home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-06 | 310.1 KB |
open in: 
MacOS 8.1
|
Win98
|
DOS
view JSON data
|
view as text
This file was not able to be converted.
This format is not currently supported by dexvert.
| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
|00000000| 1a 44 50 31 2e 31 00 00 | 00 00 00 00 00 05 64 00 |.DP1.1..|......d.|
|00000010| 00 00 16 00 00 00 30 30 | 00 00 00 01 9c 05 00 00 |......00|........|
|00000020| 25 09 00 00 30 31 00 00 | 00 01 c1 0e 00 00 b3 0d |%...01..|........|
|00000030| 00 00 30 32 00 00 00 01 | 74 1c 00 00 93 0a 00 00 |..02....|t.......|
|00000040| 30 33 00 00 00 01 07 27 | 00 00 de 0b 00 00 30 34 |03.....'|......04|
|00000050| 00 00 00 01 e5 32 00 00 | cd 0e 00 00 30 35 00 00 |.....2..|....05..|
|00000060| 00 01 b2 41 00 00 7a 0b | 00 00 30 36 00 00 00 01 |...A..z.|..06....|
|00000070| 2c 4d 00 00 31 08 00 00 | 30 37 00 00 00 01 5d 55 |,M..1...|07....]U|
|00000080| 00 00 f3 09 00 00 30 38 | 00 00 00 01 50 5f 00 00 |......08|....P_..|
|00000090| 23 0a 00 00 30 39 00 00 | 00 01 73 69 00 00 8b 09 |#...09..|..si....|
|000000a0| 00 00 31 30 00 00 00 01 | fe 72 00 00 4a 0b 00 00 |..10....|.r..J...|
|000000b0| 31 31 00 00 00 01 48 7e | 00 00 15 0c 00 00 31 32 |11....H~|......12|
|000000c0| 00 00 00 01 5d 8a 00 00 | 85 0a 00 00 31 33 00 00 |....]...|....13..|
|000000d0| 00 01 e2 94 00 00 b8 09 | 00 00 31 34 00 00 00 01 |........|..14....|
|000000e0| 9a 9e 00 00 81 0c 00 00 | 31 35 00 00 00 01 1b ab |........|15......|
|000000f0| 00 00 7c 0c 00 00 31 36 | 00 00 00 01 97 b7 00 00 |..|...16|........|
|00000100| 57 0e 00 00 31 37 00 00 | 00 01 ee c5 00 00 16 11 |W...17..|........|
|00000110| 00 00 31 38 00 00 00 01 | 04 d7 00 00 ae 09 00 00 |..18....|........|
|00000120| 31 39 00 00 00 01 b2 e0 | 00 00 96 0e 00 00 32 30 |19......|......20|
|00000130| 00 00 00 01 48 ef 00 00 | 27 0b 00 00 32 31 00 00 |....H...|'...21..|
|00000140| 00 01 6f fa 00 00 50 0a | 00 00 32 32 00 00 00 01 |..o...P.|..22....|
|00000150| bf 04 01 00 19 0f 00 00 | 32 33 00 00 00 01 d8 13 |........|23......|
|00000160| 01 00 65 0d 00 00 32 34 | 00 00 00 01 3d 21 01 00 |..e...24|....=!..|
|00000170| 60 0d 00 00 32 35 00 00 | 00 01 9d 2e 01 00 6c 0d |`...25..|......l.|
|00000180| 00 00 32 36 00 00 00 01 | 09 3c 01 00 3e 16 00 00 |..26....|.<..>...|
|00000190| 32 37 00 00 00 01 47 52 | 01 00 1f 0c 00 00 32 38 |27....GR|......28|
|000001a0| 00 00 00 01 66 5e 01 00 | a0 0a 00 00 32 39 00 00 |....f^..|....29..|
|000001b0| 00 01 06 69 01 00 86 0d | 00 00 33 30 00 00 00 01 |...i....|..30....|
|000001c0| 8c 76 01 00 fc 0a 00 00 | 33 31 00 00 00 01 88 81 |.v......|31......|
|000001d0| 01 00 2c 0c 00 00 33 32 | 00 00 00 01 b4 8d 01 00 |..,...32|........|
|000001e0| f0 0a 00 00 33 33 00 00 | 00 01 a4 98 01 00 0e 0a |....33..|........|
|000001f0| 00 00 33 34 00 00 00 01 | b2 a2 01 00 e7 0c 00 00 |..34....|........|
|00000200| 33 35 00 00 00 01 99 af | 01 00 c8 0a 00 00 33 36 |35......|......36|
|00000210| 00 00 00 01 61 ba 01 00 | 2b 09 00 00 33 37 00 00 |....a...|+...37..|
|00000220| 00 01 8c c3 01 00 96 0c | 00 00 33 38 00 00 00 01 |........|..38....|
|00000230| 22 d0 01 00 e7 09 00 00 | 33 39 00 00 00 01 09 da |".......|39......|
|00000240| 01 00 bf 08 00 00 34 30 | 00 00 00 01 c8 e2 01 00 |......40|........|
|00000250| f8 0e 00 00 34 31 00 00 | 00 01 c0 f1 01 00 7d 0d |....41..|......}.|
|00000260| 00 00 34 32 00 00 00 01 | 3d ff 01 00 21 0c 00 00 |..42....|=...!...|
|00000270| 34 33 00 00 00 01 5e 0b | 02 00 81 0a 00 00 34 34 |43....^.|......44|
|00000280| 00 00 00 01 df 15 02 00 | 74 0a 00 00 34 35 00 00 |........|t...45..|
|00000290| 00 01 53 20 02 00 4d 0a | 00 00 34 36 00 00 00 01 |..S ..M.|..46....|
|000002a0| a0 2a 02 00 35 10 00 00 | 34 37 00 00 00 01 d5 3a |.*..5...|47.....:|
|000002b0| 02 00 4a 0f 00 00 34 38 | 00 00 00 01 1f 4a 02 00 |..J...48|.....J..|
|000002c0| c8 0b 00 00 34 39 00 00 | 00 01 e7 55 02 00 af 0a |....49..|...U....|
|000002d0| 00 00 35 30 00 00 00 01 | 96 60 02 00 19 0a 00 00 |..50....|.`......|
|000002e0| 35 31 00 00 00 01 af 6a | 02 00 37 0f 00 00 35 32 |51.....j|..7...52|
|000002f0| 00 00 00 01 e6 79 02 00 | f6 0b 00 00 35 33 00 00 |.....y..|....53..|
|00000300| 00 01 dc 85 02 00 00 0b | 00 00 35 34 00 00 00 01 |........|..54....|
|00000310| dc 90 02 00 78 0a 00 00 | 35 35 00 00 00 01 54 9b |....x...|55....T.|
|00000320| 02 00 94 0f 00 00 35 36 | 00 00 00 01 e8 aa 02 00 |......56|........|
|00000330| a7 0a 00 00 35 37 00 00 | 00 01 8f b5 02 00 57 09 |....57..|......W.|
|00000340| 00 00 35 38 00 00 00 01 | e6 be 02 00 e2 15 00 00 |..58....|........|
|00000350| 35 39 00 00 00 01 c8 d4 | 02 00 2b 10 00 00 36 30 |59......|..+...60|
|00000360| 00 00 00 01 f3 e4 02 00 | f2 0a 00 00 36 31 00 00 |........|....61..|
|00000370| 00 01 e5 ef 02 00 53 0a | 00 00 36 32 00 00 00 01 |......S.|..62....|
|00000380| 38 fa 02 00 d9 0a 00 00 | 36 33 00 00 00 01 11 05 |8.......|63......|
|00000390| 03 00 04 0d 00 00 36 34 | 00 00 00 01 15 12 03 00 |......64|........|
|000003a0| 3a 0d 00 00 36 35 00 00 | 00 01 4f 1f 03 00 fa 0a |:...65..|..O.....|
|000003b0| 00 00 36 36 00 00 00 01 | 49 2a 03 00 62 0a 00 00 |..66....|I*..b...|
|000003c0| 36 37 00 00 00 01 ab 34 | 03 00 8c 0c 00 00 36 38 |67.....4|......68|
|000003d0| 00 00 00 01 37 41 03 00 | 93 0e 00 00 36 39 00 00 |....7A..|....69..|
|000003e0| 00 01 ca 4f 03 00 2b 14 | 00 00 37 30 00 00 00 01 |...O..+.|..70....|
|000003f0| f5 63 03 00 90 0d 00 00 | 37 31 00 00 00 01 85 71 |.c......|71.....q|
|00000400| 03 00 bf 10 00 00 37 32 | 00 00 00 01 44 82 03 00 |......72|....D...|
|00000410| ae 09 00 00 37 33 00 00 | 00 01 f2 8b 03 00 0b 0d |....73..|........|
|00000420| 00 00 37 34 00 00 00 01 | fd 98 03 00 75 10 00 00 |..74....|....u...|
|00000430| 37 35 00 00 00 01 72 a9 | 03 00 25 0b 00 00 37 36 |75....r.|..%...76|
|00000440| 00 00 00 01 97 b4 03 00 | 90 08 00 00 37 37 00 00 |........|....77..|
|00000450| 00 01 27 bd 03 00 4c 0e | 00 00 37 38 00 00 00 01 |..'...L.|..78....|
|00000460| 73 cb 03 00 40 0f 00 00 | 37 39 00 00 00 01 b3 da |s...@...|79......|
|00000470| 03 00 14 11 00 00 38 30 | 00 00 00 01 c7 eb 03 00 |......80|........|
|00000480| c7 07 00 00 38 31 00 00 | 00 01 8e f3 03 00 76 07 |....81..|......v.|
|00000490| 00 00 38 32 00 00 00 01 | 04 fb 03 00 9f 0b 00 00 |..82....|........|
|000004a0| 38 33 00 00 00 01 a3 06 | 04 00 e9 0a 00 00 38 34 |83......|......84|
|000004b0| 00 00 00 01 8c 11 04 00 | d9 0c 00 00 38 35 00 00 |........|....85..|
|000004c0| 00 01 65 1e 04 00 a5 0a | 00 00 38 36 00 00 00 01 |..e.....|..86....|
|000004d0| 0a 29 04 00 f0 0d 00 00 | 38 37 00 00 00 01 fa 36 |.)......|87.....6|
|000004e0| 04 00 35 0c 00 00 38 38 | 00 00 00 01 2f 43 04 00 |..5...88|..../C..|
|000004f0| 16 0c 00 00 38 39 00 00 | 00 01 45 4f 04 00 1d 0a |....89..|..EO....|
|00000500| 00 00 39 30 00 00 00 01 | 62 59 04 00 13 0d 00 00 |..90....|bY......|
|00000510| 39 31 00 00 00 01 75 66 | 04 00 ec 0d 00 00 39 32 |91....uf|......92|
|00000520| 00 00 00 01 61 74 04 00 | 30 0c 00 00 39 33 00 00 |....at..|0...93..|
|00000530| 00 01 91 80 04 00 d2 0c | 00 00 39 34 00 00 00 01 |........|..94....|
|00000540| 63 8d 04 00 f8 0c 00 00 | 39 35 00 00 00 01 5b 9a |c.......|95....[.|
|00000550| 04 00 94 0d 00 00 39 36 | 00 00 00 01 ef a7 04 00 |......96|........|
|00000560| 04 0f 00 00 39 37 00 00 | 00 01 f3 b6 04 00 3f 0b |....97..|......?.|
|00000570| 00 00 39 38 00 00 00 01 | 32 c2 04 00 40 0b 00 00 |..98....|2...@...|
|00000580| 39 39 00 00 00 01 72 cd | 04 00 0f 0b 00 00 00 00 |99....r.|........|
|00000590| 00 00 00 00 81 d8 04 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 39 31 30 30 7d |que_ID{Y|RB09100}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 54 72 65 61 74 6d 65 |..$Title|{Treatme|
|000005c0| 6e 74 20 6f 66 20 53 63 | 61 62 69 65 73 20 57 69 |nt of Sc|abies Wi|
|000005d0| 74 68 20 50 65 72 6d 65 | 74 68 72 69 6e 20 56 65 |th Perme|thrin Ve|
|000005e0| 72 73 75 73 20 4c 69 6e | 64 61 6e 65 20 61 6e 64 |rsus Lin|dane and|
|000005f0| 20 42 65 6e 7a 79 6c 20 | 42 65 6e 7a 6f 61 74 65 | Benzyl |Benzoate|
|00000600| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 48 61 75 73 74 |}..$Auth|or{Haust|
|00000610| 65 69 6e 2c 20 55 2d 46 | 0d 0a 48 6c 61 77 61 2c |ein, U-F|..Hlawa,|
|00000620| 20 42 7d 0d 0a 24 41 66 | 66 69 6c 69 61 74 69 6f | B}..$Af|filiatio|
|00000630| 6e 7b 4b 61 72 6c 20 4d | 61 72 78 20 55 6e 69 76 |n{Karl M|arx Univ|
|00000640| 2c 20 4c 65 69 70 7a 69 | 67 2c 20 45 61 73 74 20 |, Leipzi|g, East |
|00000650| 47 65 72 6d 61 6e 79 7d | 0d 0a 24 4a 6f 75 72 6e |Germany}|..$Journ|
|00000660| 61 6c 7b 41 63 74 61 20 | 44 65 72 6d 20 56 65 6e |al{Acta |Derm Ven|
|00000670| 65 72 65 6f 6c 20 5b 53 | 74 6f 63 6b 68 5d 7d 0d |ereol [S|tockh]}.|
|00000680| 0a 24 56 6f 6c 75 6d 65 | 7b 36 39 7d 0d 0a 24 50 |.$Volume|{69}..$P|
|00000690| 61 67 65 7b 33 34 38 2d | 33 35 31 7d 0d 0a 24 44 |age{348-|351}..$D|
|000006a0| 61 74 65 7b 31 39 38 39 | 7d 0d 0a 24 59 42 56 6f |ate{1989|}..$YBVo|
|000006b0| 6c 7b 31 39 39 30 20 59 | 65 61 72 20 42 6f 6f 6b |l{1990 Y|ear Book|
|000006c0| 20 6f 66 20 44 65 72 6d | 61 74 6f 6c 6f 67 79 7d | of Derm|atology}|
|000006d0| 0d 0a 24 43 68 61 70 74 | 65 72 7b 37 2d 31 35 7d |..$Chapt|er{7-15}|
|000006e0| 0d 0a 24 59 42 45 64 69 | 74 6f 72 7b 44 72 73 2e |..$YBEdi|tor{Drs.|
|000006f0| 20 53 6f 62 65 72 20 61 | 6e 64 20 46 69 74 7a 70 | Sober a|nd Fitzp|
|00000700| 61 74 72 69 63 6b 7d 0d | 0a 24 54 61 62 6c 65 7b |atrick}.|.$Table{|
|00000710| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|00000720| 52 2e 53 2e 20 53 74 65 | 72 6e 2c 20 4d 2e 44 2e |R.S. Ste|rn, M.D.|
|00000730| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|00000740| 63 29 20 59 65 61 72 62 | 6f 6f 6b 20 4d 65 64 69 |c) Yearb|ook Medi|
|00000750| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|00000760| 49 6e 63 2e 2c 20 31 39 | 39 30 0d 0a 0d 0a 31 39 |Inc., 19|90....19|
|00000770| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|00000780| 44 65 72 6d 61 74 6f 6c | 6f 67 79 20 28 52 29 0d |Dermatol|ogy (R).|
|00000790| 0a 0d 0a 43 68 61 70 74 | 65 72 20 37 2d 2d 50 68 |...Chapt|er 7--Ph|
|000007a0| 61 72 6d 61 63 6f 6c 6f | 67 79 20 61 6e 64 20 44 |armacolo|gy and D|
|000007b0| 72 75 67 20 54 68 65 72 | 61 70 79 0d 0a 0d 0a 2d |rug Ther|apy....-|
|000007c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000007f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000800| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 54 |--------|-----..T|
|00000810| 72 65 61 74 6d 65 6e 74 | 20 6f 66 20 53 63 61 62 |reatment| of Scab|
|00000820| 69 65 73 20 57 69 74 68 | 20 50 65 72 6d 65 74 68 |ies With| Permeth|
|00000830| 72 69 6e 20 56 65 72 73 | 75 73 20 4c 69 6e 64 61 |rin Vers|us Linda|
|00000840| 6e 65 20 61 6e 64 20 42 | 65 6e 7a 79 6c 20 42 65 |ne and B|enzyl Be|
|00000850| 6e 7a 6f 61 74 65 0d 0a | 0d 0a 48 61 75 73 74 65 |nzoate..|..Hauste|
|00000860| 69 6e 20 55 2d 46 3b 20 | 48 6c 61 77 61 20 42 0d |in U-F; |Hlawa B.|
|00000870| 0a 28 4b 61 72 6c 20 4d | 61 72 78 20 55 6e 69 76 |.(Karl M|arx Univ|
|00000880| 2c 20 4c 65 69 70 7a 69 | 67 2c 20 45 61 73 74 20 |, Leipzi|g, East |
|00000890| 47 65 72 6d 61 6e 79 29 | 0d 0a 41 63 74 61 20 44 |Germany)|..Acta D|
|000008a0| 65 72 6d 20 56 65 6e 65 | 72 65 6f 6c 20 5b 53 74 |erm Vene|reol [St|
|000008b0| 6f 63 6b 68 5d 20 36 39 | 3a 33 34 38 2d 33 35 31 |ockh] 69|:348-351|
|000008c0| 2c 20 31 39 38 39 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |, 1989..|--------|
|000008d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000008f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000900| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000910| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00000920| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 4c 69 6e 64 61 |ct.... | Linda|
|00000930| 6e 65 20 68 61 73 20 6c | 6f 6e 67 20 62 65 65 6e |ne has l|ong been|
|00000940| 20 75 73 65 64 20 66 6f | 72 20 74 72 65 61 74 6d | used fo|r treatm|
|00000950| 65 6e 74 20 6f 66 20 73 | 63 61 62 69 65 73 2c 20 |ent of s|cabies, |
|00000960| 62 75 74 20 62 65 63 61 | 75 73 65 20 6f 66 20 69 |but beca|use of i|
|00000970| 74 73 0d 0a 6e 65 75 72 | 6f 74 6f 78 69 63 69 74 |ts..neur|otoxicit|
|00000980| 79 20 61 6e 64 20 70 65 | 72 63 75 74 61 6e 65 6f |y and pe|rcutaneo|
|00000990| 75 73 20 61 62 73 6f 72 | 70 74 69 6f 6e 2c 20 61 |us absor|ption, a|
|000009a0| 6c 74 65 72 6e 61 74 69 | 76 65 20 74 72 65 61 74 |lternati|ve treat|
|000009b0| 6d 65 6e 74 73 20 68 61 | 76 65 20 62 65 65 6e 0d |ments ha|ve been.|
|000009c0| 0a 73 6f 75 67 68 74 2e | 20 20 54 68 65 20 65 66 |.sought.| The ef|
|000009d0| 66 69 63 61 63 79 20 61 | 6e 64 20 73 69 64 65 20 |ficacy a|nd side |
|000009e0| 65 66 66 65 63 74 73 20 | 77 65 72 65 20 63 6f 6d |effects |were com|
|000009f0| 70 61 72 65 64 20 61 66 | 74 65 72 20 32 20 61 70 |pared af|ter 2 ap|
|00000a00| 70 6c 69 63 61 74 69 6f | 6e 73 20 6f 66 0d 0a 6c |plicatio|ns of..l|
|00000a10| 69 6e 64 61 6e 65 20 68 | 79 64 72 6f 63 68 6c 6f |indane h|ydrochlo|
|00000a20| 72 69 64 65 20 6f 69 6e | 74 6d 65 6e 74 20 31 25 |ride oin|tment 1%|
|00000a30| 20 28 30 2e 33 25 20 69 | 6e 20 63 68 69 6c 64 72 | (0.3% i|n childr|
|00000a40| 65 6e 20 69 6e 20 61 20 | 73 69 6e 67 6c 65 20 6f |en in a |single o|
|00000a50| 72 20 73 70 6c 69 74 0d | 0a 61 70 70 6c 69 63 61 |r split.|.applica|
|00000a60| 74 69 6f 6e 29 2c 20 33 | 20 61 70 70 6c 69 63 61 |tion), 3| applica|
|00000a70| 74 69 6f 6e 73 20 6f 66 | 20 62 65 6e 7a 79 6c 20 |tions of| benzyl |
|00000a80| 62 65 6e 7a 6f 61 74 65 | 20 6c 69 71 75 69 64 20 |benzoate| liquid |
|00000a90| 32 30 25 20 28 31 30 25 | 20 69 6e 20 63 68 69 6c |20% (10%| in chil|
|00000aa0| 64 72 65 6e 29 2c 0d 0a | 61 6e 64 20 31 20 61 70 |dren),..|and 1 ap|
|00000ab0| 70 6c 69 63 61 74 69 6f | 6e 20 6f 66 20 70 65 72 |plicatio|n of per|
|00000ac0| 6d 65 74 68 72 69 6e 20 | 65 6d 75 6c 73 69 6f 6e |methrin |emulsion|
|00000ad0| 20 35 25 20 28 32 2e 35 | 25 20 69 6e 20 63 68 69 | 5% (2.5|% in chi|
|00000ae0| 6c 64 72 65 6e 29 20 61 | 74 20 62 65 64 74 69 6d |ldren) a|t bedtim|
|00000af0| 65 2e 0d 0a 54 68 65 20 | 70 61 74 69 65 6e 74 73 |e...The |patients|
|00000b00| 20 69 6e 63 6c 75 64 65 | 64 20 31 31 34 20 61 64 | include|d 114 ad|
|00000b10| 75 6c 74 73 20 61 6e 64 | 20 38 30 20 63 68 69 6c |ults and| 80 chil|
|00000b20| 64 72 65 6e 20 6e 6f 20 | 6f 6c 64 65 72 20 74 68 |dren no |older th|
|00000b30| 61 6e 20 35 20 79 65 61 | 72 73 20 6f 66 20 61 67 |an 5 yea|rs of ag|
|00000b40| 65 2e 0d 0a 20 20 20 20 | 20 54 72 65 61 74 6d 65 |e... | Treatme|
|00000b50| 6e 74 20 66 61 69 6c 75 | 72 65 73 2c 20 61 73 73 |nt failu|res, ass|
|00000b60| 65 73 73 65 64 20 61 74 | 20 32 32 20 64 61 79 73 |essed at| 22 days|
|00000b70| 2c 20 6f 63 63 75 72 72 | 65 64 20 69 6e 20 33 20 |, occurr|ed in 3 |
|00000b80| 61 64 75 6c 74 73 20 61 | 6e 64 20 32 0d 0a 63 68 |adults a|nd 2..ch|
|00000b90| 69 6c 64 72 65 6e 20 74 | 72 65 61 74 65 64 20 77 |ildren t|reated w|
|00000ba0| 69 74 68 20 6c 69 6e 64 | 61 6e 65 20 62 75 74 20 |ith lind|ane but |
|00000bb0| 6e 6f 74 20 77 69 74 68 | 20 74 68 65 20 6f 74 68 |not with| the oth|
|00000bc0| 65 72 20 6d 65 64 69 63 | 61 74 69 6f 6e 73 2e 20 |er medic|ations. |
|00000bd0| 20 54 68 65 0d 0a 69 6e | 63 69 64 65 6e 63 65 20 | The..in|cidence |
|00000be0| 6f 66 20 70 6f 73 74 73 | 63 61 62 69 65 73 20 65 |of posts|cabies e|
|00000bf0| 63 7a 65 6d 61 20 61 74 | 20 64 61 79 20 38 20 77 |czema at| day 8 w|
|00000c00| 61 73 20 6d 75 63 68 20 | 68 69 67 68 65 72 20 61 |as much |higher a|
|00000c10| 66 74 65 72 20 32 30 25 | 20 62 65 6e 7a 79 6c 0d |fter 20%| benzyl.|
|00000c20| 0a 62 65 6e 7a 6f 61 74 | 65 20 74 68 61 6e 20 61 |.benzoat|e than a|
|00000c30| 66 74 65 72 20 74 68 65 | 20 6f 74 68 65 72 20 74 |fter the| other t|
|00000c40| 72 65 61 74 6d 65 6e 74 | 73 2c 20 61 6e 64 20 62 |reatment|s, and b|
|00000c50| 75 72 6e 69 6e 67 2c 20 | 72 65 64 6e 65 73 73 2c |urning, |redness,|
