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Biomedical subjects

T B Fitzpatrick

Publications and source records attributed to T B Fitzpatrick.

At least 127 records · Page 7Linked to original sources
PubMed1979

On the prognostic importance of white depressed areas in the primary lesion of superficial spreading melanoma.

The lesions of 163 patients with superficial spreading melanoma (SSM) were examined for the presence of white, depressed areas; and lesions with and without these areas of "regression" were compared. There was no statistically significant correlation with the histological level of invasion (Clark-Mihm), sex or age of the patient, location of the melanoma, or presence of local, intransit or regional lymph node metastases. It is apparent from examining the recurrence rate and patient survival, that white depressed areas in an SSM are not of prognostic importance. There was a striking correlation of the presence of white depressed areas with the size of the area covered by the malignant melanoma (p less than or equal to 0.001).

Adult↗
PubMed1979

Comparison of PUVA and beta-carotene in the treatment of polymorphous light eruption.

Therapy with oral psoralen photochemotherapy (PUVA) and oral beta-carotene was compared in 29 patients with polymorphous light eruption. Complete remission occurred in 90% (9/10) of those treated with PUVA and in 32% (6/19) treated with beta-carotene. In the six patients who were treated in consecutive years with both modalities all had remissions with PUVA while only two had remissions with beta-carotene.

Administration, Oral↗
PubMed1979

Antinuclear antibodies and oral methoxsalen photochemotherapy (PUVA) for psoriasis.

In view of theoretical concern that psoralen ultraviolet A radiation (PUVA) therapy might induce a systemic lupus erythematosus-like syndrome, we studied serum antinuclear antibodies (ANAs) in patients with psoriasis who received PUVA and are participating in a five-year prospective study. At 14 centers, 1,023 patients had two or more ANA determinations. When first and last tests were compared, the incidence of positive tests for ANAs was not significantly different (P greater than .2). In addition, there was no apparent relationship between the frequency of PUVA treatments and the probability of a positive test. Over a two-year period, there is no evidence to indicate that PUVA therapy for psoriasis has resulted in a significantly higher number of positive tests for ANAs within our population.

Adolescent↗
PubMed1979

Oral methoxsalen photochemotherapy of uncommon photodermatoses.

Three uncommon idiopathic photodermatoses, refractory to other treatment, responded to oral psoralen photochemotherapy. Tow females with photosensitivity in association with atopy, one female with persistent light reaction following a systemic drug-induced photosensitivity and an elderly male with actinic reticuloid were treated.

Administration, Oral↗
PubMed1978

Iritis in patients with cutaneous melanoma and vitiligo.

Two patients with cutaneous malignant melanoma, vitiligo, and uveitis are described. The occurrence of vitiligo following cutaneous melanoma is not uncommon and has been interpreted to result from cellular and humoral factors directed against melanoma cells that also destroy normal cutaneous melanocytes. The present cases raise the possibility that melanocytes in the eye as well as the skin may be affected.

Aged↗
PubMed1978

Controlled study of PUVA and adjunctive topical therapy in the management of psoriasis.

In a random study of 116 patients with psoriasis vulgaris, oral psoralen photochemotherapy (PUVA) used alone was compared to PUVA plus adjunctive topical therapy with tar, dithranol, or topical corticosteroids. PUVA plus topical corticosteroids produced more rapid clearing of psoriasis but despite maintenance therapy, the frequency of recurrences of the disease during the early phase of follow-up was significantly higher with that treatment, as compared to all other treatments. Dithranol plus PUVA also cleared psoriasis quicker than PUVA alone but patient acceptability for that regimen was low. The addition of tar to PUVA therapy appeared to have little influence on results.

Adult↗
PubMed1978

Oral methoxsalen photochemotherapy of recalcitrant dermatoses of the palms and soles.

PUVA therapy successfully cleared various dermatoses mainly confined to the palms and soles in 18 of 20 patients treated. The conditions treated were: plaque-type psoriasis, pustular psoriasis, endogenous eczema and persistent palmoplantar pustulosis. Seventeen patients were treated in a controlled study of PUVA therapy versus no treatment at all and in 16 of these patients the disease was cleared in the PUVA-treated areas while the untreated areas remained unchanged or deteriorated. Twelve of the 18 patients were maintained in a clear state by continued maintenance PUVA treatment over 6--31 months while 3 patients had a spontaneous remission and are free of disease off all treatment.

Adolescent↗
PubMed1978

Oral psoralen photochemotherapy of atopic eczema.

Oral administration of 8-methoxypsoralen followed by exposure to a high-intensity longwave ultraviolet treatment system resulted in clearing of atopic eczema in 15 patients. Paired-comparison studies demonstrated that this treatment was superior both to conventional ultraviolet light therapy and to no treatment. Short-term observation suggests that regular therapy is necessary to maintain remission of the disease.

