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Psoriasis is a common, chronic skin disorder in which red, scaly patches appear on the back of the arms, front of the legs, and bony regions. A group of molecules suspected of playing a role in this disorder is the leukotrienes, which are known to cause allergic and inflammatory responses. These substances are present in increased concentrations in the lesioned areas of psoriatic skin, and application of one leukotriene, LTB4, has been shown to induce psoriasis-like symptoms in normal skin. To test the effects of a reduction in LTB4 levels in psoriasis sufferers, R 68 151, a drug that inhibits formation of that compound, was applied to the skin of 44 patients twice daily over a four-week period. An additional 44 patients received only vehicle (an ointment containing no active ingredients) and functioned as a control group. Ointment was applied to one active lesion only and the condition of that lesion was evaluated after two weeks and after four weeks. Signs and symptoms were scored on an 11-point scale. Results showed that the lesions in 27 percent of the patients treated with R 68 161 disappeared or improved significantly, compared with only 8 percent of patients in the control group. While these differences were not statistically significant, results of the global evaluation demonstrated a clear improvement for the drug group. When individual symptoms were studied, a 46 percent improvement in scaling of the skin was reported after R 68 151, versus a 6 percent improvement for patients using vehicle. Erythema (redness) improved by 34 percent after the drug, and actually grew worse (by 3 percent) after using the vehicle. These results applied to the patients with psoriasis vulgaris (73 out of the 88 patients) and similar results were obtained for the group as a whole, which included other psoriasis subtypes. Since the concentration of LTB4 in the treated lesion was not actually measured, it cannot be determined whether the effects of R 68 151 were due only to inhibition of that leukotriene. The results suggest that therapeutic agents that reduce the levels of leukotrienes could be effective in treating psoriasis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Contact dermatitis, inflammation of the skin after exposure to an irritating substance, has been associated with the use of several types of antiseptic agents. The active ingredients of antiseptic solutions such as iodine, chlorhexidine digluconate, and hexamidine isothionate were shown to cause contact dermatitis. Within a ten-year period, the Belgian Tricontact Group recorded 54 cases of contact sensitivity to iodine, 27 to chlorhexidine digluconate, and 13 to hexamidine isethionate. However, there are at least three reports of contact dermatitis to the solutions but not to the individual active ingredients. This suggests that elements in the solution other than the principle ingredients are capable of causing an inflammatory skin reaction. Twelve cases of contact dermatitis caused by nonoxynols, the nonionic surface active agents in antiseptic solutions, are described. Nonionic surface-active agents act as detergents to break up lipids (fats) on the skin and thereby enhance the cleansing action of antiseptic solutions. Nonoxynols have a characteristic chemical formula, and various physical properties which make them useful in several industrial, household, agricultural, cosmetic, and pharmaceutical products. Contact dermatitis to nonoxynols may contribute to intolerance to antiseptic solutions. (Consumer Summary produced by Reliance Medical Information, Inc.)