniasis (CL) is one of the most important causes of chronic ulcerative skin lesions. The disease is endemic in many parts of the world, presenting a range of clinical forms - acute, chronic, recurrent and diffuse(1). Several species of Leishmania are involved, including L. major, L. tropica and L. aethiopica in the Old World, and several members of the L. braziliensis and L. mexicana complexes in the New World. Some forms of the disease produce only mild, self-limited lesions, while at the other extreme are the destructive mucocutaneous forms caused by L. braziliensis and L. panamensis(1-7). In all cases, chemotherapy tends to be difficult - often requiring prolonged parenteral administration of toxic drugs such as pentavalent antimonials or amphotericin B. Such drugs are also expensive and relatively inefficient in the sense that much of the active ingredient is excreted by the patient before reaching its target. Consequently, there is renewed interest in the development of active formulations suitable for topical application directly onto the lesions.
We describe a case of penicillin and penicillin-related drugs that induced severe generalized pustular psoriasis on several different occasions in a young patient known to have suffered from recalcitrant psoriasis since childhood.
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We present a case of vesicular linear lichen planus in a 62-year-old woman. This unusual presentation of lichen planus and other conditions in the differential diagnosis are discussed.