|00000c60| 20 61 6e 64 20 64 72 79 | 6e 65 73 73 0d 0a 77 65 | and dry|ness..we|
|00000c70| 72 65 20 73 69 67 6e 69 | 66 69 63 61 6e 74 6c 79 |re signi|ficantly|
|00000c80| 20 6d 6f 72 65 20 66 72 | 65 71 75 65 6e 74 20 61 | more fr|equent a|
|00000c90| 66 74 65 72 20 62 65 6e | 7a 79 6c 20 62 65 6e 7a |fter ben|zyl benz|
|00000ca0| 6f 61 74 65 20 74 72 65 | 61 74 6d 65 6e 74 2e 0d |oate tre|atment..|
|00000cb0| 0a 20 20 20 20 20 50 65 | 72 6d 65 74 68 72 69 6e |. Pe|rmethrin|
|00000cc0| 20 69 73 20 61 6e 20 65 | 66 66 65 63 74 69 76 65 | is an e|ffective|
|00000cd0| 2c 20 72 65 6c 69 61 62 | 6c 65 20 74 72 65 61 74 |, reliab|le treat|
|00000ce0| 6d 65 6e 74 20 66 6f 72 | 20 73 63 61 62 69 65 73 |ment for| scabies|
|00000cf0| 2e 20 20 49 74 20 69 73 | 0d 0a 70 72 65 66 65 72 |. It is|..prefer|
|00000d00| 72 65 64 20 74 6f 20 62 | 65 6e 7a 79 6c 20 62 65 |red to b|enzyl be|
|00000d10| 6e 7a 6f 61 74 65 20 62 | 65 63 61 75 73 65 20 6f |nzoate b|ecause o|
|00000d20| 66 20 74 68 65 20 6c 61 | 74 74 65 72 27 73 20 6f |f the la|tter's o|
|00000d30| 64 6f 72 20 61 6e 64 20 | 69 72 72 69 74 61 74 69 |dor and |irritati|
|00000d40| 6e 67 0d 0a 71 75 61 6c | 69 74 79 2e 20 20 50 65 |ng..qual|ity. Pe|
|00000d50| 72 6d 65 74 68 72 69 6e | 20 69 73 20 65 73 70 65 |rmethrin| is espe|
|00000d60| 63 69 61 6c 6c 79 20 73 | 75 69 74 61 62 6c 65 20 |cially s|uitable |
|00000d70| 66 6f 72 20 69 6e 66 61 | 6e 74 73 20 61 6e 64 20 |for infa|nts and |
|00000d80| 73 6d 61 6c 6c 20 63 68 | 69 6c 64 72 65 6e 2c 0d |small ch|ildren,.|
|00000d90| 0a 70 61 74 69 65 6e 74 | 73 20 77 69 74 68 20 6e |.patient|s with n|
|00000da0| 65 75 72 6f 6c 6f 67 69 | 63 20 64 69 73 6f 72 64 |eurologi|c disord|
|00000db0| 65 72 73 2c 20 61 6e 64 | 20 74 68 6f 73 65 20 69 |ers, and| those i|
|00000dc0| 6e 20 77 68 6f 6d 20 6c | 69 6e 64 61 6e 65 20 74 |n whom l|indane t|
|00000dd0| 72 65 61 74 6d 65 6e 74 | 20 68 61 73 0d 0a 66 61 |reatment| has..fa|
|00000de0| 69 6c 65 64 2e 0d 0a 0d | 0a 50 6f 73 74 2d 43 6f |iled....|.Post-Co|
|00000df0| 6d 6d 65 6e 74 0d 0a 0d | 0a 20 20 20 20 20 54 68 |mment...|. Th|
|00000e00| 69 73 20 73 74 75 64 79 | 20 61 6e 64 20 73 75 62 |is study| and sub|
|00000e10| 73 65 71 75 65 6e 74 20 | 73 74 75 64 69 65 73 20 |sequent |studies |
|00000e20| 6f 66 20 73 79 6e 74 68 | 65 74 69 63 20 70 65 72 |of synth|etic per|
|00000e30| 6d 65 74 68 72 69 6e 73 | 20 70 72 6f 76 69 64 65 |methrins| provide|
|00000e40| 0d 0a 65 76 69 64 65 6e | 63 65 20 66 6f 72 20 74 |..eviden|ce for t|
|00000e50| 68 65 20 65 61 73 65 20 | 6f 66 20 75 73 65 2c 20 |he ease |of use, |
|00000e60| 61 70 70 61 72 65 6e 74 | 20 6c 6f 77 20 74 6f 78 |apparent| low tox|
|00000e70| 69 63 69 74 79 2c 20 61 | 6e 64 20 68 69 67 68 20 |icity, a|nd high |
|00000e80| 65 66 66 69 63 61 63 79 | 20 6f 66 0d 0a 74 68 65 |efficacy| of..the|
|00000e90| 73 65 20 61 67 65 6e 74 | 73 20 69 6e 20 73 63 61 |se agent|s in sca|
|00000ea0| 62 69 65 73 20 74 68 65 | 72 61 70 79 2e 2d 2d 52 |bies the|rapy.--R|
|00000eb0| 2e 53 2e 20 53 74 65 72 | 6e 2c 20 4d 2e 44 2e 0d |.S. Ster|n, M.D..|
|00000ec0| 0a 24 55 6e 69 71 75 65 | 5f 49 44 7b 59 52 42 30 |.$Unique|_ID{YRB0|
|00000ed0| 39 31 30 31 7d 0d 0a 24 | 54 69 74 6c 65 7b 43 72 |9101}..$|Title{Cr|
|00000ee0| 65 65 70 69 6e 67 20 45 | 72 75 70 74 69 6f 6e 20 |eeping E|ruption |
|00000ef0| 53 74 6f 70 70 65 64 20 | 69 6e 20 49 74 73 20 54 |Stopped |in Its T|
|00000f00| 72 61 63 6b 73 20 62 79 | 20 41 6c 62 65 6e 64 61 |racks by| Albenda|
|00000f10| 7a 6f 6c 65 7d 0d 0a 24 | 41 75 74 68 6f 72 7b 57 |zole}..$|Author{W|
|00000f20| 69 6c 6c 69 61 6d 73 2c | 20 48 43 0d 0a 4d 6f 6e |illiams,| HC..Mon|
|00000f30| 6b 2c 20 42 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |k, B}..$|Affiliat|
|00000f40| 69 6f 6e 7b 4b 69 6e 67 | 73 20 43 6f 6c 6c 65 67 |ion{King|s Colleg|
|00000f50| 65 20 48 6f 73 70 2c 20 | 4c 6f 6e 64 6f 6e 3b 20 |e Hosp, |London; |
|00000f60| 42 65 64 66 6f 72 64 20 | 47 65 6e 20 48 6f 73 70 |Bedford |Gen Hosp|
|00000f70| 2c 20 42 65 64 66 6f 72 | 64 2c 20 45 6e 67 6c 61 |, Bedfor|d, Engla|
|00000f80| 6e 64 7d 0d 0a 24 4a 6f | 75 72 6e 61 6c 7b 43 6c |nd}..$Jo|urnal{Cl|
|00000f90| 69 6e 20 45 78 70 20 44 | 65 72 6d 61 74 6f 6c 7d |in Exp D|ermatol}|
|00000fa0| 0d 0a 24 56 6f 6c 75 6d | 65 7b 31 34 7d 0d 0a 24 |..$Volum|e{14}..$|
|00000fb0| 50 61 67 65 7b 33 35 35 | 2d 33 35 36 7d 0d 0a 24 |Page{355|-356}..$|
|00000fc0| 44 61 74 65 7b 53 65 70 | 74 65 6d 62 65 72 20 31 |Date{Sep|tember 1|
|00000fd0| 39 38 39 7d 0d 0a 24 59 | 42 56 6f 6c 7b 31 39 39 |989}..$Y|BVol{199|
|00000fe0| 30 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 44 |0 Year B|ook of D|
|00000ff0| 65 72 6d 61 74 6f 6c 6f | 67 79 7d 0d 0a 24 43 68 |ermatolo|gy}..$Ch|
|00001000| 61 70 74 65 72 7b 37 2d | 31 36 7d 0d 0a 24 59 42 |apter{7-|16}..$YB|
|00001010| 45 64 69 74 6f 72 7b 44 | 72 73 2e 20 53 6f 62 65 |Editor{D|rs. Sobe|
|00001020| 72 20 61 6e 64 20 46 69 | 74 7a 70 61 74 72 69 63 |r and Fi|tzpatric|
|00001030| 6b 7d 0d 0a 24 54 61 62 | 6c 65 7b 7d 0d 0a 24 43 |k}..$Tab|le{}..$C|
|00001040| 6f 6d 6d 65 6e 74 61 74 | 6f 72 7b 53 2e 4c 2e 20 |ommentat|or{S.L. |
|00001050| 4d 6f 73 63 68 65 6c 6c | 61 2c 20 4d 2e 44 2e 7d |Moschell|a, M.D.}|
|00001060| 0d 0a 0d 0a 43 6f 70 79 | 72 69 67 68 74 20 28 63 |....Copy|right (c|
|00001070| 29 20 59 65 61 72 62 6f | 6f 6b 20 4d 65 64 69 63 |) Yearbo|ok Medic|
|00001080| 61 6c 20 50 75 62 6c 69 | 73 68 65 72 73 2c 20 49 |al Publi|shers, I|
|00001090| 6e 63 2e 2c 20 31 39 39 | 30 0d 0a 0d 0a 31 39 39 |nc., 199|0....199|
|000010a0| 30 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 44 |0 Year B|ook of D|
|000010b0| 65 72 6d 61 74 6f 6c 6f | 67 79 20 28 52 29 0d 0a |ermatolo|gy (R)..|
|000010c0| 0d 0a 43 68 61 70 74 65 | 72 20 37 2d 2d 50 68 61 |..Chapte|r 7--Pha|
|000010d0| 72 6d 61 63 6f 6c 6f 67 | 79 20 61 6e 64 20 44 72 |rmacolog|y and Dr|
|000010e0| 75 67 20 54 68 65 72 61 | 70 79 0d 0a 0d 0a 2d 2d |ug Thera|py....--|
|000010f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001100| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001110| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001120| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001130| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 43 72 |--------|----..Cr|
|00001140| 65 65 70 69 6e 67 20 45 | 72 75 70 74 69 6f 6e 20 |eeping E|ruption |
|00001150| 53 74 6f 70 70 65 64 20 | 69 6e 20 49 74 73 20 54 |Stopped |in Its T|
|00001160| 72 61 63 6b 73 20 62 79 | 20 41 6c 62 65 6e 64 61 |racks by| Albenda|
|00001170| 7a 6f 6c 65 0d 0a 0d 0a | 57 69 6c 6c 69 61 6d 73 |zole....|Williams|
|00001180| 20 48 43 3b 20 4d 6f 6e | 6b 20 42 0d 0a 28 4b 69 | HC; Mon|k B..(Ki|
|00001190| 6e 67 73 20 43 6f 6c 6c | 65 67 65 20 48 6f 73 70 |ngs Coll|ege Hosp|
|000011a0| 2c 20 4c 6f 6e 64 6f 6e | 3b 20 42 65 64 66 6f 72 |, London|; Bedfor|
|000011b0| 64 20 47 65 6e 20 48 6f | 73 70 2c 20 42 65 64 66 |d Gen Ho|sp, Bedf|
|000011c0| 6f 72 64 2c 20 45 6e 67 | 6c 61 6e 64 29 0d 0a 43 |ord, Eng|land)..C|
|000011d0| 6c 69 6e 20 45 78 70 20 | 44 65 72 6d 61 74 6f 6c |lin Exp |Dermatol|
|000011e0| 20 31 34 3a 33 35 35 2d | 33 35 36 2c 20 53 65 70 | 14:355-|356, Sep|
|000011f0| 74 65 6d 62 65 72 20 31 | 39 38 39 0d 0a 2d 2d 2d |tember 1|989..---|
|00001200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001220| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001230| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001240| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 0d 0a 41 |--------|---....A|
|00001250| 62 73 74 72 61 63 74 0d | 0a 0d 0a 20 20 20 20 20 |bstract.|... |
|00001260| 42 65 63 61 75 73 65 20 | 6d 6f 72 65 20 61 6e 64 |Because |more and|
|00001270| 20 6d 6f 72 65 20 70 65 | 6f 70 6c 65 20 61 72 65 | more pe|ople are|
|00001280| 20 74 61 6b 69 6e 67 20 | 61 64 76 61 6e 74 61 67 | taking |advantag|
|00001290| 65 20 6f 66 20 6c 6f 77 | 20 61 69 72 20 66 61 72 |e of low| air far|
|000012a0| 65 73 20 74 6f 0d 0a 65 | 78 6f 74 69 63 20 64 65 |es to..e|xotic de|
|000012b0| 73 74 69 6e 61 74 69 6f | 6e 73 2c 20 63 72 65 65 |stinatio|ns, cree|
|000012c0| 70 69 6e 67 20 65 72 75 | 70 74 69 6f 6e 20 64 69 |ping eru|ption di|
|000012d0| 73 65 61 73 65 20 69 73 | 20 62 65 63 6f 6d 69 6e |sease is| becomin|
|000012e0| 67 20 63 6f 6d 6d 6f 6e | 20 69 6e 20 42 72 69 74 |g common| in Brit|
|000012f0| 61 69 6e 2e 0d 0a 54 72 | 65 61 74 6d 65 6e 74 20 |ain...Tr|eatment |
|00001300| 6f 66 20 35 20 70 61 74 | 69 65 6e 74 73 20 61 67 |of 5 pat|ients ag|
|00001310| 65 64 20 31 39 2d 34 34 | 20 77 69 74 68 20 61 20 |ed 19-44| with a |
|00001320| 6e 65 77 20 61 6e 74 69 | 68 65 6c 6d 69 6e 74 68 |new anti|helminth|
|00001330| 69 63 20 61 67 65 6e 74 | 2c 0d 0a 61 6c 62 65 6e |ic agent|,..alben|
|00001340| 64 61 7a 6f 6c 65 2c 20 | 77 61 73 20 63 61 72 72 |dazole, |was carr|
|00001350| 69 65 64 20 6f 75 74 2e | 20 20 54 68 72 65 65 20 |ied out.| Three |
|00001360| 70 61 74 69 65 6e 74 73 | 20 68 61 64 20 72 65 63 |patients| had rec|
|00001370| 65 6e 74 6c 79 20 62 65 | 65 6e 20 74 6f 20 42 61 |ently be|en to Ba|
|00001380| 72 62 61 64 6f 73 2c 20 | 31 0d 0a 74 6f 20 54 68 |rbados, |1..to Th|
|00001390| 61 69 6c 61 6e 64 2c 20 | 61 6e 64 20 31 20 74 6f |ailand, |and 1 to|
|000013a0| 20 41 6e 74 69 67 75 61 | 2e 0d 0a 20 20 20 20 20 | Antigua|... |
|000013b0| 54 68 65 20 66 69 72 73 | 74 20 70 61 74 69 65 6e |The firs|t patien|
|000013c0| 74 20 68 61 64 20 35 20 | 69 6e 64 65 70 65 6e 64 |t had 5 |independ|
|000013d0| 65 6e 74 20 73 65 72 70 | 69 67 69 6e 6f 75 73 20 |ent serp|iginous |
|000013e0| 74 72 61 63 6b 73 20 61 | 6e 64 20 61 20 73 65 63 |tracks a|nd a sec|
|000013f0| 6f 6e 64 61 72 79 0d 0a | 69 6e 66 65 63 74 69 6f |ondary..|infectio|
|00001400| 6e 20 66 72 6f 6d 20 65 | 78 63 6f 72 69 61 74 69 |n from e|xcoriati|
|00001410| 6f 6e 2e 20 20 41 6c 62 | 65 6e 64 61 7a 6f 6c 65 |on. Alb|endazole|
|00001420| 2c 20 34 30 30 20 6d 67 | 20 74 77 69 63 65 20 61 |, 400 mg| twice a|
|00001430| 20 64 61 79 20 6f 72 61 | 6c 6c 79 20 66 6f 72 20 | day ora|lly for |
|00001440| 33 0d 0a 64 61 79 73 2c | 20 70 72 6f 64 75 63 65 |3..days,| produce|
|00001450| 64 20 64 72 61 6d 61 74 | 69 63 20 72 65 6c 69 65 |d dramat|ic relie|
|00001460| 66 20 6f 66 20 70 72 75 | 72 69 74 75 73 20 61 6e |f of pru|ritus an|
|00001470| 64 20 63 65 73 73 61 74 | 69 6f 6e 20 6f 66 20 77 |d cessat|ion of w|
|00001480| 6f 72 6d 20 6d 6f 76 65 | 6d 65 6e 74 0d 0a 77 69 |orm move|ment..wi|
|00001490| 74 68 69 6e 20 32 34 20 | 68 6f 75 72 73 20 77 69 |thin 24 |hours wi|
|000014a0| 74 68 6f 75 74 20 73 69 | 64 65 20 65 66 66 65 63 |thout si|de effec|
|000014b0| 74 73 2e 20 20 54 68 65 | 20 73 65 63 6f 6e 64 20 |ts. The| second |
|000014c0| 77 6f 6d 61 6e 20 68 61 | 64 20 61 20 73 6f 6c 69 |woman ha|d a soli|
|000014d0| 74 61 72 79 20 6c 65 73 | 69 6f 6e 0d 0a 6f 6e 20 |tary les|ion..on |
|000014e0| 74 68 65 20 61 62 64 6f | 6d 65 6e 20 33 20 77 65 |the abdo|men 3 we|
|000014f0| 65 6b 73 20 61 66 74 65 | 72 20 72 65 74 75 72 6e |eks afte|r return|
|00001500| 69 6e 67 20 66 72 6f 6d | 20 54 68 61 69 6c 61 6e |ing from| Thailan|
|00001510| 64 2e 20 20 54 68 65 20 | 69 74 63 68 69 6e 67 20 |d. The |itching |
|00001520| 77 61 73 20 73 6f 0d 0a | 69 6e 74 65 6e 73 65 20 |was so..|intense |
|00001530| 74 68 61 74 20 73 68 65 | 20 68 61 64 20 62 65 65 |that she| had bee|
|00001540| 6e 20 75 6e 61 62 6c 65 | 20 74 6f 20 73 6c 65 65 |n unable| to slee|
|00001550| 70 20 66 6f 72 20 73 65 | 76 65 72 61 6c 20 64 61 |p for se|veral da|
|00001560| 79 73 2e 20 20 41 6c 62 | 65 6e 64 61 7a 6f 6c 65 |ys. Alb|endazole|
|00001570| 0d 0a 6f 72 61 6c 6c 79 | 20 66 6f 72 20 33 20 64 |..orally| for 3 d|
|00001580| 61 79 73 20 77 61 73 20 | 63 75 72 61 74 69 76 65 |ays was |curative|
|00001590| 3b 20 68 65 72 20 73 79 | 6d 70 74 6f 6d 73 20 72 |; her sy|mptoms r|
|000015a0| 65 73 6f 6c 76 65 64 20 | 77 69 74 68 69 6e 20 32 |esolved |within 2|
|000015b0| 34 20 68 6f 75 72 73 2e | 20 20 54 68 65 0d 0a 74 |4 hours.| The..t|
|000015c0| 68 69 72 64 20 70 61 74 | 69 65 6e 74 20 68 61 64 |hird pat|ient had|
|000015d0| 20 61 20 74 79 70 69 63 | 61 6c 20 63 72 65 65 70 | a typic|al creep|
|000015e0| 69 6e 67 20 65 72 75 70 | 74 69 6f 6e 20 6f 6e 20 |ing erup|tion on |
|000015f0| 74 68 65 20 66 6f 6f 74 | 20 74 68 61 74 20 64 69 |the foot| that di|
|00001600| 64 20 6e 6f 74 20 72 65 | 73 70 6f 6e 64 0d 0a 74 |d not re|spond..t|
|00001610| 6f 20 74 6f 70 69 63 61 | 6c 20 31 30 25 20 74 68 |o topica|l 10% th|
|00001620| 69 61 62 65 6e 64 61 7a | 6f 6c 65 3b 20 73 68 65 |iabendaz|ole; she|
|00001630| 20 77 61 73 20 63 75 72 | 65 64 2c 20 68 6f 77 65 | was cur|ed, howe|
|00001640| 76 65 72 2c 20 77 69 74 | 68 20 6f 72 61 6c 20 61 |ver, wit|h oral a|
|00001650| 6c 62 65 6e 64 61 7a 6f | 6c 65 2e 0d 0a 54 68 65 |lbendazo|le...The|
|00001660| 20 66 6f 75 72 74 68 20 | 61 6e 64 20 66 69 66 74 | fourth |and fift|
|00001670| 68 20 70 61 74 69 65 6e | 74 73 2c 20 74 72 61 76 |h patien|ts, trav|
|00001680| 65 6c 69 6e 67 20 74 6f | 67 65 74 68 65 72 2c 20 |eling to|gether, |
|00001690| 72 65 74 75 72 6e 65 64 | 20 66 72 6f 6d 20 42 61 |returned| from Ba|
|000016a0| 72 62 61 64 6f 73 20 77 | 69 74 68 0d 0a 74 79 70 |rbados w|ith..typ|
|000016b0| 69 63 61 6c 20 63 72 65 | 65 70 69 6e 67 20 65 72 |ical cre|eping er|
|000016c0| 75 70 74 69 6f 6e 20 61 | 6e 64 20 64 69 73 74 72 |uption a|nd distr|
|000016d0| 65 73 73 69 6e 67 20 70 | 72 75 72 69 74 75 73 2e |essing p|ruritus.|
|000016e0| 20 20 49 74 63 68 69 6e | 67 20 61 6e 64 20 6d 6f | Itchin|g and mo|
|000016f0| 76 65 6d 65 6e 74 0d 0a | 72 65 73 6f 6c 76 65 64 |vement..|resolved|
|00001700| 20 77 69 74 68 69 6e 20 | 34 38 20 68 6f 75 72 73 | within |48 hours|
|00001710| 20 6f 66 20 6f 72 61 6c | 20 61 6c 62 65 6e 64 61 | of oral| albenda|
|00001720| 7a 6f 6c 65 20 74 68 65 | 72 61 70 79 2e 0d 0a 20 |zole the|rapy... |
|00001730| 20 20 20 20 43 72 65 65 | 70 69 6e 67 20 65 72 75 | Cree|ping eru|
|00001740| 70 74 69 6f 6e 20 69 73 | 20 74 68 65 20 64 69 73 |ption is| the dis|
|00001750| 74 69 6e 63 74 69 76 65 | 20 73 65 72 70 69 67 69 |tinctive| serpigi|
|00001760| 6e 6f 75 73 20 65 72 75 | 70 74 69 6f 6e 20 63 61 |nous eru|ption ca|
|00001770| 75 73 65 64 20 62 79 20 | 74 68 65 0d 0a 61 63 63 |used by |the..acc|
|00001780| 69 64 65 6e 74 61 6c 20 | 69 6e 76 61 73 69 6f 6e |idental |invasion|
|00001790| 20 6f 66 20 73 6b 69 6e | 20 62 79 20 70 61 72 61 | of skin| by para|
|000017a0| 73 69 74 65 73 2e 20 20 | 54 68 65 20 6d 6f 73 74 |sites. |The most|
|000017b0| 20 63 6f 6d 6d 6f 6e 20 | 70 61 72 61 73 69 74 65 | common |parasite|
|000017c0| 73 20 61 72 65 20 64 6f | 67 0d 0a 61 6e 64 20 63 |s are do|g..and c|
|000017d0| 61 74 20 68 6f 6f 6b 77 | 6f 72 6d 20 6c 61 72 76 |at hookw|orm larv|
|000017e0| 61 65 2e 20 20 54 68 65 | 20 77 6f 72 6d 73 20 75 |ae. The| worms u|
|000017f0| 6c 74 69 6d 61 74 65 6c | 79 20 64 69 65 2c 20 62 |ltimatel|y die, b|
|00001800| 75 74 20 69 6e 20 74 68 | 65 20 6d 65 61 6e 74 69 |ut in th|e meanti|
|00001810| 6d 65 20 74 68 65 0d 0a | 70 61 74 69 65 6e 74 20 |me the..|patient |
|00001820| 65 78 70 65 72 69 65 6e | 63 65 73 20 69 6e 74 65 |experien|ces inte|
|00001830| 6e 73 65 20 70 72 75 72 | 69 74 75 73 20 61 6e 64 |nse prur|itus and|
|00001840| 20 74 68 65 20 73 65 6e | 73 61 74 69 6f 6e 20 6f | the sen|sation o|
|00001850| 66 20 77 6f 72 6d 73 20 | 63 72 61 77 6c 69 6e 67 |f worms |crawling|
|00001860| 0d 0a 74 68 72 6f 75 67 | 68 20 74 68 65 20 73 6b |..throug|h the sk|
|00001870| 69 6e 2e 20 20 41 6c 62 | 65 6e 64 61 7a 6f 6c 65 |in. Alb|endazole|
|00001880| 20 69 6e 20 61 20 64 6f | 73 61 67 65 20 6f 66 20 | in a do|sage of |
|00001890| 34 30 30 20 6d 67 20 74 | 77 69 63 65 20 64 61 69 |400 mg t|wice dai|
|000018a0| 6c 79 20 66 6f 72 20 33 | 20 64 61 79 73 20 69 73 |ly for 3| days is|
|000018b0| 0d 0a 61 20 72 61 70 69 | 64 2c 20 73 61 66 65 20 |..a rapi|d, safe |
|000018c0| 74 72 65 61 74 6d 65 6e | 74 20 66 6f 72 20 74 68 |treatmen|t for th|
