RESUMEN
Adult acne vulgaris affects up to 43-51% of individuals. While there are numerous treatment options for acne including topical, oral, and energy-based approaches, benzoyl peroxide (BPO) is a popular over the counter (OTC) treatment. Although BPO monotherapy has a long history of efficacy and safety, it suffers from several disadvantages, most notably, skin irritation, particularly for treatment naïve patients. In this prospective, randomized, controlled, split-face study, we evaluated the comparative efficacy, safety, and tolerability of a novel 3-step azelaic acid, salicylic acid, and graduated retinol regimen versus a common OTC BPO-based regimen over 12 weeks. A total of 37 adult subjects with self-reported mild to moderate acne vulgaris were recruited. A total of 21 subjects underwent a 2-week washout period and completed the full study with 3 dropping out due to product irritation from the BPO routine, and 13 being lost to follow-up. Detailed tolerability surveys were conducted at Week 4. Additional surveys on tolerability and product preferences were collected monthly, at Week 4, Week 8, and Week 12. A blinded board-certified dermatologist objectively scored the presence and type of acne lesions (open or closed comedones, papules, pustules, nodules, and cysts) at baseline, Week 4, Week 8, and Week 12. Patients photographed themselves and uploaded the images using personal mobile phones. Detailed Week 4 survey results showed across 25 domains of user-assessed product performance, the novel routine outperformed the BPO routine in 19 (76%) which included domains in preference (e.g. "I would use this in the future) and performance ("my skin improved" and "helped my acne clear up faster"). Users of the novel routine reported less facial redness, itching, and burning, though differences did not reach statistical significance. In terms of efficacy, both products performed similarly, reducing total acne lesions by 36% (novel routine) and 40% (BPO routine) by Week 12. Overall, accounting for user preferences and tolerability the novel routine was more preferred than the BPO routine in 79% of domains (22/28). Differences in objective acne lesion reduction were not statistically significant (p = 0.97). In a randomized split-face study, a 3-step azelaic acid, salicylic acid, and graduated retinol regimen delivered similar acne lesion reduction, fewer user dropouts, greater user tolerability, and higher use preference compared to a 3-step BPO routine based in a cohort of participants with mild-to-moderate acne vulgaris.
Asunto(s)
Acné Vulgar , Peróxido de Benzoílo , Fármacos Dermatológicos , Ácidos Dicarboxílicos , Ácido Salicílico , Humanos , Acné Vulgar/tratamiento farmacológico , Peróxido de Benzoílo/administración & dosificación , Peróxido de Benzoílo/efectos adversos , Peróxido de Benzoílo/uso terapéutico , Adulto , Masculino , Femenino , Ácido Salicílico/administración & dosificación , Ácido Salicílico/efectos adversos , Ácido Salicílico/uso terapéutico , Estudios Prospectivos , Adulto Joven , Resultado del Tratamiento , Método Doble Ciego , Ácidos Dicarboxílicos/efectos adversos , Ácidos Dicarboxílicos/administración & dosificación , Ácidos Dicarboxílicos/uso terapéutico , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Vitamina A/administración & dosificación , Vitamina A/efectos adversos , Vitamina A/uso terapéutico , Administración Cutánea , Adolescente , Índice de Severidad de la Enfermedad , Medicamentos sin Prescripción/administración & dosificación , Medicamentos sin Prescripción/efectos adversos , Medicamentos sin Prescripción/uso terapéutico , Quimioterapia Combinada/métodosRESUMEN
To develop a peri-implantitis model in a Gottingen minipig and evaluate the effect of local application of salicylic acid poly(anhydride-ester) (SAPAE) on peri-implantitis progression in healthy, metabolic syndrome (MS), and type-2 diabetes mellitus (T2DM) subjects. Eighteen animals were allocated to three groups: (i) control, (ii) MS (diet for obesity induction), and (iii) T2DM (diet plus streptozotocin for T2DM induction). Maxillary and mandible premolars and first molar were extracted. After 3 months of healing, four implants per side were placed in both jaws of each animal. After 2 months, peri-implantitis was induced by plaque formation using silk ligatures. SAPAE polymer was mixed with mineral oil (3.75 mg/µL) and topically applied biweekly for up to 60 days to halt peri-implantitis progression. Periodontal probing was used to assess pocket depth over time, followed by histomorphologic analysis of harvested samples. The adopted protocol resulted in the onset of peri-implantitis, with healthy minipigs taking twice as long to reach the same level of probing depth relative to MS and T2DM subjects (â¼3.0 mm), irrespective of jaw. In a qualitative analysis, SAPAE therapy revealed decreased levels of inflammation in the normoglycemic, MS, and T2DM groups. SAPAE application around implants significantly reduced the progression of peri-implantitis after â¼15 days of therapy, with â¼30% lower probing depth for all systemic conditions and similar rates of probing depth increase per week between the control and SAPAE groups. MS and T2DM conditions presented a faster progression of the peri-implant pocket depth. SAPAE treatment reduced peri-implantitis progression in healthy, MS, and T2DM groups.
