Traditional Dermatological Therapies in The North Hans W' Rothenborg, MD

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Traditional Dermatological Therapies in The
NorthHans W. Rothenborg, MD

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When is traditional therapy justified?

• I have seen every other dermatologist in town ,
  and she/he could not help me!
• (When all else fails)

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Prerequisite

• You have to develop good working relationship
  with reliable pharmacy/pharmacist who will keep a
  small supply of your favourite prescriptions!

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• What was so special about Pyroleum Lithanthracis
  (Coal Tar) ?
• It contains a great number of antiseptic,
  antimychotic and intiinflamatory chemicals
• Remember e.g. I.G.Farben, which originally
  derived most of their chemicals and
  pharmaceuticals from extracts of coal tar from
  the Ruhr district

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Localized psoriasis, hyperkeratotic eczema or
lichen planus on skinMessy but mostly not
irritating or allegenicPerhaps combine with UVB
light (Goeckermann)

Rp. Pyroleum lithanthracis g
2 Acidum. salicyl. g
2 Petrolatum Vaseline q.s. ad g 100
MDS. Externally in thin layer at night. Cover
with linnen of cotton gloves. Remove next
morning, best w. Petrolatum. Issue in jar - stir
if mixture separates. (Soft, easy to put on)
(Tar baths obsolete?!)

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Goeckermann treatment (UVB light coal tar)

• Pyroleum lithanthracis g 2
• Vaselinum flavum (petrolatum) ad g 100
• M.D.S. Thin layer on eczematic or psoriatic
  plaques at night, expose to sun or artificial UVB
  light next morning. Short exposure time at first,
  adjust time to obtain slight erythema

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UVB-light treatment

• Niels Finsen, the Icelandic physician who
  introduced artificial light from carbon arcs as a
  treatment for dermatological disorders
• Cat on a hot tin roof!

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Recalcitrant, localized psoriasis, eczema,
lichen planus, mycoses w.moderate keratoses
Messy but no atrophy. Sun sensitization!

• Rp.
• Pyroleum lithanthracis (coal tar) g 5
• Pasta zinci molle q.s. ad g. 100
• MDS. Externally at night thin layer.
• Cover w. linnen or cotton gloves
• Issue in jar stir if mixture separates. Sticky!
• P.zinci molle 30 zinci oxidi in petrolatum
  (vaseline)

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Recalcitrant, recurrent psoriasis of the scalp.
Advantage no atrophy even with longtime use
Disadvantage messy,
Rp. Dithranol (chrysarobin) mg
400 (later 600,800) Salicylic acid
g 6 Cetylan
g 46
Parafin. liquidum q.s. d g
200 MDS Rub into scalp 30 min. No more! Then
wash, and use shampoo before adding water! Use
gloves and NB! Protect eyes and surrounding skin
well. Issue in Jar. Store in cold place. Works
even if moderately discolored. Chryssarobin /
anthrarobin / dithranol / antralin Ingram!
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Diaper rashWell tolerated in intertrigenous areas

• Rp.
• Tumenol amonium g 4
• Lanogen 1500 (Carbowax 1500) g 10
• Lin. Zinci q.s. ad
  g 200
• MDS Apply directly on rash 2-3 times daily
• Shake well before use!
• Ichtamol / Ichtyol / Tumenol / Tumenol amonium
  water soluble tar substance w. sulfor (from
  slate)

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Psoriasis, seb.dermatitis, pityriasis amiantacea
etc. in scalpFor removal of scales crusts
prior to topical treatment. Systemic treatment
as necessary

• Rp
• Salicylic acid g. 15
• Ol. ricini q.s. ad g 300
• MDS. Rub into the scalp 8-10 hours before
  shampooing. First shampoo then water!
• Repeat as necessary.

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Superficial infections w. scales and crusts in
scalp (impetigo, mycoses). Wash off with soap
water. Systemic treatment if necessary.

• Rp
• Salicylic acid g 2
• Sulfor medicinale in g 2
• Lucodan (Essex) cream q.s. ad g 100
• MDS Apply 1-2 daily in a thin a layer as agreed

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Removal of scales, keratoses crusts, combined
with infections on skin

• Rp.
• Salicylic acid g 2
• Sulfor medicinale g
  2
• Petrolatum (Vaseline) q.s. ad g 100
• MDS. Thin layer at night after local bath
• If necessary combine w. systemic treatment

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Folliculitis in scalp, on skinor areas with
intertrigoAdvantage no risk of cutaneous
allergy, disadvantage slightly messy

• Rp.
• Sulfor medicinale g
  4
• Lanogen (Carbowax) 1500 g 10
• Liniment. zinci q.s. ad g 200
• MDS Apply directly 1-2 daily on rash
• or as agreed. Shake well before use.

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Seborrhoic dermatitis in the faceNo skin
athrophy, easy to wash off

• Rp
• Cliochinol (Vioform) g
  3
• Lucodan (Essex) cream q.s. ad g 100
• Apply on rash in thin layer at night,
• wash off in the morning
• (Pillow case!)

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Non-surgical removal of thickened nails, mycotic
or otherwiseDiabetic, arteriosclerotic and timid
patients (or secretaries!)

• Rp
• Urea (Carbamid) g
  40
• Petrolatum ( Vaseline) q.s. ad g 100
• MDS Apply thinly on nail under occlusive dressing
• Daily local bath in warm water, remove softened
  surface. Repeat until nail is dissovled

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Water (H2O)

• Ofegur Ofegsson another Icelandic physician!
  Cold water on burns!
• Relieves pain and limits damage!
• Grandmothers brook!
• And remember that cold water dressings can be
  very effective on weeping dermatoses! Change 3
  times daily!

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Resistant head lice pediculosis capitis
Removal of nitidae (eggs) cemented to hairs

• 5 Acetic acid in
• water ( ordinary household vinegar).
• Moist hair with solution, put on loose shower
  cap, leave on over night, comb hair carefully
  next morning.
• Repeat as necessary

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Infected, weeping leg ulcers and wounds,
infected, weeping hand eczemasMild
oxygenation, drying, antibacterial

• Rp
• Potassium permanganate 3-5 in water
  ml 500
• DS 15-20 ml (one spoonful) per liter tepid water
  for local red bath.
• Put petrolatum on nails protect floors to avoid
  discoloration!
• KMnO4 as powder cheaper

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Irritated, itchy skin e.g. morbilli, ruballa,
varicella

• Rp
• Lin. Zinci with
• 5 Lanogen 1500 (Carbowax 1500)
• MDS Apply directly on skin 1-2 daily or as often
  as necessary. Shake bottle well before use!

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• And many more, e.g.
• 0.25 cloramin in water
• Sol. Argenti nitratis 0.1 10
• Liquor carbonis detergens
• Pure coal tar
• Castellanis paint (carbol fuchsin sol.)
• Ref e.g. Jerome Z. Litt Calling Up the
  Reserves a topical, non-steroidal therapeutic
  formulary