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To evaluate the effectiveness of topically applied metronidazole (Elyzol) for treating perioral dermatitis (a skin disorder characterized by small, persistent eruptions near the mouth), 108 patients were studied. Patients were treated with either metronidazole cream or with oral tetracycline (the accepted therapy) plus a placebo (inactive) cream. The extent of the redness of the lesions (erythema score) and the number of papules (small pimples) in each eruption were evaluated at the study's start, and again four and eight weeks after treatment began. Patients and physicians independently classified the outbreaks as improved, unchanged, or aggravated. Before the study began, patients in the metronidazole group had an average of 25 papules, while those in the tetracycline group had 21, on average. Metronidazole led to a reduction in average papule number, to 33 percent of the original number after four weeks and to 8 percent of the initial number after 8 weeks. For tetracycline, the corresponding figures were 4 and zero percent. No differences were found between the groups in physician- or patient-determined erythema scores, or in overall evaluations. Slightly more patients in the tetracycline than the metronidazole group complained of adverse reactions (most commonly abdominal discomfort). It is concluded that metronidazole was effective, but worked more slowly than tetracycline against perioral dermatitis, and tetracycline was significantly more effective than metronidazole overall. (Consumer Summary produced by Reliance Medical Information, Inc.)

AbstractIn a double blind study 69 patients with urinary tract infection (86 bacterial strains) were treated with sulphamethoxazole plus trimethoprim (5 : 1) for 6 days. The cure rate was 92. A comparable control group of 71 patients (91 bacterial strains) was treated with sulphamethoxazole in the same dose. The cure rate was 64. Follow-up 14 days after treatment showed cure rates of 66 and 39, respectively. The differences are statistically significant. The frequency of relapses was the same in the two groups of treatment. Side effects were few and corresponded to what is commonly found in single therapy with sulphonamide.

• On electron microscopy of the endothelial cells of a patient with cutaneous and CNS symptoms of malignant atrophic papulosis, paramyxovirus-like particles could be seen in the cytoplasm. These particles were interpreted as degenerative changes that were due to ischemia. Coagulation studies showed increased thrombocyte aggregation, and treatment with the platelet-suppressive drugs, aspirin and dipyridamole, was instituted. This treatment resulted in a normal thrombocyte aggregation after eight months and complete clinical remission, which still persisted four months after cessation of therapy.(Arch Dermatol 114:1687-1689, 1978)

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