Asunto(s)
Periimplantitis , Ácido Salicílico , Porcinos Enanos , Animales , Porcinos , Periimplantitis/tratamiento farmacológico , Periimplantitis/patología , Ácido Salicílico/administración & dosificación , Ácido Salicílico/farmacología , Ácido Salicílico/uso terapéutico , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Hiperglucemia/tratamiento farmacológico , Masculino , Diabetes Mellitus Experimental/tratamiento farmacológico , Síndrome Metabólico/tratamiento farmacológico , Síndrome Metabólico/metabolismo , Implantes DentalesRESUMEN
OBJECTIVE: Salicylic acid (SA) has been used for treatment of acne of different severity levels. However, there are few researches about the safety and efficacy for treatment of mild to moderate acne, and the improvement of the skin condition by using 2% supramolecular salicylic acid (SSA) compared to Davuwen Adapaline gel. METHODS: A multicenter, randomized, assessor-blind and parallel-controlled study was conducted. A total of 500 patients (trial group: 249, control group: 251) with mild to moderate (grade I-II) facial acne vulgaris were recruited in this study over a 16-week trial period. Patients in the trial group were treated with Broda 2% SSA hydrogel, while control group treated with Davuwen Adapaline gel once a day. The number of inflammatory papules, comedones, and pustules were counted and the rate of lesion reduction was calculated pre- and post-treatment. Then, the skin physiological indicators, including L*a*b*, TEWL, skin sebum and hydration were measured. Statistical analysis was conducted using SAS 9.4. Significance was set at p = 0.05. RESULTS: At the end of 12 weeks' therapy, the regression and markedly improvement rate of the trail group and the control group were 51.01% and 43.10% respectively, and there was no significant difference in the improvement rate between two groups (p = 0.0831). Although, there was no difference in adverse events rate between two groups, the adverse events rate of the trail group was 0.40%, a little lower than the control group (0.80%). Moreover, there was a significant difference in the numbers of pores at T1 between two groups. CONCLUSION: Both 2% SSA and Adapaline gel were equally effective in the treatment of mild to moderate acne vulgaris. 2% SSA is worth the clinical promotion and application in mild to moderate acne vulgaris.
Asunto(s)
Acné Vulgar , Geles , Hidrogeles , Ácido Salicílico , Índice de Severidad de la Enfermedad , Humanos , Acné Vulgar/tratamiento farmacológico , Femenino , Masculino , Ácido Salicílico/administración & dosificación , Ácido Salicílico/efectos adversos , Ácido Salicílico/uso terapéutico , Adulto Joven , Adolescente , Adulto , Método Simple Ciego , Hidrogeles/administración & dosificación , Resultado del Tratamiento , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Administración Cutánea , Adapaleno/administración & dosificación , Adapaleno/efectos adversosAsunto(s)
Ácido Salicílico , Envejecimiento de la Piel , Ácido Tricloroacético , Humanos , Ácido Tricloroacético/administración & dosificación , Ácido Tricloroacético/uso terapéutico , Ácido Salicílico/administración & dosificación , Ácido Salicílico/uso terapéutico , Envejecimiento de la Piel/efectos de los fármacos , Combinación de Medicamentos , Femenino , Persona de Mediana Edad , Cara , Cáusticos/administración & dosificación , Anciano , Masculino , Piel/patología , Piel/efectos de los fármacos , Etanol , Resorcinoles , Salicilatos , Ácido LácticoRESUMEN
BACKGROUND: Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older. OBJECTIVE: The objective of this study was to provide evidence-based recommendations for the management of acne. METHODS: A work group conducted a systematic review and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of evidence and formulating and grading recommendations. RESULTS: This guideline presents 18 evidence-based recommendations and 5 good practice statements. Strong recommendations are made for benzoyl peroxide, topical retinoids, topical antibiotics, and oral doxycycline. Oral isotretinoin is strongly recommended for acne that is severe, causing psychosocial burden or scarring, or failing standard oral or topical therapy. Conditional recommendations are made for topical clascoterone, salicylic acid, and azelaic acid, as well as for oral minocycline, sarecycline, combined oral contraceptive pills, and spironolactone. Combining topical therapies with multiple mechanisms of action, limiting systemic antibiotic use, combining systemic antibiotics with topical therapies, and adding intralesional corticosteroid injections for larger acne lesions are recommended as good practice statements. LIMITATIONS: Analysis is based on the best available evidence at the time of the systematic review. CONCLUSIONS: These guidelines provide evidence-based recommendations for the management of acne vulgaris.
