SUMMARY. Since reduced concentrations of selenium in whole blood, plasma and white cells had previously been observed in psoriasis, 69 patients were supplemented daily with either 600 J.Lg of selenium-enriched yeast, 600 J.Lg of selenium-enriched yeast plus 600 IU of vitamin E or a placebo for 12 weeks. Before supplementation, the patients' mean concentrations of selenium in whole blood and plasma were reduced compared with those of matched healthy controls but their red cell glutathione peroxidase (GSH-Px) activity was normal. After 12 weeks supplementation the patients' mean whole blood, plasma and platelet selenium concentrations, platelet GSH-Px activity and plasma vitamin E concentration had risen significantly from the baseline values but their mean skin selenium concentration and red cell GSH-Px activity remained unchanged. The mean white cell selenium concentration rose only in the group receiving selenium alone. Neither supplementation regimen reduced the severity of psoriasis or produced side-effects.The increase in platelet GSH-Px activity suggests that the supplements were bioavailable and that the patients' selenium status may have been reduced prior to supplementation. The failure of the selenium content of the skin to increase may explain why the patients' psoriasis remained unchanged during supplementation.Selenium is an essential trace element and the recommended intake for man is 50-200 J.Lg per day.' The average British diet contains 60 J.Lg of selenium per day with half derived from cereals and cereal products, and another 40% from meat and fish.' Selenium is well absorbed and in normal circumstances 55-60% is excreted in urine and most of the rest in faeces. Selenite, selenate and selenoaminoacids can all be converted into selenide.' Selenium deficiency reduces the activity of the selenium-dependent enzyme glutathione peroxidase (GSH-Px) (EC 1.11
Twenty-four patients with chronic symmetrical constitutional eczema of the hands treated with a combination of topical therapy and conventional superficial X-ray therapy. In a double-blind fashion one hand was irradiated with 100 rad (1Gy) at 50 kV on three occasions at intervals of 21 days and the other hand was given a placebo treatment. Each hand received the same topical medication, which was adjusted as necessary at each visit. The patients were seen 6, 9 and 18 weeks after X-ray therapy commenced. A significantly better therapeutic result, as assessed independently by both the patient and the observer, was recorded on the hand which had received active X-ray treatment. The advantage bestowed by active X-ray therapy was greatest 6 to 9 weeks after the start of treatment, but was still present after 18 weeks.
We report here the use of photodynamic therapy to treat two patients with multiple lesions of Bowen's disease. A total of over 500 lesions were treated, less than 10% requiring two treatments, and at follow-up 6 months later no lesions remained in either patient. The only important side-effect of treatment was a marked photosensitivity reaction. We consider photodynamic therapy an efficient treatment for Bowen's disease; multiple lesions can be treated in a short treatment session, without local anaesthesia, and healing occurs within 2 weeks.
Summary
Three cases of bullous pemphigoid are described who presented with haemorrhagic pompholyx on their palms and soles. This feature may be an indication that only low‐dose prednisolone therapy is required for control of the disease.
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