PubMed Health⌕ Search

Biomedical subjects

T Reuther

Publications and source records attributed to T Reuther.

26 records · Page 2Linked to original sources
PubMed1998

Low-dose UVA phototherapy for treatment of localized scleroderma.

BACKGROUND: For treatment of localized scleroderma numerous treatments, including ones with potentially hazardous side effects, are currently used with only limited success. OBJECTIVE: We attempted to determine the efficacy of low-dose UVA1 irradiation in patients with severe localized scleroderma. METHODS: Patients were irradiated with 20 J/cm2 UVA1 for 12 weeks (total number of treatments: 30; cumulative UVA1 dose: 600 J/cm2). RESULTS: Low-dose UVA1 irradiation induced significant clinical improvement (clearance of > 80% of lesions) in 18 of 20 patients. Clearance was documented by clinical score as well as by 20 MHz ultrasound and histopathologic analysis. CONCLUSION: Low-dose UVA1 phototherapy can be highly effective for sclerotic plaques, even in patients with advanced localized scleroderma and with lesions rapidly evolving despite conventional therapy.

Adolescent↗
PubMed1997

Intracutaneous histamine injection can detect damage of cutaneous afferent fibres in postherpetic neuralgia.

BACKGROUND: The axon reflex response in diseased skin of patients with postherpetic neuralgia may be significantly impaired. OBJECTIVE: In the present study we introduced a simple test for quantifying the decreased axon reflex flare response in the clinical routine. METHODS: Histamine was intradermally applied to the diseased dermatome as well as to the corresponding dermatome of the contralateral side of the body. Ten minutes after application, skin blood flow and the extension of the hyperaemic response were assessed by means of laser Doppler scanning. RESULTS: In the skin region affected by the postherpetic neuralgia, the hyperaemic area was significantly smaller than in the healthy skin. The mean flux values did not differ significantly between the two sites. There was no correlation between the hyperaemic response and the intensity of pain sensation assessed by a clinical visual analogue score. CONCLUSION: The smaller hyperaemic area in the dermatome with postherpetic neuralgia strongly indicates a C fibre or C nociceptor damage. We consider histamine injections as a useful tool in the differential diagnosis of postherpetic neuralgia.

Aged↗
PubMedDate not supplied

Time course of 8-methoxypsoralen-induced skin photosensitization in PUVA-bath photochemotherapy.

In recent years PUVA-bath photochemotherapy has been shown to be an effective treatment modality for several dermatoses. A limitation of PUVA-bath photochemotherapy has been the lack of guidelines for optimal performance, including the time course of photosensitization of the skin exposed to the 8-methoxypsoralen (8-MOP) bath water solution. In the present study 12 healthy volunteers were exposed to a 20 min bath in 150 l of an 8-MOP water solution (0.5 mg/l, 37 degrees C). Immediately, as well as 1, 2, 3 and 5 h after the 8-MOP bath, irradiation was performed with increasing doses of UVA (0.5, 1, 2, 3, 5 J/cm2) on 2 cm2 test areas. The minimal phototoxic dose (MPD) was determined 72 h after the UVA exposure. In all volunteers, photosensitization was highest immediately after the bath, with a MPD significantly below 5 J/cm2 (0.5-2 J/cm2). One hour after the bath, erythema could be induced by 2 to 5 J/cm2 UVA. Two hours after the bath, erythema could be induced using irradiation of 5 J/cm2 only in two volunteers. Three and five hours after the 8-MOP bath, no erythema could be induced in any volunteer by UVA doses up to 5 J/cm2. Our results indicate that optimal bath-PUVA requires UVA irradiation immediately after the 8-MOP bath. Further, these results imply that no restrictions on further sun exposure are mandatory 3 h after the 8-MOP bath, thus allowing the patient to pursue normal life activities.

Erythema↗
PubMedDate not supplied

Effects of water temperature on photosensitization in bath-PUVA therapy with 8-methoxypsoralen.

The pharmacokinetic aspects of bath-PUVA are not completely clarified. Therefore, we determined the phototoxic response of human skin following psoralen baths at temperatures ranging from 32 degrees C to 42 degrees C (71.6-107.6 degrees F) and UVA doses ranging from 0.5 to 5.5 J/cm2. The highest therapeutical photosensitization (i.e., lowest minimal phototoxic dose) was assessed at temperatures of 37 degrees C (98.6 degrees F) and above. Photosensitization was significantly decreased at lower temperatures. These data indicate that a bath temperature of 37 degrees C (98.6 degrees F) should be used to gain optimal therapeutic efficiency in a clinical setting. Furthermore, in order to minimize the risk of adverse phototoxic effects in bath-PUVA, it is important to use a constant temperature during the psoralen bath.

Adult↗
PubMedDate not supplied

The effect of the base on the kinetics of action of the capsaicinoid nonivamide: evaluation with a hyperemic test.

Because of their selective receptor-mediated action on cutaneous nociceptive C-fibers, the interest in capsaicinoids as topical analgetic drugs has been constantly growing over the past years. Knowledge of the pharmacokinetics seems particularly important for potential future clinical applications. Therefore, the aim of the present study was to investigate the influence of the type of preparation on the time course of action of the capsaicinoid nonivamide monitored by the axon-reflex-induced hyperemic action and area of erythema. Sixteen healthy subjects were included in the study. The hyperemic responses after application of nonivamide in an oil-in-water (O/W) emulsion and in a water-free ointment were assessed both by laser Doppler perfusion imaging and planimetry after 0, 15, 30, 45, 60, 120 and 240 min. They were compared with the reaction after application of the nicotinic ester nicoboxil and a combination of nonivamide and nicoboxil in the same preparations. Applied as a water-free ointment, nonivamide showed a slow onset of hyperemic action, reaching its maximum 45 min after application. When applied as an O/W emulsion, however, the increase in effect was high, reaching its maximum already after 30 min. Application of the nicoboxil preparations revealed a clearly lesser influence of the base regarding the onset of maximum effect. The combination of both substances showed an additive effect for both bases, and a maximum effect was found already after 15 min with both the water-free ointment and the O/W emulsion base. In conclusion, the results of the present study show that there appears to be a strong influence of the vehicle on the kinetics of action of capsaicinoids, and that the hyperemic test used in this paper is very useful for the quantitative determination of the pharmacokinetic properties of capsaicinoids. Moreover, the C-fiber-stimulating effect of capsaicinoids can, at least in part, be enhanced by combination with a nicotinic ester, even though these substances have no direct effect on the C-fibers.

Adolescent↗