Asunto(s)
Acné Vulgar , Antibacterianos , Peróxido de Benzoílo , Fármacos Dermatológicos , Ácidos Dicarboxílicos , Doxiciclina , Isotretinoína , Ácido Salicílico , Espironolactona , Humanos , Acné Vulgar/tratamiento farmacológico , Isotretinoína/administración & dosificación , Isotretinoína/uso terapéutico , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/uso terapéutico , Peróxido de Benzoílo/administración & dosificación , Peróxido de Benzoílo/uso terapéutico , Ácidos Dicarboxílicos/administración & dosificación , Ácidos Dicarboxílicos/uso terapéutico , Espironolactona/administración & dosificación , Espironolactona/uso terapéutico , Doxiciclina/administración & dosificación , Doxiciclina/uso terapéutico , Ácido Salicílico/administración & dosificación , Ácido Salicílico/uso terapéutico , Medicina Basada en la Evidencia/normas , Administración Oral , Retinoides/administración & dosificación , Retinoides/uso terapéutico , Tetraciclinas/administración & dosificación , Tetraciclinas/uso terapéutico , Adolescente , Minociclina/administración & dosificación , Minociclina/uso terapéutico , Niño , Administración Cutánea , Anticonceptivos Orales Combinados/administración & dosificación , Anticonceptivos Orales Combinados/uso terapéutico , Quimioterapia Combinada , Femenino , Corticoesteroides/administración & dosificación , Corticoesteroides/uso terapéutico , Inyecciones Intralesiones , Adulto , Cortodoxona/análogos & derivados , PropionatosRESUMEN
BACKGROUND: Plantar warts are common infectious cutaneous growths causing severe physiological and psychological discomforts in patients and heaving global financial burdens. However, paucity of clear-cut guidelines for plantar warts, selecting appropriate treatments for plantar warts remains challenging. The objective of the study is to evaluate the efficacy and safety of common treatments for plantar warts. METHODS: PubMed, EMbase, and The Cochrane Library were searched from inception to March 1, 2023 for randomized controlled trials (RCTs) of plantar warts. The primary outcome (complete response) and secondary outcome (recurrence and pain) were extracted and combined using Bayesian network meta-analysis (NMA) with random-effect and fixed-effect models. RESULTS: Totally, 33 RCTs were included in the systematic review and quantitative NMA. In NMA of complete response, topical application of 1% cantharidin, 20% podophylotoxin, 30% salicylic acid (CPS), microneedles plus bleomycin (MNB), and intralesional bleomycin injection (INB) were the only three treatments significantly superior to no treatment (NT) and CPS was of the highest possibility to be the top-ranked treatment (SUCRA = 0.9363). However, traditional warts treatments, salicylic acid (SA) and cryotherapy were not superior to NT. CONCLUSIONS: The NMA has produced evidence for using CPS, MNB, and INB, which are all topical antimitotic treatments, to improve the management of plantar warts. The classic treatment modalities for plantar warts, including SA and cryotherapy, may play a less important role in the clinical practice of plantar warts.
