Therapeutic effects of CO2 laser therapy of linear nevus sebaceous in the course of the Schimmelpenning-Feuerstein-Mims syndrome.

The Schimmelpenning-Feuerstein-Mims (SFM) syndrome is a rare phakomatosis which comprises a nevus sebaceous of Jadassohn, seizures and developmental delay associated with a wide spectrum of extracutaneous abnormalities including neurological, skeletal, ocular, cardiovascular and urogenital defects. We are presenting a case of an 18-year-old patient with systemic features of the SFM syndrome and an extensive linear nevus sebaceous partially removed with a carbon dioxide (CO2) laser. The treatment options of skin lesions in patients with SFM are discussed.

[Inulin: a valuable nutritional component]. / Inulina--cenny skladnik zywieniowy.

Inulin, a natural oligomer of fructose, is classified as a food component. It can be found in some plants and vegetables, i.e. chicory, Jerusalem artichoke, elecampane, and dandelion. Following ingestion, inulin reaches the lower part of the gastrointestinal tract where it is fermented increasing the bifidobacterial population of the colon. The growth of bifidobacteria regulates cholesterol concentration and absorption of minerals. Inulin added to food may prevent the spread of civilization diseases, like diabetes and obesity.

[Vitiligo as an aesthetic problem. Noninvasive therapeutic methods in vitiligo]. / Bielactwo nabyte jako problem estetyczny. Nieinwazyjne metody leczenia bielactwa.

Vitiligo is an idiopathic chronic skin disease that is notable for depigmented macules forming by destruction of melanocytes mediated by cells of the immune system. Vitiligo occurs in 1-2% of the population irrespective of race and without predilection to gender or age. The dynamics and extent of the disease vary widely, ranging from stable cases with isolated minor foci to states showing rapid progression and occupying large areas of the skin. For many patients, the disease represents a serious cosmetic defect which limits their activities in various spheres of life. There are many noninvasive methods of treatment but none of them offers a guarantee of complete therapeutic success. PUVA- and UVB-therapy are recognized as the most effective and most commonly used methods. The management of vitiligo should also include education, cosmetic correction options, and psychotherapy in some cases.

[Antimalarial drugs in contemporary dermatologic therapy]. / Miejsce leków przeciwmalarycznych we wspólczesnej terapii dermatologicznej.

Antimalarial drugs--chloroquine, hydroxychloroquine and quinacrine, initially devised for the treatment of malaria, have been used in the therapy of diverse skin diseases, including lupus erythematosus, dermatomyositis, porphyria cutanea tarda, and sarcoidosis. The mechanism of action of these drugs involves stabilization of lysosomal enzymes, inhibition of antigen-presenting cells and T lymphocyte stimulation, blocking of the pro-inflammatory cytokine cascade and endosomal toll-like receptor signaling. The understanding of potential mechanisms of action of antimalarials may extend their use to new areas in dermatology. This work describes the pharmacologic properties of antimalarial drugs and indications for their use in clinical practice. Moreover, the most important limitations of therapy with antimalarials and their adverse side effects are discussed.

[Retrospective analysis of adverse cutaneous drug reactions in patients hospitalized in Department of Dermatology and Venereology of Pomeranian Medical University in 1996-2006]. / Retrospektywna analiza niepoizdanych skórnych reakcji polekowych u pacjentów hospitalizowanych w Klinice Chorób skórnych i Wenerycznych Pomorskiej Akademii Medycznej w Latach 1996-2006.

