1,576 results on '"Keratolytic Agents therapeutic use"'
Search Results
2. Dermatological manifestations in Costello syndrome: A prospective multicentric study of 31 HRAS-positive variant patients.
- Author
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Bessis D, Bursztejn AC, Morice-Picard F, Capri Y, Barbarot S, Aubert H, Bodet D, Bourrat E, Chiaverini C, Poujade L, Willems M, Rouanet J, Dompmartin-Blanchère A, Geneviève D, Gerard M, Ginglinger E, Hadj-Rabia S, Martin L, Mazereeuw-Hautier J, Bibas N, Molinari N, Herman F, Phan A, Rod J, Roger H, Sigaudy S, Ziegler A, Vial Y, Verloes A, Cavé H, and Lacombe D
- Subjects
- Humans, Prospective Studies, Female, Male, Child, Adolescent, Child, Preschool, Adult, Young Adult, Ectodermal Dysplasia genetics, Noonan Syndrome genetics, Noonan Syndrome complications, Acanthosis Nigricans genetics, Diagnosis, Differential, Keratoderma, Palmoplantar genetics, Heart Defects, Congenital genetics, Heart Defects, Congenital complications, Phenotype, Papilloma genetics, Papilloma pathology, Acitretin therapeutic use, Eyebrows abnormalities, Eyebrows pathology, Failure to Thrive genetics, Failure to Thrive etiology, Infant, Keratolytic Agents therapeutic use, Facies, Costello Syndrome genetics, Costello Syndrome complications, Proto-Oncogene Proteins p21(ras) genetics
- Abstract
Background: Data on dermatological manifestations of Costello syndrome (CS) remain heterogeneous and lack in validated description., Objectives: To describe the dermatological manifestations of CS; compare them with the literature findings; assess those discriminating CS from other RASopathies, including cardiofaciocutaneous syndrome (CFCS) and the main types of Noonan syndrome (NS); and test for dermatological phenotype-genotype correlations., Methods: We performed a 10-year, large, prospective, multicentric, collaborative dermatological and genetic study., Results: Thirty-one patients were enrolled. Hair abnormalities were ubiquitous, including wavy or curly hair and excessive eyebrows, respectively in 68% and 56%. Acral excessive skin (AES), papillomas and keratotic papules (PKP), acanthosis nigricans (AN), palmoplantar hyperkeratosis (PPHK) and 'cobblestone' papillomatous papules of the upper lip (CPPUL), were noted respectively in 84%, 61%, 65%, 55% and 32%. Excessive eyebrows, PKP, AN, CCPUL and AES best differentiated CS from CFCS and NS. Multiple melanocytic naevi (>50) may constitute a new marker of attenuated CS associated with intragenic duplication in HRAS. Oral acitretin may be highly beneficial for therapeutic management of PPHK. No significant dermatological phenotype-genotype correlation was determined between patients with and without HRAS c.34G>A (p.G12S)., Conclusions and Relevance: This validated phenotypic characterization of a large number of patients with CS will allow future researchers to make a positive diagnosis, and to differentiate CS from CFCS and NS., (© 2024 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.)
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- 2024
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3. A report on the safety of acitretin use in patients with renal failure on haemodialysis.
- Author
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Shim PJ, Quintos JL, Faraz K, Smith IT, Petty AJ, Bottomley M, Wheless LE, and Whitley MJ
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- Humans, Female, Male, Middle Aged, Aged, Alkaline Phosphatase blood, Adult, Retrospective Studies, Acitretin adverse effects, Acitretin therapeutic use, Renal Dialysis adverse effects, Kidney Failure, Chronic complications, Kidney Failure, Chronic therapy, Psoriasis drug therapy, Psoriasis complications, Keratolytic Agents adverse effects, Keratolytic Agents therapeutic use, Bilirubin blood
- Abstract
Acitretin, commonly used for severe psoriasis and keratinocyte carcinoma chemoprevention in high-risk patients, is contraindicated in patients with end-stage renal disease (ESRD) on haemodialysis (HD). However, these patients often lack medication choices and in certain clinical scenarios the benefits of acitretin may outweigh the potential risks. We identified 24 patients with ESRD on HD undergoing acitretin treatment from the Duke and Vanderbilt University Medical Centers. While adverse effects were common, they were not a frequent cause of treatment discontinuation among patients. We also found no association between acitretin treatment and hospital admissions or mortality. Lastly, we found statistically significant increases in alkaline phosphatase (ALP; P = 0.03) and total bilirubin (P < 0.001) when patients were receiving acitretin and HD compared with baseline. However, there was no dose dependency or temporal association with acitretin or HD initiation. Based on these preliminary findings, we find that acitretin may safely be used in patients receiving HD, with close monitoring of ALP and bilirubin., Competing Interests: Conflicts of interest The authors declare no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
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4. Development of Neutropenia in an Infant with Harlequin Ichthyosis on Acitretin Therapy: A Clinical Quandary.
- Author
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Shah SR, Vyas HR, Vaghasia AT, Brahmbhatt VU, and Shah BJ
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- Humans, Infant, Male, Female, Acitretin adverse effects, Acitretin therapeutic use, Ichthyosis, Lamellar drug therapy, Keratolytic Agents adverse effects, Keratolytic Agents therapeutic use, Neutropenia chemically induced
- Published
- 2024
5. Successful Treatment of Refractory Extensive Pityriasis Rubra Pilaris With Risankizumab and Acitretin.
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Khalil K, Hamburger N, Hirt PA, and Kerdel F
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- Humans, Male, Female, Drug Therapy, Combination, Treatment Outcome, Pityriasis Rubra Pilaris drug therapy, Acitretin therapeutic use, Acitretin administration & dosage, Keratolytic Agents therapeutic use, Keratolytic Agents administration & dosage, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal administration & dosage
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- 2024
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6. Oral Psoriasis Therapies.
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James J, Otto T, Gao J, and Porter ML
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- Humans, Administration, Oral, Piperidines therapeutic use, Piperidines administration & dosage, Pyrazoles therapeutic use, Pyrimidines therapeutic use, Pyrroles therapeutic use, Pyrroles administration & dosage, Antibodies, Monoclonal, Humanized therapeutic use, Keratolytic Agents therapeutic use, Indoles therapeutic use, Nicotinic Acids therapeutic use, Nicotinic Acids administration & dosage, Antibodies, Monoclonal, Psoriasis drug therapy, Thalidomide analogs & derivatives, Thalidomide therapeutic use, Acitretin therapeutic use, Acitretin administration & dosage, Immunosuppressive Agents therapeutic use, Methotrexate therapeutic use, Methotrexate administration & dosage, Cyclosporine therapeutic use, Cyclosporine administration & dosage, Dermatologic Agents therapeutic use, Dermatologic Agents administration & dosage
- Abstract
Oral psoriasis therapies include both older traditional immunosuppressants, such as methotrexate, cyclosporine, and acitretin, as well as newer, more targeted agents, such as apremilast, deucravacitinib, and oral interleukin-23 receptor antagonists. Patients may prefer oral therapies to injectable therapies based on the route of administration. Both older and newer oral psoriasis therapies can be utilized effectively in the treatment of psoriasis. Here, we will review oral agents used in the treatment of psoriasis as well as provide commentary on their role in our current, evolving psoriasis treatment paradigm., Competing Interests: Disclosure Dr J. James has no conflicts of interest. Dr J. Gao received fellowship funding from Abbvie and Janssen. She is an investigator for Abbvie, Bristol Meyers Squibb, UCB, and Novartis. Dr T. Otto is an investigator for Abbvie, Bristol Meyers Squibb, UCB, and Novartis. Dr M.L. Porter is a consultant and/or an investigator for Abbvie, Bristol Meyers Squibb, Eli Lilly, Regeneron, Pfizer, UCB, Moonlake, Acelyrin, Incyte, Trifecta Clinical, and Novartis. She has previously received fellowship funding and honoraria from the National Psoriasis Foundation., (Copyright © 2024 Elsevier Inc. All rights reserved.)
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- 2024
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7. Chemical Peels for Melasma: A Systematic Review.
