ABSTRACT
The potential of vitamin A, or retinol, in the treatment of a variety of skin diseases has long been recognized, but because of serious toxic effects this substance generally could not be used. The recent development and marketing of two relatively non-toxic synthetic analogues, which are known as retinoids, has made it possible to treat some of the diseases that are resistant to standard forms of therapy. Isotretinoin is very effective in cystic and conglobate acne, while etretinate is especially useful in the more severe forms of psoriasis. Good results have also been obtained in other disorders of keratinization. Vitamin A and its derivatives apparently have an antineoplastic effect as well and may come to be used in both the prevention and the treatment of epithelial cancer. In many of these diseases the retinoids act by enhancing the normal differentiation and proliferation of epidermal tissues, but the exact mechanisms are not well understood. Their influence on the intracellular polyamines that control the synthesis of nucleic acids and proteins may be an important factor. Although the retinoids have few serious systemic effects, they are teratogenic, and because they persist in the body their use in women of childbearing potential is limited.
Subject(s)
Etretinate/therapeutic use , Skin Diseases/drug therapy , Tretinoin/therapeutic use , Acne Vulgaris/drug therapy , Bone Diseases/etiology , Chemical and Drug Induced Liver Injury , Etretinate/adverse effects , Etretinate/metabolism , Etretinate/pharmacology , Female , Humans , Isomerism , Isotretinoin , Keratosis/drug therapy , Kinetics , Psoriasis/drug therapy , Skin Diseases/chemically induced , Skin Neoplasms/drug therapy , Tretinoin/metabolism , Tretinoin/pharmacology , Triglycerides/blood , Vitamin A/adverse effects , Vitamin A/metabolismABSTRACT
In a series of nine consecutive cases of anterior intranasal carcinoma seen between 1965 and 1975, a single treatment failed to control the disease in four. This failure rate is much higher than that reported for squamous cell carcinomas of the skin in general and appears to indicate that tumours at this site require aggressive therapy.
Subject(s)
Carcinoma, Squamous Cell/surgery , Nose Neoplasms/surgery , Aged , Carcinoma, Squamous Cell/radiotherapy , Female , Humans , Male , Middle Aged , Nasal Cavity , Neoplasm Metastasis , Nose Neoplasms/radiotherapyABSTRACT
Pellagra due to malnutrition occurred in an Ottawa women in 1973. She was given a normal diet with supplements of riboflavin, thiamine, niacin and ascorbic acid. The clinical response was striking. Although pellagra is still common in some parts of the world, it is now rare in North America. The disease may occur secondary to malnutrition or malabsorption; inborn errors of metabolism or transport, as in Hartnup disease; deviation of precursors of niacin, as in carcinoid syndrome; or competitive inhibition of niacin incorporation into nicotinamide-adenine dinucleotide, as with administration of isoniazid.
Subject(s)
Pellagra/diagnosis , Adult , Canada , Diagnosis, Differential , Female , Humans , Pellagra/diet therapy , Pellagra/drug therapy , Recurrence , Vitamins/therapeutic useABSTRACT
Among 52 patients with squamous cell carcinoma of the skin of the pinna seen consecutively between 1952 and 1973, a single course of treatment failed to control the disease in 10 (19%). This failure rate is higher than that usually reported for squamous cell carcinomas of the skin in general (2 to 6%), and appears to be in conflict with the belief that squamous cell carcinomas of the skin of the pinna rarely metastasize. It appears that other factors than neglect are responsible for this discrepancy. In this series it was not possible to judge the relative efficacy of one mode of treatment over another.
Subject(s)
Carcinoma, Squamous Cell , Ear Neoplasms , Ear, External , Skin Neoplasms , Adult , Aged , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Curettage , Ear Neoplasms/radiotherapy , Ear Neoplasms/surgery , Female , Follow-Up Studies , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, Local , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgeryABSTRACT
Two cases of chronic myeloid leukemia in which the cytogenetic clone was 45, XO, Ph(1) are described and compared with 20 cases recorded in the literature. The 45, XO line is peculiar to the leukemic cells and is not a manifestation of constitutional mosaicism. It probably arises from a 46, XY, Ph(1) line by loss of the Y chromosome. Because of the few cases reported, one cannot be certain that these men have a better prognosis, although the median survival time suggests that this is so. Infertility is not part of this disorder.
