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Ketoprofen (KP) is a potent non-steroidal anti-inflammatory drug which is used for the treatment of rheumatoid arthritis. The oral administration of KP can cause gastric irritation and renal adverse effects. Topical application of the drug can bypass gastrointestinal disturbances and provide relatively consistent drug levels at the site of action. Since the efficacy of an ointment depends on the type of ointment base and the concentration of the drug, four different bases (white petrolatum, cold cream, hydrophilic ointment and Carbopol 940 gel) were used at 1, 3, 5, 7 and 10% concentrations of KP to evaluate the effect of ointment base and concentration. The general rank order of the drug release was found to be: Carbopol gel > hydrophilic ointment > cold cream > white petrolatum. There was a positive correlation between the concentration of KP and release rate for all bases except Carbopol gel. The in vivo percutaneous absorption of KP from different ointment bases at 3% concentration was studied by carrageenan-induced paw edema in mice. The rank order of the percent edema inhibition was as follows: Carbopol gel ≥ hydrophilic ointment > cold cream > white petrolatum. There was a good correlation between the in vitro and in vivo results.

Dithranol (D) is used as a therapeutic topical agent to treat psoriasis, although it produces inflammation and staining of skin and clothing. D-induced irritation has been evaluated by visual scoring and by bioengineering techniques, evidencing modifications of the inflammatory parameters, but no alterations of the skin barrier. The aim of our study was to evaluate the irritant reactions induced by D using ultrasound, and to compare the B-scanning data with visual assessments and colorimetric measurements. 13 healthy women underwent 2, 3-h patch tests with, respectively, 0.02% and 0.1% D in white petrolatum and 1 24-h patch test with 2% sodium lauryl sulfate (SLS). For assessing skin reactions, clinical judgement, colorimetry and echography were employed. Echographic images were evaluated by skin thickness measurements and segmentation procedures, using an 0-30 interval, marking the hyporeflecting areas in the dermis, and a 201-255 interval, assessing the hyperreflecting components of the image (both epidermal and dermal). In all subjects, D produced uniform reactions, the intensity varying according to concentration. Both echographic parameters of inflammation (skin thickness and 0-30 areas) showed an increase at all times of assessment. The 201-255D/0-30 pixel ratio, describing the distribution of dermal edema, indicated that strong inflammatory reactions, such as those caused by the application of 0.1% D, are accompanied by edema in the lower portion of the dermis. Finally, in contrast to SLS reactions, where a 24-h reduction in epidermal reflectivity was observable, D reactions appeared with an accentuation of the 201-255 epidermal band at 24-96-h examinations.

The safety and efficacy of Collagenase ABC® ointment (containing 250 units/g white petrolatum clostridiopeptidase A) in the debridement of stage III pressure sores in 50 patients were examined in a phase II, prospective, open, uncontrolled study. Ulcer size, odour, pus, inflammation and necrosis were assessed prior to study entry and after a maximum of 28 days’ treatment with the ointment, applied twice daily. All the clinical features assessed (odour, pus, inflammation, necrosis) showed progressive and highly statistically significant reductions throughout the treatment period, most notably with respect to the reduction of necrotic tissue present on the wound. The estimated area of the ulcer showed a small but significant reduction in size. All reported adverse events were recorded as being of ‘doubtful’ relationship to the test therapy, except for one case of pain at the wound site, which was classified as ‘possibly’ related. Laboratory investigations (full blood count, serum biochemistry) revealed no signs of toxicity. In the majority of patients, the ointment was considered ‘reasonably easy to apply’ and of ‘good’ acceptability by the nursing staff responsible for the application of the ointment and on patient monitoring.

Liposornes used for topical applications are often incorporated into a vehicle to achieve suitable viscosity and application properties. The effect of incorporation of liposomes into white petrolatum as a possible dermatological base was investigated. A number of formulae were developed to determine the type of petrolatum base that would be compatible with the liposomes. The physical appearance and stability of the vaseline-liposome (VL) preparations were determined by organoleptic analysis and microscopy. The effect of petrolatum base on the drug release from the liposomes was determined in a flow-through diffusion cell system using a model silastic polymer membrane as barrier. A base containing white petrolatum 46.7% (w/w), stearyl alcohol 6.7% (w/w), cholesterol 13.3 (w/w), Tween 80 16.7% (w/w) and Span 16.7% (w/w) was selected for diffusion studies, since the mixture of this base and liposome preparation, at 1:1.9 (w/w) ratios, provided a stable, dermatologically acceptable dosage form, in which the liposomes were uniformly distributed and their structures were preserved. Diffusion studies showed that the drug release rate decreases 2.5x when the liposomes are incorporated into the vaseline base; however, after a temporary decrease they seem to extend the duration of release beyond that of the original liposomal formula. These studies revealed a possibility of using white petrolatum in the topical application of liposomes.

Chitin is a polymer of D-glucosamine, beta-poly-N-acetyl D-glucosamine. The chitin derivative, 70% deacetylated chitin (DAC-70), shows immunopotentiating activity. DAC-70 ointment 3.5% in a white petrolatum base was used to treat defined areas of four patients with senile exfoliative erythroderma following eczema. The effects of DAC-70 were compared with those of glyteer (0.2% soybean tar ointment) with 0.1% dexamethasone. In all patients erythroderma ceased spreading within 1 to 2 weeks in all treated areas. Thus, topically applied 3.5% DAC-70 may be of similar value to glyteer in the treatment of exfoliative erythroderma following eczema.

Introduction The standard postsurgical treatment of wounds after dermatologic procedures is currently limited. Topical corticosteroids have been used successfully in postoperative management of ophthalmologic surgeries that involve the skin of the eyelid. In particular, tobramycin 0.3%/dexamethasone 0.1% ophthalmic ointment is considered the “gold standard” of steroid-antibiotic fixed combinations and is marketed worldwide as an agent used to control postsurgical inflammation and prevent postsurgical infection. The purpose of this study is to evaluate both the efficacy and safety of tobramycin–dexamethasone ointment for the postsurgical management of Mohs or dermatologic surgery in comparison to white petrolatum. Methods The authors employed a half-scar study in which patients who underwent skin cancer removal surgery were given tobramycin–dexamethasone ointment and white petrolatum to apply to each half of their wound for 2 weeks. The study was double blinded, and physicians and the patients independently evaluated the scars for cosmetic appearance at 2 and 6 weeks postoperatively. The evaluation criteria included judging which side of the wound looked better based on color, thickness, and discomfort. Results Eighteen patients were enrolled, of which 13 patients completed the three phases of the study. After 6 weeks the wounds did not show a statistically significant difference in color, thickness, or discomfort on either side. Conclusion Results obtained to date suggest that the application of tobramycin–dexamethasone ointment to wounds after dermatologic surgery does not promote better wound healing than white petrolatum. These findings indicate that a topical steroid and antibiotic ointment may not be an effective intervention in improving postoperative outcomes in dermatologic surgeries.

