RESUMO
El ácido retinoico tópico es eficaz para el tratamiento del fotoenvejecimiento. Sin embargo la irritación cutánea secundaria a su uso es un factor limitante del tratamiento. El retinaldehído es un precursor inmediato del ácido retinoico que posee actividad biológica en la piel, con menos efectos secundarios. Objetivo: comparar la eficacia y tolerancia del retinaldehido y el ácido retinoico tópicos en el tratamiento del fotoenvejecimiento, mediante perfil profilométrico y análisis clínico - fotográfico y determinar los efectos secundarios de estos medicamentos. Métodos: se incluyeron 126 mujeres colombianas (35 a 60 años), quienes no habían recibido tratamientos previos, no estaban embarazadas, ni lactando. En total 119 pacientes completaron las 24 semanas de seguimiento: a 61 pacientes se les aplicó retinaldehído y a 58, ácido retinoico. Se realizó un seguimiento clínico (que evaluó mejoría y tolerancia), en las semanas 4, 8, 16 y 20, y además se realizó profilometría del área de la pata de gallina y seguimiento fotográfico al ingreso y en la semana 24.
Topical retinoic acid has been effectively used to treat photo aging; nevertheless, cutaneous irritation as a side effect is a limiting factor for treatment. Retinaldehyde is an immediate precursor of retinoic acid that has biologic activity in the skin, with few side effects. The objective of this investigation was to compare efficacy and tolerability of topical retinoic acid and retinaldehyde in the treatment of photo aging, by means of profilometry and clinical-photographic analysis and to determine side effects from both medications. Methods: were included 160 colombian women (aged 35 to 60 years), who hadn't had previous treatments and weren't pregnant or breast feeding. A total of 119 patients completed 24 weeks of treatment. Of these, 61 used retinaldehyde and 58 retinoic acid. Clinical evaluation was carried out on weeks 4, 8, 16 and 20, and profilometry of the crow's feet area was done at the beginning and at week 24.
Assuntos
Humanos , Retinaldeído/efeitos adversos , Retinaldeído/história , Retinaldeído , Envelhecimento da Pele , Tretinoína , Tretinoína/efeitos adversos , TretinoínaRESUMO
Diabetic macular edema (DME) is the leading cause of visual loss in diabetic patients and is characterized by accumulation of extracellular fluid in the retina. The most important mechanism involved is breakdown of the blood-retinal barrier (BRB), which is likely to be due to changes of tight junction proteins, including occludin and the zonula occludens proteins. Hyperglycemia and retinal ischemia stimulate the synthesis and secretion of vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6). Both the aqueous humor and vitreous fluid levels of VEGF and IL-6 are significantly elevated in patients who have DME when compared with non-diabetic patients. Vascular permeability factors, including VEGF and IL-6, may act directly on endothelial cell tight junctions to decrease their protein content or increase phosphorylation. Either or both of these changes may lead to increased paracellular permeability. The specific molecules that are allowed to move through intercellular junctions may depend on the particular vascular permeability factor involved, as well as its concentration, duration of action, and interaction with other factors. Defining the molecular mechanisms of DME will be critical for the development of specific therapy.
