bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel in vitro technique for measuring the water resistance of sunscreens
Authors: Stokes R.P. , Diffey B.L. , Dawson L.C. , Barton S.P.
Published: March 2003

Synopsis

A novel in vitro technique has been used to assess the water resistance of topical sunscreens. The technique is based upon transmission spectrometry using excised human epidermis as the substrate. The sun protection factors (SPFs) of four sunscreens obtained prior to water immersion and after two immersions were compared with in vivo data determined using human volunteers. In every case there was close agreement between the SPFs obtained on dry skin and on skin that had been immersed in water. Not only does the technique provide a less expensive and less time consuming alternative to in vivo testing, it also offers the possibility to study the effect that water immersion may have on the absorption spectrum of products which cannot be determined in vivo. This can give valuable information on which, if any, of the active ingredients present in sunscreens are being preferentially removed by water. In addition, the method can be easily adapted to study the effects on sunscreen substantivity of other factors such as water temperature, salinity and turbulence.

On a utilizé une nouvelle technique in vitro pour évaluer la résistance à l'eau d'écrans solaires topiques. La technique est basée sur la spectrométrie de transmission utilisant de l'épiderme humain excisé comme support. Les IPS de 4 écrans solaires obtenus avant immersion dans l'eau et après deux immersions ont été comparés avec des données in vivo déterminées en utilisant des volontaires humains. Dans chaque cas il existe une proche correspondance entre les IPS obtenus sur peau sèche et sur peau ayant été immergée dans l'eau. Non seulement la technique apporte une alternative moins chère et moins longue aux essais in vivo, mais elle offre aussi la possibilité d'étudier l'effet que l'immersion dans l'eau peut avoir sur le spectre d'absorption de produits qui ne peuvent pas être examinés in vivo. Ceci peut fournir des informations intéressantes sur ceux, s'ils existent, des ingrédients actifs présents dans les écrans solaires qui sont préférentiellement éliminés par l'eau. En outre, la méthode peut être adaptée facilement pour étudier les effets sur la composition des écrans solaires d'autres facteurs tels que la température de l'eau, la salinité et la turbulence. © Rapid Science Ltd. 1998
O/W emulsion and W/O/W multiple emulsion: physical characterization and skin pharmacokinetic comparison in the delivery process of caffeine
Authors: Doucet O. , Ferrero L. , Garcia N. , Zastrow L.
Published: March 2003

The aim of this study was to compare the characteristics of an O/W emulsion and a W/O/W emulsion, formulated with similar ingredients. The physical properties of these two types of vehicles were characterized first. Using three types of in vitro models, human skin biopsies, nitrate acetate cellulose membranes and human reconstituted epidermis, the delivery potential of each vehicle for one hydrophilic drug, caffeine, was compared. The assessment of physical parameters, such as particle size, conductivity and rheological behavior enabled the nature of the test emulsions to be clearly identified. Clear differences were observed in the ability of each type of emulsion to deliver caffeine. Whatever the nature of the membrane used for the pharmacokinetic study, the absorption of caffeine was roughly two‐fold lower (2.6 for human skin) when the W/O/W multiple emulsion was used as the vehicle. The concomitant determination of physical and kinetic properties of these two test emulsions allowed the W/O/W multiple emulsion and a simple O/W emulsion to be clearly differentiated.
Moisturizing Effect of Vesicles Formed From Monoglycerides on Human Skin
Authors: Sone Toshiro , Hanamizu Tomoko , Ichioka Minoru , Yokokura Teruo , Yoshikawa Satoshi , Kondo‐Yanai Naomi , Hiraki Yoshio , Esumi Kunio
Published: March 2003

Synopsis

The moisturizing effect of vesicles formed from monoglycerides on human skin was studied by measurement of conductance on and transepidermal waterloss from the skin surface. Although sonication of the monoglycerides in water with Ca2+ gave multilamellar vesicles, the lamellar structure of the vesicles disappeared during their storage without any other additive. With the addition of poly(vinylpyrrolidone) after the sonication, the stability of the vesicles increased and their lamellar structure was maintained for 3 months at 40°C. These vesicles led to a significantly higher water content of the stratum corneum of human skin compared with non‐lamellar monoglyceride, and consequently they improved rough human skin.
Interaction of Fragrance Materials With 2‐Hydroxypropyl‐β‐Cyclodextrin by Static and Dynamic Head‐space Methods
Authors: Saito Y. , Tanemura I. , Sato T. , Ueda H.
Published: March 2003

The stability constants for the inclusion of fragrance materials with 2‐hydroxypropyl‐β‐cyclodextrin (2HP‐β‐C yD) in aqueous solution have been determined by the static head‐space method. The 1:1 stability constants obtained by this method were in reasonable agreement with the corresponding values in the literature. In addition, the release profiles of fragrance materials from 2HP‐β‐CyD aqueous solution were investigated using the dynamic head‐space method. It was found that the suppression of the fragrance materials release was dependent on their stability constants.
The Society of Cosmetic Scientists 1999 Spring Symposium. Cosmeceuticals – one small step or a giant leap? Proving benefits for botanical products
Authors: Dweck
Published: March 2003

Synopsis

This paper examines the various methods that are available to the scientist working with natural materials to substantiate their efficacy. The methods discussed are: literature surveys, clinical trials, instrumental measurement, products with Pharmaceutical Licenses, comparison with other plants containing same active chemicals, and comparison of benefits with related members of the same family. Examples are given using the Compositae family as a primary model, other examples are given quoting the Labiatae, and Solanaceae families.

