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Topical Treatment (topical + treatment)
Selected AbstractsOpioids and the skin , where do we stand?EXPERIMENTAL DERMATOLOGY, Issue 5 2009Paul L. Bigliardi Abstract:, The common ectodermal origin of the skin and nervous systems can be expected to predict likely interactions in the adult. Over the last couple of decades much progress has been made to elucidate the nature of these interactions, which provide multidirectional controls between the centrally located brain and the peripherally located skin and immune system. The opioid system is an excellent example of such an interaction and there is growing evidence that opioid receptors (OR) and their endogenous opioid agonists are functional in different skin structures, including peripheral nerve fibres, keratinocytes, melanocytes, hair follicles and immune cells. Greater knowledge of these skin-associated opioid interactions will be important for the treatment of chronic and acute pain and pruritus. Topical treatment of the skin with opioid ligands is particularly attractive as they are active with few side effects, especially if they cannot cross the blood,brain barrier. Moreover, cutaneous activation of the opioid system (e.g. by peripheral nerves, cutaneous and immune cells, especially in inflamed and damaged skin) can influence cell differentiation and apoptosis, and thus may be important for the repair of damaged skin. While many of the pieces of this intriguing puzzle remain to be found, we attempt in this review to weave a thread around available data to discuss how the peripheral opioid system may impact on different key players in skin physiology and pathology. [source] Topical treatment with thiazolidinediones, activators of peroxisome proliferator-activated receptor-,, normalizes epidermal homeostasis in a murine hyperproliferative disease modelEXPERIMENTAL DERMATOLOGY, Issue 3 2006Marianne Demerjian Abstract:, In a murine model of epidermal hyperplasia reproducing some of the abnormalities of several common skin disorders, we previously demonstrated the antiproliferative and pro-differentiating effects of peroxisome proliferator-activated receptor (PPAR),, PPAR,/,, and liver X receptor activators. Unlike other subgroups of PPAR activators, thiazolidinediones (TZDs), a family of PPAR, ligands, did not inhibit keratinocyte proliferation in normal murine skin. Here, we studied the effects of two TZDs, namely ciglitazone (10 mM) and troglitazone (1 mM), in the same murine model where epidermal hyperproliferation was reproduced by repeated barrier abrogation with tape stripping. Topical treatment with ciglitazone and troglitazone resulted in a marked and significant decrease in epidermal thickness. Furthermore, in all TZD-treated groups, we observed a significant decrease in keratinocyte proliferation using proliferating cell nuclear antigen, 5-bromo-2,-deoxyuridine, and tritiated thymidine incorporation. However, using the terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, we found no difference in apoptosis between different treatments, emphasizing that it is the antiproliferative role of these activators that accounts for the decrease of epidermal thickness. Finally, using immunohistochemical methods, we determined the effects of ciglitazone on keratinocyte differentiation in this hyperproliferative model. We observed an increased expression of involucrin and filaggrin following ciglitazone treatment, suggesting a pro-differentiating action of TZDs in this model. In summary, topical TZDs significantly reduce epidermal keratinocyte proliferation while promoting differentiation in a murine model of hyperproliferative epidermis. Together, these results suggest that in addition to their metabolic effects currently in use in the treatment of type 2 diabetes, topical TZDs could be considered as potential alternative therapeutic agents in hyperproliferative skin diseases such as psoriasis. [source] Bacteriotherapy with Lactobacillus plantarum in burnsINTERNATIONAL WOUND JOURNAL, Issue 1 2009Maria C Peral Abstract Bacterial colonisation and infection remain the major causes of delayed healing and graft rejection following burns. Topical treatment is necessary to reduce the incidence of burn wound infection. Silver sulphadiazine (SD-Ag) is an often used microbicidal agent. However, this treatment produces adverse reactions and side-effects. On the basis of experimental data and clinical application of lactobacilli as probiotics, we performed this exploratory study to establish the effectiveness of bacteriotherapy with topical application of the innocuous bacteria Lactobacillus plantarum cultured in De Man, Rogosa and Sharpe medium to provide an alternative method for burn treatment using SD-Ag as a reference. These innocuous bacteria would compete with other bacteria that are wound pathogens and would modify the wound environment and promote tissue repair. Eighty burned patients from the Plastic Surgery and Burns Unit were grouped into infected (delayed) second- and third-degree and non infected (early) third-degree burns and treated with L. plantarum or SD-Ag. The proportion of patients with delayed second-degree burns was 0·71 for L. plantarum and 0·73 for SD-Ag (relative rate: ,2·72%) with respect to the decrease in bacterial load (<105 bacteria/g of tissue), promotion of granulating tissue wound bed and healing. In early third-degree burns, the values were 0·75 for L. plantarum and 0·84 for SD-Ag (relative rate: ,1·07%) in preventing wound infection and promotion of granulation tissue, 0·90 in graft taking for both treatments (relative rate: 0%) and 0·75 for L. plantarum and 0·77 for SD-Ag (relative rate: ,2·60%) in healing. In delayed third-degree burns, values were 0·83 for L. plantarum and 0·71 for SD-Ag (relative rate: +16·90%) with respect to the decrease in the bacterial load (<105 bacteria/g of tissue) and providing a granulating tissue wound bed, 0·90 in graft taking for both treatments (relative rate: 0%) and 0·75 for L. plantarum and 0·64 for SD-Ag (relative rate: + 17·19%) in healing. Although the number of patients (between 12 and 15 per group) did not enable the application of a power statistical test, these results suggest that the L. plantarum treatment should be studied in greater depth and could be used as a valid alternative for the topical treatment of burns. [source] Prevalence and risk factors for allergic contact dermatitis to topical treatment in atopic dermatitis: a study in 641 childrenALLERGY, Issue 5 2009C. Mailhol Background:, There is little information regarding the risk of sensitization associated with topical atopic dermatitis (AD) treatment. Objectives:, To assess the frequency of sensitization to topical treatment of AD in children and to determine risk factors associated with skin sensitization. Methods:, Six hundred and forty-one children with AD were systematically patch tested with seven agents of common topical treatment: chlorhexidine, hexamidine, budesonide, tixocortol pivalate, bufexamac, sodium fusidate and with the current emollient used by the child. The following variables were recorded: age, sex, age at onset of AD, associated asthma, severity of AD, and history of previous exposure to topical agents used in the treatment of AD. Skin prick tests to inhalant and food allergens were used to explore the IgE-mediated sensitization. Results:, Forty-one positive patch tests were found in 40 patients (6.2%). Allergens were emollients (47.5%), chlorhexidine (42.5%), hexamidine (7.5%), tixocortol pivalate and bufexamac (2.5% each). Risk factors associated with sensitization to AD treatment were AD severity [OR: 3.3; 95% confidence interval (CI):1.5,7.1 for moderate to severe AD], AD onset before the age of 6 months (OR: 2.7; 95% CI: 1.2,6.1), and IgE-mediated sensitization (OR: 2.5; 95% CI: 1.1,5.9). Conclusions:, Topical treatment of AD is associated with cutaneous sensitization. Antiseptics and emollients represent the most frequent sensitizers and may be included in the standard series in AD children when contact dermatitis is suspected. Risk factors associated with sensitization to AD topical treatments are AD severity, early AD onset and IgE-mediated sensitization. [source] Topical treatment of recurrent herpes labialisORAL DISEASES, Issue 1 2001A Pedersen [source] Guidelines for the Management of Tinea Capitis in ChildrenPEDIATRIC DERMATOLOGY, Issue 3 2010Talia Kakourou M.D. Tinea capitis always requires systemic treatment because topical antifungal agents do not penetrate the hair follicle. Topical treatment is only used as adjuvant therapy to systemic antifungals. The newer oral antifungal agents including terbinafine, itraconazole, and fluconazole appear to have efficacy rates and potential adverse effects similar to those of griseofulvin in children with TC caused by Trichophyton species, while requiring a much shorter duration of treatment. They may be, however, more expensive (Grading of recommendation A; strength of evidence 1a). Griseofulvin is still the treatment of choice for cases caused by Microsporum species. Its efficacy is superior to that of terbinafine (Grading of recommendation A; strength of evidence 1b), and although its efficacy and treatment duration is matched by fluconazole (Grading of recommendation A; strength of evidence 1b) and itraconazole (Grading of recommendation A; strength of evidence 1b), griseofulvin is cheaper. It must be noted, however, that griseofulvin is nowadays not available in certain European countries (e.g., Belgium, Greece, Portugal, and Turkey). [source] Congenital Hypertrophy of the Lateral Nail Folds of the Hallux: Clinical Features and Follow-Up of Seven CasesPEDIATRIC DERMATOLOGY, Issue 5 2000Bianca Maria Piraccini M.D. We describe the clinical picture and follow-up of seven patients with this abnormality. In three patients the affected toe showed an asymptomatic, dome-shaped, hypertrophic lip that partially covered the nail plate. Four patients had acute inflammatory changes due to toenail ingrowth, with considerable swelling and reddening of the hypertrophic lip that was painful on pressure. Topical treatment with steroids was useful to reduce inflammation and produced persistent remission in two patients. Follow-up showed a spontaneous disappearance of the hypertrophic nail fold in one of the seven patients. In two patients the hypertrophic lip partially regressed, but remained clearly visible, while in two patients it remained unchanged. In two patients surgical correction of the soft tissue abnormality was necessary due to painful nail ingrowth unresponsive to topical treatment. [source] Therapeutic efficacy of topical hydrocortisone aceponate in experimental flea-allergy dermatitis in dogsAUSTRALIAN VETERINARY JOURNAL, Issue 7 2009S Bonneau Objective To evaluate the treatment efficacy of a topical spray containing hydrocortisone aceponate (HCA) on dogs with flea-allergy dermatitis (FAD). Design A controlled clinical study was conducted on dogs with experimentally induced FAD. Sixteen laboratory beagles with mild to moderate clinical signs were divided into two groups. The test group received HCA by topical spray once daily for 7 days, while the control group