In the course of investigating the effects of silicone surfactant (Abil WE 09®) on the microstructure of semisolid w/o emulsion systems with different water/oil ratios, only dispersed droplets of the internal water phase (1–15 μm size) were discovered in the gel network of white petrolatum. With increasing water content (from 40 to 90% w/w) the degree of dispersity was found to increase (microscopic analysis-polarized light microscopy and TEM). Experiments were also carried out using differential scanning calorimetry (DSC) and rheometry (rotational and oscillatory viscosimetry). The DSC results showed different behaviour of the investigated systems on controlled cooling. In semisolid emulsion systems with droplets small enough and of equal size, a homogeneous nucleation temperature was achieved. In emulsion systems containing a high percentage of water, the assumption that the behaviour of water was like that of the pure (bulk) water was acceptable. All semisolid emulsion systems exhibited pseudoplastic behaviour. Their viscoelastic properties determined using oscillation rheometry correlated well with rotational results.

We attempted to determine the level of sweat kallikrein (kininogenase) and to purify and characterize it using sweat collected over a white petrolatum barrier. Thermally induced eccrine sweat obtained from 24 healthy subjects showed kallikrein activity of 24.4 ng kinins generated/1 mg of sweat protein when heated plasma was used as the substrate and 16.1 ng kinin when purified low molecular weight bovine kininogen was used as the substrate. Sweat was sequentially purified by Sephacryl S-200, diethyaminoethyl Sephacel, and fast flow liquid chromatography Mono Q chromatography. Sweat kallikrein had a M(r) of 40,000 and was inhibited by aprotinin but not by soybean trypsin inhibitor. The peptide generated by sweat kallikrein was identified as lys-bradykinin using reverse phase high-performance liquid chromatography and by its amino acid sequence. Anti-human urinary kallikrein immunoglobulin G neutralized the sweat kallikrein activity completely, indicating that the sweat kallikrein is the glandular type. Purified sweat and salivary kallikrein showed similar M(r) and responses to inhibitors and antibodies. Using immunohistochemistry, kallikrein activity was localized in luminal ductal cells and in the peripheral rim of secretory coil segments, presumably the outer membrane of the myoepithelium. We also observed kininase activity in sweat at M(r) 160,000, which was inhibited by ethylenediamine tetraacetic acid, captopril, and angiotensin converting enzyme inhibitor peptide, indicating that it is kininase II (or angiotensin converting enzyme). Sweat also contains abundant non-kallikrein hydrolases for S-2266 and S-2302. The demonstration of glandular kallikrein, its tissue localization, and the presence of kininase II in sweat provide the basis for future studies on the physiologic role of the kallikrein/kinin system in the eccrine sweat gland.

A model ointment consisting of white petrolatum, mineral oil and microcrystalline wax was studied using rheology, microscopy and thermal techniques. Rheograms studied over a temperature range of 25-40°C indicated that the overall rheogram shape changed little as the temperature increased. However, two inflections gradually disappeared as the temperature increased. Thermal optical analysis showed that the temperature range over which these inflections disappeared correlated with the melting transition of the components forming the secondary structure. Another series of rheograms obtained from ointments with different combinations of the raw materials showed the rheology of the ointment is primarily controlled by the white petrolatum and mineral oil and that the microcrystalline wax acts to build-up the structure by incorporating itself into the existing white petrolatum structure. Thermal optical analysis of comelts of the raw materials proved that the ointment network structure is essentially a recombination of the naturally occurring components in differing ratios. The knowledge obtained from these studies is applied to a discussion of the thermal and mechanical stresses encountered in the filling operation.

30 patients were treated with daily application of calcitriol (1 alpha, 25-dihydroxyvitamin D3) ointment 15 micrograms/g in white petrolatum. The patients were divided into three groups according to the size of their total area of psoriasis. They were treated for 6 weeks, and investigated first with weekly and then with two-weekly estimations of calcium metabolism (serum calcium, 24-hour urinary calcium, parathyroid hormone, 25-hydroxyvitamin D3 and calcitriol). Ninety percent of the patients cleared or improved and there were no significant side effects or local intolerance. Cosmetic acceptance was good. No clinically significant changes in calcium metabolism were observed in spite of calcitriol application ranging between 73.98 and 306.10 micrograms daily (normal daily synthesis being 1-2 micrograms).

Objective:The authors discuss a case of conjunctival irritation and epiphora in a patient who had undergone dacryocystorhinostomy three years earlier.Method:Case report, and a review of the world literature concerning lacrimal canalicular air regurgitation after dacryocystorhinostomy.Results:A 70-year-old woman, who used continuous positive airway pressure therapy during sleep, complained of epiphora and conjunctival irritation. She had undergone dacryocystorhinostomy three years earlier. Her right eye had an augmented tear meniscus, with a predominantly medial conjunctival irritation. Conjunctival irritation from lacrimal canalicular air regurgitation was diagnosed. White petrolatum and mineral oil ophthalmic ointment was prescribed, applied topically before sleeping. After one month of treatment, complete relief of symptoms was obtained.Conclusion:There is little current information on managing such patients. It is imperative to discuss this potential complication when considering nasolacrimal surgery in patients using continuous positive airway pressure therapy.

We report the case of a 41-year-old female showing severe hair loss approximately 90% after the use of a hair dye. These symptoms developed six days after the use of a hair dye containing PPD. A patch test showed a (++) reaction at 48 h to 1% PPD in petrolatum, whereas all metals and white petrolatum were negative. She was therefore diagnosed with contact dermatitis due to PPD, resulting in hair loss. The skin lesions gradually improved after starting treatment with the systemic corticosteroids. The possibility that allergic contact dermatitis from hair dyes may be responsible for telogen effluvium should always be considered in a patient with increased hair loss.

The hydrolysis of the chemisorbate of p -hydroxybenzoic acid methyl ester (PHBAME) on porous silica (KG 100) incorporated in lipophilic vehicles such as liquid paraffin, synthetic oil Miglyol® 818 and white petrolatum was examined in dissolution media at pH 2 and 7.4, respectively. Chemisorbed PHBAME on KG 100 is released more rapidly in alkaline than in acidic dissolution fluids. Dispersions of the PHBAME-KG 100 chemisorbate in lipophilic vehicles modify the hydrolysis significantly. Drug release from chemisorbate dispersed in lipophilic vehicles may be controlled by the polarity of the vehicles. However, the viscosity of the vehicle, and not the polarity, exerts the strongest influence on the drug release.

The presence of urokinase-type plasminogen activator (uPA) in human eccrine sweat has not been reported previously. Clean sweat was obtained from the upper trunk and arms of subjects which had been painted with white petrolatum to minimize epidermal contamination. Sweat was concentrated x 50 by ultrafiltration, and its PA activity determined by the two-step assay method (conversion of plasminogen to plasmin with the subsequent assay of plasmin activity using the substrate S-2251). PA activity was detectable in nine of 17 subjects by this method, which probably represents an underestimate of the true activity because of possible loss of the enzyme during concentration. Scraped (crude) sweat samples contained less PA activity. Sephacryl S-200 gel chromatography of the PA-positive pooled sweat showed a major peak of PA activity at M(r) 55,000. Gelatin-polyacrylamide enzymography revealed a major PA band at M(r) 55,000 and a minor band at 33,000. Sweat PA activity was 94% inhibited by epidermal PA inhibitor and anti-uPA IgG, but not by anti-tPA IgG. We conclude that the PA activity in sweat is derived from the sweat gland and is most likely of the urokinase type. The physiological significance of sweat uPA remains to be determined.

