bluuebunny/crossref_metadata_2025 huggingface dataset:
TEA TREE OIL IN THE TREATMENT OF TINEA PEDIS
Authors: Tong Melinda M. , Altman Phillip M. , Barnetson Ross StC.
Published: June 2007

Summary

Tea tree oil (an essential oil derived primarily from the Australian native Melaleuca alternifolia) has been used as a topical antiseptic agent since the early part of this century for a wide variety of skin infections; however, to date, the evidence for its efficacy in fungal infections is still largely anecdotal. One hundred and four patients completed a randomized, double‐blind trial to evaluate the efficacy of 10% w/w tea tree oil cream compared with 1% tolnaftate and placebo creams in the treatment of tinea pedia. Significantly more tolnaftate‐treated patients (85%) than tea tree oil (30%) and placebo‐treated patients (21%) showed conversion to negative culture at the end of therapy (p◂0.001); there was no statistically significant difference between tea tree oil and placebo groups. All three groups demonstrated improvement in clinical condition based on the four clinical parameters of scaling, inflammation, itching and burning. The tea tree oil group (24/37) and the tolnaftate group (19/33) showed significant improvement in clinical condition when compared to the placebo group (14/34; p = 0.022 and p = 0.018 respectively). Tea tree oil cream (10% w/w) appears to reduce the symptomatology of tinea pedis as effectively as tolnaftate 1% but is no more effective than placebo in achieving a mycological cure. This may be the basis for the popular use of tea tree oil in the treatment of tinea pedis.
DERMATOPHYTE AND NON‐DERMATOPHYTE ONYCHOMYCOSIS IN SINGAPORE
Authors: Lim Joyce Teng‐Ee , Chua Hock Cheng , Goh Chee Leok
Published: June 2007

Summary

Onychomycosis is caused by dermatophytes, moulds and yeasts. It is important to identify the non‐dermatophyte moulds as they are resistant to the usual anti‐fungals. A prospective study was undertaken in the National Skin Centre, Singapore to study the pattern of dermatophyte and non‐dermatophyte onychomycosis. 53 male and 47 female patients seen between June 1990 and June 1991 were entered into the study. Direct microscopy was done and the nail clippings were cultured. Toe and finger nails were equally infected. Dermatophytes were isolated from 21 patients namely, T. rubrum (12/21), T. interdigitale (5/21), T. mentagrophytes (3/21) and T. violaceum (1/21). Candida onychomycosis occurred in 39 patients and was caused by C. albicans (38/39) and C. parapsilosis (1/39). 37/39 patients had associated paronychia. 5 types of moulds were isolated from 12 patients, namely Fusarium species (6/12), Aspergillus species (3/12), S. brevicaulis (1/12), Aureobasilium species (1/12) and Penicillium species (1/12). Although the clinical pattern and microscopy may predict the type of organisms, in practice this is difficult. Only cultures were confirmatory. 28% (28/100) had negative cultures despite a positive microscopy, and moulds (12/100) grown might be contaminants rather than pathogens.
PARANEOPLASTIC PYODERMA GANGRENOSUM
Authors: Duguid C.M. , O'Loughlin S. , Otridge B. , Powell F.C.
Published: June 2007

Summary

Pyoderma Gangrenosum (PG) is often associated with an underlying disease. PG as a paraneoplastic disease is illustrated by the presentation of four patients with malignancy of myeloproliferative origin and PG. An associated malignancy isfound in approximately 7% of patients with PG, most commonly haematologic in nature and in particular leukaemia. Clinically the PG is often of the superficial bullous variant and is associated with a poor prognosis.
SPOTTED CICATRICIAL ALOPECIA IN DARK SKIN
Authors: Kossard Steven , Zagarella Sam
Published: June 2007

Summary

Study of areas of cicatricial alopecia in a 42 year old black woman by dermoscopy with oil revealed uniform pale dots associated with a radiating pigment network. Scalp biopsy showed a cicatricial alopecia with lichen planopilaris and multiple fibrous tracts. The pale dots appear to correspond to focal decrease in epidermal melanin pigment overlying the site of the fibrous tracts and may provide a dermoscopic clue in analysing the cicatricial alopecias.
GENERALISED GRANULOMA ANNULARE SUCCESSFULLY TREATED WITH PENTOXIFYLLINE
Authors: Rubel D. M. , Wood G. , Rosen R. , Jopp‐McKay A.
Published: June 2007

Summary

Generalised granuloma annulare (GA) is a chronic disease of unknown aetiology and is recalcitrant to many treatment regimes. Some investigators have suggested that an immune medicated vasculitis may be involved in the pathogenesis of GA. We describe a patient with a ten year history of generalised GA, who showed dramatic clearing of the majority of papules after four weeks of treatment with pentoxifylline. This drug has shown promising results in the treatment of many dermatologic disorders including necroboisis lipoidica diabeticorum, leukocytoclastic vasculitis and Raynaud's phenomenon.

Pentoxifylline is thought to reduce blood viscosity via effects on all major blood components, and its clinical effectiveness in generalised GA lends support to a model of immunemedicated vasculitis in the pathogenesis of this disorder. Thus, pentoxifylline offers a well‐tolerated and effective alternative to the treatment options available for patients with granuloma annulare.
CONSIDERATION OF THE COST OF INTERFERON ALFA‐2b IN THE TREATMENT OF BASAL CELL CARCINOMA
Authors: Shiell Alan
Published: June 2007

Summary

Interferon alfa‐2b is an effective but expensive way of treating basal cell carcinoma. In this paper, the cost‐effectiveness of interferon relative to conventional treatment is considered. Circumstances where surgery is contra‐indicated and would not otherwise be performed are not considered.

