0
selected
-
1.
[The usefulness of thermography as a diagnostic method in dermatology on the basis of clinical trials in 2001-2005].
Mikulska, D, Maleszka, R, Parafiniuk, M
Annales Academiae Medicae Stetinensis. 2006;(3):91-7
Abstract
INTRODUCTION Thermal imaging is a powerful tool for the study of temperature of the human body. Even though the skin lies superficially and as such is an ideal object for thermography, the method has not gained widespread acceptance as a diagnostic modality in dermatology. The aim of this study was to describe the methodology of thermography for applications in dermatology and to develop a method for computer processing ofthermograms. In addition, we searched for skin factors, which could be responsible for false results in thermography and errors during interpretation of thermal images. MATERIAL AND METHODS Clinical trials were performed in 2001-2005. We enrolled 230 patients, including 70 who were hospitalized at the Department of Dermatology and Venereal Diseases, Pomeranian Medical University in Szczecin, and 160 who were referred from the Outpatient Dermatology Clinic. The control group consisted of 20 healthy volunteers. The skin was examined to disclose primary and secondary skin lesions. Thermography was performed according to recommendations of the European Association of Thermology. Therma CAM SC500 infrared camera was used and the thermograms were analyzed with Therma CAM 200 Professional software. RESULTS 1. Areas of the skin with inflammatory reactions resulting from allergy, infection or other process causing local hyperthermia could be visualized. 2. Primary eruptions (papules, nodules) and secondary eruptions (scales) presenting as hypothermia in thermography were found in the skin of the patients and some individuals from the control group. 3. Interpretation of thermograms in dermatoses can be done using various colour scales, like "rain", "iron", "medical", "grey", "greyred" and the three-dimensional scale. CONCLUSIONS 1. Thermography is a useful diagnostic method in dermatology. 2. The normal thermogram, as well as thermograms specific for various dermatoses need to be described. 3. Compliance is indispensable with rules and principles concerning the examination itself, as well as analysis and clinical interpretation of the results. 4. The person performing the examination and interpreting the thermograms should take part in history-taking and physical examination of the patient and should be familiar with photographic documentation of the examined regions of the skin.
-
2.
Evidence for immunostimulatory effects of intramuscular gold in patients with rheumatoid arthritis: correlation with skin reactions.
Ernestam, S, Lampa, J, Rogberg, S, Rönnelid, J, Klareskog, L, Hafström, I
The Journal of rheumatology. 2003;(8):1748-55
Abstract
OBJECTIVE Intramuscular gold is a well documented treatment in rheumatoid arthritis (RA), but its mechanism of action is still poorly understood. From an observation that gold sodium thiomalate (GSTM) induces monocyte-derived interleukin 6 (IL-6) and IL-10 production in vitro, a hypothesis has been proposed that gold exerts its action mainly as a selective immunostimulator rather than as a general immunosuppressant. In this prospective study we investigated cytokine production in peripheral blood from patients with RA during treatment with GSTM. METHODS A total of 20 patients with RA were treated with GSTM for at least 3 months. Disease activity was recorded at baseline, 12, 20, and 28 weeks. The ELISPOT method was used to measure spontaneous production of IL-6, IL-10, and interferon-g (IFN-g) from peripheral blood mononuclear cells (PBMC) at baseline and 4 and 12 weeks and production after incubation with GSTM in vitro, at different concentrations (0, 3, 12.5, 40 micro g/ml) at baseline. IL-6 and IL-10 concentrations in serum were measured with ELISA. RESULTS The numbers of IL-10-producing cells were increased after 4 weeks' treatment with GSTM (p < 0.01). The numbers of cells spontaneously producing IL-6 were increased after 4 weeks (p < 0.01) and 12 weeks (p < 0.01). The numbers of IFN-g-producing cells were increased after 4 weeks (p < 0.01). Serum concentrations of IL-10 were increased after 4 weeks (p < 0.01). Serum concentrations of IL-6 were not changed at any timepoint. The in vitro effect of GSTM on IL-10 production from PBMC at baseline predicted development of skin reactions during GSTM treatment, with lack of skin reactions being associated with high gold induced IL-10 production (p < 0.05). There was no correlation between clinical response and cytokine production. CONCLUSION This study indicates an immunostimulatory effect of GSTM treatment in patients with RA. The increase in IL-10 production during GSTM treatment may contribute to the positive effects of gold in RA.