We surveyed sheets prescribed by dermatologists in our hospital during a 6-month period to investigate the stability of the admixture of commercially available ointments and/or creams. The total prescribed sheets numbered 21, 626, with 690 admixtures being found in 676 sheets. Seventy-two percent of these admixtures were combined corticosteroid preparations with white petrolatum or urea creams. Seven kinds of well-prescribed admixtures were presumed to develop some combinational problems. These admixtures were then prepared in our department, and the rate of air inclusion into the admixtures by mixing process was measured. The quantities of the water phase separated by centrifugation employed as an indice of the destruction of emulsion after mixing were measured, with a high value being obtained with the combination of corticosteroid ointments and o/w-type urea creams (ranging 10-30%). From the visual change noted by a naked eye supplemented with microscopic examinations, the emulsion in these admixtures was found to have already been destroyed after mixing. In contrast, the admixtures utilizing corticosteroid ointments and w/o-type urea creams were physically stable for a month. We also discussed on prescriptions made by many physicians. Consequently, it is strongly hoped that the information described in the package inserts and the naming of the products will be improved in relative to their physico-chemical properties.

Ointment vehicles consisting of mineral oil, white petrolatum and either anhydrous lanolin, or the lanolin substitute SOFTISAN® 649 were investigated by determining the binary and ternary phase behavior of these mixtures. Rheology measurements related changes in viscosity with changes in phase behavior. Lot to lot variability of the anhydrous lanolin caused significant shifts in the binary and ternary phase behavior which resulted in changes in viscosity of the ointment base. While replacement of anhydrous lanolin with the lanolin substitute SOFTISAN® 649 significantly changed the ternary phase behavior of they system, suitable ointment vehicles could be prepared that were very reproducible utilizing different lots of SOFTISAN® 649.

The synthesis of e-aminocaproic acid esters is described. Two representative members from a group of five of the 1-alkyl homologues synthetized as flexible analogues of 1-alkylazacycloheptanone derivatives were evaluated in vitro for their effectiveness on the transport of theophylline through the excised human cadaver skin in comparison with Azone. The 1-octyl- and 1-dodecyl-e-aminocaproic acid esters (OCEAC and DDEAC) show excellent penetration enhancement. Donor samples contained 2.5% theophylline and 1% enhancers tested in three different vehicles. Fluxes of theophylline were increased with OCEAC about 19 times from olive oil, 45 times from water, and about 38 times from water–propylene glycol (3:2) vehicle toward controls (with DDEAC about 17, 39, and 35 times, respectively) and they were markedly higher than Azone under the given conditions. Acute LD50's (i.p. in mice) of OCEAC (DDEAC) were 245 mg/kg (352 mg/kg), with a slightly lower toxicity than Azone. OCEAC and DDEAC did not exhibit acute dermal irritation in vivo on rabbits at a 5% concentration in white petrolatum.

Fifty patients were enrolled in a double-blind, randomized, parallel-group study designed to determine whether tazarotene may have a role in maintenance therapy for psoriasis. The patients had stable moderate-to-severe plaque psoriasis on up to 15% of their body surface area, on sites other than the face and scalp. Their mean age was 55 years and the majority had had psoriasis for more than 10 years. Washout periods were: 2 weeks for topical drugs, 4 weeks for UVB or PUVA treatment, and 8 weeks for systemic drugs that might alter the course of psoriasis. For the initial open-label treatment phase, patients applied tazarotene 0.1% gel plus clobetasol propionate 0.05% ointment for 6 weeks. The frequency of application of both medications was initially once daily and then was tapered to ensure gradual weaning. Thus, during weeks 1 and 2, patients applied tazarotene each morning and clobetasol propionate each evening. During weeks 3 and 4, patients applied tazarotene each morning and clobetasol propionate each Tuesday, Thursday, and Saturday evening. Finally, during weeks 5 and 6, patients applied tazarotene each Monday, Wednesday, and Friday morning, and clobetasol propionate each Tuesday and Thursday evening. For the subsequent double-blind maintenance phase, patients were randomized to receive one of three maintenance regimens for 20 weeks – tazarotene/clobetasol (tazarotene 0.1% gel on Monday, Wednesday, and Friday mornings, plus clobetasol propionate 0.05% ointment on Tuesday and Thursday evenings), tazarotene/vehicle (tazarotene 0.1% gel on Monday, Wednesday, and Friday mornings, plus white petrolatum on Tuesday and Thursday evenings), and vehicle (tazarotene gel vehicle on Monday, Wednesday, and Friday mornings plus white petrolatum on Tuesday and Thursday evenings). Patients were instructed to apply a thin film of medication to their psoriatic plaques. Emollient use was permitted, but other topical formulations and excessive exposure to ultraviolet light were not. Efficacy was evaluated – at baseline, every 2 weeks during the initial treatment phase, and every 4 weeks during the maintenance phase – in terms of overall disease severity, plaque elevation, scaling, erythema, pruritus, and global response to treatment. The first four of these were rated by the physician as 0 = none, 2 = mild, 4 = moderate, 6 = severe, and 8 = very severe. Pruritus was rated as 0 = none, 1 = trace, 2 = mild, 3 = moderate, 4 = marked, and 5 = severe. Global response was rated as 0 = cleared, 1 = almost cleared (∼90% improvement), 2 = marked (∼75%) improvement, 3 = moderate (∼50%) improvement, 4 = slight (∼25%) improvement, 5 = unchanged, and 6 = worse. Analysis of variance and the Student's t-test were used to compare maintenance regimens (P ≤ 0.05). In the maintenance phase, the last recorded score for each patient was carried forward to all subsequent visits.

Neck rejuvenation predominantly targets skin laxity, with a lesser emphasis on rhytides and photoaging. Neck laxity may increase with age due to progressive prominence of platysmal bands, loss of bony mass along the mandible and mental region, increased subcutaneous fat, and loosening of the connective tissue framework. Additionally, photoaging may result in progressive solar elastosis, which may contribute to rhytides, laxity, and poor texture. Important limitations to treatment include the anterior location of the thyroid and parathyroid glands, which must be shielded from deeply penetrating wavelengths. The increased scarring risk on chest secondary to pulsed light indicates a potential increased scarring risk on the inferior aspect of the neck as compared to face, thus necessitating greater care and lower fluences in this region. Overall, neck rejuvenation targets skin laxity bringing skin tightening technologies to the forefront in this category.