The cost of achieving cure by interferon alfa‐2b in the form of Intron A® is compared with the cost of conventional treatment in four situations; simple lesions, lesions in which protacted healing is expected, lesions in areas where cosmetic result is important and large lesions where hospitalisation for skin grafting may be necessary.

For simple lesions, treatment with interferon alfa‐2b costs between $500 and $760 more per cure than conventional treatment. However, it is less expensive than conventional methods in cases that would require extensive home nursing or hospitalisation. The difference in cost in simple cases also represents the price which must be paid for the better cosmetic result achieved by interferon alfa‐2b.

In conclusion, interferon alfa‐2b adds another effective option to the treatment of BCC but it is expensive. To exploit its advantages properly, it must be targeted on those who will benefit from it the most.
KINETICS AND SPECIFICITY OF NICKEL HYPERSENSITIVITY IN THE MURINE MODEL
Authors: Siller Gregory M. , Seymour Gregory J.
Published: June 2007

Summary

Nickel contact dermatitis appears to be almost exclusively a disease of females despite the increasing exposure of males to nickel. Successful murine models of nickel allergic contact dermatitis have been described. The purpose of this study is to investigate the kinetics and specificity of the response in this model and to examine if any differences exist between male and female. Mice were sensitised epicutaneously with nickel sulphate in aqueous solution of varying concentration, volume and duration of application. Following intradermal challenge, dose dependent response kinetics which approximated linearity were demonstrated upto the point of toxicity. Sensitised mice were challenged with Cobaltous chloride, Chromic chloride and Cupric sulphate and demonstrated no evidence of cross sensitivity to cobalt or chrome. Copper produced an irritant response making interpretation difficult. Earlier and stronger responses were observed in female mice, however these differences fell short of statistical significance. The results of the present study therefore establishes a reliable model for nickel hypersensitivity, that demonstrates both specificity and dose dependent kinetics without significant sex differences.
EXTEMPORANEOUS PRESCRIBING (1)
Authors: Artemi Phillip , Land William A.
Published: June 2007

Summary

An outline of the pharmacology of important components of extemporaneous prescriptions will be undertaken over four issues of the Journal.

Substances such as dithranol, salicylic acid and coal tar will be examined in some depth with regard to their mode of action, uses and side effects. In addition, examples of extemporaneous formulations containing these substances will be provided along with regarding their use.

Substances such as sulphur, calamine, podophyllin and menthol will also be reviewed the same format but in less detail. The articles are designed to provide practical knowledge in the area of extemporaneous prescribing. Complicated areas of pharmaceutical chemistry, unless relevant to the clinical setting, will not be discussed.
TOPICAL TRETINOIN IMPROVES THE APPEARANCE OF PHOTO DAMAGED SKIN
Authors: Lowe Patricia M. , Woods Jane , Lewis Anne , Davies Alison , Cooper Alan J.
Published: June 2007

A multicentre clinical trial has been conducted to assess the efficacy and safety of tretinoin 0.05% cream (Retin‐A®) in the treatment of photodamaged Australian skin. Subjects with cutaneous facial photodamage were randomised to treatment with tretinoin (62) or vehicle (63) cream. After an initial two week run‐in, all subjects applied the cream to the face, neck and left forearm/hand, once nightly for 24 weeks. Changes in clinical signs of photodamage and parameters of cutaneous irritation were assessed by investigators using a 7 point scale, whilst changes in signs of photodamage were rated by subjects using a 5 point scale. Changes in skin biopsies and silicone skin surface replicas were also assessed. Significant improvements in skin wrinkles, mottled hyperpigmentation, laxity, lentigines and roughness of tretinoin treated subjects were noted by investigators. Subjects receiving tretinoin noted significant improvements in skin wrinkles, tightness, colour and pores. Improvement in overall severity of photodamage was significantly greater for tretinoin treated subjects and was progressive over the study period. Histological findings included a significant increase in mean epidermal thickness. Significant topographical changes were not detected in skin surface replica sets. Cutaneous irritation, the most common side effect, was usually mild and transient. We conclude that tretinoin 0.05% cream significantly improved the appearance of photodamaged skin.
Cinnamon allergy in a baker
Authors: Nixon Rosemary
Published: June 2007

Contact dermatitis in bakers is usually irritant in origin, but there are a large number of potential allergens to which bakers can be exposed. A case is presented of allergic hand dermatitis due to cinnamon.
Lichen sclerosus in childhood
Authors: Fischer Gayle O
Published: June 2007

Lichen sclerosus in childhood involves predominantly the genital area, often with purpura and erosions, which raises concerns of sexual abuse. Potent topical corticosteroids give a good clinical response over several months, although maintenance with weaker formulations is usually required. The long‐term prognosis remains uncertain.
Management of drug eruptions
Authors: Breathnach SM
Published: June 2007

In this second of two articles on adverse cutaneous drug reactions, the management of drug eruptions is reviewed. This necessitates, above all, a full history and may involve observation of the effects of drug elimination. Skin testing may be helpful in some circumstances, but is hampered by false positive and negative results, and lack of knowledge of the significant antigenic determinants for most drugs. In vitro tests are for the most part unreliable and are research tools. Challenge tests are safe in fixed drug eruption, but are absolutely contraindicated in Stevens–Johnson syndrome and toxic epidermal necrolysis. The approach to the treatment of the more serious adverse cutaneous drug reactions, including angioedema/anaphylaxis, exfoliative dermatitis erythroderma and toxic epidermal necrolysis is reviewed. For those patients who develop reactions to an essential medication for which there is no alternative, desensitization is possible.
Subcutaneous fat necrosis following traumatic pancreatitis
Authors: Lee May‐Sen , Lowe Patricia M , Nevell David F , Fryer Judith , Guay John Le
Published: June 2007

