Interdigital Webs Research Articles

Evaluation of the Skin-Roughness Caused by Aqueous Solution of Surface Active Agents

Immersion method, cup method (modified closed patch method) and dropping method (localized immersion method in which the test solution is dropped on interdigital webs) were studied.The results obtained by the cup method were not correlated to those obtained by the immersion method. The dropping method was considered as being suitable for evaluation of skin-roughness caused by detergent solution, by which the relation between detergent concentration and skin-roughness was shown.Five surface active agents were evaluated by the dropping method. Sodium laurylsulfate (SLS) and cetyldimethylbenzylammonium chloride (CDMBC) caused skin-roughness in the low concentration. The action of sodium lauryltrioxyethylenesulfate (SLTOS), which was usualy used in liquid shampoo formulation, was milder than SLS. Poly-oxyethylenelaurylether (POL), which was non-ionic one, and distearyldimethylammonium chloride (DSDMC), which was cationic one possessed rather high molecular weight, did not cause skin-roughness.Deffating rates of these surface active agents were measured and compared with the results of skin-roughness evaluetion by the dropping method. There was a rough correlation between skinroughnese and deffating rate in lanolin.

Atopy and eczema of the feet in children.

IT IS common to see children with a recurrent dermatitis of the feet, very often misdiagnosed by the nondermatologist. The eruption is described in this report, and a cause is suggested. The eruption is of variable duration and intensity. Examination reveals an acute dermatitis consisting of erythema, fissuring, weeping, and crusting. The dermatitis is bilateral, but not symmetrical. It is limited to the dorsal, lateral, and plantar surfaces of the great toes, and the dorsal aspects of the other toes. Unless there is gross infection, the interdigital webs are clear. Because of location and appearance, this condition would appear to be causally related to shoes. Elements of allergic contact dermatitis, including positive patch tests, are absent. Since the dermatitis often occurs in hot weather, primary irritancy produced by heat, perspiration, and friction must be considered as an etiologic factor. Are tight shoes, friction, heat, and perspiration sufficient to explain this

The burnt hand

Deformities from deep burns of the hand result from the sequence of edema, infection, suppuration and fibrosis. This irreversible cycle must be broken by the institution of early proper treatment, namely, the application of adequate skin coverage. The prevention of the fixed burnt hand can best be accomplished by placing the hand immediately in a position of function, elevation and occlusive voluminous pressure dressing. This will prevent the formation of massive edema. Infection cannot occur if the pellicle of crust and devitalized tissue is kept intact until replaced with a graft. If the hand is seen late and the slough has begun to separate with the formation of granulation tissue, this process should be encouraged and assisted to acquire rapidly an ideal base to receive the split graft. It must be remembered that if this process is prolonged, a layer of fibrosis is laid down under the granulation tissue. The older the burn, the more dissection must be performed for the graft to lie on a bed which will supply early subsistence. This bed or recipient site is on the fascia covering the extensor tendons. This also holds true if a decision is made to excise and graft immediately. It cannot be emphasized too much that the hand is covered by a great deal more skin than is generally supposed. A common error in the application of a split skin graft is the belief that one full drum of skin will cover the dorsum of an adult hand. To cover the entire area of the dorsum and fingers will require nearly two drums. Two weeks after the graft has been applied motion should be started, after which secondary surgical procedures may need to be carried out such as Z-plasties to the interdigital webs and capsulotomies to improve function. We advocate earlier grafting of the burnt hand than has been done in the past. If there are no complications, we believe that the best functional result can be obtained with excision and graft in one stage to prevent the invasion of bacteria and fibrosis. This will also diminish the patient's hospital stay and decrease morbidity as well as eliminate the necessity of joint surgery.

IN VITRO FUNGISTASIS BY A BACTERIUM (BACILLUS SUBTILIS VAR. XG AND XY)

THE POSSIBILITY of successful biologic therapy for fungous diseases has been partially explored by a number of observers. It is of historic interest that the work of Chambers and Weidman1antedates by a year the original observations of Fleming2on penicillin. They isolated from the apparently normal interdigital toe webs of 4 subjects bacteria which were later identified as Bacillus subtilis. When the bacterial colonies were grossly mixed with Trichophyton gypseum (Trichophyton interdigitale) and this mixture cultured out, there was complete inhibition of fungous growth. Clinical studies using the live culture of B. subtilis brought about improvement up to 50 per cent in patients with dermatophytosis. According to Waksman,3the growth of many soil fungi is inhibited by species of gram-positive spore-bearing bacilli. In 1942, Katznelson4noted that a thermostabile, diffusible substance produced by an aerobic spore-forming bacillus inhibited the growth of 71 out