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P(h)thirus pubis and lindane resistance
Volume 12 Number 5, Part 1 May, 1985
presses. After 2 days of treatment, it was apparent that the area treated with Dermovate cream was responding dramatically without significant response on the other sites. These sites were then treated with the Dermovate cream in the same way, a total of 15 to 17 gm of cream being used per day. The patient was discharged 1 week later with all areas entirely reepithelialized. At follow-up 1 month and 3 months after discharge, the lesions remained completely reepithelialized. Discussion. The decision to use potent topical corticosteroid in our patient was based on (1) the observation that corticosteroid dramatically affects the proliferation of fibrous stroma in tissue culture, 5 (2) that it depresses the proliferation of fibroblasts and inhibits deposition of collagen and synthesis of mucopolysaccharides, 6 and (3) on the well-documented vasoconstrictive effects of potent corticosteroid. C1obetasol propionate (Dermovate) in a cream base was chosen as a highly potent corticosteroid in order to demonstrate any effect in a decisive manner. We believe that any systemic effect due to corticosteroid absorption is unlikely because of the rapid response of the lesions to the topical steroid, because of the lack of response of the lesions at the control site at the same time, and since the lesions were fully reepithelialized in a few days, that the estimated amount of steroid applied to the skin was short of the amount quoted in the literature to alter the adrenocortical axis. 7 Although it has been reported that resolution of the granulation tissue occurs on withdrawal of isotretinoin,S the rapidity of response in our patient suggests that the topical steroid was specifically effective.
R. A. W. Miller, M.D., F.R.C.P.(C), J. B. Ross, M.B., F.R.C.P.(C), and J. Martin, M.D., F.R.C.P.(C) Division of Dermatology, Department of Medicine Dalhousie University at Victoria General Hospital Halifax, Nova Scotia, Canada
Correspondence
889
5. Absoe-Hansen G, Flumendrantz N: Cortisol effects on collagen biosynthesis in embryonic explants and in vitro hydroxylation of procollagen. Acta Endocrinol 83:665672, 1976. 6. Dorfman A, Schiller S: Effects of hormones on the metabolism of acid mucopolysaceharide of connective tissue. Recent Prog Horm Res 14:427-456, 1958. 7. Carruthers JA, August PJ, Staughton RCD: Observations on the systemic effect of topical clobetasol propionate (Dermovate). Br Med J 4:203, 1975. 8. Allenby CF, Main RA, Marsden RA, Sparkes CG: Effect on adrenal function of topically applied clobetasol propionate (Dermovate). Br Meal J 4:619-621, 1974.
P(h)thirus pubis and lindane resistance To the Editor: In the article, "Infections and Infestations of the Skin" by David S. Feingold and David Taplin, (J AM ACAD DERMATOL11:971-974, 1984) I find two points that require comment. Phthirus pubis is an incorrect spelling. Pthirus pubis is the correct form as shown by Harry Arnold (Parish LC, Nutting WB, Schwartzman RM: Cutaneous infestations of man and animal. New York, 1983, Praeger Publishers). To the best of my knowledge resistance to lindane in head lice has not been reported in Africa or in Central America. I know of no reference to this. I also take issue with the statement that resistance is present in Europe and the United Kingdom. Our group demonstrated that there is fallacious reasoning in the articles associated with the European resistance. 1
Lawrence Charles Parish, M.D. 160I Walnut St., Philadelphia, PA 19102
REFERENCE I. Kucirka SA, Parish LC, Witkowski JA: The story of lindane resistance and head lice. Int J Dermatol 22:551-555, 1983.
Reply
REFERENCES 1. Windhorst DB, Nigra T: General clinical toxicology of oral retinoids. J AM ACAD DERMA'rot.6:675-682, 1982. 2. Exner JH, Dahod S, Pocchi PE: Pyogenic granuloma-tike ache lesions during isotretinoin therapy. Arch Dermatol 119:808-811, 1983. 3. Valenti JP, Barr RJ, Weinstein GD: Inflammatory neovascular nodules associated with oral isotretinoin treatment of severe acne. Arch Dermatol 119:871-872, 1983. 4. Campbell JP, Grekin RC, Ellis CN, et al: Retinoid therapy is associated with excess granulation tissue responses. J AM ACAD DERMATOL9:708-713, 1983.