A 25 year old female who developed subcutaneous fat necrosis and polyarthritis secondary to post‐traumatic pancreatitis is reported. This is a well documented but uncommon phenomenom, affecting less than 1% of patients with pancreatic disease.
Pustular psoriasis of pregnancy
Authors: Lee Simon H , Hunt Michelle J , Barnetson Ross StC
Published: June 2007

The case of an 18 year old woman who developed generalized pustular psoriasis of pregnancy in the 23rd week of her first pregnancy is reported. Treatment with topical therapies was unsuccessful and oral steroids were introduced with rapid response.
Skin necrosis following subcutaneous heparin injection
Authors: Mar Adrian W‐Y , Dixon Barry , Ibrahim Kamal , Parkin John D
Published: June 2007

Heparin‐induced skin necrosis is a rare but serious complication of subcutaneously administered heparin. Previous reports indicate that the skin necrosis is often accompanied by thrombocytopenia and occasionally by lethal thromboembolism. It thus shows features similar to the heparin‐induced thrombocytopenia (HIT) syndrome and probably represents a localized form of this condition. Caution is required in the event of skin necrosis; heparin therapy should be ceased immediately and not used again if the complications of HIT are to be avoided.
Streptococcal septic vasculitis
Authors: O'Brien Timothy J , Mcdonald Malcolm I , Reid Barry F , Trethewie Douglas
Published: June 2007

A case of invasive streptococcal disease is presented. Bacteraemic spread from a peritonsillar abscess produced acral purpuric plaques that blistered and ulcerated. Histology showed a vasculitic picture. Group A beta‐haemolytic Streptococcus was cultured from the skin biopsy and seen on Gram stain.
Paediatric vulvovaginitis
Authors: O'Brien Timothy J
Published: June 2007

Vulvovaginitis in the prepubertal child may present with itch, irritation, pain, dysuria or discharge as a result of poor hygiene, contact irritants, sexual abuse or skin diseases involving the genital area. Common infectious causes include threadworms, group A beta‐haemolytic streptococci and Haemophilus influenzae. A full history and examination are essential. Investigations may include swabs, midstream urine, biopsy, ultrasound and examination under anaesthesia.
The commonest causes of symptomatic vulvar disease: A dermatologist's perspective
Authors: Fischer Gayle O
Published: June 2007

A prospective study of 141 consecutive adult patients with chronic vulvar symptoms referred to a dermatologist was carried out to determine the commonest conditions seen. Eighty‐nine per cent of patients underwent vulvar biopsy. The commonest cause of chronic vulvar symptoms in this group of patients was dermatitis, seen in 54% of patients. The other commonly seen conditions were lichen sclerosus (13%), chronic vulvovaginal candidiasis (10%), dysaesthetic vulvodynia (9%) and psoriasis (5%). Although 38% of patients had previously been diagnosed as suffering from human papillomavirus (HPV) vulvitis, histopathological evidence of HPV was seen in only 5%. All cases showing HPV also demonstrated spongiotic dermatitis on biopsy. In this study group, a majority (overall 72%) of patients with a chronic vulvar complaint had a corticosteroid responsive dermatosis rather than a gynaecological condition. The patients with HPV on biopsy also responded to topical corticosteroids, and it was concluded that their symptoms may have been due to dermatitis unrelated to the presence of HPV. In such patients, the assumption that ‘subclinical HPV’ is a cause of symptoms and the practice of focusing medical and particularly surgical treatment on eradication of the virus may be inappropriate. A review of the commonest vulvar conditions seen by the author is presented.
Dermal melanocytosis: A clinical spectrum
Authors: Stanford Duncan G , Georgouras Katherine E
Published: June 2007

While most dermal melanocytoses are congenital or have an onset in early childhood, there is a group which is clearly acquired, with an onset in adult life. While the Mongolian spot typically disappears in childhood, other dermal melanocytoses persist for life. A brief review of the clinical spectrum of the dermal melanocytoses is undertaken and three illustrative cases are described: a case of congenital naevus of Ota, a case of acquired bilateral naevus of Ota‐like macules, and an unusual case of a congenital dermal melaaocytotic lesion on the left hand which began to spread in adulthood. The possibilities regarding the pathogenesis of this intriguing group of disorders are considered.
The Acne Disability Index: Usefulness confirmed
Authors: Oakley Amanda MM
Published: June 2007

One hundred and four patients with acne completed a questionnaire derived from the Cardiff Acne Disability Index Questionnaire. In addition, 59% of patients returned an identical follow‐up questionnaire 6 months later. Significant disability from acne was identified in many patients, with the median initial Acne Disability Index (ADI) being 6 (maximum possible 15), improving to 3 after treatment. Scores correlated poorly with the clinical severity of acne. The questionnaire proved useful for identifying patients with poor self‐image who might benefit from more potent treatment for their acne, and to evaluate the effect of treatment.
Pseudoscleroderma secondary to phytomenadione (vitamin K1) injections: Texier's disease
Authors: Pang Bryan K , Munro Vincent , Kossard Steven
Published: June 2007