Résumé

Cet article examine les divers procédés à la disposition du scientifique travaillant avec des matériaux naturels pour matérialiser leur efficacité. Les procédés exposés sont les études de bibliographie, les essais cliniques, les mesures instrumentales, les produits ayant des autorisations pharmaceutiques, la comparaison avec d’autres plantes contenant les mêmes substances chimiques actives, et la comparaison des avantages avec des membres apparentés de la même famille. Des exemples sont donnés en utilisant la famille des Compositae comme modèle principal, et d’autres exemples sont donnés en citant les familles des Labiatae, et des Solanaceae.
Baker’s yeast‐mediated synthesis of endo‐2‐cineolylol, a starting compound for potential cosmetic odourants
Authors: Mariani  , Bruno  , Villa  , Neuhoff
Published: March 2003

Synopsis

Baker’s yeast‐mediated reduction of (+)‐1,3,3‐trimethyl‐2‐oxabicyclo[2,2,2]octan‐6‐one yields the corresponding 1,3,3‐trimethyl‐2‐oxabicyclo[2,2,2]octan‐6‐ol as endo configuration in optically pure form. To study the reaction behaviour we have developed a RP‐HPLC method. The synthesis and the olfactive character of some esters obtained from the endo‐2‐cineolylol are reported. A comparative odour evaluation between these esters and the corresponding compounds synthesized from the endo‐exo alcohol mixture was performed.

Résumé

La réduction de (+)‐1,3,3‐triméthyl‐2‐oxabicyclo[2,2,2]octan‐6‐one par la lévure conduit au 1,3,3‐triméthyl [2,2,2]octan‐6‐ol correspondant, de configuration endo avec une forme optique pure. On a développé une méthode RP‐HPLC pour enregistrer le comportement de la réaction. La synthèse et le caractère olfactif des esters obtenus de cet alcool sont rapportés.. On a comparé l’évaluation de l’odeur de ces composés avec celle des composés correspondants, dérivés du mélange endo‐eso des alcools.
Investigation of interactions between silicones and stratum corneum lipids
Authors: Glombitza B. , Müller‐Goymann C.C.
Published: March 2003

Synopsis

Ingredients of topically applied skin care formulations have not only positive effects on the appearance of human skin but can also disturb the Stratum corneum (SC) lipid barrier. In the present study, the influence of silicones (PDMS), as often used cosmetic ingredients, on the microstructure of SC lipids was investigated. For this purpose the interactions of four different PDMS with excised human SC were examined first using differential scanning calorimetry (DSC) and wide angle X‐ray diffraction for physical characterization. Because the physical properties of human stratum corneum strongly depend on the lipid composition, showing inter‐and intra‐individual differences, the interactions with an in vitro model lipid system containing SC fatty acids were also studied, using polarized light microscopy, transmission electron microscopy, small angle X‐ray diffraction and DSC. The results revealed that the investigated PDMS do not change either the microstructure of excised human SC or the biphasic lamellar/inverse hexagonal structure of the in vitro model. We concluded that PDMS will not cause any side‐effects when topically applied and that our simplified in vitro model could be helpful for estimating interactions between cosmetic ingredients and other topically applied substances and the skin barrier at an early moment of formulation development.

Résumé

Les produits cosmétique et d’hygiène corporelle n’entraînent seulement des effets positifs sur la peau mais peuvent également désorganiser la barrière du stratum corneum. Les silicones sont des ingrédients couramment utilisé dans ces produits. L’objet de cette recherche est d′étudier l′influence des silicones sur la microstructure des lipides du stratum corneum. Dans cet objectif, on a examiné d’abord les interactions entre différent silicones et la structure du stratum corneum excisé, au moyen de diffraction de rayons X et par calorimétrie différentielle. Etant donné que la structure du stratum corneum dépend essentiellement de sa composition en lipide, et que cette composition varie entre les individus et au sein d’eux même, un modèle artificiel de stratum corneum a été mis au point. L’étude par diffraction de rayons X, microscopie électronique et calorimétrie différentielle des interactions entre silicones et stratum corneum artificiel ne montre de modifications ni dans les propriétés caractéristique des lipides du stratum corneum ni dans la structure cristalline liquide du modèle artificiel. Les résultats suggèrent que les silicones n’affectent pas la barrière de la peau par application. En outre, le modèle artificiel, pourrait permettre d’évaluer les propriétés d’un excipent cosmétique et dès la phase de développement d′une nouvelle formulation.
Models to assess perfume diffusion from skin
Authors: Schwarzenbach R , Bertschi L
Published: March 2003

Synopsis

Temperature, fragrance concentration on the skin and power of ventilation have been determined as crucial parameters in fragrance diffusion from skin. A tool has been developed to simulate perfume diffusion from skin over time, allowing headspace analysis and fragrance profile assessments in a highly reproducible way.

