Oral treatment of keratinizing disorders of skin and mucous membranes with etretinate. Comparative study of 113 patients.

This study reports comparative results of the effects of an aromatic retinoid, etretinate (RO 10-9359), on various disorders of the skin and mucous membranes. One hundred thirteen patients suffering from psoriasis, lichen planus, keratosis follicularis, and various other disorders were treated and examined. The patients received 25 to 100 mg/day of oral etretinate for up to 30 months. Patients with erythrodermic psoriasis, pustular psoriasis, and keratosis follicularis showed the best response. The conditions of patients with psoriasis vulgaris, palmoplantar psoriasis, and lichen planus also improved, but less impressively. The mucous membrane lesions of lichen planus and leukoplakia showed only moderate improvement. The most striking adverse clinical reactions observed were cheilitis (70%), dryness of the mucous membranes (27%), and hair loss (27%).

Contact allergy to Phacelia spp. (Hydrophyllaceae).

Six persons involved with cultivation trials of Phacelia spp. developed a contact allergy to certain plants of this species. Geranyl(hydro)quinone and related substances, including the geranylhydroquinone geroquinol (INN), which has been introduced as a radioprotective agent, are potent allergens and probably are more often the cause of allergic eczema than is apparent from the literature.

Elimination of porphyrins and their precursors in rats pretreated with hexabromobenzene.

The elimination times of porphyrins and their precursors and of hexabromobenzene (HBB) itself were studied in female rats given 15 mg HBB by stomach tube every other day for 4 months. The concentrations of HBB in the blood, liver and adipose tissue were in the ratio 1:1.5:25, 24 hr after the last dose. Two weeks after the end of treatment, HBB was no longer detectable in the tissues. In animals given a single oral dose of 16.6 mg HBB/kg body weight, HBB was no longer detectable in adipose tissue 12 days after dosing. The half-life of HBB in adipose tissue was about 2.5 days in the animals given HBB for 4 months, and at the end of the treatment the concentrations of porphyrin in the liver, urine and faeces were increased to about 1000, 600-700 and 60-70 times the control values. The amounts of delta-aminolaevulinic acid and porphobilinogen in the urine of treated animals were 6-7 times those in controls. After the end of HBB treatment, it took almost 1.5 yr for delta-aminolaevulinic acid and porphobilinogen excretion to return to normal. Nearly 2 yr were needed for complete elimination of the accumulated liver porphyrins.

[Ingredients of modern hair dyes]. / Bestandteile moderner Haarfarben.

70 substances currently used in colouring human hair are reviewed from chemical and structural perspectives. On the basis of structural simularities the question of relationships to known contact allergens, in particular p-phenylendiamine and benzochinones, is examined. Hereby it may be discerned that despite the relatively large number of new substances, the dangers of new potent allergens or cross-reactions with widely encountered existing agents are limited.

[Photodermatitis bullosa generalisata]. / Photodermatitis bullosa generalisata.

Two observed cases indicate atypical forms of phyto-photodermatitis (photodermatitis bullosa striata). Unusual localisations or generalised outbreaks have to be taken into account in cases of sunbathing without clothes on. Power lawn mowers with rotating blades spread heracleum and other phototoxic juices via freshly cut grass, causing diffuse - as opposed to striped - manifestations on the uncovered skin areas. The most certain prevention of such a reaction is to known which few plants are responsible for phyto-photodermatitis and to avoid them in sunny weather. The plants should by no means be exterminated, even those (such as Heracleum mantegazzianum, "giant hogweed") which have a tendency to spread.

[Acute axillary eczema caused by mercury compounds]. / Akutes Axillarekzem durch Quecksilber-Verbindungen.

Not every axillary dermatitis is caused by an allergy against corresponding cosmetics (deodorants or anti-perspirants). This is shown in a 24-year-old man with an acute contact dermatitis in the left axilla. Sensitization probably developed against mercury salts due to the regular use of thermometers which were kept in a disinfecting solution containing phenylmercuric borate. The patient was in two hospitals for a check up before heart surgery and temperature was regularly measured in the left axilla. In both clincis phenylmercuric borate was used for desinfection of the thermometers. The sensitivity was proofed by positive patch tests.

[Allergic skin reactions in metallurgic industries (author's transl)]. / Allergische Hautschäden bei der Metallbearbeitung.

The sensitizing properties of additives to cooling emulsions are reviewed. Presently the majority oft skin disorders due to cooling emulsions is of toxic and not of allergic origin. However, the introduction of new chemical substances either as substitutes of nitrites or for a more effective preservation may reverse this ratio especially if potent allergens are used unitentionally. In evaluating the advantage of a new additive its possible sensitizing properties has to be considered.

[Contact allergy to dexpanthenol (author's transl)]. / Kontaktallergie auf Dexpanthenol.

During the testing for skin irritation of a sun protective and baby care lotion in epicutaneous tests over 24 hours, an eczematous test reaction appeared on a 30 year old physiotherapist. Testing of the single ingredients of both lotions showed the presence of contact allergy to Dexpanthenol.

[Skin lesions in metal working (author's transl)]. / Hautschäden in der metallverarbeitenden Industrie.

The results of inspections of several workshops, of examinations of patients with skin lesions, and of skin tests made with different cutting fluids have been compiled in a survey of the factors that may enhance the development of skin lesions in metal working. Some recommendations how to reduce the relatively small number of skin lesions which may however accumulate, are made and directed to the manufacturers of these cutting liquids, their users, and the individual worker.

[Contact eczema caused by isonicotinic acid hydrazide]. / Kontaktekzem durch Isonicotinsäurehydrazid.

