[Allergic contact dermatitis to common ivy (Hedera helix L.)]. / Allergische Kontaktdermatitis auf Efeu (Hedera helix L.).

Common ivy (Hedera helix L.) is a ubiquitous plant in Europe whose major allergen falcarinol has moderate allergic potential. It is not related to poison ivy (Toxicodendron spp.). There are no cross reactions between the allergens of common ivy (falcarinol) and poison ivy (urushiol). Contact with common ivy or falcarinol may lead to sensitization and then a delayed hypersensitivity reaction. There are only few cases described in the literature. We report on a male hobby gardener with appropriate clinical history and positive patch test. The pathogenic mechanism is a type IV reaction following a sensitization exposure. Gardeners and landscape architects with frequent exposure to common ivy and thus a high risk of sensitization should wear appropriate protective clothing.

[Hypno-analysis: On the integration of hypnotic elements in individual uncovering psychotherapy in patients with anxiety disorder]. / Hypno-Analyse: Zur Integration hypnotischer Behandlungselemente in aufdeckende Einzelpsychotherapie bei Angstpatienten.

Following a short history of the development of the therapeutic techniques of psychoanalysis as derived from the basic rules of hypnosis, the apparent contradictions between the two approaches are called into question, with particular reference to the importance and efficacy of suggestion and suggestibility in both methods. How the integration of hypnotic interventions can both intensify and at the same time shorten the process of analytic therapy is demonstrated by two vignettes. The range of indications for the use of hypnosis as a complementary measure is currently restricted to the analysis of resistance and of the making conscious of past traumatic experiences that are involved in the psychogenesis of anxiety disorders. Particular importance is attached to the careful establishment of the indication and then psychoanalytic working-through of the accompanying transference-countertransference-dynamics following the completion of the hypno-analytic phase and in the course of the ongoing uncovering therapeutic process.

Treatment of pruritus by capsaicin in a patient with pityriasis rubra pilaris receiving RE-PUVA therapy.

Pityriasis rubra pilaris (PRP) is characterized by redness of the skin, scaling and a variable degree of pruritus. We present a patient with extremely itchy PRP successfully treated with oral retinoids and photochemotherapy with 8-methoxypsoralene (RE-PUVA) and topical capsaicin. The PRP-related pruritus which clearly preceded photochemotherapy and for which no other cause was apparent was relieved with capsaicin. This single case report provides evidence that topical capsaicin may be a useful therapeutic option in treating PRP-associated pruritus where antihistamines have been unsuccessful.

Manipulative treatment of carpal tunnel syndrome: biomechanical and osteopathic intervention to increase the length of the transverse carpal ligament.

To quantify the amount of transverse carpal ligament (TCL) elongation in response to osteopathic manipulation or sustained load bearing (or both), a study involving seven cadaver limbs was conducted. Distances from the trapezium to the hamate (distance A) and from the scaphoid to the pisiform (distance B) were measured in five mounted cadaver limbs during and after the limbs bore the weight (2 newtons [N] to 4 N) for 2 several-hour periods. A several-hour period occurred between the weight bearing to assess recoil. Distances A and B were measured before and after the limbs were manipulated, according to previously described techniques, as well as with a new maneuver, termed the "guywire" technique. Two dissected limbs also were subjected to further weight bearing, this time increased to 8 N. Greater weight loads produced greater lengthening of the TCL, and recoil after removal of weight loads was slower than recoil after manipulation. Manipulation was more effective than weight loading for increasing distance A (distal canal), but weight loading generally was more effective than manipulation for increasing distance B (proximal canal). The guywire manipulation combined with direct transverse extension appeared to have the greatest impact on lengthening the TCL distally. These results show promise for the effective use of manipulation and load bearing for TCL elongation and nonsurgical relief of pressure on the median nerve in patients with carpal tunnel syndrome.