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Biomedical subjects

R A Sheehan-Dare

Publications and source records attributed to R A Sheehan-Dare.

At least 37 records · Page 2Linked to original sources
PubMed1994

Copper vapour laser (578 nm) and flashlamp-pumped pulsed tunable dye laser (585 nm) treatment of port wine stains: results of a comparative study using test sites.

The copper vapour laser (CVL), emitting at 578 nm, has recently become available for treating vascular skin lesions. Its place in the management of port wine stains (PWS) requires clarification. We have compared a CVL with a pulsed tunable dye laser (PTDL; 585 nm) in 43 patients with macular, blanchable PWS. Test areas were performed with the CVL, using a Hexascan and an energy fluence just sufficient to produce immediate tissue change (mean fluence 18.2 J/cm2 and mean pulse width 50 ms). Test areas were performed with the PTDL using a 5-mm spot at 6.5 J/cm2. Assessments were made after 4 months, subjectively using a clinical fading score and objectively using an index of light absorbence derived from reflectance spectrophotometry. The fading produced by the PTDL was significantly better than the CVL, as determined by clinical assessment (mean fading scores 2.41 and 1.67, respectively, P < 0.0005) and reflectance spectrophotometry (mean absorbence index 149 and 157 respectively, P < 0.0005). These results indicate that the PTDL is the preferred treatment for most macular, blanchable PWS. However, in a proportion of lesions responses were equivalent with both lasers, and in a small proportion, the CVL produced a better response.

Adolescent↗
PubMed1993

Copper vapour laser treatment of port wine stains: clinical evaluation and comparison with conventional argon laser therapy.

The copper vapour laser (CVL), emitting at 578 nm, offers potential advantages over the argon laser in the treatment of port wine stains (PWS). In this study, two test areas were performed with each laser using a Hexascan delivery system in 31 patients with PWS. One area was treated at minimal blanching fluence and one at 75% of this fluence. The pulse width was constant for each patient (mean 155 ms). Four-month assessments were made using a fading scale of 0-4, and objectively by an index of light absorbence using reflectance spectrophotometry. The CVL-treated sites had significantly better fading scores than argon laser-treated sites at minimal blanching fluence (P < 0.005) and lower absorbence indices (P < 0.05). Fading was significantly greater at minimal blanching fluence than at 75% of this fluence by fading scores and absorbence index values for both lasers. Slight textural and pigmentary changes were seen in a small minority of both CVL and argon tests at minimal blanching fluence only. This study indicates that the CVL is superior to the argon laser in treatment of predominantly red-purple or purple PWS. The minimal blanching technique produces greater fading than a lower energy fluence.

Adolescent↗
PubMed1993

Lasers in dermatology.

Lasers have many applications in dermatology. Recent developments in laser technology have produced significant therapeutic advances in several areas. The introduction of pulsed tunable dye lasers has considerably improved the treatment of vascular lesions, particularly port wine stain malformations in children. A wider range of continuous-wave and quasi-continuous-wave lasers have also become available for treating vascular lesions, and their use in conjunction with automated delivery systems has improved results whilst reducing adverse effects. Increasing interest in treatment of pigmented lesions and tattoos has led to investigation of a range of high-power short-pulse lasers, and early results look very promising. However, further work is needed in all these areas to determine which lesions respond best to each laser system, and which treatment techniques are optimal.

Dermatologic Surgical Procedures↗
PubMed1993

A sclerodermatous syndrome with unusual features following prolonged occupational exposure to organic solvents.

We describe a sclerodermatous syndrome in a middle-aged man who had worked with a wide variety of organic solvents over a prolonged period. Associated changes included cold sensitivity, a restrictive lung defect, peripheral neuropathy, oesophageal dysfunction, labile hypertension and a monoclonal paraproteinaemia. This unique syndrome is discussed in relation to other disorders associated with exposure to organic solvents.

Azathioprine↗
PubMed1990

Anxiety and depression in patients with chronic urticaria and generalized pruritus.

Thirty-four dermatology out-patients with chronic idiopathic urticaria and 34 with idiopathic generalized pruritus were investigated using standardized self-assessment psychological questionnaires to determine the incidence of significant symptoms of depression and anxiety. These patients were compared with age- and sex-matched but otherwise unselected general dermatology out-patients. Using the Beck depression inventory, significantly more patients with generalized pruritus (32.4%) had depressive symptomatology (score greater than 14) than controls (13.2%, P less than 0.05). Although more patients with chronic urticaria had depressive symptomatology (14.7%) than controls (4.4%), the difference was not statistically significant. Using the Speilberger state-trait anxiety inventory there were no significant differences between the patients with pruritus or urticaria and their controls with respect to state or trait anxiety scores above the upper 90% probability limit for the general population. Thus, significant depression may be expected in a substantial proportion of patients with idiopathic generalized pruritus but in a relatively small proportion of those with chronic urticaria.

Adult↗
PubMed1990

Ulceration of the palms and soles. An unusual feature of cutaneous T-cell lymphoma.