Cutaneous reactions to vitamin K1 (phytomenadione) are uncommon. They can present as acute eczematous reactions or late reactions that resemble localized scleroderma after vitamin K1 injections. A case is reported here of a patient who developed bilateral sclerodermoid plaques in a cowboy's holster pattern, which persisted for more than 10 years after subcutaneous vitamin K1 injections. Positive intradermal test with vitamin K1 that persisted as an erythematous indurated plaque at the test site for more than 5 months confirmed marked cutaneous hypersensitivity to vitamin K1 in this patient. Serial biopsies of the erythematous plaque at the test site showed transition from spongiotic eczematous features initially to inflammatory morphoea‐like histology over a 5 month period. Possible pathogenic mechanisms for phytomenadione‐induced pseudoscleroderma are discussed.
Congenital malalignment of the great toenails
Authors: Dyall‐Smith Delwyn
Published: June 2007

A five year old boy is presented with bilateral congenital malalignment of the great toenails. This disorder is due to lateral deviation of the nail matrix and can be complicated by hemionychogryphosis or ingrowing of the nail at a young age.
Cimetidine for mucosal warts in an HIV positive adult
Authors: Wargon Orli
Published: June 2007

An HIV‐positive adult presented with recalcitrant mucosal warts which failed to respond to therapies including curettage and cautery, cryocautery and oral etretinate. There was an apparent complete resolution of intra‐ and perioral warts with the histamine H2 antagonist, cimetidine.
Vesiculobullous Hailey‐Hailey disease: Successful treatment with oral retinoids
Authors: Hunt Michelle J , Salisbury Elizabeth LC , Painter Dorothy M , Lee Stephen
Published: June 2007

A 56‐year‐old male presented with a pruritic, generalized vesiculobullous eruption. His past history revealed classical symptoms of limited Hailey‐Hailey disease for 34 years. Clinically, vesicles, bullae and occasional pustules were present and multiple biopsies confirmed this to be an unusual presentation of Hailey‐Hailey disease. Various therapeutic modalities including topical and oral antibiotics, oral prednisone and dapsone failed to achieve sustained remission. Treatment with lowdose oral etretinate (25 mg daily) produced marked clinical improvement with complete suppression of new vesicle formation after 6 weeks.
Lamotrigine‐induced toxic epidermal necrolysis treated with intravenous cyclosporin: A discussion of pathogenesis and immunosuppressive management
Authors: Sullivan John R , Watson Alan
Published: June 2007

There is growing evidence that the final common pathway of toxic epidermal necrolysis (TEN) is mediated by the cellular immune system which targets drug altered epithelial antigens. This provides a rationale for immunosuppressive therapy. The ideal regimen for quickly turning off epidermal damage in TEN has not yet been determined and the use or benefit of routine immunosuppression remains highly controversial. This article reviews recent advances in the pathogenesis of TEN along with the theoretical benefits of early immunosuppressive treatment in severe cases, specifically utilizing cyclosporin. We describe a 29‐year‐old woman with TEN due to the anticonvulsant lamotrigine whose successful management included intravenous cyclosporin. The extension of her lesions ceased within 24 hours of initiating cyclosporin (day 7 of her admission). Complications included: scarring alopecia; Enterococcus faecalis septicaemia due to an infected central line; and ulceration and squamous metaplasia of conjunctivae, The potential role of lamotrigine as a cause of TEN is discussed.
Compliance problems in paediatric atopic eczema
Authors: Fischer Gayle
Published: June 2007

Compliance problems are a common cause of apparent treatment failure in atopic eczema. The results of a survey of parents with children attending dermatologists for atopic eczema is presented. Major reasons for failure to comply include a poor understanding of the chronic nature of the disease, a fear of topical corticosteroids, the belief that atopic eczema is due to an allergy, and the time and cost of treatment. The explanation that treatment is a control and not a cure is also important in the parent's perception of treatment results. Suggested solutions to some of these points are discussed.
Marine stingers in Far North Queensland
Authors: Holmes John L
Published: June 2007

Two box jellyfish in particular cause problems in tropical Queensland waters. Chironex fleckeri inhabit calm waters close to the shore between November and May. The venom includes three major components: haemolytic; dermatonecrotic; and myocardial. The dermatonecrotic toxin causes a ladder pattern of whiplash lesions to the skin which ulcerate, become necrotic and heal very slowly over months. Neuromuscular paralysis and cardiovascular collapse may be fatal within minutes of envenomation. Emergency treatment comprises inactivation of stinging capsules by vinegar, removal of tentacles, analgesia, cardiopulmonary resuscitation and the administration of the specific antivenom. Carukia barnesi (‘Irukandji’) are found in both coastal and open waters. A patch of erythema with papules at the sting site is characteristically followed 30 min later by the onset of a catecholamine mediated syndrome. Headache and severe abdominal and back pain are usual and may be followed by hypertension, tachyarrhythmias and cardiogenic shock.
Psoriasis: Changing clinical patterns
Authors: Rotstein Harvey
Published: June 2007

Although psoriasis has been recognized at least since Biblical times, new forms, associations and influences continue to be described in the twentieth century. New forms include the rupioid, erythema annulare centrifugum‐like and follicular patterns. Associations with vitiligo, bullous pemphigoid and lupus erythematosus have been recently described. Endoscopic surgery has increased para‐umbilical psoriasis while Sun Smart campaigns have reduced photo‐aggravated psoriasis. Infections such as paediatric perianal streptococcal cellulitis and drugs including angiotensin converting enzyme inhibitors and cytokines exacerbate psoriasis.
Copper vapour laser treatment of port‐wine stains in brown skin
Authors: Chung Jin Ho , Koh Woo Seok , Lee Dong Youn , Lee Young Suk , Eun Hee Chul , Youn Jai Il
Published: June 2007