Résumé

La température, la concentration du parfum sur la peau et la puissance de ventilation ont été déterminées comme étant des paramètres primordiaux de la diffusion du parfum à partir de la peau. Un outil a été développé pour simuler la diffusion du parfum à partir de la peau dans le temps, permettant l’analyse headspace et des évaluations de profil de parfum de façon tout à fait reproductible.
Iron: a cosmetic constituent but an essential nutrient for healthy skin
Authors: Lansdown A. B. G.
Published: March 2003

Synopsis

Iron compounds have an established role as colorants in many cosmetic products applied to the skin, hair and nails. Evidence is reviewed showing that in addition to its importance as an essential nutrient necessary for oxygen metabolism and mitrochondrial function, iron exhibits a fundamental importance as a trace metal in the normal growth and functional maturation of the skin and in the health of hair and nails. The implications of iron from cosmetic sources in the nutrition of human skin is discussed.
Assessment of sun reactive skin type with multiple correspondence analysis, hierarchical and tree‐structured classification methods
Authors: Guinot C. , Latreille J. , Morizot F. , Ambroisine L. , Mauger E. , Tenenhaus M. , Malvy D. J.‐M.
Published: March 2003

Synopsis

The sun reactive skin type classification is based on sunburn susceptibility, tanning ability and phenotypic information. As subjects rarely match all features of a given skin type, the attribution to a class is partially subjective. The aims of the study, were to analyse the contribution of each characteristic to the classification made by the expert, and to establish a classification based on a statistical approach conducted on 212 women living in the Ile‐de‐France area. Multiple regression was used to construct a formula for each phototype. The coefficients obtained demonstrated that the importance of each characteristic was extremely variable from one phototype to another, suggesting that the phototype determination could be facilitated by adding a weight for every characteristic in the decision. Then, multiple correspondence analysis and clustering analysis methods showed that one phototype could be divided into two more homogenous classes.
Dietary antioxidants and human immune function
Authors: Hughes David A.
Published: March 2003

The immune system is extremely sensitive to oxidative damage. Many immune cells produce reactive oxygen species as part of the body’s defence against infection and depend on adequate protection by antioxidants for optimal function. Many antioxidants can be obtained directly from the diet (e.g. vitamin C, vitamin E, carotenoids and polyphenolic flavonoids) or require micronutrients as integral components of protective enzymes (e.g. selenium, copper and zinc). Whilst a balanced diet should provide sufficient protection, periods of infection, inflammatory conditions or cigarette smoking may tip the balance in favour of oxidative stress. This review summarises some of the mechanisms by which antioxidants may affect immune status.
Ruminant meat as a source of conjugated linoleic acid (CLA)
Authors: Mulvihill Breda
Published: March 2003

Summary Ruminant meat is a natural source of conjugated linoleic acid (CLA). Evidence has shown that CLA has many potential health benefits on cancer, coronary heart disease and diabetes. However, to date, all of the published research has been conducted in animals and there are few data in relation to the potential health benefits of CLA in humans. Lamb is the richest meat source of CLA. The main CLA isomer found in meat is c9,t11. Research has shown that cooking or storing meat does not alter its CLA content, but it can be changed by manipulating the diet of the animal. Little information is available that quantifies the contribution of meat to CLA intake. More research is required to further improve our knowledge on the role that meat can play as a vehicle that naturally supplies dietary CLA.
The sympathetic nervous system and obesity: role in aetiology and treatment
Authors: Snitker S. , Macdonald I. , Ravussin E. , Astrup A.
Published: March 2003

The sympathetic nervous system SNS) is an important component of the autonomic nervous system, and thus plays a major role in the maintenance of homeostasis. The SNS is of particular importance in the control of the cardiovascular system and of a number of metabolic processes. Alterations in SNS effects on metabolism have been implicated in the development and maintenance of obesity, and the SNS is a potential therapeutic target in the treatment of obesity. This review provides an overview of the anatomical and physiological aspects of the SNS, before considering the evidence showing a role for the SNS in the development or treatment of obesity.
Lessons from obesity management programmes: greater initial weight loss improves long‐term maintenance
Authors: Astrup A. , Rössner S.
Published: March 2003

It is a common belief that weight loss achieved at a slow rate is better preserved than if the weight is lost more rapidly. However, the literature shows that initial weight loss is positively, not negatively, related to long‐term weight maintenance. There is evidence from randomised intervention trials to support that a greater initial weight loss induced without changes in lifestyle e.g. liquid formula diets or anorectic drugs) improves long‐term weight maintenance, providing it is followed by a 1–2 years integrated weight maintenance programme consisting of lifestyle interventions involving dietary change, nutritional education, behaviour therapy and increased physical activity. In conclusion, we find evidence to suggest that a greater initial weight loss as the first step of a weight management programme may result in improved sustained weight maintenance.
Sleep disordered breathing – a new component of syndrome x?
Authors: Coughlin S. , Calverley P. , Wilding J.
Published: March 2003

Sleep disordered breathing (SDB) is a complication of obesity estimated to occur in about 4–6% of overweight individuals. These respiratory disturbances during sleep incorporate a number of conditions including snoring, upper airway resistance syndrome and obstructive sleep apnoea syndrome (OSAS). It is thought that as well as having deleterious effects on sleep quality these conditions may also promote cardiovascular and hormonal changes leading to an elevated blood pressure and an increased incidence of cardiovascular morbidity. Evidence reviewed here points to an alteration in sympathovagal balance, baroreceptor sensitivity, insulin resistance and leptin, growth hormone and lipid levels. Whether these changes are a consequence of the associated obesity or the SDB itself remains to be proven.
Hypothalamic obesity in humans: what do we know and what can be done?
Authors: Pinkney J. , Wilding J. , Williams G. , MacFarlane I.
Published: March 2003