|000018d0| 69 73 20 75 6e 70 6c 65 | 61 73 61 6e 74 20 63 6f |is unple|asant co|
|000018e0| 6e 64 69 74 69 6f 6e 2e | 0d 0a 0d 0a 50 6f 73 74 |ndition.|....Post|
|000018f0| 2d 43 6f 6d 6d 65 6e 74 | 0d 0a 0d 0a 20 20 20 20 |-Comment|.... |
|00001900| 20 43 72 65 65 70 69 6e | 67 20 65 72 75 70 74 69 | Creepin|g erupti|
|00001910| 6f 6e 20 28 63 75 74 61 | 6e 65 6f 75 73 20 6c 61 |on (cuta|neous la|
|00001920| 72 76 61 20 6d 69 67 72 | 61 6e 73 29 20 69 73 20 |rva migr|ans) is |
|00001930| 6e 6f 74 20 75 6e 63 6f | 6d 6d 6f 6e 20 69 6e 20 |not unco|mmon in |
|00001940| 74 68 65 0d 0a 4e 6f 72 | 74 68 65 61 73 74 20 61 |the..Nor|theast a|
|00001950| 6e 64 20 69 6e 20 74 68 | 65 20 46 6c 6f 72 69 64 |nd in th|e Florid|
|00001960| 61 20 47 75 6c 66 20 63 | 6f 61 73 74 61 6c 20 61 |a Gulf c|oastal a|
|00001970| 72 65 61 73 2c 20 61 6e | 64 20 69 6e 20 43 61 72 |reas, an|d in Car|
|00001980| 69 62 62 65 61 6e 20 76 | 61 63 61 74 69 6f 6e 65 |ibbean v|acatione|
|00001990| 72 73 2e 0d 0a 43 75 72 | 72 65 6e 74 6c 79 2c 20 |rs...Cur|rently, |
|000019a0| 69 73 6f 6c 61 74 65 64 | 20 6c 65 73 69 6f 6e 73 |isolated| lesions|
|000019b0| 20 61 6e 64 20 67 65 6e | 65 72 61 6c 69 7a 65 64 | and gen|eralized|
|000019c0| 20 6c 65 73 69 6f 6e 73 | 20 61 72 65 20 74 72 65 | lesions| are tre|
|000019d0| 61 74 65 64 20 77 69 74 | 68 20 74 6f 70 69 63 61 |ated wit|h topica|
|000019e0| 6c 0d 0a 61 6e 64 20 6f | 72 61 6c 20 74 68 69 61 |l..and o|ral thia|
|000019f0| 62 65 6e 64 61 7a 6f 6c | 65 2c 20 72 65 73 70 65 |bendazol|e, respe|
|00001a00| 63 74 69 76 65 6c 79 2e | 20 20 55 6e 66 6f 72 74 |ctively.| Unfort|
|00001a10| 75 6e 61 74 65 6c 79 2c | 20 6f 72 61 6c 20 74 68 |unately,| oral th|
|00001a20| 69 61 62 65 6e 64 61 7a | 6f 6c 65 0d 0a 63 61 75 |iabendaz|ole..cau|
|00001a30| 73 65 73 20 73 69 64 65 | 20 65 66 66 65 63 74 73 |ses side| effects|
|00001a40| 20 72 65 6c 61 74 69 76 | 65 6c 79 20 66 72 65 71 | relativ|ely freq|
|00001a50| 75 65 6e 74 6c 79 20 69 | 6e 63 6c 75 64 69 6e 67 |uently i|ncluding|
|00001a60| 20 6e 61 75 73 65 61 2c | 20 76 6f 6d 69 74 69 6e | nausea,| vomitin|
|00001a70| 67 2c 20 61 6e 64 0d 0a | 76 65 72 74 69 67 6f 3b |g, and..|vertigo;|
|00001a80| 20 70 6f 74 65 6e 74 69 | 61 6c 6c 79 20 73 65 76 | potenti|ally sev|
|00001a90| 65 72 65 20 73 69 64 65 | 20 65 66 66 65 63 74 73 |ere side| effects|
|00001aa0| 20 73 75 63 68 20 61 73 | 20 6c 65 75 6b 6f 70 65 | such as| leukope|
|00001ab0| 6e 69 61 2c 20 68 61 6c | 6c 75 63 69 6e 61 74 69 |nia, hal|lucinati|
|00001ac0| 6f 6e 73 2c 0d 0a 6f 6c | 66 61 63 74 6f 72 79 20 |ons,..ol|factory |
|00001ad0| 64 69 73 74 75 72 62 61 | 6e 63 65 73 2c 20 74 69 |disturba|nces, ti|
|00001ae0| 6e 6e 69 74 75 73 2c 20 | 53 74 65 76 65 6e 2d 4a |nnitus, |Steven-J|
|00001af0| 6f 68 6e 73 6f 6e 20 73 | 79 6e 64 72 6f 6d 65 2c |ohnson s|yndrome,|
|00001b00| 20 61 6e 64 20 73 68 6f | 63 6b 20 61 6c 73 6f 20 | and sho|ck also |
|00001b10| 6d 61 79 0d 0a 64 65 76 | 65 6c 6f 70 2e 20 20 54 |may..dev|elop. T|
|00001b20| 68 65 20 62 65 6e 7a 69 | 6d 69 64 61 7a 6f 6c 65 |he benzi|midazole|
|00001b30| 73 2c 20 6f 72 61 6c 20 | 61 6c 62 65 6e 64 61 7a |s, oral |albendaz|
|00001b40| 6f 6c 65 20 61 6e 64 20 | 6d 65 62 65 6e 64 61 7a |ole and |mebendaz|
|00001b50| 6f 6c 65 2c 20 61 6e 64 | 0d 0a 69 6e 74 72 61 6d |ole, and|..intram|
|00001b60| 75 73 63 75 6c 61 72 20 | 66 6c 75 62 65 6e 64 61 |uscular |flubenda|
|00001b70| 7a 6f 6c 65 20 61 72 65 | 20 65 66 66 65 63 74 69 |zole are| effecti|
|00001b80| 76 65 20 69 6e 20 76 61 | 72 69 6f 75 73 20 69 6e |ve in va|rious in|
|00001b90| 74 65 73 74 69 6e 61 6c | 20 61 6e 64 0d 0a 65 78 |testinal| and..ex|
|00001ba0| 74 72 61 69 6e 74 65 73 | 74 69 6e 61 6c 20 70 61 |traintes|tinal pa|
|00001bb0| 72 61 73 69 74 6f 73 69 | 73 2e 20 20 41 6c 62 65 |rasitosi|s. Albe|
|00001bc0| 6e 64 61 7a 6f 6c 65 2c | 20 69 6e 20 74 68 65 20 |ndazole,| in the |
|00001bd0| 74 68 65 72 61 70 65 75 | 74 69 63 20 64 6f 73 65 |therapeu|tic dose|
|00001be0| 20 6f 66 20 34 30 30 20 | 6d 67 0d 0a 74 77 69 63 | of 400 |mg..twic|
|00001bf0| 65 20 64 61 69 6c 79 2c | 20 69 73 20 74 68 65 20 |e daily,| is the |
|00001c00| 62 65 73 74 20 74 6f 6c | 65 72 61 74 65 64 20 61 |best tol|erated a|
|00001c10| 6e 64 20 6c 65 61 73 74 | 20 74 6f 78 69 63 2c 20 |nd least| toxic, |
|00001c20| 61 6e 64 20 61 70 70 61 | 72 65 6e 74 6c 79 20 69 |and appa|rently i|
|00001c30| 73 20 76 65 72 79 0d 0a | 65 66 66 65 63 74 69 76 |s very..|effectiv|
|00001c40| 65 20 61 67 61 69 6e 73 | 74 20 63 72 65 65 70 69 |e agains|t creepi|
|00001c50| 6e 67 20 65 72 75 70 74 | 69 6f 6e 2e 2d 2d 53 2e |ng erupt|ion.--S.|
|00001c60| 4c 2e 20 4d 6f 73 63 68 | 65 6c 6c 61 2c 20 4d 2e |L. Mosch|ella, M.|
|00001c70| 44 2e 0d 0a 24 55 6e 69 | 71 75 65 5f 49 44 7b 59 |D...$Uni|que_ID{Y|
|00001c80| 52 42 30 39 31 30 32 7d | 0d 0a 24 54 69 74 6c 65 |RB09102}|..$Title|
|00001c90| 7b 43 75 74 61 6e 65 6f | 75 73 20 44 72 75 67 20 |{Cutaneo|us Drug |
|00001ca0| 52 65 61 63 74 69 6f 6e | 73 3a 20 20 43 6c 69 6e |Reaction|s: Clin|
|00001cb0| 69 63 61 6c 20 54 79 70 | 65 73 20 61 6e 64 20 43 |ical Typ|es and C|
|00001cc0| 61 75 73 61 74 69 76 65 | 20 41 67 65 6e 74 73 3a |ausative| Agents:|
|00001cd0| 20 20 41 20 46 69 76 65 | 2d 59 65 61 72 20 53 75 | A Five|-Year Su|
|00001ce0| 72 76 65 79 20 6f 66 20 | 49 6e 2d 50 61 74 69 65 |rvey of |In-Patie|
|00001cf0| 6e 74 73 20 28 31 39 38 | 31 2d 31 39 38 35 29 7d |nts (198|1-1985)}|
|00001d00| 0d 0a 24 41 75 74 68 6f | 72 7b 41 6c 61 6e 6b 6f |..$Autho|r{Alanko|
|00001d10| 2c 20 4b 0d 0a 53 74 75 | 62 62 2c 20 53 0d 0a 4b |, K..Stu|bb, S..K|
|00001d20| 61 75 70 70 69 6e 65 6e | 2c 20 4b 7d 0d 0a 24 41 |auppinen|, K}..$A|
|00001d30| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 55 6e 69 76 20 |ffiliati|on{Univ |
|00001d40| 43 65 6e 74 72 61 6c 20 | 48 6f 73 70 20 48 65 6c |Central |Hosp Hel|
|00001d50| 73 69 6e 6b 69 7d 0d 0a | 24 4a 6f 75 72 6e 61 6c |sinki}..|$Journal|
|00001d60| 7b 41 63 74 61 20 44 65 | 72 6d 20 56 65 6e 65 72 |{Acta De|rm Vener|
|00001d70| 65 6f 6c 20 28 53 74 6f | 63 6b 68 29 7d 0d 0a 24 |eol (Sto|ckh)}..$|
|00001d80| 56 6f 6c 75 6d 65 7b 36 | 39 7d 0d 0a 24 50 61 67 |Volume{6|9}..$Pag|
|00001d90| 65 7b 32 32 33 2d 32 32 | 36 7d 0d 0a 24 44 61 74 |e{223-22|6}..$Dat|
|00001da0| 65 7b 31 39 38 39 7d 0d | 0a 24 59 42 56 6f 6c 7b |e{1989}.|.$YBVol{|
|00001db0| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|00001dc0| 66 20 44 65 72 6d 61 74 | 6f 6c 6f 67 79 7d 0d 0a |f Dermat|ology}..|
|00001dd0| 24 43 68 61 70 74 65 72 | 7b 38 2d 31 7d 0d 0a 24 |$Chapter|{8-1}..$|
|00001de0| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 53 6f |YBEditor|{Drs. So|
|00001df0| 62 65 72 20 61 6e 64 20 | 46 69 74 7a 70 61 74 72 |ber and |Fitzpatr|
|00001e00| 69 63 6b 7d 0d 0a 24 54 | 61 62 6c 65 7b 54 61 62 |ick}..$T|able{Tab|
|00001e10| 6c 65 20 4f 6d 69 74 74 | 65 64 7d 0d 0a 24 43 6f |le Omitt|ed}..$Co|
|00001e20| 6d 6d 65 6e 74 61 74 6f | 72 7b 52 2e 53 2e 20 53 |mmentato|r{R.S. S|
|00001e30| 74 65 72 6e 2c 20 4d 2e | 44 2e 7d 0d 0a 0d 0a 43 |tern, M.|D.}....C|
|00001e40| 6f 70 79 72 69 67 68 74 | 20 28 63 29 20 59 65 61 |opyright| (c) Yea|
|00001e50| 72 62 6f 6f 6b 20 4d 65 | 64 69 63 61 6c 20 50 75 |rbook Me|dical Pu|
|00001e60| 62 6c 69 73 68 65 72 73 | 2c 20 49 6e 63 2e 2c 20 |blishers|, Inc., |
|00001e70| 31 39 39 30 0d 0a 0d 0a | 31 39 39 30 20 59 65 61 |1990....|1990 Yea|
|00001e80| 72 20 42 6f 6f 6b 20 6f | 66 20 44 65 72 6d 61 74 |r Book o|f Dermat|
|00001e90| 6f 6c 6f 67 79 20 28 52 | 29 0d 0a 0d 0a 43 68 61 |ology (R|)....Cha|
|00001ea0| 70 74 65 72 20 38 2d 2d | 41 64 76 65 72 73 65 20 |pter 8--|Adverse |
|00001eb0| 44 72 75 67 20 52 65 61 | 63 74 69 6f 6e 73 0d 0a |Drug Rea|ctions..|
|00001ec0| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00001ed0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001ee0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001ef0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001f10| 0d 0a 43 75 74 61 6e 65 | 6f 75 73 20 44 72 75 67 |..Cutane|ous Drug|
|00001f20| 20 52 65 61 63 74 69 6f | 6e 73 3a 20 20 43 6c 69 | Reactio|ns: Cli|
|00001f30| 6e 69 63 61 6c 20 54 79 | 70 65 73 20 61 6e 64 20 |nical Ty|pes and |
|00001f40| 43 61 75 73 61 74 69 76 | 65 20 41 67 65 6e 74 73 |Causativ|e Agents|
|00001f50| 3a 20 20 41 20 46 69 76 | 65 2d 59 65 61 72 0d 0a |: A Fiv|e-Year..|
|00001f60| 53 75 72 76 65 79 20 6f | 66 20 49 6e 2d 50 61 74 |Survey o|f In-Pat|
|00001f70| 69 65 6e 74 73 20 28 31 | 39 38 31 2d 31 39 38 35 |ients (1|981-1985|
|00001f80| 29 0d 0a 0d 0a 41 6c 61 | 6e 6b 6f 20 4b 3b 20 53 |)....Ala|nko K; S|
|00001f90| 74 75 62 62 20 53 3b 20 | 4b 61 75 70 70 69 6e 65 |tubb S; |Kauppine|
|00001fa0| 6e 20 4b 0d 0a 28 55 6e | 69 76 20 43 65 6e 74 72 |n K..(Un|iv Centr|
|00001fb0| 61 6c 20 48 6f 73 70 20 | 48 65 6c 73 69 6e 6b 69 |al Hosp |Helsinki|
|00001fc0| 29 0d 0a 41 63 74 61 20 | 44 65 72 6d 20 56 65 6e |)..Acta |Derm Ven|
|00001fd0| 65 72 65 6f 6c 20 28 53 | 74 6f 63 6b 68 29 20 36 |ereol (S|tockh) 6|
|00001fe0| 39 3a 32 32 33 2d 32 32 | 36 2c 20 31 39 38 39 0d |9:223-22|6, 1989.|
|00001ff0| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00002000| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002010| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002020| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002030| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00002040| 0a 0d 0a 41 62 73 74 72 | 61 63 74 0d 0a 0d 0a 20 |...Abstr|act.... |
|00002050| 20 20 20 20 54 68 65 20 | 64 65 76 65 6c 6f 70 6d | The |developm|
|00002060| 65 6e 74 20 6f 66 20 6e | 65 77 20 74 68 65 72 61 |ent of n|ew thera|
|00002070| 70 65 75 74 69 63 20 64 | 72 75 67 73 20 69 6e 63 |peutic d|rugs inc|
|00002080| 72 65 61 73 65 73 20 74 | 68 65 20 72 69 73 6b 20 |reases t|he risk |
|00002090| 6f 66 20 64 72 75 67 0d | 0a 65 72 75 70 74 69 6f |of drug.|.eruptio|
|000020a0| 6e 73 2e 20 20 46 72 6f | 6d 20 31 39 38 31 20 74 |ns. Fro|m 1981 t|
|000020b0| 6f 20 31 39 38 35 2c 20 | 74 68 65 72 65 20 77 65 |o 1985, |there we|
|000020c0| 72 65 20 32 32 35 20 63 | 75 74 61 6e 65 6f 75 73 |re 225 c|utaneous|
|000020d0| 20 64 72 75 67 20 72 65 | 61 63 74 69 6f 6e 73 0d | drug re|actions.|
|000020e0| 0a 72 65 70 6f 72 74 65 | 64 20 69 6e 20 32 31 39 |.reporte|d in 219|
|000020f0| 20 70 61 74 69 65 6e 74 | 73 3b 20 31 32 38 20 6f | patient|s; 128 o|
|00002100| 66 20 74 68 65 20 72 65 | 61 63 74 69 6f 6e 73 20 |f the re|actions |
|00002110| 77 65 72 65 20 63 6f 6e | 66 69 72 6d 65 64 20 62 |were con|firmed b|
|00002120| 79 20 70 72 6f 76 6f 63 | 61 74 69 76 65 0d 0a 74 |y provoc|ative..t|
|00002130| 65 73 74 69 6e 67 2e 0d | 0a 20 20 20 20 20 46 69 |esting..|. Fi|
|00002140| 78 65 64 20 64 72 75 67 | 20 65 72 75 70 74 69 6f |xed drug| eruptio|
|00002150| 6e 73 2c 20 65 78 61 6e | 74 68 65 6d 61 74 6f 75 |ns, exan|thematou|
|00002160| 73 20 65 72 75 70 74 69 | 6f 6e 73 2c 20 61 6e 64 |s erupti|ons, and|
|00002170| 20 75 72 74 69 63 61 72 | 69 61 2f 61 6e 67 69 6f | urticar|ia/angio|
|00002180| 65 64 65 6d 61 0d 0a 77 | 65 72 65 20 74 68 65 20 |edema..w|ere the |
|00002190| 6d 6f 73 74 20 63 6f 6d | 6d 6f 6e 20 63 6c 69 6e |most com|mon clin|
|000021a0| 69 63 61 6c 20 72 65 61 | 63 74 69 6f 6e 73 2e 20 |ical rea|ctions. |
|000021b0| 20 41 6e 74 69 6d 69 63 | 72 6f 62 69 61 6c 20 64 | Antimic|robial d|
|000021c0| 72 75 67 73 20 61 6e 64 | 0d 0a 61 6e 74 69 70 79 |rugs and|..antipy|
|000021d0| 72 65 74 69 63 2f 61 6e | 74 69 2d 69 6e 66 6c 61 |retic/an|ti-infla|
|000021e0| 6d 6d 61 74 6f 72 79 20 | 61 67 65 6e 74 73 20 77 |mmatory |agents w|
|000021f0| 65 72 65 20 74 68 65 20 | 6d 6f 73 74 20 66 72 65 |ere the |most fre|
|00002200| 71 75 65 6e 74 20 63 61 | 75 73 61 74 69 76 65 20 |quent ca|usative |
|00002210| 61 67 65 6e 74 73 2e 0d | 0a 41 20 63 6f 6d 70 61 |agents..|.A compa|
|00002220| 72 69 73 6f 6e 20 6f 66 | 20 72 65 63 65 6e 74 20 |rison of| recent |
|00002230| 64 72 75 67 20 65 72 75 | 70 74 69 6f 6e 73 20 77 |drug eru|ptions w|
|00002240| 69 74 68 20 74 68 6f 73 | 65 20 74 72 65 61 74 65 |ith thos|e treate|
|00002250| 64 20 61 74 20 74 68 65 | 20 73 61 6d 65 20 68 6f |d at the| same ho|
|00002260| 73 70 69 74 61 6c 0d 0a | 64 75 72 69 6e 67 20 74 |spital..|during t|
|00002270| 68 65 20 70 72 65 76 69 | 6f 75 73 20 32 35 20 79 |he previ|ous 25 y|
|00002280| 65 61 72 73 20 73 68 6f | 77 65 64 20 61 20 64 65 |ears sho|wed a de|
|00002290| 63 72 65 61 73 65 20 69 | 6e 20 74 68 65 20 6e 75 |crease i|n the nu|
|000022a0| 6d 62 65 72 20 6f 66 20 | 73 6b 69 6e 20 72 65 61 |mber of |skin rea|
|000022b0| 63 74 69 6f 6e 73 0d 0a | 28 74 61 62 6c 65 2c 20 |ctions..|(table, |
|000022c0| 70 20 31 31 30 29 2e 20 | 20 41 6c 74 68 6f 75 67 |p 110). | Althoug|
|000022d0| 68 20 74 68 65 20 64 72 | 75 67 73 20 63 68 69 65 |h the dr|ugs chie|
|000022e0| 66 6c 79 20 72 65 73 70 | 6f 6e 73 69 62 6c 65 20 |fly resp|onsible |
|000022f0| 66 6f 72 20 72 65 61 63 | 74 69 6f 6e 73 20 68 61 |for reac|tions ha|
|00002300| 76 65 0d 0a 72 65 6d 61 | 69 6e 65 64 20 74 68 65 |ve..rema|ined the|
|00002310| 20 73 61 6d 65 2c 20 74 | 68 65 20 69 6d 70 6f 72 | same, t|he impor|
|00002320| 74 61 6e 63 65 20 6f 66 | 20 73 75 6c 66 6f 6e 61 |tance of| sulfona|
|00002330| 6d 69 64 65 73 20 61 73 | 20 63 61 75 73 61 74 69 |mides as| causati|
|00002340| 76 65 20 61 67 65 6e 74 | 73 20 68 61 73 0d 0a 64 |ve agent|s has..d|
|00002350| 65 63 72 65 61 73 65 64 | 2e 0d 0a 20 20 20 20 20 |ecreased|... |
|00002360| 44 72 75 67 73 20 74 68 | 61 74 20 63 61 75 73 65 |Drugs th|at cause|
|00002370| 20 74 68 65 20 6d 6f 73 | 74 20 63 6f 6d 6d 6f 6e | the mos|t common|
|00002380| 20 73 6b 69 6e 20 72 65 | 61 63 74 69 6f 6e 73 20 | skin re|actions |
|00002390| 61 70 70 65 61 72 20 74 | 6f 20 72 65 6d 61 69 6e |appear t|o remain|
|000023a0| 20 74 68 65 20 73 61 6d | 65 0d 0a 74 68 72 6f 75 | the sam|e..throu|
|000023b0| 67 68 6f 75 74 20 74 68 | 65 20 79 65 61 72 73 2e |ghout th|e years.|
|000023c0| 20 20 48 6f 77 65 76 65 | 72 2c 20 66 65 77 65 72 | Howeve|r, fewer|
|000023d0| 20 73 6b 69 6e 20 72 65 | 61 63 74 69 6f 6e 73 20 | skin re|actions |
|000023e0| 73 65 65 6d 20 74 6f 20 | 68 61 76 65 20 6f 63 63 |seem to |have occ|
|000023f0| 75 72 72 65 64 20 69 6e | 0d 0a 74 68 65 20 65 61 |urred in|..the ea|
|00002400| 72 6c 79 20 31 39 38 30 | 73 2c 20 70 65 72 68 61 |rly 1980|s, perha|
|00002410| 70 73 20 62 65 63 61 75 | 73 65 20 6f 66 20 70 75 |ps becau|se of pu|
|00002420| 72 69 66 69 63 61 74 69 | 6f 6e 20 6f 66 20 73 75 |rificati|on of su|
|00002430| 63 68 20 64 72 75 67 73 | 20 61 73 20 70 65 6e 69 |ch drugs| as peni|
|00002440| 63 69 6c 6c 69 6e 2c 0d | 0a 6c 61 63 6b 20 6f 66 |cillin,.|.lack of|
|00002450| 20 75 73 65 20 6f 66 20 | 74 68 65 20 6c 6f 6e 67 | use of |the long|
|00002460| 2d 61 63 74 69 6e 67 20 | 73 75 6c 66 6f 6e 61 6d |-acting |sulfonam|
|00002470| 69 64 65 73 2c 20 61 6e | 64 20 62 65 74 74 65 72 |ides, an|d better|
|00002480| 20 64 69 61 67 6e 6f 73 | 65 73 20 6f 66 20 64 72 | diagnos|es of dr|
|00002490| 75 67 0d 0a 65 72 75 70 | 74 69 6f 6e 73 2e 20 20 |ug..erup|tions. |
|000024a0| 54 68 65 20 6f 6e 6c 79 | 20 63 65 72 74 61 69 6e |The only| certain|
|000024b0| 20 77 61 79 20 6f 66 20 | 63 6f 6e 66 69 72 6d 69 | way of |confirmi|
|000024c0| 6e 67 20 74 68 61 74 20 | 61 20 73 6b 69 6e 20 72 |ng that |a skin r|
|000024d0| 65 61 63 74 69 6f 6e 20 | 69 73 20 63 61 75 73 65 |eaction |is cause|
|000024e0| 64 0d 0a 62 79 20 61 20 | 70 61 72 74 69 63 75 6c |d..by a |particul|
|000024f0| 61 72 20 64 72 75 67 20 | 69 73 20 62 79 20 70 72 |ar drug |is by pr|
|00002500| 6f 76 6f 63 61 74 69 76 | 65 20 74 65 73 74 69 6e |ovocativ|e testin|
|00002510| 67 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |g.....Po|st-Comme|
|00002520| 6e 74 0d 0a 0d 0a 20 20 | 20 20 20 41 6e 20 75 70 |nt.... | An up|
|00002530| 64 61 74 65 20 6f 66 20 | 74 68 65 20 65 6c 65 67 |date of |the eleg|
|00002540| 61 6e 74 20 77 6f 72 6b | 20 6f 66 20 4b 61 75 70 |ant work| of Kaup|