INTRODUCTION: Every adverse and undesirable event observed after administration of the therapeutic dose of the drug is defined as adverse drug reaction. The aim of the study was to evaluate the incidence frequency of cutaneous adverse drug reactions, to define the drugs inducing such reactions and to define the type of the most frequently found lesions in patients admitted to Department of Dermatology and Venereology of Pomeranian Medical University in Szczecin (PAM) in 1996-2006. MATERIAL AND METHODS: A retrospective analysis of medical files of the patients, who were hospitalized in the Department of Dermatology and Venereology of PAM in Szczecin in 1996-2006, was carried out. Due to cutaneous adverse drug reactions, 386 patients were hospitalized. They made 4.25% of all admitted to our Department. RESULTS: These reactions were found more frequently in females (65.5%) than in males (34.5%). Non-steroidal anti-inflammatory drugs induced adverse events most frequently (37.6%), followed by aminopenicillin antibiotics, particularly amoxycillin-containing agents, responsible for 25.8% of these reactions. Other antibiotics were responsible for undesirable events less frequently--9.6%. Macular and maculopapular rashes were the most frequently observed adverse cutaneous drug reactions (42.0% of the cases), followed by acute urticaria and Quincke's oedema (39.1% of all reactions), whereas contact dermatitis after topical drugs was found in 8.0% of the cases. CONCLUSIONS: Cutaneous adverse drug reactions were mainly induced by non-steroidal anti-inflammatory drugs and aminopenicillin antibiotics. The most frequent forms of cutaneous adverse drug reactions were maculopapular rashes, acute urticaria and Quincke's oedema.

[Dry skin as a dermatological and cosmetic problem]. / Sucha skóra jako problem dermatologiczny i kosmetyczny.

The paper presents current opinions on aetiopathogenesis of dry skin including its occurrence in the course of certain dermatological disorders. A meaning of natural moisturizing factor, lipid barrier as well as epidermal differentiation processes in the maintenance of the proper skin moisturization is described. The importance of topical treatment is emphasized. Moreover, a survey of moisturizing factors applied in dry skin care is included.

[Androgenetic alopecia in women as an aesthetic and psychological problem]. / Lysienie androgenowe u kobiet jako problem estetyczny i psychologiczny.

Androgenetic alopecia is a fairly common disorder which causes serious aesthetic and psychological problems. The paper discusses the etiology, diagnostics and possible treatment of androgenetic alopecia in women. Preparations for both general and external use in treatment of this dermatosis have been presented herein.

[The role of biological agents in dermatology]. / Rola leków biologicznych w dermatologii.

Biological agents belong to a novel therapy method. Their immunomodulatory activity is used in treating some of the severe and chronic skin diseases. This paper presents the structure and activity of biological agents, enumerates preparations most commonly used in dermatology, their side effects and contraindications.

[Sunscreens--chemical structure and application]. / Srodki swiatloochronne--budowa i zastosowanie.

In the paper chemical structures and classification of active ingredients of sunscreens as physical or chemical filters are presented. Adequately selected to skin phototype sunscreen protects body against sunburn and prolonged sunlight exposure skin changes, induced by harmful ultraviolet radiation.

Acyclovir concentrations in the skin of humans after a single oral dose assessed by in vivo cutaneous microdialysis.

BACKGROUND/PURPOSE: Acyclovir is a synthetic deoxyguanosine analogue used in the treatment of certain viral diseases. This drug is effective primarily against Herpes simplex virus, Varicella zoster virus and to a lesser extent against Epstein-Barr virus and cytomegalovirus. The aim of the study was to determine the acyclovir concentrations in plasma and skin (cutaneous microdialysate) and to compare its penetration into real (skin) and theoretical peripheral compartment after administration of a single 0.4 g oral dose. METHODS: To evaluate the skin concentrations of the examined agent in 10 healthy male volunteers linear microdialysis probes with 2 kDa molecular-weight cut-off were inserted intradermally and were perfused with Ringer solution up to 6 h after drug ingestion. RESULTS: The mean maximum acyclovir concentrations in the plasma, skin and theoretical peripheral compartment were 3.16+/-0.86, 0.94+/-0.34 and 1.85+/-0.69 micromol/L, respectively, and were achieved after 1.6+/-0.4, 2.4+/-0.3 and 3.7+/-0.7 h. The degree of penetration into the real (skin) and theoretical peripheral compartment was 0.36+/-0.15 and 0.74+/-0.12, respectively, and the differences were statistically significant. Similarly, also, the maximum concentration, time to maximum concentration and area under the concentration-time curve differed significantly between the plasma and skin as well as between the skin and the theoretical peripheral compartment. CONCLUSIONS: In selected cases skin concentrations should be determined rather than those in blood plasma when studying the distribution of orally administered drugs. Evaluation of acyclovir concentrations in the skin cannot be replaced by the calculation of the theoretical peripheral compartment.

