Tinea pedis pathophysiology and treatment.

Fungal infections of the foot can be divided into three major varieties, all of which have differing pathophysiologic aspects with therapeutic implications. Interdigital infections involve an ecological interplay between dermatophytes and bacteria. Simple scaling types of infection are caused by dermatophyte invasion of the stratum corneum, whereas macerated, erosive infections are caused by selection and overgrowth of bacteria, particularly Brevibacterium epidermidis, Micrococcus sedantarius, and various gram-negative species.

Inherited glutathione-S-transferase deficiency is a risk factor for pulmonary asbestosis.

Pulmonary diseases attributable to asbestos exposure constitute a significant public health burden, yet few studies have investigated potential genetic determinants of susceptibility to asbestos-related diseases. The glutathione-S-transferases are a family of conjugating enzymes that both catalyze the detoxification of a variety of potentially cytotoxic electrophilic agents and act in the generation of sulfadipeptide leukotriene inflammatory mediators. The gene encoding glutathione-S-transferase class mu (GSTM-1) is polymorphic; approximately 50% of Caucasian individuals have a homozygous deletion of this gene and do not produce functional enzyme.

Localization of the gene whose mutations underlie Hailey-Hailey disease to chromosome 3q.

Hailey-Hailey disease (familial benign chronic pemphigus) is an autosomal dominant skin disease characterized by impaired keratinocyte cohesion and consequent blister formation. In the present study we have used linkage analysis to map the gene for this disease to a region of chromosome 3q between D3S1589 and D3S1316. The maximum combined two point lod score in four families studied was 14.

Treatment of kerions.

Therapy for kerions was evaluated by randomly assigning 30 patients to one of four treatment groups: group A griseofulvin, group B griseofulvin plus erythromycin, group C griseofulvin plus prednisone, and group D griseofulvin, erythromycin, and prednisone. Data indicate that antibiotic and steroid therapy, in addition to griseofulvin, may reduce scaling and pruritus, but does not reduce the time it takes for kerions to flatten.

Tinea pedis.

Tinea pedis is a term used to encompass several clinically distinctive infections of the skin of the foot. Dermatophytic fungi are primarily responsible for these infections. Several nondermatophytes have been implicated in some patients, particularly for nail infections.

Microbiology of kerions.

Qualitative and semiquantitative bacterial culture specimens were obtained from 44 patients with kerions. Staphylococcus aureus was isolated from the scalp surface overlying the kerion in 29% of patients and from the pus within the kerion in 48% of patients. Gram-negative bacteria were found in the same locations in 11.

Progression of interdigital infections from simplex to complex.

The dynamics of symptomatic toe web infections often involve an ecologic interplay in which an initial dermatophyte infection provides a hospitable niche for subsequent colonization by bacteria. Several studies suggest that exacerbation of a mild dermatophyte infection (dermatophytosis simplex) can arise in the occlusive environment of the toe web space. Fungal infection induces damage to the stratum corneum, which allows overgrowth of resident bacteria and maceration, itching, and often malodor at the site (dermatophytosis complex).

A study of the efficacy of antimicrobial detergents for hand washing: using the full-hand touch plates method.

We studied the effects of four kinds of antimicrobial detergents, 4% chlorhexidine gluconate (CHG), chlorbenzarconium (CBC), 10% povidone-iodine (PVI), 0.3% triclosan (TRI), and one non-medicated detergent (NMD) using the full-hand touch plates method. Before and after 3 minutes of hand scrubbing with a brush, bacterial colonies on the hand surface and subungual bacteria were counted.

Treatment of photoaged skin with topical tretinoin.

Once-daily application of tretinoin to photodamaged facial skin for 0-12 months results in substantial clinical and histologic improvement. As regards appearance, fine wrinkles become effaced, dyspigmentations fade, surface becomes smooth and develops a 'rosy glow'. Histologically, atrophy and dysplasia of the epidermis are completely corrected.

An ultrastructural study of the effects of topical tretinoin on microcomedones.

It has been hypothesized that topical tretinoin prevents inflammatory acne lesions by loosening follicular impactions (microcomedones) and clearing the follicular canal of retained keratin. To lend support to this hypothesis, 15 volunteers applied 0.1% tretinoin cream once daily for 12 weeks to one side of the face and an emollient cream to the other side.

