Soak and smear: a standard technique revisited.

BACKGROUND: Atopic dermatitis, nummular eczema, chronic hand dermatitis, palmar plantar psoriasis, and xerotic eczema are common inflammatory skin conditions. They may be refractory to conventional topical and even systemic treatment. Little evidence is available that demonstrates the benefits of aggressive topical treatment of patients with these disorders. OBJECTIVE: To describe a simple, inexpensive, effective topical treatment with an accompanying patient educational sheet. DESIGN: A retrospective study of 28 patients referred to a tertiary care center for refractory chronic pruritic eruptions. Intervention with a plain water 20-minute soak followed by smearing of mid-strength to high-strength corticosteroid ointment led to clearing or dramatic improvement. RESULTS: Objective and symptomatic improvement was obtained from aggressive topical treatment. It was well accepted in this group of referral patients. CONCLUSIONS: Hydration for 20 minutes before bedtime followed by ointment application to wet skin and alteration of cleansing habits is an effective method for caring for several common skin conditions. Prospective studies are needed to further validate these findings.

Tea tree oil: cutaneous effects of the extracted oil of Melaleuca alternifolia.

The use of botanical extracts for their perceived therapeutic benefits has gained increased popularity in this country and abroad. In particular, tea tree oil (the extracted oil of Melaleuca alternifolia) has gained widespread use for its purported antimicrobial and therapeutic effects. In parallel with this increased use is an expanding series of reported adverse effects, including allergic contact dermatitis, systemic contact dermatitis, linear immunoglobulin A disease, erythema multiforme-like id reactions, and systemic hypersensitivity reactions. We present a review of tea tree oil with regard to its history, chemistry, purported medicinal uses, and possible adverse cutaneous effects.

Response to carbon dioxide by the infective larvae of three species of parasitic nematodes.

The response of infective third-stage larvae (L3) of three species of parasitic nematodes, Ancylostoma caninum, Strongyloides stercoralis, and Haemonchus contortus to carbon dioxide (CO(2)) at physiological concentrations was investigated. L3 of the skin-penetrating species, A. caninum and S. stercoralis, were stimulated by CO(2) at the concentration found in human breath (3.3-4%); these larvae responded by crawling actively, but not directionally. Crawling was not stimulated by breath passed through a CO(2)-removing "scrubber" or by "bench air". Both A. caninum and S. stercoralis L3 stopped crawling when exposed to 5% CO(2) for 1 min. L3 of A. caninum became active 9-14 min after exposure to 5% CO(2) ended, but activity resumed more rapidly (10-15 s) if larvae were subsequently exposed to breath or breath through the scrubber. L3 of S. stercoralis resumed crawling 30-35 s after exposure to 5% CO(2), but resumed crawling within a very few seconds when exposed to breath or breath through the scrubber. Thus, while 5% CO(2) was inhibitory, lower concentrations of this gas stimulated L3 of both species. Apparently, exposing immobilized larvae to breath or breath through the scrubber causes the environmental CO(2) concentration to drop to a level that is stimulatory. The L3 of H. contortus ceased crawling and coiled when exposed to human breath or to 1% CO(2), but continued to move within the coil in both cases. The crawling response of the L3 of the two skin-penetrating species, A. caninum and S. stercoralis, to stimulation by CO(2) probably relates to their active host-finding behavior, while the cessation response elicited by CO(2) in H. contortus larvae may relate to the fact that they rely on passive ingestion by a ruminant host.