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Sarkar R and Lakhani R
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- Humans, Glycolates therapeutic use, Glycolates administration & dosage, Treatment Outcome, Keratolytic Agents therapeutic use, Keratolytic Agents administration & dosage, Melanosis therapy, Chemexfoliation methods
- Abstract
Background: Melasma is a common chronic, relapsing pigmentary disorder that causes psychological impact. Chemical peels are a well-known therapeutic modality used for accelerating the treatment of melasma., Objective: To review the published evidence on the efficacy and safety of chemical peels in the treatment of melasma., Methods: A systematic review was done. A meta-analysis could not be done due to the heterogeneity of data., Result: The authors conducted a PubMed search and included prospective case series of more than 10 cases and randomized controlled trials (RCTs) that have studied the safety and/or efficacy of chemical peel in melasma. Out of 24 studies, 9 were clinical/comparative trials and 15 were RCTs. The total sample size was 1,075. The duration of the study varied from 8 to 36 weeks. Only 8 studies were split face. All studies used self-assessment, physician global assessment, and Melasma Area and Severity Index (MASI) for quantifying the results. Glycolic acid was found to be the most safe and effective in melasma., Conclusion: Chemical peels were found to be safe and effective in the management of melasma., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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8. Comparison of the clinical efficacy of topical tretinoin 0.05% cream and tacrolimus 0.1% ointment plus iontophoresis in the management of palmoplantar psoriasis.
- Author
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Bubna AK
- Subjects
- Humans, Female, Male, Adolescent, Adult, Middle Aged, Aged, Child, Young Adult, Treatment Outcome, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents therapeutic use, Keratolytic Agents administration & dosage, Keratolytic Agents therapeutic use, Combined Modality Therapy, Tacrolimus administration & dosage, Tacrolimus therapeutic use, Iontophoresis methods, Psoriasis drug therapy, Tretinoin administration & dosage, Tretinoin therapeutic use, Ointments, Administration, Cutaneous
- Abstract
Background: Palmoplantar psoriasis (PPP) is a localized variant of psoriasis that may be resistant to topical therapy, owing to the poor penetrability of topical agents at this anatomical site. Modalities that enhance localized cutaneous delivery of drugs could help to solve this problem. Iontophoresis is one such procedure that augments transdermal drug delivery, thus enabling better and expeditious therapeutic outcomes., Objective: To compare the therapeutic efficacy and safety of iontophoresis with tretinoin 0.05% cream and tacrolimus 0.1% ointment in treating patients with PPP., Methods: Sixty patients with PPP (28 males and 32 females, age range 8-76 years) were enrolled and randomly assigned to one of two groups comprising 30 patients each. One group (12 males and 18 females) received iontophoresis with tretinoin 0.05% cream; the other (16 males and 14 females) received iontophoresis treatment with tacrolimus 0.1% ointment. Both groups received treatment weekly from baseline until 4 weeks and then fortnightly at weeks 6 and 8. Clinical images were taken at each visit and improvement of psoriasis was evaluated using the erythema, scaling, induration and fissuring (ESIF) score. The percentage reduction in ESIF score was also assessed on completion of treatment and the grade of improvement noted for each patient., Results: Twenty-seven patients in the iontophoresis with tretinoin 0.05% cream group and 29 in the iontophoresis treatment with tacrolimus 0.1% ointment group completed the study. The mean (SD) ESIF score in the former decreased significantly from 8.7 (2) at baseline to 3.2 (1.7) at the study endpoint (P < 0.001). Similarly, in the latter group, there was a substantial reduction in mean (SD) ESIF score from 8.2 (1.9) at baseline to 3.3 (1.1) at the study end (P < 0.001). No significant adverse effects were encountered in either treatment arm., Conclusions: Iontophoresis using tretinoin and tacrolimus was found to be effective and safe for the treatment of PPP. Although iontophoresis with tretinoin showed slightly better results than with tacrolimus, these were not statistically significant., Competing Interests: Conflicts of interest The author declares no conflicts of interest., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Association of Dermatologists. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
- Published
- 2024
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9. Plexin B2 tissue expression and related gene polymorphisms in psoriasis and their relation to NB-UVB and Acitretin therapy.
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Hegazy EM, Taieb MAE, Hassan MH, Ibrahim AK, El-Din EA, and Ibrahim HM
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- Humans, Male, Female, Adult, Middle Aged, Ultraviolet Therapy methods, Single-Blind Method, Polymorphism, Single Nucleotide, Young Adult, Skin pathology, Skin metabolism, Skin drug effects, Receptors, Immunologic genetics, Treatment Outcome, Receptors, Cell Surface genetics, Receptors, Cell Surface metabolism, Keratolytic Agents therapeutic use, Keratolytic Agents administration & dosage, Combined Modality Therapy, Psoriasis genetics, Psoriasis drug therapy, Psoriasis diagnosis, Nerve Tissue Proteins genetics, Severity of Illness Index, Acitretin therapeutic use, Acitretin administration & dosage
- Abstract
Psoriasis is a chronic, immune-mediated, hyperproliferative skin disease. Etiopathogenesis of psoriasis is not well understood. Plexin B2 was found to have effects on CD100-mediated T-cell morphology and expressed in the immune system. It may play a role in the pathogenesis of psoriasis. To assess the tissue level of plexin-B2 and plexin B2 related gene polymorphism which is signal regulatory protein gamma (SIRPγ-rs71212732) in psoriatic patients before and after NB-UVB, acitretin therapy alone or in combination and to detect correlation between level of tissue plexin B2 and disease severity and improvement. This single blinded randomized controlled trial was carried on 50 psoriatic patients and 50 healthy controls. Psoriasis Area and Severity Index score (PASI) was used to evaluate the disease severity. Tissue plexin-b2 level was measured using ELISA and SIRPγ-rs71212732 (T\C) was assessed using TaqMan™ assays and real-time PCR. A significant lower tissue plexin-B2 level was observed in control group (2.9 ± 0.6 pg/g) than cases (25.8 ± 2.8, pg/g) (p < 0.001). Also, a significantly higher tissue plexin-B2 level was observed in sever psoriasis (32.7 ± 3.8 pg/ml) in than moderate psoriasis (13.6 ± 2.1 pg/ml, p = 0.001). Tissue plexin B2 was positively correlated with diseases severity. Significantly higher (TC& TT) genotypes and mutant (C) allele among patients compared to the controls, p < 0.001 for all. Tissue plexin-b2 level was high in psoriasis vulgaris with positive correlation with disease severity and decreased after treatment. This may indicate a role of plexin-b2 in psoriasis vulgaris pathogenesis., (© 2024. The Author(s).)
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- 2024
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10. Psoriatic arthritis risk in psoriasis patients prescribed acitretin versus disease-modifying antirheumatic drugs: a nationwide cohort study.
- Author
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Lin TL, Chang YL, Ho HJ, Chen YJ, and Wu CY
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- Humans, Female, Male, Middle Aged, Taiwan epidemiology, Retrospective Studies, Adult, Incidence, Aged, Keratolytic Agents therapeutic use, Proportional Hazards Models, Cohort Studies, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Acitretin therapeutic use, Arthritis, Psoriatic drug therapy, Antirheumatic Agents therapeutic use, Psoriasis drug therapy
- Abstract
Objectives: To compare the risk of PsA in psoriasis (PsO) patients treated with acitretin vs DMARDs., Methods: This retrospective study used Taiwan's National Health Insurance Research Database from 1997 to 2013. Adult PsO patients without PsA prescribed acitretin or DMARDs for ≥30 days within a year were assigned to the acitretin cohort or DMARDs cohort, respectively. Patients in the acitretin cohort prescribed DMARDs for >7 days, or in the DMARDs cohort prescribed acitretin for >7 days, were excluded. Cumulative incidence of PsA were determined within both cohorts using the Kaplan-Meier method. The hazard ratio (HR) comparing acitretin to DMARDs was calculated with Cox regression models, adjusting for demographic and clinical covariates including the use of NSAIDs and comorbidities., Results: The study included 1948 patients in each cohort. The 5-year cumulative incidence of PsA in the acitretin cohort was lower than that in the reference cohort (7.52% vs 9.93%; P = 0.005), with a more pronounced difference in the subpopulation receiving NSAIDs treatment. However, in subpopulations without NSAIDs treatment, the 5-year cumulative incidence of PsA in the acitretin cohort was comparable to the DMARDs cohort (5.26% vs 6.98%; P = 0.106). Acitretin was not associated with PsA development in PsO (HR 0.83, 95% confidence interval 0.65-1.05). This risk remained consistent regardless of adjustments for NSAID treatment and comorbidities. Other independent risk factors for PsA included female and NSAIDs treatment., Conclusion: Compared with DMARDs, acitretin was not associated with increased PsA risk in PsO patients., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
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- 2024
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11. Acitretin induced primary hypothyroidism in Darier's disease: A rare case report.
