Long-term effects of isotretinoin in the treatment of severe nodulocystic acne.

One hundred and sixteen patients with severe nodulocystic acne were treated with 0.75 mg/kg isotretinoin daily for 6 months. One hundred and seven (92%) were completely healed or markedly improved at the end of treatment compared to 94 (81%) 42 months later. There was no significant difference in the clinical response between male and female patients. Seven of the 40 female patients gave birth to 7 fully developed and healthy children 39 months after discontinuation of therapy. Cheilitis (84%) and dry skin (54%) were the most common side effects, the severity of the side effects being dose-related. Increased serum triglyceride values following treatment were found in 31 (27%) of the patients. A better life quality was experienced by 99 (85%) patients after isotretinoin therapy.

[Distance diagnosis of skin diseases]. / Fjerndiagnostisering av hudsykdommer.

During a period of eight weeks in late 1989, doctors in general practice in Kirkenes brought 27 dermatological patients to a studio at the local hospital. Video images were transmitted via a two-way telephone and video network, which enabled the patient and the doctor in Kirkenes to consult a specialist in dermatology in Tromsø. All the patients received written information before the consultation. Anamnestic information and clinical manifestations were presented from the studio at Kirkenes sykehus. The dermatologist diagnosed the disease and prescribed treatment from the studio at the hospital in Tromsø. The technical equipment satisfied our demands for remote diagnostics in dermatology. All the patients were positive to remote consultations.

Juvenile tinea capitis caused by Trichophyton violaceum. Hepatic reactions during ketoconazole treatment.

A 10-year-old boy with T. violaceum tinea capitis was given systemic ketoconazole therapy. After 4 weeks' treatment, liver enzymes had increased considerably. Ketoconazole treatment was stopped and 3 weeks later the values had returned to normal. Three weeks thereafter the patient was completely cured and no relapses have occurred.

Psoriasis: familial predisposition and environmental factors.

In a survey for coronary risk factors 14 667 adult men and women answered a questionnaire on lifestyle, diet, and health, including whether they had psoriasis. The overall prevalence of psoriasis was 4.79% in men and 4.85% in women. The data showed an increasing incidence of psoriasis. The association with family history, lifestyle, diet, and health was explored by multiple regression analysis. The occurrence of psoriasis in first degree relatives contributed to more than 90% of the explained variance for both sexes. Of the other variables, only the positive association with rheumatoid arthritis was significant in both sexes. It is concluded that the examined environmental factors have only minor effects on the prevalence of psoriasis.

Low prevalence of psoriasis in Norwegian lapps.

The prevalence of psoriasis was found to be 0.6% in 2 000 pure Lapps from Kautokeino. Similar low prevalences have been found in Mongolians and Eskimos. HL-A studies have suggested a common origin for these populations.

Combined UVB and UVA phototherapy of atopic eczema.

The effect of combined UVB-UVA treatment in a group of 23 patients with severe atopic eczema was compared to UVB therapy alone in 33 patients. Mean age and number of treatments were approximately the same in the two groups. With UVB-UVA treatment, 48% achieved complete remission and in another 48% good improvements were obtained as compared to 27 and 58%, respectively, in the group treated with UVB alone. A few failures were recorded in the UVB group. Some possible explanations for the better effect of the combined UVB-UVA treatment are given.

[Treatment of acne vulgaris. Double-blind study of a combination of 5% benzoyl peroxide/2% miconazole (Acnidazil) and tretinoin 0.05%]. / Behandlung von Acne Vulgaris. Doppelblind-Studie zwischen einer Kombination 5% Benzoyl-Peroxid/2% Miconazol (Acnidazil) und Tretinoin 0,05%.

The clinical efficacy and tolerance of a combination of benzoyl peroxide 5% and miconazole 2%, Acnidazil, for the treatment of facial acne vulgaris have been compared with those of tretinoin 0.05% in a double-blind study with 40 patients during 12 weeks. The combination of benzoyl peroxide and miconazole gave improvement in 82% of 22 patients, compared to tretinoin which gave improvement in 50% of 18 comparable patients. The difference is significant. Also, side-effects were significantly less in the benzoyl-miconazole group than in the tretinoin group.

Trichophyton-rubrum-infected toenails treated with ketoconazole and partial nail avulsion.

30 patients with totally 178 toenails infected with Trichophyton rubrum were randomly treated with ketoconazole alone for 4 months (group A) or in combination with chemical nail avulsion (group B). Of the 14 patients in group A who completed the treatment, 4 (28%) were cured 6 months later, compared to 8 (53%) of 15 patients in group B. In 4 cases, transient elevated hepatofunction enzymes occurred. Gastrointestinal disturbances caused withdrawal in 1 case.

A case of chronic urticaria and vitiligo, associated with thyroiditis, treated with PUVA.

A case of chronic urticaria and vitiligo, associated with thyroiditis is described. Significantly elevated thyromicrosomal antibodies were found. Autoimmune reaction is a possible cause of the patient's thyroid disease, vitiligo and chronic urticaria. Following PUVA treatment with a total dose of 300 J/cm2 the patient's urticaria subsided in all irradiated areas, only to relapse 2 weeks later. Subsequently courses of PUVA gave periods of remission. The treatment also induced repigmentation in the vitiliginous spots. The results indicate a local PUVA effect upon mediators or mediator-containing cells.

Successful treatment of actinic reticuloid induced by whole-body topical application of mechlorethamine.

A man suffering from actinic reticuloid for 2 years showed highly abnormal light sensitivity over a broad action spectrum. He has been successfully treated with daily whole-body topical applications of mechlorethamine, initially for 4 weeks and after a 2-month interruption, for 3 weeks. Gauzes moistened with the same solution were placed over lichenified areas for 10-15 min. His skin became normal pale and the lichenification decreased. After treatment his tolerance for daylight increased.