|00002550| 70 69 6e 65 6e 2e 20 20 | 55 73 69 6e 67 20 70 72 |pinen. |Using pr|
|00002560| 6f 76 6f 63 61 74 69 6f | 6e 20 74 65 73 74 73 2c |ovocatio|n tests,|
|00002570| 0d 0a 74 68 69 73 20 46 | 69 6e 6e 69 73 68 20 67 |..this F|innish g|
|00002580| 72 6f 75 70 20 77 61 73 | 20 61 62 6c 65 20 74 6f |roup was| able to|
|00002590| 20 76 65 72 69 66 79 20 | 73 75 73 70 65 63 74 65 | verify |suspecte|
|000025a0| 64 20 64 72 75 67 20 72 | 65 61 63 74 69 6f 6e 73 |d drug r|eactions|
|000025b0| 20 69 6e 20 6d 6f 72 65 | 20 74 68 61 6e 0d 0a 68 | in more| than..h|
|000025c0| 61 6c 66 20 6f 66 20 74 | 68 65 20 70 61 74 69 65 |alf of t|he patie|
|000025d0| 6e 74 73 20 73 74 75 64 | 69 65 64 2e 20 20 4f 66 |nts stud|ied. Of|
|000025e0| 20 69 6e 74 65 72 65 73 | 74 20 69 73 20 74 68 65 | interes|t is the|
|000025f0| 20 6c 61 72 67 65 20 6e | 75 6d 62 65 72 20 6f 66 | large n|umber of|
|00002600| 20 66 69 78 65 64 20 64 | 72 75 67 0d 0a 65 72 75 | fixed d|rug..eru|
|00002610| 70 74 69 6f 6e 73 20 69 | 6e 20 74 68 65 69 72 20 |ptions i|n their |
|00002620| 73 65 72 69 65 73 2e 20 | 20 54 68 65 20 6d 6f 73 |series. | The mos|
|00002630| 74 20 66 72 65 71 75 65 | 6e 74 20 73 75 73 70 65 |t freque|nt suspe|
|00002640| 63 74 20 61 67 65 6e 74 | 73 20 66 6f 72 20 74 68 |ct agent|s for th|
|00002650| 65 73 65 0d 0a 72 65 61 | 63 74 69 6f 6e 73 20 69 |ese..rea|ctions i|
|00002660| 6e 63 6c 75 64 65 20 74 | 68 65 20 61 6e 74 69 6d |nclude t|he antim|
|00002670| 69 63 72 6f 62 69 61 6c | 20 61 6e 64 20 61 6e 74 |icrobial| and ant|
|00002680| 69 2d 69 6e 66 6c 61 6d | 6d 61 74 6f 72 79 20 64 |i-inflam|matory d|
|00002690| 72 75 67 73 2e 20 20 54 | 68 65 73 65 20 61 72 65 |rugs. T|hese are|
|000026a0| 0d 0a 73 69 6d 69 6c 61 | 72 20 74 6f 20 74 68 65 |..simila|r to the|
|000026b0| 20 63 61 75 73 61 74 69 | 76 65 20 61 67 65 6e 74 | causati|ve agent|
|000026c0| 73 20 73 75 67 67 65 73 | 74 65 64 20 62 79 20 6f |s sugges|ted by o|
|000026d0| 74 68 65 72 20 73 74 75 | 64 69 65 73 20 69 6e 20 |ther stu|dies in |
|000026e0| 6f 74 68 65 72 0d 0a 70 | 6f 70 75 6c 61 74 69 6f |other..p|opulatio|
|000026f0| 6e 73 2e 2d 2d 52 2e 53 | 2e 20 53 74 65 72 6e 2c |ns.--R.S|. Stern,|
|00002700| 20 4d 2e 44 2e 0d 0a 24 | 55 6e 69 71 75 65 5f 49 | M.D...$|Unique_I|
|00002710| 44 7b 59 52 42 30 39 31 | 30 33 7d 0d 0a 24 54 69 |D{YRB091|03}..$Ti|
|00002720| 74 6c 65 7b 53 6b 65 6c | 65 74 61 6c 20 54 6f 78 |tle{Skel|etal Tox|
|00002730| 69 63 69 74 79 20 57 69 | 74 68 20 49 73 6f 74 72 |icity Wi|th Isotr|
|00002740| 65 74 69 6e 6f 69 6e 20 | 54 68 65 72 61 70 79 3a |etinoin |Therapy:|
|00002750| 20 20 41 20 43 6c 69 6e | 69 63 6f 2d 52 61 64 69 | A Clin|ico-Radi|
|00002760| 6f 6c 6f 67 69 63 61 6c | 20 45 76 61 6c 75 61 74 |ological| Evaluat|
|00002770| 69 6f 6e 7d 0d 0a 24 41 | 75 74 68 6f 72 7b 43 61 |ion}..$A|uthor{Ca|
|00002780| 72 65 79 2c 20 42 4d 0d | 0a 50 61 72 6b 69 6e 2c |rey, BM.|.Parkin,|
|00002790| 20 47 4a 53 0d 0a 43 75 | 6e 6c 69 66 66 65 2c 20 | GJS..Cu|nliffe, |
|000027a0| 57 4a 0d 0a 50 72 69 74 | 6c 6f 76 65 2c 20 4a 7d |WJ..Prit|love, J}|
|000027b0| 0d 0a 24 41 66 66 69 6c | 69 61 74 69 6f 6e 7b 47 |..$Affil|iation{G|
|000027c0| 65 6e 2c 20 49 6e 66 69 | 72 6d 61 72 79 2c 20 4c |en, Infi|rmary, L|
|000027d0| 65 65 64 73 2c 20 45 6e | 67 6c 61 6e 64 7d 0d 0a |eeds, En|gland}..|
|000027e0| 24 4a 6f 75 72 6e 61 6c | 7b 42 72 20 4a 20 44 65 |$Journal|{Br J De|
|000027f0| 72 6d 61 74 6f 6c 7d 0d | 0a 24 56 6f 6c 75 6d 65 |rmatol}.|.$Volume|
|00002800| 7b 31 31 39 7d 0d 0a 24 | 50 61 67 65 7b 36 30 39 |{119}..$|Page{609|
|00002810| 2d 36 31 34 7d 0d 0a 24 | 44 61 74 65 7b 4e 6f 76 |-614}..$|Date{Nov|
|00002820| 65 6d 62 65 72 20 31 39 | 38 38 7d 0d 0a 24 59 42 |ember 19|88}..$YB|
|00002830| 56 6f 6c 7b 31 39 39 30 | 20 59 65 61 72 20 42 6f |Vol{1990| Year Bo|
|00002840| 6f 6b 20 6f 66 20 44 65 | 72 6d 61 74 6f 6c 6f 67 |ok of De|rmatolog|
|00002850| 79 7d 0d 0a 24 43 68 61 | 70 74 65 72 7b 38 2d 32 |y}..$Cha|pter{8-2|
|00002860| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|00002870| 2e 20 53 6f 62 65 72 20 | 61 6e 64 20 46 69 74 7a |. Sober |and Fitz|
|00002880| 70 61 74 72 69 63 6b 7d | 0d 0a 24 54 61 62 6c 65 |patrick}|..$Table|
|00002890| 7b 7d 0d 0a 24 43 6f 6d | 6d 65 6e 74 61 74 6f 72 |{}..$Com|mentator|
|000028a0| 7b 50 2e 45 2e 20 50 6f | 63 68 69 2c 20 4d 2e 44 |{P.E. Po|chi, M.D|
|000028b0| 2e 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |.}....Co|pyright |
|000028c0| 28 63 29 20 59 65 61 72 | 62 6f 6f 6b 20 4d 65 64 |(c) Year|book Med|
|000028d0| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|000028e0| 20 49 6e 63 2e 2c 20 31 | 39 39 30 0d 0a 0d 0a 31 | Inc., 1|990....1|
|000028f0| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00002900| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 20 28 52 29 | Dermato|logy (R)|
|00002910| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 38 2d 2d 41 |....Chap|ter 8--A|
|00002920| 64 76 65 72 73 65 20 44 | 72 75 67 20 52 65 61 63 |dverse D|rug Reac|
|00002930| 74 69 6f 6e 73 0d 0a 0d | 0a 2d 2d 2d 2d 2d 2d 2d |tions...|.-------|
|00002940| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002950| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002960| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002970| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002980| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 53 6b 65 6c 65 74 61 |-------.|.Skeleta|
|00002990| 6c 20 54 6f 78 69 63 69 | 74 79 20 57 69 74 68 20 |l Toxici|ty With |
|000029a0| 49 73 6f 74 72 65 74 69 | 6e 6f 69 6e 20 54 68 65 |Isotreti|noin The|
|000029b0| 72 61 70 79 3a 20 20 41 | 20 43 6c 69 6e 69 63 6f |rapy: A| Clinico|
|000029c0| 2d 52 61 64 69 6f 6c 6f | 67 69 63 61 6c 0d 0a 45 |-Radiolo|gical..E|
|000029d0| 76 61 6c 75 61 74 69 6f | 6e 0d 0a 0d 0a 43 61 72 |valuatio|n....Car|
|000029e0| 65 79 20 42 4d 3b 20 50 | 61 72 6b 69 6e 20 47 4a |ey BM; P|arkin GJ|
|000029f0| 53 3b 20 43 75 6e 6c 69 | 66 66 65 20 57 4a 3b 20 |S; Cunli|ffe WJ; |
|00002a00| 50 72 69 74 6c 6f 76 65 | 3b 20 4a 0d 0a 28 47 65 |Pritlove|; J..(Ge|
|00002a10| 6e 20 49 6e 66 69 72 6d | 61 72 79 2c 20 4c 65 65 |n Infirm|ary, Lee|
|00002a20| 64 73 2c 20 45 6e 67 6c | 61 6e 64 29 0d 0a 42 72 |ds, Engl|and)..Br|
|00002a30| 20 4a 20 44 65 72 6d 61 | 74 6f 6c 20 31 31 39 3a | J Derma|tol 119:|
|00002a40| 36 30 39 2d 36 31 34 2c | 20 4e 6f 76 65 6d 62 65 |609-614,| Novembe|
|00002a50| 72 20 31 39 38 38 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |r 1988..|--------|
|00002a60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002a90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00002aa0| 2d 2d 2d 2d 2d 2d 0d 0a | 0d 0a 41 62 73 74 72 61 |------..|..Abstra|
|00002ab0| 63 74 0d 0a 0d 0a 20 20 | 20 20 20 53 6b 65 6c 65 |ct.... | Skele|
|00002ac0| 74 61 6c 20 74 6f 78 69 | 63 69 74 79 20 6f 63 63 |tal toxi|city occ|
|00002ad0| 75 72 73 20 77 69 74 68 | 20 68 69 67 68 20 64 6f |urs with| high do|
|00002ae0| 73 65 73 20 6f 66 20 69 | 73 6f 74 72 65 74 69 6e |ses of i|sotretin|
|00002af0| 6f 69 6e 2e 20 20 54 68 | 65 20 63 6c 69 6e 69 63 |oin. Th|e clinic|
|00002b00| 61 6c 0d 0a 73 69 67 6e | 69 66 69 63 61 6e 63 65 |al..sign|ificance|
|00002b10| 20 61 6e 64 20 65 78 74 | 65 6e 74 20 6f 66 20 6d | and ext|ent of m|
|00002b20| 75 73 63 75 6c 6f 73 6b | 65 6c 65 74 61 6c 20 74 |usculosk|eletal t|
|00002b30| 6f 78 69 63 69 74 79 20 | 61 73 73 6f 63 69 61 74 |oxicity |associat|
|00002b40| 65 64 20 77 69 74 68 20 | 6c 6f 77 65 72 0d 0a 64 |ed with |lower..d|
|00002b50| 6f 73 65 73 20 6f 66 20 | 69 73 6f 74 72 65 74 69 |oses of |isotreti|
|00002b60| 6e 6f 69 6e 20 75 73 65 | 64 20 74 6f 20 74 72 65 |noin use|d to tre|
|00002b70| 61 74 20 73 65 76 65 72 | 65 20 61 63 6e 65 20 77 |at sever|e acne w|
|00002b80| 65 72 65 20 69 6e 76 65 | 73 74 69 67 61 74 65 64 |ere inve|stigated|
|00002b90| 20 69 6e 20 31 32 30 0d | 0a 70 61 74 69 65 6e 74 | in 120.|.patient|
|00002ba0| 73 2e 20 20 54 68 65 20 | 72 65 63 65 69 76 65 64 |s. The |received|
|00002bb0| 20 61 20 34 2d 6d 6f 6e | 74 68 20 63 6f 75 72 73 | a 4-mon|th cours|
|00002bc0| 65 20 6f 66 20 69 73 6f | 74 72 65 74 69 6e 6f 69 |e of iso|tretinoi|
|00002bd0| 6e 20 69 6e 20 6f 72 61 | 6c 20 64 6f 73 65 73 20 |n in ora|l doses |
|00002be0| 6f 66 0d 0a 30 2e 31 2d | 31 20 6d 67 2f 6b 67 2f |of..0.1-|1 mg/kg/|
|00002bf0| 64 61 79 2e 20 20 52 61 | 64 69 6f 67 72 61 70 68 |day. Ra|diograph|
|00002c00| 73 20 77 65 72 65 20 74 | 68 65 6e 20 6f 62 74 61 |s were t|hen obta|
|00002c10| 69 6e 65 64 2e 0d 0a 20 | 20 20 20 20 54 77 65 6c |ined... | Twel|
|00002c20| 76 65 20 70 65 72 63 65 | 6e 74 20 6f 66 20 74 68 |ve perce|nt of th|
|00002c30| 65 20 70 61 74 69 65 6e | 74 73 20 68 61 64 20 6d |e patien|ts had m|
|00002c40| 69 6e 6f 72 20 63 68 61 | 6e 67 65 73 2e 20 20 46 |inor cha|nges. F|
|00002c50| 6f 75 72 20 68 61 64 20 | 73 70 69 6e 61 6c 0d 0a |our had |spinal..|
|00002c60| 68 79 70 65 72 6f 73 74 | 6f 73 65 73 2c 20 61 6e |hyperost|oses, an|
|00002c70| 64 20 31 30 20 68 61 64 | 20 63 61 6c 63 61 6e 65 |d 10 had| calcane|
|00002c80| 61 6c 20 68 79 70 65 72 | 6f 73 74 6f 73 65 73 2c |al hyper|ostoses,|
|00002c90| 20 62 75 74 20 6e 6f 6e | 65 20 6f 66 20 74 68 65 | but non|e of the|
|00002ca0| 73 65 20 63 68 61 6e 67 | 65 73 20 77 61 73 0d 0a |se chang|es was..|
|00002cb0| 63 6c 69 6e 69 63 61 6c | 6c 79 20 73 69 67 6e 69 |clinical|ly signi|
|00002cc0| 66 69 63 61 6e 74 2e 20 | 20 4d 61 74 63 68 65 64 |ficant. | Matched|
|00002cd0| 20 63 6f 6e 74 72 6f 6c | 20 72 61 64 69 6f 67 72 | control| radiogr|
|00002ce0| 61 70 68 73 20 73 68 6f | 77 65 64 20 74 68 61 74 |aphs sho|wed that|
|00002cf0| 20 38 25 20 6f 66 20 74 | 68 65 0d 0a 63 6f 6e 74 | 8% of t|he..cont|
|00002d00| 72 6f 6c 20 67 72 6f 75 | 70 20 68 61 64 20 73 69 |rol grou|p had si|
|00002d10| 6d 69 6c 61 72 20 6e 6f | 6e 73 69 67 6e 69 66 69 |milar no|nsignifi|
|00002d20| 63 61 6e 74 20 63 68 61 | 6e 67 65 73 2e 20 20 54 |cant cha|nges. T|
|00002d30| 68 65 20 31 31 20 70 61 | 74 69 65 6e 74 73 20 77 |he 11 pa|tients w|
|00002d40| 69 74 68 0d 0a 61 62 6e | 6f 72 6d 61 6c 20 72 61 |ith..abn|ormal ra|
|00002d50| 64 69 6f 67 72 61 70 68 | 69 63 20 72 65 73 75 6c |diograph|ic resul|
|00002d60| 74 73 20 77 65 72 65 20 | 66 6f 6c 6c 6f 77 65 64 |ts were |followed|
|00002d70| 20 75 70 3a 20 20 31 20 | 70 61 74 69 65 6e 74 20 | up: 1 |patient |
|00002d80| 68 61 64 20 6d 69 6e 6f | 72 0d 0a 64 65 74 65 72 |had mino|r..deter|
|00002d90| 69 6f 72 61 74 69 6f 6e | 2c 20 34 20 68 61 64 20 |ioration|, 4 had |
|00002da0| 6e 6f 20 63 68 61 6e 67 | 65 2c 20 61 6e 64 20 36 |no chang|e, and 6|
|00002db0| 20 68 61 64 20 69 6d 70 | 72 6f 76 65 6d 65 6e 74 | had imp|rovement|
|00002dc0| 2e 0d 0a 20 20 20 20 20 | 44 6f 73 65 73 20 6f 66 |... |Doses of|
|00002dd0| 20 69 73 6f 74 72 65 74 | 69 6e 6f 69 6e 2c 20 30 | isotret|inoin, 0|
|00002de0| 2e 35 20 6d 67 2f 6b 67 | 2f 64 61 79 2c 20 64 6f |.5 mg/kg|/day, do|
|00002df0| 20 6e 6f 74 20 6c 65 61 | 64 20 74 6f 20 61 6e 79 | not lea|d to any|
|00002e00| 20 73 69 67 6e 69 66 69 | 63 61 6e 74 0d 0a 6c 6f | signifi|cant..lo|
|00002e10| 6e 67 2d 74 65 72 6d 20 | 6d 75 73 63 75 6c 6f 73 |ng-term |musculos|
|00002e20| 6b 65 6c 65 74 61 6c 20 | 63 68 61 6e 67 65 73 2e |keletal |changes.|
|00002e30| 20 20 44 65 72 6d 61 74 | 6f 6c 6f 67 69 73 74 73 | Dermat|ologists|
|00002e40| 20 73 68 6f 75 6c 64 20 | 62 65 20 61 77 61 72 65 | should |be aware|
|00002e50| 20 6f 66 20 74 68 65 0d | 0a 70 6f 73 73 69 62 69 | of the.|.possibi|
|00002e60| 6c 69 74 79 20 6f 66 20 | 73 6b 65 6c 65 74 61 6c |lity of |skeletal|
|00002e70| 20 74 6f 78 69 63 69 74 | 79 20 77 68 65 6e 20 74 | toxicit|y when t|
|00002e80| 72 65 61 74 69 6e 67 20 | 70 61 74 69 65 6e 74 73 |reating |patients|
|00002e90| 20 77 69 74 68 20 74 68 | 69 73 20 64 72 75 67 2e | with th|is drug.|
|00002ea0| 0d 0a 0d 0a 50 6f 73 74 | 2d 43 6f 6d 6d 65 6e 74 |....Post|-Comment|
|00002eb0| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 66 69 6e |.... | The fin|
|00002ec0| 64 69 6e 67 73 20 6f 66 | 20 74 68 69 73 20 73 74 |dings of| this st|
|00002ed0| 75 64 79 20 61 72 65 20 | 71 75 69 74 65 20 72 65 |udy are |quite re|
|00002ee0| 61 73 73 75 72 69 6e 67 | 2c 20 73 68 6f 77 69 6e |assuring|, showin|
|00002ef0| 67 20 74 68 61 74 20 69 | 6e 20 61 63 6e 65 0d 0a |g that i|n acne..|
|00002f00| 70 61 74 69 65 6e 74 73 | 20 69 73 6f 74 72 65 74 |patients| isotret|
|00002f10| 69 6e 6f 69 6e 20 61 64 | 6d 69 6e 69 73 74 65 72 |inoin ad|minister|
|00002f20| 65 64 20 6f 72 61 6c 6c | 79 20 66 6f 72 20 34 20 |ed orall|y for 4 |
|00002f30| 6d 6f 6e 74 68 73 20 70 | 72 6f 64 75 63 65 64 20 |months p|roduced |
|00002f40| 6e 6f 20 6d 61 6a 6f 72 | 20 62 6f 6e 79 0d 0a 70 |no major| bony..p|
|00002f50| 72 6f 62 6c 65 6d 73 20 | 28 31 32 25 20 69 6e 63 |roblems |(12% inc|
|00002f60| 69 64 65 6e 63 65 20 76 | 73 2e 20 38 25 20 69 6e |idence v|s. 8% in|
|00002f70| 20 6e 6f 6e 61 63 6e 65 | 20 63 6f 6e 74 72 6f 6c | nonacne| control|
|00002f80| 73 29 2e 20 20 4d 6f 72 | 65 6f 76 65 72 2c 20 77 |s). Mor|eover, w|
|00002f90| 68 65 6e 20 63 68 61 6e | 67 65 73 0d 0a 64 69 64 |hen chan|ges..did|
|00002fa0| 20 6f 63 63 75 72 2c 20 | 66 6f 6c 6c 6f 77 2d 75 | occur, |follow-u|
|00002fb0| 70 20 72 61 64 69 6f 6c | 6f 67 69 63 20 73 74 75 |p radiol|ogic stu|
|00002fc0| 64 69 65 73 20 72 65 76 | 65 61 6c 65 64 20 65 69 |dies rev|ealed ei|
|00002fd0| 74 68 65 72 20 69 6d 70 | 72 6f 76 65 6d 65 6e 74 |ther imp|rovement|
|00002fe0| 20 6f 72 20 6e 6f 0d 0a | 66 75 72 74 68 65 72 20 | or no..|further |
|00002ff0| 70 72 6f 67 72 65 73 73 | 69 6f 6e 20 69 6e 20 76 |progress|ion in v|
|00003000| 69 72 74 75 61 6c 6c 79 | 20 61 6c 6c 20 63 61 73 |irtually| all cas|
|00003010| 65 73 2e 0d 0a 20 20 20 | 20 20 49 74 20 73 68 6f |es... | It sho|
|00003020| 75 6c 64 20 62 65 20 6e | 6f 74 65 64 2c 20 68 6f |uld be n|oted, ho|
|00003030| 77 65 76 65 72 2c 20 74 | 68 61 74 20 74 68 65 20 |wever, t|hat the |
|00003040| 64 6f 73 65 20 6f 66 20 | 6f 72 61 6c 20 69 73 6f |dose of |oral iso|
|00003050| 74 72 65 74 69 6e 6f 69 | 6e 20 69 6e 20 37 35 25 |tretinoi|n in 75%|
|00003060| 20 6f 66 0d 0a 74 68 65 | 20 70 61 74 69 65 6e 74 | of..the| patient|
|00003070| 73 20 77 61 73 20 30 2e | 35 20 6d 67 2f 6b 67 2f |s was 0.|5 mg/kg/|
|00003080| 64 61 79 20 6f 72 20 6c | 65 73 73 2e 20 20 46 6f |day or l|ess. Fo|
|00003090| 72 20 69 6e 64 69 76 69 | 64 75 61 6c 73 20 77 69 |r indivi|duals wi|
|000030a0| 74 68 20 62 6f 64 79 20 | 77 65 69 67 68 74 73 0d |th body |weights.|
|000030b0| 0a 72 61 6e 67 69 6e 67 | 20 66 72 6f 6d 20 35 30 |.ranging| from 50|
|000030c0| 20 74 6f 20 38 30 20 6b | 67 20 28 31 31 30 2d 31 | to 80 k|g (110-1|
|000030d0| 37 35 20 6c 62 29 2c 20 | 61 20 64 6f 73 61 67 65 |75 lb), |a dosage|
|000030e0| 20 6f 66 20 30 2e 35 20 | 6d 67 2f 6b 67 2f 64 61 | of 0.5 |mg/kg/da|
|000030f0| 79 20 77 6f 75 6c 64 0d | 0a 74 72 61 6e 73 6c 61 |y would.|.transla|
|00003100| 74 65 20 74 6f 20 61 20 | 64 6f 73 65 20 72 61 6e |te to a |dose ran|
|00003110| 67 65 20 6f 66 20 32 35 | 2d 34 30 20 6d 67 2f 64 |ge of 25|-40 mg/d|
|00003120| 61 79 2e 20 20 54 68 65 | 73 65 20 61 6d 6f 75 6e |ay. The|se amoun|
|00003130| 74 73 20 61 72 65 20 63 | 6c 69 6e 69 63 61 6c 6c |ts are c|linicall|
|00003140| 79 0d 0a 65 66 66 65 63 | 74 69 76 65 20 69 6e 20 |y..effec|tive in |
|00003150| 61 63 6e 65 2c 20 62 75 | 74 20 74 68 65 72 65 20 |acne, bu|t there |
|00003160| 69 73 20 6d 75 63 68 20 | 70 75 62 6c 69 73 68 65 |is much |publishe|
|00003170| 64 20 69 6e 66 6f 72 6d | 61 74 69 6f 6e 20 69 6e |d inform|ation in|
|00003180| 64 69 63 61 74 69 6e 67 | 20 74 68 61 74 20 74 68 |dicating| that th|
|00003190| 65 0d 0a 6d 6f 73 74 20 | 73 69 67 6e 69 66 69 63 |e..most |signific|
|000031a0| 61 6e 74 20 66 61 63 74 | 6f 72 20 69 6e 20 61 63 |ant fact|or in ac|
|000031b0| 6e 65 20 72 65 6c 61 70 | 73 65 20 61 66 74 65 72 |ne relap|se after|
|000031c0| 20 73 75 63 63 65 73 73 | 66 75 6c 20 69 73 6f 74 | success|ful isot|
