[Caesar Boeck and Boeck's sarcoid]. / Caesar Boeck og Boecks sarkoid.

Caesar Boeck (1845-1917) and his uncle Carl Wilhelm Boeck (1808-1875) established dermatovenerology in the 19th century in Norway. Caesar Boeck began his academic career in the skin department at Rikshospitalet in Oslo in 1875 where the was appointed chief in 1889 and professor in 1895. He retired in 1915. Caesar Boeck was a great clinical capacity, a gifted teacher and a prolific writer. His most important scientific work is the identification of the disease named after him as Sarcoidosis Boeck.

Double-blind comparison of azelaic acid 20% cream and its vehicle in treatment of papulo-pustular rosacea.

Previous investigations have indicated that topical azelaic acid has beneficial effects in rosacea. This 3-month randomized, double-blind, multicentre study compared the efficacy and safety of azelaic acid 20% cream with its vehicle, in the treatment of papulo-pustular rosacea. A total of 116 patients were enrolled in the study and medication was applied twice daily. Azelaic acid cream produced significantly greater mean reductions in total inflammatory lesions than did vehicle (azelaic acid: 73.4%; vehicle: 50.6%; (p = 0.011), and erythema severity score (azelaic acid: 47.9%; vehicle: 37.9%; (p = 0.031). Azelaic acid cream treatment also resulted in significantly more favourable overall improvements than vehicle in both physician (p = 0.020) and patient ratings (p = 0.042). Neither azelaic acid cream nor vehicle produced any clinically relevant improvement in telangiectasia. Local adverse events were transient and mainly mild or moderate, and rates were similar for azelaic acid cream (39.5%) and vehicle (38.5%). Burning was the symptom most frequently reported. More than 90% of patients rated the overall local tolerability of their treatment as good or acceptable. In conclusion, azelaic acid 20% cream is effective and well tolerated in the treatment of papulo-pustular rosacea.

[Treatment of acne]. / Behandling av akne.

Acne is a disfiguring disease, occurring mainly in adolescence. It is a common disorder, affecting above 80% of adolescents in some degree. 50% wish to have treatment for the condition. Acne appears in many forms; from the more common comedonal and papulopustular types to the often devastating cystic and fulminant acne. Some patients develop disfiguring scarring and keloidal reactions, which persist for the rest of their lives. With the treatment facilities available in modern medicine, acne problems can be eliminated through topical and/or systemic treatment options.

Roaccutane treatment guidelines: results of an international survey.

BACKGROUND: Oral isotretinoin (Roaccutane) revolutionized the treatment of acne when it was introduced in 1982. METHODS: Twelve dermatologists from several countries with a special interest in acne treatment met to formally review the survey of their last 100 acne patients treated with oral isotretinoin. The primary purpose of the survey was to identify the types of acne patients who were prescribed oral isotretinoin and how the patients were managed. RESULTS: Of the 1,000 patients reviewed, 55% of those who received oral isotretinoin had those indications treated historically, i.e. severe nodular cystic acne or severe inflammatory acne, not responding to conventional treatment. Forty-five percent of patients who were prescribed oral isotretinoin however had either moderate or mild acne. Most patients in this group had moderate acne (85%). However, 7.3% had mild acne on physical examination. The criteria for prescribing oral isotretinoin in this less severe group of patients included acne that improves < 50% after 6 months of conventional oral antibiotic and topical combination therapy, acne that scars, acne that induces psychological distress and acne that significantly relapses during or quickly after conventional therapy. Treatment is usually initiated at daily doses of 0.5 mg/kg (but may be higher) and is increased to 1.0 mg/kg. Most of the physicians aimed to achieve a cumulative dose of > 100-120 mg/kg. Mucocutaneous side-effects occur frequently but are manageable while severe systemic side-effects are rarely problematic (2%). The teratogenicity of oral isotretinoin demands responsible consideration by both female patients and their physicians. Significant cost savings when treating acne patients with oral isotretinoin as compared to other treatment modalities were further proven in this study. CONCLUSIONS: Our recommendation is that oral isotretinoin should be prescribed not only to patients with severe disease but also to patients with less severe acne, especially if there is scarring and significant psychological stress associated with their disease. Acne patients should, where appropriate, be prescribed isotretinoin sooner rather than later.

The history of venereology in Norway.

Syphilis became a problem at the beginning of the eighteenth century when a virulent microbe was brought to Norway. This new disease was called "radesyken", a Nordic name for "the wicked disease". "Rade" hospitals were built and this was the beginning of the Norwegian hospital system. Professor Caesar Boeck refused to use mercury in the treatment of syphilis; 2000 of his patients were included in the Oslo study of untreated syphilis. With the use of penicillin and other antibiotics, syphilis and gonorrhoea decreased. More frequent now are the viral diseases, herpes genitalis and condylomata acuminata. HIV is seldom found in the STD clinic in Oslo: only 5-6 HIV-positive persons per year; that is, about 0.09% of all new patients.

Acne in pubertal boys undergoing treatment with androgens.

In the present study, the development of acne lesions was studied in boys deemed to be too tall, for which they were treated with injections of androgens. In a retrospective and a prospective group of pubertal boys, an increased incidence of acne was observed as a consequence of treatment with androgens.

[Roaccutan treatment of cystic acne in women]. / Roaccutan-behandling av cystisk akne hos kvinner.

Since 1982, systemic Roaccutan has been used to treat acne that is resistant to traditional therapy. The treatment produces certain side effects and a potential for teratogenesis. The result has been worldwide reports of a number of malformed and abnormal infants. In the present questionnaire presented to 94 Norwegian women of child-bearing potential, no pregnancy occurred during the treatment period. Before start of treatment, all patients agreed to have an abortion if conception occurred during treatment. The article discusses the type of contraception, the quality of information and the effect of treatment upon the acne condition. The study confirms the importance of Roaccutan in the treatment of cystic acne, and shows that the Norwegian prescription routine for Roaccutan is adequate.

[Power and health services--the role of hospital architects]. / Makt i helsevesenet--sykehusarkitekturens rolle.

Architectural expression influences our surroundings in a symbolic manner. The present architectural design of our health institutions can be traced as far back as to Medieval religious centres. The ultimate aim of this architecture is to demonstrate the power of the system. The present article underlines the importance of designing future health institutions with the aim of preserving and establishing the dignity and confidence of the human beings in the system.

[Development of acne in systemic androgen therapy in boys during puberty]. / Utvikling av akne ved systemisk androgenterapi hos gutter i puberteten.

Acne is a multifactorial disease. Hereditary factors and the hormonal influences of androgens are important. In this study the development of acne lesions are studied in boys treated with androgens for expected excessive bodily height. In two groups of pubertal boys increased incidense of acne was observed during the period of treatment.

[The skin and aging. Spontaneous and drug-induced repair of radiation-induced dermal injuries]. / Hud og aldring. Spontan og terapiindusert reparasjon av dermale "stråleskader".

For the last 2 1/2 years, supervision groups for general practitioners have been run at Telemark sentralsjukehus. Initially the instructors emphasised flexibility, utility and servicemindedness. By means of group process thinking and emphasis on distinct contracts the meetings eventually developed into consultation groups. Parallel with the group process we have experienced more informal contact and new forms of collaboration with the individual general practitioners which may indicate an increased interest among them for psychiatry.