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Biomedical subjects

M Jarratt

Publications and source records attributed to M Jarratt.

At least 19 recordsLinked to original sources

Once-daily topical metronidazole cream formulations in the treatment of the papules and pustules of rosacea.

BACKGROUND: The papules and pustules of rosacea can be effectively treated with topical metronidazole. The optimal concentrations of metronidazole and optimum frequencies of application are uncertain. Traditionally, twice-daily applications have been advised, based on the pharmacokinetic profile of metronidazole. Once-daily applications may be safer and less expensive, and they may enhance patient compliance. OBJECTIVE: We compared the efficacy and safety of 2 commercially available topical metronidazole formulations (0.75% metronidazole cream formulation and 1.0% metronidazole cream formulation) when both were used in a once-daily regimen. METHODS: A multicenter, randomized, investigator-blind, parallel group trial was conducted at 3 separate clinical sites located in 3 US cities. The study enrolled 72 rosacea patients with at least 8 to 50 inflammatory facial lesions (pustules and papules) and moderately severe facial erythema. Patients were randomly assigned to receive either 0.75% metronidazole cream or 1.0% metronidazole cream and instructed to apply the medication once daily for 12 weeks. Patients' lesions were evaluated at baseline and at weeks 3, 6, 9, and 12. RESULTS: There were no significant differences between treatment groups for any of the efficacy parameters evaluated. The overall median percentage change in lesion count at end point for patients in the 0.75% metronidazole cream treatment group was -62% compared with -60% for the 1.0% metronidazole cream treatment group. The overall percentage change in erythema scores at endpoint for patients in the 0.75% metronidazole cream treatment group was -26% compared with -30% for patients in the 1.0% metronidazole cream treatment group. Regarding physician assessment of global severity, 57% of subjects (20/35) in the 0.75% metronidazole cream group compared with 37% of subjects (13/35) in the 1.0% metronidazole cream group were rated as having a clear to mild condition at end point. Both drugs were well tolerated; there was no significant difference in the number of drug-related adverse events between the two agents. CONCLUSION: This controlled trial demonstrates that both 0.75% metronidazole cream and 1.0% metronidazole cream, when used once daily, provide well-tolerated efficacy for moderate to severe rosacea.

Administration, Topical↗

Acute hypoxemic respiratory failure following intrapleural thrombolytic therapy for hemothorax.

Intrapleural instillation of thrombolytic agents has been useful in the treatment of hemothorax when thoracostomy tube drainage is unsuccessful. We present a patient who developed acute hypoxemic respiratory failure following the intrapleural instillation of both streptokinase and urokinase 24 h apart. Hypoxemia most likely resulted from a direct effect of the products of fibrinolysis on the pulmonary circulation.

Acute Disease↗

Angiolymphoid hyperplasia with eosinophilia.

Angiolymphoid hyperplasia has become a well-recognized entity in adults. Kimura's disease is a similar and possibly identical disease occurring in Oriental children. This is a case report of angiolymphoid hyperplasia with eosinophilia occurring in a 12-year-old Caucasian boy with elevated levels of serum IgE. The condition responded to intralesional triamcinolone. A brief review of the literature is presented and various modes of therapy are discussed.

Angiolymphoid Hyperplasia with Eosinophilia↗

Familial acanthosis nigricans.

A mother and daughter had benign familial acanthosis nigricans. Familial acanthosis nigricans begins in early childhood and may be accentuated at puberty. The eruption is not associated with underlying illness. Forms of acanthosis nigricans are associated with obesity, endocrinologic abnormalities, drug ingestion, and malignant neoplasms.

Acanthosis Nigricans↗

Topical protection against long-wave ultraviolet A.

A PABA ester-oxybenzone preparation is superior to PABA or sulisobenzone alone in protecting the skin from methoxsalen-induced ultraviolet A (UVA) phototoxicity after water substantivity challenge. Such a mixture would be useful as a UVA screen for uninvolved or actinically damaged skin in patients receiving psoralens and ultraviolet A (PUVA) therapy. An effective topical UVA screen also may protect against UVA-induced diseases like solar urticaria, polymorphic light eruptions, drug-induced phototoxicity or photoallergy, and possibly against the deep degenerative changes of solar elastosis.

