Larry Millikan | Tulane University (original) (raw)
Papers by Larry Millikan
International journal of dermatology
Cutis; cutaneous medicine for the practitioner
Nineteen patients with severe or recalcitrant rosacea were treated twice daily with 0.75 percent ... more Nineteen patients with severe or recalcitrant rosacea were treated twice daily with 0.75 percent metronidazole topical gel in an open label study. Sixteen of the patients (84 percent) showed 50 percent or greater reduction in inflammatory lesions, while fifteen (79 percent) demonstrated a reduction in erythema severity and an improvement when evaluated by the investigator global assessment. No positive response was recorded for any patient prior to topical medication, whereas six of nine patients previously treated with tetracycline/minocycline demonstrated improvement. Seven of these nine patients responded to topical metronidazole treatment. One additional patient who did not respond to minocycline or desonide treatment showed a good response to topical metronidazole. Only one patient reported local irritation after using metronidazole. These results demonstrate that topical metronidazole gel is safe and effective for the treatment of severe or recalcitrant rosacea.
International Journal of Dermatology
Drugs under experimental and clinical research
Trospectomycin sulphate is a new, more potent analog of spectinomycin, which is active in vitro a... more Trospectomycin sulphate is a new, more potent analog of spectinomycin, which is active in vitro against penicillin-sensitive and penicillin-resistant strains of Neisseria gonorrhoeae. This study was designed to determine the bacteriologic and clinical efficacy as well as safety of a single intramuscularly administered 250 mg dose of trospectomycin sulphate in the treatment of uncomplicated gonorrhoea (cervical, urethral, pharyngeal and anal). Ceftriaxone sodium was used as a comparator antibiotic in a single 250 mg intramuscular dose. Seventy-four patients (36 women and 38 men) were evaluable in the trospectomycin treated group and 40 patients (22 women and 18 men) in the ceftriaxone treated group. The overall bacteriologic cure rate was 98.6% (73/74) for trospectomycin and 95% (38/40) for ceftriaxone. Bacteriologic failures were observed among women 1/36 (2.8%) treated with trospectomycin and 2/22 (9.1%) treated with ceftriaxone. The overall clinical success rate (clinically cured plus clinically improved) was 90.5% for trospectomycin and 100% for ceftriaxone. Adverse events were reported rarely in both groups. Less than 10% of patients complained of pain and/or tenderness at the injection site for both drugs; one patient developed a generalized, pruritic rash which occurred three days after administration of trospectomycin and resolved within six days. In conclusion, a single dose of 250 mg i.m. trospectomycin appears to be at least as effective and safe as a single dose of ceftriaxone in the treatment of uncomplicated gonorrhoea.
Journal of Investigative Medicine
Lichen planus (LP) and the lichenoid variant of chronic graft-versus-host disease (cGVHD) can pre... more Lichen planus (LP) and the lichenoid variant of chronic graft-versus-host disease (cGVHD) can present with similar clinical and histological findings. The distinction, although difficult, is important both prognostically and therapeutically. The mechanism and effector cell phenotypes have also shown to differ between the 2 entities. While the lichenoid infiltrate of LP is predominantly T lymphocytes helper/inducer cell phenotype, the suppressor/cytotoxic subset appears to play a major role in cGVHD. The aim of this study is to determine whether the immunophenotypic character of the lichenoid infiltrate can aid in distinguishing the 2 entities. Biopsies were obtained from 2 patients with lichenoid papules and a history of transplantation. Light microscopy revealed lichenoid inflammation in both cases characterized by a band-like lymphohistiocytic infiltrate at the dermal-epidermal junction. Immunochemistry was performed on fresh tissue using a panel of monoclonal antibodies including...
International Journal of Dermatology
Drugs can inhibit or assist wound healing. The effect of a specific drug depends on its mechanism... more Drugs can inhibit or assist wound healing. The effect of a specific drug depends on its mechanism of action, dosage, route, and administration in relation to the specific phase of wound healing. A discussion of the major classes of drugs that impact wound healing follows, ...
Cutis; cutaneous medicine for the practitioner
The roundtable discussion encompassed many topics-from seminal research by Ronald Marks to the la... more The roundtable discussion encompassed many topics-from seminal research by Ronald Marks to the latest National Rosacea Society-funded studies on the pathophysiology of rosacea. All participants commented on the value of the new National Rosacea Society classification system for subtypes of rosacea, designed to direct future research and help physicians better diagnose and manage these subtypes. A lively discussion centered on treatment options for the various subtypes of rosacea ensued.
International Journal of Dermatology, 1997
International Journal of Dermatology, 1994
International journal of dermatology
Scabies occurred in three nursing homes (two in Missouri and one in Pennsylvania) where the diagn... more Scabies occurred in three nursing homes (two in Missouri and one in Pennsylvania) where the diagnosis was obscured by a lack of the usual clinical signs. Topical steroids can aggravate scabies and help to confirm the diagnosis; treatment with lindane lotion is successful, provided all patients and health personnel are treated.
International journal of dermatology, 1991
International journal of dermatology, 1999
International journal of dermatology, 1997
Discussion Only 10% of all cases of GLTs are of the multiple type.'GLTs are usually small, me... more Discussion Only 10% of all cases of GLTs are of the multiple type.'GLTs are usually small, measuring less than io cm in diameter; however, there are several reports of larger lesions.^ While solitary GLTs are usually on the extremities, multiple GLTs can be located ...
