Demodex granuloma.
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Biomedical subjects
Publications and source records attributed to R Mihan.
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A synergism between vitamins A and E has been demonstrated by a number of investigators, notably Stanley R. Ames, who showed that in rats on a vitamin E deficient diet, the serum vitamin A level remained low, no matter how much vitamin A was given by mouth, or even by injection, but that adding vitamin E to the diet restored the vitamin A serum level to normal. We have utilized these observations with a high degree of success where vitamin A alone had failed to control three dermatologic conditions involving a defect in keratinization, namely, keratosis follicularis (Darier's disease), pityriasis rubra pilaris, and acne vulgaris. It is possible that a number of additional dermatoses characterized by dyskeratosis or hyperkeratosis might also be benefited by this combination.
A case report is presented herein of a twenty year old woman in whom an acute dermatitis of the face developed, which may have been caused by the use of a skin machine, possibly in combination with the use of a topical medication.
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Despite conflicting opinions, our personal experience and a number of reviewed clinical reports indicate that vitamin E, properly administered in adequate doses, is a safe and effective treatment for chronic discoid lupus erythematosus, and may be of value in treating other types of the disease. A possible mechanism leading to the development of autoimmune diseases, including lupus erythematosus, is discussed, together with a rational approach aimed at the cellular level, rather than at attacking the body's immune defenses, which could lead to increased susceptibility to malignant and infectious diseases.
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Autoimmune diseases are characterized by an alteration of the body's defense mechanism, designed for protection against infections and toxic injuries, which for unknown reasons attacks and destroys normal tissue. Some evidence strongly suggests that such diseases are the result of hydrolytic enzymes that escape from lysosomes whose membranes have been damaged by lipid peroxidation or other causes and that combine with and denature normal tissue proteins--in effect converting them into foreign proteins--to which the body then reacts by producing antibodies. During the past ten years, in a private dermatologic practice, we have conducted clinical investigations on the possible therapeutic value of vitamin E in the management of a number of disabling skin diseases of unknown etiology as well as several muscular disorders. Among the diseases that were successfully controlled were a number in the autoimmune category, including scleroderma, discoid lupus erythematosus, porphyria cutanea tarda, several types of vasculitis, and polymyositis. Since vitamin E is a physiologic stabilizer of cellular and lysosomal membranes, and since some autoimmune diseases respond to vitamin E, we suggest that a relative deficiency of vitamin E damages lysosomal membranes, thus initiating the autoimmune process.
Porphyria cutanea tarda is a disease characterized by a triad of cutaneous manifestations: "fragile" skin, usually involving the dorsal aspects of the hands, forearms, legs, or feet; mild hyperpigmentation; and hypertrichosis, especially of the face. The condition is due to a metabolic defect of liver function involving heme synthesis, resulting in the formation of abnormal amounts of uroporphyrin, and sometimes, coproporphyrin or both, which can be measured quantitatively in the urine. Present methods of treatment, including repeated phlebotomy, alkalinization, or chloroquine leave much to be desired. Based on recent experimental and clinical reports and on our personal experience with two patients, we suggest a more logical therapeutic approach in the form of large doses of vitamin E, which apparently corrects the metabolic defect causing the disease.
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A 70-year-old woman with polymyositis was treated with three different immunosuppressive drugs. Her condition deteriorated over a three-month period until she became totally helpness. She then made a dramatic improvement when large doses of vitamin E (d, alpha-tocopheryl acetate) were administered. Current knowledge regarding the nature of polymyositis and the rationale for using vitamin E to treat it are discussed.
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