Drug eruptions at five institutes in Bangkok.

The study was performed in five hospitals in Bangkok for a period of one year. All in- and outpatients who developed drug eruption from January to December 2001 were enrolled into the study. Physical examinations and complete history-taking were performed by one of the authors. A skin biopsy was done to confirm the diagnosis in every suspected case. Oral challenge test was performed to obtain a definite diagnosis only in some patients with informed consent. Among 212 patients, the most common causative drugs were antimicrobial agents with cephalosporin group in the highest rank. Maculopapular rash was the most common type of drug eruption followed by urticaria and photosensitivity reaction. It was concluded that antimicrobial agents were the predominant causative agents and maculopapular eruption was the most frequent clinical manifestation. New kinds of antimicrobial agents, anti-inflammatory drugs and lipid lowering agents could cause various patterns of drug eruption.

Phototoxicity of new psoralen-containing gels and creams versus bath PUVA.

BACKGROUND: Bath-PUVA-photochemotherapy has become a useful alternative to oral PUVA therapy due to a number of advantages over systemic PUVA, for example, no ophthalmologic risk and nausea, and a lower cumulative UVA doses. However, its major disadvantage is the logistical requirement for bath tubs in practice and some patients feel uncomfortable to share the same bath with others. Topical psoralen contained preparation may be a good candidate for safe, convenient, and useful regimen in the topical PUVA therapy. OBJECTIVES: The purpose of the present study was to investigate the intensity of the phototoxic response of 8-MOP bath solution to different concentrations of preparations of 8-MOP gels and creams. MATERIAL AND METHOD: Following informed consent, the test bath solution (0.375%), gels (0.0025% to 0.010%) and creams (0.0025% to 0.010%) were applied to the normal-appearing skin of the upper back of 23 volunteers who had no history of photosensitivity. The escalating UVA doses (0.25 to 7.0 J/cm2) were given 15 minutes after application of test substances. Seventy-two hours after UVA exposure minimal phototoxic doses (MPD) were defined visually and the intensity of the erythema response was also assessed by using a narrowband spectrophotometer The MPD and the dose-response curves for erythema response of the gels and creams were compared with those of the bath. RESULTS: There were no significant differences between the overall mean MPD of tested gels and that of bath solution (p > 0.05). On the contrary, the cream preparations induced phototoxic response (MPDs) to a lesser degree than bath solution and gels (p < 0.05). When comparing the slope of the dose-response curve for erythema of 0.0025% and 0.0100% gel to that of the bath solution, the correlation is very strong (R2 = 0.987 and 0.936, respectively, p < 0.0001). CONCLUSION: The present study shows that the threshold of phototoxic response of 0.0025% 8-MOP gel indicated by MPD is well correlated with those of the bath solution. The slope of the dose-response curve for erythema of this preparation also significantly corresponded to that of the bath solution. Thus, the penetration and drug delivery of 0.0025% 8-methoxypsoralen gel may be similar to 8-methoxypsoralen bath solution. This preparation may be a good candidate for a useful therapeutic modality for topical PUVA therapy, and further clinical trial should be performed.

A girl with A glowing tooth : A case of congenital erythropoietic porphyria.

Congenital erythropoietic porphyria is a rare type of porphyria caused by inherited defects of uroporphyrinogen III synthase, an enzyme in the heme biosynthetic pathway. The resultant accumulation of porphyrins causes damage to the skin and erythrocytes, leading to cutaneous photosensitivity and hemolytic anemia. Furthermore, excess porphyrins are also deposited in tissues, bone, and teeth, resulting in a reddish-brown discoloration of the teeth (erythrodontia) which fluoresces under long-wavelength ultraviolet light. In this report, a case of a 9-month old infant girl with recurrent skin eruptions, anemia with hepatosplenomegaly, and erythrodontia is presented. The diagnosis of congenital erythropoietic porphyria was made based on the clinical manifestations and biochemical investigations. The patient was treated successfully with allogenic bone marrow transplantation and is still in remission after almost 3 years posttransplantation.

Comparative study of the efficacy of topical corticosteroid: five locally made and one brand name creams.

The aim of this study was to evaluate the efficacy of 5 locally made clobetasol propionate creams compared with a brand name product. The study was divided into 3 parts 1) pharmacological study, 2) vasoconstriction test, and 3) double blind clinical trial. The results showed that the pharmacological properties of the locally made products were not different from the brand name product. Product C and D could diffuse through cellulose acetate membrane 3 fold more than the brand name product. Product D and E caused less vasoconstriction than the brand name product. This double blind study showed that all locally made products could improve psoriasis to the same extent as the brand name product, but there was more recurrence of psoriasis while using all the locally made products. It was concluded that locally made products were as effective as the brand name product in the treatment of psoriasis evaluated over a 2 week peroid, but more recurrence was observed with locally made products.

Can aloe vera treat or protect from sunburn.

Aloe vera gel continues to be an ingredient in a wide variety of topical products, including sunscreen and after-sun products, even though there has been little scientific evidence to support its use. Evidence does exist to support the use of Aloe vera as a therapeutic modality in the treatment of thermal burns and radiodermatitis. We investigated the efficacy of topic Aloe vera gel in the treatment and prevention of cutaneous erythema following ultraviolet B. Ten healthy Thai volunteers were irradiated on control-untreated, pre-and post-Aloe vera-treated areas with UVB doses ranging 25 to 300 mJ/cm2. The threshold doses of UVB which induced a well-defined border erythema (MED) of the three areas were determined and compared. There were no statistically significant differences in MEDs in pre-, post-Aloe vera treated areas compared with those in untreated control sites (p>0.468). Our results suggest that topically applied of Aloe vera gel both before and after UVB-irradiation dose not affect UVB erythema.