Posters - Therapy S231

(1.0) > F (0.5) >TA (0.4). This correlated well with the GR affinity: FP >MF = BMP rB > FA >F = TA. Affinity for the GR predicts topical anti-inflammatory potency and is highest in the corticosteroids tested for FP.

I P359 Functional antioxidants in skin protection and prophylaxis of polymorphic light eruption

F. Stab, R. Wolber, S. Untiedt, I. Hadshiew ‘, K. Bohnsack, M. Sepehrmanesh, R. Keyhani, G. Lanzendorfer, H. Wenck, F. Rippke, G. Sauermann, U. Hoppe, E. Holzle ’ . ’ Clinical Department of Dermatology LIKE, Hamburg; Paul Gerson Unna Research Center, BeiersdorfAG, Hamburg, Germany

The glutathione redoxsystem is one of the most important in- tracellular antioxidant systems. In ex viva/in vitro studies using human suction blister epidermis and skin biopsies we found that natural antioxidants can protect the intracellular glutathione (GSH) level of keratinocytes and fibroblasts from depletion by free radicals. Our findings from ex vivolin vitro investigations show that i. e. flavonoid systems have an excellent antioxidant activity and a high antiinflammatory potential. The intracellular signal transduction pathway in primary keratinocytes stressed in vitro by H202 can be modulated on the level of src -phospo- tyrosine kinase (PTK) activity by in vitro and/or topically applied antioxidant systems. In vivo studies on normal human skin using UV-induced or peroxide-induced ultraweak photon emission measurements (UPE) as read out system to quantify oxidative stress in vivo confirmed the antioxidative and the UV-protecting potential of the antioxidant systems investigated. Based on our in vitro and in vivo data we tested an antioxidant system for PLE prophylaxis in a clinical trial including 30 volunteers with an anamnesis for PLE. For the in vivo UPE a group of 28 matched pair volunteers with healthy normal skin was used as reference to the PLE panel additionally. The parameters used for the clinical evaluation of PLE (itching, formation of erythema, plaques and papules) show a significant improvement of the PLE score at the skin sites treated with antioxidants compared with untreated or placebo treated skin sites. These clinical findings correlate significantly with the data of the in vivo UPE on normal and on PLE skin demonstrating a highly significant reduction of UV-induced oxidative stress of verum treated skin sites compared with placebo or untreated controls.

I P360 Delusions of parasitosis-combined therapy with clomipramine and haloperidol

ES. Ser ’ , M. Veljkovic ’ , M. LazoviC ’ , I. Tom&PavloviC2. ’ City Department for Skin and Venereal Diseases, Belgrade; 2Clinical Center Zemun, Yugoslavia

A rather rare syndrome which leads to artificial skin damage mainly described in women aged sixty and over. Standard rec- ommended therapy with pimozide restricts the use of the drug with associated organic disease due to side-effects profile of the drug. Pimozide is also in many only approved for treatment of Tourette-s disorder. Authors describe the alternate regimen with low-dose haloperidol used in conjuction with approved an- tiobsessive drug of tricyclic antidepressant class clomipramine.

Starting with 0.5 mg of haloperidol and lo mg clomipramine daily, dose adjustments were made according to therapeutic response at week intervals. Usually marked improvement was noted in the second week of therapy. After approximately three months, haloperidol medication was gradually tappered and terminated, while clomipramine was given for a period of addi- tional symptom-free six months in a dose-range 25-50 mg. We found this regimen very effective, lacking serious side effects. Low dose combination of those two drugs was for the majority of patients activating and usual quality of life restored.

El P361 Two cases of the yellow nail syndrome successfully treated with pulses of itraconazole

S. Urbanowski, Z. Gwieidzinski, E. Nierebhska. Department of Dermatology, University School of Medical Sciences, ul. Kurpiriskiego 5, 85-096 Bydgoszcz, Poland

The Yellow Nail Syndrome is a rare disease, of unknown etiology. So far, effective therapy is unknown. We reported two cases of this syndrome successfully treated with pulses of itraconazole.

The first a 40 year old women with 5 years history. All 10 nails of fingers showed a yellowish discoloration, thickening and round form of nail plate and disappearance of the cuticle. Nails were arrested in about from 10 to 40%. Patient also suffered from periodical shortness of breath and bronchiectasis. The second case concerns a 52 year old women with 7 years history. All 20 nails of fingers and toes showed a white-yellow- ish discoloration. Nails were almost totally arrested. Patient also suffered from bronchial asthma. These two patients received pulse therapy regimen with monthly cycles of 1 week 400 mg (2 x 200 mg) itraconazole for 5 months (first case) and 7 months (second case). These cases responded clearly. 6 months after the end of the pulse therapy the recurrence of the Yellow Nail Syndrome has not been observed.

In authors opinion pulse therapy with a dose of 400 mg itraconazole should be recommended in the Yellow Nail Syn- drome.

El P362 Topical acyclovir in the treatment of erythema annulare centrifugum

R. Iankova. Department of Dermatology, Medical University, Plovdiv, Bulgaria

Erythema annulare centrifugum (EAC) is an etiologically ob- scure dermatosis manifested by erythematous, at times edema- tous patches, which in common have a centrifugal advance and regress from the center.

Two patients have presented with patterns of circumscribed EAC consequent on herpes simplex virus infection (HSVI) clin- ical signs. The first episode of EAC in case I was histologically identified and positive for HSVI by ELISA. The patient was treated with topical steroid that blanched the skin lesions over 2 weeks. One month later the condition relapsed more seriously. Then topical acyclovir was administered and provided a stable therapeutic result. In case 2 the first complaints were of sparse erythematoedematous papules and plaques, surrounding groups of vesicles and having EAC histologic features. They disap-