Management of post-infectious olfactory dysfunction: a nationwide survey of UK ENT consultants.

Objective: To determine the current practice of UK ENT consultants in investigating cases of suspected post-infectious olfactory dysfunction.

Method: We prepared questionnaires and posted these to every consultant ENT surgeon registered with the British Association of Otolaryngologists Head and Neck Surgeons (BAO-HNS). Questions included preferred radiological investigation, smelling test and follow up.

Search for the psoriasis susceptibility gene: the Newfoundland Study.

The authors review early pioneering research on the genetics of psoriasis and recently published independent and collaborative investigations searching for the psoriasis susceptibility genes. We describe the research design and current plans for a joint pursuit between the Psoriasis Research Institute, the Memorial University of Newfoundland, and Chiroscience R&D, Inc., for susceptibility genes.

Childhood psoriasis.

Psoriasis is a common skin disease in infants, children, and adolescents. A review of the clinical, epidemiologic, genetic, and therapeutic aspects of childhood psoriasis is presented. Population studies indicate that the first signs of psoriatic lesions occur in the pediatric age group, birth to 18 years of age, and that both genetic and environmental factors interact to precipitate the development of psoriasis.

Fatal outcome of jugular vein cannulation.

We describe the case of a woman who had cannulation of the internal jugular vein for the placement of a hemodialysis catheter. The procedure was unsuccessful and resulted in a retropharyngeal hematoma, which in turn caused severe compression on a carotid artery that was already severely narrowed by atherosclerosis. This resulted in massive cerebral hemispheric infarction and death.

Sequential endoscopic/laparoscopic management of sickle hemoglobinopathy-associated cholelithiasis and suspected choledocholithiasis.

We reviewed the medical records of 17 patients with sickle hemoglobinopathy-associated cholelithiasis who were candidates for laparoscopic cholecystectomy (LC) between 1991 and 1994. Eight patients with suspected choledocholithiasis (CDL) were identified, all of whom had preoperative endoscopic retrograde cholangiopancreatography (ERCP), which revealed CDL in 3 patients (18%), all of whom had endoscopic ductal clearance. Choledocholithiasis was suspected because of hyperbilirubinemia or serum liver enzyme abnormalities.

Psoriasis in the tropics. Epidemiologic, genetic, clinical, and therapeutic aspects.

There is a dearth of information on psoriasis in the tropics. Psoriasis occurs more frequently in northern geographic regions than in tropical climates. Its prevalence varies not only within the ethnic groups of a country but from country to country.

Psoriasis and alcoholism.

The association of psoriasis and alcoholism is controversial. Early studies negate a relationship of psoriasis and alcohol intake, whereas more recent studies demonstrate a positive correlation between the two. Results of investigations of familial aggregation, adoption studies, twin concordance, marker gene associations, and biochemical and genetic evidence suggest that alcoholism is a multifactorial disorder with both genetics and environmental factors playing a role.

Systemic antifungals.

The administration, effectiveness, action, adverse reactions, and commentary are presented in Table I for a selected number of systemic antifungal agents.

Psoriasis and ultraviolet radiation.

Prevention and detection screening programs as a public health service in curtailing the ever-increasing incidence of all forms of skin cancer are reviewed. The effect of solar and artificial ultraviolet radiation on the general population and persons with psoriasis is examined.

Psoriasis associated with human immunodeficiency virus/acquired immunodeficiency syndrome.

Since the prevalence of psoriasis is between 1.5 to 2 percent, it would be expected to occur by chance in a person infected with HIV who is genetically predisposed to psoriasis. Several studies in the literature on HIV/AIDS-associated psoriasis have reported such percentages of frequency.

Psoriasis: a stress-related disease.

Stress is a well-known triggering factor in the appearance or exacerbation of psoriasis. The concept of psychoneuroimmunology in relation to stress is described. As part of the total care of the psoriasis patient, physicians are urged to augment traditional psoriasis treatment regimens with stress-reduction strategies, such as biofeedback, meditation, and self-help approaches.