Asunto(s)
Teorema de Bayes , Metaanálisis en Red , Ensayos Clínicos Controlados Aleatorios como Asunto , Verrugas , Humanos , Verrugas/tratamiento farmacológico , Antimitóticos/uso terapéutico , Antimitóticos/administración & dosificación , Ácido Salicílico/uso terapéutico , Ácido Salicílico/administración & dosificación , Bleomicina/administración & dosificación , Bleomicina/uso terapéutico , Podofilotoxina/uso terapéutico , Podofilotoxina/administración & dosificación , Cantaridina/uso terapéutico , Cantaridina/administración & dosificación , Administración TópicaRESUMEN
Antibiotics have constituted the mainstay of acne therapy despite acne being classified as an inflammatory disorder. The indiscriminate usage of antibiotics over the years has thus fueled the issue of antimicrobial resistance. Cutibacterium acnes (C. acnes) can acquire resistance due to chromosomal mutation or genetic acquisition. C. acnes can transfer resistance to other resident flora, complicating the management of skin and soft tissue infections. It can also transfer resistant strains to other body sites and to immunocompromised and elderly patients thus putting them at risk of serious infections. Recent studies have highlighted the physiologic role of C. acnes in maintaining the normal homeostasis of the skin microbiome. The role of Malassezia in causation of acne has piqued interest in recent times. The efficacy of antibiotics in acne is attributed to their para-antibiotic, anti-inflammatory action rather than antimicrobial action. Thus, usage of low-dose antibiotics and alternatives to antibiotics has been advocated. Some alternative therapies showing efficacy in acne are probiotics, oral zinc, precision therapy using succinic acid, bacteriophages, and anti-biofilm therapy like myrtacin, topical azelaic acid, and salicylic acid. Using isotretinoin in early stages of acne can reduce the incidence of scarring and alleviate the need for antibiotics. Thus, a gradual shift from antibiotics to alternative therapies in acne is the need of the hour.
Asunto(s)
Acné Vulgar , Antibacterianos , Humanos , Anciano , Antibacterianos/uso terapéutico , Acné Vulgar/tratamiento farmacológico , Acné Vulgar/microbiología , Isotretinoína/uso terapéutico , Piel , Ácido Salicílico/uso terapéutico , Propionibacterium acnesRESUMEN
INTRODUCTION: Acne vulgaris (acne) is characterized by both inflammatory and non-inflammatory lesions. Benzoyl peroxide (BPO) 5% is approved to treat acne but may cause skin irritation and/or contact allergy. OBJECTIVES: To compare the benefit in acne of a multitargeted dermocosmetic cream containing salicylic acid, lipohydroxy acid, niacinamide, 2-oleamido-1,3-octadecanediol, piroctone olamine, zinc, Aqua posae filiformis, and thermal spring water (DC-Eff) to BPO 5% gel. MATERIALS AND METHODS: 150 Caucasian subjects (50% female) aged between 18 and 40 years, with mild to moderate acne according to the GEA (Global Evaluation of Acne) grading system were randomized into two parallel groups (DC-Eff or BPO to be applied twice daily for 56 days). IGA (investigator global assessment), GEA, lesion count, clinical signs and symptoms, and subject assessment were evaluated at baseline, and after 28 and 56 days (D28 and D56) of treatment. RESULTS: The responder analyses of the IGA and GEA scores showed that 62.2% and 47.3%, respectively, in the DC-Eff, compared with 50.0% and 36.5%, respectively, in the BPO, had improved by at least one point at D56. Inflammatory, non-inflammatory, and total lesion counts significantly (p < 0.0001) decreased with both products from baseline, with no between-group difference. Subjects considered that their skin was smoother and that DC-Eff was easy to apply. DC-Eff was better tolerated than BPO. CONCLUSIONS: DC-Eff applied twice daily is as beneficial as BPO in improving mild-to-moderate acne. DC-Eff was better tolerated than BPO and highly appreciated.
Asunto(s)
Acné Vulgar , Fármacos Dermatológicos , Femenino , Humanos , Masculino , Acné Vulgar/tratamiento farmacológico , Acné Vulgar/patología , Peróxido de Benzoílo/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Combinación de Medicamentos , Geles , Ácido Salicílico/uso terapéutico , Resultado del Tratamiento , Adolescente , Adulto Joven , AdultoRESUMEN
BACKGROUND: Plantar warts, or verruca plantaris, are common cutaneous lesions of the plantar surface caused by the human papilloma virus (HPV) infection. Current treatments include salicylic acid, cryotherapy, bleomycin, and immunotherapy; however, they have limitations of low-cure rates or side effects. Plantar warts treated with bee venom (BV) have not been reported. Here we present a case of a patient who showed complete remission of multiple plantar warts after BV treatment. CASE PRESENTATION: A 13-year-old boy experienced total of 16 plantar warts and visited department of dermatology of Korean Medicine. BV was injected into wart sites. Warts were completely removed at the end of the 8-week treatment with no adverse event recorded. There was improvement during the follow-up after 4 weeks. CONCLUSION: This is the first case of plantar warts that improved with BV injection. This study suggests that BV may be a therapeutic option for individuals who cannot receive cryotherapy due to pain during and after treatment or who have refractory or relapsed warts.
