著者
日本皮膚科学会疥癬診療ガイドライン策定委員会 石井 則久 浅井 俊弥 朝比奈 昭彦 石河 晃 今村 英一 加藤 豊範 金澤 伸雄 久保田 由美子 黒須 一見 幸野 健 小茂田 昌代 関根 万里 田中 勝 谷口 裕子 常深 祐一郎 夏秋 優 廣田 孝司 牧上 久仁子 松田 知子 吉住 順子 四津 里英 和田 康夫
出版者
公益社団法人 日本皮膚科学会
雑誌
日本皮膚科学会雑誌 (ISSN:0021499X)
巻号頁・発行日
vol.125, no.11, pp.2023-2048, 2015-10-20 (Released:2015-10-22)
参考文献数
185

Here, we present our new guideline for the diagnosis and treatment of scabies which we, the executive committee convened by the Japanese Dermatological Association, developed to ensure proper diagnosis and treatment of scabies in Japan. Approval of phenothrin topical use under the National Health Insurance in August 2014 has contributed to this action. Permethrin, a topical anti-scabietic medication belonging to the same pyrethroid group as phenothrin, is already in use worldwide. For making proper diagnosis of scabies, following three points should be taken into consideration: clinical findings, detection of the mite(s) (Sarcoptes scabiei var. hominis), and epidemiological findings. The diagnosis is confirmed when the mites or their eggs are identified by microscopy or by dermoscopy. As we now have a choice of phenothrin, the first line therapy for classical scabies is either topical phenothrin lotion or oral ivermectin. Second line for topical treatment is sulfur-containing ointments, crotamiton cream, or benzyl benzoate lotion. Gamma-BHC ointment is no more provided for clinical use. If the patient is immunosuppressed, the treatment option is still the same, but he or she should be followed up closely. If the symptoms persist, diagnosis and treatment must be reassessed. For hyperkeratotic (crusted) scabies and nail scabies, removal of thick scabs, cutting of nails, and occlusive dressing are required along with topical and/or oral treatments. It is important to apply topical anti-scabietic lotion/cream/ointment below the neck for classical scabies or to the whole body for hyperkeratotic scabies, including the hands, fingers and genitals. For children and elderlies, it is recommended to apply treatment to the whole body even in classical scabies. The dosage for ivermectin is a single oral administration of approximately 200 μg/kg body weight. It should be taken on an empty stomach with water. Administration of a second dose should be considered at one-week with new lesions and/or with detection of mites. Safety and effectiveness of combined treatment with topical and oral medications are not yet confirmed. Further assessment is needed. Taking preventative measures is as important as treating those infected. It is essential to educate patients and healthcare workers and conduct epidemiological studies to prevent further spread of the disease through effectively utilizing available resources including manpower, finance, logistics, and time. (Jpn J Dermatol 125: 2023-, 2015)
著者
松田 知子 原田 忠夫 中村 薫
出版者
社団法人 有機合成化学協会
雑誌
有機合成化学協会誌 (ISSN:00379980)
巻号頁・発行日
vol.59, no.7, pp.659-669, 2001-07-01 (Released:2010-01-22)
参考文献数
17
被引用文献数
3 4

Biocatalyst has been attracted increasing attention for asymmetric synthesis due to the high enantioselectivities and environmentally friendliness. We have been developing methods using a fungus, Geotrichum candidum, which has many enzymes catalyzing the enantioselective oxidation and reduction reactions of non-natural substrates. These enzymes in the resting or dried cells were used in an organic solvent, supercritical carbon dioxide, or aqueous media for oxidation, reduction or deracemization reactions. The usefulness of these methods was also demonstrated in the preparation, on a multi-gram scale, of optically pure alcohols.The effect of fluorine substituents on the enantioselectivity of the reduction using the dried cell was also investigated thoroughly, and it was found that the reduction of trifluoromethyl ketones affords (S) -trifluoromethyl carbinols in excellent ee, whereas the reduction of methyl ketones gives the corresponding alcohols of the opposite configuration in excellent ee. The enzymes in the cells were separated to investigate the origin of different enantioselectivities between the methyl and trifluoromethyl ketones.