EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 20, 2004
To contact Thomas Ruzicka, M.D., e-mail: ruzicka{at}uni-duesseldorf.de.

PATIENTS WITH MODERATE OR SEVERE HAND DERMATITIS RESPONSIVE TO DRUG THERAPY

CHICAGO—Use of the oral medication alitretinoin was effective in treating moderate or severe hand dermatitis in nearly half of patients previously unresponsive to standard treatment, according to an article in the December issue of the Archives of Dermatology, one of the JAMA/Archives journals.

Hand dermatitis affects six to 11 percent of the population in northern Europe, according to background information in the article. The disease can include redness, scaling, blistering, swelling, itching, and fissures of the skin on the hands. Chronic hand dermatitis (CHaD) has been known to cause psychological distress and temporary or permanent working disability. Although mild cases of CHaD usually respond to topical treatment, more severe cases can be incapacitating in patients who are unresponsive to standard therapy.

Thomas Ruzicka, M.D., of Heinrich-Heine University Hospital Dusseldorf, Germany, and colleagues tested the safety and effectiveness of oral alitretinoin in the treatment of CHaD in patients previously unresponsive to treatment. Three-hundred nineteen patients with moderate or severe CHaD were divided into four treatment groups: to take 10 mg/day, 20 mg/day, or 40 mg/day of alitretinoin, or placebo orally once a day for twelve weeks. Participants were classified as responsive if their dermatitis was clear (no visible dermatitis) or almost clear (minimal redness and/or scaling).

Twenty-nine to 39 percent of patients receiving 10 mg/day of alitretinoin were responsive, 34 to 41 percent in the 20 mg/day group were responsive, and 43 to 53 percent of those in the 40 mg/day group were responsive to treatment, compared to 12 to 27 percent of patients in the placebo group who were responsive. Headache was the most frequent adverse effect leading to withdrawal from the study in participants who received alitretinoin.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 20, 2004
To contact A. Marco van Coevorden, M.D., e-mail: a.m.van.coevorden{at}derm.azg.nl.

HOME-BASED TREATMENT AS EFFECTIVE AS HOSPITAL-BASED TREATMENT FOR HAND ECZEMA

CHICAGO—An at-home hand dermatitis treatment with oral medication and use of a portable tanning unit appears to be as effective as a hospital-based treatment in reducing the symptoms of hand dermatitis, according to an article in the December issue of the Archives of Dermatology, one of the JAMA/Archives journals.

According to background information in the article, hand eczema, also called hand dermatitis, refers to the inflammation of the skin on the hands. This often chronic condition affects 10 percent of adults in the general population within one year, and includes scaling, redness, and blistering of the skin. One treatment option for hand dermatitis is psoralen-UV-A (PUVA). PUVA involves the administration of psoralen-either orally (as a pill) or locally (as a hand-bath soak, or applied as a gel or cream)-and subsequent exposure to UV-A light from tanning units.

A. Marco van Coevorden, M.D., from the University Hospital Groningen, the Netherlands, and colleagues compared the effectiveness of an at-home PUVA treatment (with portable tanning unit) to hospital-based hand bath PUVA in patients with moderate to severe chronic hand dermatitis. Patients in the home group (n = 78) received 30 treatments, three times a week for ten weeks. Two hours after taking an oral medication methoxsalen, the patients used a portable tanning unit on their hands, increasing the time and intensity of treatment throughout the study. Those in the hospital group (n = 80) received UV-A treatment 20 times during 10 weeks, preceded by a 15-minute hand bath with the medication trioxsalen.

The researchers found that, according to changes in hand dermatitis scores, the average improvement after ten weeks was 41 percent in the home group and 31 percent in the hospital group. Overall, the researchers reported no statistically significant difference over time and between groups.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, December 20, 2004
To contact Carlos H. Morales, M.D., M.Sc, email: cmorales{at}epm.net.co.

PATIENTS WITH ABDOMINAL TRAUMA AT RISK FOR INTRA-ABDOMINAL INFECTIONS FOLLOWING SURGERY

CHICAGO—Patients who undergo surgery for abdominal trauma caused by firearm wounds or by blunt trauma are at risk for developing intra-abdominal infections, and several factors increase that risk, according to a study in the December issue of the Archives of Surgery, one of the JAMA/Archives journals.

According to background information in the article, "Infection is responsible for most deaths in trauma patients who survive longer than 48 hours after trauma. Intra-abdominal infection (organ/space surgical site infection) in patients with abdominal trauma constitutes one of the most frequent infectious problems and poses a major challenge to trauma surgeons." The authors write that the incidence of these infections ranges from 2 percent to 9 percent and that the death rate from intra-abdominal infection can be higher than 50 percent if the diagnosis is delayed after development of multiple organ failure.

Carlos H. Morales, M.D., M.Sc., from Universidad de Antioquia, Medellin, Colombia, and colleagues analyzed the records of 762 patients with abdominal trauma who underwent surgery and were admitted to a level I trauma center in Medellin between November 1, 2000 through August 31, 2002. The majority of the patients were male (91.2 percent) and the average age was 27.9 years. The researchers were seeking information on the incidence of intra-abdominal infection and the risk factors associated with the development of this complication.