Forty‐seven Korean patients with port‐wine stains were treated with a copper vapour laser and clinical responses were assessed at three months after the last treatment by comparing photographs taken before each treatment The immediate histologic changes within 15min after laser treatment were also observed by routine H & E and nitroblue tetrazolium chloride staining. When we treated port‐wine stains with minimal whitening doses of 6‐8 J/cm2, no or slight colour changes were obtained. Thus, all port‐wine stain lesions in this study were treated with non‐specific energy densities ranging from 10‐20 J/cm2. Good to excellent results were obtained in 18 (38.2%) of 47 Korean patients with port‐wine stains. Repeated treatment can continue to reduce colour. Darker lesions (purple or red) are more likely to result in a marked colour change. At above threshold dose, there was wedge‐shaped diffuse coagulation necrosis and loss of viability of the epidermis and underlying dermis. Even though copper vapour laser treatment of port‐wine stains in brown skin is not as selective as in white skin because of epidermal melanin, our clinical data demonstrate the usefulness of the copper vapour laser for the treatment of port‐wine stains in brown skin.
Pityriasis rubra pilaris and focal acantholytic dyskeratosis
Authors: Cowen Peter , O'Keefe Rodney
Published: June 2007

A 65‐year‐old man presented with a widespread erythematous maculopapular eruption. Skin biopsy showed spongiosis and focal acantholytic dyskeratosis consistent with Grover's disease. Clinically the eruption evolved to erythroderma with typical features of pityriasis rubra pilaris. On review of the histology, changes consistent with this diagnosis were also present in addition to the acantholytic dyskeratosis.
Cutaneous manifestations of chronic graft‐versus‐host disease
Authors: Andrews Megan L , Robertson Ivan , Weedon David
Published: June 2007

Graft‐versus‐host disease (GVHD) occurs in a number of clinical settings. It is well recognized after bone marrow transplantation, an increasingly used therapeutic option for haematologicl disorders. Chronic GVHD, occurring at an interval greater than 100 days post‐transplant, has many systemic manifestations, but it is the cutaneous manifestations which are most frequent and often most troubling to the patient In this review article, the wide spectrum of cutaneous chronic GVHD (including involvement of hair, nails and mucosae), and its complications and associations are discussed. The clinical and histological features and management guidelines are presented to assist the dermatologist with diagnosis and treatment of this condition.
Trigeminal trophic syndrome
Authors: Su John C , Downes Nicholas P
Published: June 2007

A case report of a 51‐year‐old woman who developed trigeminal trophic syndrome Following craniectomy is presented. This syndrome represents trophic ulceration by self‐induced trauma to skin in the trigeminal area. Treatment of the present case was complicated by the patient's underlying psychological problems.
Haber's Syndrome
Authors: McCormack Christopher J , Cowen Peter
Published: June 2007

Haber's syndrome is a rare genodermatosis characterised by an early onset rosacea‐like eruption associated with multiple truncal keratoric lesions. The present study reports the clinical presentation, histology and response to therapy of two cases of Haber's syndrome. The cases presented with the typical features of Haber's syndrome. Case 1 also had diffuse palmoplantar keratoderma and prominent nail cuticles, and case 2 had diffuse palmar keratoderma. These features have not been previously reported in Haber's syndrome. In the present study Haber's syndrome is reviewed, and its relationship to Dowling‐Degos disease and acropigmentation of Kitamura are discussed.
Pseudomonas folliculitis
Authors: Hogan Peter A
Published: June 2007

Previous reports of Pseudomonas folliculitis in children identified heated pools, hot tubs or spa baths as the source of the infection. This report presents a 4‐year‐old female with Pseudomonas folliculitis acquired from the family bath tub. The source of the infection was contaminated bath toys and bath plug.
A study of clinical and aetiological factors and possible associations of lichen sclerosus in males
Authors: Lipscombe Tasman K , Wayte Jeff , Wojnarowska Fenella , Marren Pauline , Luzzi Graz
Published: June 2007

Lichen sclerosus is a chronic skin condition with a predilection for the genital area. In the present study, 35 male patients with lichen sclerosus were interviewed and examined. Blood screens were performed and histology was requested if not already performed. The findings indicate that lichen sclerosus in males exists as a spectrum of disease, ranging from a mild form with white plaques and few symptoms to a severe form with inflammation, atrophy and scarring with possible urological consequences. In many areas it differs from the condition in females; the association with autoimmune disease is weaker and there is less perianal and extragenital involvement The association with malignancy in males is of lesser significance than initially believed.
Pigmented squamous cell carcinoma with dendritic melanocytes
Authors: Kossard Steven , Cook David
Published: June 2007

A 79‐year‐old man presented with a pigmented nodule on the right ear which, on epiluminescence microscopy, demonstrated a diffuse grey‐blue colour. Skin biopsy revealed an irregularly acanthotic epidermis with lobular clusters of atypical keratinocytes that projected into the dermis in the pattern of an invasive squamous cell carcinoma. Numerous dendritic melanocytes were present throughout the lesion. Although the close relationship between the highly dendritic intra‐epidermal melanocytes and the atypical keratinocytes raised the issue of whether this tumour represented a malignant melanoacanthoma, the authors considered the lesion to be better classified as an unusual variant of pigmented squamous cell carcinoma.
Topical diclofenac/hyaluronic acid gel in the treatment of solar keratoses
Authors: McEwan Lena E , Smith Jennifer G
Published: June 2007