International journal of dermatology, 1995
International journal of dermatology, 1995
International journal of dermatology, 1982
International journal of dermatology
International journal of dermatology, 1984
International journal of dermatology
International journal of dermatology
Cutis; cutaneous medicine for the practitioner
Nineteen patients with severe or recalcitrant rosacea were treated twice daily with 0.75 percent ... more Nineteen patients with severe or recalcitrant rosacea were treated twice daily with 0.75 percent metronidazole topical gel in an open label study. Sixteen of the patients (84 percent) showed 50 percent or greater reduction in inflammatory lesions, while fifteen (79 percent) demonstrated a reduction in erythema severity and an improvement when evaluated by the investigator global assessment. No positive response was recorded for any patient prior to topical medication, whereas six of nine patients previously treated with tetracycline/minocycline demonstrated improvement. Seven of these nine patients responded to topical metronidazole treatment. One additional patient who did not respond to minocycline or desonide treatment showed a good response to topical metronidazole. Only one patient reported local irritation after using metronidazole. These results demonstrate that topical metronidazole gel is safe and effective for the treatment of severe or recalcitrant rosacea.
International Journal of Dermatology
Drugs under experimental and clinical research
Trospectomycin sulphate is a new, more potent analog of spectinomycin, which is active in vitro a... more Trospectomycin sulphate is a new, more potent analog of spectinomycin, which is active in vitro against penicillin-sensitive and penicillin-resistant strains of Neisseria gonorrhoeae. This study was designed to determine the bacteriologic and clinical efficacy as well as safety of a single intramuscularly administered 250 mg dose of trospectomycin sulphate in the treatment of uncomplicated gonorrhoea (cervical, urethral, pharyngeal and anal). Ceftriaxone sodium was used as a comparator antibiotic in a single 250 mg intramuscular dose. Seventy-four patients (36 women and 38 men) were evaluable in the trospectomycin treated group and 40 patients (22 women and 18 men) in the ceftriaxone treated group. The overall bacteriologic cure rate was 98.6% (73/74) for trospectomycin and 95% (38/40) for ceftriaxone. Bacteriologic failures were observed among women 1/36 (2.8%) treated with trospectomycin and 2/22 (9.1%) treated with ceftriaxone. The overall clinical success rate (clinically cured plus clinically improved) was 90.5% for trospectomycin and 100% for ceftriaxone. Adverse events were reported rarely in both groups. Less than 10% of patients complained of pain and/or tenderness at the injection site for both drugs; one patient developed a generalized, pruritic rash which occurred three days after administration of trospectomycin and resolved within six days. In conclusion, a single dose of 250 mg i.m. trospectomycin appears to be at least as effective and safe as a single dose of ceftriaxone in the treatment of uncomplicated gonorrhoea.
Journal of Investigative Medicine
Lichen planus (LP) and the lichenoid variant of chronic graft-versus-host disease (cGVHD) can pre... more Lichen planus (LP) and the lichenoid variant of chronic graft-versus-host disease (cGVHD) can present with similar clinical and histological findings. The distinction, although difficult, is important both prognostically and therapeutically. The mechanism and effector cell phenotypes have also shown to differ between the 2 entities. While the lichenoid infiltrate of LP is predominantly T lymphocytes helper/inducer cell phenotype, the suppressor/cytotoxic subset appears to play a major role in cGVHD. The aim of this study is to determine whether the immunophenotypic character of the lichenoid infiltrate can aid in distinguishing the 2 entities. Biopsies were obtained from 2 patients with lichenoid papules and a history of transplantation. Light microscopy revealed lichenoid inflammation in both cases characterized by a band-like lymphohistiocytic infiltrate at the dermal-epidermal junction. Immunochemistry was performed on fresh tissue using a panel of monoclonal antibodies including...
International Journal of Dermatology
Drugs can inhibit or assist wound healing. The effect of a specific drug depends on its mechanism... more Drugs can inhibit or assist wound healing. The effect of a specific drug depends on its mechanism of action, dosage, route, and administration in relation to the specific phase of wound healing. A discussion of the major classes of drugs that impact wound healing follows, ...
Cutis; cutaneous medicine for the practitioner
The roundtable discussion encompassed many topics-from seminal research by Ronald Marks to the la... more The roundtable discussion encompassed many topics-from seminal research by Ronald Marks to the latest National Rosacea Society-funded studies on the pathophysiology of rosacea. All participants commented on the value of the new National Rosacea Society classification system for subtypes of rosacea, designed to direct future research and help physicians better diagnose and manage these subtypes. A lively discussion centered on treatment options for the various subtypes of rosacea ensued.
International Journal of Dermatology, 1997
International Journal of Dermatology, 1994
International journal of dermatology
Scabies occurred in three nursing homes (two in Missouri and one in Pennsylvania) where the diagn... more Scabies occurred in three nursing homes (two in Missouri and one in Pennsylvania) where the diagnosis was obscured by a lack of the usual clinical signs. Topical steroids can aggravate scabies and help to confirm the diagnosis; treatment with lindane lotion is successful, provided all patients and health personnel are treated.
International journal of dermatology, 1991
International journal of dermatology, 1999
International journal of dermatology, 1997
Discussion Only 10% of all cases of GLTs are of the multiple type.'GLTs are usually small, me... more Discussion Only 10% of all cases of GLTs are of the multiple type.'GLTs are usually small, measuring less than io cm in diameter; however, there are several reports of larger lesions.^ While solitary GLTs are usually on the extremities, multiple GLTs can be located ...
International journal of dermatology, 1995
International journal of dermatology, 1995
International journal of dermatology, 1982
International journal of dermatology
International journal of dermatology, 1984
International journal of dermatology