did not. Pruritic events (time and frequency) were videotaped and then scored. Clinical signs (erythema, papules, excoriation and alopecia) present on four anatomical regions were monitored and their severity directly assessed. Results After 2 days, pruritus was reduced by 94% in the treatment group and by 24% in the control group (P = 0.014) in cumulative time, and by 86% versus 34% (P = 0.034) in frequency. The HCA spray also resulted in significant improvements in overall clinical signs: 23% versus 0% in the control group (P = 0.0006) on day 3 and 43% versus 15% in the control group (P = 0.0006) on day 7. During the 7-day trial, no drug-related adverse effects were observed. Conclusions Topical treatment with HCA showed a rapid and potent antipruritic effect on dogs with FAD. HCA also demonstrated significant overall therapeutic effects on FAD-associated skin lesions. [source] Topical treatment of perianal eczema with tacrolimus 0·1%BRITISH JOURNAL OF DERMATOLOGY, Issue 6 2009J. Schauber Summary Background, Perianal eczema is an inflammatory skin disease with a high prevalence in most industrialized countries. As general practitioners and dermatologists frequently see patients with perianal eczema the need for efficient, fast and safe therapies is high. Topical calcineurin inhibitors such as tacrolimus (FK506) ameliorate cutaneous inflammation and associated pruritus in an array of inflammatory dermatoses. Objectives, To investigate the effect of topical tacrolimus in perianal eczema. Methods, Twenty-four patients with perianal eczema were treated with tacrolimus 0·1% ointment twice daily on the affected skin area for 2 weeks. Results, All returning patients showed clinical improvement as assessed by macroscopic appearance and clinical score (modified SCORAD index). Conclusions, In this short-term trial we demonstrate that topical tacrolimus 0·1% is safe, efficient and well tolerated in patients with perianal eczema irrespective of the underlying cause. [source] Topical application of acidified nitrite to the nail renders it antifungal and causes nitrosation of cysteine groups in the nail plateBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2007M.J. Finnen Summary Background, Topical treatment of nail diseases is hampered by the nail plate barrier, consisting of dense cross-linked keratin fibres held together by cysteine-rich proteins and disulphide bonds, which prevents penetration of antifungal agents to the focus of fungal infection. Acidified nitrite is an effective treatment for tinea pedis. It releases nitric oxide (NO) and other NO-related species. NO can react with thiol (-SH) groups to form nitrosothiols (-SNO). Objectives, To determine whether acidified nitrite can penetrate the nail barrier and cure onychomycosis, and to determine whether nitrosospecies can bind to the nail plate. Methods, Nails were treated with a mixture of citric acid and sodium nitrite in a molar ratio of 0·54 at either low dose (0·75%/0·5%) or high dose (13·5%/9%). Immunohistochemistry, ultraviolet-visible absorbance spectroscopy and serial chemical reduction of nitrosospecies followed by chemiluminescent detection of NO were used to measure nitrosospecies. Acidified nitrite-treated nails and the nitrosothiols S-nitrosopenicillamine (SNAP) and S-nitrosoglutathione (GSNO) were added to Trichophyton rubrum and T. mentagrophytes cultures in liquid Sabouraud medium and growth measured 3 days later. Thirteen patients with positive mycological cultures for Trichophyton or Fusarium species were treated with topical acidified nitrite for 16 weeks. Repeat mycological examination was performed during this treatment time. Results, S-nitrothiols were formed in the nail following a single treatment of low- or high-dose sodium nitrite and citric acid. Repeated exposure to high-dose acidified nitrite led to additional formation of N-nitrosated species. S-nitrosothiol formation caused the nail to become antifungal to T. rubrum and T. mentagrophytes. Antifungal activity was Cu2+ sensitive. The nitrosothiols SNAP and GSNO were also found to be antifungal. Topical acidified nitrite treatment of patients with onychomycosis resulted in > 90% becoming culture negative for T. rubrum. Conclusions, Acidified nitrite cream results in the formation of S-nitrosocysteine throughout the treated nail. Acidified nitrite treatment makes a nail antifungal. S-nitrosothiols, formed by nitrosation of nail sulphur residues, are the active component. Acidified nitrite exploits the nature of the nail barrier and utilizes it as a means of delivery of NO/nitrosothiol-mediated antifungal activity. Thus the principal obstacle to therapy in the nail becomes an effective delivery mechanism. [source] Topical treatment of Netherton's syndrome with tacrolimus ointment without significant systemic absorptionBRITISH JOURNAL OF DERMATOLOGY, Issue 1 2003G. Bens No abstract is available for this article. [source] Topical treatment of uveitis resulting in adrenal insufficiencyACTA PAEDIATRICA, Issue 3 2009Liisa Kröger Abstract The adverse effects of corticosteroids are well-known and occur more frequently when corticosteroids are used perorally or intravenously. The management of uveitis, which normally consists of topical corticosteroids and mydriates, can be challenging. We report a case in which continuous use of topical corticosteroids resulted in adrenal insufficiency and obesity. Conclusion: When topical corticosteroids are used over longer periods, hypophysis-pituitary-adrenal (HPA) function should be carefully monitored. [source] Topical treatment with aqueous solutions of rofleponide