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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors studied the skin disorders in 50 patients who have undergone renal transplantation. They observed: -- Viral infections (herpes simplex, herpes Zoster, warts) in 56% of the patients. -- Bacterial infections in 36%, resulting in septicemia in 8% of the cases. -- Fungal infections in 26% of the patients. These infections appeared more severe than usual and recurred frequently. The occurence of several infections processes in the same patient was not uncommon. The clinical aspect and high incidence of various infections is related to immunosuppresive therapy. However, there is no clear-cut correlation between the type of infection and the type of treatment used. -- Squamous cell carcinoma occured in one patient. A high incidence of malignancies is known to occur in immunosuppressed patients. -- Skin signs related to hemodialysis (pruritus, hypermelanosis, skin dryness, vascular disturbances) regressed. -- The incidence of adverse reactions to drugs was high. -- 4 cases of ulcerations of the oral mucosa probably related to Azathioprine were observed.
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PMID:[Skin manifestations in renal transplants]. 21 59

The efficacy of oral acyclovir 400 mg twice daily in suppressing frequently relapsing genital herpes simplex was evaluated in an open multicenter study. Seventy-one patients were treated for 12 months. During treatment, 73% of the patients were completely free of symptoms when taking the tablets continuously, and another 14% had mild symptoms such as erythema and/or itching at single occasions. An accidental treatment interruption for 2-4 days led to mild but definite herpes episodes within a few days in 5 otherwise symptom free patients. Definite herpes episodes despite acyclovir medication occurred in 3 cases (4%). No noteworthy side effects were recorded during the acyclovir treatment. After withdrawal of acyclovir, herpes relapsed within 1-4 weeks in 69% of the patients. The frequency of relapses during the following months was reported to be equal to that before the treatment period in most of the patients. Acyclovir susceptibility of the isolated herpes simplex virus (HSV) strains did not change during treatment. The mean titres of antibodies against HSV type-common glycoprotein antigen, HSV-2 type-specific antigen and varicella zoster virus antigens decreased significantly during treatment with acyclovir.
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PMID:One year acyclovir suppression of frequently recurring genital herpes: a study of efficacy, safety, virus sensitivity and antibody response. 166 44

In many cases of chronic intractable pain without any discernible causes, when both Western medical treatment and acupuncture treatment failed to eliminate the pain, this pain is often due to the unrecognized presence of viral or bacterial infection. Even effective anti-viral or bacterial agents often fail to eliminate or inhibit the infection, as these drugs may also fail to reach the most painful area where often unrecognizable circulatory disturbances co-exist. Using the Bi-Digital O-Ring Test Molecular Identification Method, we were able to localize substance P and thromboxane B2 (a good indicator of the presence and degree of circulatory disturbances) in the painful area along with virus or bacteria. Based on the Bi-Digital O-Ring Test localization method for specific substances or microbes, the author has successfully treated cases of chronic intractable pain by the combination of anti-viral or bacterial agents with either manual acupuncture, electro-acupuncture or transcutaneous electrical stimulation through a pair of surface electrodes. Among a variety of infections, the most common cause of severe intractable pain was herpes simplex virus, and the most common bacterial cause of intractable pain of moderate degree was campylobacter. In addition, chlamydia was a very common cause of mild intractable pain. When peripheral nerve fibers are hypersensitive from nerve injury due to viral infection, in addition to the drug therapy for infection, use of Vitamin B1 25 mg., 2 times a day for an average adult often accelerates recovery time. As an anti-viral agent for the herpes virus family, the author found that EPA (Omega 3 fish oil, Eicosa Pentaenoic Acid, C20:5 omega 3), at doses between 180 mg. and 350 mg (depending upon body weight) 4 times a day for 2 to 6 weeks, without prescribing the common anti-viral agent Acyclovir, often eliminated the symptoms due to viral infection including all well-known types of the herpes virus, such as herpes simplex virus, Epstein-Barr virus, and cytomegalovirus. Epstein-Barr virus and cytomegalovirus are usually not associated with intractable severe pain, but they are often associated with a recurrent burning or itching sensation and they can cause intractable frequent muscle twitching. Viruses belonging to the herpes family almost always exist between the midline of one side of the spinal cord and the midline of the front of the body where these nerves from the spinal cord end and the same virus is localized only on one side of the body at the same spinal level.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Treatment of acute or chronic severe, intractable pain and other intractable medical problems associated with unrecognized viral or bacterial infection: Part I. 197 80