Two patients, one with Sézary syndrome and one with mycosis fungoides are described, in whom lesions on the palms and soles were associated with extensive ulceration and gave rise to diagnostic difficulty. Extensive ulceration of the palms and soles is uncommon; its presence should alert clinicians to the possibility of cutaneous T-cell lymphoma.

Diagnosis, Differential↗
PubMed1990

A double-blind comparison of topical clindamycin and oral minocycline in the treatment of acne vulgaris.

Sixty-six patients with moderate to severe facial acne vulgaris were entered in a 12-week double-blind study to compare the efficacy of topical clindamycin phosphate 1% twice daily and oral minocycline 50 mg twice daily. Both treatments gave significant overall improvements from baseline observations in acne grade and inflamed lesion counts, but not in noninflamed lesion counts. There were no significant differences between the two treatment groups in respect of acne grade, inflamed or non-inflamed lesion counts. Both treatment regimes were well tolerated. This study has shown that topical clindamycin twice daily is an effective alternative to oral minocycline 50 mg twice daily in the treatment of moderate to severe facial acne vulgaris.

Acne Vulgaris↗
PubMed1989

The treatment of decorative tattoos with the carbon dioxide laser.

The carbon dioxide laser was used in the treatment of 51 patients with decorative tattoos. Sixty-eight treatments were performed under local anaesthesia. Morbidity from treatment was low. Results 6 months after treatment in 44 patients revealed excellent or good results in 24 patients and hypertrophic scarring in three patients. These results confirm the value of this laser in the treatment of tattoos and demonstrate the advantages of this therapy over other treatments currently employed.

Adolescent↗
PubMed1989

Topical psoralen photochemotherapy (PUVA) and superficial radiotherapy in the treatment of chronic hand eczema.

The therapeutic efficacy of conventional superficial radiotherapy and topical psoralen photochemotherapy (topical PUVA) administered over a 6 week period was compared in a double-blind study of 21 patients with chronic bilateral constitutional hand eczema. One hand was treated with conventional superficial radiotherapy and the other with topical 8-methoxy-psoralen and long-wave ultraviolet light (topical PUVA). Significantly better clinical improvement was seen in superficial radiotherapy treated hands over topical PUVA treated hands after 6 weeks of treatment, but this difference was not maintained at 9 or 18 weeks. There was no significant difference in symptom severity between the two treatments after 6 weeks, but superficial radiotherapy produced significantly more symptomatic improvement at 9 and 18 weeks. Superficial radiotherapy is a less time consuming procedure than topical PUVA and leads to more rapid improvement.

Adult↗
PubMed1989

Hydroxyurea in the management of therapy resistant psoriasis.

Eighty-five patients with extensive chronic plaque psoriasis, unresponsive to conventional topical therapy, were treated with long-term hydroxyurea in a dose of 0.5-1.5 g daily. Fifty-two (61%) had a satisfactory remission during treatment without significant adverse effects. Treatment was discontinued in 33 patients (39%), due to an inadequate response or significant relapse during treatment and because of adverse reactions (19%). Four (4.7%) patients on hydroxyurea developed actinic psoriasis. Significant haematological abnormalities occurred in 30 patients (35%), but these became normal following a reduction in the dose of hydroxyurea or temporarily stopping the drug. In only six was it considered necessary to discontinue treatment because of bone marrow suppression. Our experience suggests that hydroxyurea is an effective long-term treatment for psoriasis that is refractory to conventional topical therapy and that the incidence of serious adverse effects compares favourably with other cytotoxic drugs.

Adult↗
PubMed1989

Axillary artery occlusion as a presenting feature of Crohn's disease.

A 20 year old Caucasian woman with Crohn's disease is described in whom axillary artery occlusion due to arteritis dominated the clinical picture. This case demonstrates that isolated large vessel arteritis can be an unusual feature of Crohn's disease. Crohn's disease should be considered in any patient presenting with a large vessel arteritis.

Adult↗
PubMed1988

Hepatic tumors with hyperglucagonemia. Response to treatment with human lymphoblastoid interferon.

A 62-year-old man had necrolytic migratory erythema in association with hyperglucagonemia and multiple hepatic tumors. A diagnosis of metastatic glucagonoma was made. He was treated with human lymphoblastoid interferon given subcutaneously in the dose of 2.8 to 7.1 X 10(6) IU/day. This produced a considerable fall in plasma glucagon and resolution of the associated rash. The treatment was continued for 10 weeks over a 4-month period. Computed tomography demonstrated a reduction in hepatic tumor mass.

Adenoma, Islet Cell↗
PubMed1988

Acne vulgaris and malignancy.

Seventy patients with lymphomas and leukaemias were interviewed. Details of past acne vulgaris were recorded and a clinical examination performed. A history of acne was less common in the patients than in matched controls. In addition, fewer patients had received treatment prescribed by a medical practitioner for their acne than had the controls. Examination revealed fewer patients with acne. These results suggest a reduced incidence of acne or its more severe forms in patients who have developed lymphomas and leukemias, and provide some support for the hypothesis that increased exposure or response to P. acnes, as appears to occur with acne, could confer protection against malignant disease.

Acne Vulgaris↗