|000031d0| 72 65 74 69 6e 6f 69 6e | 0d 0a 74 72 65 61 74 6d |retinoin|..treatm|
|000031e0| 65 6e 74 20 69 73 20 74 | 68 65 20 64 6f 73 61 67 |ent is t|he dosag|
|000031f0| 65 20 75 73 65 64 2e 20 | 20 53 6f 2c 20 61 20 71 |e used. | So, a q|
|00003200| 75 65 73 74 69 6f 6e 20 | 72 65 6d 61 69 6e 73 20 |uestion |remains |
|00003210| 77 68 65 74 68 65 72 20 | 74 68 65 20 70 72 6f 62 |whether |the prob|
|00003220| 61 62 69 6c 69 74 79 0d | 0a 6f 66 20 74 68 65 20 |ability.|.of the |
|00003230| 6e 65 65 64 20 66 6f 72 | 20 6d 6f 72 65 20 74 68 |need for| more th|
|00003240| 61 6e 20 31 20 63 6f 75 | 72 73 65 20 6f 66 20 69 |an 1 cou|rse of i|
|00003250| 73 6f 74 72 65 74 69 6e | 6f 69 6e 20 69 73 20 6d |sotretin|oin is m|
|00003260| 6f 72 65 20 28 6f 72 20 | 6c 65 73 73 29 0d 0a 64 |ore (or |less)..d|
|00003270| 65 73 69 72 61 62 6c 65 | 2c 20 66 72 6f 6d 20 74 |esirable|, from t|
|00003280| 68 65 20 70 6f 69 6e 74 | 20 6f 66 20 76 69 65 77 |he point| of view|
|00003290| 20 6f 66 20 73 6b 65 6c | 65 74 61 6c 20 74 6f 78 | of skel|etal tox|
|000032a0| 69 63 69 74 79 2c 20 74 | 68 61 6e 20 61 20 68 69 |icity, t|han a hi|
|000032b0| 67 68 65 72 20 64 6f 73 | 65 20 69 6e 0d 0a 74 68 |gher dos|e in..th|
|000032c0| 65 20 69 6e 69 74 69 61 | 6c 20 63 6f 75 72 73 65 |e initia|l course|
|000032d0| 2e 2d 2d 50 2e 45 2e 20 | 50 6f 63 68 69 2c 20 4d |.--P.E. |Pochi, M|
|000032e0| 2e 44 2e 0d 0a 24 55 6e | 69 71 75 65 5f 49 44 7b |.D...$Un|ique_ID{|
|000032f0| 59 52 42 30 39 31 30 34 | 7d 0d 0a 24 54 69 74 6c |YRB09104|}..$Titl|
|00003300| 65 7b 53 6b 65 6c 65 74 | 61 6c 20 48 79 70 65 72 |e{Skelet|al Hyper|
|00003310| 6f 73 74 6f 73 69 73 20 | 61 6e 64 20 45 78 74 72 |ostosis |and Extr|
|00003320| 61 6f 73 73 65 6f 75 73 | 20 43 61 6c 63 69 66 69 |aosseous| Calcifi|
|00003330| 63 61 74 69 6f 6e 20 69 | 6e 20 50 61 74 69 65 6e |cation i|n Patien|
|00003340| 74 73 20 52 65 63 65 69 | 76 69 6e 67 20 4c 6f 6e |ts Recei|ving Lon|
|00003350| 67 2d 54 65 72 6d 20 45 | 74 72 65 74 69 6e 61 74 |g-Term E|tretinat|
|00003360| 65 20 28 54 69 67 61 73 | 6f 6e 29 7d 0d 0a 24 41 |e (Tigas|on)}..$A|
|00003370| 75 74 68 6f 72 7b 57 69 | 6c 73 6f 6e 2c 20 44 4a |uthor{Wi|lson, DJ|
|00003380| 0d 0a 4b 61 79 2c 20 56 | 0d 0a 43 68 61 72 69 67 |..Kay, V|..Charig|
|00003390| 2c 20 4d 0d 0a 48 75 67 | 68 65 73 2c 20 44 47 0d |, M..Hug|hes, DG.|
|000033a0| 0a 43 72 65 61 73 79 2c | 20 54 53 7d 0d 0a 24 41 |.Creasy,| TS}..$A|
|000033b0| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 4a 6f 68 6e 20 |ffiliati|on{John |
|000033c0| 52 61 64 63 6c 69 66 66 | 65 20 48 6f 73 70 2c 20 |Radcliff|e Hosp, |
|000033d0| 4f 78 66 6f 72 64 2c 20 | 45 6e 67 6c 61 6e 64 7d |Oxford, |England}|
|000033e0| 0d 0a 24 4a 6f 75 72 6e | 61 6c 7b 42 72 20 4a 20 |..$Journ|al{Br J |
|000033f0| 44 65 72 6d 61 74 6f 6c | 7d 0d 0a 24 56 6f 6c 75 |Dermatol|}..$Volu|
|00003400| 6d 65 7b 31 31 39 7d 0d | 0a 24 50 61 67 65 7b 35 |me{119}.|.$Page{5|
|00003410| 39 37 2d 36 30 37 7d 0d | 0a 24 44 61 74 65 7b 4e |97-607}.|.$Date{N|
|00003420| 6f 76 65 6d 62 65 72 20 | 31 39 38 38 7d 0d 0a 24 |ovember |1988}..$|
|00003430| 59 42 56 6f 6c 7b 31 39 | 39 30 20 59 65 61 72 20 |YBVol{19|90 Year |
|00003440| 42 6f 6f 6b 20 6f 66 20 | 44 65 72 6d 61 74 6f 6c |Book of |Dermatol|
|00003450| 6f 67 79 7d 0d 0a 24 43 | 68 61 70 74 65 72 7b 38 |ogy}..$C|hapter{8|
|00003460| 2d 33 7d 0d 0a 24 59 42 | 45 64 69 74 6f 72 7b 44 |-3}..$YB|Editor{D|
|00003470| 72 73 2e 20 53 6f 62 65 | 72 20 61 6e 64 20 46 69 |rs. Sobe|r and Fi|
|00003480| 74 7a 70 61 74 72 69 63 | 6b 7d 0d 0a 24 54 61 62 |tzpatric|k}..$Tab|
|00003490| 6c 65 7b 54 61 62 6c 65 | 20 4f 6d 69 74 74 65 64 |le{Table| Omitted|
|000034a0| 7d 0d 0a 24 43 6f 6d 6d | 65 6e 74 61 74 6f 72 7b |}..$Comm|entator{|
|000034b0| 50 2e 45 2e 20 50 6f 63 | 68 69 2c 20 4d 2e 44 2e |P.E. Poc|hi, M.D.|
|000034c0| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|000034d0| 63 29 20 59 65 61 72 62 | 6f 6f 6b 20 4d 65 64 69 |c) Yearb|ook Medi|
|000034e0| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|000034f0| 49 6e 63 2e 2c 20 31 39 | 39 30 0d 0a 0d 0a 31 39 |Inc., 19|90....19|
|00003500| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|00003510| 44 65 72 6d 61 74 6f 6c | 6f 67 79 20 28 52 29 0d |Dermatol|ogy (R).|
|00003520| 0a 0d 0a 43 68 61 70 74 | 65 72 20 38 2d 2d 41 64 |...Chapt|er 8--Ad|
|00003530| 76 65 72 73 65 20 44 72 | 75 67 20 52 65 61 63 74 |verse Dr|ug React|
|00003540| 69 6f 6e 73 0d 0a 0d 0a | 2d 2d 2d 2d 2d 2d 2d 2d |ions....|--------|
|00003550| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003560| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003570| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003580| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003590| 2d 2d 2d 2d 2d 2d 0d 0a | 53 6b 65 6c 65 74 61 6c |------..|Skeletal|
|000035a0| 20 48 79 70 65 72 6f 73 | 74 6f 73 69 73 20 61 6e | Hyperos|tosis an|
|000035b0| 64 20 45 78 74 72 61 6f | 73 73 65 6f 75 73 20 43 |d Extrao|sseous C|
|000035c0| 61 6c 63 69 66 69 63 61 | 74 69 6f 6e 20 69 6e 20 |alcifica|tion in |
|000035d0| 50 61 74 69 65 6e 74 73 | 20 52 65 63 65 69 76 69 |Patients| Receivi|
|000035e0| 6e 67 0d 0a 4c 6f 6e 67 | 2d 54 65 72 6d 20 45 74 |ng..Long|-Term Et|
|000035f0| 72 65 74 69 6e 61 74 65 | 20 28 54 69 67 61 73 6f |retinate| (Tigaso|
|00003600| 6e 29 0d 0a 0d 0a 57 69 | 6c 73 6f 6e 20 44 4a 3b |n)....Wi|lson DJ;|
|00003610| 20 4b 61 79 20 56 3b 20 | 43 68 61 72 69 67 20 4d | Kay V; |Charig M|
|00003620| 3b 20 48 75 67 68 65 73 | 20 44 47 3b 20 43 72 65 |; Hughes| DG; Cre|
|00003630| 61 73 79 20 54 53 0d 0a | 28 4a 6f 68 6e 20 52 61 |asy TS..|(John Ra|
|00003640| 64 63 6c 69 66 66 65 20 | 48 6f 73 70 2c 20 4f 78 |dcliffe |Hosp, Ox|
|00003650| 66 6f 72 64 2c 20 45 6e | 67 6c 61 6e 64 29 0d 0a |ford, En|gland)..|
|00003660| 42 72 20 4a 20 44 65 72 | 6d 61 74 6f 6c 20 31 31 |Br J Der|matol 11|
|00003670| 39 3a 35 39 37 2d 36 30 | 37 2c 20 4e 6f 76 65 6d |9:597-60|7, Novem|
|00003680| 62 65 72 20 31 39 38 38 | 0d 0a 2d 2d 2d 2d 2d 2d |ber 1988|..------|
|00003690| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000036d0| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|000036e0| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 54 68 65 |ract....| The|
|000036f0| 20 73 79 6e 74 68 65 74 | 69 63 20 61 6e 61 6c 6f | synthet|ic analo|
|00003700| 67 75 65 73 20 6f 66 20 | 76 69 74 61 6d 69 6e 20 |gues of |vitamin |
|00003710| 41 20 61 72 65 20 77 69 | 64 65 6c 79 20 75 73 65 |A are wi|dely use|
|00003720| 64 20 74 6f 20 74 72 65 | 61 74 20 73 6b 69 6e 0d |d to tre|at skin.|
|00003730| 0a 64 69 73 6f 72 64 65 | 72 73 20 62 75 74 20 61 |.disorde|rs but a|
|00003740| 72 65 20 61 73 73 6f 63 | 69 61 74 65 64 20 77 69 |re assoc|iated wi|
|00003750| 74 68 20 76 61 72 69 6f | 75 73 20 73 69 64 65 20 |th vario|us side |
|00003760| 65 66 66 65 63 74 73 2c | 20 65 73 70 65 63 69 61 |effects,| especia|
|00003770| 6c 6c 79 20 64 75 72 69 | 6e 67 0d 0a 6c 6f 6e 67 |lly duri|ng..long|
|00003780| 2d 74 65 72 6d 20 75 73 | 65 2e 20 20 54 68 65 73 |-term us|e. Thes|
|00003790| 65 20 65 66 66 65 63 74 | 73 20 69 6e 63 6c 75 64 |e effect|s includ|
|000037a0| 65 20 73 6b 65 6c 65 74 | 61 6c 20 63 68 61 6e 67 |e skelet|al chang|
|000037b0| 65 73 2c 20 77 69 74 68 | 20 62 6f 6e 65 20 73 70 |es, with| bone sp|
|000037c0| 75 72 72 69 6e 67 20 61 | 6e 64 0d 0a 6f 73 73 69 |urring a|nd..ossi|
|000037d0| 66 69 63 61 74 69 6f 6e | 20 6f 66 20 6c 69 67 61 |fication| of liga|
|000037e0| 6d 65 6e 74 73 2c 20 6d | 69 6d 69 63 6b 69 6e 67 |ments, m|imicking|
|000037f0| 20 64 69 66 66 75 73 65 | 20 69 64 69 6f 70 61 74 | diffuse| idiopat|
|00003800| 68 69 63 20 73 6b 65 6c | 65 74 61 6c 20 68 79 70 |hic skel|etal hyp|
|00003810| 65 72 6f 73 74 6f 73 69 | 73 2e 0d 0a 48 6f 77 65 |erostosi|s...Howe|
|00003820| 76 65 72 2c 20 74 68 65 | 72 65 20 61 72 65 20 63 |ver, the|re are c|
|00003830| 6f 6e 66 6c 69 63 74 69 | 6e 67 20 72 65 70 6f 72 |onflicti|ng repor|
|00003840| 74 73 20 6f 6e 20 74 68 | 65 20 72 65 6c 61 74 69 |ts on th|e relati|
|00003850| 6f 6e 73 68 69 70 20 62 | 65 74 77 65 65 6e 20 74 |onship b|etween t|
|00003860| 6f 74 61 6c 20 64 6f 73 | 65 0d 0a 61 6e 64 20 73 |otal dos|e..and s|
|00003870| 6b 65 6c 65 74 61 6c 20 | 65 66 66 65 63 74 73 2c |keletal |effects,|
|00003880| 20 61 6e 64 20 74 68 65 | 20 69 6e 63 69 64 65 6e | and the| inciden|
|00003890| 63 65 20 6f 66 20 74 68 | 65 73 65 20 65 66 66 65 |ce of th|ese effe|
|000038a0| 63 74 73 20 69 73 20 75 | 6e 63 6c 65 61 72 2e 20 |cts is u|nclear. |
|000038b0| 20 4e 65 69 74 68 65 72 | 0d 0a 69 73 20 74 68 65 | Neither|..is the|
|000038c0| 72 65 20 61 67 72 65 65 | 6d 65 6e 74 20 6f 6e 20 |re agree|ment on |
|000038d0| 74 68 65 20 62 65 73 74 | 20 74 65 63 68 6e 69 71 |the best| techniq|
|000038e0| 75 65 20 66 6f 72 20 6d | 6f 6e 69 74 6f 72 69 6e |ue for m|onitorin|
|000038f0| 67 20 70 61 74 69 65 6e | 74 73 20 67 69 76 65 6e |g patien|ts given|
|00003900| 0d 0a 6c 6f 6e 67 2d 74 | 65 72 6d 20 74 68 65 72 |..long-t|erm ther|
|00003910| 61 70 79 2e 0d 0a 20 20 | 20 20 20 54 68 69 72 74 |apy... | Thirt|
|00003920| 65 65 6e 20 70 61 74 69 | 65 6e 74 73 20 77 69 74 |een pati|ents wit|
|00003930| 68 20 61 20 63 6f 6e 67 | 65 6e 69 74 61 6c 20 6f |h a cong|enital o|
|00003940| 72 20 69 6e 68 65 72 69 | 74 65 64 20 64 69 73 6f |r inheri|ted diso|
|00003950| 72 64 65 72 20 6f 66 0d | 0a 6b 65 72 61 74 69 6e |rder of.|.keratin|
|00003960| 69 7a 61 74 69 6f 6e 20 | 61 6e 64 20 31 30 20 77 |ization |and 10 w|
|00003970| 69 74 68 20 70 73 6f 72 | 69 61 73 69 73 20 77 65 |ith psor|iasis we|
|00003980| 72 65 20 72 65 63 65 69 | 76 69 6e 67 20 6c 6f 6e |re recei|ving lon|
|00003990| 67 2d 74 65 72 6d 20 65 | 74 72 65 74 69 6e 61 74 |g-term e|tretinat|
|000039a0| 65 0d 0a 74 68 65 72 61 | 70 79 2e 20 20 53 6b 65 |e..thera|py. Ske|
|000039b0| 6c 65 74 61 6c 20 73 63 | 69 6e 74 69 67 72 61 70 |letal sc|intigrap|
|000039c0| 68 79 2c 20 70 6c 61 69 | 6e 20 72 61 64 69 6f 67 |hy, plai|n radiog|
|000039d0| 72 61 70 68 73 2c 20 61 | 6e 64 20 68 65 6d 61 74 |raphs, a|nd hemat|
|000039e0| 6f 6c 6f 67 69 63 20 61 | 6e 64 0d 0a 62 69 6f 63 |ologic a|nd..bioc|
|000039f0| 68 65 6d 69 63 61 6c 20 | 73 74 75 64 69 65 73 20 |hemical |studies |
|00003a00| 77 65 72 65 20 64 6f 6e | 65 2e 20 20 55 73 69 6e |were don|e. Usin|
|00003a10| 67 20 61 6c 6c 20 63 72 | 69 74 65 72 69 61 2c 20 |g all cr|iteria, |
|00003a20| 37 20 70 61 74 69 65 6e | 74 73 20 69 6e 20 74 68 |7 patien|ts in th|
|00003a30| 65 20 66 69 72 73 74 0d | 0a 64 69 61 67 6e 6f 73 |e first.|.diagnos|
|00003a40| 74 69 63 20 67 72 6f 75 | 70 20 68 61 64 20 65 76 |tic grou|p had ev|
|00003a50| 69 64 65 6e 63 65 20 6f | 66 20 68 79 70 65 72 6f |idence o|f hypero|
|00003a60| 73 74 6f 73 69 73 2e 20 | 20 4e 6f 20 73 69 6e 67 |stosis. | No sing|
|00003a70| 6c 65 20 73 74 75 64 79 | 20 77 61 73 20 61 62 6c |le study| was abl|
|00003a80| 65 20 74 6f 0d 0a 64 65 | 74 65 63 74 20 61 6c 6c |e to..de|tect all|
|00003a90| 20 6f 66 20 74 68 65 73 | 65 20 63 61 73 65 73 2e | of thes|e cases.|
|00003aa0| 20 20 52 65 73 75 6c 74 | 73 20 6f 66 20 73 6b 65 | Result|s of ske|
|00003ab0| 6c 65 74 61 6c 20 73 63 | 69 6e 74 69 67 72 61 70 |letal sc|intigrap|
|00003ac0| 68 79 20 77 65 72 65 20 | 70 6f 73 69 74 69 76 65 |hy were |positive|
|00003ad0| 20 66 6f 72 0d 0a 6f 6e | 6c 79 20 39 20 6f 66 20 | for..on|ly 9 of |
|00003ae0| 74 68 65 20 31 33 20 70 | 61 74 69 65 6e 74 73 20 |the 13 p|atients |
|00003af0| 77 69 74 68 20 68 79 70 | 65 72 6f 73 74 6f 73 69 |with hyp|erostosi|
|00003b00| 73 2e 20 20 45 6c 65 76 | 65 6e 20 70 61 74 69 65 |s. Elev|en patie|
|00003b10| 6e 74 73 20 77 69 74 68 | 0d 0a 68 79 70 65 72 6f |nts with|..hypero|
|00003b20| 73 74 6f 73 69 73 20 68 | 61 64 20 61 20 68 69 73 |stosis h|ad a his|
|00003b30| 74 6f 72 79 20 6f 66 20 | 6d 75 73 63 75 6c 6f 73 |tory of |musculos|
|00003b40| 6b 65 6c 65 74 61 6c 20 | 73 79 6d 70 74 6f 6d 73 |keletal |symptoms|
|00003b50| 2c 20 63 6f 6d 70 61 72 | 65 64 20 77 69 74 68 20 |, compar|ed with |
|00003b60| 6f 6e 6c 79 20 33 0d 0a | 6f 66 20 74 68 65 20 31 |only 3..|of the 1|
|00003b70| 30 20 70 61 74 69 65 6e | 74 73 20 77 69 74 68 6f |0 patien|ts witho|
|00003b80| 75 74 20 68 79 70 65 72 | 6f 73 74 6f 73 69 73 2e |ut hyper|ostosis.|
|00003b90| 20 20 4e 6f 20 63 6c 65 | 61 72 20 61 73 73 6f 63 | No cle|ar assoc|
|00003ba0| 69 61 74 69 6f 6e 20 77 | 69 74 68 20 74 6f 74 61 |iation w|ith tota|
|00003bb0| 6c 20 64 6f 73 65 0d 0a | 6f 72 20 74 72 65 61 74 |l dose..|or treat|
|00003bc0| 6d 65 6e 74 20 64 75 72 | 61 74 69 6f 6e 20 63 6f |ment dur|ation co|
|00003bd0| 75 6c 64 20 62 65 20 66 | 6f 75 6e 64 2e 20 20 53 |uld be f|ound. S|
|00003be0| 65 72 75 6d 20 63 68 65 | 6d 69 73 74 72 79 20 61 |erum che|mistry a|
|00003bf0| 6e 64 20 68 65 6d 61 74 | 6f 6c 6f 67 69 63 0d 0a |nd hemat|ologic..|
|00003c00| 65 76 61 6c 75 61 74 69 | 6f 6e 73 20 79 69 65 6c |evaluati|ons yiel|
|00003c10| 64 65 64 20 6e 6f 72 6d | 61 6c 20 72 65 73 75 6c |ded norm|al resul|
|00003c20| 74 73 2e 20 20 49 6e 20 | 32 20 70 61 74 69 65 6e |ts. In |2 patien|
|00003c30| 74 73 20 74 68 65 20 32 | 34 2d 68 6f 75 72 20 75 |ts the 2|4-hour u|
|00003c40| 72 69 6e 61 72 79 20 63 | 61 6c 63 69 75 6d 0d 0a |rinary c|alcium..|
|00003c50| 65 78 63 72 65 74 69 6f | 6e 20 77 61 73 20 73 69 |excretio|n was si|
|00003c60| 67 6e 69 66 69 63 61 6e | 74 6c 79 20 69 6e 63 72 |gnifican|tly incr|
|00003c70| 65 61 73 65 64 2c 20 61 | 6e 20 61 62 6e 6f 72 6d |eased, a|n abnorm|
|00003c80| 61 6c 69 74 79 20 6e 6f | 74 20 64 65 73 63 72 69 |ality no|t descri|
|00003c90| 62 65 64 0d 0a 70 72 65 | 76 69 6f 75 73 6c 79 2e |bed..pre|viously.|
|00003ca0| 20 20 41 6e 6e 75 61 6c | 20 6c 61 74 65 72 61 6c | Annual| lateral|
|00003cb0| 20 74 68 6f 72 61 63 69 | 63 20 73 70 69 6e 65 20 | thoraci|c spine |
|00003cc0| 72 61 64 69 6f 67 72 61 | 70 68 73 20 77 69 74 68 |radiogra|phs with|
|00003cd0| 20 61 64 64 69 74 69 6f | 6e 61 6c 20 76 69 65 77 | additio|nal view|
|00003ce0| 73 0d 0a 6f 66 20 73 79 | 6d 70 74 6f 6d 61 74 69 |s..of sy|mptomati|
|00003cf0| 63 20 61 72 65 61 73 20 | 77 65 72 65 20 72 65 63 |c areas |were rec|
|00003d00| 6f 6d 6d 65 6e 64 65 64 | 20 66 6f 72 20 70 61 74 |ommended| for pat|
|00003d10| 69 65 6e 74 73 20 72 65 | 63 65 69 76 69 6e 67 20 |ients re|ceiving |
|00003d20| 6c 6f 6e 67 2d 74 65 72 | 6d 0d 0a 65 74 72 65 74 |long-ter|m..etret|
|00003d30| 69 6e 61 74 65 20 74 68 | 65 72 61 70 79 20 28 46 |inate th|erapy (F|
|00003d40| 69 67 73 20 38 2d 31 20 | 61 6e 64 20 38 2d 32 29 |igs 8-1 |and 8-2)|
|00003d50| 2e 0d 0a 20 20 20 20 20 | 44 65 74 65 63 74 61 62 |... |Detectab|
|00003d60| 6c 65 20 68 79 70 65 72 | 6f 73 74 6f 73 69 73 20 |le hyper|ostosis |
|00003d70| 69 73 20 66 61 69 72 6c | 79 20 63 6f 6d 6d 6f 6e |is fairl|y common|
|00003d80| 20 61 6d 6f 6e 67 20 70 | 61 74 69 65 6e 74 73 20 | among p|atients |
|00003d90| 67 69 76 65 6e 20 6c 6f | 6e 67 2d 74 65 72 6d 0d |given lo|ng-term.|
|00003da0| 0a 65 74 72 65 74 69 6e | 61 74 65 20 74 72 65 61 |.etretin|ate trea|
|00003db0| 74 6d 65 6e 74 2e 20 20 | 49 74 20 69 73 20 6e 6f |tment. |It is no|
|00003dc0| 74 20 6b 6e 6f 77 6e 20 | 77 68 65 74 68 65 72 20 |t known |whether |
|00003dd0| 74 68 65 73 65 20 70 61 | 74 69 65 6e 74 73 20 77 |these pa|tients w|
|00003de0| 69 6c 6c 0d 0a 64 65 74 | 65 72 69 6f 72 61 74 65 |ill..det|eriorate|
|00003df0| 2c 20 6f 72 20 77 68 65 | 74 68 65 72 20 77 69 74 |, or whe|ther wit|
|00003e00| 68 64 72 61 77 61 6c 20 | 6f 66 20 74 68 65 20 64 |hdrawal |of the d|
|00003e10| 72 75 67 20 77 6f 75 6c | 64 20 6c 65 61 64 20 74 |rug woul|d lead t|
|00003e20| 6f 20 72 65 76 65 72 73 | 61 6c 20 6f 66 20 74 68 |o revers|al of th|
|00003e30| 65 0d 0a 68 79 70 65 72 | 6f 73 74 6f 73 69 73 2e |e..hyper|ostosis.|
|00003e40| 0d 0a 0d 0a 50 6f 73 74 | 2d 43 6f 6d 6d 65 6e 74 |....Post|-Comment|
|00003e50| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 69 6e 63 |.... | The inc|
|00003e60| 69 64 65 6e 63 65 20 61 | 6e 64 20 74 79 70 65 20 |idence a|nd type |