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Verrugas , Masculino , Humanos , Adolescente , Resultado del Tratamiento , Verrugas/tratamiento farmacológico , Ácido Salicílico/uso terapéutico , Crioterapia , Respuesta Patológica CompletaRESUMEN
BACKGROUND: A dermocosmetic (DC) containing salicylic acid, niacinamide, and thermal spring water has been developed for the management of mild to moderate acne. AIM: To assess the efficacy of DC as an adjunct to benzoyl peroxide (BPO) every other day compared with BPO over 3 months, and its efficacy as maintenance post-BPO care compared with vehicle for another 3 months. METHODS: Single-center, randomized, double-blind study in 100 patients with mild to moderate facial acne according to the Global Acne Severity (GEA) Scale. During phase 1, subjects received either BPO + vehicle (vehicle group) or BPO + DC (DC group) for 12 weeks. During phase 2, patients were re-randomized to receive either the vehicle or the DC for 12 weeks. Assessments included inflammatory and non-inflammatory lesion count, acne severity using the GEA Scale, local tolerance, quality of life, and quantity of product used. RESULTS: During phase 1, both groups, DC and vehicle, reached the same level of efficacy at month 3, although the quantity of BPO used was significantly reduced in the DC group (P=0.0001). During phase 2, acne continued to significantly improve (all P<0.05) in the DC group, as did clinical signs and symptoms; while patients randomized to vehicle reported relapses of their acne and related symptoms. CONCLUSION: The use of DC significantly reduces the need for BPO with no impact on the efficacy of mild to moderate acne. The use of DC as a maintenance post-BPO allowed a significant reduction of acne relapse compared with vehicle after 3 months of follow-up, with a good tolerance. J Drugs Dermatol. 2023;22(12):1172-1177. doi:10.36849/JDD.7449R1.
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Acné Vulgar , Fármacos Dermatológicos , Humanos , Acné Vulgar/diagnóstico , Acné Vulgar/tratamiento farmacológico , Adapaleno , Peróxido de Benzoílo/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Combinación de Medicamentos , Calidad de Vida , Ácido Salicílico/uso terapéutico , Resultado del Tratamiento , Método Doble CiegoRESUMEN
Keratosis pilaris (KP) is a chronic disorder of follicular hyperkeratinization and perifollicular erythema with lesions affecting the extensor surfaces of arms, upper legs, and buttocks. While there is some evidence that laser therapies and topical therapies such as lactic acid reduce the follicular papules of KP, support is limited with respect to which topical treatments dermatologists utilize and their perception of efficacy. A 16-question survey was distributed to a random sampling of the ODAC Conference listserv to determine which topical treatments dermatologists utilize the most, the duration of therapy needed with various treatment modalities, and the effectiveness of topical and laser therapy for treating KP. Our study found topical lactic acid is the most used first-line therapy for KP (43.63% of survey respondents), followed by salicylic acid (20.72%). Laser therapy is only utilized by 8.76% of survey respondents, with a lack of insurance coverage and proper equipment limiting its use. KP is often recalcitrant to treatment, and our study demonstrated that over 60% of respondents found recurrence of KP lesions within three months of stopping salicylic acid treatment and OTC moisturizer treatment. The data herein can be used to better utilize the selection of topical and laser therapies for the treatment of KP. J Drugs Dermatol. 2023;22(10):985-989 doi:10.36849/JDD.7534.
