ABSTRACT
Delusions of parasitosis is a rare disorder in which patients have the false and fixed belief that they are infested by parasites. It is a psychiatric disorder, but patients usually present to a dermatologist and referral to a psychiatrist is almost always rejected. Treating a patient with delusions of parasitosis requires patience and tact. The neuroleptic pimozide is the treatment of choice, but a significant problem is convincing the patient to take the drug. We report a study of 33 patients (13 men and 20 women) with delusions of parasitosis. The mean age at onset was 56.9 years and the mean duration of symptoms before attending the department of dermatology was 1.3 years. Pimozide (Orap) was prescribed for 24 patients, but only 18 patients took it. Follow-up information was available for 18 patients: five had full remission, four were less symptomatic, five were unchanged and four had died of unrelated causes.
Subject(s)
Delusions/drug therapy , Parasitic Diseases/psychology , Adolescent , Adult , Aged , Aged, 80 and over , Antipsychotic Agents/therapeutic use , Female , Humans , Male , Middle Aged , Patient Acceptance of Health Care , Pimozide/therapeutic useSubject(s)
Clinical Protocols , Urethritis/therapy , Family Practice , Humans , Urethritis/diagnosis , Urethritis/etiologyABSTRACT
Terbinafine is an allylamine antifungal compound shown to be effective in the oral treatment of onychomycosis. Because of the fungicidal activity of the drug, a shorter duration of treatment, compared with the currently used oral treatment modalities, can be expected in onychomycosis of the toenail. In the present randomized study, the efficacy of oral terbinafine treatment (250 mg/day) was assessed for periods of 6, 12, and 24 weeks. All patients were followed for up to 48 weeks after starting treatment. Of the 120 patients with toenail onychomycosis who entered the study, 98 were evaluable for efficacy. The involvement of the toenails was assessed both clinically and mycologically throughout the study. Evaluation at 24 weeks showed that complete cure of toenail onychomycosis was achieved in 67% of patients treated for 6 weeks, 82% treated for 12 weeks, and 85% treated for 24 weeks. At the end of a further 24 weeks of follow-up, cure rates were 40%, 71% and 79%, respectively. The adverse effects of terbinafine were mostly mild-to-moderate gastrointestinal symptoms. Three patients discontinued treatment because of side-effects. In conclusion, oral treatment with terbinafine is effective and generally well tolerated in patients with onychomycosis. Our results demonstrate that, for toenail onychomycosis, a treatment period of 12 weeks is sufficient.
Subject(s)
Antifungal Agents/administration & dosage , Naphthalenes/administration & dosage , Onychomycosis/drug therapy , Adult , Double-Blind Method , Drug Administration Schedule , Female , Foot Dermatoses/drug therapy , Humans , Male , Middle Aged , TerbinafineABSTRACT
Educative campaigns on the danger of HIV infection have been quite successful. Within a decade the number of cases of gonorrhoea has sharply fallen. However, fear of AIDS does to some extent increase the demand for medical examination for sexually transmitted diseases. This explains why there is a discrepancy between the total number of consultations in the outpatient department and the actual number of cases of gonorrhoea diagnosed. From 1987 onward more time is being spent per consultation on counselling concerning HIV and prevention of HIV transmission by discouraging risk-bearing sexual practices. The numbers show that the target group has been reached successfully. In the University Hospital of Utrecht about half the patients with positive HIV serology were known before 1987 in the outpatient department for sexually transmitted diseases of that hospital. In the near future it will be mostly the venereal diseases clinics that will deal with the increasing demands concerning HIV.
Subject(s)
Acquired Immunodeficiency Syndrome/therapy , Ambulatory Care Facilities/statistics & numerical data , Health Services Needs and Demand , Health Services Research , Sexually Transmitted Diseases/therapy , Acquired Immunodeficiency Syndrome/prevention & control , Female , Health Education , Humans , Male , NetherlandsSubject(s)
Autonomic Nerve Block , Guanethidine , Leg Ulcer/therapy , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedSubject(s)
Bone Marrow/drug effects , Methotrexate/adverse effects , Aged , Arthritis, Rheumatoid/drug therapy , Female , Half-Life , Humans , Leukopenia/chemically induced , Methotrexate/metabolism , Methotrexate/therapeutic use , Pancytopenia/chemically induced , Psoriasis/drug therapy , Thrombocytopenia/chemically inducedSubject(s)
Etretinate/therapeutic use , Papilloma/drug therapy , Skin Neoplasms/drug therapy , Adult , Humans , MaleABSTRACT
An unusual annular erythema occurred in a 6-month-old girl. Recurrent annular lesions appeared on the face and back, but annular lesions persisted for ten months on the distal extremities. Eleven months after the eruption appeared, it resolved completely without recurrence. This seemingly unique condition is compared with other cases of chronic annular erythemas, especially those previously described as erythema gyratum perstans.