- Author
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Babu BS, Fernandes CZ, and Bhat B
- Subjects
- Humans, Male, Adult, Thyroxine therapeutic use, Acitretin adverse effects, Acitretin therapeutic use, Hypothyroidism chemically induced, Hypothyroidism drug therapy, Darier Disease drug therapy, Darier Disease chemically induced, Keratolytic Agents adverse effects, Keratolytic Agents therapeutic use
- Abstract
Abstract: Acitretin is a synthetic, second-generation retinoid mainly used for the treatment of Darier's disease (DD), which impacts biological processes by binding to a nuclear receptor from the corticosteroid/thyroid receptor superfamily, thereby altering gene expression. Our report outlines the case of a 41-year-old male patient who has received a clinical diagnosis of DD and does not exhibit any other coexisting comorbidities, who developed hypothyroidism posttreatment with acitretin, an unusual and rare side effect of the drug. His baseline routine investigations fell within normal limits before the initiation of acitretin. Acitretin-induced hypothyroidism was treated with thyroxine. Although a good therapeutic response was seen with acitretin, it could not be continued due to the development of side effects and was continued on topical therapy. This case emphasizes the likelihood of adverse effects linked to therapeutic levels of acitretin in patients without any prior history and signifies the critical importance of consistent blood monitoring throughout drug therapy., (Copyright © 2024 Copyright: © 2024 Indian Journal of Pharmacology.)
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- 2024
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12. Peeling with retinoic acid in microemulsion for treatment of melasma: A double-blind randomized controlled clinical study.
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de Andrade ACDV, Coqueiro RDS, Pithon MM, and Leite MF
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- Humans, Keratolytic Agents therapeutic use, Quality of Life, Treatment Outcome, Tretinoin therapeutic use, Melanosis drug therapy
- Abstract
Objective: To evaluate the clinical efficacy of peeling with a microemulsion formulation containing 1% retinoic acid., Materials and Methods: After development of the product, 60 patients with melasma were randomly divided into three groups (n = 20): Group 1-application of conventional 1% retinoic acid peeling (RA 1%). Group 2-application of 1% retinoic acid peeling in microemulsion (RA 1%M). Group 3-Application of placebo. The groups were submitted to four peeling sessions, fortnightly on Days 0, 15, 30, and 45, and analyzed at the time intervals of 0, 15, 30, 45, and 60 days. Evaluation was made by using the Melasma Area and Severity Index (MASI) and Melasma Quality of Life (MelasquoL) instrument. Hemato-biochemical parameters were also evaluated at Days 0 and 60. After obtaining the results, normality was evaluated by means of the Kolmogorov-Smirnov test and afterwards, the following tests were applied: Friedman statistical (to test the effect of the treatments on the MASI index); Wilcoxon, (for comparison between pairs to test the effect of treatments on the MelasQoL index); Kruskal-Wallis, (to test the differences between the groups); and Mann-Whitney, (comparisons between treatments). The level of significance adopted was 5% (α = 0.05)., Results: The three groups presented a significant reduction in the MASI index, indicating the effect of all the treatments on reducing the melasma (p < 0.001). A significant reduction in the stains was observed with the use of retinoic acid peeling delivered in microemulsion (62%) when compared with the conventional peeling with 1% retinoic acid in a conventional vehicle (26%) and the placebo (12%). There was also a significant reduction in the MelasQoL index (sum of all the aspects) in the three groups, indicating the effect of all the treatments, including the placebo, on the overall quality of life of those with melasma. However, RA 1%M the treatment that promoted the greatest effect on the quality of life of individuals. In percentage terms, the RA 1%M provided a mean reduction of 30% in the MelasQoL index, against 13% of the conventional treatment and only 4% of the placebo. When the hemato-biochemical parameters were compared on Days 0 and 60, there were no significant changes in the results., Conclusion: The chemical peeling performed with RA 1%M was effective for the treatment of melasma, and was shown to be superior to the peeling performed with retinoic acid in a conventional vehicle, in reducing the stains and improving the quality of life of patients., (© 2023 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.)
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- 2024
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13. Chemical Peels in Treatment of Melasma.
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Sarkar R and Katoch S
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- Humans, Salicylic Acid therapeutic use, Keratolytic Agents therapeutic use, Trichloroacetic Acid therapeutic use, Drug Combinations, Chemexfoliation methods, Melanosis therapy
- Abstract
Superficial chemical peels are one of the most popular skin resurfacing procedures in a dermatologists' clinic today due to quick application process, fast recovery, good patient acceptance, and excellent cosmetic results. The role of various peeling agents like glycolic acid, salicylic acid, trichloroacetic acid, Jessner's solution, retinoic acid, and lactic acid in the management of melasma has been established as that of an additional or maintenance therapy. This article details the current evidence and recommendations for the use of chemical peels in the treatment of melasma, a chronic and recurrent hyperpigmentary disorder., (Copyright © 2023 Elsevier Inc. All rights reserved.)
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- 2024
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14. Improvements in acne and skin oiliness with tazarotene 0.045% lotion in patients with oily skin.
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Tanghetti EA, Zeichner JA, Gold M, Sadick N, Cook-Bolden FE, Kircik LH, Stein Gold L, Weiss J, Tyring SK, Del Rosso JQ, and Guenin E
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- Humans, Tretinoin therapeutic use, Keratolytic Agents therapeutic use, Quality of Life, Severity of Illness Index, Skin Cream therapeutic use, Administration, Cutaneous, Treatment Outcome, Double-Blind Method, Emulsions, Acne Vulgaris drug therapy, Acne Vulgaris pathology, Dermatologic Agents adverse effects
- Abstract
Background: Excessive sebum production is a factor in acne development. Tazarotene 0.045% lotion has demonstrated reductions in acne lesions and acne-induced sequelae., Objective: Evaluate efficacy, changes in skin oiliness, and safety with tazarotene 0.045% lotion in participants with moderate-to-severe acne and oily skin., Methods: In two phase 3, double-blind, 12-week studies (NCT03168321; NCT03168334), participants aged ≥ 9 years with moderate-to-severe acne were randomized 1:1 to once-daily tazarotene 0.045% lotion or vehicle lotion ( N = 1614). This pooled, post hoc analysis included only participants self-categorized with oily skin at baseline on the Acne-Specific Quality of Life questionnaire item 19 (scores: 0 [extremely oily] to 6 [not at all oily]). Inflammatory/noninflammatory lesion counts, treatment success, skin oiliness, treatment-emergent adverse events (TEAEs), and cutaneous safety/tolerability were evaluated., Results: In all participants with oily skin ( n = 793), tazarotene provided greater reductions in inflammatory/noninflammatory lesions ( p < 0.001, both) and greater treatment success rates versus vehicle ( p < 0.01) at week 12. Over two-thirds of polymeric lotion-treated participants had subjective skin oiliness reductions by week 12, with around a third reporting 'low/not' oily skin. Tazarotene TEAE rates were similar to the overall population., Conclusions: Once-daily treatment with tazarotene 0.045% polymeric emulsion lotion may help improve patient-perceived skin oiliness in those with moderate-to-severe acne.
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- 2023
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15. A Comprehensive Bibliographic Review Concerning the Efficacy of Organic Acids for Chemical Peels Treating Acne Vulgaris.
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Măgerușan ȘE, Hancu G, and Rusu A
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- Adolescent, Young Adult, Humans, Keratolytic Agents therapeutic use, Keratolytic Agents pharmacology, Salicylic Acid pharmacology, Skin, Acne Vulgaris drug therapy, Chemexfoliation methods
- Abstract
Acne vulgaris stands out as the most prevalent skin disorder among teenagers and young adults, causing physical discomfort and considerable economic and psychological burdens on individuals and society. A wide range of topical and systemic therapies are available in acne treatment. Chemical peeling is a skin resurfacing technique designed to rebuild healthy skin using exfoliating substances, a simple and affordable process with various dermatological uses. Chemical peels, classified as superficial, medium, and deep, have been utilized for acne vulgaris and multiple other skin issues. In these chemical peels, a diverse range of chemical substances is employed, each with its unique mode of action. Among these, α-hydroxy and β-hydroxy acids have gathered attention for their efficacy in reducing acne lesions and enhancing overall skin appearance. Acids, such as salicylic acid, glycolic acid, or lactic acid, are commonly used in chemical peels due to their exfoliating and sebum-regulating properties. Despite the widespread use of these acids, there exists a lack of consensus regarding the most effective acid type and concentration for treating acne-prone skin. This review aims to bridge this knowledge gap by evaluating the effectiveness and safety of various organic acids used in chemical peels specifically for acne-prone skin. The findings of this comprehensive bibliographic review indicate that organic acid-based chemical peels represent effective and safe treatment options for individuals with acne-prone skin. Their adaptability sets these treatments apart; the choice of organic acid can be tailored to meet individual patient needs and tolerability levels. This personalized approach ensures that patients receive optimal care while minimizing the risks associated with the treatment. As research in this field progresses, it is anticipated that a more nuanced understanding of the ideal acid type and concentration will emerge, further enhancing the efficacy and safety of chemical peels for acne-prone skin.