An animal study was conducted to elucidate the role of ovalbumin (OA) in the development of eczematous lesions in intrauterine sensitized newborns. Four groups of pregnant guinea pigs were used: group A, immunized by oral administration of 1% OA in drinking water until parturition; group B, immunized by intradermal injection of OA with Freund's complete adjuvant; group C, immunized by both methods; and group D (control), not immunized. The newborn guinea pigs of each group were patch tested with 10% OA in white petrolatum. Positive reactions were seen in the newborns of groups B and C, but not in those in groups A and D. By enzyme-linked immunosorbent assay and passive cutaneous anaphylaxis, a high titre of OA-specific IgG was detected in the group B and C newborns. The number of positive patch test reactions decreased concomitantly with the decline of specific IgG. Histologically, eczematous changes were observed in the positive reaction sites. Many OA antigen-bearing Langerhans cells were found by the immuno-double labelling technique. Immuno-electron microscopic findings revealed the presence of OA antigens as well as IgG molecules on the cytoplasmic membranes of Langerhans cells. Our studies demonstrated that maternal sensitization with OA can induce an eczematous reaction in the newborns to OA patch testing under the presence of high levels of OA-specific IgG in the serum. From these findings it is suggested that IgG plays an essential role in the development of contact hypersensitivity reaction to OA.

In vitro tests in our laboratory have shown that 40% tetracycline HC1 in a white petrolatum carrier (TTC-WP) has potential as a sustained release, auto-dissipating system. The present study tested subgingival placement of TTC-WP via syringe in vivo. Quadrants (2 diseased sites in each) in 9 patients with moderate/severe periodontitis were randomly assigned to receive the following treatments: (1) TTC-WP; (2) WP only; (3) scaling and root planing; (4) untreated control. TTC release into gingival crevicular fluid (GCF) over time (baseline, 1, 8, 24, 72 and 168 h) was measured using an agar diffusion bioassay. Clinical parameters and subgingival bacterial morphotypes (darkfield analysis) were also evaluated over time (baseline, 2, 4, 8, 12 weeks). Results indicated that TTC-WP was easily placed into periodontal pockets and biologically effective TTC was released into GCF for at least 3 days (mean concentration = 115.8 ± 43.1 μg/ml at 3 days). TTC-WP reduced probing pocket depths and bleeding on probing relative to baseline measurements for 8–12 weeks post-treatment, and reduced %s of motile rods and spirochetes, with an accompanying increase in cocci, for 2–8 weeks. Similar effects were noted in the scaled and root-planed sites, but for a longer duration. TTC-WP and WP were clinically dissipated after 2 weeks and no adverse tissue reactions were observed. From these findings, subgingival TTC-WP cannot replace scaling and root planing therapy, but has characteristics useful in subgingival plaque control.

Ointment vehicles consisting of moderate amounts of propylene glycol (5–10%) and large amounts of white petrolatum (greater than 80%) were investigated by determining the ternary phase behavior bet...

A stable composition of mechlorethamine hydrochloride in vehicles composed of white petrolatum and white mineral oil or solid and liquid vegetable oils which will resist degradation at room temperature is presented. The composition is highly antimitotic and effective when applied topically as a treatment for psoriasis. Also disclosed is a method for inducing immunity in patients prior to treatment of psoriasis with the composition of this invention by intraveneous injections of minute quantities of an aqueous solution of mechlorethamine hydrochloride weekly for a period of at least 3 weeks.

Compression coating was investigated for use in preparing controlled release dosage forms having a polymer shell surrounding a soluble core. The purpose of the study was to develop a method of measure flux and permeability of water across the outer shell (coat) of the compression-coated tablet. One half of the shell of the press-coated tablets was mounted on the platform of the receptor port of the Thomas diffusion cell by embedment in white petrolatum. The cumulative amount of tritium labeled water per square centimeter permeating across the barrier was plotted vs time, and flux, lag time, diffusion coefficient and permeability were calculated from the steady-state slope. No difference was found whether the outside or inside of the membrane was exposed to the donor phase. The lag time increased linearily and significantly from 0.3 to 0.79 to 1.1 h with increasing shell thickness from 1.08 to 1.66 to 2.12 mm, respectively. Flux and permeability decrease hyperbolically with increasing shell thickness. Increasing hardness at constant shell amount significantly increases lag time and decreases flux and permeability. Compression-coating seems to be a viable technique for preparation of controlled release drug delivery systems with a wide range for adjustment of permeability.

BACKGROUND The reproducibility and consistency of patch-test techniques can be problematic, making controlled clinical trials of patch testing difficult. OBJECTIVE To measure the accuracy and reproducibility of applying controlled quantities of petrolatum onto Finn Chambers. METHODS Four dermatology nurses applied a total of 240 samples of white petrolatum, using three syringe sizes and types. Three different amounts of white petrolatum (0.02 mL, 0.05 mL, and the "usual" amount) were expressed onto previously weighed Finn Chambers, using three different syringe sizes (5 mL, 1 mL, and 0.5 mL), five times each on two separate days. RESULTS The average weights of 0.05 mL of petrolatum expressed with each type of syringe (5 mL: 0.04252 g; 1 mL: 0.04084 g; and 0.5 mL: 0.04139 g) were not significantly different from each other in pairwise comparisons (p > .36) or from the "gold standard" expected value (0.04138 g, p > .72). The average weights of 0.02 mL of petrolatum expressed with two types of syringes (5 mL: 0.02138 g; 0.5 mL: 0.01778 g) were significantly different from each other (p = .0012), but neither differed significantly from the expected value (0.01655 g, p > .08). The variance due to the effect modifications of nurse, day, and interaction of nurse and day was statistically significant for measurements made with the 5 mL syringe but not for measurements made with the 1 mL or 0.5 mL syringe. CONCLUSION The average amounts of petrolatum extruded from smaller syringes (0.5 mL and 1 mL) were less variable and more reproducible than those extruded from a 5 mL syringe.

Benzoyl peroxide (BP) is commonly used for topical acne treatment and has long been known to be a weak allergen and a strong irritant. We report a case of a 26-year-old woman, who presented with an itchy erythematous reaction and strong oedema localized to the face. Two weeks before angioedema, the patient had started a new topical treatment with a gel containing 10% BP for acne. She was patch tested to European Standard Series, including BP 1% in white petrolatum, and to the 10% BP-containing gel previously used by herself, showing positivity on day 2 to BP 1% and to the 10% BP-containing gel. Factors that suggested an association between the severe angioedematous reaction and BP topical application include the strong reaction to BP in the patch-test, the temporal relationship, the complete resolution of symptoms after the drug was withdrawn and the absence of other identified explanations.