[Application of phototherapy in dermatology]. / Zastosowanie fototerapii w dermatologii.

Phototherapy is nowadays one of the main methods used in dermatology. It can be used alone or in combination with oral and/or topical treatment. The action of ultraviolet radiation is exploited for the treatment of many diseases. This paper presents the application of various phototherapy methods, their side-effects and ways of preventing them.

[Protection of the skin from harmful ultraviolet radiation]. / Ochrona skóry przed szkodliwym dzialaniem promieniowania ultrafioletowego.

Ultraviolet radiation from the sun or artificial sources can exert beneficial and/or damaging effect on human skin. Excessive UV radiation has been implicated in the increased incidence of skin malignancies and accelerated skin photoaging. Thus, the skin requires adequate protection and sunscreens are useful for this purpose. Physical (inorganic) and chemical (organic) filters protect the skin from the action of both UVA and UVB. Apart from sunscreens, avoidance of excessive exposure to sunlight is the most important recommendation to protect the skin.

Germline mutation and large deletion analysis of the CDKN2A and ARF genes in families with multiple melanoma or an aggregation of malignant melanoma and breast cancer.

The CDKN2A/ARF genes have been associated with increased risk of malignant melanoma (MM) in families with multiple members affected by disease and in families characterized by the constellation of breast cancer and MM. The exact contribution of CDKN2A/ARF to disease risk remains poorly characterized, especially in diverse populations. In this report, the contribution of CDKN2A/ARF germline mutations and large rearrangements to disease in Polish familial MM (FMM) and aggregations of breast cancer and MM were assessed using a strategy that included genomic sequencing, restriction fragment length polymorphism and multiplex ligation-dependent probe amplification. We examined 16 FMM cases (group 1), 44 MM probands with a cancer family aggregation (CFA) that included at least one breast cancer (group 2) and 22 breast cancer probands with CFA and MM (group 3). The results revealed a paucity of mutations in CDKN2A/ARF, suggesting that in the Polish population this gene does not contribute significantly to either FMM or MM within the context of CFA.

Penetration of cotrimoxazole components into skin after a single oral dose. Theoretical versus experimental approach.

Concentrations of trimethoprim and sulfamethoxazole in plasma, cantharidin-induced skin blister fluid and theoretical peripheral compartment were determined in twelve male subjects suffering from bacterial skin diseases after a single oral dose of 0.32 g of trimethoprim and 1.6 g of sulfamethoxazole. Maximum trimethoprim concentrations of 8.5 +/- 1.1 micromol/l in plasma, 5.6 +/- 0.8 micromol/l in blister fluid and 5.8 +/- 2.2 micromol/l in theoretical peripheral compartment were found after 3 +/- 1, 7 +/- 2 and 9 +/- 6 h, respectively. Degree of penetration into blister fluid and theoretical peripheral compartment was 0.94 +/- 0.23 and 1.05 +/- 0.09, respectively. The differences between respective pharmacokinetic parameters of trimethoprim in blister fluid and theoretical peripheral compartment were statistically insignificant. Maximum sulfamethoxazole concentrations of 295 +/- 47 micromol/l in plasma, 182 +/- 46 micromol/l in blister fluid and 239 +/- 58 micromol/l in theoretical peripheral compartment were found after 3 +/- 1, 8 +/- 2 and 7 +/- 4 h, respectively. Degree of penetration into blister fluid and theoretical peripheral compartment was 0.82 +/- 0.20 and 1.04 +/- 0.02, respectively. In contrast to trimethoprim, the differences between respective pharmacokinetic parameters of sulfamethoxazole in blister fluid and theoretical peripheral compartment, except time to maximum concentration, were statistically significant. Cantharidin-induced skin blister fluid method can be used to estimate drug penetration into skin. Due to differences between the respective pharmacokinetic parameters in experimental and theoretical peripheral compartment, in some cases evaluation of drug penetration into skin should not be replaced by the theoretical peripheral compartment calculation.