Obesity is a common sequel to tumours of the hypothalamic region and their treatment with surgery and radiotherapy. The prevalence of hypothalamic obesity has been underestimated because it may take some years to develop, and the problem has been under‐recognized by physicians. Weight gain results from damage to the ventromedial hypothalamus which leads, variously, to hyperphagia, a low metabolic rate, autonomic imbalance, growth hormone (GH) deficiency and various other problems that contribute to weight gain. However, with the exception of GH replacement, few clinical trials have evaluated significant numbers of patients and so the roles of various behavioural, dietary, pharmacological and obesity surgery approaches are controversial. Sufficient knowledge exists to identify those at high risk of hypothalamic obesity so that weight gain prevention approaches can be offered. In those who are already obese, we propose that the principal causal mechanisms in individual patients should be considered as a basis for guiding clinical management.
Prostate cancer: another aspect of the insulin‐resistance syndrome?
Authors: Barnard R. J. , Aronson W. J. , Tymchuk C. N. , Ngo T. H.
Published: March 2003

Insulin resistance and compensatory hyperinsulinaemia are thoughtto be the underlying factors in the metabolic or insulin‐resistancesyndrome and can be controlled by diet and exercise. Hyperinsulinaemiahas been shown to have a direct effect on the liver, suppressingthe production of sex hormone‐binding globulin (SHBG) and insulin‐likegrowth factor‐binding proteins 1 and 2 (IGFBP‐1, ‐2) while stimulatingthe production of insulin‐like growth factor 1 (IGF‐1). These factorshave been proposed to be important modulators of hormone‐related cancers,such as prostate cancer. Men adopting a low‐fat diet and daily exercise reducedtheir levels of serum insulin and IGF‐1, while increasing theirlevels of IGFBP‐1 and sex hormone‐binding globulin (SHBG). Cell‐culturestudies with LNCaP prostate cancer cells showed apoptosis of tumourcells and a reduction in serum‐stimulated cell growth in the postdiet and exercise serum. These results suggest that prostate cancermay be another aspect of the insulin‐resistance syndrome and thatadopting a low‐fat diet combined with regular exercise may reducethe risk for prostate and other hormone‐related cancers. This needsto be tested with prospective studies.
Does European or non‐European origin influence health care and prognosis for HIV patients in Europe?
Authors: Blaxhult A. , Mocroft A. , Phillips A. , Van Lunzen J. , Bentwich Z. , Stergiou G. , Colebunders R. , Benfield TL. , Mulcahy F. , Lundgren JD. , Group The EuroSidA. Study
Published: March 2003

Background Previous studies, especially in North America, have shown that socio‐economic factors may influence the prognosis for patients with HIV. This study was performed in order to determine if European or non‐European origin influence provision of health‐care and survival among HIV patients in Europe.

Methods Fifty HIV clinics in 17 European countries are involved in a European prospective, observational multicentre study. In total, 7230 consecutive patients with HIV attending a routine clinic visit were included in the study. Data on demographics, treatment and laboratory results were collected at time of recruitment into the study and thereafter every 6 months.

Results The median CD4+ lymphocyte count at AIDS diagnosis was 60/mm3, and was similar for all ethnic groups (P = 0.87, Kruskall–Wallis test). The median terminal CD4+ lymphocyte count was 17/mm3 and, again, there was no significant difference between continents of origin (P = 0.35, Kruskall–Wallis test). Antiretroviral drugs were initiated at similar median CD4+ lymphocyte counts and there was no statistically significant difference in survival after a diagnosis of AIDS.

Conclusions AIDS was diagnosed at the same level of immunodeficiency independent of European or non‐European origin and antiretroviral drugs were provided at similar levels of immunodeficiency. No differences in survival depending on continent of origin was found. In spite of these encouraging findings concerns remain that belonging to an ethnic minority can be an obstacle in getting into contact with treatment facilities and thus benefiting from developments in the management of HIV.
Participation in clinical studies among patients infected with HIV‐1 in a single treatment centre over 12 years
Authors: Madge S , Mocroft A , Wilson D , Youle M , Lipman MCI , Phillips A , Tyrer M , Cozzi‐Lepri A , Swaden L , Johnson MA
Published: March 2003

Objective  To examine a complete population of clinic attenders in order to compare the demographics of patients who participated in a clinical study with those who had not. These were subdivided into trials of antivirals, trials for drugs used in opportunistic infections or symptomatic HIV and epidemiological studies. The setting was an established London teaching hospital. All patients diagnosed HIV‐positive and attending between July 1983 and 1 January 1999 with one measured CD4 count and at least one follow‐up visit were included.

Methods  The demographics of those participating in a clinical study were compared to those not enrolling using χ2 tests and Wilcoxon tests. Cox models were used to determine factors related to participation in clinical studies.

Results  Data from 2703 patients representing 5342.7 person‐years' follow‐up were assessed. Median time of follow‐up was 23.6 months. Six hundred and eighty‐seven (33%) patients had ever participated in a clinical study. After adjustment for demographic factors in multivariate analysis using Cox models, homosexuals were more likely to participate compared with heterosexuals or injecting drug users (IDU) (P = 0.0035 and P = 0.0001, respectively). Women were more likely to enter a study (P = 0.02) and there was no difference between Caucasians and black Africans (P = 0.35). Between the three types of studies few differences were seen.

