[Etiology, pathogenesis and treatment of seborrheic dermatitis].
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Biomedical subjects
Publications and source records attributed to M Seidenbaum.
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There are currently 200 patients with Hansen's disease in Israel who are being followed by the Hansen's Disease Government Hospital and the Ministry of Health (prevalence 4.4/100,000). Most of them immigrated from countries where the disease is endemic. Dermatological findings dominated the initial clinical picture, although 5% of patients are asymptomatic contacts of known cases. Age at onset of disease was less than 20 years in 1/4 of the cases. The incidence in Israel is falling: 0.4/100,000 in 1985-89 compared to 3.6/100,000 in 1950-54. Neurologic and dermatologic findings in an immigrant of any age originating from countries where Hansen's disease is endemic, should prompt appropriate diagnostic evaluation, even years after immigration to Israel. Contacts of known cases of Hansen's disease should be aggressively screened, even if asymptomatic.
The concentration of zinc in the skin has been determined noninvasively in patients with varicose vein ulcers. The examinations were performed with the use of diagnostic x-ray spectrometry, a method based on x-ray fluorescence for in vivo noninvasive evaluation of trace elements. Four skin foci were examined: at the periphery of the ulcer and control areas in a nonulcerated area in the diseased leg, in the noninvolved leg, and in the proximal inner surface of the arm. Zinc levels around the ulcer (mean +/- SD, 9.8 +/- 4.0 micrograms of zinc in 1 g of wet tissue) were higher than those in the nonulcerated skin in the diseased leg (6.9 +/- 3.0 micrograms/g, p greater than 0.05) and those in the noninvolved leg (5.4 +/- 2.0 micrograms/g, p less than 0.01). The concentration of zinc in the inner proximal surface of the arm (9.8 +/- 2.8 micrograms/g) was significantly higher than those of a control group (5.3 +/- 1.9 micrograms/g, p less than 0.01). These results suggest a defect of zinc distribution in patients with varicose vein ulcers.
A survey of 115 pemphigus patients who have been followed for 4-24 years was carried out in an attempt to analyze the possible factors influencing the course and prognosis of the disease. At the time of the study, 45 patients were in complete remission, 45 still had lesions, and 25 had died. In 12 cases, the death occurred from causes related to the disease or consequences of treatment. The comprehensive statistical analysis revealed that a good prognosis may be expected for patients who, in the initial stage of the disease, show involvement of the skin only (p less than 0.05) and when systemic steroid therapy is instituted within half a year of appearance of the disease (p less than 0.05). There were no significant differences in the rate of recovery and mortality between the different groups of patients in regard to the initial dose of prednisone. A daily dose of 120 mg of prednisone was sufficient to control the lesions in most of the severe cases and less contributory to death in comparison with previous studies.
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The brown pigmentation of the skin associated with venous ulceration is caused by increased local iron deposition. Diagnostic x-ray spectrometry, a method based on x-ray fluorescence analysis, was used for the noninvasive determination of iron levels in the skin of patients with venous ulceration. The mean (+/- SEM) iron concentration in the skin around the venous ulcer was elevated, compared with control values of nonulcerated skin (250 +/- 54 vs 128 +/- 39 micrograms) and compared with normal skin from the forearm (250 +/- 54 vs 14 +/- 2.5 micrograms). These data suggest that dermal iron deposition may not be an incidental by-product of increased venous pressure, but may actively perpetuate tissue damage in venous ulcerations.
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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