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P342 Melatonin: A new cause of fixed drug eruption
Posters -
18 patients on hemodialysis were enrolled into a 4 month clinical trial providing dietary supplementation of omega 3-6 EFA with a natural integrator containing oil of borago officinalis, soja oil, vit. E and vit. B6 (Daiet B - Humana). All patients presented xerotic skin, graded slight-medium-severe, three of whom also complained of pruritus, apparently not associated to any other cause. 20 drops were administered three times a day. At the end of the study 9 patients had dropped out (non-compliance (4) ictus (l), gastro-enteric intollerance (3 pts), transient hypertriglicederemia (I)), the remaining nine patients reported subjective and objective improvement of systoms. Clinical examination showed redution of desquamation, skin was pliable and pruritus had disappeared. On the basis of our results we suggest that supplementation with EFA may prevent xerosis and precocious ageing of the skin in hemodialytic patients.
P342 El
Melatonin: A new cause of fixed drug eruption
F. Bardazzi, I. Neri, A. Patrizi, C. Landi. Dept.
of Clinical Experimental Medicine, Division of Dermatology (Head Claudio VarottiJ, University . ofthe Study .” ofBologna,I Italy ”
and
Fixed drug eruption (FDE) is an annoying but benign mucocutaneous reaction due to a systemically administered drug which provokes one or many round erythematous plaques, blisters or erosions. Many different types of medication may cause FDE; we report here the first cases of FDE of the genitalia due to melatonin in two businessmen who intook this drug in order to prevent the symptoms of jet lag syndrome. In both patients we performed a challenge test consisting of the administration of 1 mg of pure melatonin. Six to 8 hours after taking the drug, plaques appeared in both patients in the previously affected sites. Melatonin is a hormone synthesised by the pineal gland whose phyisiologica role in humans is still unknown. It has been hypothesized that melatonin has an anticancer activity, as well as being a good treatment for some mental deseases, jet lag syndrome, insomnia, sarcoidosis, AIDS and retardation of ageing. In the USA, melatonin is an over the counter drug which can be found supermarkets or drugstores whereas in Europe the uncontrolled sale of melatonin is, or at least is supposed to be, forbidden.
P343 Effect of topical vitamin D3 (tacalcitol) for pruriginous skin diseases - Mechanisms of action I. Katayama’ , M. Fukuoka, T. Ohta, E. Komoriya*. Dermatology, Nagasaki University School of Medicine, Nagasaki; *Pharmaceutical Development Laboratories, Institute for Biological Research, Tokyo, Japan
‘Dept.
of
Teijin
We have already reported that topical tacalcitol[la24(OH)2D3] improved steroid-resistant refractory prurigo nodularis. To clarify mechanism of action of vitamin D3, immunohistochemical analysis of prurigo nodularis after topical tacalcitol [lor24(OH)2D3] and effect of tacalcitol[la24(0H)2D3] on cytokine, cell adhesion molecule and NGF/J mRNA expression by cultured keratinocyte cell line were investigated.