The most commonly encountered vulvar dermatoses present as cutaneous papules or scaly plaques. The two major categories are the papulosquamous disorders, which include psoriasis, seborrhoea and the 'lichens' (lichen planus, lichen sclerosus, lichen simplex chronicus) and chronic or recurrent infections (tinea, Candida, papillomavirus, herpes simplex). These conditions are morphologically similar, and treatment for one condition may affect the appearance of another. Lichen simplex chronicus (LSC, histologically squamous cell hyperplasia) is a secondary dermatosis, a non-specific cutaneous change indicating the presence of pruritus. Candida, tinea, lichen sclerosus, papillomavirus and topical agents have all been implicated in the development of LSC. Chronic vulvar burning (vulvodynia) is rarely associated with cutaneous change other than erythema, but may occur with vulvar dermatoses, occult Candida or papillomavirus infection, vulvar vestibulitis or cutaneous dysaesthesias. Topical preparations are most commonly used to treat vulvar disorders. Treatment trials typically require several weeks of therapy to determine responses. Allergic reactions to components must be distinguished from irritants, and complications of therapy must be recognised and prevented if possible. Overuse of topical medications, especially steroids, may lead to mycotic superinfection or to rebound dermatoses related to steroid withdrawal. Anxious patients may overclean or overtreat sensitive genital skin in the belief that they are unclean or harbour a sexually transmitted disease. In some situations, systemic medication may offer an appropriate adjunct or alternative to topical therapy.
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PMID:Vulvar dermatoses: common problems in dermatological and gynaecological practice. 209 34

A significant association exists between the use of epidural morphine (EM), reactivation of herpes labialis (HL) commonly known as coldsores, and pruritus in the obstetric population. A randomized prospective study was designed to eliminate previously identified confounding variables. Immediately following delivery, parturients having undergone cesarean section with epidural anesthesia with carbonated lidocaine (Xylocaine CO2, Astra, Mississauga, Ontario, Canada) with 1:200,000 epinephrine were sequentially randomized to receive either EM or im opioids for postoperative analgesia. One blood sample was collected for viral serology and two mouthwashes (day 0 and 2) were collected to determine oral viral shedding. The patients were observed daily for 5 days. Coldsores were cultured for herpes simplex virus (HSV). Of 187 patients, 96 received EM and 91 im opioids; herpes labialis occurred in 14 of 96 (14.6%) of the former but in 0 of 91 of the latter (P = 0.0004). All 14 experienced facial pruritus. The two groups were at equal risk for reactivation (seropositivity 64.6% and 62.6%, respectively). Analysis of data for those with positive HSV serology reveals 14 of 62 (22.5%) had EM and herpes labialis compared with 0 of 57 in the im group (P less than 0.0001). The incidence of oral viral shedding was low. Surgical stress, the local anesthetic solution, and epinephrine addition to the local anesthetic were eliminated as confounders. Stepwise logistic regression analysis revealed that EM and a history of herpes labialis in these patients were predictive for reactivating oral HSV.
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PMID:Herpes labialis in parturients receiving epidural morphine following cesarean section. 184 64

Atopic dermatitis is a pruritic, inflammatory cutaneous disorder found most frequently among patients with a personal or family history of atopic disease. A primary defect is found in bone marrow cells. The most consistent abnormality relates to the overproduction of IgE. Pharmacophysiologic abnormalities include abnormal vascular responses, abnormal sweating responses, and a reduced threshold for itch. In addition, seven of 12 patients with pure atopic dermatitis with no respiratory disease have an abnormal methacholine inhalation test. There is an abnormal response of leukocyte cyclic AMP to a variety of adenylate cyclase stimulants. Characteristic histological findings are interepidermal edema, called spongiosis, which is consistent with a composite of late-phase and delayed hypersensitivity. The brittle stratum corneum can be treated with hydration, a commonly neglected aspect of management. An overlooked complication is herpes simplex infection of the eye. Overall management includes stress control, treating allergenic trigger factors, topical steroids, systemic antibiotics, antihistamines, ultraviolet light, and hospitalization in severe cases.
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PMID:Recognizing and managing clinical problems in atopic dermatitis. 248 93