|00003e70| 6f 66 20 6f 73 73 65 6f | 75 73 20 63 68 61 6e 67 |of osseo|us chang|
|00003e80| 65 73 20 63 61 75 73 65 | 64 20 62 79 20 65 74 72 |es cause|d by etr|
|00003e90| 65 74 69 6e 61 74 65 20 | 74 68 65 72 61 70 79 2c |etinate |therapy,|
|00003ea0| 0d 0a 61 6e 64 20 68 6f | 77 20 6f 66 74 65 6e 20 |..and ho|w often |
|00003eb0| 74 68 65 79 20 61 72 65 | 20 73 79 6d 70 74 6f 6d |they are| symptom|
|00003ec0| 61 74 69 63 2c 20 68 61 | 76 65 20 6e 6f 74 20 62 |atic, ha|ve not b|
|00003ed0| 65 65 6e 20 77 65 6c 6c | 20 65 73 74 61 62 6c 69 |een well| establi|
|00003ee0| 73 68 65 64 20 64 65 73 | 70 69 74 65 20 61 0d 0a |shed des|pite a..|
|00003ef0| 6c 61 72 67 65 20 6e 75 | 6d 62 65 72 20 6f 66 20 |large nu|mber of |
|00003f00| 70 75 62 6c 69 73 68 65 | 64 20 72 65 70 6f 72 74 |publishe|d report|
|00003f10| 73 2e 20 20 46 72 6f 6d | 20 74 68 65 20 72 65 73 |s. From| the res|
|00003f20| 75 6c 74 73 20 6f 66 20 | 74 68 69 73 20 73 74 75 |ults of |this stu|
|00003f30| 64 79 20 62 79 20 61 20 | 67 72 6f 75 70 0d 0a 6f |dy by a |group..o|
|00003f40| 66 20 72 61 64 69 6f 6c | 6f 67 69 73 74 73 20 69 |f radiol|ogists i|
|00003f50| 6e 20 77 68 69 63 68 20 | 70 61 74 69 65 6e 74 73 |n which |patients|
|00003f60| 20 77 69 74 68 20 64 69 | 73 6f 72 64 65 72 73 20 | with di|sorders |
|00003f70| 6f 66 20 6b 65 72 61 74 | 69 6e 69 7a 61 74 69 6f |of kerat|inizatio|
|00003f80| 6e 20 61 6e 64 0d 0a 70 | 73 6f 72 69 61 73 69 73 |n and..p|soriasis|
|00003f90| 20 77 65 72 65 20 65 76 | 61 6c 75 61 74 65 64 20 | were ev|aluated |
|00003fa0| 72 65 74 72 6f 73 70 65 | 63 74 69 76 65 6c 79 2c |retrospe|ctively,|
|00003fb0| 20 74 68 65 20 63 6f 6e | 63 6c 75 73 69 6f 6e 20 | the con|clusion |
|00003fc0| 77 61 73 20 72 65 61 63 | 68 65 64 20 74 68 61 74 |was reac|hed that|
|00003fd0| 0d 0a 68 79 70 65 72 6f | 73 74 6f 73 69 73 20 69 |..hypero|stosis i|
|00003fe0| 73 20 63 6f 6d 6d 6f 6e | 20 62 75 74 20 74 68 61 |s common| but tha|
|00003ff0| 74 20 74 68 65 20 64 6f | 73 65 20 61 6e 64 20 64 |t the do|se and d|
|00004000| 75 72 61 74 69 6f 6e 20 | 6f 66 20 64 72 75 67 20 |uration |of drug |
|00004010| 61 72 65 20 6e 6f 74 0d | 0a 63 61 75 73 61 74 69 |are not.|.causati|
|00004020| 76 65 20 66 61 63 74 6f | 72 73 3b 20 74 68 65 20 |ve facto|rs; the |
|00004030| 6c 61 74 74 65 72 20 66 | 69 6e 64 69 6e 67 73 20 |latter f|indings |
|00004040| 61 72 65 20 72 61 74 68 | 65 72 20 73 75 72 70 72 |are rath|er surpr|
|00004050| 69 73 69 6e 67 20 61 6e | 64 20 61 73 20 6c 69 6b |ising an|d as lik|
|00004060| 65 6c 79 20 61 0d 0a 72 | 65 66 6c 65 63 74 69 6f |ely a..r|eflectio|
|00004070| 6e 20 6f 66 20 74 68 65 | 20 73 6d 61 6c 6c 20 6e |n of the| small n|
|00004080| 75 6d 62 65 72 73 20 6f | 66 20 70 61 74 69 65 6e |umbers o|f patien|
|00004090| 74 73 20 73 74 75 64 69 | 65 64 2e 20 20 54 68 65 |ts studi|ed. The|
|000040a0| 20 61 75 74 68 6f 72 73 | 20 63 6f 75 6c 64 20 73 | authors| could s|
|000040b0| 68 6f 77 2c 0d 0a 68 6f | 77 65 76 65 72 2c 20 74 |how,..ho|wever, t|
|000040c0| 68 61 74 20 73 63 69 6e | 74 69 67 72 61 70 68 79 |hat scin|tigraphy|
|000040d0| 20 77 61 73 20 6e 6f 74 | 20 73 75 70 65 72 69 6f | was not| superio|
|000040e0| 72 20 74 6f 20 70 6c 61 | 69 6e 20 78 2d 72 61 79 |r to pla|in x-ray|
|000040f0| 20 65 78 61 6d 69 6e 61 | 74 69 6f 6e 2c 20 61 6e | examina|tion, an|
|00004100| 64 0d 0a 74 68 65 69 72 | 20 72 65 63 6f 6d 6d 65 |d..their| recomme|
|00004110| 6e 64 61 74 69 6f 6e 20 | 74 68 61 74 20 61 6e 6e |ndation |that ann|
|00004120| 75 61 6c 20 78 2d 72 61 | 79 20 73 74 75 64 69 65 |ual x-ra|y studie|
|00004130| 73 20 62 65 20 70 65 72 | 66 6f 72 6d 65 64 20 6f |s be per|formed o|
|00004140| 66 20 74 68 65 20 6c 61 | 74 65 72 61 6c 0d 0a 74 |f the la|teral..t|
|00004150| 68 6f 72 61 63 69 63 20 | 73 70 69 6e 65 20 61 6e |horacic |spine an|
|00004160| 64 20 6f 66 20 6f 74 68 | 65 72 20 61 72 65 61 73 |d of oth|er areas|
|00004170| 20 77 68 65 72 65 20 70 | 61 69 6e 20 69 73 20 65 | where p|ain is e|
|00004180| 78 70 65 72 69 65 6e 63 | 65 64 20 73 65 65 6d 73 |xperienc|ed seems|
|00004190| 20 72 65 61 73 6f 6e 61 | 62 6c 65 2e 0d 0a 2d 2d | reasona|ble...--|
|000041a0| 50 2e 45 2e 20 50 6f 63 | 68 69 2c 20 4d 2e 44 2e |P.E. Poc|hi, M.D.|
|000041b0| 0d 0a 24 55 6e 69 71 75 | 65 5f 49 44 7b 59 52 42 |..$Uniqu|e_ID{YRB|
|000041c0| 30 39 31 30 35 7d 0d 0a | 24 54 69 74 6c 65 7b 42 |09105}..|$Title{B|
|000041d0| 65 74 61 2d 41 64 72 65 | 6e 6f 63 65 70 74 6f 72 |eta-Adre|noceptor|
|000041e0| 20 41 6e 74 61 67 6f 6e | 69 73 74 2d 49 6e 64 75 | Antagon|ist-Indu|
|000041f0| 63 65 64 20 50 73 6f 72 | 69 61 73 69 66 6f 72 6d |ced Psor|iasiform|
|00004200| 20 45 72 75 70 74 69 6f | 6e 3a 20 20 43 6c 69 6e | Eruptio|n: Clin|
|00004210| 69 63 61 6c 20 61 6e 64 | 20 50 61 74 68 6f 67 65 |ical and| Pathoge|
|00004220| 6e 65 74 69 63 20 41 73 | 70 65 63 74 73 7d 0d 0a |netic As|pects}..|
|00004230| 24 41 75 74 68 6f 72 7b | 48 65 6e 67 2c 20 4d 43 |$Author{|Heng, MC|
|00004240| 59 0d 0a 48 65 6e 67 2c | 20 4d 4b 7d 0d 0a 24 41 |Y..Heng,| MK}..$A|
|00004250| 66 66 69 6c 69 61 74 69 | 6f 6e 7b 55 6e 69 76 20 |ffiliati|on{Univ |
|00004260| 6f 66 20 43 61 6c 69 66 | 6f 72 6e 69 61 2c 20 4c |of Calif|ornia, L|
|00004270| 6f 73 20 41 6e 67 65 6c | 65 73 3b 20 56 41 20 4d |os Angel|es; VA M|
|00004280| 65 64 20 43 74 72 2c 20 | 53 65 70 75 6c 76 65 64 |ed Ctr, |Sepulved|
|00004290| 61 2c 20 43 61 6c 69 66 | 7d 0d 0a 24 4a 6f 75 72 |a, Calif|}..$Jour|
|000042a0| 6e 61 6c 7b 49 6e 74 20 | 4a 20 44 65 72 6d 61 74 |nal{Int |J Dermat|
|000042b0| 6f 6c 7d 0d 0a 24 56 6f | 6c 75 6d 65 7b 32 37 7d |ol}..$Vo|lume{27}|
|000042c0| 0d 0a 24 50 61 67 65 7b | 36 31 39 2d 36 32 37 7d |..$Page{|619-627}|
|000042d0| 0d 0a 24 44 61 74 65 7b | 4e 6f 76 65 6d 62 65 72 |..$Date{|November|
|000042e0| 20 31 39 38 38 7d 0d 0a | 24 59 42 56 6f 6c 7b 31 | 1988}..|$YBVol{1|
|000042f0| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00004300| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 7d 0d 0a 24 | Dermato|logy}..$|
|00004310| 43 68 61 70 74 65 72 7b | 38 2d 34 7d 0d 0a 24 59 |Chapter{|8-4}..$Y|
|00004320| 42 45 64 69 74 6f 72 7b | 44 72 73 2e 20 53 6f 62 |BEditor{|Drs. Sob|
|00004330| 65 72 20 61 6e 64 20 46 | 69 74 7a 70 61 74 72 69 |er and F|itzpatri|
|00004340| 63 6b 7d 0d 0a 24 54 61 | 62 6c 65 7b 54 61 62 6c |ck}..$Ta|ble{Tabl|
|00004350| 65 20 4f 6d 69 74 74 65 | 64 7d 0d 0a 24 43 6f 6d |e Omitte|d}..$Com|
|00004360| 6d 65 6e 74 61 74 6f 72 | 7b 7d 0d 0a 0d 0a 43 6f |mentator|{}....Co|
|00004370| 70 79 72 69 67 68 74 20 | 28 63 29 20 59 65 61 72 |pyright |(c) Year|
|00004380| 62 6f 6f 6b 20 4d 65 64 | 69 63 61 6c 20 50 75 62 |book Med|ical Pub|
|00004390| 6c 69 73 68 65 72 73 2c | 20 49 6e 63 2e 2c 20 31 |lishers,| Inc., 1|
|000043a0| 39 39 30 0d 0a 0d 0a 31 | 39 39 30 20 59 65 61 72 |990....1|990 Year|
|000043b0| 20 42 6f 6f 6b 20 6f 66 | 20 44 65 72 6d 61 74 6f | Book of| Dermato|
|000043c0| 6c 6f 67 79 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |logy (R)|....Chap|
|000043d0| 74 65 72 20 38 2d 2d 41 | 64 76 65 72 73 65 20 44 |ter 8--A|dverse D|
|000043e0| 72 75 67 20 52 65 61 63 | 74 69 6f 6e 73 0d 0a 0d |rug Reac|tions...|
|000043f0| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00004400| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004410| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004420| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004430| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00004440| 0a 42 65 74 61 2d 41 64 | 72 65 6e 6f 63 65 70 74 |.Beta-Ad|renocept|
|00004450| 6f 72 20 41 6e 74 61 67 | 6f 6e 69 73 74 2d 49 6e |or Antag|onist-In|
|00004460| 64 75 63 65 64 20 50 73 | 6f 72 69 61 73 69 66 6f |duced Ps|oriasifo|
|00004470| 72 6d 20 45 72 75 70 74 | 69 6f 6e 3a 20 20 43 6c |rm Erupt|ion: Cl|
|00004480| 69 6e 69 63 61 6c 20 61 | 6e 64 0d 0a 50 61 74 68 |inical a|nd..Path|
|00004490| 6f 67 65 6e 65 74 69 63 | 20 41 73 70 65 63 74 73 |ogenetic| Aspects|
|000044a0| 0d 0a 0d 0a 48 65 6e 67 | 20 4d 43 59 3b 20 48 65 |....Heng| MCY; He|
|000044b0| 6e 67 20 4d 4b 0d 0a 28 | 55 6e 69 76 20 6f 66 20 |ng MK..(|Univ of |
|000044c0| 43 61 6c 69 66 6f 72 6e | 69 61 2c 20 4c 6f 73 20 |Californ|ia, Los |
|000044d0| 41 6e 67 65 6c 65 73 3b | 20 56 41 20 4d 65 64 20 |Angeles;| VA Med |
|000044e0| 43 74 72 2c 20 53 65 70 | 75 6c 76 65 64 61 2c 20 |Ctr, Sep|ulveda, |
|000044f0| 43 61 6c 69 66 29 0d 0a | 49 6e 74 20 4a 20 44 65 |Calif)..|Int J De|
|00004500| 72 6d 61 74 6f 6c 20 32 | 37 3a 36 31 39 2d 36 32 |rmatol 2|7:619-62|
|00004510| 37 2c 20 4e 6f 76 65 6d | 62 65 72 20 31 39 38 38 |7, Novem|ber 1988|
|00004520| 0d 0a 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |..------|--------|
|00004530| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004540| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004550| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004560| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004570| 0d 0a 0d 0a 41 62 73 74 | 72 61 63 74 0d 0a 0d 0a |....Abst|ract....|
|00004580| 20 20 20 20 20 52 65 70 | 6f 72 74 65 64 6c 79 2c | Rep|ortedly,|
|00004590| 20 63 65 72 74 61 69 6e | 20 62 65 74 61 2d 61 64 | certain| beta-ad|
|000045a0| 72 65 6e 6f 72 65 63 65 | 70 74 6f 72 20 62 6c 6f |renorece|ptor blo|
|000045b0| 63 6b 69 6e 67 20 64 72 | 75 67 73 20 63 61 6e 20 |cking dr|ugs can |
|000045c0| 69 6e 64 75 63 65 20 61 | 0d 0a 70 61 70 75 6c 6f |induce a|..papulo|
|000045d0| 73 71 75 61 6d 6f 75 73 | 20 65 72 75 70 74 69 6f |squamous| eruptio|
|000045e0| 6e 20 72 65 73 65 6d 62 | 6c 69 6e 67 20 70 73 6f |n resemb|ling pso|
|000045f0| 72 69 61 73 69 73 2e 20 | 20 48 6f 77 65 76 65 72 |riasis. | However|
|00004600| 2c 20 61 74 20 70 72 65 | 73 65 6e 74 20 69 74 20 |, at pre|sent it |
|00004610| 69 73 0d 0a 75 6e 6b 6e | 6f 77 6e 20 77 68 65 74 |is..unkn|own whet|
|00004620| 68 65 72 20 74 68 65 20 | 62 65 74 61 2d 62 6c 6f |her the |beta-blo|
|00004630| 63 6b 65 72 2d 69 6e 64 | 75 63 65 64 20 65 72 75 |cker-ind|uced eru|
|00004640| 70 74 69 6f 6e 20 69 73 | 20 61 6e 20 65 6e 74 69 |ption is| an enti|
|00004650| 74 79 20 75 6e 74 6f 20 | 69 74 73 65 6c 66 2c 20 |ty unto |itself, |
|00004660| 6f 72 0d 0a 77 68 65 74 | 68 65 72 20 74 68 65 73 |or..whet|her thes|
|00004670| 65 20 64 72 75 67 73 20 | 61 67 67 72 61 76 61 74 |e drugs |aggravat|
|00004680| 65 20 61 6e 20 65 78 69 | 73 74 69 6e 67 20 70 73 |e an exi|sting ps|
|00004690| 6f 72 69 61 74 69 63 20 | 74 65 6e 64 65 6e 63 79 |oriatic |tendency|
|000046a0| 2e 20 20 49 74 20 69 73 | 20 61 6c 73 6f 0d 0a 75 |. It is| also..u|
|000046b0| 6e 63 6c 65 61 72 20 77 | 68 65 74 68 65 72 20 69 |nclear w|hether i|
|000046c0| 74 20 69 73 20 62 65 74 | 61 20 62 6c 6f 63 6b 61 |t is bet|a blocka|
|000046d0| 64 65 20 6f 72 20 74 68 | 65 20 64 72 75 67 20 69 |de or th|e drug i|
|000046e0| 74 73 65 6c 66 20 74 68 | 61 74 20 69 73 20 72 65 |tself th|at is re|
|000046f0| 73 70 6f 6e 73 69 62 6c | 65 20 66 6f 72 0d 0a 74 |sponsibl|e for..t|
|00004700| 68 65 20 73 79 6e 64 72 | 6f 6d 65 2e 20 20 41 20 |he syndr|ome. A |
|00004710| 67 72 6f 75 70 20 6f 66 | 20 31 36 20 70 61 74 69 |group of| 16 pati|
|00004720| 65 6e 74 73 20 67 69 76 | 65 6e 20 62 65 74 61 2d |ents giv|en beta-|
|00004730| 61 64 72 65 6e 6f 72 65 | 63 65 70 74 6f 72 2d 62 |adrenore|ceptor-b|
|00004740| 6c 6f 63 6b 69 6e 67 0d | 0a 61 67 65 6e 74 73 20 |locking.|.agents |
|00004750| 77 68 6f 20 68 61 64 20 | 70 73 6f 72 69 61 73 69 |who had |psoriasi|
|00004760| 66 6f 72 6d 20 63 75 74 | 61 6e 65 6f 75 73 20 65 |form cut|aneous e|
|00004770| 72 75 70 74 69 6f 6e 73 | 20 77 65 72 65 20 73 74 |ruptions| were st|
|00004780| 75 64 69 65 64 2e 20 20 | 4e 69 6e 65 20 70 61 74 |udied. |Nine pat|
|00004790| 69 65 6e 74 73 0d 0a 68 | 61 64 20 6e 6f 20 70 61 |ients..h|ad no pa|
|000047a0| 73 74 20 6f 72 20 66 61 | 6d 69 6c 79 20 68 69 73 |st or fa|mily his|
|000047b0| 74 6f 72 79 20 6f 66 20 | 70 73 6f 72 69 61 73 69 |tory of |psoriasi|
|000047c0| 73 2c 20 61 6e 64 20 36 | 20 68 61 64 20 6f 6e 67 |s, and 6| had ong|
|000047d0| 6f 69 6e 67 20 70 73 6f | 72 69 61 73 69 73 0d 0a |oing pso|riasis..|
|000047e0| 61 67 67 72 61 76 61 74 | 65 64 20 62 79 20 62 65 |aggravat|ed by be|
|000047f0| 74 61 20 62 6c 6f 63 6b | 65 72 73 2e 20 20 41 6c |ta block|ers. Al|
|00004800| 6c 20 70 61 74 69 65 6e | 74 73 20 75 6e 64 65 72 |l patien|ts under|
|00004810| 77 65 6e 74 20 70 75 6e | 63 68 20 62 69 6f 70 73 |went pun|ch biops|
|00004820| 69 65 73 20 6f 66 0d 0a | 69 6e 76 6f 6c 76 65 64 |ies of..|involved|
|00004830| 20 73 6b 69 6e 3b 20 70 | 75 6e 63 68 20 62 69 6f | skin; p|unch bio|
|00004840| 70 73 79 20 73 70 65 63 | 69 6d 65 6e 73 20 61 6c |psy spec|imens al|
|00004850| 73 6f 20 77 65 72 65 20 | 6f 62 74 61 69 6e 65 64 |so were |obtained|
|00004860| 20 66 72 6f 6d 20 75 6e | 69 6e 76 6f 6c 76 65 64 | from un|involved|
|00004870| 20 73 6b 69 6e 0d 0a 69 | 6e 20 34 20 70 61 74 69 | skin..i|n 4 pati|
|00004880| 65 6e 74 73 20 69 6e 20 | 65 61 63 68 20 67 72 6f |ents in |each gro|
|00004890| 75 70 2e 20 20 44 69 72 | 65 63 74 20 69 6d 6d 75 |up. Dir|ect immu|
|000048a0| 6e 6f 66 6c 75 6f 72 65 | 73 63 65 6e 63 65 20 6f |nofluore|scence o|
|000048b0| 66 20 74 68 65 20 73 6b | 69 6e 20 77 61 73 0d 0a |f the sk|in was..|
|000048c0| 63 61 72 72 69 65 64 20 | 6f 75 74 2e 0d 0a 20 20 |carried |out... |
|000048d0| 20 20 20 43 6c 69 6e 69 | 63 61 6c 6c 79 2c 20 69 | Clini|cally, i|
|000048e0| 74 20 61 70 70 65 61 72 | 65 64 20 74 68 61 74 20 |t appear|ed that |
|000048f0| 74 68 65 20 70 73 6f 72 | 69 61 73 69 66 6f 72 6d |the psor|iasiform|
|00004900| 20 6c 65 73 69 6f 6e 73 | 20 69 6e 64 75 63 65 64 | lesions| induced|
|00004910| 20 62 79 20 62 65 74 61 | 0d 0a 62 6c 6f 63 6b 65 | by beta|..blocke|
|00004920| 72 73 20 77 65 72 65 20 | 74 68 69 6e 6e 65 72 2c |rs were |thinner,|
|00004930| 20 6c 65 73 73 20 73 63 | 61 6c 79 2c 20 61 6e 64 | less sc|aly, and|
|00004940| 20 6c 65 73 73 20 65 72 | 79 74 68 65 6d 61 74 6f | less er|ythemato|
|00004950| 75 73 20 69 6e 20 74 68 | 65 20 64 72 75 67 2d 69 |us in th|e drug-i|
|00004960| 6e 64 75 63 65 64 0d 0a | 67 72 6f 75 70 20 74 68 |nduced..|group th|
|00004970| 61 6e 20 69 6e 20 74 68 | 65 20 64 72 75 67 2d 61 |an in th|e drug-a|
|00004980| 67 67 72 61 76 61 74 65 | 64 20 67 72 6f 75 70 2e |ggravate|d group.|
|00004990| 20 20 54 68 65 20 74 72 | 75 6e 6b 20 61 6e 64 20 | The tr|unk and |
|000049a0| 6c 69 6d 62 73 20 77 65 | 72 65 20 75 73 75 61 6c |limbs we|re usual|
|000049b0| 6c 79 0d 0a 69 6e 76 6f | 6c 76 65 64 20 73 79 6d |ly..invo|lved sym|
|000049c0| 6d 65 74 72 69 63 61 6c | 6c 79 2c 20 62 75 74 20 |metrical|ly, but |
|000049d0| 74 68 65 20 66 61 63 65 | 20 77 61 73 20 73 70 61 |the face| was spa|
|000049e0| 72 65 64 20 69 6e 20 74 | 68 65 20 67 72 6f 75 70 |red in t|he group|
|000049f0| 20 77 69 74 68 20 64 72 | 75 67 2d 69 6e 64 75 63 | with dr|ug-induc|
|00004a00| 65 64 0d 0a 6c 65 73 69 | 6f 6e 73 2e 20 20 50 61 |ed..lesi|ons. Pa|
|00004a10| 6c 6d 73 2c 20 73 6f 6c | 65 73 2c 20 61 6e 64 20 |lms, sol|es, and |
|00004a20| 65 6c 62 6f 77 73 20 77 | 65 72 65 20 73 65 6c 64 |elbows w|ere seld|
|00004a30| 6f 6d 20 69 6e 76 6f 6c | 76 65 64 20 28 74 61 62 |om invol|ved (tab|
|00004a40| 6c 65 29 2e 20 20 57 69 | 74 68 0d 0a 74 72 65 61 |le). Wi|th..trea|
|00004a50| 74 6d 65 6e 74 2c 20 74 | 68 65 20 65 72 75 70 74 |tment, t|he erupt|
|00004a60| 69 6f 6e 20 74 79 70 69 | 63 61 6c 6c 79 20 73 75 |ion typi|cally su|
|00004a70| 62 73 69 64 65 64 20 77 | 69 74 68 69 6e 20 36 20 |bsided w|ithin 6 |
|00004a80| 77 65 65 6b 73 20 6f 66 | 20 64 69 73 63 6f 6e 74 |weeks of| discont|
|00004a90| 69 6e 75 61 74 69 6f 6e | 0d 0a 6f 66 20 74 68 65 |inuation|..of the|
|00004aa0| 20 62 65 74 61 20 62 6c | 6f 63 6b 65 72 2e 20 20 | beta bl|ocker. |
|00004ab0| 54 68 65 20 67 72 6f 75 | 70 20 77 69 74 68 20 64 |The grou|p with d|
|00004ac0| 72 75 67 2d 61 67 67 72 | 61 76 61 74 65 64 20 6c |rug-aggr|avated l|