S233
Therapy
Expressions of cell adhesion molecules were reduced after 12 weeks ointment of tacalcitol. Number of infiltrating CD8 cells into the epidermis was reduced after the therapy. CDI(+) DC (dendritic cell) distributed mainly in the middle part of epidermis while FcsRI(+) DC distributed throughout the epidermis and upper layer of dermis. These Fc&RI(+) DC but not FceRI(+) mast cell increased in number in dermis but reduced in epidermis after the therapy. Expression of VCAM-1 but not ICAM- 1 or ELAM- 1 mRNA was reduced while expression of NGFj3 mRNA was increased after the therapy. In vitro studies demonstrated that tacalcitol[la!24(OH)2D3] down-regulates mRNA expression of ILIa, TNFa, RANTES ant cell adhesion molecules and up-regulates mRNA expression of NGF/l These results suggest that clinical effect of vitamin D3 might be attribuable to modulation of cytokine and cell adhesion molecule expressions by keratinocytes and up-regulation of NGFj3 expression might be crucial for the improvement of pruriginous skin diseases. 0 P344
Hydroxyurea-induced eruption
dermatomyositis-like
B. Bartolome, R. Valks, S. Cordoba, M. Aragtles, R. Martin ’ , I. Fembdez-Herrera. ’ Departamenst of Dermatology and Pathology, Spain
Hospital
Universitario
de la Princesa,
Madrid,
Hydroxyurea is a citotoxic drug used to treat chronic myelogenous leukemia, other myeloproliferative syndromes and, occasionally for psoriasis. lO-35% patients treated with hydroxyurea for a long period show cutaneous adverse reactions. These are mainly xerosis and nail hyperpigmentation. Alopecia, oral ulceration, vasculitis and fixed drug eruption have also been documented. In 1975 Kennedy et al. first described cutaneous reactions during long-term maintenance therapy with hydroxyurea. Nearly twenty cases have been described in the literature since then. Case Report: A 37 year-old man diagnosed of chronic myelogenous leukemia was treated with hydroxyurea between July 1994 and February 1996. Twenty-two days after the removal of treatment aiming an allogenic bone marrow transplantation, developed erythematous lesions on dorsa of finger joints, elbows and palma, that dissapeared spontaneously after seven days. Histopathological examination showed hyperkeratosis, acanthosis, vacuolar changes in the basal cell layer and chronic inflamatory dermal infiltrate. We describe a new case of dermatomyositis-like eruption in a patient treated with hydroxyurea. ElP345
PUVA followed by cyclosporin is implicated in the development of squamous cell carcinoma
P Reid, E.A. Bingham, J. McMillan. Dept. of Dermatology, Royal Victoria City Hospital,
Hospital, Belfast; Belfast, N. Ireland
Dept.
of Dermatology,
BeCfast
The association between longterm PUVA and development of skin tumours is well recognised. Cyclosporin treatment has also
18 patients on hemodialysis were enrolled into a 4 month clinical trial providing dietary supplementation of omega 3-6 EFA with a natural integrator containing oil of borago officinalis, soja oil, vit. E and vit. B6 (Daiet B - Humana). All patients presented xerotic skin, graded slight-medium-severe, three of whom also complained of pruritus, apparently not associated to any other cause. 20 drops were administered three times a day. At the end of the study 9 patients had dropped out (non-compliance (4) ictus (l), gastro-enteric intollerance (3 pts), transient hypertriglicederemia (I)), the remaining nine patients reported subjective and objective improvement of systoms. Clinical examination showed redution of desquamation, skin was pliable and pruritus had disappeared. On the basis of our results we suggest that supplementation with EFA may prevent xerosis and precocious ageing of the skin in hemodialytic patients.
P342 El
Melatonin: A new cause of fixed drug eruption
F. Bardazzi, I. Neri, A. Patrizi, C. Landi. Dept.
of Clinical Experimental Medicine, Division of Dermatology (Head Claudio VarottiJ, University . ofthe Study .” ofBologna,I Italy ”
and
Fixed drug eruption (FDE) is an annoying but benign mucocutaneous reaction due to a systemically administered drug which provokes one or many round erythematous plaques, blisters or erosions. Many different types of medication may cause FDE; we report here the first cases of FDE of the genitalia due to melatonin in two businessmen who intook this drug in order to prevent the symptoms of jet lag syndrome. In both patients we performed a challenge test consisting of the administration of 1 mg of pure melatonin. Six to 8 hours after taking the drug, plaques appeared in both patients in the previously affected sites. Melatonin is a hormone synthesised by the pineal gland whose phyisiologica role in humans is still unknown. It has been hypothesized that melatonin has an anticancer activity, as well as being a good treatment for some mental deseases, jet lag syndrome, insomnia, sarcoidosis, AIDS and retardation of ageing. In the USA, melatonin is an over the counter drug which can be found supermarkets or drugstores whereas in Europe the uncontrolled sale of melatonin is, or at least is supposed to be, forbidden.