Cutaneous manifestations of AIDS in the 1st 91 cases diagnosed in French Guiana between 1982-October 1987 included 40 cases of candidiasis, 29 of prurigo, 13 of herpes simplex, 5 of trichomoniasis, 7 of human papilloma virus, 3 of shingles, 3 of donovanoses, and 1 of Kaposi's sarcoma. There were also 7 cases of seborrheic dermatitis, 6 of capillary dystrophies, and 1 of leucoplasia. 26 of the 40 cases of candidiasis were buccal or buccopharyngeal and 14 were vaginal. Such infections are intense, chronic, and easy to diagnose. Local treatment with Nystatin or Amphotericin B in solution for buccal cases and with imidazole derivatives for vaginal cases should be supplemented with systemic medications such as ketoconazole. Most herpes simplex cases are type 2 genital infections which may be chronic and extensive. A perfusion of Aciclovir usually gives good results in 5 or 6 days. Shingles during AIDS often has nonthoracic localizations; involves itching, pain, and burning sensations; is recurrent, perhaps on the contralateral side; and may leave scars. Sensitivity to Aciclovir is less than for herpes simplex. Human papilloma virus lesions that are not too large are treated locally. Although tuberculosis is in 2nd place after candidiasis among opportunistic infections in AIDS patients in French Guiana. Only 2 cases of cutaneous tuberculosis were observed. 3 cases of Donovanosis due to Calymmatobacterium granulomatis were observed, with 2 cases with 1 couple. Chronic prurigo has been observed frequently in AIDS patients in Africa and Haiti. Along with asthenia, polyadenopathies, and shingles, it is often an early sign of AIDS. The pruritus becomes more and more intense and the only treatment providing some relief is local corticotherapy. The dermatovenereal signs of AIDS in tropical environments should raise suspicions of the disease in undiagnosed cases, and they also provide an explanation for the high rate of heterosexual transmission in individuals with various disorders involving genital lesions. Some dermatological disorders common in French Guiana have not been observed in AIDS patients to date.
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PMID:[Infection by the human immunodeficiency virus (HIV) in French Guyana. Dermato-venereologic problems]. 272 41

Twenty-seven patients suffering from long-standing, severe, recurrent herpes simplex (14 labial and 13 genital) who had not responded adequately to prior therapy were recruited for this open, monitored study. They were treated with thymopentin 50 mg subcutaneously three times weekly for a period of 6 weeks. Clinical controls were performed once a week and then again 6 weeks after cessation of therapy; laboratory investigations were done at time points 0, 3, and 6 weeks. Additionally, information was collected with regard to the clinical course during the following year. Thirteen of 14 patients with labial infection and 10 of the 13 with genital herpes improved markedly (p less than 0.05) as shown by decrease in the relapse rate of at least 50%, shorter relapse episodes, and improvement of symptoms such as pain and itching. Fourteen of these 27 patients experienced no relapse for a period longer than 4 months after cessation of therapy. These favorable results were paralleled by a statistically significant increase in the T cell helper/suppressor ratio. This finding indicates that thymopentin acts as an immunodomulator; it is assumed that the activation of T helper cells induces-presumable via interleukin 2-the proliferation of cytotoxic T lymphocytes and natural killer cells which play a major role in the natural immune defense. No serious side effects of thymopentin were recorded.
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PMID:Thymopentin treatment of herpes simplex infections. An open, monitored, multicenter study. 286 60

The HIV epidemic probably arose in Africa at about the same time as in the West, and there is a significant seroprevalence of HIV in the central African region. However, the epidemiology and clinical course of AIDS are different in Africa and in the West. In Africa males are infected as often as females, and the commonest means of transmission is heterosexual intercourse. Many HIV-infected people are symptomless, but many others present with or progress to generalized lymphadenopathy, pruritus, herpes zoster, herpes simplex, cellulitis, and oral candidiasis. The World Health Organization developed a clinical case-definition of AIDS in Africa, which was found to have a specificity of 90% and a sensitivity of 59% when tested in Zaire. The Kaposi's sarcoma seen in African AIDS patients is more aggressive than that seen in the West and is often visceral. Gastrointestinal AIDS (the "slim" disease) with weight loss and diarrhea is common in Africa, as are oral and esophageal candidiasis. In Africa Pneumocystis carinii pneumonia is rare, but pulmonary tuberculosis is common. Neurological manifestations include cerebral toxoplasmosis, cytomegalovirus infection, headache, and terminal encephalopathy. About 60% of infants born to seropositive women are infected and die within the 1st year of life. Lack of drugs and diagnostic facilities make both diagnosis and treatment of opportunistic infections difficult.
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PMID:Clinical aspects of HIV infection in developing countries. 305 40

A multi-institutional double blind study was performed in 66 patients in order to evaluate the action of human leukocyte interferon, type alpha (IFN) in lesions produced by herpes simplex virus. Lesions were localized in genital area in 34 cases and in facial area in 32 of them. From the total, 38 patients were treated with 7,000 Ul/gm. of interferon ointment and 28 with carbowax 4,000 as placebo. The symptoms pain, ardor, itching and paresthesia were evaluated asking to patients. Erythema, vesicles, crust, scale adenopathy were objectivated. Signs and symptoms were controlled on days 3 and 7 of treatment. In 42 patients, lesions specimens were taken for virus isolation. In 23 of them, cytopathic effect was detected (54.76%). Results showed a rapid relief from pain (p less than 0.05), ardor (p less than 0.01) and paresthesia (p less than 0.001) and also accelerated healing of vesicles in patients treated with interferon. Tendency to reduce the total time of the disease in those patients treated with IFN was observed.
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PMID:[Therapeutic use of human leukocyte interferon in dermatologic disorders caused by herpes simplex virus. Multicenter study]. 307 70


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