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- 2023
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16. Acitretin plus macrolides and acitretin monotherapy in the management of hidradenitis suppurativa.
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Molinelli E, Sapigni C, Simonetti O, D'Agostino GM, Brisigotti V, Rizzetto G, and Offidani A
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- Humans, Macrolides, Keratolytic Agents therapeutic use, Anti-Bacterial Agents therapeutic use, Acitretin therapeutic use, Hidradenitis Suppurativa complications, Hidradenitis Suppurativa drug therapy
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- 2023
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17. Treatments for Non-Syndromic Inherited Ichthyosis, Including Emergent Pathogenesis-Related Therapy.
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Hasbani DJ, Hamie L, Eid E, Tamer C, Abbas O, and Kurban M
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- Humans, Keratolytic Agents therapeutic use, Mutation, Retinoids therapeutic use, Vitamin D, Ichthyosis genetics, Ichthyosis therapy
- Abstract
The term 'inherited ichthyosis' refers to a heterogeneous group of mendelian disorders of cornification that involve the integument with varying degrees of scaling. The management of ichthyosis poses a challenge for most physicians. Treatment options proposed in the literature include moisturizers, topical keratolytics, topical and systemic vitamin D analogues, and topical and systemic retinoids; however, some of these modalities are less reliable than others. Despite the therapeutic impasse imposed by the options above, the emergence of pathogenesis-based treatments along with novel gene therapies appear promising and hold the potential to halt or even revert disorders that arise from single genetic mutations, although research is still quite lacking in this domain. Hence, this review aims to highlight the various treatment modalities available for the management of the cutaneous manifestations of non-syndromic inherited ichthyosis, with an added emphasis on pathogenesis-targeted therapies., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)
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- 2022
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18. Treatment of Scalp Psoriasis.
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Ghafoor R, Patil A, Yamauchi P, Weinberg J, Kircik L, Grabbe S, and Goldust M
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- Administration, Topical, Betamethasone, Humans, Keratolytic Agents therapeutic use, Scalp, Treatment Outcome, Dermatologic Agents therapeutic use, Psoriasis diagnosis, Psoriasis drug therapy, Scalp Dermatoses diagnosis, Scalp Dermatoses drug therapy
- Abstract
Scalp involvement is seen in a majority of individuals with psoriasis, a chronic autoimmune skin disease with variable phenotypes. Occasionally, isolated scalp involvement is observed; and this causes significant psychosocial morbidity. Management of scalp psoriasis is difficult, in part due to the difficulty of applying topical agents and its refractory nature. Various treatment options are available with variable efficacy. Topical agents include topical steroids, keratolytics, tar and anthralin compounds, vitamin D analogues, and vitamin A derivatives. The combination treatment of topical betamethasone and calcipotriene is the most effective topical therapy. Systemic agents include conventional agents such as methotrexate, cyclosporine, and oral retinoids. Biologics offer a greater efficacy, with near complete or complete clearance of the scalp. In this article we review the published literature on adult and scalp psoriasis to highlight its treatment. Articles published in peer-reviewed journals were included for qualitative analysis of the literature, including reviews, clinical trials, case series, case reports published in the electronic database (MEDLINE/PubMed) through June 2021, cross references of respective articles, and trials from clinicaltrials.gov. J Drugs Dermatol. 2022;21(8):833-837. doi:10.36849/JDD.6498.
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- 2022
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19. Dramatic improvement of lenvatinib-induced hand-foot skin reaction with 7-day oral prednisolone and acitretin.
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Liu HL and Hung CT
- Subjects
- Acitretin adverse effects, Humans, Keratolytic Agents therapeutic use, Phenylurea Compounds adverse effects, Prednisolone therapeutic use, Keratoderma, Palmoplantar drug therapy, Quinolines
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- 2022
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20. Role of sequential chemical peel in cutaneous amyloidosis: a pilot case series.
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Divyalakshmi C, Hazarika N, and Barnwal S
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- Humans, Keratolytic Agents therapeutic use, Salicylic Acid therapeutic use, Treatment Outcome, Amyloidosis, Familial, Chemexfoliation
- Abstract
Cutaneous amyloidosis can be a part of a systemic disease or can result from a localized process limited to the skin. It usually presents as pruritic hyperpigmented macules, papules or nodules, which are notoriously resistant to treatment. We performed a hospital-based pilot case series to assess the efficacy and safety of sequential salicylic acid (SA) and glycolic acid (GA) chemical peels. Patients underwent sequential chemical peel therapy with SA 20% and GA 35% used alternately each week for a total of 6 weeks. At subsequent follow-up visits, good clinical outcome and long-term maintenance was observed. This study highlights the promising role of chemical peels in this difficult and distressing disorder., (© 2021 British Association of Dermatologists.)
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- 2022
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21. Papillon-Lefevre syndrome treated by acitretin: case report and cytokine profile.
- Author
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Leuenberger M, Fischer L, Mylonas A, Huber M, Di Domizio J, Gilliet M, Conrad C, and Hohl D
- Subjects
- Cytokines, Humans, Keratolytic Agents therapeutic use, Acitretin therapeutic use, Papillon-Lefevre Disease
- Published
- 2022
- Full Text
- View/download PDF
22. A case of hidradenitis suppurativa and Darier disease in a patient treated with acitretin: how to kill two birds with one stone.
- Author
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D'Ambra I, Caccavale S, Ronchi A, Franco R, and Argenziano G
- Subjects
- Acitretin therapeutic use, Humans, Keratolytic Agents therapeutic use, Severity of Illness Index, Darier Disease drug therapy, Hidradenitis Suppurativa complications
- Published
- 2021
- Full Text
- View/download PDF
23. The randomized trials of 10% urea cream and 0.025% tretinoin cream in the treatment of acanthosis nigricans.
- Author
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Treesirichod A, Chaithirayanon S, Chaikul T, and Chansakulporn S
- Subjects
- Humans, Keratolytic Agents therapeutic use, Randomized Controlled Trials as Topic, Urea, Acanthosis Nigricans drug therapy, Tretinoin therapeutic use
- Abstract
Background: Acanthosis nigricans is characterized as hyperpigmented skin and velvety surface on posterior and lateral folds of the neck and the intertriginous areas. This study aimed to assess the efficacy of topical 10% urea cream compared to 0.025% tretinoin cream in the treatment of acanthosis nigricans., Material and Methods: This was an 8-week trial, double-blind, randomized, comparative study of topical 10% urea and 0.025% tretinoin for the treatment of the neck hyperpigmentation. The Mexameter MX18 was used for assessing treatment efficacy. The global evaluation scale was also used to evaluate the overall success rate at weeks 2, 4, and 8 of the study., Results: There was a statistically significant difference between 10% urea and 0.025% tretinoin in the treatment of acanthosis nigricans ( p < 0.01). The efficacy of 10% urea and 0.025% tretinoin treatment shows 11.4 ± 5.7% and 20.1 ± 9.7% improvement, respectively. The treatment efficacy using the investigator's global evaluation found that 36.8% of participants treated with 10% urea and 63.2% of participants treated with 0.025% tretinoin had more than 75% skin improvement., Conclusion: Both medications significantly improved neck hyperpigmentation. However, the efficacy of 0.025% tretinoin was significantly better than 10% urea in the treatment of acanthosis nigricans., Clinical Trials Registry: TCTR20180703003.
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- 2021
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24. An innoxious combination for depigmentation.
- Author
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Hongal AA, Revathi TN, Sijimol MV, and Ramamurthy R
- Subjects
- Administration, Cutaneous, Humans, Keratolytic Agents therapeutic use, Male, Middle Aged, Radiation-Protective Agents therapeutic use, Hydroquinones therapeutic use, Tretinoin therapeutic use, Vitiligo drug therapy
- Published
- 2021
- Full Text
- View/download PDF
25. Keratosis lichenoides chronica showing significant response to acitretin.
- Author
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Bhari N, Jassi R, Ramam M, and Abhishek GN
- Subjects
- Female, Humans, Keratosis etiology, Lichen Planus diagnosis, Young Adult, Acitretin therapeutic use, Keratolytic Agents therapeutic use, Keratosis drug therapy, Lichen Planus drug therapy
- Published
- 2021
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26. t(1;22)(p13;q13) Acute Megakaryoblastic Leukemia Complicated by Hepatic Fibrosis: Antifibrosis Therapy?