palmitate and budesonide in a pollen-season model of allergic rhinitisCLINICAL & EXPERIMENTAL ALLERGY, Issue 5 2004C. Ahlström-Emanuelsson Summary Background Rofleponide palmitate is an esterified glucocorticosteroid pro-drug with a promising pre-clinical profile designed to deliver topical airway treatment for allergic rhinitis and asthma in a novel manner. Thus, the rofleponide palmitate pro-drug is designed to provide topical exposure of the mucosa to the inactive lipophilic drug, which would be locally metabolized to the more hydrophilic and readily cleared drug rofleponide. Objective To examine whether rofleponide palmitate affects nasal symptoms and peak inspiratory flow (PIF) in a pollen-season model of allergic rhinitis and to compare any such effects with those of another glucocorticosteroid (i.e., budesonide). Methods During the pollen-free season, 40 patients with strictly seasonal allergic rhinitis received topical nasal spray treatment with an aqueous solution of rofleponide palmitate 400 ,g and an aqueous solution of budesonide 128 ,g once daily for 10 days in a double-blind, placebo-controlled, and crossover study. After 3 days of drug treatment, individualized allergen challenges were given once daily for 7 days while the treatment continued. The washout periods between each of the challenge series were 2 weeks. Nasal symptoms and PIF were recorded in the morning and evening, as well as 10 and 20 min after each allergen challenge. The mean recordings obtained during the last 3 days of the allergen-challenge series, when symptoms were established and when the treatment had lasted for 8,10 days, were used in the analysis. Results Both active treatments reduced nasal symptoms and improved nasal PIF compared with placebo (P<0.01,0.001). There was no overall difference in efficacy between rofleponide palmitate 400 ,g and budesonide 128 ,g. Conclusions Topical treatment with aqueous solutions of rofleponide palmitate attenuates nasal symptoms and improves nasal PIF in allergic rhinitis. The overall efficacy of 400 ,g of rofleponide palmitate is similar to that of 128 ,g of budesonide in the pollen-season model used in this study. [source] Topical treatment of intraepithelial penile carcinoma with imiquimodCLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 2003G. Micali Summary Intraepithelial penile carcinoma (IPC) is an in situ carcinoma of the penis, which can be difficult to diagnose. Current treatments include excisional surgery, Mohs' micrographic surgery, cryotherapy, carbon dioxide laser therapy and topical 5-fluorouracil. We report two cases of men with 12,18 month histories of IPC (Bowen's disease, squamous cell carcinoma in situ) that were previously unsuccessfully treated with antifungals and antibiotics. Treatment with imiquimod 5% cream for 8,10 weeks was effective in both cases with no clinical evidence of relapse at 4 and 6 months. Both patients experienced adverse effects, resulting in temporary discontinuation of treatment. [source] Topical revitalization of body skinJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 4 2000Timothy Corcoran Flynn Abstract Topical treatments for the body are beneficial for photoageing as well as for specific disease processes, such as scars or striae. Every patient should topically apply photoprotectants in order to prevent photodamage to the skin. Tretinoin can improve body skin and has a documented use in striae. ,-Hydroxy acids can restore body skin when used on a regular basis. Antioxidants may be of benefit. Scars can be improved with a variety of topically applied agents ranging from silicone gel sheeting to super-potent topical steroids. Chemical peeling for the body can improve the skin with the use of ,- or ,-hydroxy acids. While topical therapy can improve body skin, adjunctive surgical therapy may be needed to correct body skin disorders or concerns fully. [source] Treatment of Parthenium dermatitis with methotrexateCONTACT DERMATITIS, Issue 2 2007Vinod K. Sharma Patients with parthenium dermatitis are often unresponsive to topical steroids, and immunosuppressive agents may be necessary to reduce their need for systemic corticosteroids. We evaluated the efficacy of methotrexate in parthenium dermatitis. Sixteen patients unresponsive to topical treatment were included after baseline investigations, and treated with oral methotrexate (15 mg/week). Clinical response was monitored using a dermatitis area and severity index (DASI). Seven patients completed ,6 months' follow-up, and their mean DASI fell to 5, 2.7 and 2.1 at the end of 1, 3 and 6 months respectively, from a baseline score of 10. Only 3/7 patients required oral prednisolone in the initial 2,4 weeks. Side effects were minor, being mainly folliculitis and furuncles. Methotrexate may hence be a useful alternative for patients with severe parthenium dermatitis. [source] Photoallergic contact dermatitis from topical diclofenac in Solaraze® gelCONTACT DERMATITIS, Issue 6 2006L. Kowalzick Solaraze® gel (Shire Deutschland GmbH & Co. KG, Cologne, Germany) containing 3% diclofenac has been licensed in 2001 as a topical treatment for actinic keratoses. It is commonly used in dermatological practice. Undesirable effects are believed to be rare but include pruritus, paresthesia and application-site reactions (dry skin, rash, erythema, contact dermatitis and vesicobullous eruptions). Recently, a few cases of contact dermatitis due to three different allergens including diclofenac have been reported (1,2). [source] Positive lymphocyte transformation test in a patient with allergic contact dermatitis of the scalp after