[Determination of sulfur in ichthammol and some preparations containing ichthammol].
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The clinical efficacy of glycerine-ichthammol in otitis externa may be due to an anti-inflammatory action of ichthammol or a dehydrating effect of glycerine on the oedematous ear canal. Its antimicrobial activity, if any, against the common organisms in otitis externa is not well known. A study of the antibacterial property of glycerine-ichthammol as measured by a growth inhibition test and a modified cidal assay, showed inhibition of selected gram positive organisms (Streptococcus pyogenes and Staphylococcus aureus) by ichthammol and glycerine-ichthammol combination, but only negligible antibacterial activity against Pseudomonas aeruginosa and Escherichia coli. Candida albicans was also weakly inhibited. As the activity against gram negative organisms is minimal, incorporation of an anti-gram negative antibiotic such as gentamicin in the glycerine-ichthammol compound to enhance its antibacterial spectrum is suggested.
Glycerol and ichthammol (G & I) has been used for generations by otologists. However, there is a paucity of information on both its mode of action and its anti-bacterial properties. The aim of this paper was to ascertain firstly, what the most common organisms found in discharging ears were and secondly, what antibacterial activity G & I had against these organisms. All ear swabs from 1992-1994 in our unit were reviewed to ascertain the prevalence of the commonly isolated organisms. Fresh isolates of these organisms were collected and plated onto agar with wells of glycerol, ichthammol and a combination of both as used in clinical practice. The diameters of the zones of inhibition observed after incubation were measured in millimetres. Common isolates were: Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabalis, Streptococcus pyogenes in descending order of frequency. Pure glycerol showed no significant zones of inhibition against any of the organisms tested. The average zones of inhibition for G & I and ichthammol alone were for Staphylococcus aureus 15 mm and 18 mm and for Streptococcus pyogenes: 16 mm and 23 mm. Ichthammol alone was significantly more effective than G & I (p < 0.001). There was no significant activity against Proteus mirabalis and Pseudomonas aeruginosa. The therapeutic benefit of G & I is due in part to the inherent anti-bacterial activity of ichthammol against the Gram positive organisms as well as its anti-inflammatory action and the dehydrating effect of the glycerol.
Dark sulfonated shale oil (Ichthammol, ammoniumbituminosulfonate) is an active ingredient of natural origin that was included in Annex II of European Council Regulation (EEC) 2377/90. Therefore, this well-tolerated substance is available further on as a dermatological agent for the application to animals from which food is produced for human consumption. The manifold pharmacological actions could be substantiated in numerous in-vitro studies using the Ichthammol from Seefeld, Austria. The antiinflammatory action which is well-known from clinical experience could be traced back to an influence of the substance on the formation, secretion and effect of inflammation mediators. Antibacterial and antimycotic actions which are well-known from clinical use could be confirmed in in-vitro studies as well.
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Bituminous tars (Ichthammol and Ichthyol Pale) are widely used in pharmaceutical, veterinary and cosmetic industries for their anti-microbial, anti-inflammatory and anti-pruritic effects. In contrast to coal tar, no phototoxicity of bituminous tars has been reported in man, although both Ichthammol and Ichthyol Pale exhibit UV absorption which is higher and broader for the former. The validated 3T3 NRU phototoxicity test indicated phototoxic potential of both substances. The phototoxicity test in a 3D human skin model (EpiDerm) only confirmed phototoxicity for Ichthammol. Human data on Ichthammol phototoxicity are missing. A photopatch test in human volunteers was performed in order to clarify the discrepancy between the phototoxicity found in the skin model and the absence of reported human phototoxicity. Following 4h exposure to 5% and 10% aqueous solutions of Ichthammol and Ichthyol Pale the test sites were irradiated with a UVA dose of 5 J/cm(2). Early phototoxic reaction (erythema) within 4-6h after irradiation was only elicited by Ichthammol and not by Ichthyol Pale. These data correspond well with those from the 3D skin model test and suggest the necessity to employ several test systems for final phototoxicity assessment. In addition to the results obtained in 3T3 NRU PT, further testing on 3D skin models may better reflect bioavailability of a given chemical in the skin, relevant to the situation in humans.