- Author
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Feng J, Leung AWK, Cheng FWT, Lam GKS, Chow TTW, Ng MHL, Chu WCW, Chan NPH, and Li CK
- Subjects
- Antioxidants therapeutic use, Child, Preschool, Drug Therapy, Combination, Female, Humans, Infant, Newborn, Keratolytic Agents therapeutic use, Leukemia, Megakaryoblastic, Acute complications, Leukemia, Megakaryoblastic, Acute genetics, Leukemia, Megakaryoblastic, Acute pathology, Liver Cirrhosis complications, Liver Cirrhosis genetics, Liver Cirrhosis pathology, Prognosis, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chromosomes, Human, Pair 1 genetics, Chromosomes, Human, Pair 22 genetics, Leukemia, Megakaryoblastic, Acute drug therapy, Liver Cirrhosis drug therapy, Translocation, Genetic, Tretinoin therapeutic use, alpha-Tocopherol therapeutic use
- Abstract
Background: There is no established effective treatment for patients with t(1;22)(p13;q13) acute megakaryoblastic leukemia (AMKL) and hepatic fibrosis., Observation: Here we report the outcomes of 2 t(1;22)(p13;q13) AMKL patients with hepatic fibrosis. One patient died from liver failure despite the control of leukemia. The other patient was successfully treated with reduced-intensity chemotherapy and antifibrosis therapy with tretinoin and α-tocopheryl acetate, the hepatic fibrosis resolved and leukemia was in remission for 3 years., Conclusions: Reduced-intensity chemotherapy plus antifibrosis therapy with tretinoin and α-tocopheryl acetate could be a treatment option for these patients with t(1;22)(p13;q13) AMKL and hepatic fibrosis., Competing Interests: The authors declare no conflict of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)
- Published
- 2021
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27. Lichen spinulosus: insights into treatment.
- Author
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Sahni VN, Dao DP, Sahni DR, and Secrest AM
- Subjects
- Administration, Topical, Adrenal Cortex Hormones therapeutic use, Emollients therapeutic use, Female, Humans, Keratolytic Agents therapeutic use, Keratosis etiology, Lactic Acid therapeutic use, Male, Retinoids therapeutic use, Salicylic Acid therapeutic use, Urea therapeutic use, Vitamin D analogs & derivatives, Vitamin D therapeutic use, Dermatologic Agents therapeutic use, Keratosis diagnosis, Keratosis drug therapy
- Published
- 2021
- Full Text
- View/download PDF
28. A short, 8-week course of imiquimod 5% cream versus podophyllotoxin in the treatment of anogenital warts: A retrospective comparative cohort study.
- Author
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Nicolaidou E, Kanelleas A, Nikolakopoulos S, Bezrodnii G, Nearchou E, Gerodimou M, Papadopoulou-Skordou E, Paparizos V, and Rigopoulos D
- Subjects
- Adjuvants, Immunologic therapeutic use, Adult, Cohort Studies, Female, Humans, Keratolytic Agents therapeutic use, Male, Ointments, Retrospective Studies, Anus Diseases drug therapy, Condylomata Acuminata drug therapy, Imiquimod therapeutic use, Podophyllotoxin therapeutic use
- Abstract
Background: Studies comparing head-to-head treatment modalities for anogenital warts are lacking., Aim: We sought to compare a short, 8-week course of imiquimod 5% cream to versus the standard 4 week course of podophyllotoxin in the treatment of anogenital warts and to assess factors that may affect response to treatment., Methods: This was a retrospective cohort study. We reviewed medical files of otherwise healthy patients with a first episode of anogenital warts who were treated with either a short, 8-week course of imiquimod or the standard 4-week course of podophyllotoxin. Inverse probability of treatment weighted (IPTW). Logistic regression was employed to evaluate factors that may affect response to therapy., Results: The study included 347 patients. In patients with lesions on dry, keratinized anatomical sites, the complete clearance rates were 7.6% for imiquimod and 27.9% for podophyllotoxin (P < 0.001). In patients with lesions on moist, partially keratinized sites, no difference between the treatments was revealed. Significant predictors of > 50% reduction in wart area were location of lesions [odds ratio (OR) (95% confidence interval (CI)): 3.6 (1.84-7.08), P = 0.0002] for "partially keratinized" versus "keratinized" sites and treatment used [OR (95% CI): 1.79 (1.08-2.97), P = 0.024] for podophyllotoxin versus imiquimod., Limitations: The retrospective design of the study was a limitation that we mitigated against with the use of IPTW logistic regression., Conclusion: A standard 4 week course of Podophyllotoxin was more effective than an 8-week course of imiquimod only for lesions on keratinized sites. Treatment with podophyllotoxin and location of lesions on partially keratinized sites were independent predictors of >50% reduction in wart area.
- Published
- 2021
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29. The factors influencing the unmet effects of alpha hydroxy acid peels on acne vulgaris: A single tertiary center experience.
- Author
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Tang J, Yang J, Zhang C, Zhang X, Chen Q, Zhang S, Chen L, Wang C, and Li W
- Subjects
- Adult, Female, Humans, Keratolytic Agents therapeutic use, Male, Retrospective Studies, Salicylic Acid, Treatment Outcome, Acne Vulgaris diagnosis, Acne Vulgaris drug therapy, Chemexfoliation adverse effects
- Abstract
Acne vulgaris is a common condition. Alpha hydroxy acid (AHA) peels have been previously recommended as an option for patients with intolerance to first-line treatments especially when long-term use. The safety and efficacy of AHA peels for acne have been established, but the factors influencing the ultimate effects are unknown. We recruited patients diagnosed with acne who were intolerant to or refused the first-line treatments from July 2017 to December 2019 at our hospital and retrospectively collected the medical and demographic information of patients treated with a full course of AHA peels; data collected included age, sex, treatment history, compliance status, and efficacy after treatment. The efficacy score was defined by revised scales: 2 points indicated significant improvement, 1 point indicated mild improvement, and 0 point indicated no improvement. Additionally, only efficacy scores of 2 points were classified in the satisfactory group; the others were classified in the unmet effect group. Analyses were used to evaluate the potential influencing factor(s). A total of 141 patients (120 females, 21 male) were included in the final analysis. The patients in the satisfactory group were significantly older (higher proportion aged >28 years) (47.4% vs 29.5%, P = .046) and showed better compliance (88.7% vs 54.5%, P = .001) than the patients in the unmet effect group. Multiple analyses confirmed the effects of younger age (OR 2.70, 95% CI 1.15-6.34, P = 022) and poor compliance (OR 2.74, 95% CI 1.74-4.32, P = .001) on the unmet effect. Unsatisfactory compliance and age might decrease the effects of AHA peels on acne., (© 2021 Wiley Periodicals LLC.)
- Published
- 2021
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30. Efficacy of a combined chemical peel and topical salicylic acid-based gel combination in the treatment of active acne.
- Author
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Calvisi L
- Subjects
- Adolescent, Female, Humans, Keratolytic Agents therapeutic use, Quality of Life, Salicylic Acid therapeutic use, Treatment Outcome, Acne Vulgaris drug therapy, Chemexfoliation
- Abstract
Background: Acne vulgaris is a common skin condition affecting the pilosebaceous unit of the skin characterized by the presence of comedones, papules, pustules, nodules, and cysts, which might result in permanent scars. It commonly affects adolescents, but it can occur in any age-group with the second group of incidence in young women in their 30s. Acne vulgaris can highly affect a person's quality of life. Therefore, it is necessary to act against it to prevent emotional impact and long-term complications., Aim: This study aimed to demonstrate the efficacy of a chemical peel in combination with a home care-exfoliating and purifying product in improving mild and moderate acne., Methods: The study included 45 patients with mild-to-moderate acne. Patients were treated with a chemical peel containing a mix of salicylic acid, pyruvic acid, and retinoic acid once every 3 weeks for 4 times, plus a home care treatment after the healing process. Michaelson's acne severity score, Subject Global Aesthetic Improvement Scale, and Face Skin Q questionnaire were used to evaluate patients' skin improvement and patients' satisfaction., Results: All patients have shown improvement in skin lesions after 4 sessions of chemical peel according to Michaelson's acne severity score and Subject Global Aesthetic Improvement Score. Face Skin Q questionnaire demonstrated an improved quality of life in all treated patients., Conclusion: The combination of salicylic acid-based chemical peel plus exfoliating home care treatment appears to be a very good strategy against acne. Therefore, the physician may use this combination as an effective treatment for patients dealing with acne vulgaris., (© 2021 Wiley Periodicals, LLC.)