A randomized double‐blind controlled trial of 130 patients was performed to study the efficacy and tolerability of topical 3% diclofenac in 2.5% hyaluronic acid (HA) gel (active) versus gel containing 2.5% HA alone (control) in the treatment of solar keratoses. Patients were asked to apply trial gel to the target lesion twice a day and also sunscreen once a day for 24 weeks. The complete response rates were 29% for the active gel and 17% for the control gel. The difference was not statistically significant (P= 0.14). A high percentage of patients in both groups experienced a partial response to treatment (38% active, 45% control) but there was no significant difference in the spectrum of response between the two treatments (P= 0.18). Local adverse reactions occurred significantly more frequently in patients using the active gel (29% compared to 5% using control gel, P= 0.0002).
Naltrexone: A case report of pruritus from an antipruritic
Authors: Sullivan John R , Watson Alan
Published: June 2007

Intense, generalized pruritus associated with mycosis fungoides was relieved using subcutaneous naloxone but intensified when changed to the new oral opioid antagonist, naltrexone. Rechallenge again led to worsening in pruritus. This unexpected adverse effect is surprising as naltrexone and naloxone are currently thought to work via similar opioid receptor binding. The worsening of the itch may have been due to adaptation in opioid receptor expression induced by prolonged naloxone therapy, possibly highlighting differential opioid receptor affinity between naltrexone and naloxone, or may have represented an idiosyncratic adverse reaction. Naltrexone and naloxone have been reported to reduce pruritus due to cholestasis, uraemia, morphine epidurals, and possibly atopic dermatitis and urticaria. Naltrexone has the convenience of oral administration and a longer half‐life. The role of the opioid system and naltrexone in pruritus is reviewed.
Hidradenitis suppurativa, Dowling Degos disease and perianal squamous cell carcinoma
Authors: Li Michael , Hunt Michelle J , Commens Christopher A
Published: June 2007

A patient with hidradenitis suppurativa (HS) is described in association with Dowling Degos disease and perianal squamous cell carcinomas. As the initial treatment for HS failed to give any satisfactory relief, he sought no further medical help for the subsequent 40 years. This patient illustrates the management difficulties in HS and the need for regular surveillance to exclude the development of anogenital squamous cell carcinoma. Previous reports of hidradenitis suppurativa in association with Dowling Degos disease are reviewed and the aetiology is discussed.
Long‐term follow up of patients with toenail onychomycosis after treatment with terbinafine
Authors: Watson Alan B , Marley John E , Ellis David H , Williams Tony G
Published: June 2007

The long‐term outcome of 111 patients treated with oral terbinafine for toenail onychomycosis with a novel treatment protocol was assessed a median of 138 weeks alter entry into the trial. All but three patients had either one or two 12 week courses of terbinafine 250 mg daily. 01 the 77 evaluable patients, 72.7% were still classified as responders (i.e. negative mycological culture and at least 3 mm olnew unaffected nail growth) on reassessment. The present study shows that a favourable long‐term outcome can be achieved in patients who have been treated with at least one 12 week course of terbinafine.
A philosophy for the Skin and Cancer Foundation
Authors: Paver Ken , Pettit Peter
Published: June 2007

The Skin and Cancer Foundation is now 21 years old in Sydney and 10 years old Melbourne, and a third is being planned for Brisbane. The achievements of these institutions are quite remarkable but the philosophy on which they were based may not now be applicatble. An understanding of this original philosophy may assist future plaming. People suffering from skin disease in Australia need help which can only be delivered by combination of several institutions such as government, hiospitals and the Australasian College of Dermatologists (College).
Localized lichen sclerosus with nail loss
Authors: Kossard Steven , Cornish Norm
Published: June 2007

A 52‐year‐old woman who developed a pale sclerotic second left toe with loss of the nail plate is described. Biopsy showed changes of lichen sclerosus. There were no other skin or genital lesions present.
Factors that may affect the response of onychomycosis to oral antifungal therapy
Authors: Gupta Aditya K , Daniel C Ralph
Published: June 2007

With the advent of the newer oral antifungals available to treat onychomycosis, the majority of patients respond to therapy. However, there may be subsets of patients who exhibit poor response or failure. Possible explanations for this may be grouped into categories, including: (i) patient characteristics; (ii) organisms causing or associated with the nail infection; (iii) nail characteristics; and (iv) local diseases involving the nail.
The effects of 2‐thiophenecarboxylic acid on serum ionic calcium and magnesium levels in rats
Authors: Raman A. , Chong Y. K.
Published: June 2007

1. Administration of 2‐thiophenecarboxylic acid to rats maintained on a low calcium diet resulted in a significant depression in the serum levels of total and ionized calcium and inorganic phosphate.

2. The serum magnesium levels were not altered by the drug.
Some actions of chandonium iodide, a new short‐acting muscle relaxant, in anaesthetized cats and on isolated muscle preparations
Authors: Gandiha A. , Marshall I. G. , Paul D. , Rodger I. W. , Scott W. , Singh H.
Published: June 2007

1. The actions of the new skeletal muscle relaxant chandonium (HS310) on the cardiovascular, respiratory and skeletal muscle systems of the cat under chloralose anaesthesia and on chick and rat isolated skeletal muscle preparations have been described.

