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Biomedical subjects

W Wigger-Alberti

Publications and source records attributed to W Wigger-Alberti.

At least 19 recordsLinked to original sources

Assessment of topical corticosteroid activity using the vasoconstriction assay in healthy volunteers.

OBJECTIVE AND DESIGN: The aim of the study was to evaluate the vasoconstrictive activity of four new galenic preparations of hydrocortisone and to compare it with concentration-equivalent reference preparations. The study comprised two study phases: the pilot study phase and the main study phase. During open, nonrandomized pilot study, the optimal administration period was tested. The main study was performed in a randomized, double-blind intraindividual comparative design. SUBJECTS: Twenty male and female volunteers with healthy skin who responded to topically applied clobetasol-17-propionate before entering the trial participated in this study. TREATMENT: All subjects received the same treatments. The test preparations new galenic formulation (NGF) hydrocortisone 0.25% cream, NGF hydrocortisone acetate 0.25% cream, NGF hydrocortisone 0.5% cream, and NGF hydrocortisone 1.0% cream were compared with the respective reference preparations Soventol hydrocortisone (hydrocortisone acetate 0.25%), Hydroderm HC 0.5% cream (hydrocortisone 0.5%), Hydrogalen cream (hydrocortisone 1.0%) and placebo (vehicle of test preparations). METHOD: The topical preparations were applied occlusively for 2 h (pilot study) or 24 h (main study) on outlined areas (5 x 5 cm with a distance of 3 cm) of both forearms (4 areas for each). Assessment of vasoconstriction was performed before treatment, and 0.5, 4, 6 and 24 h after treatment (observation period) using a subjective rating scale (OLSEN vasoconstriction score) and measuring the colorimetric parameter a* (redness) by use of the Chroma-Meter (Minolta company, Ahrensburg, Germany). RESULTS: A significant vasoconstriction (positive blanching effect) was measured by use of chromametry for test preparations hydrocortisone 0.25% cream, hydrocortisone 0.5% cream, hydrocortisone 1.0% cream and for the reference preparation Hydrogalen cream compared to placebo 30 min after the end of treatment. In contrast, the reference preparations Soventol hydrocortisone and Hydroderm HC 0.5% did not differ significantly from placebo 30 min after treatment. No statistically significant effect of all formulations was observed 4-24 h after treatment in comparison with placebo. CONCLUSIONS: The vasoconstrictive efficacy of test preparations was mostly stronger than the concentration-equivalent reference preparations. This effect was achieved by use of new galenics of test preparations resulting in enhanced skin penetration and improved efficiency. No unwanted side effects were observed during the course of the study despite increased efficacy of the topically applied test preparations.

Administration, Cutaneous↗

Skin-conditioning products in occupational dermatology.

Moisturizers are frequently used in the prevention of occupational contact dermatitis. This review discusses their chemistry and mode of action. Methods to prove their preventive efficacy are presented. In addition to pharmacological efficacy, subjective factors that influence application of the products and compliance come into play. In conclusion, moisturizers are only one element of skin-disease prevention at the workplace that should be viewed as a complex, inter-dependent system. The efficacy of the complete, integrated system of occupational skin care has to be proven.

Dermatitis, Occupational↗

The atopy patch test -- reproducibility and comparison of different evaluation methods.

BACKGROUND: There is still a lack of standardization of the atopy patch test (APT) in test procedures and evaluation methods. Our aim was to examine the reproducibility of APT results and to compare visual evaluation to chromametry and laser Doppler imaging. METHODS: Fifty-two volunteers with atopic eczema/dermatitis syndrome (AEDS) were included. The APT was performed on tape-stripped and unstripped test fields on their backs using cat dander, house dust mite and grass pollen allergens from two different suppliers. Responders were re-tested 4-12 weeks later with the same allergens on their forearms. RESULTS: Using Allergopharma allergens, 14 (26.9%) volunteers showed one or more positive reactions. The reproducibility rate was 56.3%. The Erlangen atopy score in APT-positive and negative volunteers was 19 +/- 6 vs 15 +/- 6. The test agreement in volunteers tested with both allergens, from Allergopharma and Stallergènes, was poor. Correlation of the results between the three evaluation methods was significant (P < or = 0.001). CONCLUSIONS: The low reproducibility rate of APT results and the poor inter-test-agreement using allergens from different suppliers show that much work remains to make the APT a reliable tool in identifying relevant aeroallergens that lead to flare ups of AEDS. Compared to chromametry and laser Doppler imaging, visual scoring was superior in differentiation between irritative and allergic reactions.

Adolescent↗

Natural vegetable fats in the prevention of irritant contact dermatitis.