-
3.
Tacrolimus ointment in the treatment of chronic cutaneous graft-vs-host disease: a case series of 18 patients.
Choi, CJ, Nghiem, P
Archives of dermatology. 2001;(9):1202-6
Abstract
BACKGROUND Tacrolimus (formerly FK 506) is an immunosuppressive drug that works by inhibiting calcineurin, a calcium-dependent protein phosphatase required for immune function. Tacrolimus has been shown to be effective topically in atopic dermatitis and systemically in psoriasis and graft-vs-host disease (GVHD). However, its efficacy in treating cutaneous GVHD when applied topically has not been reported. OBJECTIVE To assess the therapeutic efficacy of 0.1% tacrolimus ointment on chronic cutaneous GVHD in patients with symptoms refractory to systemic corticosteroid therapy. RESULTS Tacrolimus ointment effectively treated pruritus and/or erythema in 13 (72%) of 18 patients with chronic GVHD. Responding patients had a rapid effect within several hours to days. Effectiveness was measured by means of patient report, results of physical examination, side-by-side comparisons of tacrolimus vs a vehicle control, and temporal flares of the cutaneous symptoms of the disease in the context of stopping tacrolimus ointment therapy. Because of the progression of GVHD and in 2 cases, loss of drug efficacy, all patients eventually went on to receive more aggressive treatment, including increases in steroid dosage, psoralen-UV-A therapy, and extracorporeal photopheresis. CONCLUSIONS This case series suggests that tacrolimus ointment has efficacy in treating the erythema and pruritus of steroid-refractory, chronic cutaneous GVHD in most patients. The rapid response of tacrolimus ointment may provide a useful therapeutic bridge to systemic therapies that have slower onset, such as psoralen-UV-A therapy or extracorporeal photopheresis.
-
4.
Effectiveness of nystatin in polysymptomatic patients. A randomized, double-blind trial with nystatin versus placebo in general practice.
Santelmann, H, Laerum, E, Roennevig, J, Fagertun, HE
Family practice. 2001;(3):258-65
Abstract
BACKGROUND Antifungal therapy has been claimed to be effective in polysymptomatic patients with diffuse symptoms from multiple body systems and even well defined diseases, traditionally not related to fungi. Hypersensitivity to fungus proteins and mycotoxins has been proposed as the cause. METHODS We conducted a 4-week randomized, double-blind, placebo-controlled study in 116 individuals selected by a 7-item questionnaire to determine whether the antifungal agent nystatin given orally was superior to placebo. At the onset of the study, the patients were free to select either their regular diet or a sugar- and yeast-free diet, which resulted in four different subgroups: nystatin + diet (ND); placebo + diet (PD); nystatin (N); and placebo (P). RESULTS Nystatin was significantly better than placebo in reduction of the overall symptom score (P < 0.003). In six of the 45 individually recorded symptoms, the improvement was significant (P < 0.01). All three active treatment groups reduced their overall symptom scores significantly (P < 0.0001), while the placebo regimen had no effect (P = 0.83). The benefit of diet was significant within both the nystatin (ND > N) and the placebo groups (PD > P). CONCLUSIONS Nystatin is superior to placebo in reducing localized and systemic symptoms in individuals with presumed fungus hypersensitivity as selected by a 7-item questionnaire. This superiority is probably enhanced even further by a sugar- and yeast-free diet.
-
5.
Stress and skin diseases in musicians: evaluation of the beck depression scale, general psychologic profile (the brief symptom inventory [BSI]), beck anxiety scale and stressful life events in musicians.
Onder, M, Cosar, B, Oztas, MO, Candansayar, S
Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie. 2000;(5):258-62
Abstract
We had previously investigated skin problems of musicians (N = 117) working in a professional orchestra. The results of this survey suggest a significant incidence of occupational and stress-related skin problems in musicians such as hyperhydrosis, lichen planus, psoriasis, seborrheic dermatitis and urticaria. It was thought that emotional factors exacerbate their problems [6]. This article discusses the importance of psychiatric consultations in dermatologic problems.