P343 Effect of topical vitamin D3 (tacalcitol) for pruriginous skin diseases - Mechanisms of action I. Katayama’ , M. Fukuoka, T. Ohta, E. Komoriya*. Dermatology, Nagasaki University School of Medicine, Nagasaki; *Pharmaceutical Development Laboratories, Institute for Biological Research, Tokyo, Japan
‘Dept.
of
Teijin
We have already reported that topical tacalcitol[la24(OH)2D3] improved steroid-resistant refractory prurigo nodularis. To clarify mechanism of action of vitamin D3, immunohistochemical analysis of prurigo nodularis after topical tacalcitol [lor24(OH)2D3] and effect of tacalcitol[la24(0H)2D3] on cytokine, cell adhesion molecule and NGF/J mRNA expression by cultured keratinocyte cell line were investigated.
S233
Therapy
Expressions of cell adhesion molecules were reduced after 12 weeks ointment of tacalcitol. Number of infiltrating CD8 cells into the epidermis was reduced after the therapy. CDI(+) DC (dendritic cell) distributed mainly in the middle part of epidermis while FcsRI(+) DC distributed throughout the epidermis and upper layer of dermis. These Fc&RI(+) DC but not FceRI(+) mast cell increased in number in dermis but reduced in epidermis after the therapy. Expression of VCAM-1 but not ICAM- 1 or ELAM- 1 mRNA was reduced while expression of NGFj3 mRNA was increased after the therapy. In vitro studies demonstrated that tacalcitol[la!24(OH)2D3] down-regulates mRNA expression of ILIa, TNFa, RANTES ant cell adhesion molecules and up-regulates mRNA expression of NGF/l These results suggest that clinical effect of vitamin D3 might be attribuable to modulation of cytokine and cell adhesion molecule expressions by keratinocytes and up-regulation of NGFj3 expression might be crucial for the improvement of pruriginous skin diseases. 0 P344
Hydroxyurea-induced eruption
dermatomyositis-like
B. Bartolome, R. Valks, S. Cordoba, M. Aragtles, R. Martin ’ , I. Fembdez-Herrera. ’ Departamenst of Dermatology and Pathology, Spain
Hospital
Universitario
de la Princesa,
Madrid,
Hydroxyurea is a citotoxic drug used to treat chronic myelogenous leukemia, other myeloproliferative syndromes and, occasionally for psoriasis. lO-35% patients treated with hydroxyurea for a long period show cutaneous adverse reactions. These are mainly xerosis and nail hyperpigmentation. Alopecia, oral ulceration, vasculitis and fixed drug eruption have also been documented. In 1975 Kennedy et al. first described cutaneous reactions during long-term maintenance therapy with hydroxyurea. Nearly twenty cases have been described in the literature since then. Case Report: A 37 year-old man diagnosed of chronic myelogenous leukemia was treated with hydroxyurea between July 1994 and February 1996. Twenty-two days after the removal of treatment aiming an allogenic bone marrow transplantation, developed erythematous lesions on dorsa of finger joints, elbows and palma, that dissapeared spontaneously after seven days. Histopathological examination showed hyperkeratosis, acanthosis, vacuolar changes in the basal cell layer and chronic inflamatory dermal infiltrate. We describe a new case of dermatomyositis-like eruption in a patient treated with hydroxyurea. ElP345
PUVA followed by cyclosporin is implicated in the development of squamous cell carcinoma
P Reid, E.A. Bingham, J. McMillan. Dept. of Dermatology, Royal Victoria City Hospital,
Hospital, Belfast; Belfast, N. Ireland
Dept.
of Dermatology,
BeCfast
The association between longterm PUVA and development of skin tumours is well recognised. Cyclosporin treatment has also