Chronic irritant contact dermatitis (ICD) is one of the most pressing problems in occupational medicine and is common in the food processing industry. To date, protective creams that fulfil the special requirements in the foodstuffs industry have not been available. Therefore, we studied the efficacy of pre-exposure application of natural vegetable fats in the prevention of experimentally induced ICD. A panel of 20 healthy volunteers was tested with a repetitive irritation test using sodium lauryl sulfate (SLS) as a standard irritant in a randomized study. Application sites were assessed clinically and by the use of bioengineering techniques (evaporimetry, chromametry, and corneometry). Rape seed and palm fats showed significant protective potential. Gas-chromatographic analysis revealed differences in the fatty acid composition of the vegetable. Higher content of linoleic acid and lower content of oleic acid was associated with beneficial effects. Our results are a new approach in the prevention of ICD and towards the development of new protective preparations for workplaces in the foodstuffs industry.

Adult↗

Case report. Monascus purpureus--a new fungus of allergologic relevance.

Anaphylactic reactions to food containing allergens in the consumption or preparation of food are well known. However, allergy in the preparation of sausages has rarely been described. In the present study a 26-year-old-butcher was investigated who had a severe anaphylactic reaction developing sneezing, rhinitis, conjunctivitis, generalised pruritus, followed by widespread urticaria, Quincke's oedema and dyspnoe after starting to prepare sausages containing red yield rice. Red yield rice is produced by the fungus Monascus purpureus. It was the first time that Monascus purpureus could be shown as allergic agent by means of prick-to-prick test, Cellular Antigen Stimulation Test (CAST) and different immunoblots.

Adult↗

[Clinical effectiveness and tolerance of climbazole containing dandruff shampoo in patients with seborrheic scalp eczema].

Pityrosporum ovale appears to play an important role in the pathogenesis of dandruff as a symptom of seborrheic dermatitis. Climbazole is an antimycotic agent with a high in vitro and in vivo efficacy against P. ovale. In the presented work we investigated the efficacy and safety of a climbazole 0.65% shampoo on seborrheic dermatitis of 30 volunteers. Subjects were diagnosed as having moderate to severe seborrheic dermatitis of the scalp. After a 1-week washout and a 4-week treatment the clinical evaluation showed a successful reduction of dandruff, skin redness and itching in 80% of the volunteers and a mild improvement in 20% of the volunteers. The cosmetic acceptability was very good by the majority. It is concluded that the formulation tested is effective in the treatment of moderate to severe dandruff.

Adult↗

[Mucocutaneous candidosis in a patient with Sjögren syndrome].

Oral candidiasis is common among patients with Sjögren's syndrome. For the first time we report on a 60-year-old female patient, who developed a non-familiar chronic mucocutaneous candidiasis of later life. She presented with the following symptoms: oral candidiasis and glossitis, angulus infectious, vulvovaginitis, lichen planus-like onychodystrophy of the finger-nails and chronic nail bed inflammation of the nails of the big toes. The knowledge of chronic mucocutaneous candidiasis is of prognostic and therapeutic relevance, since topical treatment often fails.

Candidiasis, Chronic Mucocutaneous↗

Efficacy of a barrier cream and its vehicle as protective measures against occupational irritant contact dermatitis.

The actual advantage of barrier creams over bland emollients for skin protection is still hotly debated. In a randomized, double-blinded study, a newly-introduced barrier cream and its moisturizing vehicle were compared regarding their skin compatibility, efficacy and resulting acceptance. Thus, 2 panels of 25 hospital nurses with mild signs of skin irritation were asked to use 1 of the test products provided (verum or vehicle) over a period of 4 weeks. Effects of both types of preparations were studied weekly by clinical examination and the instrumental assessment of bioengineering parameters. Results showed no significant differences between barrier cream and vehicle. In both groups, clinical skin status improved and stratum corneum hydration increased significantly during the study period. Both preparations were tolerated and accepted well, thus showing both skin protection and skin care. These results contribute to the debate as to whether a strict distinction between "skin care" and "skin protection" products is justified. The vehicle alone is capable of positively influencing skin status. Emphasis must be laid on regular, frequent, and correct application of a product for it to be effective.

Adult↗

Multicentre study for the development of an in vivo model to evaluate the influence of topical formulations on irritation.

