The prevalence of skin conditions in Romanian school children

Virtually nothing is known about the prevalence of skin conditions in children in the general population. Although we know something about the relative frequency of skin conditions seen by dermatologists, we do not know how such referrals are influenced by factors such as social class, accessibility to medical services or educational and cultural background. In order to estimate the burden and relative frequency of dermatological disease in children in the community, we measured the point prevalence of skin conditions in 1114 Romanian schoolchildren aged 6-12 years, using the British Association of Dermatologists diagnostic index. The overall point prevalence of children with one or more skin diseases was 22.8%, with no significant differences according to age group or sex, except for pityriasis alba which showed a male predominance (P = 0. 007). The most common diseases were infectious dermatoses such as viral warts and insect bites (6.3%), dermatitis/eczema (5.1%), pityriasis alba (5.1%), keratosis pilaris (4.0%) and urticaria (1. 9%). Together, these five groups accounted for more than 84% of the cases. Of the 1114 children, 213 (19.1%) had only one skin disease and 41 (3.7%) had two skin diseases. While acknowledging the limitations in defining which skin conditions can benefit from medical care, this study suggests that skin disorders are common in Romanian schoolchildren, affecting about one-quarter of 6-12 year olds. Such a point prevalence is likely to be conservative because of the tendency of prevalence estimates to exclude many other dermatoses of short duration. The finding that over 80% of the disorders can be grouped into fewer than six categories is important in informing training programmes and delivery of service for primary health care teams. This study provides a baseline for further studies into the morbidity and use of health care services by children with skin disease in the community.

Community validation of the United Kingdom diagnostic criteria for atopic dermatitis in Romanian schoolchildren

Although the U.K. modification of Hanifin and Rajka's diagnostic criteria for atopic dermatitis (AD) for use in epidemiological studies has demonstrated good validity and repeatability when previously tested in a U.K. community setting, little is known about its performance in other countries where different cultural, educational and linguistic factors could impair validity. We used a questionnaire to test the validity of the U.K. criteria as a point prevalence measure of AD in 1114 Romanian schoolchildren aged 6-12 years against the clinical diagnosis of a dermatologist with an interest in AD, who was unaware of the questionnaire content and responses. The sensitivity and specificity of the U.K. criteria for AD in this setting was 74% and 99%, respectively, an improvement rather than a deterioration in validity when compared with the previous U.K. study. Test-retest repeatability for all of the questions pertaining to the U.K. criteria using the chance-corrected kappa statistic was high, with values of 0.72 and over. The positive predictive value of the criteria was lower than in the U.K. study (63% compared with 80%, respectively) due to the very low prevalence of AD in this study (2.4%). The validity of a parental report of 'eczema' was poor, with a sensitivity of 22%, specificity of 97% and positive predictive value of 18%. This study suggests that the U.K. criteria perform well in settings outside the U.K., although care has to be taken when using the criteria to ascertain cases in settings where the prevalence of AD is very low.

Experimental use of prostaglandin E2 (Dinoprost) in the treatment of duodenal ulcer in humans

Oral administration of 20 mg PGE2/day/patient (5 mg every 4 hours, 4 times a day) promptly relieved pain in 10 patients suffering from duodenal ulcer. After 3 days of treatment, the ulceration--observed by radiologic and gastrofibroscopic means--diminished by 30% in dimensions, and after 10 days, it almost disappeared. The results were compared with those observed in a placebo-group, who received 20 mg lactose/day/patient and with those in another group treated by sodium bicarbonate.

The role of prostaglandins in the development of malignant melanoma in hamsters

A deficiency of prostaglandins (especially of group E) could be an important factor in the genesis and evolution of malignant melanoma. Compensation for such a deficit would be a logical way of medically treating this tumour. In order to test this hypothesis two groups of hamsters bearing malignant melanomas were used. The first group was treated locally with PGE2 while the other group received control injections. After 12 days tumour growth in the PG test group was sharply reduced in comparison with the controls. Tumour growth resumed when PG treatment was stopped.