James J. Leyden

Analysis of characteristic odors from human male axillae

A number of studies concerning the analysis of axillary odors have assumed that the characteristic odor produced in the axillae is due to volatile steroids and isovaleric acid. Organoleptic evaluation of Chromatographic eluants from axillary extracts was employed to isolate the region in the chromatogram where the characteristic odor eluted. The odor of the dissolved eluant was eliminated when it was treated with base, suggesting that acids make up the characteristic axillary odor. Subsequent extraction of the pH-adjusted axillary extract in conjunction with organoleptic evaluation of the Chromatographic eluant, preparative gas chromatography, and analysis by GC-MS as well as GC-FTIR showed the presence of a number of C6 to C11 straight-chain, branched, and unsaturated acids as important contributors to the axillary odor. The major odor component is (E)-3-methyl-2-hexenoic acid. Three homologous series of minor components are also important odor contributors; these consist of the terminally unsaturated acids, the 2-methyl-C6 to -C10 acids and the 4-ethyl-C5 to -C11 acids. These types of acids have not been reported previously as components of the human axillary secretions and have not been proposed previously as part of the principal odor components in this area.

Erythromycin 2% gel in comparison with clindamycin phosphate 1 % solution in acne vulgaris

One hundred two patients with mild to moderate facial acne vulgaris completed a 12-week, investigator-masked, randomized, parallel-group comparison of a gel formation of erythromycin (2%) with clindamycin phosphate 1% solution. Patients were evaluated at a baseline visit and after 4, 8, and 12 weeks of twice-daily treatment. Both medications significantly reduced the numbers of papules and open and closed comedones. No significant differences in lesion count reductions were detected between the treatment groups after 8 and 12 weeks of treatment. By the end of 12 weeks, 48% of the patients in the erythromycin group and 47% in the clindamycin group had good or excellent responses to treatment. No patient was terminated from the study for side effects. Most patients, 65% in the erythromycin 2% gel group and 67% in the clindamycin phosphate 1% solution group, had a favorable impression of the overall cosmetic characteristics of their study medication.

Contact sensitization to benzoyl peroxide

Four formulations of benzoyl peroxide, two 5 % and two 10 % gels, were assayed for contact sensitizing capability by the human maximization test. Seventy‐six per cent became sensitized. Sensitized subjects reacted to all four formulations. Benzoic acid and related compounds failed to elicit an allergic reaction.

Staphylococcus aureus isolation from the lesions, the hands, and anterior nares of patients with atopic dermatitis☆

Staphylococcus aureus colonization is common in atopic dermatitis (AD) and can exacerbate the disease. Some patients with atopic dermatitis may act as a reservoir for S. aureus transmission to others. This study compared S. aureus colonization in atopic dermatitis patients and their caregivers with control patients and their caregivers. Quantitative cultures were obtained from the lesions, clinically normal skin, hands, and anterior nares of 100 patients with atopic dermatitis, 100 controls with other cutaneous disorders, and 200 caregivers. The AD patients had significantly greater presence of S. aureus from lesional and clinically normal skin, as well as the hand. Significantly increased carriage of S. aureus was found in the anterior nares of caretakers of AD patients compared with control caretakers. Topical corticosteroid use did not affect recovery of S. aureus. There was a significant correlation between recovery of S. aureus from lesional skin and recovery from the anterior nares and hands. The nares and hands may be important reservoirs and vectors for autotransmission of S. aureus to lesional skin and for transmission to patients with AD.

Retinoids and acne

Retinoids, chemicals that have vitamin A activity, have become important therapeutic agents for a variety of cutaneous disorders, including acne. This paper reviews the history of retinoid use in acne, including retinol, topical tretinoin, topical and systemic isotretinoin, systemic etretinate, and new investigational retinoid molecules.

Cryoprobe treatment of acne conglobata.

Twenty‐five patients with acne conglobata were treated with cryotherapy delivered via probes. The probe was applied to nodular lesions for 20–25s without pressure. Freon, carbon dioxide and nitrous oxide were found to be therapeutically equivalent. Nodulo‐cystic lesions resolved within 7–10 days leaving a thin atrophic scar on the back and no scar on the face. The treatment was almost painless; no recurrence has appeared in the treated areas.

Contact dermatitis from topical auranofin

Auranofin is an organogold complex composed of gold, thiosugar, and triethylphosphine that has been successfully used parenterally in the treatment of rheumatoid arthritis. More recently, a crude 0.18% auranofin ointment was used to treat psoriasis, resulting in clearing of lesions in some patients. 1 To confirm and extend these preliminary findings, a multicenter investigation was conducted in patients with mild to moderate-plaque psoriasis. During this investigation, in 17 of 76 subjects treated with auranofin ointment, contact dermatitis developed at the treatment site (Fig. 1).

Topical Antibiotics in the Prophylaxis of Experimental Staphylococcus Aureus and Streptococcus Pyogenes Infections in Humans

Minor cuts and abrasions are common events in the lives of all and are particularly frequent in young children. While a great deal of study has centered on the healing of superficial wounds, the frequency of infection by virulent organisms has received scant attention. There is no agreement and, indeed, much argument as to how minor cuts and abrasions should be treated to prevent infection. The infection rate varies considerably from one population to another, being strongly influenced by personal hygiene and climate.

Nosologie et classification

Le classement nosologique d’une maladie devrait etre fonde sur des criteres explicites, par exemple, etiologiques, pathogeniques ou therapeutiques. La conception actuelle de l’HS est celle d’une maladie bien individualisee, nettement differente de l’acne ou des folliculites par exemple. Une meilleure comprehension de l’etiologie et de la pathogenie permettrait dans le futur de resoudre l’impasse nosologique actuelle.

Nosology and Classification

HS is multifactorial. Follicular occlusion and disruption are predisposing factors, but other factors, including bacterial colonization and an as yet unknown pro-inflammatory mechanism, are at work. HS can be described as inverse recurrent suppuration according to topography, clinical evolution, and morphology. Looking at the parameters of etiology, morphology, pathogenesis, and therapy, HS can be differentiated from the acnes and from simple folliculitis.