2. In the cat chandonium exhibited a potent, competitive, non‐depolarizing neuromuscular blocking action that was rapid in onset and of short duration. It possessed a selective atropine‐like action at the cardiac vagus neuro‐effector junction but little or no ganglion blocking activity. Neither adrenergic neurone nor α‐adrenoceptor blocking properties were evident.

3. Unlike tubocurarine, chandonium was without effect on the airways system of the anaesthetized cat.

4. Chandonium possessed weak anticholinesterase action. It is conceivable that this effect may contribute to its short duration of action.

5. The results from these studies suggest that chandonium may have possible clinical applications as a short‐acting muscle relaxant.
Thermal anomalies in ion distribution in rat kidney slices and in a model system
Authors: Wiggins Philippa M.
Published: June 2007

1. Both a porous silica gel and thin cortical slices of the kidneys of rats showed highly anomalous temperature dependence of selectivity for K+ relative to Na+.

2. Maxima occurred at about 15°C, 30°C, 45°C and 60°C in the gel, and at about 15°C and 28°C in kidney slices.

3. It is suggested that since the anomalies resemble Drost‐Hansen anomalies, they are consistent with the proposal that both in the model silica gel system and in rat kidney slices ion distribution might be determined to some extent by a difference in solvent properties between interfacial and bulk phase water.
Occurrence of 5‐hydroxy‐3‐indoleacetic acid in urine from several animal species
Authors: Logan Mary Ruth , Drotman Robert B.
Published: June 2007

1. The normal levels of 5‐hydroxy‐3‐indoleacetic acid (5HIAA) were determined in the urine of four species of laboratory animals (dog, rabbit, rat and guinea‐pig).

2. When 5HIAA excretion was calculated as mg/24 h, the output in the four species was in the order of rabbit > dog > guinea‐pig > rat; but when it was calculated as μg/mg of creatinine, the order was guinea‐pig > rabbit > rat > dog.

3. There were significant differences in the excretion of urinary 5HIAA between males and females within two species: rats and dogs.
Plasma renin concentration in hypertension produced by unilateral renal artery constriction in the rat
Authors: Oates Helen F. , Stokes Gordon S. , Storey Brian G.
Published: June 2007

1. Plasma renin concentration (PRC) and blood pressure were studied sequentially, 24 h to 42 days post‐operatively, in rats subjected to unilateral renal artery constriction without contralateral nephrectomy.

2. The PRC of rats failing to develop hypertension remained normal, whereas the mean PRC of twenty‐two rats that became hypertensive was five times normal on day 14 of the study when the hypertension was becoming established.

3. In eleven of the twenty‐two rats that became hypertensive, PRC did not exceed the upper limit of normal. In the remaining hypertensive rats, the increase in PRC was not always temporally related to the increase in blood pressure. A significant correlation between PRC and blood pressure did not emerge until day 35 of the study

4. Despite these anomalies, linear regression analysis of 169 pairs of PRC and blood pressure measurements during the 42 day period of development of hypertension in twenty‐two rats revealed a highly significant correlation between log PRC and blood pressure (P < 0·001).

5. It is concluded that factors other than the plasma concentration of renin are involved in the early stages of development of hypertension induced by renal artery constriction. Nevertheless, PRC and blood pressure are intricately related.
Stimulation by angiotensin II of the release of vasopressin from incubated rat neurohypophyses—possible involvement of cyclic AMP
Authors: Gagnon D. J. , Sirois P. , Boucher P. J.
Published: June 2007

1. Calcium did not influence the spontaneous release of vasopressin from rat neurohypophyses in vitro when used in concentrations of 0·05, 0·5 and 2·8 mM in the bathing medium.

2. Stimulation of the basal output of vasopressin by angiotensin II (1 · 10–9 M) required at least 0·5 mM calcium in the medium.

3. Angiotensin II stimulated the release of vasopressin within 2·5 min of incubation, maximal release was observed after 10 min.

4. Angiotensin II rapidly promoted the accumulation of tissue cyclic AMP; maximal accumulation was observed after 5 min of incubation.

5. Theophylline and dibutyryl cyclic AMP produced varying degree of stimulation of the release of vasopressin.

6. Increases in vasopressin secretion and in the accumulation of cyclic AMP were always present when neurohypophyses were exposed to optimal concentrations of angiotensin II. The results presented suggested that cyclic AMP may be an intermediate step for the release of vasopressin by endogenous angiotensin II.
Salt loss as a possible mechanism eliciting an acute malignant phase in renal hypertensive rats
Authors: Gross F. , Dietz R. , Mast G. J. , Szokol M.
Published: June 2007

1. The acute malignant phase of hypertension in rats with an untouched contralateral kidney is characterized by salt and fluid loss, increased fluid intake, decrease in body‐weight gain, and reduced food consumption. Plasma concentrations of sodium and potassium were reduced, and plasma angiotensin II rose to about four times normal.

2. To investigate the significance of an untouched contralateral kidney for the development of the acute malignant phase in renal hypertensive rats, comparative studies were undertaken in unilaterally nephrectomized rats with stenosis of the remaining renal artery and in rats with bilateral renal artery stenosis. In addition, the effect of declamping one renal artery in rats with bilateral stenosis was studied.

3. In unilaterally nephrectomized rats, no signs of sodium and fluid loss were demonstrable, despite marked increase in blood pressure. Similarly, rats with bilateral renal artery stenosis had no acute malignant phase of hypertension.

4. In hypertensive rats with bilateral stenosis, removal of the clip from one renal artery was followed by an immediate fall in blood pressure and a subsequent gradual increase. Eleven of sixteen rats lost salt and fluid and developed an acute malignant phase. Plasma angiotensin II was high and serum urea elevated.