Review of mupirocin ointment in the treatment of impetigo.

The introduction of mupirocin ointment gives the pediatrician a reliable topical alternative to oral antibiotic therapy for group A streptococcal and staphylococcal impetigo. It is as effective as oral antibiotics and is associated with fewer adverse effects. In superficial skin infections that are not widespread, mupirocin ointment offers several advantages.

An investigation of human apocrine gland secretion for axillary odor precursors.

Recently completed studies from our laboratories have demonstrated that the characteristic human male axillary odors consist of C6 to C11 normal, branched, and unsaturated aliphatic acids, with (E)-3-methyl-2-hexenoic acid being the most abundant. To investigate the mechanism by which the odor is formed, it is necessary to determine the nature of the odorless precursor(s) found in the apocrine secretion which is converted by the cutaneous microorganisms to the characteristic axillary odor. Pooled apocrine secretion was obtained from several male volunteers by intracutaneous injection of epinephrine.

Efficacy of a 1-week, twice-daily regimen of terbinafine 1% cream in the treatment of interdigital tinea pedis. Results of placebo-controlled, double-blind, multicenter trials.

Background: Patients with tinea pedis often discontinue treatment before eradication of the fungus when their symptoms improve. The result is an incomplete cure/recurrence.

Objective: Terbinafine, a topical fungicidal agent, was evaluated in double-blind, placebo-controlled trials (159 patients) for its ability to achieve cure and relief of symptoms in the same time frame, that is, before compliance wanes.

Antibiotic resistance patterns in coagulase-negative staphylococci after treatment with topical erythromycin, benzoyl peroxide, and combination therapy.

Antibiotic resistance of the resident cutaneous bacterial flora is a well recognized consequence of systemic antibiotic therapy. In this study, we followed the development of antibiotic resistance of coagulase-negative staphylococci (CNS), the most numerous aerobic bacteria found on the skin surface, during treatment with three topical antimicrobial agents used to treat acne vulgaris. Groups of 20 subjects received either topical erythromycin, benzoyl peroxide or a combination of the two for 16 weeks.

Effects of topical ammonium lactate on cutaneous atrophy from a potent topical corticosteroid.

Background: Topical corticosteroids produce atrophic changes in skin, including thinning of the epidermis and decrease in dermal ground substance. We observed that 12% ammonium lactate produced an increase in the thickness of epidermis and increased amounts of dermal glycosaminoglycans.

Objective: Our purpose was to determine whether 12% ammonium lactate could minimize cutaneous atrophy produced by a potent topical corticosteroid.

Pneumocystis carinii pneumonia (PCP) and your child: a parent information booklet.

A parent education booklet describing Pneumocystis carinii pneumonia (PCP) was prepared by the Pediatric Branch of the National Cancer Institute. In addition to information about prophylaxis and treatment of PCP, the booklet discusses overall care of children infected with human immunodeficiency virus.

Handwashing practices and resistance and density of bacterial hand flora on two pediatric units in Lima, Peru.

The handwashing practices and bacterial hand flora of 62 pediatric staff members of a teaching hospital in Lima, Peru, were studied. Handwashing followed patient contact 29.3% of the time (204/697 contacts).

Skin replica analysis of photodamaged skin after therapy with tretinoin emollient cream.

Computerized image analysis of silicone replicas, a reproducible, objective technique for measuring skin topography, was used in addition to clinical measures in two multicenter, double-blind, randomized, controlled studies of tretinoin emollient cream, a new formulation for treating photodamaged skin. Previously, the skin replica technique had been successfully used in a pilot study of tretinoin 0.05% cream by one investigator.

Analysis of characteristic odors from human male axillae.

A number of studies concerning the analysis of axillary odors have assumed that the characteristic odor produced in the axillae is due to volatile steroids and isovaleric acid. Organoleptic evaluation of Chromatographic eluants from axillary extracts was employed to isolate the region in the chromatogram where the characteristic odor eluted. The odor of the dissolved eluant was eliminated when it was treated with base, suggesting that acids make up the characteristic axillary odor.