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Enfermedad de Darier , Dermatólogos , Humanos , Enfermedad de Darier/diagnóstico , Enfermedad de Darier/terapia , Enfermedad de Darier/patología , Ácido Salicílico/uso terapéutico , Ácido LácticoRESUMEN
BACKGROUND: Psoriasis is a chronic immune-mediated dermatologic disorder with multisystemic comorbidities, which is effectively treated with a range of prescription therapies. Studies have reported epidermal barrier abnormalities in the lesional skin of psoriasis patients; however, there is currently insufficient information about skin barrier function in psoriasis patients. This review discusses the potential role of gentle cleansers and moisturizers in the management of psoriasis and in promoting a healthy skin barrier. METHODS: A literature review was followed by the authors' discussions and agreement on 5 statements to provide expert guidance for gentle cleansers and moisturizer use in psoriasis patients. RESULTS: In a workshop, the authors provided feedback on 15 draft statements created prior to the meeting, and agreed upon 5 statements. The authors agreed that guidelines rarely mention skincare for psoriasis patients, demonstrating a potential knowledge gap. Skincare may play a role in managing psoriasis as an adjuvant treatment of acute psoriasis and for maintenance treatment of healing skin during asymptomatic periods. Studies of patients with psoriasis applying topical moisturizers (such as those containing salicylic acid or ceramides) showed softened plaques, enhancing the absorption of topical treatments such as corticosteroids. Studies applying ceramide-containing skincare showed an overall improvement in the appearance of the skin and provided relief for psoriasis. CONCLUSION: The authors agreed that skincare and barrier restoration in treating psoriasis is a relatively new concept for most dermatologists. There is a need to develop a more robust body of evidence on skincare for psoriasis to influence clinical practice in a meaningful way. Kircik L, Alexis AF, Andriessen A, et al. Psoriasis and skin barrier dysfunction: the role of gentle cleansers and moisturizers in treating psoriasis. J Drugs Dermatol. 2023;22(8):773-778. doi:10.36849/JDD.7411.
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Psoriasis , Enfermedades de la Piel , Humanos , Psoriasis/diagnóstico , Psoriasis/tratamiento farmacológico , Piel , Cuidados de la Piel , Ácido Salicílico/uso terapéuticoRESUMEN
BACKGROUND: Salicylic acid has been used as an anti-acne agent with its comedolytic property and antimicrobial activity. However, there is a limit to use for leave-on cosmetics because of the transient skin irritation and low efficacy at neutral pH condition. We prepared a salicylic acid-based ionic pair with L -carnitine (we named, IP-BHA) overcoming the limitation of salicylic acid. We examined the effect of IP-BHA as well as the combination effect with magnolol, a bioactive organic lignan, in order to clarify their efficacy as anti-acne agents. METHODS: After verifying the structure of IP-BHA, we confirmed anti-acne activities including the regulation of exfoliation, lipogenesis, bacterial growth, and inflammation with IP-BHA and/or magnolol. RESULTS: The antibacterial activity of IP-BHA and magnolol was evaluated by determining the minimum antibacterial inhibitory concentration. Magnolol showed strong activity against Cutibacterium acnes, which was better than a medical antibiotic acne drug, clindamycin. The combined application with IP-BHA was more effective in antibacterial activity by 2.5 times. It was confirmed that testosterone-induced lipogenesis was significantly inhibited by treatment with IP-BHA and magnolol, while single treatment had no significant inhibitory effect. Interestingly, MMP-1 and VEGF were induced by C. acnes lysate in human keratinocytes. We found that these inflammatory molecules were completely inhibited by combined application of IP-BHA and magnolol. Through ex vivo test, the dose-dependent exfoliation effect of IP-BHA was confirmed at pH 5.5, and the synergic exfoliation effect was shown in the combined application of IP-BHA and magnolol. When topically applied, the emulsion containing IP-BHA and magnolol relieved the sodium dodecyl sulfate-induced erythema and improved inflamed acne with papule and pustule. CONCLUSION: Our data demonstrate that the ionic paired salicylic acid with L -carnitine can overcome the limitations of salicylic acid at low concentration and natural skin pH. Based on the dual administration effects, we suggest that IP-BHA and magnolol may be the potential agent for acne by improving inflammatory skin condition.
