Journal of the American Academy of Dermatology
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J. Am. Acad. Dermatol. · Dec 1987
Comparative Study Clinical Trial Controlled Clinical TrialClinical effects of diaper types on the skin of normal infants and infants with atopic dermatitis.
Cloth diapers, cellulose core diapers (conventional disposable diapers), and cellulose core diapers containing absorbent gelling material were examined for their effects on diaper rash and skin microbiology of normal infants and infants with atopic dermatitis in a 26-week double-blind clinical trial. Infants with atopic dermatitis wearing the diapers containing absorbent gelling material had significantly lower diaper rash grades than infants with atopic dermatitis wearing cloth diapers at five of eight grading visits. Infants with atopic dermatitis wearing conventional cellulose core diapers had statistically less rash at one of eight visits. ⋯ A statistical correlation between the severity of general atopic dermatitis outside the diaper area and the diaper rash condition under the diaper occurred only in the atopic dermatitis group wearing cloth diapers. Isolation of microorganisms from the intact, uninvolved skin surface both inside and outside the diaper showed no biologically significant changes in the presence or numbers of selected skin organisms. Repeated isolation, at multiple grading visits of Staphylococcus aureus from uncompromised skin inside the diaper area was infrequent but correlated with the diagnosis of atopic dermatitis when observed.
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J. Am. Acad. Dermatol. · Dec 1987
Comparative Study Clinical Trial Controlled Clinical TrialClinical studies with disposable diapers containing absorbent gelling materials: evaluation of effects on infant skin condition.
Disposable infant diapers with absorbent gelling material (cross-linked sodium polyacrylates) incorporated into the core were clinically evaluated for their effect on infant skin condition. Absorbent gelling materials tightly hold water and provide pH control by a buffering capacity as well as by helping to segregate urine apart from feces. Four clinical studies were conducted with each following a rigid protocol that controlled for variables of diet and age in addition to the diaper material that may influence the development of diaper dermatitis and helped to control for any inherent bias in the study. ⋯ Objective measurements of skin wetness (transepidermal water loss) and skin pH, as well as double-blind grading of diaper dermatitis, were the measures of skin condition. Absorbent gelling material disposable diapers were associated with significantly reduced skin wetness, closer to normal skin pH, and lower degrees of diaper dermatitis when compared to conventional disposable or home-laundered cloth diapers. The results are consistent with the hypothesis that better control in the diaper area of skin wetness, skin pH, and the prevention of the mixing of urine and feces produces a better diaper environment.
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J. Am. Acad. Dermatol. · Sep 1987
Clinical Trial Controlled Clinical TrialAmikacin alone and in combination with trimethoprim-sulfamethoxazole in the treatment of actinomycotic mycetoma.
We report the excellent therapeutic response obtained with amikacin alone and in combination with trimethoprim-sulfamethoxazole in the treatment of 15 patients with actinomycotic mycetoma who had a poor response to the traditional pharmacologic agents and/or in whom important organs such as lungs, spinal cord, and bone were involved. We evaluated the results by clinical, radiologic, and laboratory tests. No important side effects were detected during or after the therapy.
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J. Am. Acad. Dermatol. · Aug 1987
Painful piezogenic pedal papules in patients with Ehlers-Danlos syndrome.
Painful piezogenic pedal papules were observed in 10 of 29 patients with Ehlers-Danlos syndrome. The diagnosis was made by examining each patient while he or she stood with full body weight on the heels and by observing the appearance of the painful papules on the medial, posterior, and lateral aspects of both heels. ⋯ Painful piezogenic pedal papules are due to herniation of subcutaneous fat into the dermis, which is possibly due to structural defects of the connective tissue. The high prevalence of painful piezogenic pedal papules in our group of patients (34.5%) makes its direct association with the Ehlers-Danlos syndrome highly feasible, most probably because of the connective tissue defect that occurs in patients with Ehlers-Danlos syndrome.
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J. Am. Acad. Dermatol. · Jul 1987
Case ReportsRecurrent eruptions following unusual solitary coelenterate envenomations.
The case history of four patients is presented. The first patient exhibited normal immunologic reactions to large artificial intradermal challenge with jellyfish venom and later, multiple small natural stings. ⋯ The third and fourth patients exhibited recurrent eruptions after solitary envenomations by different coelenterates. These case histories demonstrate that multiple recurrent eruptions may follow solitary envenomations by different subphyla of coelenterates, that the initial eruption induced by the sting may be delayed by the administration of high doses of systemic corticosteroids, and that an immunologic reaction in both the B and T cell systems can follow jellyfish envenomation.