- Published
- 2021
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31. [Consensus on HPV of the Portuguese Society of Andrology, Sexual Medicine and Reproduction: Treatment].
- Author
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Jorge Pereira B, Graça B, Palmas A, Eufrásio P, Lebre A, Andrade P, Louro N, Azinhais P, Cardoso P, Tomada N, and Vendeira P
- Subjects
- Adjuvants, Immunologic therapeutic use, Aminoquinolines therapeutic use, Antimetabolites therapeutic use, Condylomata Acuminata virology, Consensus, Decision Making, Humans, Interferons therapeutic use, Keratolytic Agents therapeutic use, Papillomavirus Infections virology, Podophyllin therapeutic use, Podophyllotoxin therapeutic use, Portugal, Practice Guidelines as Topic, Andrology standards, Antiviral Agents therapeutic use, Condylomata Acuminata therapy, Cryotherapy, Immunologic Factors therapeutic use, Papillomavirus Infections therapy, Warts drug therapy
- Abstract
The treatment of condyloma is generally a challenge in clinical practice. Although the spontaneous resolution rate is high, a significant proportion of patients seek treatment, not because of symptomatology, but mainly for aesthetic issues and concerns related to the transmission or worsening of existing lesions. The available treatments should be applied only for clinically evident macroscopic lesions. Ideally, available therapies should have rapid action onset and clearance, resolve symptoms, reduce recurrence rate and viral load, be effective in treating small lesions, and be well tolerated. However, none of the currently available treatments is clearly more effective than the others and there is no ideal treatment for all patients or for all condyloma. Therefore, the therapeutic decision should be based on the clinician's experience, available resources, lesion morphology, size, number and location, primary or recurrent lesions, disease severity, patient preference and expectations, patient's immune competence, convenience, tolerance, cost of treatment and results of previous therapies. The available treatments are divided into three groups: applied by the patient himself (imiquimod 3.75 or 5%, podophyllotoxin .5%, synecatekines 10% or 15%), applied by the health care provider (bi- and tricloacetic acids 80%-90%, intralesional interferon alpha, cryotherapy, surgical removal, electrofulguration, laser ablation) and experimental or alternative therapies (topical cidofovir, intralesional bleomycin, photodynamic therapy). Treatment methodologies can be further divided into their action - ablative or destructive treatment (cryotherapy, electrofulguration, laser ablation, surgical excision), cytotoxic or proapoptotic treatments (podophyllotoxin .5%, 5-fluoruracil, bleomycin) and immunomodulatory treatments (imiquimod 3.75% or 5%, synecatekines 10% or 15%, intralesional interferon alpha). The overall success rate of the various treatments available ranges from 23% to 94%. Only treatments that include cryotherapy or surgical excision are suitable in condyloma with any anatomical location and that have the highest success rate in monotherapy. Recurrences are common regardless of the treatment received. In contrast, immunomodulatory therapies despite having lower initial clearance rates appear to have higher probabilities of cure in the medium term, with low recurrence rates. Some treatments may be combined with each other and the effectiveness of combined therapies appears to be superior to monotherapy (proactive sequential treatment). The consensuses for the treatment of HPV also consider special situations: immunocompromised patients, meatus and intraurethral lesions and treatment of the partner., (Copyright © 2020 Asociación Española de Andrología, Medicina Sexual y Reproductiva. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Published
- 2021
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32. The status of treatment for plantar warts in 2021: No definitive advancements in decades for a common dermatology disease.
- Author
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Hekmatjah J, Farshchian M, Grant-Kels JM, and Mehregan D
- Subjects
- Adult, Child, Cryotherapy, Humans, Keratolytic Agents therapeutic use, Salicylic Acid therapeutic use, Treatment Outcome, Dermatology, Warts therapy
- Abstract
Plantar warts are among the most common skin conditions and are classically resistant to treatment. To perform an evidence-based evaluation of the efficacy and safety of available treatment options for plantar warts, we conducted a systematic review of PubMed and Cochrane databases to identify large interventional and observational studies involving more than 100 patients who were treated for plantar warts from inception to October 2020. We identified only nine contributions meeting our inclusion criteria (N ≥ 100), representing 1,657 adult and pediatric patients with plantar warts. Treatments included in this review were topical keratolytic agents, cryotherapy, laser therapies, and intralesional and systemic treatments. Our evidence-based review of the larger studies suggests keratolytic agents and destructive treatments, in particular salicylic acid and cryotherapy, remain the primary treatments for plantar warts. Treatment with pulsed dye laser had the lowest rate of recurrence. Newer treatments and intralesional treatments were not represented owing to lack of large studies involving these modalities., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest except for Jane Grant-Kels, Chief Medical Officer and Investor for VeraDermics, Inc., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2021
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33. Tazarotene 0.045% Lotion for Moderate-to-Severe Acne Patients: Pooled Phase 3 Analysis by Age and Sex.
- Author
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Green LJ, Del Rosso JQ, Tanghetti EA, and Guenin E
- Subjects
- Administration, Cutaneous, Adolescent, Adult, Dermatologic Agents adverse effects, Double-Blind Method, Female, Humans, Keratolytic Agents therapeutic use, Male, Nicotinic Acids, Quality of Life, Severity of Illness Index, Skin Cream, Treatment Outcome, Young Adult, Acne Vulgaris diagnosis, Acne Vulgaris drug therapy
- Abstract
Background: Two identical phase 3 trials (NCT03168321 and NCT03168334) and pooled post hoc analyses have established efficacy and safety of a polymeric tazarotene 0.045% lotion formulation in patients with moderate-to-severe acne. Presented here are post hoc analyses that further examine efficacy and safety of tazarotene 0.045% lotion by age and sex., Methods: Patients aged ≥ 9 years with moderate-to-severe acne (score 3 or 4 on the Evaluator's Global Severity Score [EGSS]) were equally randomized to once-daily tazarotene 0.045% lotion or vehicle lotion for 12 weeks. Efficacy outcomes included inflammatory/noninflammatory lesion counts and treatment success (proportion of participants achieving ≥ 2-grade reduction from baseline in EGSS and score of 0 [clear] or 1 [almost clear]). Adolescent and adult females (n=1,013) and males (n=529) were subdivided into 3 age groups: 13–19, 20–29, and ≥30 years., Results: At week 12, large least-squares mean percent reductions in inflammatory and noninflammatory lesions were observed across all 3 tazarotene-treated age groups in males and females (range, -50.2% to -64.8%). Treatment success rates ranged from 23.6% to 38.4%. Across all efficacy assessments, significant differences between tazarotene and vehicle (P<0.05) were generally observed in the younger male and female participants (13–19 and 20–29). No notable age-related patterns were found for safety outcomes, though tazarotene-treated males of all age groups reported fewer adverse events than females., Conclusions: Tazarotene 0.045% lotion is efficacious and well tolerated in female and male adolescents and adults with moderate-to-severe acne. J Drugs Dermatol. 2021;20(6):608-615. doi:10.36849/JDD.6070.
- Published
- 2021
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34. Hand-Foot Skin Reaction Secondary to Sunitinib in a Patient With Metastatic Clear Cell Renal Cell Carcinoma.
- Author
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Férez-Blando K, Castro-Alonso F, Domínguez-Cherit J, and Bourlon MT
- Subjects
- Adrenal Cortex Hormones therapeutic use, Antineoplastic Agents therapeutic use, Hand-Foot Syndrome drug therapy, Humans, Keratolytic Agents therapeutic use, Male, Middle Aged, Sunitinib therapeutic use, Antineoplastic Agents adverse effects, Carcinoma, Renal Cell drug therapy, Hand-Foot Syndrome pathology, Kidney Neoplasms drug therapy, Sunitinib adverse effects
- Abstract
A man, age 45 years, was diagnosed with intermediate-risk stage IV clear cell renal carcinoma (lung and lymph node metastases). He was prescribed first-line systemic treatment with sunitinib (Sutent) 50 mg per day (each cycle: 4 weeks on, 2 weeks off). Upon day 22 of his second sunitinib cycle, he came to the oncology clinic complaining of difficulty walking due to bilateral sole pain. He described initial tingling sensations, which then became burning and painful, with symmetrical erythema and edema of the soles, without blisters. These turned into painful plaques with yellowish discoloration and hyperkeratosis on pressure-bearing areas. He denied fever or other symptoms. The pain limited his instrumental activities of daily living, but not his self-care activities of daily living. Total body skin examination disclosed hyperkeratotic plaques on the undersurface of the great toes and heels of both feet, predominantly at sites of pressure; no blisters, crusts, ulcers, or fissures were found. No relevant findings were found upon physical examination of his hands, mucosae, and scalp. A diagnosis of grade 2 hand-foot skin reaction (HFSR) was made.
