LITERATURE REVIEW Bruce A. Brad, MD Marti Jill Rothe, MD

Commercial Sunscreen Lotions Prevent UV Radiation-Induced Immune Suppression of

Contact Hypersensitivity

This report, supported by Schering-Plough HealthCare Products, attempts to show that com- mercial sunscreen preparations effectively prevent UV-induced immune suppression in mice. Al- though similar studies have previously been per- formed, the authors argue that they were flawed because the light source did not accurately mimic natural sunlight and noncommercial sunscreens were used. The mice were exposed to Kodacel- filtered FS sunlamps that do not emit immune- suppressing UVC light, which could have been a factor in previous studies. Contact hypersensitivity was measured in standard fashion, whereby mice were challenged with dinitrofluorobenzene and then later rechallenged on the ear with subsequent measurement of ear swelling. Although sun protec- tion factor (SPF) 4 and SPF 8 sunscreens signifi- cantly decreased the UV suppression of immune response, the SPF 15 and higher sunscreens gave similar results to mice that were not exposed to any UV light. When they performed similar testing in mice exposed to unfiltered sunlamps, they found that the sunscreens were not nearly as effective in blocking immune suppression based on contact hypersensitivity response. Thus, the authors con- clude that previous data stating that sunscreens are less effective in preventing UV-induced immune suppression may have been flawed.

Roberts LK Beasley DG: J Invest Dermatol 105:339-344, 1995

Bruce A. Brad, MD Department ofDermatology

Medical College ofPennsylvania and Hahnemann University

Philadelphia, PA

A Nonconventional Approach to the Treatment of Environmental Illness

This is a pilot study evaluating the effect of two forms of acupuncture on 20 patients with

environmental illness. The patient population was referred to a dermatology clinic because they had significant dermatologic complaints, including red- ness, burning, itching, and rosacea along with central nervous system disturbances. All subjects reported that electromagnetic fields precipitated their symptoms. They were randomly assigned to a group receiving superficial acupuncture designed as a placebo and to a group receiving classical deep acupuncture. Treatments were administered twice a week for 5 weeks with a &month follow-up period. Both groups improved in key variables based on questionnaires, including longer time to develop work intolerance, fewer physical symptoms, and better ability to relax after a day’s work. Serum cortisol levels increased in both groups, although more significantly in those receiving deep acupunc- ture. The authors propose that acupuncture is a neutral-type treatment that offers a feeling of hope to these patients. They theorize that it deconditions the patients from the negative response they expe- rience from the environment.

Arnetz BB, Berg M, Anderzen I, et al: J Occup Environ Med 37:838-844,1995

Bruce A. Brad, MD

Treatment of Scabies With Ivermectin

In this study, the authors from the University of Miami tested the efficacy of ivermectin, an anthelmintic agent, in an open-label study. The study group consisted of 13 healthy patients with scabies and 11 patients with human immunodefi- ciency virus with scabies, 7 of whom had acquired immunodeficiency syndrome. Patients were admin- istered 200 p,g/kg body weight of the ivermectin. After a single dose of ivermectin, none of the 11 healthy patients had scabies 4 weeks after treat- ment. Although 2 of the 11 patients with human immunodeficiency virus required a second dose of the ivermectin, 10 of the 11 patients had no evidence of scabies 4 weeks after treatment. The other patient had severe crusted scabies and re- quired supplemental topical therapy. Although this

254 American Journalof Contact Dermatitis, Vol7, No 4 (December), 1996: pp 254-257