Scaling scalp diseases in children.

Scaling scalp diseases in 142 children were evaluated. Included were seborrheic dermatitis, atopic dermatitis, tinea capitis, and psoriasis. Clinical signs were noted, and various treatments were then undertaken. Patients with seborrheic dermatitis responded well to treatment with antiseborrheic shampoo and topical corticosteroids. Atopic disease was more resistant to treatment, but did improve with less frequent shampooing and twice daily topical corticosteroid application. Selenium shampoo was a useful adjunct in the treatment of tinea capitis (cultures became negative at two weeks compared to persistent positivity in other treatment groups).

Effect of acarbose on the 24-hour blood glucose profile and pattern of carbohydrate absorption.

Acarbose (Bay g 5421) is a powerful alpha-glucoside hydrolase inhibitor of potential value in the treatment of diabetes and hypoglycemic dumping syndrome after gastric surgery. The extent of its use may be limited by symptoms produced by carbohydrate malabsorption. To minimize these, the action of low doses of acarbose on 24-h blood glucose profiles and hydrogen evolution have been studied on four ambulant volunteers on control diets, after exclusion of sucrose and also after addition of guar in an attempt to enhance the therapeutic effect. Replacement of dietary sucrose by starch abolished significant hydrogen evolution in the morning after low doses of acarbose but did not reduce its effectiveness in decreasing the mean three-meal blood glucose area by 41% (P less than 0.002). Addition of hydrated guar to this diet reduced the mean three-meal glucose area after acarbose further by 72% (P less than 0.001) but increased hydrogen evolution. The results suggest that acarbose will be both effective and acceptable given at low dose when the dietary carbohydrate is starch.

Selenium sulfide: adjunctive therapy for tinea capitis.

Selenium sulfide lotion used as a shampoo has been shown to be an effective adjunctive agent to griseofulvin in the treatment of tinea capitis. Of 16 children with Trichophyton tonsurans infections 15 had negative fungal cultures at two weeks following a regimen of daily oral griseofulvin and selenium sulfide shampooing twice weekly. All patients treated with griseofulvin alone or in combination with either a bland shampoo or topical clotrimazole had positive cultures not only at the two-week interval but also as long as eight weeks later. In vitro analysis shows selenium sulfide to be sporicidal, correlating well with the in vivo observations. It is postulated that selenium sulfide usage may lessen the chances for spreading of infectious spores to other individuals.

Oral vitamin A in acne vulgaris. Preliminary report.

Oral vitamin A (retinol) is generally not considered useful in the treatment of acne vulgaris. We conducted a study which showed that retinol was indeed ineffective at the usual doses of 50,000 to 100,000 IU daily. Retinol was highly efficacious in doses of 300,000 units for women and 400,000 to 500,000 units for men, toxicity was slight and limited mainly to skin (xerosis) and mucous membranes (cheilitis). The danger of hypervitaminosis A in this dosage range has been exaggerated. Retinol is a valuable drug for treating stubborn, severely inflammatory acne vulgaris. It is administered until the disease is brought under control, usually within three to four months. Then the dosage is progressively reduced relying on conventional drugs to keep the disease in abeyance.

Acne vulgaris aggravated by sunlight.

The symptoms of approximately 3 percent of our patients with acne vulgaris worsen during the summer months even though they maintain previously effective therapy. We show herein that the addition of 5 percent para-aminobenzoic acid (PABA) in alcohol (used as a sunscreen) resulted in marked improvement in their ability to tolerate sunlight. This condition, acne vulgaris aggravated by sunlight, has been compared to acne aestivalis which is another sunlight-induced disorder.

Acquired digital fibrokeratoma.

Three patients with acquired digital fibrokeratoma are presented herein. This tumor may be confused clinically with other lesions including supernumerary digits, fibromas, neuromas, and neurofibromas. As a result, the histologic picture is most helpful in making a correct diagnosis. Since this lesion has been noted to occur in areas other than the digits, a more appropriate designation may be "acquired fibrokeratoma".

Reactions to manganese and cadmium in tattoos.

Concomitant allergic reactions to manganese and cadmium sulfide developed in a patient in tattooed areas. Although the reaction to cadmium was elicited by sunlight, attempts to reproduce it with artificial long-wave ultraviolet light were unsuccessful.

Hyperpigmented tinea versicolor.

Examination of specimens from lesions of hyperpigmented tinea versicolor and from unaffected skin disclosed that the lesions showed increased stratum corneum turnover (8.2 +/- 0.6 vs 14.8 +/- 0.4 days, respectively), slight to moderate routine histological changes, such as acanthosis and perivascular inflammation, and dramatic electron microscopical changes (larger, singly distributed melanosomes vs small, packaged melanosomes, respectively). Brown hyperpigmentation in tinea versicolor appears to arise from an increase in melanosome size and a change in their epidermal distribution pattern.