- Published
- 2021
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35. Efficacy of 30% azelaic acid peel in the nonpharmacological treatment of facial acne.
- Author
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Szymańska A, Budzisz E, and Erkiert-Polguj A
- Subjects
- Acne Vulgaris pathology, Adolescent, Adult, Drug Administration Schedule, Female, Humans, Middle Aged, Severity of Illness Index, Treatment Outcome, Young Adult, Acne Vulgaris drug therapy, Dicarboxylic Acids therapeutic use, Face pathology, Keratolytic Agents therapeutic use
- Abstract
Background: Acne is a common, chronic, inflammatory disease of the pilosebaceous unit. It has a significant impact on patient quality of life, especially when lesions occur on cosmetically sensitive areas. Chemical peeling is a well-known option in the treatment of acne vulgaris, but little is known about azelaic acid (AZA) peels., Objectives: To determine the efficacy of 30% AZA peel, in decreasing the amount of secreted sebum, and reducing acne lesions., Methods: The study involved 35 women, with acne lesions on face skin. All the subjects underwent a series of six treatments, performed every 2 weeks., Results: A series of treatments contributed to a statistically significant reduction in the amount of secreted sebum. Similarly, highly significant values determining the overall number of acne lesions and the severity of the disease according to the IGA scale were also changed. The procedure was well tolerated by all participants., Conclusions: Peels with 30% AZA reduced acne lesions and normalized the activity of the sebaceous glands. The reduction of sebum allows us to believe that obtained good results in patients will be stable and long-lasting.
- Published
- 2021
- Full Text
- View/download PDF
36. Subcorneal pustular dermatosis associated with IgG monoclonal gammopathy of undetermined significance.
- Author
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Young PA, Bae GH, and Konia TH
- Subjects
- Acitretin therapeutic use, Adult, Female, Humans, Immunoglobulin A, Immunoglobulin M, Keratolytic Agents therapeutic use, Male, Neutrophils, Skin Diseases, Vesiculobullous drug therapy, Skin Diseases, Vesiculobullous immunology, Skin Diseases, Vesiculobullous pathology, Immunoglobulin G, Monoclonal Gammopathy of Undetermined Significance complications, Skin Diseases, Vesiculobullous complications
- Abstract
Subcorneal pustular dermatosis is a rare chronic relapsing bullous neutrophilic dermatosis. Because it can be associated with monoclonal gammopathy of undetermined significance and multiple myeloma, screening for these conditions is necessary. Herein, we present a case of subcorneal pustular dermatosis, with concurrent monoclonal gammopathy of undetermined significance, successfully treated with acitretin.
- Published
- 2021
37. Porokeratosis ptychotropica: a 30-year wait for the correct diagnosis and a challenging therapeutic endeavour.
- Author
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Wateetip W and Asawanonda P
- Subjects
- Acitretin therapeutic use, Diagnostic Errors, Groin, Humans, Keratolytic Agents therapeutic use, Male, Middle Aged, Porokeratosis drug therapy, Scrotum, Porokeratosis diagnosis, Porokeratosis pathology
- Published
- 2021
- Full Text
- View/download PDF
38. Influence of keratolytics on cutaneous pharmacokinetics of glucocorticoids.
- Author
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Wohlrab J
- Subjects
- Administration, Cutaneous, Humans, Keratolytic Agents therapeutic use, Skin, Betamethasone, Glucocorticoids
- Abstract
Background: Keratolytics are often used to accelerate and improve the therapeutic response of hyperkeratotic dermatoses. Keratolytics are a chemically inhomogeneous group of substances and substance mixtures that clinically lead to a decrease in symptoms of a cornification disorder, but mediate different effects. Thus, keratolytic, keratoplastic, keratoemulsifying and keratodiluting effects are distinguished. The physicochemical effects or pharmacological efficacy of the respective keratolytics result in different mechanism as well as risks with regard to local or systemic compatibility. Until now, only little attention has been paid upon selection of keratolytics to the immediate consequences regarding diffusion conditions and pharmacokinetics of sequentially applied topicals, in particular of glucocorticoids., Patients and Methods: This paper deals with the influence of keratolytics on the penetration-time profile of betamethasone dipropionate in sequential application. For this purpose, cutaneous bioavailability was investigated with the Franz chamber test using a tritium-labeled drug depending on the previous application of a keratolytic agent. Comparative data analyses were performed., Results: It was shown that keratoplastic substances significantly promote diffusion of the glucocorticoid. Keratoemulsifying substance mixtures exert no relevant effects in this regard, while keratodiluting substance mixtures inhibit penetration., Conclusions: The targeted selection of a keratolytic can optimize the therapeutic effect and influence the bioavailability of sequentially applied topicals., (© 2021 The Authors. Journal der Deutschen Dermatologischen Gesellschaft published by John Wiley & Sons Ltd on behalf of Deutsche Dermatologische Gesellschaft.)
- Published
- 2021
- Full Text
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39. Darier Disease.
- Author
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Patel TS and Herrera-Martinez M
- Subjects
- Female, Humans, Middle Aged, Acitretin therapeutic use, Darier Disease diagnosis, Darier Disease drug therapy, Keratolytic Agents therapeutic use
- Published
- 2021
- Full Text
- View/download PDF
40. Dermocosmetics: beneficial adjuncts in the treatment of acne vulgaris.
- Author
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Araviiskaia E, Lopez Estebaranz JL, and Pincelli C
- Subjects
- Acne Vulgaris radiotherapy, Anti-Bacterial Agents chemistry, Anti-Bacterial Agents therapeutic use, Anti-Inflammatory Agents chemistry, Anti-Inflammatory Agents therapeutic use, Antioxidants chemistry, Cosmetics chemistry, Emulsions chemistry, Humans, Keratolytic Agents chemistry, Keratolytic Agents therapeutic use, Sebum chemistry, Ultraviolet Rays, Acne Vulgaris drug therapy, Cosmetics therapeutic use
- Abstract
Introduction: Dermocosmetics are increasingly being recognized as an integral part of acne management. Dermocosmetics may minimize the side effects of acne medications, provide synergistic effects by improving the efficacy of other treatments, and limit exposure to environmental factors such as ultraviolet radiation. We aimed to provide an overview of the active ingredients and different types of preparations used in dermocosmetics for acne, and highlight supporting evidence for their use in clinical practice. Methods: A literature search for selected key words was performed using PubMed. Additional papers were identified based on author expertize. Results and discussion: The different types of active ingredients in dermocosmetics for acne can be classified as: sebum-controlling, antimicrobial, anti-inflammatory, anti-oxidant and/or keratolytic. Such agents may modulate the pathogenic pathways in acne. Dermocosmetics can be formulated as emulsions/creams, cleansers or camouflaging make-up. Dermocosmetics are useful treatment adjuncts for acne and have been shown to improve the clinical signs of acne, reduce transepidermal water loss and modify sebum production. Dermocosmetics have also been associated with reducing side effects of pharmacological treatments, high levels of patient satisfaction and increased adherence to treatment regimens. Together this evidence supports the use of dermocosmetics in clinical practice.
- Published
- 2021
- Full Text
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41. Bilateral Systematised Epidermolytic Epidermal Nevus: A case report.
- Author
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Kerawala SR, Rizvi NU, and Tabassum S
- Subjects
- Administration, Topical, Child, Emollients administration & dosage, Hamartoma, Humans, Keratolytic Agents administration & dosage, Male, Mosaicism, Nevus, Pakistan, Emollients therapeutic use, Hyperkeratosis, Epidermolytic drug therapy, Keratolytic Agents therapeutic use, Nevus, Sebaceous of Jadassohn drug therapy
- Abstract
Verrucous epidermal nevi (VEN) are benign congenital hamartomas consisting of keratinocytes. Histological examination mostly exhibits hyperkeratosis, acanthosis, papillomatosis and, rarely, the features of epidermolytic hyperkeratosis (EHK). We report a case of a 6-year-old boy who presented at Aga Khan University Hospital, Karachi, Pakistan with bilaterally symmetrical linear epidermal nevi following Blaschko's lines and showing epidermolytic hyperkeratosis on histology. The patient was treated with topical keratolytics and emolients which led to considerable improvement. To the best of the authors' knowledge, this is the first report of VEN from Pakistan., (© Copyright 2021, Sultan Qaboos University Medical Journal, All Rights Reserved.)
