M illions of people suffer from skin problems. About 15 per cent of all the diseases seen by family doctors and internists are skin ailments. Now many victims stand a far better chance of being rid of blemishes, rashes and other unsightly disturbances thanks to new techniques for some of the most common dermatological disorders. A vegetable ingredient for the sun-sensitive. At Harvard Medical School and Columbia's College of Physicians and Surgeons, physicians have found a way to help people who can't tolerate even brief exposure to sunlight. Their problem: erythropoietic proto- porphyria, involving excessive production of a blood pigment, protoporphy- ria. The highly successful new treatment consists of large doses of beta-carotene, a yellow material that occurs naturally in yellow and green leafy vegetables and yellow fruit. Among patients treated in Boston, New York and several other areas, 86 per cent have quadrupled the time they can be out in the sun, another 8 per cent have doubled it. Some report that for the first time in their lives they've been able to acquire suntans. Self-treatment with carotene-rich vegetables isn't practical; huge quantities would be needed. But for many sun-sensitive persons with protopor- phyria, a visit to a physician can be a rewarding experience. In and out treatment for acne. For both teen-agers and adults suffering from acne, several developments improve the outlook. One is a special form of vitamin A, called tretinoin, which can be applied directly to acne lesionsrit's far more effective than any previous topical agent. It represses new blackhead formation and helps eliminate existing ones. Some reddening and peeling occur early in treatment but when acne is relatively mild or blackheads are the main problem, tretinoin alone is often enough to produce great improvement within six weeks. When acne is more, severe and pimples numerous, a combination of treti- noin applied to the skin with an antibiotic, demeclocycline hydrochloride, taken internally, is effective. At the University of Pennsylvania/Dr. A. M. Kligman and other physicians report that once the combination gets the acne under control, the antibiotic can be cut down and finally stopped and treti- noin can be kept up until the skin Is permanently clear. Â· Stopping recurrent fever blisters. These lip sores that first blister, then break, yellow and crust, are produced by a virus; herpes simplex. Some people get them repeatedly. One new treatment calls for a doctor to unroof the sores, apply a special dye, New MedH Tre a traits for tto Skin by Lawrence Galton New techniques allow more Americans to aspire to skin as clear as this model's. and focus a 15-watt fluorescent light on them for 15 minutes, after which the patient, at home, repeats the-light exposure. Developed by Dr. Troy Felber and a team from Baylor University College of Medicine, the dye-light treatment not only has quickly relieved pain-(often within an hour) and shortened healing time (from the usual two weeks to a few days); it also has greatly reduced recurrences. An even simpler method has been reported by Drs. G. R. Nugent and S. M. Chou of West Virginia University Medical Center. An ether-soaked applicator stick is dabbed onto a developing blister 10 times. This treatment is repeated three times a day. Healing starts immediately. Canker sores. These painful mouth ulcers long were thought to be virus- caused. But more recently, instead of a virus, the culprit has been found to be a peculiar bacterium, called an L-form of alpha-streptococcus. Consequently, Â·antibiotics that couldn't be expected to work against a virus have been tried. Now tetracycline syrups are being used with some success. A common regimen, reports Dr. Richard L. Zuehlke of the University of Iowa College of Medicine, is to have a patient hold a teaspoqn of the syrup (250 milligrams per five cubic centimeters dosage) on the sore or sores for five minutes, then swallow, and repeat four times a day. Warts. Tretinoin, valuable for acne, also has turned out to be useful for people with flat warts too numerous for freezing or other customary treatments. Dr. Zuehlke reports using an 0.05 per cent solution of tretinoin twice daily with good results. For tough-to-treat plantar warts on the soles of the feet, including the mo- saic type, Dr. Zuehlke reports that another preparation--glutaraldehyde in a 25 per cent solution--is effective. Applied daily, it hardens the warts, making (hem easy for the patient or a member of the family to pare, and usually results in cure within three months. Â· Contact dermatitis. The best treatment for contact dermatitis--a rash with itching, swelling, blistering, oozing and scaling produced by a chemical from the outside environment coming into contact with the skin--is to find and avoid the culprit. Now the finding should be easier for the physician--and even for many patients themselves--as the result of a -study of 1200 patients that has revealed the most common causes. At the head of the list: nickel sulfate, often an ingredient in inexpensive costume jewelry. Also high on the list: potassium dichromate, an ingredient in tanned leather; thimerosal, an ingredient of an antiseptic, Merthiolate; and p-phenylenediamine, used in some hair dyes. Other common culprits: turpentine and neomycin sulfate, an antibiotic. Another recent finding: a growing * number of people are getting contact dermatitis from the formaldehyde used in crease-resistant fabrics. Those with least formaldehyde: 100 per cent polyester knit and 100 per cent orlon acrylic. Psoriasis. This chronic, scaly disease is a tough one. There's no cure, but in many cases it may be controlled by persistent medical treatment--including use of topical corticosteroids, coal tar or wood tar preparations, anthralin ointments, or a combination of tar and ultraviolet light. New hope for psoriasis victims stems from excellent early results with a simple, experimental treatment. Developed by Dr. Thomas B. Fitzpatrick and other physicians at Massachusetts General Hospital, Boston, it combines special long-wave ultraviolet light with a drug --methoxsalen--taken by mouth. A first report from these investigators tells of complete clearing of psoriasis in 50 patients there and in another 35 in a study program under way at the .University of Vienna. Two hours after receiving an amount of drug calculated on the basis of individual body weight, patients are exposed to seven to 14 minutes of the special light. Seven to 18 treatments are needed for complete clearance. Afterward, maintenance treatments--at first three times a week, later once a week-may keep the skin free of psoriasis. The special light device, designed by GTE Sylvania's Light Therapy Center in Danvers, Mass., is as yet being "made available only for further experimental studies now going on in Boston, Vienna and elsewhere. There is hope that if all goes well, the treatment may become Â· generally available sometime next year.
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