5. Consumption of 2% saline in addition to water as drinking fluid had a beneficial effect, since only five of fourteen rats showed signs of the acute malignant phase, which were milder than in rats on water only.

6. It is concluded that the untouched contralateral kidney is responsible for the negative salt and water balance and its consequences, which are characteristic of the acute malignant phase of experimental renal hypertension.
Influence of changes in amine substitution on the β‐adrenoceptor stimulant activity of soterenol and related compounds in the anaesthetized cat
Authors: Malta E. , Raper C.
Published: June 2007

1. Three 3‐methanesulphonamido, 4‐hydroxy ring substituted phenylethanol‐amines with n‐isopropyl (soterenol), n‐t‐butyl (MJ7999–1) and n‐(1‐phenyl‐t‐butyl) (MJ9184–1) amine substituents have been compared with (—)‐isoprenaline for their ability to produce β‐receptor mediated reductions in serotonin‐induced increases in pulmonary resistance, decreases in soleus muscle contractility, and increases in heart rate in anaesthetized cats. For each parameter, the dose of a compound required to produce 50% of its maximal response (ED50) was calculated.

2. For all three parameters (—)‐isoprenaline was the most potent of the compounds studied, and the rank order of potency of the methanesulphonanilides was MJ9184–1 (n‐(1‐phenyl‐t‐butyl))≃MJ7999–1 (n‐t‐butyl)> soterenol (N‐isopropyl).

3. For each individual drug, molar dose‐ratios [drug: (—)‐isoprenaline] were calculated. Ratios for the effects of the compounds on the soleus muscle and in the bronchi were similar. With each compound higher dose‐ratios were found in the heart. The rank order for relative β2‐selectivity was soterenol (n‐isopropyl)> MJ7999–1 (n‐t‐butyl)≃MJ9184–1 (n‐(1‐phenyl‐t‐butyl)).
Coronary reactive hyperaemia and coronary dilator action of adenosine during normal respiration and hypercapnic acidosis in the dog
Authors: Raberger G. , Schütz W. , Kraupp O.
Published: June 2007

1. The effects of hypercapnic acidosis on coronary conductance, the coronary dilator effect of adenosine administered into the coronary artery and the reactive hyperaemic response after short and long periods of coronary artery occlusion were investigated in thoracotomized dogs.

2. The coronary conductance was positively correlated to the arterial PCO2 and negatively correlated to the arterial pH.

3. During control periods the reactive hyperaemic response increased with increasing duration of coronary artery occlusion, whereas the percentage repayment of the deficit remained unchanged.

4. The reactive hyperaemic response after short periods of coronary artery occlusion (up to ten beats) was diminished during hypercapnic acidosis. This decrease may be explained on the basis of an increased tissue PO2 or a decreased relative change in tissue pH.

5. The dilator effect of adenosine administered into the coronary artery was enhanced during hypercapnic acidosis.

6. The reactive hyperaemic response after long periods of coronary artery occlusion (above fifteen to twenty beats) was also enhanced during hypercapnic acidosis, and may be a result of myocardial adenosine formation during coronary artery occlusion.

7. The findings indicate that coronary blood flow after coronary artery occlusions may be primarily regulated by local pH changes in the coronary vessel cells. Additional dilatation after longer coronary artery occlusion may result from the release of adenosine by the hypoxic myocardium.
Massive ingestion of kerosene: a study of gastric clearance in primates
Authors: Wolfsdorf Jack
Published: June 2007

1. Metoclopramide hydrochloride (Maxolon) a potent intestinal clearing agent and powerful anti‐emetic, was utilized to promote gastric clearance of kerosene from baboons, experimentally poisoned.

2. When compared to a control group, treated baboons have significantly decreased amounts of kerosene in the stomach 2 h after treatment, ‘full’ stomach/body weight ratios confirming this.

3. The study suggests that metoclopramide, by its gastric clearing and anti‐emetic action, may reduce the risk of vomiting, and thus of aspiration pneumonia, in kerosene poisoning.
Phenazone (antipyrine) metabolism and distribution in young and elderly adults
Authors: Liddell Deborah E. , Williams Faith M. , Briant Robin H.
Published: June 2007

1. The plasma half‐life and apparent volume of distribution of phenazone (antipyrine) was studied in twenty‐six normal adults (20–40 years of age) and twenty‐six geriatric patients.

2. A wide range of values for plasma half‐life was recorded in both groups (young 7·7–19·9 h, elderly 9·5–30·1 h) but the mean plasma half‐life for the geriatric group (16·8 h; s.e.m. = 5·9) was significantly longer (P < 0·01) than the normal adult group (12·5 h; s.e.m. = 3·2).

3. No difference in plasma half‐life was noted between sexes in either the geriatric or control groups.

4. Doubling the dose of phenazone from 10 to 20 mg/kg made no difference to the plasma half‐life in a subgroup of the geriatric patients.

5. The volume of distribution of phenazone, representing total body water, was 0·59–0·63 l/kg in all groups except the elderly females, in whom it was 0·48 l/kg. This latter group showed a correspondingly higher plasma concentration extrapolated to time zero.

6. The difference in plasma half‐life phenazone between normal adult and elderly groups is statistically significant, but the wide range of values in each group makes the biological significance less clear. Alteration of drug distribution with resultant higher plasma or tissue concentrations may contribute to adverse drug effects, particularly in the elderly female.