Essential oils are widely used in pharmaceutical and cosmetic preparations e.g. as fragrance, active ingredient or penetration enhancer. However, reports on skin absorption are rare. Therefore, the aim of our study was to investigate the capability of terpinen-4-ol, the main compound of Australian tea tree oil (TTO), to permeate human skin. In static Franz diffusion cells permeation experiments with heat separated human epidermis were carried out using infinite dosing conditions and compared to liberation experiments. The flux values of three different semisolid preparations with 5% TTO showed the rank order semisolid O/W emulsion (0.067 microl/cm2 h) > white petrolatum (0.051 microl/cm2 h) > ambiphilic cream (0.022 microl/cm2 h). In comparison to the flux value obtained with the native TTO (0.26 microl/cm2 h), the flux values are remarkably reduced due to the lower amount of terpinen-4-ol. P(app) values for cream (2.74+/-0.06 x 10(-7) cm/s) and native TTO (1.62+/-0.12 x 10(-7) cm/s) are comparable whereas white petrolatum (6.36+/-0.21 x 10(-7) cm/s) and semisolid O/W emulsion (8.41+/-0.15 x 10(-7) cm/s) demonstrated higher values indicating a penetration enhancement. No relationship between permeation and liberation was found.

A 31-year-old Caucasian woman presented with a 20-year history of presumed atopic dermatitis. She complained of severe pruritus and the presence of extensive patches of erythema and scale. Her previous treatments included: multiple topical corticosteroids, tacrolimus 0.1% ointment, pimecrolimus 1% cream, and cyclosporine with no improvement of her symptoms. Her past medical history was unremarkable and she was on no other oral medications, including over-the-counter products. On physical examination, multiple erythematous, scaly patches were present on the chest, abdomen,back, and upper extremities. Lichenification of both antecubital fossa was present. Extensive excoriations on her arms and abdomen were also noted. Although the patient had a long-standing history of presumed atopic dermatitis, she had never undergone a skin biopsy. A skin biopsy was performed which demonstrated a perivascular lymphocytic infiltrate with eosinophils and dermal edema (Figures 1, 2). The biopsy was suggestive of possible hypersensitivity dermatitis. The patient then underwent patch testing. The following patch tests were applied to normal back skin using IQ chambers:North American Contact Dermatitis Group (NACDG) expanded standard, textile, fragrance trays, and ingredients found in her products (Chemotechnique, Malmo, Sweden). A total of 89 patches were applied, removed at 48 hours, and read both at 48 and 96 hours. At 48 hours, a total of 70 allergens were positive, 69 of those allergens were in a petrolatum vehicle. There were 50, 3+ reactions to sites of allergens in petrolatum (Figure 3). There were only two sites with petrolatum that were negative: budesonide (a corticosteroid) and melamine formaldehyde. In contrast, all of the sites where there were allergens in liquid vehicles were negative, with the exception of a 1+ reaction to cocamidopropyl betaine. At 48 hours,four additional patch tests were applied to plain petrolatum. Two of these patches were in plastic IQ chambers and two in aluminum Finn Chambers. At 48 hours, all four of the sites showed 3+ reactions (Figure 4). By 96 hours, all of the patch test sites that were positive at 48 hours, and much of the surrounding skin, showed a diffuse "angry back" reaction, which made an accurate 96-hour reading impossible.

The aim of this study was to investigate the usefulness of topical provocation in the diagnosis of metamizol- and naproxen-induced fixed drug eruption (FDE). Five patients with metamizol- and four patients with naproxen-induced FDE established by oral provocation were tested with the causative drugs at concentrations of 10%, 20%, and 50% in white petrolatum both on previously involved and uninvolved skin using the occlusive patch test technique. Additionally, four patients with metamizol- and five patients with naproxen-induced FDE, and 20 healthy controls were tested openly with drug preparations in dimethyl sulfoxide (DMSO). Tape-stripping occlusive patch testing in petrolatum remained negative in all. Open testing with drug preparations in DMSO revealed positive results in all four patients tested with metamizol mainly at concentrations of 20%, and in three of five patients tested with naproxen exclusively at concentrations of 50%. No positive reaction was seen on previously uninvolved skin and in healthy controls with any drug concentration and pure DMSO. In conclusion, repeated open testing with concentrations of the drugs up to 50% in DMSO seems to be a reliable test method in metamizol-induced FDE whereas oral provocation is still the most reliable method for naproxen-induced FDE as false negative results were common when testing topically with naproxen.

Four methods were tried in order to reduce the growth of granulation tissue on the dura. The best results were obtained using white petrolatum jelly, which almost completely suppressed the growth of granulation tissue when the recording chamber was filled with petrolatum. Collagen and acrylic seals were very effective in one monkey. Panalog ointment slowed the growth of granulation tissue; preformed silicon sheets had no apparent effect. We conclude that long-term application of petrolatum jelly has no adverse effects and achieves striking suppression of the growth of granulation tissue.

White petrolatum is known for its nonsensitizing and nonirritating properties. Only a few cases of allergic contact dermatitis to white petrolatum have been reported. Although it is a rare event, the finding of contact sensitization to white petrolatum raises the potential problem of its usage of common topical agents or vehicles for patch testing. We herein report a case of allergic contact dermatitis to white petrolatum.

We report 11 new cases of hereditary nasal parakeratosis in Labrador retrievers. The disease was first observed when the dogs were 6 months to 2 years of age, and affected dogs of either sex and all coat colours. Hyperkeratosis and depigmentation were confined to the nasal planum, and affected dogs were otherwise healthy. The principal histological findings in biopsy specimens were marked diffuse parakeratotic hyperkeratosis, multiple intracorneal serum lakes and superficial interstitial-to-interface lymphoplasmacytic dermatitis. Topical applications of propylene glycol in water or white petrolatum were often effective for treatment of the dermatosis. However, continued applications were required to maintain a beneficial response. A retrospective histological study of parakeratotic inflammatory diseases of canine haired skin and inflammatory diseases of the canine nasal planum was performed. The degree of parakeratotic hyperkeratosis and the number and size of intracorneal serum lakes were evaluated. The degree of parakeratotic hyperkeratosis was greater in hereditary nasal parakeratosis specimens than that seen in discoid lupus erythematosus and Malassezia dermatitis. There were more serum lakes in hereditary nasal parakeratosis specimens than in specimens from dogs with discoid lupus erythematosus, Malassezia dermatitis, primary seborrheic dermatitis or zinc-responsive dermatosis. Significant differences in sizes of serum lakes (if present) were not seen.

Fifty-two patients with American cutaneous leishmaniasis (ACL) from the Pacific coast of Ecuador were treated topically with an ointment containing 15% paramomycin (PR) and 12% methylbenzethonium chloride (MBCL) in vaselinum album (white soft paraffin; white petrolatum). After 20 applications (over 10 or 20 d) all lesions showed complete epithlialization within the first 100 d. Five patients developed new lesions during the one year observation period; 2 of these were probably reinfections. Considering all 5 cases as treatment failures, the healing rates were: 72% after 50 d, 90% after 100 d, and 85% after 360 d. In a separate study in the same area, a group of 23 patients was left without treatment for 3 months. Only 9% of the untreated patients healed spontaneously after 50 d. Growth of the lesion, inflammation and pain were observed at the beginning of treatment. After treatment, most lesions healed rapidly without scars. The drug was well accepted by the patients and was easy to administer under tropical field conditions.