Conclusion  High rates of participation in clinical trials and epidemiological studies were seen in this cohort. In keeping with other studies, homosexual men were well represented but IDU were under‐represented. However, women and black African patients showed good uptake of all clinical studies. Hence in this population there is some success in targeting representative groups to participate in clinical studies, but more effort needs to be made with IDU.
Molecular correlates in AIDS patients following antiretroviral therapy: diversified T‐cell receptor repertoires and in vivo control of cytomegalovirus replication
Authors: Worrell S , Deayton J , Hayes P , Emery Vc , Gotch F , Gazzard B , Larsson‐Sciard E‐L
Published: March 2003

1

Department of Immunology and

2

The Kobler Centre, Chelsea and Westminster Hospital, and

3

Royal Free Hospital and University College Medical School, London, UK

Objectives  To evaluate whether successful, long‐term immune reconstitution in vivo can be achieved in end‐stage AIDS patients following antiretroviral therapy (ART).

Methods  A 1‐year prospective study of changes of CD4+ and CD8+ T‐cell surface phenotypes, T‐cell receptor (TCR) repertoires and capacity to control in vivo replication of cytomegalovirus (CMV) was performed in five treatment‐naive end‐stage AIDS patients (median CD4+ T‐cell counts of 19 cells/μL) following therapy. Proportions of CD45RA+, CD45RO+ and CD28+ cells within the CD4+ and CD8+ subsets, were determined by flow cytometry. Changes in TCR Vβ repertoires within the CD4+ and CD8+ T‐cell compartments were evaluated using CDR3 spectratyping. CMV replication was determined by a sensitive polymerase chain reaction (PCR) assay using whole blood.

Results  Following ART, proportionate increases in ‘naive’ (CD45RA+) and ‘memory’ (CD45RO+) T cells were observed within both CD4+ and CD8+ T‐cell subsets, while increased numbers of CD28+ T cells were mainly observed within the CD4+ subset. Diversification of CD4+ and CD8+ TCR repertoires was established concomitantly with renewed in vivo control of CMV replication.

Conclusions  An important degree of molecular and functional immune recovery is possible in end‐stage AIDS patients introduced to therapy. Diversification of TCR repertoires and the in vivo restoration of immunocompetence to control opportunistic infections clearly show that an important degree of molecular immune reconstitution is established following the initiation of ART even in late‐stage AIDS.
The use of calcium carbonate in nelfinavir‐associated diarrhoea in HIV‐1‐infected patients
Authors: Jensen‐Fangel S , Justesen US , Black FT , Pedersen C , Obel N
Published: March 2003

Objectives

To evaluate the efficacy of oral calcium supplements in HIV‐infected patients with nelfinavir (NFV)‐associated diarrhoea, and to investigate the influence on the pharmacokinetics of nelfinavir and the active metabolite M8.

Methods

An open‐label prospective trial with enrolment of 15 patients with NFV‐associated diarrhoea. Study subjects received either calcium carbonate or calcium gluconate/calcium carbonate in addition to highly active antiretroviral therapy (HAART), and were randomized to (i) calcium supplements for 14 days followed by 14 without calcium supplements, or (ii) 14 days without calcium supplements followed by calcium supplements for 14 days. Clinical endpoint was the severity of diarrhoea, graded and summarized for the specific 14 day‐period. In the pharmacokinetic evaluation concentrations of NFV and M8 were measured before morning dosing, and 3 h after dosing.

Results

Nine patients were treated with calcium carbonate, and six with calcium gluconate/calcium carbonate. In the paired analysis, neither of the groups had a significant improvement in diarrhoea score when treated with calcium supplements (P = 0.34 and 0.46, respectively). We found no significant differences in the concentrations of NFV and M8 between the calcium and control periods.

Conclusions

Oral calcium supplements did not significantly improve nelfinavir‐associated diarrhoea. In the pharmacokinetic analysis calcium supplements did not induce major alterations in plasma concentrations of NFV and M8.
Amiodarone pigmentation, eye and thyroid alterations
Authors: Bahadır S , Apaydın R , Çobanoılu Ü , Kapıcıoılu Z , Özoran Y , Gökçe M , Alpay K
Published: March 2003

Amiodarone is an effective cardiac antiarytmic drug. Long‐term, high dose use of the drug is associated with skin discolouration, corneal deposition and alterations in thyroid hormone levels. We present the case of a 61‐year‐old woman suffering from the combination of these three side‐effects.
Darier’s disease complicated by Kaposi’s varicelliform eruption due to herpes simplex virus
Authors: Pantazi Vassiliki , Potouridou Irene , Katsarou Alexandra , Papadogiorgaki Helen , Katsambas Andreas
Published: March 2003

Darier’s disease is an autosomal dominant dermatosis. It may rarely be complicated by localized or widespread cutaneous viral infections. We describe a case of Kaposi’s varicelliform eruption due to herpes simplex virus type 1 presenting in a patient with Darier’s disease.
Biosurgery in wound healing – the renaissance of maggot therapy
Authors: Wollina Uwe , Karte Kerstin , Herold Claudia , Looks Annette
Published: March 2003

Chronic wounds are a challenge for modern health care. A basic principle of treatment is the removal of sloughy, necrotic, devitalized tissue to prevent wound infection and delayed healing. Biosurgery (syn. maggot or larval therapy) is a promising adjunct to the whole spectrum of topical treatment methods, in particular for debridement. The term ‘biosurgery’ describes the use of living maggots on wounds to remove devitalized tissue, decrease the risk of infection and improve wound healing. The present paper gives a brief review of history, entomology, biochemistry and medical indications of biosurgery and the practical handling of maggots. We also provide some clinical data from the literature and our own experience in a wound care unit. Biosurgery is an effective and safe treatment option for debridement and disinfection.
Eosinophilic pustular eruption associated with transdermal fentanyl
Authors: Mancuso G , Berdondini RM , Passarini B
Published: March 2003

