[Loss of taste sensation in terbinafine administration]. / Smaakverlies tijdens gebruik van terbinafine.

Terbinafine is a new antifungal agent for oral treatment of dermatomycosis. Seven patients are reported who developed taste loss after treatment with terbinafine. In four of them, taste loss was complete while one patient was still able to taste sweet products, and a second and third patient no longer tasted salty and sweet products, respectively. In all patients, the onset of the adverse reaction occurred 4-8 weeks after starting treatment. As far as known, taste loss is a transient effect which disappears within 3-6 weeks after discontinuation of terbinafine.

Allergic contact dermatitis from tocopheryl acetate in cosmetic creams.

4 cases of cosmetic allergy to tocopheryl acetate are reported. The literature on contact allergy to vitamin E and its derivatives is reviewed.

[Peri-anal allergic contact eczema with dyshidrotic eczema of the hands due to the use of Kathon CG moist toilet wipes]. / Allergisch contacteczeem rond de anus met dyshidrotisch eczeem van de handen door Kathon CG in vochtige toiletdoekjes.

Two cases of dyshidrotic eczema of the hands caused by perianal allergic contact dermatitis due to Kathon CG in moist toilet paper are described.

Purpuric contact dermatitis to benzoyl peroxide.

Patch test reactions in a patient with purpuric contact dermatitis to 5% benzoyl peroxide are described. Alterations of the capillary endothelium included obliteration of the lumina with perivascular mononuclear cell infiltrates. There were no epidermal alterations. These observations are discussed with reference to the data in the literature on vascular damage in "dermal" contact dermatitis.

Solid phase enzyme immunoassay for detection of non-complicated cervical infection with Chlamydia trachomatis.

To evaluate the usefulness of a solid phase enzyme immunoassay for diagnosis of cervical chlamydial infections, cervical smear samples from 246 women were tested using the assay and cell culture. The overall sensitivity of the assay was 67% and the specificity 92.4%. The sensitivity of the immunoassay was 54% in samples with chlamydial culture with less than 20 inclusions per slide. Thus the enzyme immunoassay failed to detect chlamydial infections in nearly half of the patients with a low amount of chlamydial antigen.

Contact allergy to denture materials in the burning mouth syndrome.

Several factors may be responsible for stomatitis in general and the burning mouth syndrome in particular. The results of patch testing are reported in 4 patients with burning mouth symptoms thought to be due to sensitization to denture material. 2 patients reacted to substances in Luxene dentures, but the allergens were not identified. In a 3rd patient, sensitization was found to monomeric methyl methacrylate. The other patient gave positive patch tests to epoxy resin (and bisphenol A), probably present in glue used for repair of dental plates. To obtain a complete diagnosis in cases of suspected contact stomatitis due to allergens in dentures, a reliable standard test series is required.

Evaluation of an enzyme immunoassay for detection of herpes simplex virus antigen in genital lesions.

To evaluate a non-marketed research prototype of a solid-phase enzyme immunoassay for detection of herpes simplex virus in genital lesions, 154 clinical specimens were collected from 127 men and 27 women with symptoms suggestive of herpes simplex virus infection (erythema, vesicles, ulcers and crustae). The samples were tested using the assay and cultures on four monolayers of human embryonic lung fibroblasts and Vero cells. When the culture was used as reference method, sensitivity was 76.9% and specificity 100% (prevalence 42.4%). Comparison of results by patient group showed that sensitivity was highest in material from patients with vesicles and ulcers. The highest sensitivity was obtained in specimens which developed a cytopathological effect within 48 h and in specimens with three or four positive cell cultures. These findings suggest that the assay is more successful in specimens with high virus titres. The enzyme immunoassay was found to be a rapid, moderately sensitive, highly specific test for detection of herpes simplex virus from genital lesions, but the usefulness of the assay is limited and culture methods should be preferred.

Allergy to spermicidal lubricant in a contraceptive.