Adolescent↗
PubMed1977

Oral methoxsalen photochemotherapy for the treatment of psoriasis: a cooperative clinical trial.

Extensive psoriasis in 1,308 patients has been treated two or three times a week with oral 8-methoxypsoralen followed by high intensity, long-wave ultraviolet light (PUVA). Excluding 169 patients still under early treatment, psoriasis cleared in 88% and failed to clear in 3%. One percent dropped out due to complications of treatment, and 8% for other reasons. The twice-a-week schedule was superior for patients with lighter skin types. Once a remission was induced, there was no difference in its maintenance when patients were treated once a week, once every other week, or once every third week. Each of these schedules was superior to no maintenance treatment. Immediate side effect of the 45,000 treatments administered in the first 18 months of this study were uncommon, temporary, and generally mild. No clinically significant changes in laboratory screening or eye examinations attributable to PUVA have been uncovered.

Administration, Oral↗
PubMed1977

Localization of malanin pigmentation in the skin with Wood's lamp.

Examination of the skin or hair with Wood's lamp has long been used to aid in the clinical diagnosis of some cutaneous disorders. A new observation reported here illustrates that Wood's light can be used to determine the depth of melanin pigmentation in the skin: contrast in epidermal pigmentation is increased while contrast in dermal pigmentation is decreased under Wood's lamp illumination compared to ambient visible light. The principles underlying this phenomenon are discussed. Use of the Wood's lamp to localize abnormal melanin pigmentation in the skin can be a guide to clinical diagnosis of hypermelanosis.

Diagnosis, Differential↗
PubMed1977

Monobenzylether of hydroquinone. A retrospective study of treatment of 18 vitiligo patients and a review of the literature.

Of 18 severely afffected vitiligo patients who used 20% monobenzylether of hydroquinone (MBEH, Benoquin) as a depigmenting agent, 8 achieved complete depigmentation after 10 months or more of use and 3 dramatic but no complete hypopigmentation. The 3 patients with no results did not use MBEH for more than 4 months. Complications were frequent particularly among those who did well, but only 1 case of contact dermatitis limited therapy. All patients who depigmented fully were very pleased with their results. As depigmentation induced by MBEH is generally irreversible, MBEH use must be reserved for induction of complete depigmentation of severely affected vitiligo patients who cannot or do not choose to repigment and who can accept the permanence of never tanning. The history, histology and mechanism of MBEH depigmentation are discussed.

Adult↗
PubMed1977

Photochemotherapy of psoriasis using methoxsalen and sunlight. A controlled study.

Fifty-one patients with psoriasis were treated with oral methoxsalen and sunlight exposure. Twelve of these patients received either methoxsalen or placebo prior to whole-body exposure. The remainder were treated with methoxsalen and sunlight to one side of the body and sunlight alone to the other. The conventional dose of methoxsalen (0.6 mg/kg) was compared with a low dose (0.3 mg/kg). Oral methoxsalen when used in the higher dose followed by sun exposure is an effective treatment for psoriasis. Accurate ultraviolet dosimetry is essential to avoid phototoxic burns. The advantages and disadvantages of solar photochemotherapy are discussed.

Clinical Trials as Topic↗
PubMed1977

Beta carotene therapy for erythropoietic protoporphyria and other photosensitivity diseases.

We treated with high doses of oral beta carotene (Solatene) (15 to 180 mg/day) 133 patients suffering from erythropoietic protoporphyria (EPP), 27 patients with polymorphous light eruption, six patients with solar urticaria, three patients with hydroa aestivale, one patient with porphyria cutanea tarda, and two patients with actinic reticuloid to relieve the photosensitivity associated with these diseases. Eighty-four percent of the patients with erythropoietic protoporphyria increased by a factor of 3 or more their ability to tolerate sunlight. On the other hand, only nine of the patients with polymorphous light eruption, and one fifth of the patients with all of the other forms of photosensitivity treated showed similar improvement. We conclude that beta carotene is an effective treatment for EPP, but that other forms of photosensitivity will need empirical therapeutic study with beta carotene to determine the range of effectiveness, if any, of this compound in conditions other than EPP.

Adult↗
PubMed1976

Photochemotherapy of vitiligo. Use of orally administered psoralens and a high-intensity long-wave ultraviolet light system.

A new light source that provides high-intensity ultraviolet light (UVA) (300 to 400 nm) to the entire body surface makes orally administered psoralen treatment of vitilligo with an artificial light practical. In the 26 patients studied, the degree of repigmentation with either trioxsalen (TMP) or methoxsalen (8-MOP) and high intensity UVA was at least as great as that with the same oral agents and sunlight. With artificial UVA and similar treatment conditions, the two psoralen derivatives were compared in the treatment of vitiligo; TMP stimulated repigmentation as well as 8-MOP and caused fewer side effects.

Administration, Oral↗