|00004ad0| 65 73 69 6f 6e 73 20 68 | 61 64 20 6f 6e 6c 79 20 |esions h|ad only |
|00004ae0| 70 61 72 74 69 61 6c 0d | 0a 72 65 6d 69 73 73 69 |partial.|.remissi|
|00004af0| 6f 6e 20 61 66 74 65 72 | 20 62 65 74 61 20 62 6c |on after| beta bl|
|00004b00| 6f 63 6b 65 72 20 77 69 | 74 68 64 72 61 77 61 6c |ocker wi|thdrawal|
|00004b10| 2e 20 20 53 6b 69 6e 20 | 69 6d 6d 75 6e 6f 66 6c |. Skin |immunofl|
|00004b20| 75 6f 72 65 73 63 65 6e | 63 65 20 64 69 64 20 6e |uorescen|ce did n|
|00004b30| 6f 74 0d 0a 72 65 76 65 | 61 6c 20 74 68 65 20 70 |ot..reve|al the p|
|00004b40| 72 65 73 65 6e 63 65 20 | 6f 66 20 61 6e 74 69 62 |resence |of antib|
|00004b50| 6f 64 79 20 6f 72 20 63 | 6f 6d 70 6c 65 6d 65 6e |ody or c|omplemen|
|00004b60| 74 20 64 65 70 6f 73 69 | 74 73 2e 20 20 54 68 65 |t deposi|ts. The|
|00004b70| 20 63 6f 6d 70 6f 73 69 | 74 69 6f 6e 20 6f 66 0d | composi|tion of.|
|00004b80| 0a 62 69 6f 70 73 79 20 | 73 70 65 63 69 6d 65 6e |.biopsy |specimen|
|00004b90| 73 20 6f 66 20 65 72 75 | 70 74 69 6f 6e 73 20 63 |s of eru|ptions c|
|00004ba0| 61 75 73 65 64 20 62 79 | 20 73 65 6c 65 63 74 69 |aused by| selecti|
|00004bb0| 76 65 20 62 65 74 61 20 | 62 6c 6f 63 6b 65 72 73 |ve beta |blockers|
|00004bc0| 20 64 69 66 66 65 72 65 | 64 20 66 72 6f 6d 0d 0a | differe|d from..|
|00004bd0| 74 68 61 74 20 63 61 75 | 73 65 64 20 62 79 20 6e |that cau|sed by n|
|00004be0| 6f 6e 73 65 6c 65 63 74 | 69 76 65 20 62 65 74 61 |onselect|ive beta|
|00004bf0| 20 62 6c 6f 63 6b 65 72 | 73 2e 0d 0a 20 20 20 20 | blocker|s... |
|00004c00| 20 62 65 74 61 2d 42 6c | 6f 63 6b 65 72 2d 69 6e | beta-Bl|ocker-in|
|00004c10| 64 75 63 65 64 20 65 72 | 75 70 74 69 6f 6e 73 20 |duced er|uptions |
|00004c20| 6d 61 79 20 72 65 73 75 | 6c 74 20 66 72 6f 6d 20 |may resu|lt from |
|00004c30| 69 6e 63 72 65 61 73 65 | 64 20 70 72 6f 6c 69 66 |increase|d prolif|
|00004c40| 65 72 61 74 69 6f 6e 2c | 0d 0a 6d 6f 74 69 6c 69 |eration,|..motili|
|00004c50| 74 79 2c 20 61 6e 64 20 | 61 63 74 69 76 69 74 79 |ty, and |activity|
|00004c60| 20 6f 66 20 6c 79 6d 70 | 68 6f 63 79 74 65 73 2c | of lymp|hocytes,|
|00004c70| 20 6e 65 75 74 72 6f 70 | 68 69 6c 73 2c 20 61 6e | neutrop|hils, an|
|00004c80| 64 20 63 65 6c 6c 73 20 | 6f 66 20 74 68 65 0d 0a |d cells |of the..|
|00004c90| 6d 61 63 72 6f 70 68 61 | 67 65 2d 4c 61 6e 67 65 |macropha|ge-Lange|
|00004ca0| 72 68 61 6e 73 20 63 65 | 6c 6c 20 73 65 72 69 65 |rhans ce|ll serie|
|00004cb0| 73 2e 20 20 54 68 69 73 | 20 61 63 74 69 6f 6e 20 |s. This| action |
|00004cc0| 6d 61 79 20 73 74 65 6d | 20 66 72 6f 6d 20 64 65 |may stem| from de|
|00004cd0| 70 72 65 73 73 65 64 0d | 0a 69 6e 74 72 61 63 65 |pressed.|.intrace|
|00004ce0| 6c 6c 75 6c 61 72 20 63 | 79 63 6c 69 63 20 61 64 |llular c|yclic ad|
|00004cf0| 65 6e 6f 73 69 6e 65 20 | 6d 6f 6e 6f 70 68 6f 73 |enosine |monophos|
|00004d00| 70 68 61 74 65 20 6c 65 | 76 65 6c 73 20 63 61 75 |phate le|vels cau|
|00004d10| 73 65 64 20 62 79 20 74 | 68 65 20 62 65 74 61 0d |sed by t|he beta.|
|00004d20| 0a 62 6c 6f 63 6b 61 64 | 65 2e 0d 0a 24 55 6e 69 |.blockad|e...$Uni|
|00004d30| 71 75 65 5f 49 44 7b 59 | 52 42 30 39 31 30 36 7d |que_ID{Y|RB09106}|
|00004d40| 0d 0a 24 54 69 74 6c 65 | 7b 43 75 74 61 6e 65 6f |..$Title|{Cutaneo|
|00004d50| 75 73 20 41 64 76 65 72 | 73 65 20 52 65 61 63 74 |us Adver|se React|
|00004d60| 69 6f 6e 73 20 41 73 73 | 6f 63 69 61 74 65 64 20 |ions Ass|ociated |
|00004d70| 57 69 74 68 20 43 61 6c | 63 69 75 6d 20 43 68 61 |With Cal|cium Cha|
|00004d80| 6e 6e 65 6c 20 42 6c 6f | 63 6b 65 72 73 7d 0d 0a |nnel Blo|ckers}..|
|00004d90| 24 41 75 74 68 6f 72 7b | 53 74 65 72 6e 2c 20 52 |$Author{|Stern, R|
|00004da0| 0d 0a 4b 68 61 6c 73 61 | 2c 20 4a 48 7d 0d 0a 24 |..Khalsa|, JH}..$|
|00004db0| 41 66 66 69 6c 69 61 74 | 69 6f 6e 7b 42 65 74 68 |Affiliat|ion{Beth|
|00004dc0| 20 49 73 72 61 65 6c 20 | 48 6f 73 70 2c 20 42 6f | Israel |Hosp, Bo|
|00004dd0| 73 74 6f 6e 3b 20 46 6f | 6f 64 20 61 6e 64 20 44 |ston; Fo|od and D|
|00004de0| 72 75 67 20 41 64 6d 69 | 6e 69 73 74 72 61 74 69 |rug Admi|nistrati|
|00004df0| 6f 6e 2c 20 52 6f 63 6b | 76 69 6c 6c 65 2c 20 4d |on, Rock|ville, M|
|00004e00| 64 7d 0d 0a 24 4a 6f 75 | 72 6e 61 6c 7b 41 72 63 |d}..$Jou|rnal{Arc|
|00004e10| 68 20 49 6e 74 65 72 6e | 20 4d 65 64 7d 0d 0a 24 |h Intern| Med}..$|
|00004e20| 56 6f 6c 75 6d 65 7b 31 | 34 39 7d 0d 0a 24 50 61 |Volume{1|49}..$Pa|
|00004e30| 67 65 7b 38 32 39 2d 38 | 33 32 7d 0d 0a 24 44 61 |ge{829-8|32}..$Da|
|00004e40| 74 65 7b 41 70 72 69 6c | 20 31 39 38 39 7d 0d 0a |te{April| 1989}..|
|00004e50| 24 59 42 56 6f 6c 7b 31 | 39 39 30 20 59 65 61 72 |$YBVol{1|990 Year|
|00004e60| 20 42 6f 6f 6b 20 6f 66 | 20 44 65 72 6d 61 74 6f | Book of| Dermato|
|00004e70| 6c 6f 67 79 7d 0d 0a 24 | 43 68 61 70 74 65 72 7b |logy}..$|Chapter{|
|00004e80| 38 2d 35 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |8-5}..$Y|BEditor{|
|00004e90| 44 72 73 2e 20 53 6f 62 | 65 72 20 61 6e 64 20 46 |Drs. Sob|er and F|
|00004ea0| 69 74 7a 70 61 74 72 69 | 63 6b 7d 0d 0a 24 54 61 |itzpatri|ck}..$Ta|
|00004eb0| 62 6c 65 7b 54 61 62 6c | 65 20 4f 6d 69 74 74 65 |ble{Tabl|e Omitte|
|00004ec0| 64 7d 0d 0a 24 43 6f 6d | 6d 65 6e 74 61 74 6f 72 |d}..$Com|mentator|
|00004ed0| 7b 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |{}....Co|pyright |
|00004ee0| 28 63 29 20 59 65 61 72 | 62 6f 6f 6b 20 4d 65 64 |(c) Year|book Med|
|00004ef0| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00004f00| 20 49 6e 63 2e 2c 20 31 | 39 39 30 0d 0a 0d 0a 31 | Inc., 1|990....1|
|00004f10| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00004f20| 20 44 65 72 6d 61 74 6f | 6c 6f 67 79 20 28 52 29 | Dermato|logy (R)|
|00004f30| 0d 0a 0d 0a 43 68 61 70 | 74 65 72 20 38 2d 2d 41 |....Chap|ter 8--A|
|00004f40| 64 76 65 72 73 65 20 44 | 72 75 67 20 52 65 61 63 |dverse D|rug Reac|
|00004f50| 74 69 6f 6e 73 0d 0a 0d | 0a 2d 2d 2d 2d 2d 2d 2d |tions...|.-------|
|00004f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f80| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004f90| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00004fa0| 2d 2d 2d 2d 2d 2d 2d 0d | 0a 43 75 74 61 6e 65 6f |-------.|.Cutaneo|
|00004fb0| 75 73 20 41 64 76 65 72 | 73 65 20 52 65 61 63 74 |us Adver|se React|
|00004fc0| 69 6f 6e 73 20 41 73 73 | 6f 63 69 61 74 65 64 20 |ions Ass|ociated |
|00004fd0| 57 69 74 68 20 43 61 6c | 63 69 75 6d 20 43 68 61 |With Cal|cium Cha|
|00004fe0| 6e 6e 65 6c 20 42 6c 6f | 63 6b 65 72 73 0d 0a 0d |nnel Blo|ckers...|
|00004ff0| 0a 53 74 65 72 6e 20 52 | 3b 20 4b 68 61 6c 73 61 |.Stern R|; Khalsa|
|00005000| 20 4a 48 0d 0a 28 42 65 | 74 68 20 49 73 72 61 65 | JH..(Be|th Israe|
|00005010| 6c 20 48 6f 73 70 2c 20 | 42 6f 73 74 6f 6e 3b 20 |l Hosp, |Boston; |
|00005020| 46 6f 6f 64 20 61 6e 64 | 20 44 72 75 67 20 41 64 |Food and| Drug Ad|
|00005030| 6d 69 6e 69 73 74 72 61 | 74 69 6f 6e 2c 20 52 6f |ministra|tion, Ro|
|00005040| 63 6b 76 69 6c 6c 65 2c | 20 4d 64 29 0d 0a 41 72 |ckville,| Md)..Ar|
|00005050| 63 68 20 49 6e 74 65 72 | 6e 20 4d 65 64 20 31 34 |ch Inter|n Med 14|
|00005060| 39 3a 38 32 39 2d 38 33 | 32 2c 20 41 70 72 69 6c |9:829-83|2, April|
|00005070| 20 31 39 38 39 0d 0a 2d | 2d 2d 2d 2d 2d 2d 2d 2d | 1989..-|--------|
|00005080| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005090| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000050a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000050b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000050c0| 2d 2d 2d 2d 2d 0d 0a 0d | 0a 41 62 73 74 72 61 63 |-----...|.Abstrac|
|000050d0| 74 0d 0a 0d 0a 20 20 20 | 20 20 54 68 65 20 63 61 |t.... | The ca|
|000050e0| 6c 63 69 75 6d 20 63 68 | 61 6e 6e 65 6c 20 62 6c |lcium ch|annel bl|
|000050f0| 6f 63 6b 65 72 73 20 6e | 69 66 65 64 69 70 69 6e |ockers n|ifedipin|
|00005100| 65 2c 20 76 65 72 61 70 | 61 6d 69 6c 2c 20 61 6e |e, verap|amil, an|
|00005110| 64 20 64 69 6c 74 69 61 | 7a 65 6d 20 61 72 65 0d |d diltia|zem are.|
|00005120| 0a 77 69 64 65 6c 79 20 | 75 73 65 64 20 74 6f 20 |.widely |used to |
|00005130| 74 72 65 61 74 20 70 61 | 74 69 65 6e 74 73 20 77 |treat pa|tients w|
|00005140| 69 74 68 20 63 61 72 64 | 69 6f 76 61 73 63 75 6c |ith card|iovascul|
|00005150| 61 72 20 64 69 73 65 61 | 73 65 2e 20 20 48 6f 77 |ar disea|se. How|
|00005160| 65 76 65 72 2c 20 74 68 | 65 72 65 20 69 73 0d 0a |ever, th|ere is..|
|00005170| 6c 69 74 74 6c 65 20 69 | 6e 66 6f 72 6d 61 74 69 |little i|nformati|
|00005180| 6f 6e 20 6f 6e 20 74 68 | 65 20 66 72 65 71 75 65 |on on th|e freque|
|00005190| 6e 63 79 20 61 6e 64 20 | 73 70 65 63 74 72 75 6d |ncy and |spectrum|
|000051a0| 20 6f 66 20 63 75 74 61 | 6e 65 6f 75 73 20 72 65 | of cuta|neous re|
|000051b0| 61 63 74 69 6f 6e 73 0d | 0a 61 73 73 6f 63 69 61 |actions.|.associa|
|000051c0| 74 65 64 20 77 69 74 68 | 20 74 68 65 73 65 20 61 |ted with| these a|
|000051d0| 67 65 6e 74 73 2e 0d 0a | 20 20 20 20 20 42 65 74 |gents...| Bet|
|000051e0| 77 65 65 6e 20 31 39 37 | 38 20 61 6e 64 20 31 39 |ween 197|8 and 19|
|000051f0| 38 35 2c 20 74 68 65 20 | 46 6f 6f 64 20 61 6e 64 |85, the |Food and|
|00005200| 20 44 72 75 67 20 41 64 | 6d 69 6e 69 73 74 72 61 | Drug Ad|ministra|
|00005210| 74 69 6f 6e 20 28 46 44 | 41 29 20 61 6e 64 20 74 |tion (FD|A) and t|
|00005220| 68 65 0d 0a 41 6d 65 72 | 69 63 61 6e 20 41 63 61 |he..Amer|ican Aca|
|00005230| 64 65 6d 79 20 6f 66 20 | 44 65 72 6d 61 74 6f 6c |demy of |Dermatol|
|00005240| 6f 67 79 27 73 20 41 64 | 76 65 72 73 65 20 44 72 |ogy's Ad|verse Dr|
|00005250| 75 67 20 52 65 61 63 74 | 69 6f 6e 20 52 65 70 6f |ug React|ion Repo|
|00005260| 72 74 69 6e 67 20 53 79 | 73 74 65 6d 0d 0a 28 41 |rting Sy|stem..(A|
|00005270| 44 52 52 53 29 20 72 65 | 63 65 69 76 65 64 20 33 |DRRS) re|ceived 3|
|00005280| 37 39 20 63 61 73 65 20 | 72 65 70 6f 72 74 73 20 |79 case |reports |
|00005290| 6f 66 20 63 75 74 61 6e | 65 6f 75 73 20 61 64 76 |of cutan|eous adv|
|000052a0| 65 72 73 65 20 64 72 75 | 67 20 72 65 61 63 74 69 |erse dru|g reacti|
|000052b0| 6f 6e 73 0d 0a 61 73 73 | 6f 63 69 61 74 65 64 20 |ons..ass|ociated |
|000052c0| 77 69 74 68 20 74 68 65 | 73 65 20 33 20 63 61 6c |with the|se 3 cal|
|000052d0| 63 69 75 6d 20 63 68 61 | 6e 6e 65 6c 20 62 6c 6f |cium cha|nnel blo|
|000052e0| 63 6b 65 72 73 2e 20 20 | 4f 66 20 74 68 65 73 65 |ckers. |Of these|
|000052f0| 2c 20 31 34 36 20 77 65 | 72 65 0d 0a 61 73 73 6f |, 146 we|re..asso|
|00005300| 63 69 61 74 65 64 20 77 | 69 74 68 20 6e 69 66 65 |ciated w|ith nife|
|00005310| 64 69 70 69 6e 65 2c 20 | 31 35 33 20 77 69 74 68 |dipine, |153 with|
|00005320| 20 76 65 72 61 70 61 6d | 69 6c 2c 20 61 6e 64 20 | verapam|il, and |
|00005330| 37 32 20 77 69 74 68 20 | 64 69 6c 74 69 61 7a 65 |72 with |diltiaze|
|00005340| 6d 20 28 74 61 62 6c 65 | 29 2e 0d 0a 54 68 75 73 |m (table|)...Thus|
|00005350| 2c 20 61 6c 74 68 6f 75 | 67 68 20 74 68 65 20 66 |, althou|gh the f|
|00005360| 72 65 71 75 65 6e 63 79 | 20 6f 66 20 61 64 76 65 |requency| of adve|
|00005370| 72 73 65 20 63 75 74 61 | 6e 65 6f 75 73 20 65 76 |rse cuta|neous ev|
|00005380| 65 6e 74 73 20 61 73 73 | 6f 63 69 61 74 65 64 20 |ents ass|ociated |
|00005390| 77 69 74 68 20 74 68 65 | 73 65 0d 0a 64 72 75 67 |with the|se..drug|
|000053a0| 73 20 69 73 20 6c 6f 77 | 2c 20 73 65 76 65 72 65 |s is low|, severe|
|000053b0| 20 72 65 61 63 74 69 6f | 6e 73 20 63 61 6e 20 6f | reactio|ns can o|
|000053c0| 63 63 75 72 20 6f 6e 20 | 6f 63 63 61 73 69 6f 6e |ccur on |occasion|
|000053d0| 2e 20 20 54 68 65 20 6d | 6f 72 65 20 73 65 72 69 |. The m|ore seri|
|000053e0| 6f 75 73 0d 0a 69 6e 63 | 6c 75 64 65 20 74 6f 78 |ous..inc|lude tox|
|000053f0| 69 63 20 65 70 69 64 65 | 72 6d 61 6c 20 6e 65 63 |ic epide|rmal nec|
|00005400| 72 6f 6c 79 73 69 73 20 | 61 73 73 6f 63 69 61 74 |rolysis |associat|
|00005410| 65 64 20 77 69 74 68 20 | 64 69 6c 74 69 61 7a 65 |ed with |diltiaze|
|00005420| 6d 2c 20 53 74 65 76 65 | 6e 73 2d 4a 6f 68 6e 73 |m, Steve|ns-Johns|
|00005430| 6f 6e 0d 0a 73 79 6e 64 | 72 6f 6d 65 20 61 6e 64 |on..synd|rome and|
|00005440| 20 65 72 79 74 68 65 6d | 61 20 6d 75 6c 74 69 66 | erythem|a multif|
|00005450| 6f 72 6d 65 20 77 69 74 | 68 20 61 6c 6c 20 33 20 |orme wit|h all 3 |
|00005460| 61 67 65 6e 74 73 2c 20 | 61 6e 64 20 65 78 66 6f |agents, |and exfo|
|00005470| 6c 69 61 74 69 76 65 20 | 64 65 72 6d 61 74 69 74 |liative |dermatit|
|00005480| 69 73 0d 0a 77 69 74 68 | 20 61 6c 6c 20 33 2e 20 |is..with| all 3. |
|00005490| 20 4d 6f 73 74 20 6f 66 | 20 74 68 65 20 73 65 72 | Most of| the ser|
|000054a0| 69 6f 75 73 20 72 65 61 | 63 74 69 6f 6e 73 20 68 |ious rea|ctions h|
|000054b0| 61 76 65 20 6f 63 63 75 | 72 72 65 64 20 77 69 74 |ave occu|rred wit|
|000054c0| 68 69 6e 20 32 20 77 65 | 65 6b 73 20 6f 66 0d 0a |hin 2 we|eks of..|
|000054d0| 69 6e 69 74 69 61 74 69 | 6f 6e 20 6f 66 20 64 72 |initiati|on of dr|
|000054e0| 75 67 20 74 68 65 72 61 | 70 79 2e 20 20 50 68 79 |ug thera|py. Phy|
|000054f0| 73 69 63 69 61 6e 73 20 | 73 68 6f 75 6c 64 20 62 |sicians |should b|
|00005500| 65 20 61 6c 65 72 74 20 | 74 6f 20 74 68 65 20 70 |e alert |to the p|
|00005510| 6f 73 73 69 62 69 6c 69 | 74 79 20 6f 66 0d 0a 63 |ossibili|ty of..c|
|00005520| 75 74 61 6e 65 6f 75 73 | 20 72 65 61 63 74 69 6f |utaneous| reactio|
|00005530| 6e 73 20 77 68 65 6e 20 | 63 61 6c 63 69 75 6d 20 |ns when |calcium |
|00005540| 63 68 61 6e 6e 65 6c 20 | 62 6c 6f 63 6b 65 72 73 |channel |blockers|
|00005550| 20 61 72 65 20 67 69 76 | 65 6e 2e 0d 0a 24 55 6e | are giv|en...$Un|
|00005560| 69 71 75 65 5f 49 44 7b | 59 52 42 30 39 31 30 37 |ique_ID{|YRB09107|
|00005570| 7d 0d 0a 24 54 69 74 6c | 65 7b 45 63 7a 65 6d 61 |}..$Titl|e{Eczema|
|00005580| 2d 4c 69 6b 65 2c 20 45 | 72 79 74 68 65 6d 61 74 |-Like, E|rythemat|
|00005590| 6f 75 73 2c 20 49 6e 66 | 69 6c 74 72 61 74 65 64 |ous, Inf|iltrated|
|000055a0| 20 50 6c 61 71 75 65 73 | 3a 20 20 41 20 43 6f 6d | Plaques|: A Com|
|000055b0| 6d 6f 6e 20 53 69 64 65 | 20 45 66 66 65 63 74 20 |mon Side| Effect |
|000055c0| 6f 66 20 53 75 62 63 75 | 74 61 6e 65 6f 75 73 20 |of Subcu|taneous |
|000055d0| 48 65 70 61 72 69 6e 20 | 54 68 65 72 61 70 79 7d |Heparin |Therapy}|
|000055e0| 0d 0a 24 41 75 74 68 6f | 72 7b 4b 6c 65 69 6e 2c |..$Autho|r{Klein,|
|000055f0| 20 47 46 0d 0a 4b 6f 66 | 6c 65 72 2c 20 48 0d 0a | GF..Kof|ler, H..|
|00005600| 57 6f 6c 66 2c 20 48 0d | 0a 46 72 69 74 73 63 68 |Wolf, H.|.Fritsch|
|00005610| 2c 20 50 4f 7d 0d 0a 24 | 41 66 66 69 6c 69 61 74 |, PO}..$|Affiliat|
|00005620| 69 6f 6e 7b 55 6e 69 76 | 20 6f 66 20 49 6e 6e 73 |ion{Univ| of Inns|
|00005630| 62 72 75 63 6b 2c 20 41 | 75 73 74 72 69 61 7d 0d |bruck, A|ustria}.|
|00005640| 0a 24 4a 6f 75 72 6e 61 | 6c 7b 4a 20 41 6d 20 41 |.$Journa|l{J Am A|
|00005650| 63 61 64 20 44 65 72 6d | 61 74 6f 6c 7d 0d 0a 24 |cad Derm|atol}..$|
|00005660| 56 6f 6c 75 6d 65 7b 32 | 31 7d 0d 0a 24 50 61 67 |Volume{2|1}..$Pag|
|00005670| 65 7b 37 30 33 2d 37 30 | 37 7d 0d 0a 24 44 61 74 |e{703-70|7}..$Dat|
|00005680| 65 7b 4f 63 74 6f 62 65 | 72 20 31 39 38 39 7d 0d |e{Octobe|r 1989}.|
|00005690| 0a 24 59 42 56 6f 6c 7b | 31 39 39 30 20 59 65 61 |.$YBVol{|1990 Yea|
|000056a0| 72 20 42 6f 6f 6b 20 6f | 66 20 44 65 72 6d 61 74 |r Book o|f Dermat|
|000056b0| 6f 6c 6f 67 79 7d 0d 0a | 24 43 68 61 70 74 65 72 |ology}..|$Chapter|
|000056c0| 7b 38 2d 36 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |{8-6}..$|YBEditor|
|000056d0| 7b 44 72 73 2e 20 53 6f | 62 65 72 20 61 6e 64 20 |{Drs. So|ber and |
|000056e0| 46 69 74 7a 70 61 74 72 | 69 63 6b 7d 0d 0a 24 54 |Fitzpatr|ick}..$T|
|000056f0| 61 62 6c 65 7b 7d 0d 0a | 24 43 6f 6d 6d 65 6e 74 |able{}..|$Comment|
|00005700| 61 74 6f 72 7b 7d 0d 0a | 0d 0a 43 6f 70 79 72 69 |ator{}..|..Copyri|
|00005710| 67 68 74 20 28 63 29 20 | 59 65 61 72 62 6f 6f 6b |ght (c) |Yearbook|
|00005720| 20 4d 65 64 69 63 61 6c | 20 50 75 62 6c 69 73 68 | Medical| Publish|
|00005730| 65 72 73 2c 20 49 6e 63 | 2e 2c 20 31 39 39 30 0d |ers, Inc|., 1990.|
|00005740| 0a 0d 0a 31 39 39 30 20 | 59 65 61 72 20 42 6f 6f |...1990 |Year Boo|