A 70‐year‐old man developed a widespread eruption of sterile pustules on normal skin, mainly on the trunk, face and base of the limbs, 2 days after application of a fentanyl‐transdermal therapeutic system (fentanyl‐TTS) patch. The eruption was not accompanied by fever. The main histopathological finding was an intraepidermal pustule filled almost exclusively with eosinophils. Suspension of the fentanyl‐TTS led to rapid and definitive spontaneous regression of the pustules in about 10 days. A similar pustular reaction related temporally to fentanyl‐TTS administration had appeared several weeks before the current eruption.
Eccrine syringofibroadenoma: case report and review of the literature
Authors: Takeda H , Mitsuhashi Y , Hayashi M , Kondo S
Published: March 2003

Eccrine syringofibroadenoma (ESFA) is a rare disorder that shows differentiation toward eccrine sweat apparatus. There is a controversy concerning the pathogenesis and differentiation of this tumour. We report a case of ESFA in a 63‐year‐old Japanese man. We review the literature presenting a classification, including a newly reported subtype. Clinically and pathogenically, ESFA is probably a group of heterogeneous disorders.
Junctional epidermolysis bullosa gravis (Herlitz): diagnostic and genetic aspects
Authors: Hauschild R , Wollina U , Bruckner‐Tuderman L
Published: March 2003

We report on a boy suffering from lethal junctional epidermolysis bullosa gravis (JEBH) (Herlitz‐type) (OMIM 226700). Screening for mutations of LAMB3 gene with polymerase chain reaction (PCR) amplification of all exons from genomic DNA and subsequent heteroduplex analysis and dideoxynucleotide sequencing of heteroduplex forming PCR products disclosed two mutations: the recurrent maternal mutation R635X and the novel paternal mutation 1629insG, both in exon 14 of LAMB3. Both mutations lead to a premature termination code, non‐sense mediated mRNA decay and to absence of the synthesis of the β3 chain of laminin 5. During the mutation screening of the index patient a second pregnancy was ascertained. After amniocentesis (14 + 1 week of pregnancy), prenatal diagnosis from fetal cells was performed and compound heterozygosity for both mutations was evident. The consultants decided to have a termination of pregnancy shortly after the diagnosis. Remarkable skin fragility of the fetus was evident by clinical examination. Complete absence of laminin 5 could be demonstrated by immunofluorescence staining. By the third pregnancy of this couple so far screened for mutations by chorionic villus sampling for prenatal molecular diagnosis a healthy but heterozygous child is expected.
Cutaneous umbilical endosalpingiosis with severe abdominal pain
Authors: Redondo P , Idoate M , Corella C
Published: March 2003

Cutaneous endosalpingiosis is a very rare entity, and to our knowledge umbilical location has been reported in only one patient who developed salpingectomy shortly after. We report cutaneous umbilical endosalpingiosis associated with severe abdominal pain that disappeared after surgical treatment.
Histiocytic necrotizing lymphadenitis preceding systemic lupus erythematosus
Authors: Komócsi A , Tóvári E , Pajor L , Czirják L
Published: March 2003

Necrotizing histiocytic lymphadenopathy (NHL) is a rarely observed clinical entity that is occasionally associated with systemic lupus erythematosus (SLE). The histological features of the condition have been considered to be indistinguishable from those of lymphadenitis in subjects with SLE, and the clinical symptoms of the two disorders share common features. This report presents the case history of a subject who developed SLE with central nervous system involvement 3 years following onset of Kikuchi’s disease (histiocytic necrotizing lymphadenitis). Repeated lymph node biopsies confirmed the diagnosis in relation to the clinical progression. A review of the literature on this topic is also presented.
Calciphylaxis in two patients with end‐stage renal disease
Authors: Filosa G , Bugatti L , Nicolini M , Verdolini R
Published: March 2003

Fatal calciphylaxis (CPX) occurred in two 71‐year‐old females both requiring haemodialysis for end‐stage renal disease. Case 2 also had an associated follicular lymphoplasmocytoid lymphoma. Although laboratory tests disclosed normal coagulation parameters, this woman had a striking cutaneous histological picture of vessel thrombosis and finally died of disseminated intravascular coagulation. CPX is a rare but potentially life‐threatening complication of renal failure. The clinical picture is primarily characterized by livedoid purpura with subsequent cutaneous ischaemia and painful ulcerations. Cutaneous ischaemic phenomena are sustained by a progressive process of vascular calcification and thrombosis involving small to medium size arteries of the dermis and subcutis. Although not yet clearly explained, the pathogenetic role of a predisposing hypercoagulability state is currently the most frequently considered hypothesis.
Dermatological immune restoration syndrome: does it exist?
Authors: Handa S , Bingham JS
Published: March 2003

Dermatological conditions are often an early clue to HIV infection and are common. As the disease progresses patients develop a dominant Th‐2 immunological response that may facilitate the development of a number of skin conditions. With antiretroviral therapy the Th‐1 response is restored and some skin problems regress. But, paradoxically, some cutaneous conditions may worsen, such as herpes zoster, mucocutaneous herpes, eosinophilic folliculitis and mycobacterial infections. This may be because immune restoration of a host’s immunity causes recognition of silent or latent infection and results in development of the condition.
High‐dose cytosine arabinoside‐induced cutaneous reactions
Authors: Cetkovská P , Pizinger K , Cetkovský P
Published: March 2003

Background High‐dose cytosine arabinoside (HDAC) is being used increasingly to treat haematological malignancies. The therapy is associated with various non‐haematological negative side‐effects, frequently involving the skin.

