Tinea pedis and onychomycosis in Danish soldiers before and after service in ex-Yugoslavia.

Seventy-three 1-year-experienced Danish soldiers were examined for tinea pedis as well as onychomycoses before and after a duty period of 6 months in ex-Yugoslavia. The incidence of fungal infections was 16.4% before and 32.3% after their duty period abroad. At first investigation Trichophyton rubrum and T. mentagrophytes were dominant but onychomycosis and tinea pedis were found as well. In contrast, Candida albicans was the predominant pathogen in the second investigation. We explain this by means of the more aggressive nature that yeasts can show when host-parasite relations are disturbed or compromised. Twelve soldiers with positive mycology were offered treatment and the final investigation showed a cure rate of 50%. This result is satisfactory in view of the difficult sanitary conditions.

[Investigation of malignant melanoma in an "open house" setting]. / Undersøgelse for malignt melanom ved et "åbent hus"-arrangement.

Individuals with a self-evaluated risk of malignant melanoma were invited to an "open house" where trained dermatologists examined suspected lesions. The attendants filled in a short questionnaire relating to skin cancer risk factors. Persons with skin changes suspected for malignancy were referred for excision in the dermatological department. The clinical evaluation included dermatoscopy. Nine hundred and eleven individuals attended. Among 16 individuals referred for excision one malignant melanoma, one lentigo maligna melanoma and two in situ melanomas were histologically verified. Furthermore, 21 basal cell carcinomas were identified clinically. The most frequent clinical diagnoses were melanocytic naevi and seborrhoic keratoses.

A single-blind study of podophyllotoxin cream 0.5% and podophyllotoxin solution 0.5% in male patients with genital warts.

OBJECTIVE: To evaluate the efficacy-safety ratio of a new topical podophyllotoxin cream 0.5% compared with podophyllotoxin solution 0.5% (Condyline) in male patients with genital warts. METHODS: In an observer-blinded controlled study a total of 136 and 133 wart lesions were treated with podophyllotoxin cream 0.5% and podophyllotoxin solution 0.5%, respectively. The preparations were applied twice daily for 3 days, repeated with 4 days intervals for a minimum of two and a maximum of four treatment cycles. RESULTS: At the conclusion of the study (8 weeks after completion of therapy) a significant reduction in mean wart area was observed in both the cream group (87.7, SD 8.4 to 20.6, SD 2.7) and in the solution group (92.3, SD 7.5 to 21.5, SD 2.8) (p < 0.01). At the same time all treated warts had completely cleared in 63% of patients in both study groups. Mild to moderate side effects occurred to the same extent in both podophyllotoxin cream and podophyllotoxin solution recipients. CONCLUSION: We conclude that podophyllotoxin 0.5% administered in a cream formulation does not give additional clinical benefits when compared with podophyllotoxin solution 0.5% in male patients with external genital warts.

A quantitative study of the melanogenic effect of multiple suberythemal doses of different ultraviolet radiation sources.

The melanogenic potential of multiple suberythemogenic doses of 6 different ultraviolet (UV) sources was investigated. The UV sources emitted different amounts of UVA and UVB. The backs of 12 volunteers were exposed to the 6 UV sources 10 times during 4 weeks. Every volunteer was exposed to the same suberythemogenic dose (0.75 basic minimal erythema dose) of each of the UV sources. The changes in pigmentation and minimal erythema dose of the UV exposed test sites were registered during the 10 sessions. Three UVA sources with a low emission in the UVB area (0.2-3.1%) had a high melanogenic potential. Two UVB sources (UVB emission 74.3% and 94.5%) were unable to induce a significant increase in skin pigmentation. The 3 UVA sources with a low UVB output increased skin pigmentation significantly better than a UVA source with a UVB output of 6.9%. All 6 lamps were able to increase photoprotection significantly. The increase in photoprotection was not significantly different between any of the 6 UV sources. This study shows that, if humans are exposed to equally suberythemogenic doses of different types of UV radiation, then radiation obtained from UVA sources greatly enhances melanogenesis, whereas UVB radiation sources are unable to induce pigmentation.

Acanthosis nigricans and bile duct malignancy.

A case of acanthosis nigricans associated with a metastatic adenocarcinoma is presented. To our knowledge this is the first one reported in the literature. The primary tumour is unknown, but it is presumably a cholangiocarcinoma. The skin changes preceded the detection of malignancy by 2 years, during which the skin lesions progressed though the patient was still in good health. If malignant acanthosis nigricans is suspected and the underlying malignancy cannot be found at the initial screening, repeated screenings are necessary because of the time factor.

Gallbladder stones classified by chemical analysis of cholesterol content. Frederiksberg, 1987-1988.

Gallstones from 80 cholecystectomies and 81 autopsies were chemically analysed and showed a trend of decreasing cholesterol content with increasing age (p = 0.00009). The frequency of cholesterol stones (cholesterol content greater than 70%) was higher in operated women (81%) than in operated men (33%) (p = 0.0006) and in the total autopsy material (42%). The study supports the theory that the predominance of gallstone disease in women is an effect of the preponderance of cholesterol stones. The accuracy of estimates of cholesterol content of gallstones from the appearance of the cut surface was low. When the chemical analysis was used as a key, only one in three was correct. There was a tendency to underestimate cholesterol content.

Sphincter of Oddi and filling of the gallbladder. A necropsy study.

The importance of the sphincter of Oddi for the filling of the gallbladder has not been definitely established. It was the aim of this study to establish the extent to which gallbladder filling is affected by the total absence of resistance at the sphincter of Oddi. The external bile ducts were dissected out in 20 autopsies. After elimination of the sphincter of Oddi and division of the cystic duct at the junction to the gallbladder, infusion of water into the common hepatic duct under physiological flow conditions showed that no water passed the spiral valve of the cystic duct. Water flow stopped here in all 20 cases, i.e. 100% (95% confidence limits 83-100). If gallbladder filling is not possible it may be difficult to accomplish non-invasive procedures for the elimination of stones in the gallbladder.

Bowen's disease and internal malignant diseases. A study of 581 patients.

In a retrospective study of 581 patients with a diagnosis of Bowen's disease (BD) treated over a 40-year period, we traced patient records to identify later diagnoses of nonskin cancer. Fifty patients had nonskin cancer, as against an expected number of 40, but this difference was not significant. The lack of association was equally true for BD on sun-exposed and non-sun-exposed skin. Our findings support the view that BD is not a skin marker for internal malignant disease.

Morbus Bowen. A description of the disease in 617 patients.

Between 1943 and 1983 a total of 617 patients were diagnosed to have morbus Bowen (m.B.). Eighty percent of the patients were over 60 years old at the time of diagnosis. Three-fourth had their disease on sun-exposed areas (head, neck and hands). Almost 1/4 had concomitant basal cell epithelioma (c.b.) and 1/10 squamous cell carcinoma (c.s.). Approximately 1/5 had multiple m.B. tumours. Effective therapy was curettage followed by cauterization, excision, or X-ray.