New uses for benzoyl peroxide: a broad-spectrum antimicrobial agent.

Benzoyl peroxide is a useful agent in the treatment of acne, chronic ulcers, tinea pedis, and tinea versicolor, probably because of its antimicrobial power. 2.5% concentration is almost as active as 5%.

Interdigital athlete's foot: new concepts in pathogenesis.

In our view, interdigital athlete's foot usually begins with invasion of the horny layer by dermatophytes. Because of hot weather, sweating, exercise, or tight shoes, enough moisture accumulates to stimulate an overgrowth of bacteria. Large numbers of normally resident aerobic diphtheroids cause the common wet, macerated type of athlete's foot, while an overgrowth of Gram-negative organisms, such as Pseudomonas and Proteus, is responsible for the more serious cases.

Rapid blister formation in human skin with ammonium hydroxide.

The topical application to human skin of a 1:1 aqueous solution of ammonium hydroxide in a well drilled into a plastic block will provoke an intra-epidermal blister in an average time of about 13 min. The blister roof can be used for physico-chemical analyses of the horny layer while the base is suitable for studies of wound healing, bacterial infections, etc. The minimal blistering time (MBT) increases directly as the number of cell layers of the stratum corneum and ranges from 3 to 57 min in different regions and persons.

Clinical and histological study of coal tar phototoxicity in humans.

Coal tars of different origin were compared with regard to their capacity to cause a phototoxic reaction in human skin. The photosensitizing potencies were found to differ. Tars that were partially refined had less activity than crude coal tar.

Topical methoxsalen and blacklight in the treatment of psoriasis.

Thirty patients with recalcitrant psoriasis were treated with topical methoxsalen and blacklight (UVA). A 1% concentration either in an acetone, alcohol, propylene glycol vehicle, or hydrophilic ointment, USP, applied two hours before light exposure was highly effective. Twelve patients were completely cleared and nine were markedly improved in three to five weeks.

The chamber-scarification test for irritancy.

A procedure has been designed (the chamber-scarification test), which possesses greatly increased sensitivity for assessing the irritancy of topically applied materials. A forearm test site is criss-cross scarified by drawing a 30-gauge needle over the skin with just enough pressure to cleave the epidermis without drawing blood. The test agent is applied in an aluminum chamber once daily for 3 days.

Assay of topical corticosteroids. Efficacy of suppression of experimental Rhus dermatitis in humans.

Rhus dermatitis, experimentally induced in humans, was used as a model for determining the efficacy of various proprietary topical steroids. One-centimeter squares of vesicular dermatitis were induced by patch application of Rhus oleoresin. The steroids were then applied without occlusion once daily for four days, with readings of the therapeutic effect taken on the fifth day.

Tris (2,3-dibromopropyl) phosphate: human contact sensitization.

Liquid TBP caused delayed hypersensitivity in human subject maximization tests. It showed a dose/response relationship and is judged a weak to mild sensitizer. Patch testing a pre-sensitized subjects using fabrics containing TBP produced responses varying with the availability of the agent at the fiber surface.

Role of microorganisms in dandruff.

The role of microorganisms in dandruff was studied, by suppressing individually and then collectively the three major components of the scalp microflora. The effect on dandruff was assessed subjectively by clinical grading and objectively by the corneocyte count. No effect on dandruff was demonstrated when scalp organisms were suppressed.

Acne vulgaris: new concepts in pathogenesis and treatment.

The successful management of acne involves a careful detailing of the factors involved in pathogenesis to ensure confidence and co-operation with the now quite successful therapeutic measures available.

Further studies of photoaugmentation in humans: phototoxic reactions.

The addition of modest amounts of long ultraviolet light (UV-A) to 1/2 minimal erythema dose (MED) of sunburning irradiation (UV-B) produced erythema visible at 24 hr, the prototype of the photoaugmentation phenomenon. The results were the same whether UV-A was given before or after UV-B. Photoaugmentation could be demonstrated after an inverval of 6 hr between doses, but not after 1 day.

Age-related changes in the resident bacterial flora of the human face.

Quantitative levels of resident aerobic and anaerobic bacteria of the face, show a characteristic age-related pattern. The density of anaerobic diptheroids and surface aerobic micrococci is higher in infancy than in early childhood. At puberty the quantity of organisms increases, with significantly higher levels achieved in late adolescence.

Propionibacterium levels in patients with and without acne vulgaris.

Propionibacterium species were quantified on the foreheads and cheeks of persons with and without acne in three age groups: 11 to 15, 16 to 20, and 21 to 25. Propionibacteria were virtually absent in the pubertal non-acne group compared to a geometric mean density of 114,800 per sq cm in the acne group. A similar sharp difference existed between the acne subjects and normals in the age range of 16 to 20 years: 85,800 organisms per sq cm compared to 588 per sq cm.

Updating the maximization test for identifying contact allergens.

The maximization test for detecting contact allergens has proved to possess both sensitivity and specificity. However, modifications have become necessary because of excessive irritancy reactions to sodium lauryl sulfate. Fewer exposures are now recommended during induction and lower concentrations for challenge patch testing.

Aluminum chloride in the treatment of symptomatic athelete's foot.

Various aluminum salts were evaluated for in vitro and in vivo antimicrobial activity and ability to bind with serum proteins (astrigency) with the object of finding a colorless substance to substitute for carbol-fuchsin solution (Castellani paint) in the treatment of symptomatic interdigital athlete's foot. Aluminum chlorohydrate was more powerful in killing bacteria and fungi than aluminum acetate and aluminum chloride. However, aluminum chloride showed pronounced astringency and was the only compound to bring about rapid resolution of the signs and symptoms of athlete's foot in open-ended clinical trials.

Treatment of psoriasis with topically applied tretinoin and steroid ointment.

The sequential application of tretinoin and a corticosteroid ointment was considerably more effective in the treatment of plaque-type psoriasis than either drug alone in a pilot study. The best results were obtained with 0.3% tretinoin followed by a potent corticosteroid ointment.

Effect of hydrogenated fat on the plasma cholesterol and triglyceride levels of man.

A group of 33 adult males was fed for 21 days a formula diet that supplied 38 per cent of their calories as fat. The fatty acid composition of the diet was 25 per cent saturates, 16 per cent polyunsaturates and 58 per cent monounsaturates. All of the unsaturated acids were in the cis configuration.

Acne aestivalis.

This is the first American report, to our knowledge, of a case of acne aestivalis, which occurred in a woman with a recurrent acneform eruption in summertime. The histopathologic sequence was very similar to that found in cases of steroid acne; namely, local necrosis of the follicular epithelium was followed by the formation of a comedo. No cause was found.

Treatment of solar keratoses of the extremities with retinoic acid and 5-fluorouracil.

In contrast to solar keratoses of the face, twice daily application of 5% 5-fluorouracil cream was found to be incapable of destroying such lesions situated on the forearms and hands. Twice daily application of 0-1% retinoic acid was also ineffective. Combined use of these agents eradicated keratoses in all twenty subjects with numerous keratoses of the forearms; in only two was the treatment ineffective for keratoses of the hands.