Objective Our aim was to evaluate the actual occurrence of adverse skin reactions to HDAC over the 10‐year period from 1989 to 1999.

Methods One hundred and seventy‐two subjects, 118 with acute myelogenous leukaemia and 54 with acute lymphoblastic leukaemia, between 16 and 71 years of age were treated with 226 post‐remission consolidation regimens with HDAC (54 subjects underwent two cycles of treatment). Treatment was combined with standard doses of other cytotoxic drugs. A prospective study of the skin changes was then performed.

Results The overall incidence of cutaneous reactions was almost 53%, with rashes occurring in 72.7% and 40.6% of subjects who received total doses of 30 and 24 g/m2, respectively. In the group of subjects who received a second cycle of treatment not all of those who experienced exanthema after the first cycle (44.4%) experienced this reaction after the second cycle (only 33.3%). The most commonly observed reactions were morbilliform eruptions on the trunk and extremities and acral erythema, although severe reactions with swelling and generalized urticaria developed in some cases.

Conclusions HDAC‐induced cutaneous reactions in 53% of subjects. The skin changes were found to be dose related and most cleared spontaneously without requiring treatment. A clinical grading of cutaneous toxicity has been proposed to allow better comparison of cutaneous adverse effects in different reports.
Pseudoverrucous papules: an aspect of incontinence in children
Authors: Coppo P , Salomone R
Published: March 2003

Pseudoverrucous papules and nodules can be observed on skin surrounding urostomies and colostomies. These lesions appear to be uncommon, and sometimes can be misdiagnosed, even leading to surgical removal. We report the case of a 12‐year‐old boy whose lesions appeared in crops in an area subjected to urine leakage and spontaneously regressed in time. In this patient, anogenital warts had to be ruled out, but many skin diseases must be considered in the differential diagnosis of these misunderstood lesions. We stress the importance of a skin examination by a trained professional aware of these problems to avoid unnecessary investigations and treatments.
A case of loiasis in Rome
Authors: Morrone A , Franco G , Toma L , Tchangmena OB , Marangi M
Published: March 2003

Background  Owing to the increase of an immigrant population and of Italian citizens travelling for tourism or on business, it is nowadays possible to observe clinical pictures characteristic of tropical regions, often with indistinct symptoms. One of these is Loa loa infestation, or loiasis, a form of filariasis caused by Loa loa and transmitted by the Chrysops fly. We present the case of a male immigrant from Cameroon. Characteristic symptoms were intense xerosis, mostly of the third inferior part of the legs, intensely pruritic, with numerous lesions from scratching. No benefit was obtained by emollient topics, anti‐acarus and systemic antihistamines.

Method  Serum samples and Giemsa, haematoxylin, haematoxylin + Giemsa concentration‐on‐membrane stains, have evidenced the presence of Loa loa microfilariae.

Results  A diagnosis for L. loa (loiasis) infestation was made.

Conclusions  At the beginning of the migration phenomenon, particularly from Africa, Italian physicians, especially dermatologists, were eagerly looking for ‘tropical’ diseases; this approach can be defined as ‘Salgari's syndrome’ from the name of the Italian novelist who, though never travelling out of Italy, had perfectly described environments and habits typical of far away countries. Now, conversely, we have to avoid the opposite approach of considering real tropical diseases as related to social or psychological difficult conditions.
Varicella zoster viraemia during herpes zoster is not associated with neoplasia
Authors: Bezold G , Lange M , Pillekamp H , Peter RU
Published: March 2003

Background Shingles are caused by an endogenous or exogenous reinfection with varicella zoster virus (VZV). Up to 50% of individuals with Hodgkin's disease develop herpes zoster; however, no association could be shown between the occurrence of herpes zoster and underlying subclinical malignancies.

Objective This study was conducted to investigate whether VZV DNA could be detected by polymerase chain reaction (PCR) in the blood of herpes zoster patients and whether there was an association between VZV viraemia and previous or concurrent neoplasias.

Methods At least five blood samples from 28 patients with herpes zoster were investigated by internally controlled PCR enzyme‐linked immunosorbent assay prior to and during therapy with aciclovir.

Results None of 13 patients, two with a history of neoplasia and two with a neoplasia at the time of the study, showed any signs of viraemia with VZV, and 14 patients had inconsistent viraemia, one with a history of neoplasia and two with neoplasia at the time of the study. In one patient VZV DNA was detected in the blood for 6 days. This patient died soon after from metastatic malignant melanoma.

Conclusions VZV viraemia may occur during herpes zoster episodes, even in patients without evidence of immunosuppression; however, this viraemia is, in most cases, inconsistent and does not provide any specific information concerning underlying unrecognized malignancies.
Inhibitory effects of Leopoldine spa water on inflammation caused by sodium lauryl sulphate
Authors: Hercogova J , Stanghellini E , Tsoureli‐Nikita E , Menchini G
Published: March 2003

Background Sulphur mineral waters may have anti‐inflammatory effects on human skin. We evaluated the anti‐inflammatory effects of Leopoldine spa water, a salso‐sulphate water (Table 1), on human skin tested with sodium lauryl sulphate (SLS).