The office visit and the self-help concept in treating the patient with psoriasis: a strategy revisited.

All dermatologists and physicians who care for patients with psoriasis should be aware that their patients may have an insufficient understanding of their disease. Every effort should be made to help patients fully comprehend their condition: to become aware of factors that can improve self-care and environmental events that can exacerbate the disorder. Strategies for self-help instructions can be modified from the highly structured approach in a university setting to the more informal atmosphere of a physician's office using the abundant patient educational resources available today.

Guttate psoriasis.

Prevention and early treatment with appropriate antibiotics administered at the onset of upper respiratory infections in children with psoriasis may be able to block the appearance of acute guttate psoriasis. A careful screening for a focus of infection is also indicated, especially in children.

Erythrodermic (exfoliative) psoriasis.

Erythrodermic (exfoliative) psoriasis represents a manifestation of psoriasis that is difficult to treat and requires the execution of consummate clinical skills. Careful analysis of precipitating factors may prevent recurrences. Systemic as well as topical therapy are essential for a favorable outcome.

Pustular psoriasis.

Pustular psoriasis may appear as localized pustular psoriasis, which runs a chronic course, or, in a more severe state, generalized pustular psoriasis. Precipitating factors influencing both local and generalized forms include various drugs (eg, lithium, hydrochloroquine), irritative topical therapy (eg, coal tar), dental and upper respiratory infections, pregnancy, and solar irradiation. Both adults and children are affected, but infantile and juvenile pustular psoriasis is rare.

Nonpustular palmoplantar psoriasis.

Nonpustular palmoplantar psoriasis can be disabling in causing painful fissuring and scaling. Preventive measures in avoiding friction and irritants can reduce the morbidity of this variant. Lubricants, anthralin, and corticosteroids form the mainstay of therapy in mild and moderate psoriasis of the palms and soles.

Perianal and intergluteal psoriasis.

Psoriasis of the perianal and intergluteal areas can cause pain and discomfort. Individualized therapeutic programs will reduce the morbidity. It is essential that optimal hygienic conditions be maintained in these regions to avoid itching and inflammation.

Genital psoriasis.

Psoriasis of the genitalia occurs in all age groups from infancy to the elderly. Approximately one-quarter to one-half of various epidemiologic studies report that genital psoriasis occurs with a higher frequency in males than in females. Therapeutic modalities for management of psoriasis in this site underscore the need for caution in not irritating the sensitive genital skin.

Nail psoriasis.

Psoriatic nail involvement is common and accompanies skin lesions on the body surface. The occurrence of nail psoriasis has been reported in up to 50 percent of patients, including children, adults, and the elderly. The characteristics of psoriatic nails are pitting, discoloration, onycholysis, subungual hyperkeratosis, as well as crumbling and grooving of nails and splinter hemorrhages.

Natural history and treatment of scalp psoriasis.

The scalp is a common site of involvement at onset and throughout the course of psoriasis. Worldwide census studies report that approximately half of the psoriasis population are afflicted with psoriasis of the scalp. We describe the frequency, clinical aspects, and treatment of scalp psoriasis in childhood, adulthood, and in the geriatric age groups.

Tinea versicolor: epidemiologic, clinical, and therapeutic aspects.

Age of the patient, climate, season, and local environmental factors influence the onset and course of tinea versicolor (pityriasis versicolor). A number of effective topical therapies are available. In addition, a single dose of 400 mg of oral ketoconazole eliminates the disease and can be used prophylactically in some cases to prevent recurrence.

The action and safety of ketoconazole: a brief literature review.

A great number of human diseases can be attributed in some way to the effects of fungi, and consequently have long been recognized as important to the dermatologist and mycologist. However, not in all spheres of medicine are fungi significant in the diagnosis and treatment of disease. Fungi are biochemically similar to the host since they are eukaryotic.