4-Aminobenzoic Acid↗

Benign neonatal hemangiomatosis.

Diffuse neonatal hemangiomatosis is a serious multisystem syndrome of multiple cutaneous hemangiomas, visceral hemangiomatosis with arteriovenous shunts, high output congestive heart failure, thrombocytopenia with hemorrhage and central nervous system involvement. Some neonates with multiple cutaneous hemangiomas, however, may follow a benign course of spontaneous resolution without symptomatic visceral involvement. Such cases may be called benign neonatal hemangiomatosis.

Female↗

Annular erythema of infancy.

The lesions of an unusual annular erythema in an infant evolved from erythematous papules, to rings, to interrupted arcs over 36 to 48 hours, and then resolved without a trace. New lesions appeared and evolved with remarkable uniformity for eight months and then disappeared. This seemingly unique eruption is compared with other annular erythemas described in infants.

Erythema↗

Pruritus and nonspecific nodules preceding myelomonocytic leukemia.

Subacute myelomonocytic leukemia is typically preceded by a preleukemic phase lasting 1 to 10 years. We describe a case of subacute myelomonocytic leukemia preceded by pruritus for 7 years and by the intermittent appearance of nonspecific necrotic dermal nodules for 4 years.

Aged↗

Botryomycosis. A bacterial cause of mycetoma.

Botryomycosis is a chronic, granulomatous, bacterial infection in which grains are produced. Clinically, it may not be distinguished from a mycetoma of fungal origin. A case is reported in which the causative organisms were Staphylococcus aureus and Pseudomonas aeruginosa.

Child↗

Bullous disease of childhood.

Bullous disease of childhood (BDC) is a persistent or recurrent blistering skin disease characterized by large, tense bullae in a generalized distribution, but with a predilection for the scalp, trunk, pubis, and inner thighs. It usually begins in the first decade of life and spontaneously remits after several months to three years of activity. Sulfapyridine or dapsone therapy usually controls the disease. Administration of corticosteroids for systemic effects should be avoided.

Basement Membrane↗

Eosinophilic fasciitis: an early variant of scleroderma.

Eosinophilic fasciitis, originally reported as a syndrome distinct from scleroderma, appears now to be an early inflammatory variant of scleroderma. No less than one half of the cases reported as eosinophilic fasciitis have convincing features of scleroderma, including Raynaud's phenomenon, esophageal dysmotility, restrictive lung disease, diffuse hyperpigmentation, synovitis, flexion contractures, dermal sclerosis, colonic diverticula, scleroderma kidney, positive latex fixation test, and the presence of serum antinuclear antibodies (ANA). Clinical presentations of scleroderma range from isolated acrosclerosis to rapidly progressive systemic sclerosis. As clinical experience and long-term follow-up data on eosinophilic fasciitis accumulate, it appears that the syndrome may well represent another variant in the scleroderma spectrum. Reported here is a case which presented clinically and histologically as eosinophilic fasciitis, but which progressed over 3 years to diffuse, histologically confirmed scleroderma.

Eosinophils↗

Infantile acropustulosis.

Infantile acropustulosis is a syndrome that is characterized by recurrent crops of 1- to 2-mm, intensely pruritic vesicopustules on the distal extremities. The eruption is unresponsive to topical steroids, and pruritus is relieved only by soporific doses of antihistamines.

Child, Preschool↗

Toxic epidermal necrolysis from graft-vs-host disease. Occurrence in a patient with thymic hypoplasia.

An infant with diarrhea, failure to thrive, and a seborrhea-like skin eruption was thought to have fatal familial Leiner's syndrome. Treatment with nonirradiated plasma was followed by graft-vs-host disease and fatal toxic epidermal necrolysis; thymic hypoplasia was found at autopsy. Accurate diagnosis of immunodeficiency syndromes is essential to avoid potentially harmful therapy.

DiGeorge Syndrome↗