Phillip Frost

Efficacy of mycophenolic acid for the treatment of psoriasis

The efficacy of orally administered mycophenolic acid (MPA), an inhibitor of guanosine monophosphate (GMP) synthesis, for the treatment of psoriasis, was studied in a double-blind fashion. Of twenty-one patients completing the study period, ten of eleven patients treated with MPA had a greater than 25% decrease in severity score compared with only two of ten patients treated with placebo. The placebo group had a slight increase in severity score compared to almost 50% reduction in the average severity score of the MPA-treated group. After termination of the double-blind portion of the study, the placebo group was treated with MPA and showed a 60% decrease in severity score. Adverse effects encountered included anorexia, nausea, vomiting, and diarrhea. One patient had an uncomplicated episode of herpes zoster. Other than a mild decrease hemoglobin, no hematologic toxicity was noted.

An assessment of factors influencing flexibility of human fingernails

A new instrument has been developed and used to determine the effect of various materials on nail flexibility. It repeatedly flexes longitudinal nail sections through 90 degrees and records the number of flexions required to fracture each section.

Addition of a topically applied corticosteroid to a modified Goeckerman regimen for treatment of psoriasis: Effect on duration of remission

A double-blind parallel group study was undertaken to assess the effect of adding a topically applied corticosteroid cream to a modified Goeckerman regimen to treat patients with psoriasis. Nineteen patients with psoriasis were treated with either this regimen and hydrocortisone valerate cream or the regimen and vehicle cream. Patients were given daily treatments until their skin cleared or until twenty-eight treatments were received. They were then followed up until rebound or relapse occurred or 6 months had passed. The addition of hydrocortisone valerate cream to the modified Goeckerman regimen led to relapse after 5.9 weeks in comparison with 17.9 weeks for the control group.

The treatment of keratosis palmaris et plantaris with isotretinoin: A multicenter study

Five of six patients with keratoderma palmaris et plantaris were safely and effectively treated with isotretinoin with dramatic and definite clearing of the keratoderma within the first 4 weeks of therapy. The mean dose was 1.95 mg/kg/day with a mean duration of 113 days.

Reduction of the erythema response to ultraviolet light by nonsteroidal antiinflammatory agents

SummaryThe effect of three nonsteroidal antiinflammatory agents (NSAIA) on ultraviolet B (UV-B)-induced erythema was studied in normal human volunteers. Aspirin, indomethacin, and ibuprofen were administered orally 2 h before exposure to UV-B from fluorescent sunlamps and at 4-h intervals for a total of four doses. The minimal dose of light to produce erythema (MED) was determined for each subject with and without drugs. There was a 240% increase in the mean MED when the NSAIA were given. NSAIA, given orally, can increase the threshold for UV-B-induced erythema when administered near the time of irradiation.ZusammenfassungDer Effekt von drei nicht-steroidalen antientzündlichen Substanzen (NSAIA) auf das durch Ultraviolettlicht B (UV-B) erzeugte Erythem wurde an gesunden Freiwilligen untersucht. Aspirin, Indomethazin und Ibuprofen wurden 2 h vor der UV-B-Exposition mit Fluoreszenzlampen und danach in Intervallen von 4 h insgesamt viermal oral verabreicht. Die minimale erythemerzeugende Lictosis (MED) wurde an allen Probanden mit und ohne Medikation bestimmt. Bei Verabreichung von NSAIA fand sich ein durchschnittlicher Anstieg der MED um 240%. Oral verabreichte NSAIA können die Erythemschwellendosis für UV-B erhöhen, wenn sie in kurzem zeitlichen Abstand zur Bestrahlung verabfolgt werden.

Cutaneous β‐glucuronidase: cleavage of mycophenolic acid by preparations of mouse skin

Mycophenolic acid, a new chemotherapeutic agent for the treatment of psoriasis, is known to be rapidly conjugated on absorption and to circulate largely in the form of its glucuronide conjugate. Since this metabolite does not readily penetrate intact cells and is cleaved by the enzyme β‐glucuronidase to yield free mycophenolic acid, the ability of preparations of mouse skin to cleave mycophenolic glucuronide was studied. The time course of mycophenolic acid liberation by such preparations and the dependence upon the amount of enzyme preparation were demonstrated. Preparations of mouse skin and mouse liver, kidney, spleen, lung, heart and small intestine were assayed for β‐glucuronidase activity using ρ‐nitrophenyl‐β‐D‐glucuronide as substrate. Skin yielded preparations with higher β‐glucuronidase activity per/mg protein than any of the other organs tested. When expressed on the basis of β‐glucuronidase activity recovered per milligram of tissue DNA, skin, liver and kidney showed higher levels than the other organs tested.

The antiviral effectiveness of butylated hydroxytoluene on herpes cutaneous infections in hairless mice

Abstract Hairless mice, cutaneously infected with herpes simplex virus type 1 (HSV-1), were treated topically with butylated hydroxytoluene (BHT). The effectiveness of BHT in shortening the duration of infections was assayed under three conditions. In the first experiments, mice undergoing primary infections with no prior immunity to HSV-1 were utilized. These animals tended to develop deep lesions that were not typical of recurrent HSV-1 infections in humans. A second set of experiments utilized mice that had recovered from a primary infection and that were immunosuppressed by γ irradiation. Immunosuppression was essential for the full development of lesions upon reinfection. The lesions in these animals remained more localized with less tendency to spread into deep tissues. A third set of experiments utilized animals that were subcutaneously inoculated with human serum γ-globulin 24 hr prior to infection. Lesions on these animals also remained localized and did not penetrate into deep tissues. Under all three conditions, BHT was found to be effective in reducing the clearance time of HSV-1 cutaneous lesions when applied topically to the infected area.

Mycosis Fungoides Treated With Acyclovir-Reply

In Reply.— We have noted the comments by Mahrle and colleagues regarding the failure of two of their patients with mycosis fungoides to respond to intravenously administered acyclovir. We do not believe that their conclusions are supported by treating only two patients. While acyclovir may not be effective for treating all patients with mycosis fungoides, there may be a population of these patients in whom this drug will be effective. We have initiated a comprehensive trial of acyclovir in patients with mycosis fungoides at 15 medical centers in the United States. The preliminary results of this trial have demonstrated benefit in some patients.