short-term use of topical minoxidil solutionCONTACT DERMATITIS, Issue 1 2005Tobias Hagemann Topical 2,4-diamino-6-piperidinopyrimidine-3-oxide (minoxidil) solution has been widely used for the treatment of androgenetic alopecia for over 15 years now and the substance is currently approved for this indication in 2% and 5% formulation. Typical side effects of this topical treatment include irritative dermatitis going along with pruritus, erythema, scaling and dryness, which occur especially at the onset of the therapy. In some cases, allergic contact dermatitis or exacerbation of seborrhoic dermatitis has been reported. While most of the patients with allergic contact dermatitis described in the literature showed a positive sensitization to the vehicle substance propylene glycol evaluated by patch testing, reactions to the active ingredient minoxidil are rare. Here, we report a case of allergic sensitization to minoxidil, which we evaluated and differentiated from an irritative reaction by a combination of patch testing and lymphocyte transformation test. The differentiation of allergic and irritative adverse effects and the identification of the causative allergen are of major relevance for the proceeding and adjustment of the therapy. Patients with sensitizations against propylene glycol are candidates for preparations with alternative solvents but can proceed treatment with minoxidil. In contrast, patients with allergies to the active ingredient itself are no longer candidates for treatment with minoxidil and should undergo alternative therapeutic options. [source] Pulp revascularization of replanted immature dog teeth after different treatment methodsDENTAL TRAUMATOLOGY, Issue 5 2000K. Yanpiset Abstract , The purpose of the present study was to determine the effect of topical treatment with doxycycline and/or the application of unfilled resin to the anatomical crown on the occurrence of revascularization in reimplanted dog teeth. Ninety-six teeth in 4 young mongrel dogs were used. Eighty one teeth were atraumatically extracted and divided into four groups. Group 1, 17 teeth were kept dry for 5 min and then replanted. Group 2, 21 teeth were soaked with a freshly prepared solution of doxycycline (1 mg/20 mL saline) for 5 min before replantation. Group 3, 23 teeth were soaked with the doxycycline solution for 5 min, and then replanted. The crowns were coated with 2 layers of light cured unfilled resin. Group 4, 20 teeth were kept dry for 5 min, and then replanted. The crowns were treated as with the teeth in Group 3. Three months after surgery, radiographic evaluation revealed that 27 teeth had continued root development and 32 teeth showed arrested root development with periradicular pathosis. The remaining 17 teeth, which had arrested root development but no signs of periradicular pathosis, were all histologically evaluated for final assessment. The occurrence of revascularization according to treatment group was 29.4%, 60%, 60%, 36.8% in Group 1, 2, 3, and 4, respectively. A multiple logistic regression analysis in SAS indicated there was no significant association between vitality and dog (P=0.7564). Soaking for 5 min in doxycycline significantly increased the revascularization rate (P=0.024) while the addition of resin to the crown did not result in an increased incidence of pulp revascularization (P=0.823). [source] Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination CreamDERMATOLOGIC SURGERY, Issue 6 2010SE-YEONG JEONG MD BACKGROUND Topical triple combination (TC) treatment is considered the primary approach to melasma. Recently, collimated low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment has attracted attention as an alternative approach. OBJECTIVES To compare the clinical efficacy and adverse effects of low-fluence Q-switched Nd:YAG laser when performed before and after treatment with topical TC using a split-face crossover design. METHODS Thirteen patients with melasma received topical treatment with TC cream or 1,064-nm Q-switched Nd:YAG laser treatment on opposite sides of the face for 8 weeks, and then treatments were reversed for 8 weeks. Responses were evaluated using the Melasma Area and Severity Index scoring system, spectrophotometry measurements, and a subjective self-assessment method. RESULTS After 16 weeks, better results were seen in subjective assessments when laser treatment was used after 8 weeks of topical TC treatment than before usage of TC. There were no significant adverse effects with the laser treatments. CONCLUSIONS Laser treatment after topical TC cream was found to be safer and more effective than the post-treatment use of topical agents. The authors have indicated no significant interest with commercial supporters. [source] Novel Approach to the Treatment of Hyperpigmented Photodamaged Skin: 4% Hydroquinone/0.3% Retinol versus Tretinoin 0.05% Emollient CreamDERMATOLOGIC SURGERY, Issue 2005Zoe Diana Draelos MD Background. Mild to moderately photodamaged skin is characterized by dyspigmentation, fine wrinkles, and tactile roughness. An optimal approach to the topical treatment of photoaging would simultaneously address all appearance issues. Objective. This study was undertaken to evaluate the effect of 4% hydroquinone and 0.3% retinol in photoaging. Materials and Methods. A 16-week study was designed to evaluate the efficacy and tolerance of a single cream containing prescription topical 4% hydroquinone for dyspigmentation and the cosmeceutical 0.3% retinol for fine wrinkles in an emollient vehicle for tactile roughness. This novel formulation was compared with 0.05% tretinoin emollient