In the present study, the abilities of major Malassezia species, M. sympodialis, M. globosa and M. furfur, to assimilate topical agents, which have been widely used as a material of ointment for skin diseases, were tested. Obvious growth of M. furfur on GYEP agar plate was noted in the presence of white petrolatum, purified white petrolatum, hydrophilic ointment and heparinoid in hydrophilic ointment, and also M. sympodialis showed similar growth when they were cultured with hydrophilic or heparinoid in hydrophilic ointment. In contrast, M. globosa did not grow on GYEP in the presence of the any topical agents tested. These results suggest that Malassezia species, especially M. furfur and M. sympodialis, assimilate several topical agents and showed the drug-depended cell growth.

We present two Japanese cases of involutional lipoatrophy. The first case is that of a 30-year-old woman, who first appeared at our hospital complaining of a localized, well-demarcated depression, approximately 3 × 4 cm in size, normal to slightly erythematous in coloration, on the lateral side of the left upper arm (Fig. 1a). The condition was asymptomatic, and she had noticed this anomaly a month prior to consultation. She received intramuscular injections of corticosteroids of unknown dosage at the affected site for the treatment of allergic rhinitis 4 months prior to her present consultation. Figure 1. Clinical, histological and immunohistological findings in two cases of localized involutional lipoatrophy. Loss of subcutaneous tissue in the left upper arm is seen both in the first (a) and second (b) cases. Arrowheads indicate the depressed region. (c) The involved regions showed a decrease in the size of individual lipocytes in the first case (bar = 10 µm). (d) Immunoperoxidase staining for CD68 in the first case. Scattered macrophages (arrowheads) were identified within the affected adipose tissue and surrounding connective tissue (bar = 10 µm) Download figure to PowerPoint The second patient, a 23-year-old woman, appeared at our hospital complaining of a similar macule 4 × 4 cm in size, which she noticed several weeks prior to her most recent consultation. She had no history of injury or injection at the site before the development of the condition (Fig. 1b). She had been under treatment for atopic dermatitis since early childhood and was treated only with topical applications of white petrolatum containing 2% salicylic acid for the past several years. In order to rule out the possibility of acquired partial lipodystrophy associated with localized scleroderma, lupus profundus and the other connective tissue diseases, a histological examination was performed for both patients. Histopathological analysis of the region exhibited a well-defined fat lobule composed of numerous small adipocytes (Fig. 1c) embedded in hyaline connective tissue. Edema and dilated capillaries were noticeable in the subcutaneous tissue surrounding the area. Inflammatory cells were not prominent, although mononuclear cells were observed in both patients. No epidermal change was seen in either patient. Direct and indirect immunofluorescence studies revealed no deposits of immunoreactants in the skin of either patient. Immunohistochemical studies with the antibody against macrophage (anti-CD68 antigen; DAKO.) showed that positive cells were scattered around blood vessels and shrunken lipocytes in the subcutaneous tissues (Fig. 1d). Most of these cells in the fat lobules were also positive for mucin stains such as Alcian blue. No abnormal findings came to light in the ordinary hematological and blood chemistry examinations of both patients. The autoantibody screening tests using antinuclear, anti-DNA, anticentromere, and anti-Scl-70 antibodies were negative in both patients.

The purpose of this study was to investigate the usefulness of topical provocation in the diagnosis of cotrimoxazole-induced fixed-drug eruption (FDE). 27 patients with established cotrimoxazole-induced FDE by oral provocation and 20 healthy controls were tested with drugs at increasing concentrations in white petrolatum and dimethyl sulfoxide (DMSO) both on previously involved and uninvolved skin sites. Tape-stripping occlusive patch testing in petrolatum remained negative in 19 tested patients. Open testing with drug preparations in DMSO revealed positive results in 25 of 27 tested patients. 1 patient showed an additional positive reaction on previously uninvolved skin. Lesions on male genitalia and on face reacted to testing once with 10% or 20% of the suspected drug, whereas repeated testing with concentrations up to 50% was necessary in lesions on trunk & extremities. Open testing with drug preparations in DMSO at concentrations of 10%, 20% and 50% and pure DMSO remained negative in 20 healthy controls. The present study shows that repeated open testing with graded concentrations of the drugs up to 50% in DMSO is a reliable test method in sulfamethoxazole/trimethoprim-induced FDE. Patients and physicians should be aware of the transient irritant reaction to DMSO that is not infrequent, so as to avoid false-positive interpretations.

Shiunko is a typical Kampo drug made from herbal extracts and used to treat a range of conditions including atopic dermatitis. Shiunko, white petrolatum and 3.5% salt water were applied to the skin of atopic dermatitis patients, and their clinical effectiveness, and the changes in bacterial species and cell numbers on the skin were studied. Staphylococcus aureus was the main species seen but several other coagulase-negative staphylococci were also identified on some patients. Shiunko was clinically effective in four of seven patients (57%) compared with no patients for petrolatum and one of seven (14%) for salt water. Bacterial counts were reduced with Shiunko in four of seven patients compared with one of seven patients (14%) for both petrolatum and salt water. The results suggest that Shiunko may have antibacterial effects on staphylococci, and may be an effective treatment for atopic dermatitis and other skin infections caused mainly by Staphylococcus species

Several of the products formed after oxidation of d-limonene exhibit strong contact allergenic properties. Some, e.g., the hydroperoxides, are unstable compounds. In this study, we have examined whether the limonene hydroperoxides are chemically stable in white petrolatum used for patch testing. We found that the stability of the hydroperoxides was strongly dependent on whether or not the petrolatum was stabilized with alpha-tocopheryl acetate. In the presence of this antioxidant, the hydroperoxides were degraded to a greater extent. The hydroperoxides were shown to be directly reduced to the corresponding alcohols by this agent. On the other hand, the compounds where shown to be stable in non-stabilized petrolatum throughout clinical patch testing for a period of 6 weeks, provided that the preparations were stored in a refrigerator when not used. Thus, it is recommended that vehicles without alpha-tocopheryl acetate are used when peroxy or hydroperoxy compounds are patch tested or used in sensitization experiments. However, it is important to limit the storage time so that optimal conditions are at hand. A fast method was developed to enable isolation and quantification of the hydroperoxides in white petrolatum. This analytical method may also be applicable to other compositions of patch test preparations.

Clostridiopeptidase A, also called collagenase 1, is a proteolytic enzyme capable of digesting collagen. Preparations containing clostridiopeptidase A are used topically for the debridement of dermal ulcers, burns and other necrotic lesions to facilitate the formation of granulation tissue and subsequent epithelization. We observed 4 patients with a periulcerative eczema after repeated applications of Noruxol ointment (Smith & Nephew Ltd, L Hull, UK). Patch testing with Noruxol ointment as is and its excipients (soft paraffin and white petrolatum), as well as scaled dilutions of the main ingredient of this topical preparation, clostridiopeptidase A (Firma, Florence, Italy), showed doubtful reactions to Noruxol ointment in 3 patients and a positive reactions only in 1 patient. All patients showed positive reactions to clostridiopeptidase A 1% in pet. This study shows the sensitizing capacity of clostridiopeptidase A that should be tested in all patients with suspect sensitization to Noruxol ointment.

