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The antifungal agent naftifine has been approved in the United States for twice daily treatment of fungal infections of the foot, skin, and other areas of the body. Studies in Europe showed that naftifine may also be effective in a once-daily regimen. The effectiveness of naftifine 1 percent cream applied once or twice daily was compared with twice-daily applications of clotrimazole 1 percent cream. The study involved 155 men and 55 women with tinea pedis, or fungal infection of the foot. Within six weeks, treatment success was achieved in 81 percent of patients receiving twice- daily naftifine compared with 58 percent of patients treated with twice-daily clotrimazole who responded to treatment. Once- or twice-daily naftifine was more effective in resolving symptoms, such as redness, cracking, and itching, than twice-daily clotrimazole. There were no differences in the effects of the different doses of naftifine. Once- and twice-daily naftifine was more effective than twice-daily clotrimazole in treating the hyperkeratotic plantar-type of tinea pedis. Treatment-associated side effects included blisters or increased scaling with once-daily naftifine; skin inflammation with naftifine twice-daily; and flaring of blisters with clotrimazole twice-daily. The success of antifungal treatment applied to the skin depends on both the effectiveness of the drug and the ability of the patient to comply with a drug regimen. The results show that the once-daily application of the antifungal agent naftifine is more effective than twice-daily treatment with the antifungal agent clotrimazole. (Consumer Summary produced by Reliance Medical Information, Inc.)

1. Three groups of anaesthetized dogs were studied to determine the role of renal prostaglandins in glucagon-induced natriuresis. 2. Urine flow, sodium and prostaglandin E excretion rates increased significantly in the experimental kidney with glucagon infusion (0.20 μg/min) into the renal artery. These changes were completely reversed after the administration of either of two inhibitors of prostaglandin synthesis. 3. Infusion of glucagon (0.20 μg/min) after the administration of either of the prostaglandin synthetase inhibitors failed to increase either urine flow rate or sodium excretion above control values and failed to elevate urine prostaglandin E excretion rates. 4. Infusion of glucagon (0.75–1.25 μg/min) resulted in significant elevations in urine flow rate, glomerular filtration rate, renal plasma flow, urine sodium and prostaglandin E excretion rates. 5. The data presented indicate that the diuresis and natriuresis seen with the infusion of glucagon (0.20 μg/min) are accompanied by an increase in urine prostaglandin E excretion and are reversed by the administration of inhibitors of prostaglandin synthesis, suggesting that the increased urine flow and sodium excretion rates are dependent on prostaglandin-mediated mechanisms. The administration of glucagon in higher doses appears to be associated with alterations in electrolyte excretion and glomerular filtration rate, which presumably is related to factors other than prostaglandin synthesis and release.

IntroductionThe clinical complex, sarcoidosis, has gradually emerged and enlarged since the descriptions of Hutchinson,1 Besnier,2 Boeck,3 and Schaumann.4 The "concept" of sarcoidosis has been the subject of a great deal of controversy which at the present time is still far from being resolved. The present case offers a perplexing example of the complexity seen in the sarcoidosistuberculosis relationship. REPORT OF CASE The patient is a 75-year-old retired white male schoolteacher. He was seen for the first time at the University of Chicago Clinics in December of 1930, at the age of 45. Physical examination at that time was normal with the exception of the chest. Rales were heard posteriorly at both apices, and bilateral narrowing of Krönig's isthmus to percussion was noted. A large chest roentgenogram revealed the presence of lacy shadows extending bilaterally from the hilus to the apices and toward the third interspaces.

The cutaneous manifestations of tuberculosis can be grouped into two categories: (1) those in which actively multiplying tubercle bacilli are present in the lesions, and (2) those, the tuberculids, in which tubercle bacilli or their products embolize to the skin from some active, but at times obscure focus of the disease. In tuberculids, the embolized bacilli do not long remain viable, apparently because of the intense tissue reaction elicited by their presence in the skin.1,2 Two well-defined types of tuberculids are papulonecrotic tuberculid and erythema induratum. In this report we present evidence that the extreme tuberculin sensitivity which characterizes these tuberculids3 can best be demonstrated with old tuberculin (O.T.) rather than with more purified derivatives such as the purified protein derivative (PPD).It is of interest that Darier4 in 1896 introduced the concept of tuberculid before knowledge about tuberculin skin testing was developed shortly after the turn

Studies of percutaneous absorption of C14-labeled triamcinolone acetonide in two normal subjects revealed urinary excretion of 2.3% and 0.6% of applied steroid. These preliminary findings indicate that triamcinolone penetrates normal skin sites in approximately the same quantities as those reported previously for cortisone and hydrocortisone.Studies of the absorption of C14-labeled triamcinolone acetonide through stripped skin sites showed far slower penetration than that demonstrated previously for hydrocortisone alcohol. For example, 20% or more of applied triamcinolone was still demonstrable at test sites 20-24 hours after application, while for hydrocortisone 20% of applied material remained only 1-2½ hours after application.Investigations of the inhibitory effects of high tissue concentration gradients and vasoconstriction induced by triamcinolone are described for the subsequent absorption of C14-labeled triamcinolone and testosterone-4-C14 at stripped skin sites.Factors important to the increased potency of triamcinolone—in the absence of enhanced absorption—have been discussed. Emphasis has been placed on the necessity for further quantitative absorption data for derivatives of hydrocortisone and prednisolone in view of recent reports of adrenal cortical suppression following the topical use of adrenal steroid compounds.

• Two mentally retarded siblings, one with severe segmental scleroderma and the other with atrophoderma of Pasini and Pierini, were found at the ages of 6 and 10 years to have phenylketonuria (PKU). The belief that a common pathomechanism exists between morphea and atrophoderma of Pasini and Pierini is supported by the case of the two siblings. Disorders in tryptophan metabolism can occur in both PKU and scleroderma. For a low phenylalanine diet to be effective in PKU, it has to be instituted at an early age. Phenylketonuria should be considered in infants and children with sclerodermatous skin lesions.(Arch Dermatol 114:1215-1217,1978)