RESUMO
BACKGROUND: Treatment of severe alopecia areata is difficult, and most efforts to successfully treat this condition have been disappointing. Systemic corticosteroids have been demonstrated as an effective treatment of severe alopecia areata. METHODS: Eighteen patients with alopecia areata (extensive patchy and totalis universalis types) were treated with systemic corticosteroids. RESULTS: Satisfactory hair regrowth was achieved in seven patients (38.9%). Hair fall subsequently occurred in all of these patients on discontinuation or tapering of corticosteroid therapy. CONCLUSIONS: Systemic corticosteroid therapy does not prevent the spread or relapse of severe alopecia areata and, when complete regrowth is obtained, it is rarely maintained off therapy.
Assuntos
Alopecia em Áreas/tratamento farmacológico , Glucocorticoides/uso terapêutico , Prednisona/uso terapêutico , Adolescente , Adulto , Alopecia em Áreas/fisiopatologia , Criança , Feminino , Cabelo/fisiologia , Humanos , MasculinoRESUMO
BACKGROUND: Epidermolysis bullosa is recognized to be rare, but its prevalence in the Eastern Province of Saudi Arabia had not been previously established. METHODS: We reviewed 49,902 dermatology cases seen in our clinic over a 7-year period (1984 through 1990) and carried out a therapeutic trial of oral phenytoin in three severe cases of epidermolysis bullosa dystrophica (Recessive dystrophic type). RESULTS: Sixteen cases of epidermolysis bullosa were found in this series, ten (62.5%) of which were of the dermolytic type (epidermolysis bullosa dystrophica), and four (25%) of the epidermolytic type (epidermolysis bullosa simplex). Parental consanguinity was established in fourteen (87.5%) of these cases. All ten cases of epidermolysis bullosa dystrophica developed complications. Three severe cases were treated with oral phenytoin and managed with meticulous nursing and nutrition with blended foods and protein and vitamin supplements and responded satisfactorily. CONCLUSIONS: This study confirmed the rarity of epidermolysis bullosa in this province (population 3,000,000), and demonstrated the usefulness of oral phenytoin therapy, meticulous nursing, and good nutrition in the management of epidermolysis bullosa dystrophica.
Assuntos
Epidermólise Bolhosa/epidemiologia , Adulto , Pré-Escolar , Epidermólise Bolhosa/genética , Epidermólise Bolhosa/terapia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Fenitoína/uso terapêutico , Arábia Saudita/epidemiologiaRESUMO
Three patients with severe recessive dystrophic epidermolysis bullosa were treated with oral phenytoin and palliative and supportive measures for variable periods. Their progress was compared with that of three milder cases managed only with palliative and supportive measures. The phenytoin-treated group showed marked decrease in blister count, increase in trauma tolerance, a rise in hemoglobin level, and considerable weight gain. The results support earlier reports that collagenase inhibitors are useful in controlling blister formation in recessive dystrophic epidermolysis bullosa.
Assuntos
Epidermólise Bolhosa Distrófica/tratamento farmacológico , Epidermólise Bolhosa Distrófica/genética , Fenitoína/uso terapêutico , Administração Oral , Epidermólise Bolhosa Distrófica/sangue , Feminino , Genes Recessivos , Hemoglobinas/análise , Humanos , Lactente , Recém-Nascido , Masculino , Fenitoína/administração & dosagem , Fenitoína/sangue , Aumento de PesoRESUMO
Granulomas in the diaper area developed in four patients; two male infants following surgery for Hirschsprung's disease and two female children with urinary (and/or fecal) incontinence. The use of the term 'Diaper area granuloma of incontinence' is suggested to describe these lesions seen in the elderly, as well as in incontinent infants and children.