In the treatment of an ulcerous reaction to BCG vaccination with isonicotinic acid hydrazide cones, a 20 year old nurse developed a contact eczema within four weeks under the influence of this tuberculostatic.

[Erosions caused by crystalline substances. Report of 3 iatrogenic cases]. / Verätzungen durch kristalline Substanzen. Bericht über drei iatrogene Fälle.

Three examples demonstrate how therapeutics (potassium permanganate and silver nitrate), improperly applied, can lead to erosions the determination of which is difficult if a relatively low water solubility causes a prolonged latency between impact and perceptible consequence. This latency can be considerably extended by a slight development of subjective symptoms of such erosions. Two of the cases show that the prescription of granulated potassium permanganate requires an accurate information of the patient.

[Phototoxic reaction to figs]. / Phototoxische Reaktion auf Feigen.

In several patients the effect of a phototoxic reaction to the juice of fresh figs (ficus carica) was observed as a striped pigmentation on the arms (after rubbing in the fruit juice followed by exposure to the sun), or as a patchy pigmentation of the face after eating fresh figs. Reference is made to the pathogenetic identity of this furocoumarin phototoxic reaction and the clinical transition of ficus dermatitis both to "Berloque dermatitis" (from the oil of types of citrus) and to bullous meadow dermatitis (from the juice of types of heracleum). Reference is also made to the similarity of the therapeutic furocoumarin reaction in PUVA therapy.

[Contact allergy to Anacardiaceae. A review and case reports of poison ivy allergy in central Europe]. / Kontaktallergie gegen Anacardiaceen. Ubersicht und Kasuistik zur "Poison Ivy" -Allergie in Mitteleuropa.

In Europe, as opposed to North America, poison-ivy rash is hardly known. For this reason a detailed review of the allergenic members of the Anacardiaceae family is given, and the misleading nomenclature of "poison ivy", "poison oak", and some other species of this family are discussed. An up-to-date representation of the chemical structure of the allergenic substance group (denoted as "Urushiol") from this family is provided as well as botanical information regarding the plants themselves. Prevention of this dangerous sensitization and the therapy of this allergic reaction are discussed. The four cases presented are as follows: a young German woman who became sensitized to poison ivy or poison oak while in the USA and showed a cross reaction to other Rhus species (R. copallina, R. javanica (semialata), R. trichocarpa) as well as to Choerospondias axillaris var. japonica and to mangoes; a landscape gardener with an occupationally acquired allergy to Anacardium occidentale; and two control persons giving positive results to skin tests with Urushiol and Rhus trichocarpa respectively, to which the source of sensitization could not be clarified. Tests with three kinds of pistachio and two native-European Anacardiaceae (Rhus typhina and Cotinus coggygria) yielded negative results in each case. Prophylaxis to sensitization requires familiarity with the numerous Anacardiaceae and derivative products to which one could come in contact. These substances, summarized in a table, include mango, cashew and "sweet pepper".

[Phytophotodermatitis caused by plant trimming (edger's rash)]. / Phytophotodermatitis durch "Rasentrimmer" ("Strimmer Rash").

The use of a trimmer for a lawn, which is covered with phototoxic plants such as Heracleum sphondylium and other Umbellifers, can lead to a phytophotodermatitis (trimmer's rash). An erythema of the light exposed skin, following a moderate hyperpigmentation, can cause a focal, vesicular lifting of the upper epidermis, whereby this toxic skin lesion appears similar to an allergic eczema. The best prevention of this harmless but bothersome reaction lies in the use of such an edger only in the evening hours.

Nitro musk.

The detection of nitro musk compounds in breast milk and in human adipose tissue is mainly due to the use of such substances as perfume in detergents from which they enter the sewage and finally the whole freshwater system. Due to their low degradability and a high biological concentration factor, they enter the food chain without the toxicological investigations to date allowing any certain conclusions on the effect of such accumulation in the human organism or on the effect of accumulation in ecological systems.

[Clinical aspects of pigmentation disorders due to oral contraceptives]. / Klinik der Pigmentveränderungen durch orale Kontrazeptiva.

PIP: A questionnaire and an examination were given to 617 women to determine whether oral hormonal contraceptives might cause a chloasmalike hyperpigmentation and its frequency and whether clinically this type of hyperpigmentation could be delineated from those of other causes. 105 of the women were 17-41 years old in the 2nd to 10th month of pregnancy; the other 512 were 15-57 years old: 4 had chloasma, 322 had skin diseases, 154 accompanied children with skin diseases to the Dusseldorf University Dermatological Clinic, and 32 were clinic personnel. A surprising 45% were using or had used oral contraceptives. 94.5% regularly employed cosmetics. 60 women (11.7%) had chloasmal hyperpigmentation; the figure was 16.2% for the pregnant group (17 women). But 28 of the 60 chloasma patients had not used contraceptives. Thus, a cosmetic-induced berlock dermatitis was suspected. 4 patients clearly had chloasma gravidarum (melasma). In other cases, contact with estrogen and gestagen preparations as well as with the "pill" was established. The clinical appearance of the facial pigmentation signs could not always be correlated with the etiology. Several patients had a sudden recrudescence of hyperpigmentation when exposed to strong sunlight, whether thay had been using cosmetics or contraceptives. This was particularly noted in the summertime. This clinical experience shows that oral contraceptives can induce chloasmalike facial hyperpigmantation; its frequency can be easily overestimated unless cosmetic-induced chloasma is excluded. To an extent, an etiological diagnosis can only be made if asymmetrical berlock dermatitis is present. The "pill-induced chloasma" is light-dependent to a great extent, so women using contraceptives should avoid unnecessary exposure to the light and should use strong protective agents. The likelihood of complications is greater in women who by constitution have heavily pigmented nipples and eyes.^ieng