Although skin protective products to prevent irritant skin reactions are in wide use, neither standardized test models to prove differences in efficacy exist, nor has the quality or the reproducibility of results been evaluated in a multicentre approach. This should be mandatory when developing or testing skin care products. Therefore, we have designed a multicentre study in an approach to find a standardized test procedure for the evaluation of skin protective products. In this irritation study, a repeated short-time occlusive irritation test (ROIT) with a standardized protocol has been evaluated in 2 phases (12 days and 5 days protocol) in 4 (n=20) respectively 6 (n=33) skilled centres. The skin reaction was induced by 2 irritants (0.5% aq. SLS and toluene, 2x a day for 30 min). Its modification by 3 different cream bases with different hydrophilicity was analyzed. The irritation was monitored by bioengineering methods (TEWL measurement, colorimetry) and by clinical scoring. The evaluation showed that significant results could already be achieved with the 5-day protocol. Furthermore, in spite of the expected inter-centre variations due to heterogeneity of the individual threshold of irritation, interpretation of clinical score, and inter-instrumental variability, the ranking of the vehicles regarding reduction of the irritant reaction was consistent in all centres.

Administration, Topical↗

Experimental irritant contact dermatitis due to cumulative epicutaneous exposure to sodium lauryl sulphate and toluene: single and concurrent application.

In clinical practice, cutaneous exposure to a variety of irritants such as surfactants and solvents is frequent. Although the induction of irritant dermatitis by single irritants has been extensively studied in recent years, our knowledge of the effects of simultaneous application of different irritants is limited. Using non-invasive techniques for measurements of transepidermal water loss (TEWL) and skin colour reflectance, we quantified the irritant effects of single and concurrent application of 0.5% sodium lauryl sulphate (SLS) and undiluted toluene (TOL) in vivo. The irritants were applied twice daily for 30 min to the volar forearms of 20 volunteers. Repeated application of SLS and TOL induced an irritant reaction, as indicated by an increase in TEWL and skin redness. In contrast to SLS alone, the application of TOL alone induced only a moderate increase in TEWL, confirming previous results. Concurrent application of SLS/TOL and TOL/SLS induced significantly stronger reactions than those caused by twice daily application of each irritant on its own. Our results demonstrate that a mixed application of an anionic detergent and an organic solvent has an additive effect on skin irritation. It is suggested that pretreatment with SLS causes an increased susceptibility to TOL irritation and vice versa. Thus, the necessity for special precautions against skin absorption of TOL when handling detergents such as SLS is emphasized.

Administration, Cutaneous↗

[Monascus purpureus: a new fungus of allergenic relevance].

Anaphylactic reactions to food containing allergens in the consumption or preparation of food are well known. However, allergy in the preparation of sausages have rarely been described. In the present study a 26-year-old butcher was investigated who had a severe anaphylactic reaction developing sneezing, rhinitis, conjunctivitis, generalised pruritus, followed by widespread urticaria, Quincke's oedema and dyspnoe after starting to prepare sausages containing red yield rice. Red yield rice is produced from polished and washed rice by means of the fungus Monascus purpureus. It was the first time that Monascus purpureus could be shown as allergic agent by means of prick-to-prick test, Cellular Antigen Stimulation Test (CAST) and different other immunoblots.

Adult↗

[Giant condylomata acuminata (Buschke-Löwenstein tumor)].

HISTORY AND ADMISSION FINDINGS: A 59-year-old woman had for 3 weeks been suffering from painful, moist skin changes on the external genitals, for 3 months having noticed vegetations in the anogenital and perineal region. She had been fatigued and lacking in energy since then. Her last gynecological examination had been 20 years ago. Examination of the skin on admission revealed extensive plaque and cauliflower-like warts and large areas of maceration in the anogenital region, the labia and perineum, with large areas of maceration. Nodules were clearly palpable in the left labium majora: the inner aspects were markedly reddened and had some cutaneous erosions. These findings suggested giant condyloma (GC; Buschke-Löwenstein tumour). INVESTIGATIONS: Biopsy showed marked condylomatous epithelial proliferations which, with the formation of markedly thickened epithelial cones, had reached the stage of a verrucous carcinoma. TREATMENT AND COURSE: Under local anti-inflammatory and adstringent medications the inflammatory reaction quickly subsided. Vulvectomy was performed to remove the tumour. CONCLUSION: Giant condyloma (Buschke-Löwenstein tumour) is a rare pseudocancereous lesion. If human papilloma viruses of type 16 or 18 is demonstrated in the lesions, malignant degeneration should be considered. Histological examination is essential to differentiate it from squamous cell carcinoma.

Carcinoma, Verrucous↗

[Prevention of allergy by protective skin creams: possibilities and limits].

