Effect of fenticonazole spray in cutaneous mycosis: a double-blind clinical trial versus cyclopyroxolamine spray.

A double-blind clinical trial was performed to evaluate efficacy and tolerance of once-daily 2% fenticonazole compared with 1% cyclopyroxolamine spray applied for 2-4 weeks in 100 patients with cutaneous mycotic lesions. After treatment lasting 21.9 +/- 6.7 or 22.5 +/- 6.2 days, respectively, patients receiving fenticonazole or cyclopyroxolamine had negative microscopic findings and cultures were sterile. Comparable clinical improvement was observed in both treatment groups, with 91.8% and 89.8% of patients, respectively, receiving fenticonazole or cyclopyroxolamine being evaluated as cured or greatly improved. Following a drug-free period, the clinical evaluation of nine (20.9%) patients treated with fenticonazole and 14 (30.4%) treated with cyclopyroxolamine worsened. The incidence of side-effects was low; only one patient withdrew from treatment because of a slight itch. It is suggested that fenticonazole and cyclopyroxolamine are equally effective in eradicating cutaneous mycoses and that their efficacy and tolerance are comparable.

[Reduced diclofenac administration by B vitamins: results of a randomized double-blind study with reduced daily doses of diclofenac (75 mg diclofenac versus 75 mg diclofenac plus B vitamins) in acute lumbar vertebral syndromes]. / Einsparung von Diclofenac durch B-Vitamine: Ergebnisse einer randomisierten Doppelblindprüfung mit reduzierten Tagesdosierungen von Diclofenac (75 mg Diclofenac versus 75 mg Diclofenac plus B-Vitamine) bei akuten Lendenwirbelsäulensyndromen.

Pain syndromes of the lumbar spine are one of the main problems in orthopedic practice. The therapeutic effect of NSAIDs is not subject to doubt in this connection. But considering that the application of NSAIDs is frequently associated with side effects, a reduction of dosage would be to the patient's benefit. Clinical studies have shown that concomitant treatment with vitamins B1, B6, B12 and diclofenac leads to a more efficient pain relief than treatment using diclofenac alone and thus provides the possibility of saving NSAIDs. This clinical trial was carried out in order to determine whether these results can also be achieved when a reduced dosage of diclofenac (75 mg daily) is used. 123 patients with acute pain syndromes of the lumbar spine were treated with either B-vitamins and diclofenac or diclofenac alone for a maximum of 7 days. There was the option to terminate therapy in the trial after 3-4 days in the case of total pain relief. 45 patients could stop the treatment due to remission of symptoms. 30 patients belonged to the combination therapy group, the other 15 took diclofenac alone; this difference is statistically significant (p less than 0.05). All parameters concerning pain relief and movement of the vertebral column showed statistically significant differences in favour of the B-vitamin-diclofenac-combination, too. The results document the positive influence of B-vitamins on painful vertebral syndromes and indicate that B-vitamins contribute to saving of NSAIDs by shortening the treatment time and reducing daily NSAID-dosage.

[Fungal involvement of the penis in patients with penile condylomata acuminata]. / Hefebefall des Penis bei Patienten mit penilen Condylomata acuminata.

In a study on 129 patients with penile condylomata acuminata we recognised an incidence of 32% penile yeast affection. Candida was found in 54%, Torulopsis in 30% and Rhodotorula in 17% of all cases. The high rate of yeasts not belonging to the candida species is remarkable. There was no correlation between our test results regarding the cell-mediated immunity against candida albicans and the local yeast infection.

[Condylomata acuminata and HIV infection--an epidemiologic study]. / Condylomata acuminata und HIV-Infektion--eine epidemiologische Studie.

Within a period of 15 months, 134 patients suffering from condylomata acuminata were investigated with regard to simultaneous infection with HIV. 3 of these patients--2 showing warts in the anal region, 1 on the glans penis--were found positive for anti-HIV antibodies.

[Cutaneous myxoma (focal dermal mucinosis)]. / Kutanes Myxom (fokale dermale Muzinose).

Two cases of cutaneous myxoma are presented. In case 1 the cutaneous myxoma was localized on the left thumb and clinically resembled a pyogenic granuloma. In case 2 it was found at the left nipple. The benign cutaneous tumor may herald a cardiac myxoma and other conditions. Thus, a cutaneous myxoma should be accepted as an indication for thorough investigation of the whole body at regular intervals. As there are neither clinically nor histologically adequate criteria for differentiation, cutaneous myxoma and focal dermal mucinosis can be considered as variants of a single entity.

[Allergic contact eczema caused by dicyanodiamide]. / Allergisches Kontaktekzem auf Dicyandiamid.

After four years employment in a factory manufacturing flame retardants, a 29 year old man developed eczematous reactions on both hands. Patch tests performed with different agents handled by the patient solely at his place of work were positive for the flame retardant and dicyanodiamide, even in high dilutions. Upon changing jobs, the lesions healed completely. To our knowledge, this is the first recorded instance of a contact allergy due to dicyanodiamide in the pertinent literature.