Use of an intraluminal guide wire in linear microdialysis probes: effect on recovery?

BACKGROUND/PURPOSE: For microdialysis studies in the skin, laboratory-made linear probes are often used. Probes can be assembled with or without a stainless-steel guide wire in the lumen of the dialysis fibre. From a theoretical viewpoint, this will alter the performance of the probe. The aim of this study was to compare the in vitro microdialysis recovery using probes with and without an internal guide wire, employing two different model drugs and a range of perfusate flow rates. METHODS: In vitro microdialysis recovery experiments were performed with and without internal guide wires at perfusion flow rates from 1 to 15 microL/min, using either salicylic acid or metronidazole as test compounds at 5 mg/L. Phosphate buffer (pH 7.4) was used as perfusate. Dialysates were analysed by a validated HPLC assay with spectrophotometric detection. RESULTS: For both test compounds, the mean microdialysis recovery did not differ significantly between microdialysis probes with and without an internal guide wire at lower flow rates. At very high flow rates (10-15 microL/min), a significant difference in recovery could be seen for probes with internal guide wires when compared with probes without. CONCLUSIONS: The use of a stabilizing internal guide wire in linear microdialysis probes did not influence the in vitro recovery of microdialysis at volumetric flow rates below 10 microL/min. These are the flow rates most frequently used for in vivo microdialysis studies in the skin.

Evaluation of ofloxacin penetration into the skin after a single oral dose assessed by cutaneous microdialysis.

An antibacterial drug can exert its therapeutic action if it is present in target tissue at proper concentration. Cutaneous microdialysis is a relatively new technique, which allows to determine drug concentration in the skin. The aim of the study was to evaluate the ofloxacin concentrations in plasma and skin following a single oral dose of 0.4 g. Drug concentration in the skin was assessed by applying cutaneous microdialysis. The penetration of the studied agent into dermal microdialysate was compared with its penetration into theoretical peripheral compartment. Maximum ofloxacin concentration in plasma was 9.26 micromol/l on average and was achieved after about 1.7 h. Mean peak concentrations in cutaneous microdialysate and in theoretical peripheral compartment were comparable (4.16 versus 4.50 micromol/l), but time to peak concentration in theoretical peripheral compartment was significantly longer than in microdialysates (5.8 and 2.0 h, respectively). Degree of penetration into cutaneous microdialysate was about 0.54. Cutaneous microdialysis seems to be a valuable technique to evaluate drug penetration into the skin.

A simple and rapid liquid chromatographic method for the determination of metronidazole and its hydroxymetabolite in plasma and cutaneous microdialysates.

A rapid, accurate, simple and low-cost method for quantitative determination of metronidazole and its hydroxymetabolite, in plasma and microdialysate samples, using tinidazole as an internal standard, has been developed. Metronidazole is widely used as a valuable agent for antiprotozoal as well as antibiotic therapy when anaerobic organisms are involved. Separation of the compounds studied was performed on a 120 x 4 mm analytical column, filled with LiChrosorb RP-8, 5 microm, the mobile phase consisted of 0.05 mol/L aqueous solution of potassium dihydrogen phosphate, adjusted to pH = 3.5 with orthophosphoric acid, methanol and acetonitrile (40:2:3. v/v/v). Detection was performed at 320 nm. Intra- and interserial precision was below 4.6% and 7.9%, respectively, for both the compounds studied. The presented method is suitable for pharmacokinetic studies.