Antifungal activity of sodium bicarbonate against fungal agents causing superficial infections.

Although sodium bicarbonate-NaHCO(3) (SB) has many domestic and medical, traditional and empirical uses, only little scientific documentation of its activity is available. The aims of this study were to investigate the antifungal activity of SB on the three fungal groups (yeasts, dermatophytes and molds) responsible for human skin and nail infections. We first evaluated the in vitro antifungal activity of SB on 70 fungal strains isolated from skin and nail infections: 40 dermatophytes, 18 yeasts and 12 molds. A concentration of 10 g/L SB inhibited the growth of 80% of all the fungal isolates tested on Sabouraud dextrose agar. The minimal inhibitory concentration 90 (MIC90) of SB measured on Sabouraud dextrose agar, Sabouraud dextrose broth and potato dextrose broth was 5 g/L for the yeasts, 20 g/L for the dermatophytes and 40 g/L for the molds. In a second step, we prospectively evaluated the ex vivo antifungal activity of SB on 24 infected (15 dermatophytes, 7 yeasts and 2 molds) clinical specimens (15 nails and 9 skin scrapings). The fungal growth was completely inhibited for 19 (79%) specimens and reduced for 4 (17%) specimens after 7 days of incubation on Sabouraud dextrose-chloramphenicol agar supplemented with 10 g/L of SB as compared to Sabouraud dextrose-chloramphenicol agar without SB. In conclusion, we documented the antifungal activity of SB on the most common agents of cutaneous fungal infection and onychomycosis, and we specified the effective concentrations for the different groups of pathogenic fungi. The mechanism of action of SB has yet to be explored.

[Clinical aspects, epidemiology and economic impact of foot epidermomycosis in an industrial milieu]. / Clinique, épidémiologie et incidences économiques des épidermomycoses des pieds en milieu industriel.

Fungal infections of the feet are very common in some professions. This has been particularly studied in coal mine workers up to 50 p. 100 of whom were found to have dermatophytosis of the feet. The purpose of this study was to determine the clinical, epidemiological and evolutive characteristics of interdigital and plantar intertrigo of the feet among people working in a coking plant, a potash mine and a motorcar factory. We have also evaluated the cost of treatments in relation to their immediate effectiveness and their preventive effects on relapses. Initially, 208 workers entered the study: 84 (40.7 p. 100) had a mycotic infection (M) and 124 (59.3 p. 100) presented with a non-mycotic (NM) inflammation between the toes and on the soles, characterized by maceration of the skin, hyperhidrosis and bromhidrosis. Change in the lesions under treatment were subjected to statistical analysis. In both M and NM groups the workers were allocated by randomization to a double-blind treatment consisting of: group M: either 2 p. 100 miconazole powder or talcum powder with 2 p. 100 salicylic acid and boric acid; group NM: either 2 p. 100 miconazole powder or ordinary talcum powder. Each subject was seen on at least two occasions after 3 and 12 months of daily foot care and topical treatment. Mycological examinations in group M subjects showed that fungal infections of the feet were primarily due to Trichophyton mentagrophytes or to Trichophyton rubrum. A logistic regression analysis (BMDPLR program) of anamnestic and clinical data (table IV) led to a "mathematical model of the mycotic foot", characterized by 6 main parameters of statistically significant occurrence: a history of interdigital-plantar intertrigo, recurrent in 90 p. 100 of subjects in group M (significant association at 0.1 p. 100); a functional symptom, pruritus, present in 71 p. 100 of subjects with mycosis; the stronger, more disturbing the pruritus, the greater the probability of it being of fungal origin (significant association at 0.1 p. 100); 4 physical signs: lack of maceration (0.1 p. 100), lesions limited to the interdigital spaces and respecting the soles (0.1 p. 100), presence of interdigital fissures (0.5 p. 100) and vesiculation (2.5 p. 100). When the respective diagnostic values of these elementary symptoms were considered, it appeared that their various combinations might have predictive values which could be calculated.(ABSTRACT TRUNCATED AT 400 WORDS)

[Various aspects of cosmetic allergy in Strasbourg]. / Einige Aspekte zur Kosmetika-Allergie in Strassburg.

Intending to determine the substances responsible in Strasbourg for allergies to cosmetics, we checked through all our cases from 1973 to 1980. Two main causes of the allergies were determined: Cosmetic cream and skin lotion (31.2% of cases) as well as nail enamel (20.8%). The importance of allergy to these enamels is notable compared with the extremely low figures found in the other countries (USA 1%, Sweden 6%).

Patch testing with hexavalent chromium salts in different vehicles and with nickel and cobalt in petrolatum.

