PubMed Health⌕ Search

Biomedical subjects

R J van Dooren-Greebe

Publications and source records attributed to R J van Dooren-Greebe.

16 recordsLinked to original sources
PubMed2000

An impressive therapeutic result of class III compression stockings in a patient with longstanding, extensive, combined leg ulcers.

BACKGROUND: Only a few publications are available in the literature concerning the treatment of venous leg ulcers by means of medical compression stockings. SUBJECT: A 59-year-old female patient with longstanding, extensive bilateral leg ulcers due to venous insufficiency, arteriolosclerosis and secondary lymphoedema, was treated successfully by flat-knitted medical compression stockings of compression-class III. CONCLUSION: The great advantage of this treatment is the fact that it is comfortable and easy to carry out at home. Furthermore, the costs of compression therapy with medical compression stockings are only a fraction of those of conventional therapy by means of compressive non-elastic bandages. Once or twice weekly visits of the patient to the hospital are not necessary and less specialized dermatological nurses are needed.

Bandages↗
PubMed1999

Familial primary cryofibrinogenemia.

BACKGROUND: To our best knowledge this is the second case ever described of familial primary cryofibrinogenemia (CFG). PATIENTS: A 29-year-old Moroccan female and two of her three children suffered from painful purpura, slow healing small ulcerations and edema of both feet during the winter season. Laboratory investigations revealed the presence of cryofibrinogen in their blood plasma. All three patients were otherwise healthy and no associated disease could be demonstrated. CONCLUSIONS: The diagnosis of CFG has to be considered in patients with livedo reticularis, edema, painful purpura and slow healing ulcera after cold exposure. Cryofibrinogen-precipitates in the blood plasma have to be determined. Because secondary CFG occurs much more frequently than the primary form, it is important to rule out associated diseases through extensive physical examination and laboratory investigations. This communication also stresses the importance of a through family history of patients with CFG. An autosomal dominant mode of inheritance is supposed.

Adult↗
PubMed1997

[D-penicillamine in treatment of scleroderma "en coup de sabre"].

A ten year old boy with linear erythema above the right eyebrow and a groove in the underlying skull bone is described. Histological examination of a biopsy revealed a spotty, periadnexal, perivascular, lymphocytic infiltrate. The papillary dermis was almost absent and the collagen fibres were slightly thickened. Based on the clinical appearance and the histology a diagnosis of linear scleroderma (en coup de sabre) was made. As the signs and symptoms were progressive, treatment with D-penicillamine was started. Subsequently the erythema disappeared. The shallow groove in the skull bone remained palpable. After thirteen months, treatment was stopped. The patient is currently free of signs and symptoms after a follow-up period of three and a half years. We feel that the strong clinical improvement is due to treatment with D-penicillamine rather than to the natural course of the disease.

Adolescent↗
PubMed1996

[Parasitic pruritus: bird mite zoonosis].

In three women with persistent pruritus, aged 49, 28 and 4 years, infestation with the bird or chicken mite (Dermanyssus gallinae) was demonstrated. These mites live in narrow openings and cracks close to the bird housing during the daytime. At night they attack the birds on whose blood they live. When their host disappears, they may attack men, notably when their breeding places are in or near houses. Mite bites result in urticarial and itchy papulovesicular skin eruptions. Treatment of bird mite infestation consists of removing the old nests. Treatment of the patients is symptomatic. Epizoonosis belongs in the differential diagnosis of pruritus; infestation with bird or chicken mites is one of the possibilities.

Adult↗
PubMed1996

Acrodermatitis continua of Hallopeau: response to combined treatment with acitretin and calcipotriol ointment.

Treatment of acrodermatitis continua of Hallopeau (ACH) is difficult and often disappointing. We describe a patient with an extensive ACH of all finger- and toetips, who was treated with acitretin combined with calcipotriol. A within-subject left/right comparison was carried out between calcipotriol ointment (50 micrograms/g) and the ointment base to investigate the additional value of calcipotriol above the ointment base. The side treated with calcipotriol as adjunct therapy showed an impressive improvement, well beyond the degree of improvement at the side treated with the ointment base only.

Acitretin↗
PubMed1995

Extensive extraspinal hyperostoses after long-term oral retinoid treatment in a patient with pityriasis rubra pilaris.

We describe a patient with severe pityriasis rubra pilaris in whom extensive extraspinal hyperostoses developed after 13 years of oral retinoid treatment. The most prominent abnormality was a bridging exostosis between the left acetabulum and collum. X-ray examinations of the spine during retinoid therapy showed no abnormalities. During oral retinoid treatment, it is important to ask the patient on a regular basis about any skeletal pains or mobility restriction. Normal spinal x-ray results are no guarantee that a patient is free of hyperostoses. Discontinuation of acitretin therapy resulted in a severe exacerbation of the patient's pityriasis rubra pilaris after 2 weeks. The clinical response to administration of azathioprine was clearly inferior to that of acitretin. However, low-dose oral methotrexate therapy appeared to be a good alternative in this patient, with a clinical result comparable to acitretin and no side effects after 6 months of therapy.