BACKGROUND: Application of various technological procedures for the manufacture of officinal preparation ointment against chilblains (Unguentum contra perniones) produce essential variations in the quality and stability of the final product. Changing the sequence of admixing active substances into the ointment base indicated the presence of incompatibility between the active substances, as well as between the active substances and the ointment base components. The aim was to examine the influence of various technological manufacturing procedures on quality and stability of the preparation. METHODS: Changes in the samples of ointments and aqueous solutions of active substances were analysed microscopically. RESULTS: Microscopic analysis of hydrosoluble active substance solutions demonstrated destruction of ichthammol, induced by an acidic medium due to the dissolution of tannin and resorcinol, which is well known from the literature. It also demonstrated the destruction of tannin and resorcinol in aqueous solution, which had not been described in the literature. Application of the prescribed procedure for the manufacturing of ointment against chilblains, conceals the incompatibility reactions due to a slow dissolution of the tannin suspended in the officinal ointment base Unguentum cera lanae. Admixture of an ready-made aqueous solution of tannin caused an instant contact between ichthammol and the acidic medium, which caused the destruction or the complete absence of the formation of emulsion droplets. The problem of incompatibility reactions between lanolin alcohols in the ointment base and ichthammol and resorcinol, as well as the reaction between Peruvian balsam and sulfur from the ichthammol sulfate ion was observed. Numerous incompatibility reactions of ointment against chilblains, components indicated that it was necessary to introduce alterations in both the qualitative and quantitative composition of the preparation. CONCLUSION: Excipient preparation procedure, as well as the technological procedure for incorporation of active ingredients can cause the incompatibilities and therefore the formulation stability problems.
Sulfonated shale oils (ammonium bituminosulfonate, ichthammol, Ichthyol), shown previously to induce the directed migration of human neutrophils in Boyden chambers and to inhibit the directed migration towards the chemotactic factors C5a, LTB4, and f-Met-Leu-Phe, were studied for their effect on other neutrophil functions, which are stimulated by chemotactic factors. Like other chemotactic factors ammonium bituminosulfonate increased the adherence of neutrophils to nylon fibers, but it did not induce the release of the primary granule enzyme glucosaminidase from cytochalasin B-treated cells and it did not stimulate the production of oxygen radicals as measured by lucigenin-dependent chemiluminescence if studied under nontoxic conditions. When added together with the chemotactic tripeptide f-Met-Leu-Phe, ammonium bituminosulfonate inhibited adherence augmentation, enzyme release, and oxygen-radical production induced by the chemotactic factor. The results indicate that ammonium bituminosulfonate not only inhibited chemotactic migration but the whole spectrum of neutrophil functions induced by a chemotactic factor.
A 36-year-old man presented with a non-pruritic, erythematous facial rash with peri-oral and peri-orbital sparing. The initial clinicopathological diagnosis was rosacea fulminans, which was treated with 25 mg oral prednisolone and cephalexin. The patient re-presented 1 week later with exacerbation of his rash in addition to constitutional symptoms of fever and malaise. A further skin biopsy was taken and the marked neutrophilic infiltrate in the absence of vasculitis made the diagnosis of Sweet's syndrome (acute febrile neutrophilic dermatosis). High-dose prednisolone (50 mg daily), topical hydrocortisone cream and ichthammol in zinc ointment were commenced with rapid clinical improvement. This case highlights the importance of considering Sweet's syndrome as a differential diagnosis when presented with a facial eruption.
OBJECTIVE: To determine whether serum soluble interleukin 2 receptor concentrations are related to disease activity in atopic eczema. DESIGN: Single cohort longitudinal study with controls. SETTING: Outpatient and general medicine departments in secondary referral centre. PATIENTS: Of 15 patients aged 17-57 with severe atopic eczema, all with acute exacerbations of disease, 13 were admitted to hospital and two treated as outpatients until the skin lesions had resolved or greatly improved. Nineteen controls gave single blood samples. INTERVENTIONS: Daily skin dressing with betamethasone valerate (0.025%) and ichthammol paste and tubular dressings. END POINT: Resolution of or considerable improvement in skin lesions. MEASUREMENTS AND MAIN RESULTS: Enzyme linked immunosorbent assays (ELISA) were used to measure serum soluble interleukin 2 receptor concentrations in blood samples taken on admission, at intervals subsequently, and on discharge. Clinical scores of disease activity were also made. Median concentrations on admission were significantly higher (770 U/ml) in the patients than the controls (300 U/ml). Concentrations fell significantly during treatment. In 25 assessments made at different times in 13 patients serum soluble interleukin 2 receptor concentration correlated significantly (R = 0.73) with clinical disease activity. CONCLUSIONS: Cellular immunopathogenic mechanisms contribute to atopic eczema. Immune activation can be measured in atopic eczema by measurements of soluble interleukin 2 receptor, and this should facilitate assessment of response to treatment.
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