cream, the standard against which all other topical photoaging treatments are compared. Investigator assessments, subject assessments, and photography represented the evaluation end points. Results. The cosmeceutical emollient 4% hydroquinone/0.3% retinol cream more effectively diminished the collective signs of photodamage than 0.05% tretinoin emollient cream in terms of dyspigmentation, fine wrinkles, and tactile roughness in 16 weeks. Conclusion. Combination therapy of hydroquinone and retinol may improve photoaging-associated hyperpigmentation. THIS STUDY WAS CONDUCTED AS PART OF A RESEARCH GRANT FROM MEDICIS THE DERMATOLOGY COMPANY, PHOENIX, ARIZONA. DR. DRAELOS HAS NO FINANCIAL INTEREST IN ANY OF THE MEDICATIONS DISCUSSED IN THIS RESEARCH. [source] Development of fluridil, a topical suppressor of the androgen receptor in androgenetic alopeciaDRUG DEVELOPMENT RESEARCH, Issue 3 2003Allen L Seligson Abstract Nonsteroidal antiandrogens (AA) cannot be topically used for androgenetic alopecia (AGA) because of systemic resorption. A new class of androgen receptor (AR) suppressors designed for safe topical treatment of AGA was synthesized from (3-amino-2-hydroxy-2-methyl- N -(4-nitro-3-trifluoromethyl)phenyl) propanamide (BP-34), to contain perfluoroalkyl moieties. The trifluoromethyl derivative (fluridil) at 10 ,M decreased expression of the AR in LNCaP human cells by 95%, its serum half-life was 6 h; it decomposes hydrolytically to BP-34 and trifluoroacetic acid. Acute intraperitoneal maximum tolerated dose (MTD) of fluridil in mice is 270,300 mg/kg/d and the subacute MTD is 450 mg/kg/d. The oral LD50 in mice was 2,872 mg/kg in males, 2,232 mg/kg in females, and >2,500 mg/kg in rats. Fluridil solution in isopropanol was not cutaneously absorbed in rabbits, did not sensitize or show any phototoxic or photoallergic effects on guinea pig skin, and demonstrated no skin irritation potential in rabbits and humans. Fluridil solid induced only slight and reversible eye irritancy in rabbits and displayed no cytotoxicity to rabbit corneal fibroblasts in vitro. Fluridil demonstrated no significant mutagenicity potential by Ames method. In a double-blind study, 43 males with AGA, Norwood grade II to Va, used topical 2% fluridil in isopropanol or the vehicle daily for 12 months. Anagens (growing hairs) increased in the fluridil group from 76% to 89%. All hematological and biochemistry values remained within normal range, including testosterone, which varied but seasonally. No fluridil or its decomposition product (BP-34) was detected in serum. No adverse side effects were reported. Drug Dev. Res. 59:292,306, 2003. © 2003 Wiley-Liss, Inc. [source] Imaging studies of biodistribution and kinetics in drug developmentDRUG DEVELOPMENT RESEARCH, Issue 2 2003Marc S. Berridge Abstract Although the intravenous route of administration is rarely used for drugs, it is by far the most common route for PET and SPECT radiotracers. This article discusses the use of planar and tomographic nuclear medicine technologies to image and quantify the distribution of drugs after local administration. In principle, this would include topical dermatologic, otic, ophthalmic, rectal, and vaginal administration, as well as the intramuscular, oral, and inhalation routes, although precedents do not yet exist for all of these. The studies reviewed focus mainly on oral ingestion and oral and nasal inhalation. The use of nondrug tracers for formulations is discussed, principally with planar imaging or SPECT using radionuclides such as 99mTc, as well as PET imaging where the active ingredient of a formulation can be labeled with 11C or sometimes 18F. An example of the latter type is a study of the deposition and kinetics in the lungs and airways of triamcinolone acetonide, an antiinflammatory steroid used for topical treatment of allergic rhinitis and asthma, dispensed from an inhaler. PET has high potential for evaluation of different formulations and delivery devices in the development of topically applied drugs. Drug Dev. Res. 59:208,226, 2003. © 2003 Wiley-Liss, Inc. [source] Topical dose delivery in the reptilian egg treatment modelENVIRONMENTAL TOXICOLOGY & CHEMISTRY, Issue 5 2007Jennifer K. Muller Abstract Developing assays to detect endocrine-mediated toxicity from in ovo or in utero exposure is a current challenge in regulatory toxicology. Some species of reptiles exhibiting a unique mode of sex determination, in which the incubation temperature during a critical period determines gonadal sex, have been explored as an in ovo model to screen environmental contaminants for endocrine effects. We critically review published egg-exposure studies and conclude that data regarding the pharmacokinetics of topically applied substances are insufficient to validate dose,response relationships for the effects of chemicals on in ovo endocrine function or gender determination in reptiles. The insufficiencies in these data largely result from methodological failures, including lack of measurement verification, failure to investigate and control extraneous factors affecting the measurements, and lack of independent replication of results. Considerable additional research will be necessary to alleviate these methodological inadequacies. Given the current status of the data, topical treatment of reptilian eggs cannot be considered to be a valid means of establishing causal relationships between chemical treatment and biological outcome. [source] Inhibition of T-cell activation in vitro in human peripheral blood mononuclear cells by pimecrolimus and glucocorticosteroids and combinations