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Acné Vulgar , Lignanos , Humanos , Carnitina/uso terapéutico , Lipogénesis , Acné Vulgar/tratamiento farmacológico , Lignanos/farmacología , Lignanos/uso terapéutico , Ácido Salicílico/uso terapéutico , Antibacterianos/farmacología , InflamaciónRESUMEN
BACKGROUND: Photodynamic therapy (PDT) is approved for treatment of actinic keratoses (AKs) and field-cancerisation. Pretreatment with pharmacological compounds holds potential to improve PDT efficacy, through direct interaction with PpIX formation or through an independent response, both of which may improve PDT treatment. OBJECTIVE: To present the currently available clinical evidence of pharmacological pretreatments prior to PDT and to associate potential clinical benefits with the pharmacological mechanisms of action of the individual compounds. METHODS: A comprehensive search on the Embase, MEDLINE, and Web of Science databases was performed. RESULTS: In total, 16 studies investigated 6 pretreatment compounds: 5-fluorouracil (5-FU), diclofenac, retinoids, salicylic acid, urea, and vitamin D. Two of these, 5-FU and vitamin D, robustly increased the efficacy of PDT across multiple studies, illustrated by mean increases in clearance rates of 21.88% and 12.4%, respectively. Regarding their mechanisms, 5-FU and vitamin D both increased PpIX accumulation, while 5-FU also induced a separate anticarcinogenic response. Pretreatment with diclofenac for four weeks improved the clearance rate in one study (24.9%), administration of retinoids had a significant effect in one of two studies (16.25%), while salicylic acid and urea did not lead to improved PDT efficacy. Diclofenac and retinoids demonstrated independent cytotoxic responses, whereas salicylic acid and urea acted as penetration enhancers to increase PpIX formation. CONCLUSION: 5-FU and vitamin D are well-tested, promising candidates for pharmacological pretreatment prior to PDT. Both compounds affect the haem biosynthesis, providing a target for potential pretreatment candidates. KEY WORDS: Photodynamic Therapy, Actinic Keratosis,Pre-tretment,Review,enhancement.
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Queratosis Actínica , Fotoquimioterapia , Humanos , Queratosis Actínica/tratamiento farmacológico , Fármacos Fotosensibilizantes/uso terapéutico , Ácido Aminolevulínico/uso terapéutico , Fotoquimioterapia/métodos , Diclofenaco/uso terapéutico , Ácido Salicílico/uso terapéutico , Fluorouracilo/uso terapéutico , Retinoides/uso terapéutico , Vitamina D/uso terapéutico , Urea/uso terapéutico , Resultado del TratamientoRESUMEN
PURPOSE: This study evaluated the association among the plasma concentration of ticagrelor, ARC124910XX, aspirin, and salicylic acid with the risk of recent bleeding in patients with the acute coronary syndrome. To this end, we developed an accurate model to predict bleeding. METHODS: A total of 84 patients included in this study cohort between May 2021 and November 2021. The risk factors were identified by univariate and multivariate analyses, and statistically significant risk factors identified in the multivariate analysis were included in the nomogram. We used the calibration curve and the receiver operating characteristic curve to verify the accuracy of the prediction model. RESULTS: Multivariable logistic analysis showed that ticagrelor concentration (odds ratio [OR]: 2.47, 95% confidence interval [CI], 1.51-4.75, P = 0.002), ST-segment elevation acute myocardial infarction (OR: 32.2, 95% CI, 2.37-780, P = 0.016), and lipid-lowering drugs (OR: 11.52, 95% CI, 1.91-110, P = 0.015) were positively correlated with bleeding. However, angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker (OR: 0.04, 95% CI, 0.004-0.213, P < 0.001) was negatively correlated with bleeding. The receiver operating characteristic curve analysis showed that ticagrelor concentration and these factors together predict the occurrence of bleeding (area under receiver operating characteristic curve = 0.945, 95% CI, 0.896-0.994) and that ticagrelor concentration >694.90 ng/mL is the threshold of bleeding concentration (area under receiver operating characteristic curve = 0.696, 95% CI, 0.558-0.834). CONCLUSION: In patients with acute coronary syndrome treated with dual antiplatelet therapy, ticagrelor concentration >694.90 ng/mL was an independent risk factor for bleeding (OR: 2.47, 95% CI, 1.51-4.75, P = 0.002), but ARC124910XX and salicylic acid concentration did not affect bleeding risk ( P > 0.05).