Microdialysis has been used to determine the concentration of salicylic acid in skin tissue and plasma periodically for 4 h to evaluate the effect of ointment bases on topical and transdermal delivery of salicylic acid. The ointment bases examined were solbase (water-soluble), poloid and white petrolatum (oleaginous), hydrophilic poloid (water in oil (w/o) type emulsion lacking water) and absorptive ointment (w/o-type emulsion containing water). The ointments (0.1 g) containing 25 μmol salicylic acid were applied for 2 h to the surface of rat skin (1 cm2) with (intact) or without the stratum corneum. For intact skin, the extent of topical delivery from different ointments, evaluated by the area under the concentration-time curve (AUC) of salicylic acid in the skin tissue (AUCskin), increased in the order solbase. white petrolatum, poloid, hydrophilic poloid. absorptive ointment. The ratio of AUCskin (topical delivery) to the AUC of salicylic acid in plasma (AUCplasma, transdermal delivery) varied remarkably among the different bases, the greatest ratio being observed for absorptive ointment. When the ointments were applied to skin surface without stratum corneum, AUCskin for solbase was much higher (about 45 times that for intact skin), whereas only a small (two-fold) increase was observed for poloid and hydrophilic poloid and the increase was negligible for white petrolatum and absorptive ointment. For skin without the stratum corneum, the ratio AUCskin/AUCplasma for the different ointments was comparable, although the magnitudes of AUCskin and AUCplasma still varied substantially. The variance of AUC values arises as a result of the different rates of release of salicylic acid from the bases. These results indicate that: the topical and transdermal delivery of salicylic acid in intact skin varies substantially among different ointment bases, and the greatest topical delivery is observed for absorptive ointment; use of absorptive ointment increases the retention of salicylic acid in the stratum corneum; and the stratum corneum functions strongly as a penetration barrier for solbase, moderately for poloid and hydrophilic poloid, and less for absorptive ointment and white petrolatum.

Turchi et al. [Turchi, P., Canale, D., Ducci, M., Nannipieri, E., Serafini, M.F., Menchini Fabris, G.F. (1992). The transdermal route in the treatment of male sexual impotence: preliminary data on the use of yohimbine. Int. J. Impotence Res. 4, 45–50.] showed that the application on penile skin of an oil-in-water cream (cream I.G) containing yohimbine (YO) was successful in the treatment of male sexual impotence. The components of the cream were stearyl alcohol, isopropyl lanolate, white petrolatum, liquid petrolatum, sodium lauryl sulphate (NaLS), propylene glycol (PG) and water. In the present study, a number of creams were derived from the cream I.G by adding, eliminating or replacing one or more constituents, and the effects of such changes on YO permeation through excised hairless mouse skin were investigated. From the data emerged the possibility of improving YO permeation even through slight changes in I.G composition. The stratum corneum-vehicle interactions were investigated by analyzing samples of isolated hairless mouse stratum corneum by DSC.

Background: Protective creams (PCs) have been studied in different models indicating a protective effect of some products. In order to compare PCs in different studies, a generic reference standard should be available. Objective: The purpose of this study was to investigate if petrolatum prevents epidermal barrier disruption induced by various irritants in a repetitive irritation test (RIT) and to assess its potential as a standard reference product. Methods: White petrolatum was evaluated against a set of 4 irritants [10% sodium lauryl sulphate (SLS), 1% sodium hydroxide (NaOH), 30% lactic acid (LA) and undiluted toluene (TOL)] in the RIT. Twenty subjects were tested on the paravertebral skin of the mid-back. Irritation was assessed by visual scoring, transepidermal water loss and colorimetry. Results: Petrolatum was very effective against SLS, NaOH and LA irritation, and it provided a moderate protection against TOL. Conclusion: Petrolatum can be recommended as a standard reference substance against which PCs may be compared as it is effective against water-soluble and water-insoluble irritants in a standardized test procedure.

Until now, the common strategy for atopic eczema (AE) therapy is how to treat or suppress the already established eczema, or how to control the general immune responses against antigens. It has been accepted that AE shows a delayed-type hypersensitivity to exogenous antigens especially in adulthood [1]. The characteristic distribution of skin lesions, of the exposed and flexure regions, are also suggestive of dose dependency of exogenous antigen distribution over the skin. On the other hand, dry and rough surface of AE patients’ skin [2] strongly suggests decreased skin surface water content [3] and lipid [4], which was supported by the increased transepidermal water loss (TEWL) in AE patients. The increased TEWL dose does not mean simply increased transport of water, but also easier penetration of larger materials such as antigens, which is compatible to deteriorated skin barrier function. Recently, we showed the importance of epidermal ceramides in cutaneous barrier function in the essential fatty acid deficiency rat model [5]. Among the variety of ceramides, pseudo-o-acylceramide with linoleic acid (OAC) only showed significant effects in the recovery of TEWL in the rat experimental model. As we expected, topical OAC treatment on AE skin successfully suppressed TEWL close to normal level. Since the vehicle (OAC cream minus OAC) alone and white petrolatum had no significant effects in restoring of TEWL, we could confirm the effect of OAC in AE-related dry skin.

Figure 2. Dermal lymphohistiocytic infiltrate with typical plasma cells (arrows). A 10-year old boy presented with a slowly growing (over 1 year) painless nodule on his left temple, pre-existing for 1 year (Figure 1). His general health was excellent; travel outside Germany was denied. The skin biopsy showed a diffuse granulomatous dermatitis mainly composed of epitheloid cells, and occasional multinucleated foreign body type giant cells. A granulomatous foreign body reaction after a ruptured epidermal cyst was diagnosed. After ineffective topical corticosteroid therapy, the first of a scheduled sequential excision was done. This specimen once more showed epitheloid granulomas now consuming the whole dermis. However, in contrast to the first biopsy, plasma cells were now spotted within the lymphohistiocytic infiltrate that prompted us to re-evaluate the diagnosis (Figure 2). Investigations for Borrelia and Mycobacteria were negative, but polymerase chain reaction revealed the presence of Leishmania donovani complex DNA. After confronting the patient and his mother with this result, the boy recalled a 2-week journey to a rural area near Barcelona, Spain, approximately 1 year before the skin lesion had occurred, thus, pointing at Leishmania infantum as the culprit infectious agent. Laboratory tests, clinical, and ultrasound investigations did not reveal any signs of systemic disease. Consequently, cutaneous leishmaniasis was diagnosed and topical 15% paromomycin/12% methylbenzethonium chloride in white petrolatum treatment under occlusion was initiated. After 2 months of treatment, the lesion completely resolved, leaving an atrophic scar.

