Hepatitis and HIV risk review.
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HIV Infections↗
Biomedical subjects
S I Cullen
Publications and source records attributed to S I Cullen.
Successful treatment of disseminated cutaneous sporotrichosis with ketoconazole.
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Aged↗
Double-blind bilateral paired comparison of 0.05% halobetasol propionate cream and its vehicle in patients with chronic atopic dermatitis and other eczematous dermatoses.
Six investigators evaluated 0.05% halobetasol propionate cream and its vehicle in 111 patients with chronic atopic dermatitis and several other eczematous dermatoses. Patients applied treatment twice daily to bilateral lesions for 14 days. Investigators graded pruritus, erythema, scaling, papulation, and lichenification using 4-point severity scales on days 0, 7, and 14. On day 14 patients provided an assessment of efficacy for both treatments. Statistically significant differences favoring halobetasol propionate over the vehicle were seen for all signs and symptoms (p less than 0.001). Substantial improvements were achieved by the active treatment by day 7 (p less than 0.001). Patients assessments of efficacy were significantly higher for halobetasol cream than for vehicle (p less than 0.001). No instances of systemic effects or skin atrophy were reported and adverse experiences were limited to burning or stinging and other minor, nonspecific complaints distributed uniformly between active treatment and vehicle. These results demonstrate that 0.05% halobetasol propionate cream is highly effective in the treatment of atopic dermatitis and other eczematous dermatoses.
Administration, Cutaneous↗
Acquired progressive kinking of the hair.
The clinical findings in three new cases of acquired progressive kinking of the hair, all in females, are reported, and a review of all previously reported cases is presented. Acquired progressive kinking of the hair is an acquired disorder of hair formation in which patches of hair become tightly curled and resemble pubic hair. It seems to be more common in males and is associated with darkening of the involved hair in about two thirds of the patients. The differential diagnosis includes inherited forms of kinky hair and kinky hair secondary to mechanical, chemical, or traumatic manipulation. Drugs are infrequently implicated in its causation.
Adolescent↗
Effective topical dermatologic therapy.
Experienced dermatologists regularly use a great variety of topical dermatologic mixtures. Extemporaneously prepared medications are of great value in the treatment of those problems that fail to respond to the usually therapeutic commercially available products. These mixtures are also desirable in treating individuals in whom corticosteroid preparations were initially beneficial but were of less value with continued application. This article presents an accumulation of a quarter century of practical extemporaneously compounded dermatologic preparations.
Administration, Topical↗
Tretinoin-sunscreen mixture in the treatment of acne vulgaris.
In an open design study of fifty-four patients with grade I or grade II acne vulgaris, the combination of 0.1 percent tretinoin cream (Retin-A) and a sunscreen with sun protection factor 15 (Sundown) was evaluated. Overall study results of the forty-six patients who could be evaluated demonstrated a decrease in papule count of 25.9 percent, a decrease in closed comedones of 49.1 percent, and a decrease in open comedones of 36.3 percent by the end of the eight-week study period. These results indicate that the addition of a noncomedogenic sunscreen to tretinoin did not compromise its effectiveness and successfully prevented photoaccentuation reactions.
Acne Vulgaris↗
Treatment of tinea pedis with econazole nitrate cream.
This study investigated the clinical effectiveness and the long-term relapse rate of the topical imidazole, econazole nitrate, in the treatment of tinea pedis. Econazole nitrate cream was applied by twenty-two patients with tinea pedis for twenty-eight consecutive days. Therapy was then discontinued and patients were evaluated to determine the long-term relapse rate. Nineteen (86 percent) of the twenty-two patients were considered cured at the end of twenty-eight days of treatment. At the follow-up examinations, 74 percent of the group considered to be clinically cured at the end of therapy remained clear for one month, 84 percent for two months, and 63 percent for three months after stopping active treatment. These data demonstrate that econazole nitrate is a highly effective topical agent in the treatment of tinea pedis and that clinical and mycologic cures in almost two thirds of the patients last for at least three months.
Econazole↗
Age of patients with tines versicolor.
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Adolescent↗
Abrasive cleansing in the management of acne vulgaris.
The comparative effectiveness of an abrasive cleaner and the same cleansing agent without the abrasive granules was evaluated using a bilateral paired comparison method in 44 patients with acne vulgaris. Lesion counts and an appraisal of the severity of disease were made every two weeks for a total of eight weeks. An equal reduction in both the number and severity of acne lesions was seen with each test product. Substantial differences between the adverse effects of these two products were not observed.
Acne Vulgaris↗
Topical fluorouracil therapy for precancers and cancers of the skin.