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Síndrome Coronario Agudo , Intervención Coronaria Percutánea , Infarto del Miocardio con Elevación del ST , Humanos , Ticagrelor/efectos adversos , Aspirina , Inhibidores de Agregación Plaquetaria , Síndrome Coronario Agudo/diagnóstico , Síndrome Coronario Agudo/tratamiento farmacológico , Pueblos del Este de Asia , Hemorragia/inducido químicamente , Hemorragia/epidemiología , Hemorragia/tratamiento farmacológico , Infarto del Miocardio con Elevación del ST/tratamiento farmacológico , Ácido Salicílico/uso terapéutico , Intervención Coronaria Percutánea/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: Lupus anticoagulant (LA) may be a cause of poor obstetric outcome. OBJECTIVE: To search the association of LA with risk factors for obstetric complications and adverse gestational outcome. METHODS: This retrospective cohort was consisted of 2 groups of pregnancies with poor obstetric history; 1) LA (+) gestations (Study Group, n= 20) and 2) LA (-) gestations (Control Group, 78). All patients were admitted to a special antenatal care program and were examined in terms of risk factors for thrombotic events, placenta-related obstetric complications, and poor gestational outcomes. Patients were administered low-dose low-molecular-weight heparin (LMWH), low-dose salicylic acid and low-dose corticosteroid (if necessary) within the framework of a prophylaxis protocol in addition to their already existing medications. RESULTS: We have shown that adverse gestational outcome was 1.7-fold more frequent in LA (+) pregnancies with poor obstetric history (p= 0.039, 70% vs. 41%). Higher rates of autoimmune diseases and hereditary thrombophilia were observed among LA (+) patients compared to LA (-) gestations (35% vs. 10.3%, p< 0.012 and 55% vs. 19.2%, p< 0.003, respectively). To identify the effectiveness of low-dose LMWH prophylaxis protocol, we compared gestational outcomes and demonstrated that the miscarriage rate was significantly decreased to half in current pregnancies compared to the previous gestations (73.6% vs. 35%, p= 0.003). CONCLUSIONS: Autoimmune diseases and hereditary thrombophilia are more frequent in LA (+) pregnancies, and these women are prone to obstetric problems. Low-dose LMWH and salicylic acid prophylaxis are critical in the management of LA (+) pregnant women.
Asunto(s)
Síndrome Antifosfolípido , Complicaciones Hematológicas del Embarazo , Trombofilia , Femenino , Humanos , Embarazo , Heparina de Bajo-Peso-Molecular/uso terapéutico , Inhibidor de Coagulación del Lupus , Estudios Retrospectivos , Complicaciones Hematológicas del Embarazo/tratamiento farmacológico , Complicaciones Hematológicas del Embarazo/etiología , Síndrome Antifosfolípido/complicaciones , Síndrome Antifosfolípido/tratamiento farmacológico , Trombofilia/tratamiento farmacológico , Factores de Riesgo , Ácido Salicílico/uso terapéuticoRESUMEN
The treatment of acne vulgaris and enlarged pore remains challenging. The 30% supramolecular salicylic acid (SSA) is a newly developed form of SA which affects pathogenic factors of acne. Non-ablative fractional laser (NAFL) promotes remodeling and decreases sebum excretion with minimal side effect. The current study was aimed to evaluate the sequential modality with 30% SSA followed by 1565-nm NAFL on facial acne and subsequent enlarged pores. A 20-week-duration prospective study was performed. Consecutive 4 sessions of 30% SSA treatment were conducted, at 2-week intervals. Two weeks after the last session of 30% SSA, 3 sessions of 1565-nm NAFL treatment were applied, at 4-week intervals. The noninvasive devices measured scores of red areas and pores, cuticle moisture, and sebum secretion. The main subjective evaluation was global acne grading system (GAGS). The side effects were recorded. Compared to baseline, the scores of red areas and pores, sebum secretion, and GAGS significantly decreased after series sessions of 30% SSA treatments (P < 0.05). The sequential application of 1565-nm NAFL maintained the good results (P < 0.05, comparing to baseline) and even further decreased the sebum secretion (P < 0.05, comparing to SSA). The cuticle moisture remained unchanged during whole period, and side effects including tingling sensation, pain, erythema, and edema were quickly reversible and acceptable. The significant improvements of acne and pores were produced by 30% SSA, and 1565-nm NAFL inhibited the sebum secretion and maintained the efficacies of 30% SSA. The sequential modality of 30% SSA followed by 1565-nm NAFL was an alternative choice for acne vulgaris companied with enlarged pores.
Asunto(s)
Acné Vulgar , Ácido Salicílico , Humanos , Ácido Salicílico/uso terapéutico , Estudios Prospectivos , Acné Vulgar/terapia , Eritema/etiología , Rayos Láser , Resultado del Tratamiento , Cicatriz/patologíaRESUMEN
Radiofrequency microneedle (RFM) is relatively safe to use for all skin types but there is still possibility of adverse events. Tram-track scarring or uniform papular eruptions is a rarely reported adverse event, but it is challenging to manage. We report a case of successful treatment of tram track scarring post RFM using a combination of light emitting diodes 640 nm and a salicylic acid peel and home treatment with a combination of azelaic acid and retinoic acid. There is still no standard therapy to treat this case. The results of clinical observations showed the lesions completely recovered in 6 months.