VOLUME 87 NUMBER 6 remaining threads will serve to retain the acrylic resin and thus keep the coping in a fixed position). Place a small amount of utility wax (Kerr, Romulus, Mich.) in the abutment screw access hole to prevent the acrylic resin from flowing into it (Fig. 1). Leave the impression coping screw untightened so that the abutment screw can be loosened easily. 3. Lubricate the abutment and the conical abutment impression coping screw with petroleum jelly (White Petrolatum USP; E. Foguera and Co, Melville, N.Y.). 4. Place pattern resin around the abutment, keeping A customized guide for transferring angled abutments

Purpose: The authors of the present study report a case of phthiriasis palpebrarum treated with petrolatum ointment and tea tree oil in a 12-month-old boy. Case summary: A bluish-gray macule and blood clots were found on the central portion of the upper eyelid of a boy who had rubbed his eyelid vigorously 1 week prior. Several 0.5 mm sized brownish-gray nits and 1.6 mm sized lice on the eyelashes were visible and was diagnosed with phthiriasis palpebrarum after light microscopic examination. The nits and lice were gently removed mechanically with the help of a white petrolatum ointment (Vaseline) and the eyelashes were cleaned with 50% tea tree oil. Nits and lice were successfully eradicated without recurrence 10 days after daily treatment with petrolatum ointment and 10% tea tree oil eyelash cleansing. J Korean Ophthalmol Soc 2011;52(10):1222-1226

Calcitriol, 1 alpha,25 dihydroxycholecalciferol (1 alpha,25 (OH)2 D3) is a natural active vitamin D3 metabolite, which has been shown to have antipsoriatic efficacy. In vitro studies have demonstrated that calcitriol influences various aspects of inflammation, epidermal proliferation and keratinization. The aim of the present study was to determine to what extent calcitriol (3 micrograms/g in white petrolatum) affects these parameters in vivo. Using an immunohistochemical assessment of recruitment of cycling epidermal cells, filaggrin and involucrin expression, T-cell accumulation, polymorphonuclear neutrophil (PMN) accumulation, amount of endothelium and ICAM-1 expression, we demonstrated that: (i) modulation of all these parameters occurred during calcitriol treatment; (ii) there was early reduction of epidermal proliferation and PMN accumulation; (iii) the order of changes was comparable with the response to treatment with calcipotriol. In conclusion, at the cell biological level, calcitriol (3 micrograms/g in white petrolatum) has a substantial effect on various elements of the psoriatic lesion.

Sir, applying colophony 0.02% in white petrolatum or the vehicle alone. They were similar to each other at 24 h after irradiation, Chronic actinic dermatitis (1) is an idiopathic photosensitivity disorder.A high incidence of a previous chronic contact allergy while ` MEDs’’ at 48 h after irradiation upon applying colophony were de® nitely lower than those upon applying white caused by several materials, including the Compositae family, fragrances and lichens, has been reported (2). Here we report petrolatum from 290 to 320nm, thus the patient showed photosensitivity from colophony where the action spectrum a case of chronic actinic dermatitis associated with contact allergy as well as photosensitivity from colophony. Study of for the photosensitivity ranged from 290 to 320nm (Fig. 1). The shape of the diŒerence action spectrum at 48h after the mechanisms of photosensitivity from contact allergens in such cases may indicate how repeated exposure evolves into irradiation upon applying colophony 0.02% in white petrolatum or the vehicle diŒered from that of the absorption chronic actinic dermatitis. spectrum of colophony 0.02% and abietic acid, one of major antigenic components of colophony (4), 0.02% in white petrolatum (Fig. 2). We also examined 4 subjects without CASE REPORT contact allergy from colophony on their action spectrum. Two A 72-year-old Japanese woman had been weeding the garden of them were aŒected with chronic actinic dermatitis, one with for about 30 years. For about 10 years she had been aŒected seborrheic dermatitis, and one with prurigo subacuta. Their by chronic eczema on sun-exposed areas. The eczema was average diŒerence action spectrum was generally lower than worse during spring and summer. She noticed that the eruption the score of 0, which may indicate that colophony acted as a appeared after exposure to sunlight through a windowpane. sunscreen in those subjects (Fig. 2). At her ® rst visit in June 1998, she presented with erythema Her eruption was remitted by avoiding sun-exposure as an and oedema on the face, nape of the neck and the V-shaped inpatient for 2 weeks. Since her discharge, her skin condition area of her upper chest. She always wore gloves while working has almost recovered to normal by applying sunscreens prooutdoors and the dorsa of the handswere spared. Her personal tecting from both UVB and UVA during her work outdoors. and family history was unremarkable except for the eruption, and she had never used any medications habitually. The histology of the specimen from a lesion on her cheek showed a chronic eczematous reaction. Patch tests to the European Standard and Photoallergens Series (Trolabâ , Hermal, Hamburg, Germany) and to materials including pesticides were performed. These were read at day 3 and day 4 in accordance with the criteria of the International Contact Dermatitis Research Group, and the results on both days showed weakly positive reactions to colophony at concentrations down to 0.02% in white petrolatum, one-thousandth of the preparation established in the European Standard Series. More concentration of colophony added stronger reactions in patch testing. Open patch tests were positive to colophony at 0.06% but negative to 0.02% in white petrolatum. Photopatch testing was also carried out on the same series irradiated at day 2 with half the minimal erythema dose (MED) from FL20S E-30 (Toshiba, Tokyo, Japan) as the ultraviolet B (UVB) source, or with 6 J/cm2 from FL32S BL (Toshiba) as the UVA light source through a window-glass ® lter to cut-oŒ wavelengths shorter than 320nm. The photopatch test results were all negative, including those to colophony, where there were no diŒerences in the grade of reactions to colophony 20% to 0.06% in white petrolatum between patch and photopatch testing at day 3 and day 4. The MEDs judged on the uninvolved abdominal skin at 24h after irradiation with an irradiation monochromFig. 1. Action spectrum for erythema at (a) 24h and (b) 48h after ator (Jasco, Tokyo, Japan) were lower than the normal range irradiation, where colophony 0.02% in white petrolatum (solid line) between 290 and 350nm (3). Then the action spectrum for or the vehicle (broken line) had been applied 24h earlier on the patient’s abdomen. erythema was tested on the patient’s abdomen 24 h after

REFERENCES 1. Sulzberger MB, Lazar MP. A study of the allergenic constituents of lanolin (wool fat). J Invest Dermatol 1950;15:453-8. 2. Guin JD. Eyelid dermatitis: experience in 203 cases. J Am Acad Dermatol 2002;47:755-65. 3. Green CM, Holden CR, Gawkrodger DJ. Contact allergy to topical medicaments becomes more common with advancing age: an age-stratified study. Contact Dermatitis 2007;56: 229-31. 4. Machet L, Couhe C, Perrinaud A, Hoarau C, Lorette G, Vaillant L. A high prevalence of sensitization still persists in leg ulcer patients: a retrospective series of 106 patients tested between 2001 and 2002 and a meta-analysis of 1975-2003 data. Br J Dermatol 2004;150:929-35. 5. Smack DP, Harrington AC, Dunn C, Howard RS, Szkutnik AJ, Krivda SJ, et al. Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial. JAMA 1996;276:972-7.