Topical fluorouracil (FU) is an extremely effective agent for treating multiple actinic keratoses. It is also of value in the treatment of Bowen's disease, actinic cheilitis, arsenical keratoses, radiodermatitis, X-ray-induced keratoses, leukoplakia, and the erythroplasia of Queyrat. Topical FU may be successful in the treatment of superficial basal-cell carcinomas, but should not be used for nodular carcinomas of the face or neck except under unusual circumstances and with mandatory histologic follow-up evaluation. The usual method of treatment is twice daily application of a 1 percent FU solution in propylene glycol. Several modifications of various types of commonly employed preparations and the manner in which each is used are described, along with the respective indications. The considerable discomfort associated with the use of topical FU can be lessened by the stepwise approach outlined--a method extraordinarily valuable for older patients. Occasional complications are primary irritant dermatitis and allergic contact dermatitis; these must be recognized promptly and treated, as must other less frequent side effects. Topical FU appears to be of great value in the destruction of existing precancerous skin lesions. When used repeatedly, it may postpone indefinitely the development of significant precancerous and cancerous skin lesions.
Administration, Topical↗
Dermatologic adverse drug reactions in hospitalized patients.
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Adolescent↗
The dropout patient.
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Clinical Trials as Topic↗
Successful treatment of reactive perforating collagenosis with tretinoin.
The clinical and histologic features of lifelong reactive perforating collagenosis in a twenty-five year old woman are presented. Experimentally induced lesions showed the expected evolution and regression, although total time for the experimental lesion to develop and regress was shorter than the time necessary for those occurring spontaneously. Therapeutic trials with a wide variety of topical and systemic medications were without benefit, with the exception of tretinoin cream (0.1 percent), which was regularly effective in reducing the total number of lesions present.
Administration, Topical↗
Localized Ehlers-Danlos syndrome.
A 34-year-old woman had the cutaneous features of the Ehlers-Danlos syndrome, which was strictly limited to the skin and subcutaneous tissue in the region of the left shoulder. The disorder started at approximately age 22 with the development of subcutaneous nodules. Hyperextensibility of the skin in this region developed within the subsequent five years. There was a notable lack of the usually associated joint hyperextensibility, bleeding tendency, scar formation, or the serious systemic components of the Ehlers-Danlos syndrome.
Adult↗
Low-dose minocycline therapy in tetracycline-recalcitrant acne vulgaris.
Ninety-one patients with acne vulgaris were selected for a two-part study primarily because the severity of disease suggested that it might be tetracycline-recalcitrant. Of the eighty-eight patients completing the first part of the study, thirty-two were judged to have tetracycline-nonresponsive acne and received 50 mg of minocycline twice daily for the next six to eight weeks. Twenty-five patients completed this second part of the study. Of these twenty-five, twenty-two experienced a 33 percent or greater reduction in the number of lesions. It is concluded that minocycline in a dosage of 50 mg twice daily is a safe and effective antibiotic for those patients with tetracycline-recalcitrant acne vulgaris.
Acne Vulgaris↗
Minocycline therapy in acne vulgaris.
A double-blind, random distribution study showed that a lower than recommended dose of minocycline--50 mg twice daily--was as effective as a dose of 250 mg twice daily of tetracycline for treatment of acne vulgaris in comparable patient groups, and that minocycline produced no vestibular side effects at the lower dosage. Like tetracycline, minocycline did not produce the phototoxicity associated with demeclocycline or the life-threatening colitis associated with clindamycin. Patients in this study did not develop a resistance either to minocycline or to tetracycline. Studies of the use of minocycline in patients who have developed tetracycline resistance and long-range studies of patients on the new lower dose of minocycline are now underway.
Acne Vulgaris↗
Pseudopelade of Brocq secondary to lichen planus.
Immunofluorescence studies as as the underlying cause of pseudopelade of Brocq (PPOB) in a middle-aged woman. The routine use of immunofluorescent studies in clinical cases of pseudopelade of Brocq might make more specific diagnoses possible.
Alopecia↗
Topical methenamine therapy for hyperhidrosis.
Methenamine, in a gel stick formulation, effectively decreased palmar and plantar sweating in 24 of 26 individuals studied. All patients had essential hyperhidrosis and were evaluated in a double-blind, placebo-controlled study. Even though methenamine is believed to act by the slow release of formaldehyde, one patient, who had a formaldehyde sensitivity that was proved by a patch test, was able to use the methenamine gel stick without difficulty. Approximately one third of the patients experienced some continuing relief for one to three weeks after discontinuing the trial medication. I conclude that methenamine is a safe, effective addition to the available types of topical therapy for essential hyperhidrosis.
Administration, Topical↗