Acetabulum↗
PubMed1995

Interruption of long-term methotrexate treatment in psoriasis. Evaluation of clinical course and laboratory parameters after discontinuation and reintroduction of weekly oral methotrexate.

The effects of interval treatment were evaluated in 10 psoriatic patients on long-term treatment with low-dose oral methotrexate (MTX). In all patients, the dosage of MTX had already been tapered off as much as possible. After interruption of MTX treatment, the clinical course and changes in laboratory parameters were evaluated. The mean MTX-free period was 17 weeks, and the mean reduction in cumulative MTX dose was 76 mg (p = 0.05). However, only 3 patients preferred interval treatment to a continuous schedule. During the first 3 weeks of discontinuation, a significant decrease in the serum transaminases was observed, indicating a direct toxic influence of MTX on the liver parenchym. We conclude that interruption of long-term MTX treatment leads to a substantial reduction of the cumulative MTX dose and reduces the hepatotoxic load of MTX. It is necessary to motivate patients on long-term MTX treatment for regular treatment interruptions to establish a further reduction in their cumulative MTX dose.

Administration, Oral↗
PubMed1991

Ichthyosis bullosa of Siemens responds well to low-dosage oral retinoids.

Two patients with ichthyosis bullosa of Siemens (IBS) and one patient with bullous ichthyosiform erythroderma of Brocq (BIE) were treated with etretinate. Two additional patients with IBS received acitretin. All the patients had a marked improvement when on retinoids and the maintenance dose required was for IBS 10-25 mg per day. The patient with BIE was on a maintenance dose of 40-60 mg per day.

Acitretin↗
PubMed1990

[Acitretin therapy in keratinization disorders].

The introduction of the oral retinoid etretinate in the past decade has proved to be a major advance in the treatment of disorders of keratinization. During the past few years a new retinoid acitretin has been investigated in clinical trials. Acitretin has a half-life time of 2 days, versus 100 days for etretinate. Acitretin has therefore a great advantage with respect to the teratogenic potential of retinoids. The period of contraception after cessation of acitretin therapy is only two months, compared with two years for etretinate. From December 1989, etretinate has been replaced by acitretin in The Netherlands. In the Department of Dermatology of the University Hospital of Nijmegen, 36 patients with various disorders of keratinization were treated with acitretin. In this communication therapeutic results of acitretin therapy are reported. Clinical efficacy and side effects of acitretin are similar to those observed with etretinate.

Acitretin↗
PubMed1990

Severe hepatotoxic reaction with progression to cirrhosis after use of a novel retinoid (acitretin).

We report the case of a 50-year-old female who suffered from severe palmar and plantar pustulosis. During treatment with acitretin, a novel oral retinoid, which is the main derivative of etretinate, the patient developed a severe hepatotoxic reaction. Subsequent histological studies strongly suggested the development of liver cirrhosis. Reversible elevation of serum aminotransferase values during treatment with acitretin has been reported. However, the present observation indicates that severe hepatotoxic injury may also follow treatment with this agent.

Acitretin↗
PubMed1990

Acitretin in the treatment of erythrokeratodermia variabilis.

A patient with erythrokeratodermia variabilis (Mendes da Costa's disease) is presented, and the clinical and histological response to acitretin is described. An initial dose of 35 mg of acitretin and a maintenance dose of 25-35 mg resulted in a pronounced and sustained improvement. Further reduction of the dosage resulted in a relapse within a few days. At the histological level the extensive hyperkeratosis and the moderate dermal inflammatory infiltrate decreased during treatment with acitretin. In comparison with the other retinoids available so far, acitretin is the derivative of first choice in the treatment of erythrokeratodermia variabilis Mendes da Costa.

Acitretin↗
PubMed1989

Acitretin monotherapy in Darier's disease.

The dose response relationship to acitretin in five patients with Darier's disease was investigated. The patients received in the first 3 months 35 mg daily, and the dose was adjusted according to the clinical response. Four of the five patients showed a marked improvement with up to total clearance, although in two patients isomorphic reactions due to a relative overdose were seen. These isomorphic reactions improved with a reduction of dose. We suggest that treatment with acitretin is initiated at 10-25 mg daily with gradual adjustment of the dose.

Acitretin↗
PubMed1989

Acitretin monotherapy in acrodermatitis continua Hallopeau.

In a patient affected with acrodermatitis continua Hallopeau, acitretin (Ro 10-1670) monotherapy resulted in a complete clearance of pustulation at a dosage of 45 mg per day. At this dosage the leukotriene B4-induced intraepidermal accumulation of polymorphonuclear leukocytes was markedly inhibited.

Acitretin↗