Treatment of mild to moderate acne with a fixed combination of hydroxypinacolone retinoate, retinol glycospheres and papain glycospheres.

AIM: A fixed combination of 0.1% hydroxypinacolone retinoate (synthetic esther of 9-cis-retinoic acid), 1% retinol in glycospheres and 2% papain in glycospheres in aqueous gel has been recently introduced into the Italian market in order to reduce the incidence and severity of irritant contact dermatitis caused by topical retinoids, without compromising their efficacy. Primary objectives of this sponsor-free, pilot, open, multicenter study were to evaluate the efficacy and tolerability of this gel in patients with comedonal-papular, mild to moderate acne of the face. METHODS: Ninety-eight Caucasian patients (28 males and 70 females), with an age ranging from 15 to 40 years, were treated with the gel once daily for 12 weeks. Acne severity and treatment efficacy were evaluated by means of the Global Acne Grading System (GAGS) and lesions count. RESULTS: Ninety-four patients were considered evaluable. A 41% mean reduction in the GAGS score was observed; a 40.8% mean reduction of total lesions was recorded; 15.3% of patients experienced mild to moderate local side effects (dryness, peeling, erythema, burning). No patients stopped the treatment because of these side effects. CONCLUSION: This study, based on a high number of evaluable patients, demonstrates that this fixed combination is an effective and safe option for the treatment of comedonal-papular, mild to moderate acne of the face. A controlled clinical study is necessary to confirm these data.

Botulinum toxin type-A for the treatment of inverse psoriasis.

OBJECTIVE: To evaluate the efficacy of botulinum toxin type-A (BoNTA) for the treatment of inverse psoriasis. BACKGROUND: The use of BoNTA in inverse psoriasis would be a novel approach compared with conventional treatments and may act at the neuroglandular junction level to reduce local sweating with its consequent skin maceration and secondary infection and at the extra-junction level to inhibit the liberation of neuropeptides and other pro-algogenic substances responsible for inflammation, hyperkeratosis and pain transmission. PATIENTS: Fifteen patients with a confirmed diagnosis of inverse psoriasis were enrolled into the study. The psoriasis was located in several areas: armpits (7 patients), submammary sulcus (6 patients), intergluteal folds (7 patients), inguinal folds (5 patients) and umbilicus (1 patient). METHODS: BoNTA treatment comprised individual injections 2.8 cm apart of 2.4 U BoNTA, with a total dosage between 50 and 100 U per patient depending on the extent and severity of the psoriasis. Patient assessments were done pre-treatment and at 2, 4 and 12 weeks post-treatment. The erythematous area was defined using objective photographic evidence, and subjective patient assessment of pain and itch was assessed using a 10-point visual analogue scale scale. RESULTS: Subjective symptomatology improved in all patients and erythema extension, intensity and infiltration improved in 13 of 15 patients (87%). Treatment was well tolerated with no reported adverse events. CONCLUSIONS: BoNTA therapy resulted in improvements in subjective patient symptomatology and objective reductions in erythema and maceration in the treated areas according to photographic evidence. Further large-scale methodologically rigorous studies are required to investigate the safety and efficacy of BoNTA in this indication.