PIP: Allergic contact dermatitis is reported in a patient using a condom with the spermicidal lubricant Tectol. A 36 year old female, with no history of dermatitis or pruritus of the vagina or vulva, experienced itchy dermatitis 24-48 hours after her partner used a Durex Top Safe contraceptive containing Tectol. The dermatitis appeared on the neck, upper legs, underarms, and trunk area. When another contraceptive was used Durex Featherlite (without Tectol), the patient experienced no problems. Patch tests concluded that the Tectol lubricant was the cause for the reaction in the patient. Transmission of the lubricant to the patient occurred when the patient's partner, after handling the contraceptive (Durex Top Safe) during intercourse, placed his hands on the patient's body. To which exact element of Tectol the patient was sensitized could not be determined as the patient refused further treatment.^ieng

Comparison of oral treatment of uncomplicated urogenital and rectal gonorrhoea with cefuroxime axetil ester or clavulanic acid potentiated amoxycillin (Augmentin).

In a randomised study of two drugs for the oral treatment of uncomplicated urogenital and rectal gonorrhoea the therapeutic effect of cefuroxime axetil ester (CAE) and amoxycillin plus clavulanic acid (A + C) was compared. Cefuroxime axetil ester 1.5 g was given to 129 men and 118 women. Amoxycillin 3.0 g and clavulanic acid 0.25 g was given to 131 men and 122 women. Both treatments were combined with probenecid 1.0 g and administered in a single oral dose. Of the 500 patients thus treated, 376 were assessable. In the group taking CAE, failure rates were 0.9% for the men and 0% for the women; and the overall failure rate was 0.5%. In the group taking A + C the equivalent failure rates were 4.6%, 1.2%, and 3.1%. The differences were not significant. Penicillinase producing Neisseria gonorrhoeae (PPNG) was isolated from 5.6% of the assessable patients. All 10 PPNG infections in the group taking CAE and four of 11 PPNG infections in the group taking A + C were cured. These numbers were too small to draw a definite conclusion about the efficacy of both drugs in this type of infection. Postgonococcal urethritis was observed in 35% of the men in the group taking CAE and in 32% of those in the group taking A + C. Side effects were noted in 38% of the group taking CAE and 28% of the group taking A + C. Nausea and vomiting were more commonly observed in the group taking CAE; and diarrhoea was more commonly observed in the group taking A + C.

Experience with a modified solid-phase enzyme immunoassay for detection of gonorrhea in prostitutes.

The modified Gonozyme Test (Abbott Laboratories; Chicago, IL), a new enzyme immunoassay for detection of Neisseria gonorrhoeae, was evaluated in testing of 266 prostitutes. When the enzyme immunoassay was used with material from the cervix, the prevalence of gonorrhea was 8.4%. As compared with culture results, this rate represents a sensitivity of 88% and a specificity of 99.2%. A sensitivity of 71% and a specificity of 98.9% were registered for tests of urethral material. In a comparison of the two tests without accepting either one as standard, the sensitivity of the enzyme immunoassay was 90% for material from the cervix and the specificity was 100%. There are several possible causes for discordance between results of culture and of enzyme immunoassay. The high predictive value of a negative enzyme immunoassay in screening urogenital samples from prostitutes makes this test very suitable for rapid elimination of gonorrhea from this pool of patients.

Solid-phase enzyme immunoassay for detection of Chlamydia trachomatis.

The prototype of a solid-phase enzyme immunoassay for the detection of Chlamydia trachomatis antigen was tested in 403 men and 135 women attending a venereal disease clinic. Culture on HeLa 229 cells was used as reference method. In men the overall sensitivity and specificity of the enzyme immunoassay was 70% and 98.5% respectively. In the 158 men with non-gonococcal urethritis the sensitivity and specificity was 73% and 96.5% respectively, in the 31 men with post-gonococcal urethritis 82% and 100%, in the 48 men with gonococcal urethritis 67% and 100%, in the 125 men with discharge but normal urinary sediment 54% and 99.1% and in the 41 men with no signs or symptoms 50% and 100%. In women the sensitivity and specificity of the assay was 70% and 92% respectively. On account of the low degree of sensitivity in both men and women and the low degree of specificity in women the prototype of the enzyme immunoassay is not yet considered suitable for clinical use. An improved model is being developed.

Antibodies against Chlamydia of lymphogranuloma-venereum type in Crohn's disease.

Antibodies against Chlamydia of lymphogranuloma-venereum type were detected by the micro-immunofluorescence technique in 38 (69%) of 55 patients with Crohn's disease. Weak positive reactions were seen in only 2 or 21 patients with other gastrointestinal disorders and 1 of 50 healthy blood-donors.