Chemical composition of the Leopoldine spa water

Ions
g/L

Na+
 7.348

K+
 0.196

Mg2+
 0.167

Ca2+
 0.858

Cl−
12.048

SO42–
 1.930

HCO3−
 0.732

pH
 6.73

Fixed residue at 180 °C (g/L)
24.18

Patients and methods Ten healthy, Caucasian volunteers 28–53 years old were enrolled in this study. SLS was tested on the right arm, in two concentrations (0.5% and 1%) dissolved in both double‐distilled non‐pyrogenic water and Leopoldine spa water in four separate test tubes; 0.02 mL of each solution was applied via the testing apparatus (Vand der Bend chambers, four squares measuring 1 × 1 cm), which was fixed and remained in contact with the skin surface. The anti‐inflammatory effect was measured via the variations of redness (chromometry, parameter a*), using a Minolta CR 200 chromometer.

Results At base condition the values of a* of the areas that were tested ranged from 7.11 to 9.30 with a mean of 7.97. In regard to the reaction caused by SLS dissolved in double‐distilled water, the values of a* ranged from 8.98 to 9.53, mean 9.24, for 0.5% SLS and from 12.81 to 14.33, mean 13.59, for 1% SLS. The a* values for the cutaneous reaction caused by SLS dissolved in Leopoldine spa water ranged from 7.22 to 9.60 (mean 8.20) for 0.5% SLS and from 10.8 to 12.36 (mean 11.68) for the 1% SLS.

Conclusions These data show the potential anti‐inflammatory effects of Leopoldine mineral water on human skin affected by modest inflammatory reactions caused by the direct application of the chemical irritant SLS. Leopoldine spa water can, thus, be considered a natural therapeutic alternative for the treatment of inflammatory skin conditions.
Seasonality trends of Pediculosis capitis and Phthirus pubis in a young adult population: follow‐up of 20 years
Authors: Mimouni D , Ankol OE , Gdalevich M , Grotto I , Davidovitch N , Zangvil E
Published: March 2003

Background It is not mandatory to report Pediculosis capitis and Phthirus pubis in most countries; therefore, little is known about the seasonality of these infestations.

Methods We analysed the data based on routine and mandatory reporting of every case of Pediculosis capitis and Phthirus pubis to the Army Health Branch Epidemiology Department, Israel, over the last two decades.

Results The average 20‐year incidence of Pediculosis capitis shows a significant rise during the warmer months (R2 = 0.692, P < 0.05) with a parallel significant decrease in the cooler months (R2 = 0.893, P < 0.05). The results for Phthirus pubis show a significantly higher person‐time incidence in the winter (P < 0.001). Sensitivity analysis to investigate possible sources of heterogeneity during this time indicated that no single year was an important source of heterogeneity.

Conclusions Pediculosis capitis is more frequent in the warmer months, whereas Phthirus pubis is more dominant in the cooler months.
The image of a leper (?): a paradigm of hidden fears of contagious diseases (Exemplified in a wall painting of Saint Elizabeth of Hungary)
Authors: Fatovic‐Ferencic S , Buklijaš T
Published: March 2003

This is a brief study on the popular ideas about leprosy based on an 18th century wall painting in north‐western Croatia portraying Saint Elisabeth healing a sick man, possibly a leper. The analysis uses examples from the history of medicine, semantics, toponymy and iconography.
Pachydermoperiostosis and psoriatic onychopathy: an unusual association
Authors: Fietta P , Manganelli P
Published: March 2003

A 33‐year‐old man, suffering from cutaneous psoriasis since the age of 16, in the last 6 years experienced slow and painless enlargement at his fingertips and later at his big toes, which resulted in digital clubbing. Since the age of 31, the patient also presented psoriatic nail changes involving all his fingernails, without joint pain or inflammation. The patient's family history was negative for psoriasis, however, his brother, a 29‐year‐old healthy man, also presented digital clubbing. The diagnosis of pachydermoperiostosis coexistent with ungual and cutaneous manifestations of psoriasis vulgaris was made. The differential diagnosis with psoriatic onycho‐pachydermo‐periostitis, as well as other clinical conditions that involve the distal interphalangeal joints is discussed.
Treating Encopresis in People with Intellectual Disabilities: a Literature Review
Authors: Lancioni Giulio E. , O'Reilly Mark F. , Basili Gabriella
Published: March 2003

The purpose of the present paper was to review research studies of faecal soiling (not linked to anatomical anomalies) in people with intellectual disabilities. The research studies were identified through: (1) computerized searches of the PSYCLIT and MEDICAL EXPRESS databases for journal articles published between 1975 and 2000; and (2) a hand search of the reference lists of the articles found through the computerized process. Twenty‐one studies were reviewed: 13 dealt with the treatment of non‐retentive faecal soiling (i.e. soiling occurring in the absence of constipation); and eight were on retentive faecal soiling (i.e. soiling occurring in the presence of constipation). Treatment and follow‐up data tended to be fairly encouraging, with clear performance changes. An analysis of the results, in relation to the treatment conditions and designs of the studies, underlined several procedural and practical questions. Possible research initiatives to clarify those questions are presented.