In approaching the question as to which test preparations are most suitable for patch testing of metals, 25 chromium sensitive patients were tested with 0.5% potassium dichromate either in water or petrolatum. The aqueous solution proved better than the petrolatum preparation at a 48 h reading with Neodermtest Roc. No difference in sensitivity was recorded between 4 hexavalent chromium salts. 3 patients who were only sensitive to chromium solution in water also reacted positively to a 1% cobalt chloride solution and a 5% nickel sulfate solution in petrolatum.

HLA antigens in discoid lupus erythematosus.

HLA-A, B, C and Bf typing was performed in 55 cases of Discoid Lupus Erythematosus (DLE). When both the sex and age of the patient at the onset of the disease were taken into consideration (group I under 40 years, group II over 40), the following increases in antigen frequency were observed: group I: A2 in women, B5, A10 in men; group II: Aw19.2 in women, B8 in both sexes. Nevertheless, if the probability is multiplied by the number of antigens tested, these results are no longer significant.

[Lymphoedema of penis and scrotum: two observations (author's transl)]. / Le lymphcedème péno-scrotal : 2 observations.

Two cases of lymphoedema of penis and scrotum are reported: lymphanogiography is useful to distinguish between primary or secondary lymphoedema. In the first case, this is a primary tarda lymphoedema of penis and scrotum with hypoplastic lymphatics of the right leg. In the second case the lymphoedema follows repeated infection and paraphimosis. This infection may have worsened an already compromised lymphatic circulation. These genital elephantiasis are quite different from penile venereal edema, which disappears quickly after sexual abstinence. The operative treatment of lymphoedema is lymphangiectomy.

[Cross sensitivity between aminoside antibiotics (author's transl)]. / Allergie croisée entre les antibiotiques aminosides.

The great number of topical preparation containing neomycin and their frequent use for a long period induce a lot of contact dermatitis. It is interesting to detect the importance of cross sensitivity between aminosides among the patients whose dermatitis was caused by neomycin. 15 neomycin eczematous patients were investigated. The research about cross-sensitivity concerned 6 antibiotics: streptomycin, framycetin, ribostamycin, gentamycin, kanamycin, tobramycin. Patch-tests (20 p. 100 in petrolatum) were used in order to show this cross-sensitivity. The results of these tests are nearly the same as in the other studies, as for 5 of the antibiotics; but it is the first time, to our knowledge, that a cross-sensitivity between ribostamycin and neomycin is observed. The cross-sensitivity between these two aminosides can be explained by their chemical structure. There are four rings in neomycin: the main components are neamin and neobiosamin. Only three rings are found in ribostamycin: ribostamycin is constitued of neomycin lacking neosamin of neobiosamin. Thus the structure of the 3 rings of ribostamycin is identical with the structure of 3 out of 4 rings of neomycin. The study about cross-sensitivity between aminosides suggests two conclusions: 1. The use of local antibiotics must be prescribed only when is it really necessary. 2. It seems wise to avoid all systemic aminosid antibiotics for patients who are sensitized by neomycin ointment.

[Epidemiologic study of leprosy in metropolitan France]. / Contribution a l'étude épidémiologique de la lèpre en France métropolitaine.

322 new cases of leprosy in France are registered by a postal survey among 11 towns, from 1970 to 1978. 217 are detected in Paris, 105 in other parts of France. 137 are foreigners, 104 come from overseas French territories, 45 are reapatriated French nationals. 39.7% are lepromatous, 43.6% tuberculoid, 13.9% indeterminate. 35 cases are followed out of which 16 cases in Alsace were discovered in Strasbourg.

[Allergy to betalactamins. Diagnosis in vivo and correlations with tests in vitro (lymphocyte transformation and specific IgE) (author's transl)]. / L'allergie aux bêtalactamines. Protocole diagnostique in vivo. Corrélations avec les tests in vitro (T.T.L. et IgE spécifiques).

A comparative study of the results of skin tests and tests in vitro (lymphocyte transformation L.T. and R.A.S.T. for specific IgE) in 21 patients allergic to penicillin or penicillin-derivates revealed that tests in vivo are more sensitive and reliable than L.T. and R.A.S.T. This discordance needs future research for more valuable tests in vitro, such as specific histamine-release by leucocytes or determination of IgG4 reagins by R.A.S.T. procedure. A method of diagnosis of betalactamin hypersensitivity by skin tests, including penicilloylpolylysine, benzyl-penicillin, ampicillin and cephalosporin, is suggested; this method was experienced in 21 patients and 23 control subjects and proved to be safe and reproducible.