- Published
- 2021
- Full Text
- View/download PDF
42. Old drug, new tricks - successful treatment of Hailey-Hailey disease with thalidomide.
- Author
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Kearney N, Raichura S, Houghton J, and O'Kane D
- Subjects
- Administration, Oral, Female, Humans, Middle Aged, Treatment Outcome, Keratolytic Agents therapeutic use, Pemphigus, Benign Familial drug therapy, Thalidomide therapeutic use
- Published
- 2021
- Full Text
- View/download PDF
43. Erosive pustular dermatosis of the scalp: causes and treatments.
- Author
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Karanfilian KM and Wassef C
- Subjects
- Acitretin therapeutic use, Adrenal Cortex Hormones therapeutic use, Aminolevulinic Acid therapeutic use, Anti-Infective Agents therapeutic use, Calcitriol analogs & derivatives, Calcitriol therapeutic use, Dapsone therapeutic use, Humans, Immunosuppressive Agents therapeutic use, Isotretinoin therapeutic use, Keratolytic Agents therapeutic use, Photochemotherapy, Tacrolimus therapeutic use, Dermatologic Agents therapeutic use, Scalp Dermatoses drug therapy, Scalp Dermatoses etiology
- Abstract
Erosive pustular dermatosis of the scalp is a rare condition which primarily affects older women after local trauma and has historically been treated with topical steroids. As it is a rare entity and resembles other dermatologic conditions, it may easily be misdiagnosed. Identifying the causes and evaluating the efficacy of treatments of erosive pustular dermatosis of the scalp (EPDS) is of great importance to both avoid misdiagnosis and ensure optimal treatment of this rare condition. There are numerous causes. In addition to surgeries and physical injuries, topical and procedural treatments for actinic keratoses and androgenetic alopecia can trigger the development of lesions. There are also documented associations with several autoimmune and systemic conditions. Besides corticosteroids, topical tacrolimus and photodynamic therapy were the most commonly used treatments for EPDS. They were effective with few recurrences and adverse effects. Other successful treatment options were topical dapsone, silicone gels, calcipotriol, acitretin, and isotretinoin. Oral dapsone can be used in cases of disseminated disease. Zinc sulfate should be considered with low-serum zinc levels. While cyclosporine was effective, there were adverse effects that may limit its use. It is important for dermatologists to be aware of the wide array of potential causes of erosive pustular dermatosis and include it on their differential. Additionally, although high-potency topical steroids have been historically used as the first-line treatment, there are many other effective treatments that may avoid recurrence and skin atrophy, particularly in the elderly population., (© 2020 the International Society of Dermatology.)
- Published
- 2021
- Full Text
- View/download PDF
44. Prophylaxis of Post-Inflammatory Hyperpigmentation From Energy-Based Device Treatments: A Review [Formula: see text].
- Author
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Wong ITY and Richer V
- Subjects
- Adrenal Cortex Hormones therapeutic use, Adrenergic alpha-2 Receptor Agonists therapeutic use, Antifibrinolytic Agents therapeutic use, Antioxidants therapeutic use, Brimonidine Tartrate therapeutic use, Glycolates therapeutic use, Humans, Hydroquinones therapeutic use, Hyperpigmentation diagnosis, Hyperpigmentation etiology, Inflammation etiology, Keratolytic Agents therapeutic use, Retinoids therapeutic use, Sunscreening Agents therapeutic use, Tranexamic Acid therapeutic use, Hyperpigmentation prevention & control, Laser Therapy adverse effects
- Abstract
Post-inflammatory hyperpigmentation (PIH) is an acquired hypermelanosis that can result from inflammatory dermatologic disease, trauma, or iatrogenesis from procedures. This condition disproportionately affects individuals with skin of color, and it can place a significant psychosocial burden on affected patients. The management of PIH is, therefore, of great interest to clinicians, especially dermatologists. The treatment of established PIH has long been a principal focus within the literature, with publications on the topic outnumbering publications on prophylaxis of PIH. Prophylaxis strategies to prevent PIH vary greatly in clinical practice, likely due to the absence of an evidence-based consensus. Published approaches to PIH prophylaxis include pretreatment (topical alpha hydroxy acids, retinoids, hydroquinone, and brimonidine) and post-treatment strategies (photoprotection, corticosteroids, and tranexamic acid). This review will examine the current literature on prophylaxis of PIH from energy-based device treatments.
- Published
- 2021
- Full Text
- View/download PDF
45. Efficacy and Cost Analysis for Acitretin for Basal and Squamous Cell Carcinoma Prophylaxis in Renal Transplant Recipients.
- Author
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Badri O, Schmults CD, Karia PS, and Ruiz ES
- Subjects
- Acitretin therapeutic use, Costs and Cost Analysis, Humans, Keratolytic Agents therapeutic use, Transplant Recipients, Acitretin economics, Carcinoma, Basal Cell drug therapy, Carcinoma, Squamous Cell drug therapy, Keratolytic Agents economics, Kidney Transplantation, Skin Neoplasms drug therapy
- Published
- 2021
- Full Text
- View/download PDF
46. Quantifying Actinic Keratosis Transformation Using a Risk Analysis Calculator.
- Author
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Ravishankar A, Maher IA, Gravely AA, and Goldfarb NI
- Subjects
- Aged, Carcinoma, Squamous Cell prevention & control, Decision Making, Female, Humans, Male, Risk Assessment, Skin Neoplasms prevention & control, Carcinoma, Squamous Cell pathology, Cell Transformation, Neoplastic, Keratolytic Agents therapeutic use, Keratosis, Actinic drug therapy, Keratosis, Actinic pathology, Skin Neoplasms pathology
- Published
- 2021
- Full Text
- View/download PDF
47. Is Cutaneous Cryosurgery the Best Treatment Option for Cutaneous Warts?
- Author
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Fay DL
- Subjects
- Administration, Cutaneous, Administration, Topical, Family Practice, Humans, Salicylic Acid therapeutic use, Cryosurgery methods, Keratolytic Agents therapeutic use, Skin Diseases therapy, Warts therapy
- Published
- 2020
48. Drugs for acne.
- Subjects
- Adolescent, Adult, Androgen Receptor Antagonists adverse effects, Androgen Receptor Antagonists therapeutic use, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents therapeutic use, Child, Female, Humans, Keratolytic Agents adverse effects, Keratolytic Agents therapeutic use, Male, Phototherapy adverse effects, Phototherapy methods, Young Adult, Acne Vulgaris drug therapy, Acne Vulgaris epidemiology, COVID-19, Masks adverse effects, Pandemics
- Published
- 2020
49. Case Report: Treatment of Chromoblastomycosis with Combinations including Acitretin: A Report of Two Cases.
- Author
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Belda W, Criado PR, and Domingues Passero LF
- Subjects
- Acitretin administration & dosage, Adjuvants, Immunologic administration & dosage, Adjuvants, Immunologic therapeutic use, Antifungal Agents administration & dosage, Antifungal Agents therapeutic use, Drug Therapy, Combination, Humans, Imiquimod administration & dosage, Itraconazole administration & dosage, Keratolytic Agents administration & dosage, Keratolytic Agents therapeutic use, Male, Middle Aged, Acitretin therapeutic use, Chromoblastomycosis drug therapy, Chromoblastomycosis pathology, Imiquimod therapeutic use, Itraconazole therapeutic use
- Abstract
Chromoblastomycosis is a cutaneous fungal infection caused by dematiaceous fungi that belong to the order Chaetothyriales and family Herpotrichiellaceae . This infection is prevalent in tropical and subtropical areas and has been designated as a neglected tropical disease according to the WHO. Chromoblastomycosis infection is difficult to treat, and there are limited therapeutic options, making urgent the characterization of new medicines or approaches to treat such infection. In the present case report, two patients with extensive chromoblastomycosis lesions were treated with the combination of itraconazole, acitretin, and imiquimod. In the fourth month of treatment, both patients showed improvement of verrucous plates, suggesting that acitretin combined with drugs already used in chromoblastomycosis therapy can decrease the time of treatment, improving patient's quality of life.
- Published
- 2020
- Full Text
- View/download PDF
50. Sporadic late-onset Darier's disease.
- Author
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Chew CY and Nguyen RA
- Subjects
- Aged, Darier Disease pathology, Female, Humans, Keratolytic Agents therapeutic use, Treatment Outcome, Darier Disease diagnosis, Darier Disease drug therapy, Dermatologic Agents therapeutic use
- Published
- 2020
- Full Text
- View/download PDF
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