Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Apr 2001
Correlation between 8-methoxypsoralen bath-water concentration and photosensitivity in bath-PUVA treatment.
Bath-PUVA treatment, originally established in Scandinavia, offers several advantages over oral PUVA and has become increasingly popular in recent years. Outside Scandinavia 8-methoxypsoralen (8-MOP) is the prevailing photosensitizer for this PUVA modality and is used arbitrarily in a wide range of concentrations. Up to the present, data are lacking on the impact of 8-MOP bath-water concentration on UVA dosimetry. ⋯ UVA dose requirements in bath-PUVA treatment decrease linearly with increasing 8-MOP concentrations. A single MPD assessment at 72 hours after the UVA exposure is inappropriate for accurate determination of the patients' photosensitivity. The hazard of wrong UVA dosimetry is comparable at all psoralen concentrations.
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J. Am. Acad. Dermatol. · Mar 2001
Clinical TrialTreatment of prurigo nodularis with topical capsaicin.
Prurigo nodularis is an eruption of lichenified or excoriated nodules caused by intractable pruritus that is difficult to treat. Therefore the antipruritic efficacy of capsaicin seemed to be of particular interest because this alkaloid, extractable from red pepper, interferes with the perception of pruritus and pain by depletion of neuropeptides in small sensory cutaneous nerves. ⋯ Topical treatment of prurigo nodularis with capsaicin proved to be an effective and safe regimen resulting in clearing of the skin lesions.
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J. Am. Acad. Dermatol. · Feb 2001
Case ReportsLidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosa.
We describe a 3-year-old child with mollusca contagiosa whose caregiver applied a eutectic mixture of 5% lidocaine and prilocaine (EMLA) in excessive amounts with the subsequent development of adverse reactions, including methemoglobinemia and hypoxemia. Because of the significant systemic absorption of lidocaine and prilocaine, the patient required overnight admission to the pediatric intensive care unit for close monitoring. A brief description of the proper dosing, pharmacokinetics, and possible side effects of EMLA cream are reviewed.
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J. Am. Acad. Dermatol. · Feb 2001
Case ReportsChildhood bullous pemphigoid developed after the first vaccination.
Bullous pemphigoid (BP) typically affects the elderly. There are at least 40 reported cases of BP in childhood, 10 reported cases at 1 year of age or younger. The antigen of this autoimmune disease is localized to the hemidesmosome. ⋯ Anti-influenza vaccine, tetanus toxoid booster, and tetracoq vaccine were the possible causes of these cases. We report herein a 3.5-month-old BP case in whom the lesions developed 24 hours after the first tetracoq vaccine. We suggest that vaccination may be the triggering factor of BP of any age by stimulating the immune system with an unexplained mechanism.