[Fungal involvement of the intestinal tract in HIV-positive males]. / Hefebefall des Intestinaltraktes bei HIV-positiven Männern.

In a retrospective study on 21 HIV-positive patients (aged between 18 and 28) in stage WR 1 CDC II and WR 2 CDC III, we looked for yeast in tongue swabs and stool samples. About 2/3 of the cultures of stage WR 1 CDC II and nearly all cultures of stage WR CDC III revealed infection with yeasts.

[Linear circumscribed scleroderma--case report. Classification and differentiation of circumscribed scleroderma]. / Lineare zirkumskripte Sklerodermie--ein Fallbericht. Einteilung und Differenzierung der zirkumskripten Sklerodermie.

In linear scleroderma, a rare form of circumscribed scleroderma, the lesions are arranged in a band-shaped linear distribution and both the superficial and the deeper layers of the skin are attached to the underlying structures. This disease must principally be differentiated from eosinophilic fasciitis (Shulman's syndrome). On the basis of the clinical and laboratory data, systemic scleroderma can be excluded in nearly all the cases. Nevertheless, patients with linear scleroderma might develop systemic scleroderma or other systemic diseases of the connective tissue even after years. As a consequence, thorough physical examination as well as laboratory evaluation is necessary over a long follow-up period. We introduce a new classification of circumscribed scleroderma.

[Urticaria pigmentosa adultorum and systemic mastocytosis--diagnostic principles and therapeutic possibilities]. / Urticaria pigmentosa adultorum und systemische Mastozytose--Diagnostische Grundzüge und therapeutische Möglichkeiten.

We report on the clinical picture of urticaria pigmentosa adultorum and systemic mastocytosis. In four out of five patients, we proved systemic mastocytosis by means of a biopsy from the iliac crest, although these patients did not complain of systemic signs and symptoms. In all cases, the cutaneous changes and clinical symptoms could be improved by a four-week-heliotherapy in the North Sea summer climate; itching did not reappear but five months later. Heliotherapy is regarded as an useful alternative concerning the treatment of urticaria pigmentosa and cutaneous manifestation of systemic mastocytosis.

[Subungual exostosis]. / Subunguale Exostose.

Representative of seven cases observed during the last four years, we report on two cases of subungual exostosis. We present the clinical symptoms, our radiographical and histopathological findings, as well as the possible differential diagnoses. Local curettage or excision are regarded as the treatment of choice.

[Cell-mediated immune reaction in patients with condylomata acuminata C. A.)]. / Zellulär vermittelte Immunreaktion bei Patienten mit Condylomata acuminata (C. A.).

A study on cellularly mediated immune reaction in male patients aged between 18 and 30 years and suffering from condylomata acuminata (C.A.) revealed immune suppression particularly of the cellularly mediated system. As compared with the normal population, our study proved a significantly increased portion of hypergic patients and a clear decrease of the various groups of lymphocytes.

[Jadassohn type anetoderma--case report]. / Anetodermie Typ Jadassohn--Fallbericht.

A 19-year-old patient suffering from Jadassohn's anetoderma with progressive dermatrophia showed positive reaction to treatment with chloroquin diphosphate.

[Multiple sensitization to topically used corticosteroids]. / Mehrfachsensibilisierung gegen topisch angewandte Kortikosteroide.

Sensitivity to single corticosteroids is well known. Polyvalent sensitization towards several different steroids has been described rarely. Contact allergy due to diflucortolone-21-valerate has not been described previously as far as we know. In our case the patient was allergic to three corticosteroids.

[Porokeratosis linearis unilateralis (linear porokeratosis)]. / Porokeratosis linearis unilateralis (Linear porokeratosis).

A case of linear porokeratosis is reported. This rare disease is described and the different entities that can be grouped under the term porokeratosis are discussed.

[Osseous choristoma in vitiligo]. / Ossäres Choristom bei Vitiligo.

This article deals with a typical case of both the conditions vitiligo and osseous choristoma of the intraoral soft tissue. Because of the close association between vitiligo and other diseases, it is very important to have each patient thoroughly examined with regard to thyroid diseases, pernicious anemia, diabetes mellitus, and autoimmune phenomena. We have detected a very rare tumescence of mature bony tissue, such as described in literature in only 25 cases, so far.

[Congenital fistula of the raphe penis]. / Congenitaler Fistelgang im Bereich der Raphe penis.

One case of a congenital fistula of the raphe penis with gonorrhoea is reported. In this case spectinomycin seemed to fail in therapy, because pus was still remaining in the fistula, but not in the urethra. As the antibiotic resistogram did not prove our assumption, we tried the double dose and succeeded in killing the bacteria.

[Tetanus antitoxin levels and reactions following tetanus vaccination]. / Tetanusantitoxintiter und Reaktionen nach Tetanusimpfungen.

The tetanus antibody levels and skin tests of 33 soldiers with adverse reactions to tetanus toxoid immunization are reported. All had antibody levels above the minimum protective level, and one was found to have delayed hypersensitivity to Na-timerfonate.