Pascal del Giudice, MD; Oliver Chosdiow, MD, PhD and Erci Caumes, MD
Ivermectin, a broad-spectrum anti-parasitic agent first used in veterinary medicine, is active against numerous species of
helminths and arthropods. For the past few years, world-wide reports on the use of ivermectin in various parasitic diseases
with cutaneous tropism have led to its use in the field of skin parasitology. In this paper we review parasitoses which have
been treated with ivermectin; mainly, filariasis, strongyloidiasis, cutaneous larva migrans, and scabies and head lice.
S. Ronger, MD; A.M .Villard, MD; F. Meunier-Mure, MD; B. Balme, MD and L. Thoma., MD
Background: Lichen sclerosus remains an elusive disease with an uncertain relationship to morphea and scleroderma.
The disorder has been difficult to treat, with no consistent and reproducible efficacious therapy.
Recently, a beneficial effect of treatment with oral calcitriol (1-25 dihydroxyvitamin D3) in patients
with scleroderma or morphea was described. This fact could be ascribed to the immunomodulatory
effects of calcitriol observed in vitro and to inhibition of fibroblastic growth. Because of the success of
calcitriol in localized scleroderma, we attempted this therapy in a patient with LS.
Observation: One patient with cutaneous generalized LS resistant to different therapeutics was treated with calcitriol
in an oral daily dose of 0.5 mcg. After 6 months of treatment, the skin extensibility increased, and the
lesions improved. The improvement persisted after discontinuation of therapy during a follow-up period
of one year. The only side effect was hypercalciuria, which resolved with dose reduction.
Conclusion: Calcitriol has shown a beneficial effect in scleroderma and morphea during open studies. A case is
reported of a patient with LS who had a dramatic response to calcitriol. Double blind, placebo-con
trolled trials are needed to assess the therapeutic value of calcitriol in patients with LS.
Aditya K. Gupta, MD, PhD, FRCP(C) and Robert Baran, MD
Onychomycosis in children is relatively uncommon, with a prevalence of approximately 0.3% worldwide. The most common
etiologic organism is Trichophyton rubrum. The oral antifungal agents terbinafine, itraconazole, and fluconazole, and
the topical nail lacquers ciclopirox and amorolfine, are not approved for use in treating onychomycosis in children.
However, these agents appear to be effective and safe in this indication.
James Q. del Rosso, Do, FAOCD
The use of topical agents for treatment of most dermatologic disorders is integral to the practice of dermatology. The
innate properties and therapeutic mechanisms of the active component(s) of a topical preparation and the ability of the
vehicle formulation to deliver adequate concentrations of drug to the site of disease directly affect clinical efficacy.
Other factors influencing efficacy in clinical practice correlate closely with the extent of patient compliance, including
the degree of local tolerability and patient acceptability of the product, frequency of application and duration of therapy.
The following provides a discussion of newer medical therapies for the treatment of actinic keratosis based on current literature
and clinical experience.
Julian S. Conejo-Mir, MD; Susana del Canto, MD; Miguel Angel Muñoz, MD; Lourdes Rodríguez-Freire, MD; Amalia Serrano, MD; Carlos Hernandez, MD and Agueda Pulpillo, MD
Recurrent erythema multiforme is a rare disorder, clinically characterized by symmetrically distributed, erythematous, and
bullous skin and mucous lesions, mainly precipitated by a preceding herpes simplex infection. In rare cases, EM presents
continuous or persistent relapses, and has been related to an Epstein-Barr virus infection. We report 2 cases of severe, persistent
erythema multiforme, treated with thalidomide, with complete disease suppression in both cases. Thalidomide
induces immunomodulator, anti-inflammatory, and anti-angiogenic effects, and may be considered as the elective treatment
of this rare variety of erythema multiforme. However, in order to avoid neuropathic side effects, patients under
thalidomide therapy should be monitored every 6 months with nerve conduction studies while taking the drug.
Hendrik Uyttendaele, MD, PhD; Adam Geyer, MD and Richard K. Scher, MD, FACP
No abstract details for the moment.
F. Emily Bell, MD and Melissa P. Daniles, MCS
Ciclopirox is a hydroxylated pyridone, a unique substance in our tropical treatment armamentarium. It first came to market in Europe and has been in use for a number of years1. Worldwide it is or has been available as a spray, vaginal cream, powder, solution, cream, lotion, gel, and nail lacquer. The latter four are available in the United States at the time of this article. Ciclopirox gel differs from other formulations. It contains ciclopirox as a free acid, as opposed to an olamine salt. Superficial fungal infections and seborrheic dermatitis are two of the most common disorders seen in dermatology and indeed in medicine in general; ciclopirox is active against both, and literally may be used head to foot.
Andreas J. Bircher, MD and Christian Surber, MD
Unconventional (i.e. alternative, traditional, or complementary) treatments are used by many individuals for a variety of
symptoms and disorders. Reports on fraudulent products used for unconventional treatments are not uncommon.
These include herbal remedies offered as "natural" while containing non-labeled synthetic pharmacological ingredients
or even toxic agents, patients not being informed of active ingredients, products containing no active substances,
or unqualified individuals or "clinics" delivering dangerous advice or treatment. Reports on tainted topical products
remain rare due to the high analytical demands necessary to detect minimal traces of unknown ingredients, the fact
that patients often use medications from different sources, and patient over-reliance on the effectiveness of folk remedies
or advertised claims. The patients' assumption of receiving a safe and effective therapy by "natural" products has
shown to be unreliable. The authors urge that quality standards for "natural" and pharmaceutical products should be the
same and that only qualified professionals should deliver treatment and medical advice.