To the Editor: Dr. Parish correctly identified a misprint. We used the common spelling Phthirus pubis for the crab louse. Computer searches of the literature indicate that the vast majority of citations are listed under this spelling. The article cited by Dr, Parish ~ deals primarily with the problems of measuring insecticide resistance by in vitro methods. In developing our section of "Analysis and Needs in Dermatology," we also took into
presses. After 2 days of treatment, it was apparent that the area treated with Dermovate cream was responding dramatically without significant response on the other sites. These sites were then treated with the Dermovate cream in the same way, a total of 15 to 17 gm of cream being used per day. The patient was discharged 1 week later with all areas entirely reepithelialized. At follow-up 1 month and 3 months after discharge, the lesions remained completely reepithelialized. Discussion. The decision to use potent topical corticosteroid in our patient was based on (1) the observation that corticosteroid dramatically affects the proliferation of fibrous stroma in tissue culture, 5 (2) that it depresses the proliferation of fibroblasts and inhibits deposition of collagen and synthesis of mucopolysaccharides, 6 and (3) on the well-documented vasoconstrictive effects of potent corticosteroid. C1obetasol propionate (Dermovate) in a cream base was chosen as a highly potent corticosteroid in order to demonstrate any effect in a decisive manner. We believe that any systemic effect due to corticosteroid absorption is unlikely because of the rapid response of the lesions to the topical steroid, because of the lack of response of the lesions at the control site at the same time, and since the lesions were fully reepithelialized in a few days, that the estimated amount of steroid applied to the skin was short of the amount quoted in the literature to alter the adrenocortical axis. 7 Although it has been reported that resolution of the granulation tissue occurs on withdrawal of isotretinoin,S the rapidity of response in our patient suggests that the topical steroid was specifically effective.
R. A. W. Miller, M.D., F.R.C.P.(C), J. B. Ross, M.B., F.R.C.P.(C), and J. Martin, M.D., F.R.C.P.(C) Division of Dermatology, Department of Medicine Dalhousie University at Victoria General Hospital Halifax, Nova Scotia, Canada
Correspondence
889
5. Absoe-Hansen G, Flumendrantz N: Cortisol effects on collagen biosynthesis in embryonic explants and in vitro hydroxylation of procollagen. Acta Endocrinol 83:665672, 1976. 6. Dorfman A, Schiller S: Effects of hormones on the metabolism of acid mucopolysaceharide of connective tissue. Recent Prog Horm Res 14:427-456, 1958. 7. Carruthers JA, August PJ, Staughton RCD: Observations on the systemic effect of topical clobetasol propionate (Dermovate). Br Med J 4:203, 1975. 8. Allenby CF, Main RA, Marsden RA, Sparkes CG: Effect on adrenal function of topically applied clobetasol propionate (Dermovate). Br Meal J 4:619-621, 1974.
P(h)thirus pubis and lindane resistance To the Editor: In the article, "Infections and Infestations of the Skin" by David S. Feingold and David Taplin, (J AM ACAD DERMATOL11:971-974, 1984) I find two points that require comment. Phthirus pubis is an incorrect spelling. Pthirus pubis is the correct form as shown by Harry Arnold (Parish LC, Nutting WB, Schwartzman RM: Cutaneous infestations of man and animal. New York, 1983, Praeger Publishers). To the best of my knowledge resistance to lindane in head lice has not been reported in Africa or in Central America. I know of no reference to this. I also take issue with the statement that resistance is present in Europe and the United Kingdom. Our group demonstrated that there is fallacious reasoning in the articles associated with the European resistance. 1
Lawrence Charles Parish, M.D. 160I Walnut St., Philadelphia, PA 19102
REFERENCE I. Kucirka SA, Parish LC, Witkowski JA: The story of lindane resistance and head lice. Int J Dermatol 22:551-555, 1983.
Reply
REFERENCES 1. Windhorst DB, Nigra T: General clinical toxicology of oral retinoids. J AM ACAD DERMA'rot.6:675-682, 1982. 2. Exner JH, Dahod S, Pocchi PE: Pyogenic granuloma-tike ache lesions during isotretinoin therapy. Arch Dermatol 119:808-811, 1983. 3. Valenti JP, Barr RJ, Weinstein GD: Inflammatory neovascular nodules associated with oral isotretinoin treatment of severe acne. Arch Dermatol 119:871-872, 1983. 4. Campbell JP, Grekin RC, Ellis CN, et al: Retinoid therapy is associated with excess granulation tissue responses. J AM ACAD DERMATOL9:708-713, 1983.
To the Editor: Dr. Parish correctly identified a misprint. We used the common spelling Phthirus pubis for the crab louse. Computer searches of the literature indicate that the vast majority of citations are listed under this spelling. The article cited by Dr, Parish ~ deals primarily with the problems of measuring insecticide resistance by in vitro methods. In developing our section of "Analysis and Needs in Dermatology," we also took into