Search

Mathias Tiedemann Svendsen,1–3 Klaus Ejner Andersen,1–3 Flemming Andersen,1,3 Jakob Hansen,4 Anton Pottegård,5 Helle Johannessen6 1Department of Dermatology and Allergy Centre, Odense University Hospital, 2Centre for Innovative Medical Technology, Institute of Clinical Research, University of Southern Denmark, Odense C,3Dermatological Investigations Scandinavia, University of Southern Denmark, Odense C, 4Leo Pharma, Ballerup, 5Clinical Pharmacology, Department of Public Health, University of Southern Denmark, 6Research Unit of User Perspectives, Department of Public Health, University of Southern Denmark, Odense C, Denmark Abstract: Nonadherence to topical treatment of psoriasis is a common cause of treatment failure. This focus group study was conducted to obtain the patients’ own experiences and explanations regarding medical adherence. The participants consisted of eight primary adherent patients with moderate psoriasis treated with corticosteroid or corticosteroid–calcipotriol combinations, purposefully sampled by age and sex at a dermatology outpatient clinic. Secondary medical adherence was supported by accessibility of the prescribing physician, the prescriber taking time to listen, having a more manageable disease, using a nonstaining product, and establishing routines around treatment at home. Secondary medical adherence was affected negatively by changes in daily routines, if the treatment influenced the patient’s sexual life, having too little time in the consultation room, lack of confidence in the prescriber, diverging information from health care personnel, experiencing side effects, having fear of side effects, impractical formulations of topical products, and impatience regarding time before an effect of the treatment was observed. From this study, the recommendations for the prescribing doctor to improve medical adherence are, the doctor needs to take time to listen to the patient, prescribe a topical product that is easy to apply and less greasy, inform the patients about benefits from treatments, and explain the rationale behind the treatment plan. Keywords: psoriasis, adherence, corticosteroids, calcipotriol, focus groups

Mercaptobenzothiazole (MBT) compounds are well known contact allergens. To detect rubber allergic patients we use both MBT (2% in petrolatum) and a mercapto-mix with 4 constituents of 0.5% each in our standard series. In this article the EECDRG presents data of in total 32,475 consecutive tested patients attending the respective contact dermatitis clinics from 11 centres in Europe to determine if the mix and MBT detected the same allergic patients. We found 327 patients positive to the mix or MBT, or to both. 261 were positive to the mix and 254 to MBT. MBT was negative in 73 patients who were positive to the mix. If the mix had not been in the standard series, on average 22% of patients allergic to a mercapto-compound would have been missed, for MBT this would have been on average 20%. All clinics would have missed a significant number of positive reactions if both compounds had not been tested. We conclude, that both the mercapto mix and MBT are required in the standard series.

A group of interested European Contact Dermatologists/Photobiologists met to produce a consensus statement on methodology, test materials and interpretation of photopatch testing. While it is recognized that a range of local variables operate throughout Europe, the underlying purpose of the work is to act as an essential preamble to a Pan European Photopatch Test Study focusing particularly on sunscreen chemicals.

Calcium transfer during intermittent peritoneal dialysis (IPD) was studied in four groups of patients with chronic renal failure. Group I dialyzed with a dialysis fluid concentration of 2.16 mmol/l. Group II dialyzed with the same calcium content, but with a hyperosmotic solution. Group III dialyzed with a high calcium concentration, 4.47 mmol/l in dialysis fluid and in group IV the patients dialyzed 5 cycles against a calcium-free solution followed by 5 cycles with normal calcium content. In the first three groups a significant rise in serum total calcium and ionized serum calcium took place. At balance studies a positive net transfer of calcium from dialysis fluid to blood was demonstrated, the largest transfer occurring in group III. High osmolality in dialysis fluid is of no importance for the calcium transfer. In group IV a significant fall in serum total calcium during the first 5 cycles was removed. The loss of albumin to the dialysate did not affect the calcium transfer as well as the changes in serum albumin and pH did not influence the calcium state during IPD.