Despite promising efficacy data for protective creams and many scientifically proven advances that have been achieved concerning the prevention of irritative contact dermatitis, protection against sensitising substances remains a particular problem due to the minimal amounts of allergen that trigger allergic contact dermatitis. Therefore, specific allergen-blocking substances have been tested which are designed to prevent sensitising processes and in particular avoid occurrence of contact dermatitis in already sensitised individuals. In this review, we present the results of current studies mainly focussed on preventing occupational contact dermatitis caused by metal salts, using different chelating agents. In the United States allergic contact dermatitis is often due to strongly sensitising plant allergens of Toxicodendron species, a factor of importance in outdoor professions. Therefore, attempts have been made to use linoleic acid dimers and organoclay materials such as quaternium-18 bentonite for prophylaxis in topical treatments. Most studies investigate effectiveness against experimentally induced allergic contact dermatitis in sensitised volunteers using standardised allergen extracts. Although several preparations showed some benefit by possibly preventing certain quantities of allergen from penetrating the epidermis, further effort will be required before sufficient protective creams with allergen-blocking properties are available for workplaces.

Adrenal Cortex Hormones↗

[Acquired reactive perforating collagenosis in diabetes mellitus].

HISTORY AND ADMISSION FINDINGS: A 70-year-old woman with type 2B diabetes mellitus was referred to the dermatology department because of inflammatory skin changes of unknown origin over the trunk and limbs. On admission follicular and parafollicular livid-red papulae with central crusts and reddened margins were noted over the lower legs and the lumbosacral region. INVESTIGATIONS: Further physical examination revealed no additional abnormalities. Erythrocyte sedimentation rate was 41/79 mm. The day-time blood-glucose profile was raised (10.2, 12.6 and 8.6 mmol/l), as was the glycosylated haemoglobin HbA1c (9.0%). Swabs from fresh lesions gave no evidence of fungal or bacterial infection. Biopsies revealed areas of widened epidermis with central ulceration filled with fibrin, granulocytes and collagen fibres. DIAGNOSIS, TREATMENT AND COURSE: The clinical and histological findings indicated an acquired reactive perforating collagenosis (dermatosis) which should be judged in relation to the long-standing diabetes mellitus. The cutaneous changes were covered with salicylate- and steroid-containing preparations, while individual lesions were excised or removed by curettage. CONCLUSION: The condition of acquired reactive perforating collagenosis is, like Kyrle's disease (perforating follicular and parafollicular hyperkeratotic dermatosis), perforating serpiginous elastosis and perforating folliculitis classified among the perforating dermatoses. In the presence of renal failure and (or) diabetes mellitus these dermatoses must be thought of in the differential diagnosis, in addition to the more frequent pruriginous conditions, if there are corresponding skin changes.

Administration, Cutaneous↗

[Melatonin in dermatology. Experimental and clinical aspects].

Melatonin (N-acetyl-5-methoxytryptamine) is a hormone with multiple functions in humans, produced by the pineal gland and stimulated by beta-adrenergic receptors. Serum melatonin levels exhibit a circadian rhythm with low levels during the day, rise in the evening and maximum levels at night between 2 and 4 a.m. Melatonin participates in the regulation of several physiological processes such as seasonal biological rhythm, daily sleep induction, aging and modulation of immunobiological defence reactions. Furthermore, melatonin has a highly lipophilic molecular structure facilitating penetration of cell membranes and serving as an extra- and intracellular free radical scavenger. Melatonin seems to quench mainly hydroxyl radicals, the most damaging of all free radicals. Melatonin may play a role in the etiology and treatment of several dermatoses e.g. atopic eczema, psoriasis and malignant melanoma. The influence of melatonin on hair growth is another aspect. Topical application of melatonin inhibits the development of UV-erythema. Penetration through skin after topical application and oral bioavailability auxit further investigations on the pharmacokinetic and pharmacodynamic actions of melatonin.

Animals↗

Experimentally induced chronic irritant contact dermatitis to evaluate the efficacy of protective creams in vivo.

BACKGROUND: Widely accepted in vivo models to evaluate the efficacy of protective creams (PCs) are still missing. OBJECTIVE: The effect of petrolatum's ability to protect against irritation was tested in a repetitive irritation test to optimize the concentration of irritants against which PCs are tested and to evaluate the necessary cumulative application time. METHODS: On 20 healthy volunteers, the irritants (sodium lauryl sulfate 5% vs 10%, sodium hydroxide 0.5% vs 1%, lactic acid 20% vs 30%, and toluene undiluted) were applied daily for 2 weeks on the ventral forearms after 30 minutes of pretreatment with petrolatum. The irritant cutaneous reactions were quantified by erythema score, transepidermal water loss, and chromametry. RESULTS: For petrolatum, a significant protective effect was obtained against irritation by sodium lauryl sulfate, sodium hydroxide, and toluene in different degrees. Less efficacy was observed against lactic acid. CONCLUSION: It was concluded that a 1-week period of cumulative irritation is enough to evaluate the efficacy of PCs against most irritants, even if lower concentrations of irritants are used.

Adult↗