|00005750| 6b 20 6f 66 20 44 65 72 | 6d 61 74 6f 6c 6f 67 79 |k of Der|matology|
|00005760| 20 28 52 29 0d 0a 0d 0a | 43 68 61 70 74 65 72 20 | (R)....|Chapter |
|00005770| 38 2d 2d 41 64 76 65 72 | 73 65 20 44 72 75 67 20 |8--Adver|se Drug |
|00005780| 52 65 61 63 74 69 6f 6e | 73 0d 0a 0d 0a 2d 2d 2d |Reaction|s....---|
|00005790| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000057d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 0d 0a 45 63 7a |--------|---..Ecz|
|000057e0| 65 6d 61 2d 4c 69 6b 65 | 2c 20 45 72 79 74 68 65 |ema-Like|, Erythe|
|000057f0| 6d 61 74 6f 75 73 2c 20 | 49 6e 66 69 6c 74 72 61 |matous, |Infiltra|
|00005800| 74 65 64 20 50 6c 61 71 | 75 65 73 3a 20 20 41 20 |ted Plaq|ues: A |
|00005810| 43 6f 6d 6d 6f 6e 20 53 | 69 64 65 20 45 66 66 65 |Common S|ide Effe|
|00005820| 63 74 20 6f 66 0d 0a 53 | 75 62 63 75 74 61 6e 65 |ct of..S|ubcutane|
|00005830| 6f 75 73 20 48 65 70 61 | 72 69 6e 20 54 68 65 72 |ous Hepa|rin Ther|
|00005840| 61 70 79 0d 0a 0d 0a 4b | 6c 65 69 6e 20 47 46 3b |apy....K|lein GF;|
|00005850| 20 4b 6f 66 6c 65 72 20 | 48 3b 20 57 6f 6c 66 20 | Kofler |H; Wolf |
|00005860| 48 3b 20 46 72 69 74 73 | 63 68 20 50 4f 0d 0a 28 |H; Frits|ch PO..(|
|00005870| 55 6e 69 76 20 6f 66 20 | 49 6e 6e 73 62 72 75 63 |Univ of |Innsbruc|
|00005880| 6b 2c 20 41 75 73 74 72 | 69 61 29 0d 0a 4a 20 41 |k, Austr|ia)..J A|
|00005890| 6d 20 41 63 61 64 20 44 | 65 72 6d 61 74 6f 6c 20 |m Acad D|ermatol |
|000058a0| 32 31 3a 37 30 33 2d 37 | 30 37 2c 20 4f 63 74 6f |21:703-7|07, Octo|
|000058b0| 62 65 72 20 31 39 38 39 | 0d 0a 2d 2d 2d 2d 2d 2d |ber 1989|..------|
|000058c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000058f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00005900| 2d 2d 2d 2d 2d 2d 2d 2d | 0d 0a 0d 0a 41 62 73 74 |--------|....Abst|
|00005910| 72 61 63 74 0d 0a 0d 0a | 20 20 20 20 20 53 74 75 |ract....| Stu|
|00005920| 64 69 65 73 20 73 75 67 | 67 65 73 74 20 74 68 61 |dies sug|gest tha|
|00005930| 74 20 65 72 79 74 68 65 | 6d 61 74 6f 75 73 2c 20 |t erythe|matous, |
|00005940| 69 6e 66 69 6c 74 72 61 | 74 65 64 20 70 6c 61 71 |infiltra|ted plaq|
|00005950| 75 65 73 20 61 72 65 20 | 61 20 63 6f 6d 6d 6f 6e |ues are |a common|
|00005960| 20 62 75 74 0d 0a 6e 65 | 67 6c 65 63 74 65 64 20 | but..ne|glected |
|00005970| 72 65 61 63 74 69 6f 6e | 20 74 6f 20 68 65 70 61 |reaction| to hepa|
|00005980| 72 69 6e 20 74 72 65 61 | 74 6d 65 6e 74 2e 20 20 |rin trea|tment. |
|00005990| 49 6e 20 31 34 20 77 6f | 6d 65 6e 20 61 6e 64 20 |In 14 wo|men and |
|000059a0| 31 20 6d 61 6e 20 77 69 | 74 68 20 68 65 70 61 72 |1 man wi|th hepar|
|000059b0| 69 6e 0d 0a 69 6e 74 6f | 6c 65 72 61 6e 63 65 2c |in..into|lerance,|
|000059c0| 20 65 72 79 74 68 65 6d | 61 74 6f 75 73 2c 20 69 | erythem|atous, i|
|000059d0| 6e 66 69 6c 74 72 61 74 | 65 64 20 70 6c 61 71 75 |nfiltrat|ed plaqu|
|000059e0| 65 73 20 64 65 76 65 6c | 6f 70 65 64 20 74 68 61 |es devel|oped tha|
|000059f0| 74 20 72 65 73 65 6d 62 | 6c 65 64 0d 0a 63 6f 6e |t resemb|led..con|
|00005a00| 74 61 63 74 20 64 65 72 | 6d 61 74 69 74 69 73 20 |tact der|matitis |
|00005a10| 63 6c 69 6e 69 63 61 6c | 6c 79 20 61 6e 64 20 68 |clinical|ly and h|
|00005a20| 69 73 74 6f 6c 6f 67 69 | 63 61 6c 6c 79 2e 20 20 |istologi|cally. |
|00005a30| 54 68 65 20 70 6c 61 71 | 75 65 73 20 64 65 76 65 |The plaq|ues deve|
|00005a40| 6c 6f 70 65 64 0d 0a 77 | 69 74 68 69 6e 20 33 2d |loped..w|ithin 3-|
|00005a50| 32 31 20 64 61 79 73 20 | 61 66 74 65 72 20 69 6e |21 days |after in|
|00005a60| 69 74 69 61 74 69 6f 6e | 20 6f 66 20 73 75 62 63 |itiation| of subc|
|00005a70| 75 74 61 6e 65 6f 75 73 | 20 68 65 70 61 72 69 6e |utaneous| heparin|
|00005a80| 20 74 72 65 61 74 6d 65 | 6e 74 2e 20 20 41 6c 6c | treatme|nt. All|
|00005a90| 20 68 61 64 0d 0a 72 65 | 63 65 69 76 65 64 20 35 | had..re|ceived 5|
|00005aa0| 2c 30 30 30 2d 37 2c 35 | 30 30 20 75 6e 69 74 73 |,000-7,5|00 units|
|00005ab0| 20 6f 66 20 68 65 70 61 | 72 69 6e 20 32 20 6f 72 | of hepa|rin 2 or|
|00005ac0| 20 33 20 74 69 6d 65 73 | 20 61 20 64 61 79 20 61 | 3 times| a day a|
|00005ad0| 66 74 65 72 20 73 75 72 | 67 65 72 79 20 6f 72 20 |fter sur|gery or |
|00005ae0| 66 6f 72 0d 0a 74 68 65 | 20 74 72 65 61 74 6d 65 |for..the| treatme|
|00005af0| 6e 74 20 6f 66 20 70 72 | 6f 70 68 79 6c 61 78 69 |nt of pr|ophylaxi|
|00005b00| 73 20 6f 66 20 74 68 72 | 6f 6d 62 6f 65 6d 62 6f |s of thr|omboembo|
|00005b10| 6c 69 63 20 64 69 73 65 | 61 73 65 2e 0d 0a 20 20 |lic dise|ase... |
|00005b20| 20 20 20 54 68 65 20 70 | 72 65 73 65 6e 63 65 20 | The p|resence |
|00005b30| 6f 66 20 61 20 64 65 6c | 61 79 65 64 20 68 79 70 |of a del|ayed hyp|
|00005b40| 65 72 73 65 6e 73 69 74 | 69 76 69 74 79 20 72 65 |ersensit|ivity re|
|00005b50| 61 63 74 69 6f 6e 20 77 | 61 73 20 73 75 67 67 65 |action w|as sugge|
|00005b60| 73 74 65 64 20 62 79 20 | 74 68 65 0d 0a 63 6c 69 |sted by |the..cli|
|00005b70| 6e 69 63 61 6c 20 61 70 | 70 65 61 72 61 6e 63 65 |nical ap|pearance|
|00005b80| 2c 20 72 6f 75 74 69 6e | 65 20 68 69 73 74 6f 70 |, routin|e histop|
|00005b90| 61 74 68 6f 6c 6f 67 69 | 63 20 61 6e 64 20 69 6d |athologi|c and im|
|00005ba0| 6d 75 6e 6f 68 69 73 74 | 6f 70 61 74 68 6f 6c 6f |munohist|opatholo|
|00005bb0| 67 69 63 0d 0a 66 69 6e | 64 69 6e 67 73 2c 20 61 |gic..fin|dings, a|
|00005bc0| 6e 64 20 72 65 73 75 6c | 74 73 20 6f 66 20 76 61 |nd resul|ts of va|
|00005bd0| 72 69 6f 75 73 20 73 6b | 69 6e 20 74 65 73 74 73 |rious sk|in tests|
|00005be0| 2e 20 20 53 75 62 63 75 | 74 61 6e 65 6f 75 73 20 |. Subcu|taneous |
|00005bf0| 70 72 6f 76 6f 63 61 74 | 69 6f 6e 20 74 65 73 74 |provocat|ion test|
|00005c00| 73 0d 0a 77 65 72 65 20 | 73 75 70 65 72 69 6f 72 |s..were |superior|
|00005c10| 20 74 6f 20 69 6e 74 72 | 61 63 75 74 61 6e 65 6f | to intr|acutaneo|
|00005c20| 75 73 20 6f 72 20 65 70 | 69 63 75 74 61 6e 65 6f |us or ep|icutaneo|
|00005c30| 75 73 20 74 65 73 74 73 | 20 69 6e 20 65 73 74 61 |us tests| in esta|
|00005c40| 62 6c 69 73 68 69 6e 67 | 20 74 68 65 0d 0a 64 69 |blishing| the..di|
|00005c50| 61 67 6e 6f 73 69 73 20 | 6f 66 20 65 72 79 74 68 |agnosis |of eryth|
|00005c60| 65 6d 61 74 6f 75 73 2c | 20 69 6e 66 69 6c 74 72 |ematous,| infiltr|
|00005c70| 61 74 65 64 20 70 6c 61 | 71 75 65 73 2e 20 20 54 |ated pla|ques. T|
|00005c80| 68 65 20 70 6c 61 71 75 | 65 73 20 77 65 72 65 20 |he plaqu|es were |
|00005c90| 63 61 75 73 65 64 20 62 | 79 0d 0a 68 65 70 61 72 |caused b|y..hepar|
|00005ca0| 69 6e 20 63 6f 6e 73 74 | 69 74 75 65 6e 74 73 20 |in const|ituents |
|00005cb0| 69 6e 20 61 6c 6c 20 6f | 66 20 74 68 65 20 77 6f |in all o|f the wo|
|00005cc0| 6d 65 6e 3b 20 69 6e 20 | 74 68 65 20 6d 61 6e 2c |men; in |the man,|
|00005cd0| 20 63 68 6c 6f 72 6f 63 | 72 65 73 6f 6c 20 77 61 | chloroc|resol wa|
|00005ce0| 73 0d 0a 69 6d 70 6c 69 | 63 61 74 65 64 2e 0d 0a |s..impli|cated...|
|00005cf0| 20 20 20 20 20 45 72 79 | 74 68 65 6d 61 74 6f 75 | Ery|thematou|
|00005d00| 73 2c 20 69 6e 66 69 6c | 74 72 61 74 65 64 20 70 |s, infil|trated p|
|00005d10| 6c 61 71 75 65 73 20 61 | 72 65 20 6e 6f 74 20 6f |laques a|re not o|
|00005d20| 66 74 65 6e 20 64 69 61 | 67 6e 6f 73 65 64 20 61 |ften dia|gnosed a|
|00005d30| 73 20 61 20 63 75 74 61 | 6e 65 6f 75 73 0d 0a 72 |s a cuta|neous..r|
|00005d40| 65 61 63 74 69 6f 6e 20 | 74 6f 20 68 65 70 61 72 |eaction |to hepar|
|00005d50| 69 6e 2e 20 20 48 6f 77 | 65 76 65 72 2c 20 74 68 |in. How|ever, th|
|00005d60| 65 79 20 6d 61 79 20 6f | 63 63 75 72 20 69 6e 20 |ey may o|ccur in |
|00005d70| 72 65 61 63 74 69 6f 6e | 20 74 6f 20 73 75 63 68 |reaction| to such|
|00005d80| 20 74 72 65 61 74 6d 65 | 6e 74 0d 0a 6d 75 63 68 | treatme|nt..much|
|00005d90| 20 6d 6f 72 65 20 6f 66 | 74 65 6e 20 74 68 61 6e | more of|ten than|
|00005da0| 20 70 72 65 76 69 6f 75 | 73 6c 79 20 62 65 6c 69 | previou|sly beli|
|00005db0| 65 76 65 64 2e 20 20 4e | 65 69 74 68 65 72 20 65 |eved. N|either e|
|00005dc0| 70 69 63 75 74 61 6e 65 | 6f 75 73 20 6e 6f 72 0d |picutane|ous nor.|
|00005dd0| 0a 69 6e 74 72 61 63 75 | 74 61 6e 65 6f 75 73 20 |.intracu|taneous |
|00005de0| 74 65 73 74 69 6e 67 20 | 69 73 20 73 75 69 74 61 |testing |is suita|
|00005df0| 62 6c 65 20 66 6f 72 20 | 74 68 65 20 64 69 61 67 |ble for |the diag|
|00005e00| 6e 6f 73 69 73 20 6f 66 | 20 68 65 70 61 72 69 6e |nosis of| heparin|
|00005e10| 20 73 65 6e 73 69 74 69 | 76 69 74 79 0d 0a 72 65 | sensiti|vity..re|
|00005e20| 61 63 74 69 6f 6e 20 75 | 6e 64 65 72 6c 79 69 6e |action u|nderlyin|
|00005e30| 67 20 65 72 79 74 68 65 | 6d 61 74 6f 75 73 2c 20 |g erythe|matous, |
|00005e40| 69 6e 66 69 6c 74 72 61 | 74 65 64 20 70 6c 61 71 |infiltra|ted plaq|
|00005e50| 75 65 73 2e 20 20 48 6f | 77 65 76 65 72 2c 20 73 |ues. Ho|wever, s|
|00005e60| 75 62 63 75 74 61 6e 65 | 6f 75 73 0d 0a 70 72 6f |ubcutane|ous..pro|
|00005e70| 76 6f 63 61 74 69 6f 6e | 20 69 73 20 72 65 6c 69 |vocation| is reli|
|00005e80| 61 62 6c 65 2e 20 20 4c | 6f 77 2d 6d 6f 6c 65 63 |able. L|ow-molec|
|00005e90| 75 6c 61 72 2d 77 65 69 | 67 68 74 20 68 65 70 61 |ular-wei|ght hepa|
|00005ea0| 72 69 6e 20 61 6e 61 6c | 6f 67 75 65 73 20 63 61 |rin anal|ogues ca|
|00005eb0| 6e 6e 6f 74 20 62 65 0d | 0a 75 6e 69 76 65 72 73 |nnot be.|.univers|
|00005ec0| 61 6c 6c 79 20 72 65 63 | 6f 6d 6d 65 6e 64 65 64 |ally rec|ommended|
|00005ed0| 20 61 73 20 61 20 73 75 | 62 73 74 69 74 75 74 65 | as a su|bstitute|
|00005ee0| 3b 20 33 20 6f 66 20 74 | 68 65 20 36 20 70 61 74 |; 3 of t|he 6 pat|
|00005ef0| 69 65 6e 74 73 20 69 6e | 20 74 68 65 20 73 65 72 |ients in| the ser|
|00005f00| 69 65 73 0d 0a 74 65 73 | 74 65 64 20 68 61 64 20 |ies..tes|ted had |
|00005f10| 72 65 61 63 74 69 6f 6e | 73 20 74 6f 20 61 74 20 |reaction|s to at |
|00005f20| 6c 65 61 73 74 20 31 20 | 6c 6f 77 2d 6d 6f 6c 65 |least 1 |low-mole|
|00005f30| 63 75 6c 61 72 2d 77 65 | 69 67 68 74 20 68 65 70 |cular-we|ight hep|
|00005f40| 61 72 69 6e 20 61 6e 61 | 6c 6f 67 75 65 2e 0d 0a |arin ana|logue...|
|00005f50| 24 55 6e 69 71 75 65 5f | 49 44 7b 59 52 42 30 39 |$Unique_|ID{YRB09|
|00005f60| 31 30 38 7d 0d 0a 24 54 | 69 74 6c 65 7b 41 6e 61 |108}..$T|itle{Ana|
|00005f70| 70 68 6c 61 63 74 69 63 | 20 53 79 6d 70 74 6f 6d |phlactic| Symptom|
|00005f80| 73 20 44 75 65 20 74 6f | 20 43 68 6c 6f 72 68 65 |s Due to| Chlorhe|
|00005f90| 78 69 64 69 6e 65 20 47 | 6c 75 63 6f 6e 61 74 65 |xidine G|luconate|
|00005fa0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 4f 6b 61 6e 6f |}..$Auth|or{Okano|
|00005fb0| 2c 20 4d 0d 0a 4e 6f 6d | 75 72 61 2c 20 4d 0d 0a |, M..Nom|ura, M..|
|00005fc0| 48 61 74 61 2c 20 53 0d | 0a 4f 6b 61 64 61 2c 20 |Hata, S.|.Okada, |
|00005fd0| 4e 0d 0a 53 61 74 6f 2c | 20 4b 0d 0a 4b 69 74 61 |N..Sato,| K..Kita|
|00005fe0| 6e 6f 2c 20 59 0d 0a 54 | 61 73 68 69 72 6f 2c 20 |no, Y..T|ashiro, |
|00005ff0| 4d 0d 0a 59 6f 73 68 69 | 6d 6f 74 6f 2c 20 59 0d |M..Yoshi|moto, Y.|
|00006000| 0a 48 61 6d 61 2c 20 52 | 0d 0a 41 6f 6b 69 2c 20 |.Hama, R|..Aoki, |
|00006010| 54 7d 0d 0a 24 41 66 66 | 69 6c 69 61 74 69 6f 6e |T}..$Aff|iliation|
|00006020| 7b 4f 73 61 6b 61 20 55 | 6e 69 76 3b 20 48 61 6e |{Osaka U|niv; Han|
|00006030| 2d 6e 61 6e 63 68 75 6f | 20 48 6f 73 70 3b 20 48 |-nanchuo| Hosp; H|
|00006040| 61 62 69 6b 69 6e 6f 20 | 48 6f 73 70 20 6f 66 20 |abikino |Hosp of |
|00006050| 4f 73 61 6b 61 2c 20 4a | 61 70 61 6e 7d 0d 0a 24 |Osaka, J|apan}..$|
|00006060| 4a 6f 75 72 6e 61 6c 7b | 41 72 63 68 20 44 65 72 |Journal{|Arch Der|
|00006070| 6d 61 74 6f 6c 7d 0d 0a | 24 56 6f 6c 75 6d 65 7b |matol}..|$Volume{|
|00006080| 31 32 35 7d 0d 0a 24 50 | 61 67 65 7b 35 30 2d 35 |125}..$P|age{50-5|
|00006090| 32 7d 0d 0a 24 44 61 74 | 65 7b 4a 61 6e 75 61 72 |2}..$Dat|e{Januar|
|000060a0| 79 20 31 39 38 39 7d 0d | 0a 24 59 42 56 6f 6c 7b |y 1989}.|.$YBVol{|
|000060b0| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|000060c0| 66 20 44 65 72 6d 61 74 | 6f 6c 6f 67 79 7d 0d 0a |f Dermat|ology}..|
|000060d0| 24 43 68 61 70 74 65 72 | 7b 38 2d 37 7d 0d 0a 24 |$Chapter|{8-7}..$|
|000060e0| 59 42 45 64 69 74 6f 72 | 7b 44 72 73 2e 20 53 6f |YBEditor|{Drs. So|
|000060f0| 62 65 72 20 61 6e 64 20 | 46 69 74 7a 70 61 74 72 |ber and |Fitzpatr|
|00006100| 69 63 6b 7d 0d 0a 24 54 | 61 62 6c 65 7b 7d 0d 0a |ick}..$T|able{}..|
|00006110| 24 43 6f 6d 6d 65 6e 74 | 61 74 6f 72 7b 52 2e 53 |$Comment|ator{R.S|
|00006120| 2e 20 53 74 65 72 6e 2c | 20 4d 2e 44 2e 7d 0d 0a |. Stern,| M.D.}..|
|00006130| 0d 0a 43 6f 70 79 72 69 | 67 68 74 20 28 63 29 20 |..Copyri|ght (c) |
|00006140| 59 65 61 72 62 6f 6f 6b | 20 4d 65 64 69 63 61 6c |Yearbook| Medical|
|00006150| 20 50 75 62 6c 69 73 68 | 65 72 73 2c 20 49 6e 63 | Publish|ers, Inc|
|00006160| 2e 2c 20 31 39 39 30 0d | 0a 0d 0a 31 39 39 30 20 |., 1990.|...1990 |
|00006170| 59 65 61 72 20 42 6f 6f | 6b 20 6f 66 20 44 65 72 |Year Boo|k of Der|
|00006180| 6d 61 74 6f 6c 6f 67 79 | 20 28 52 29 0d 0a 0d 0a |matology| (R)....|
|00006190| 43 68 61 70 74 65 72 20 | 38 2d 2d 41 64 76 65 72 |Chapter |8--Adver|
|000061a0| 73 65 20 44 72 75 67 20 | 52 65 61 63 74 69 6f 6e |se Drug |Reaction|
|000061b0| 73 0d 0a 0d 0a 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |s....---|--------|
|000061c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000061d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000061e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000061f0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006200| 2d 2d 2d 0d 0a 41 6e 61 | 70 68 6c 61 63 74 69 63 |---..Ana|phlactic|
|00006210| 20 53 79 6d 70 74 6f 6d | 73 20 44 75 65 20 74 6f | Symptom|s Due to|
|00006220| 20 43 68 6c 6f 72 68 65 | 78 69 64 69 6e 65 20 47 | Chlorhe|xidine G|
|00006230| 6c 75 63 6f 6e 61 74 65 | 0d 0a 0d 0a 4f 6b 61 6e |luconate|....Okan|
|00006240| 6f 20 4d 3b 20 4e 6f 6d | 75 72 61 20 4d 3b 20 48 |o M; Nom|ura M; H|
|00006250| 61 74 61 20 53 3b 20 4f | 6b 61 64 61 20 4e 3b 20 |ata S; O|kada N; |
|00006260| 53 61 74 6f 20 4b 3b 20 | 4b 69 74 61 6e 6f 20 59 |Sato K; |Kitano Y|
|00006270| 3b 20 54 61 73 68 69 72 | 6f 20 4d 3b 20 59 6f 73 |; Tashir|o M; Yos|
|00006280| 68 69 6d 6f 74 6f 20 59 | 3b 0d 0a 48 61 6d 61 20 |himoto Y|;..Hama |
|00006290| 52 3b 20 41 6f 6b 69 20 | 54 0d 0a 28 4f 73 61 6b |R; Aoki |T..(Osak|
|000062a0| 61 20 55 6e 69 76 3b 20 | 48 61 6e 2d 6e 61 6e 63 |a Univ; |Han-nanc|
|000062b0| 68 75 6f 20 48 6f 73 70 | 3b 20 48 61 62 69 6b 69 |huo Hosp|; Habiki|
|000062c0| 6e 6f 20 48 6f 73 70 20 | 6f 66 20 4f 73 61 6b 61 |no Hosp |of Osaka|
|000062d0| 2c 20 4a 61 70 61 6e 29 | 0d 0a 41 72 63 68 20 44 |, Japan)|..Arch D|
|000062e0| 65 72 6d 61 74 6f 6c 20 | 31 32 35 3a 35 30 2d 35 |ermatol |125:50-5|
|000062f0| 32 2c 20 4a 61 6e 75 61 | 72 79 20 31 39 38 39 0d |2, Janua|ry 1989.|
|00006300| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00006310| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006320| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006330| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00006340| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|00006350| 0a 0d 0a 41 62 73 74 72 | 61 63 74 0d 0a 0d 0a 20 |...Abstr|act.... |
|00006360| 20 20 20 20 43 68 6c 6f | 72 68 65 78 69 64 69 6e | Chlo|rhexidin|
|00006370| 65 20 67 6c 75 63 6f 6e | 61 74 65 2c 20 6f 72 20 |e glucon|ate, or |
|00006380| 48 69 62 69 74 61 6e 65 | 2c 20 68 61 73 20 62 65 |Hibitane|, has be|
|00006390| 65 6e 20 77 69 64 65 6c | 79 20 75 73 65 64 20 61 |en widel|y used a|
|000063a0| 73 20 61 20 6d 65 64 69 | 63 61 6c 0d 0a 64 69 73 |s a medi|cal..dis|
|000063b0| 69 6e 66 65 63 74 61 6e | 74 2e 20 20 41 6c 74 68 |infectan|t. Alth|
|000063c0| 6f 75 67 68 20 69 74 20 | 69 73 20 74 68 6f 75 67 |ough it |is thoug|
|000063d0| 68 74 20 74 6f 20 62 65 | 20 73 61 66 65 2c 20 74 |ht to be| safe, t|
|000063e0| 68 65 72 65 20 68 61 76 | 65 20 62 65 65 6e 20 73 |here hav|e been s|
|000063f0| 65 76 65 72 61 6c 0d 0a | 70 72 65 76 69 6f 75 73 |everal..|previous|
+--------+-------------------------+-------------------------+--------+--------+
Only 25.0 KB of data is shown above.
