[Photodynamic diagnosis and therapy in dermatology. Experience with use of TPPS4 in skin diseases]. / Fotodynamická diagnostika a terapie v dermatologii. Zkusenosti s aplikací TPPS4 u nekterých kozních afekcí.

BACKGROUND: Some skin lesions e.g. basal cell carcinomas are sometimes difficult to remove completely and frequent relapses can develop after their imperfect removal. In case the patient refuses to undergo a radical surgical intervention, more painful alternative like cryotherapy comes into consideration as a method of tumour destruction. Not even such a procedure does guarantee complete destruction of all tumour cells. During the last years new diagnostics and therapeutic methods like photodynamic diagnostic and photodynamic therapy have been developed and they became subjects of our interest. METHODS AND RESULTS: Lesions were treated with photosensitizer (meso-tetra-para-sulphonato-phenyl-porfine-TPPS4) administered in an injection or in the ointment under occlusion. Six to 24 hours later we checked presence of photosensitizer in the lesions and in positive cases we irradiated the lesions with light of suitable wave length (630 nm). CONCLUSIONS: PDD and PDT were used for diagnostics and treatment of different dermatoses (basal cell carcinomas, malignant melanoma metastases, verrucae vulgares, keratoacanthomas, solitary lesions of T lymphoma--mycosis fungoides, m. Bowen, psoriasis vulgaris, pustulosis palmoplantaris, solar keratoma) with very good medical and cosmetic effect. Results are presented in the table. Authors do not consider the PDT to be the only and miraculous method relevant to treatment of all skin tumours or other skin diseases. They are of the opinion that this technique, when properly used, can extend the scale of therapeutic methods. The advantage of PDT is its selectivity, good tolerance and generally good cosmetic effect.

[Therapy of pruritus using ultraviolet irradiation in patients on hemodialysis]. / Terapie pruritu UV zárením u hemodialyzovanych pacientu.

BACKGROUND: Patients with chronic renal insufficiency (CHRI) frequently suffer from generalized pruritus, which is difficult to palliate. One of the treatments with favourable effect on pruritus is UV radiation. METHODS AND RESULTS: Fifteen patients were exposed to UVB radiation in doses from 20 to 45 s or from 1 min and 20 s to 18 min (i.e. 0.09-0.18 J/cm2 to 1.9-4.32 J/cm2). Ten of the treated patients reported a marked regression of pruritus, three a slight relief and two of them did not notice any change in the intensity of itching. Another four patients were exposed to the UVA radiation from 0.5 J/cm2 to 10.0 J/cm2 With exception of one female patient non-of them revealed any improvement in the intensity of pruritus the irradiation. CONCLUSIONS: UVB is probably highly effective on inhibition of pruritus and thus can be used as an efficient method, which extends contemporary antipruriginous treatment of patients with CHRI. However, so far it is difficult to explain its favorable effect.

Epidemiology of nickel allergy.

In 2400 consecutive patients at 8 clinics in 5 countries, nickel hypersensitivity was found in 176 cases (7.3%), 19 male (2.1%) and 157 female (10.5%). The incidence ranged from 15 to 38 cases in 300 patients of every department (5.0% Sofia to 12.7% Erfurt). 60.6% of the nickel positives were schoolgirls or younger than 25 years. The exposure time was 3 years, in 49% 1 year or shorter. Most cases (75%) are not occupationally acquired, but due to costume jewelry (31.8%), wrist watches (23.3%), metal clothing buckles (3.4%) including jeans buttons. Job dependent nickel dermatitis is often (36/51 cases) linked with wet work. Atopic dermatitis was found in 8.3% of female nickel allergy. Nickel positivity without a dermatitis history was seen in 9/176 cases (5%). Nickel allergy will become a sex-indifferent phenomenon in Europe, because of the changing customs of adornment.

The development and prognosis of chronic intoxication by tetrachlordibenzo-p-dioxin in men.

During 1965 to 1968, 80 workers who had been engaged in the production of 2, 4, 5-sodium trichlorphenoxyacetate and butylester of trichlorphenoxyacetate acid became ill. The cause of the illness was 2, 4, 7, 8-tetrachlordibenzo-p-dioxin. A 10-yr study has been conducted for 55 exposed individuals. The majority of the patients developed chloracne, and 11 manifested porphyria cutanea tarda. Approximately one-half of the patients suffered from metabolic disturbances, i.e., pathologically elevated lipids with abnormalities in the lipoprotein spectrum, and two-fifths of the patients had pathological changes in the glucose tolerance test. One-third of the patients had biochemical deviations indicative of a mild liver lesion. Histological examination revealed light steatosis, or periportal fibrosis, or activation of Kupffer cells. Fluorescence of the liver tissues was present in ultraviolet light. In 17 persons symptoms of nervous system focal damage existed, with predominance of peripheral neuron lesion of the lower extremities (verified by EMG examination). The majority of patients suffered from various psychological disorders. As of this date, two patients have died of bronchogenic lung carcinoma; one of liver cirrhosis; one of a rapidly developed, extremely unusual type of atherosclerosis precipue cerebri; and two patients have died in traffic accidents. The conditions of most other patients have improved.

Sacroiliac joints in chronic dermatoses.

In 34 patients with different chronic skin diseases (including eczemas, lichen ruber, erythrodermia, pyodermia, pemphigus erythematosus, vasculitis, parapsoriasis varioliformis, scleroderma adultorum Buschke, prophyria cutanea tarda, rosacea, dermatomyositis, erythematodes chronicus discoides and indurative tuberculosis), X-ray studies revealed sacroiliac-changes consistent with a low-grade inflammation. This oteoarthritis slightly differs from the patterns disclosed earlier by the same authors in psoriatic patients, lacking any clinical bone or joint symptoms. So far, it has not been possible to explain their nature, cause or development.