thereofEXPERIMENTAL DERMATOLOGY, Issue 8 2007Anthony Winiski Abstract:, Pimecrolimus is an ascomycin macrolactam derivative that has been recently approved for the topical treatment of atopic dermatitis. In this study we report for the first time on a direct comparison of the inhibitory activity of pimecrolimus and the glucocorticosteroids betamethasone 17-valerate, dexamethasone and hydrocortisone at the level of T-cell proliferation and cytokine production. Stimulated human peripheral blood mononuclear cell (PBMC) systems were used that are either sensitive or resistant to calcineurin inhibitors or glucocorticosteroids. Pimecrolimus and the glucocorticosteroids inhibited dose-dependently T-cell proliferation and cytokine production in a sensitive system (anti-CD3 mAb-stimulated PBMC) with the following rank order of potency: pimecrolimus , betamethasone 17-valerate , dexamethasone > hydrocortisone. In resistant systems (anti-CD3 plus anti-CD28- or Staphylococcal enterotoxin B-stimulated PBMC), pimecrolimus or the glucocorticosteroids alone exerted either no effect, or only a partial inhibitory effect. However, combinations of pimecrolimus with a glucocorticosteroid synergistically and strongly inhibited T-cell proliferation. Taken together, the data indicate that medium potency glucocorticosteroids, such as betamethasone 17-valerate and dexamethasone, are as potent T-cell inhibitors as pimecrolimus. Furthermore, the experimental evidence suggests that combinations of glucocorticosteroids and pimecrolimus could be used clinically to achieve superior therapeutic efficacy, when monotherapy with the individual agents is unsatisfactory. [source] 17,-estradiol induces aromatase activity in intact human anagen hair follicles ex vivoEXPERIMENTAL DERMATOLOGY, Issue 4 2002R. Hoffmann Abstract: For topical treatment of androgenetic alopecia (AGA) in women, solutions containing either estradiol benzoate, estradiol valerate, 17,- or 17,-estradiol are commercially available in Europe and some studies show an increased anagen and decreased telogen rate after treatment as compared with placebo. At present it is not precisely known how estrogens mediate their beneficial effect on AGA-affected hair follicles. We have shown recently that 17,-estradiol is able to diminish the amount of dihydrotestosterone (DHT) formed by human hair follicles after incubation with testosterone, while increasing the concentration of weaker steroids such as estrogens. Because aromatase is involved in the conversion of testosterone to estrogens and because there is some clinical evidence that aromatase activity may be involved in the pathogenesis of AGA, we addressed the question whether aromatase is expressed in human hair follicles and whether 17,-estradiol is able to modify the aromatase activity. Herewith we were able to demonstrate that intact, microdissected hair follicles from female donors express considerably more aromatase activity than hair follicles from male donors. Using immunohistochemistry, we detected the aromatase mainly in the epithelial parts of the hair follicle and not in the dermal papilla. Furthermore, we show that in comparison to the controls, we noticed in 17,-estradiol-incubated (1 nM) female hair follicles a concentration- and time-dependent increase of aromatase activity (at 24 h: 1 nM = +18%, 100 nM = +25%, 1 µM = +57%; 24 h: 1 nM = +18%, 48 h: 1 nM = +25%). In conclusion, our ex vivo experiments suggest that under the influence of 17,-estradiol an increased conversion of testosterone to 17,-estradiol and androstendione to estrone takes place, which might explain the beneficial effects of estrogen treatment of AGA. [source] HORMONAL CONTROL OF THE VITELLOGENESIS IN THE JAPANESE OAK SILKWORM, ANTHERAEA YAMAMAZ (LEPIDOPTERA: SATURNIIDAE)INSECT SCIENCE, Issue 1 2002YE Gong-yin Abstract Effects of ecdysteroid and juvenile hormone (JH) on vitellogenesis of the Japanese oak silkworm, Antheraea yamami are reported in this article. After topical treatment with 20-hydroxyecdysone alone or JH analog (i.e. methoprene) alone and combined treatment with these two chemicals, vitellogenin (Vg) titers in the fat body and haemolymph at the pupal stage were mostly higher than those of the control, indicating that both ecdysteroid and JH exerted a promoting effect on the synthesis of Vg. In contrast, the Vg uptake was markedly inhibited by JH while stimulating effect of the ecdysteroid could be shown that vitellin (Vt) titer in the ovary was lower after methoprene treatments, but higher after 20-hydroxyecdyson treatments. Meanwhile, effects of these two hormones on Vg synthesis in the fat body were also tested with the incubation in vitro with Grace medium containing H-leucine and the hormones. The results demonstrated that Vg synthesis was stimulated after treating with methoprene alone or 20-hydroxyecdysone alone and combined treating with these two chemicals, and particularly ecdysteroid had more marked positive effect. To comprehensively concluded our results, it could be regarded that ecdysteroid play the main role in the regulation of vitellogenesis for the Japanese oak silkworm. [source] Efficacy of chemical and botanical over-the-counter pediculicides available in Brazil, and off-label treatments, against head lice ex vivoINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 3 2010André Asenov MD Background, There is a lack of reliable data on the efficacy of over-the-counter (OTC) pediculicides in Brazil. Methods, We performed ex vivo assays of eight marketed pediculicides: 1% permethrin (Kwell®, Clean Hair®, Keltrina®, Nedax®), 0.02% deltamethrin (Deltacid®, Pediderm®), and two "natural" products (Piolho e Lêndea®, Pilogenio®). We also tested 5% permethrin (Keltrina Plus®), traditional home remedies and an ivermectin-based product used in veterinary medicine. Head lice (49,52 per group) were immersed in the compound for 3 min and washed after 20 min to simulate the typical in vivo treatment protocol. Lice were examined for activity up to 24 h using stringent criteria for survival. Results, Of the permethrin containing products, highest mortality was observed with Kwell® and Clean Hair® (97.9 and 90.2% after 4 h). Keltrina®, Nedax®, Keltrina Plus®, and the two deltamethrin-based products showed only a low efficacy of <60% after 4 h. With exception of pure coconut oil (80% mortality after 4 h), home remedies showed a very low efficacy, and both marketed products killed few lice. The ivermectin-based product caused a mortality of 100% after 4 h. Conclusions, Most Brazilian OTC products did not show a satisfactory efficacy against head lice. Resistance may be present. Ivermectin and coconut oil are promising compounds for topical treatment. Laboratory-based tests should be used to assess resistance patterns and to identify formulations of the active ingredient that increase the efficacy. Standardized testing should be performed before a product is licensed for head lice treatment. [source] From basic research to the bedside: efficacy of topical treatment with pseudocatalase PC-KUS in 71 children with vitiligoINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2008Karin U. Schallreuter MD Background The epidermal accumulation of hydrogen peroxide (H2O2) has been documented in vitiligo. Aim To assess the effect on disease cessation and repigmentation of the reduction/removal of H2O2 using low-dose, narrow-band, ultraviolet-B (UV-B)-activated pseudocatalase PC-KUS in 71 children with vitiligo. Methods This uncontrolled and retrospective study included 45 girls and 26 boys (mean age, 10.3 years) who applied topical PC-KUS twice daily to the entire body surface without narrow-band UV-B dose increments. The affected body areas were documented by special photography at the first visit and after 8,12 months. The response was evaluated by two independent physicians as > 75% vs. < 75% total repigmentation of the face/neck, trunk, extremities, and hands/feet. Generalized (n = 61) and segmental (n = 10) vitiligo were evaluated as different entities. The effect of total-body, low-dose, narrow-band UV-B (0.15 mJ/cm2) monotherapy once daily without any increments and without application of PC-KUS was tested over 6 months in 10 children with vitiligo vulgaris (mean age, 8.4 years). Results One hundred per cent cessation was observed in 70 of the 71 children. More than 75% repigmentation was achieved in 66 of 71 patients on the face/neck, 48 of 61 on the trunk, and 40 of 55 on the extremities; however, repigmentation on the hands/feet was disappointing (five of 53). The response was independent of skin color, age of onset, duration of disease, other demographic features, and previous treatments. The follow-up after narrow-band UV-B monotherapy showed no significant repigmentation in all areas. Seven of 10 patients showed progression of their vitiligo. Conclusion A reduction in epidermal H2O2 using low-dose, narrow-band UV-B-activated pseudocatalase PC-KUS is an effective treatment for childhood vitiligo which can be safely performed at home. [source] Effectiveness of kukui nut oil as a topical treatment for psoriasisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 8 2005Amy C. Brown PhD Background, No cure for psoriasis exists for the 1,3% of the American population who suffer from it; however, anecdotal reports from patients with psoriasis visiting Hawaii who purchased kukui nut oil, claim it helped reduce the severity of their lesions. Objective, This pilot study was a double-blind, placebo-controlled clinical trial to determine the effectiveness of kukui nut oil as a topical treatment for psoriasis. Methods, Thirty adult subjects (18,78 year) were recruited from the community for a 12-week randomized, double-blind, placebo-controlled pilot study. Subjects were previously diagnosed with mild, stable plaque psoriasis (less than 15% of total body surface area [TBSA]) and agreed to abstain from other treatments during the course of the study. Following a 4-week washout period the subjects were randomized into a treatment group (15 subjects applying kukui nut oil) or a control group (15 applying the mineral oil placebo). Patients were seen every 2 weeks (seven visits at 0, 2, 4, 6, 8, 10, and 12 weeks) by a dermatological nurse practitioner under the general supervision of a board certified dermatologist. Measurable outcomes included evaluation of one targeted lesion and of the overall severity of their psoriasis using clinical evaluation, Psoriasis Area and Sensitivity Index (PASI), Global Severity of Psoriasis Scale, and photographs. Each patient also evaluated their own lesions daily using the Global Severity of Psoriasis Scale, and noted any side-effects or other treatments used. Results, Although both groups improved, we found no significant difference between the treatment (kukui nut oil) and the placebo (mineral oil) among the 24 out of 30 subjects (80%) who completed the study. No side-effects or adverse events were reported. Conclusion, Kukui nut oil did not significantly reduce symptoms of psoriasis; however, this was a small pilot study, and the use of this oil cannot be dismissed without using a larger study population of patients with psoriasis. [source] | |||||||||||||||||||||||||||||||||||||