Corticosteroid-induced cutaneous atrophy and telangiectasia. Experimental production associated with weight loss in rats.

A bioassay for the evaluation of certain adverse effects of various corticosteroids was performed. Twenty-eight daily topical applications of corticosteroids to young rats produced reduction in body-weight gain, atrophy of the skin as determined by double skin-fold thickness micrometer measurement, and mild to severe telangiectasia. This animal model demonstrates corticosteroid-induced skin atrophy and telangiectasia and the correlation of the degree of atrophy and telangiectasia to body-weight change. Nine corticosteroids were evaluated by this method and are listed in terms of increasing severity of side-effects as follows: 1.0% hydrocortisone cream, 0.1% betamethasone valerate cream, 0.025% betamethasone benzoate cream, 0.05% flurandrenolide cream, 0.05% fluocinonide cream, 0.1% dexamethasone cream, and 0.03% flumethasone pivalate cream. Triamcinolone acetonide cream, 0.5%, and 0.2% fluocinolone acetonide cream resulted in death of the animals prior to completion of 28 days of topical application.

Considerations in selecting a moisturizer.

The symptoms of xerosis (dry skin) can be ameliorated by increasing the hydration state of the stratum corneum through a humectant or occlusive effect, smoothing the rough surface with an emollient, replenishing natural moisturizing factors, and normalizing the stratum corneum. We present the primary and secondary functions of various "active" and vehicle ingredients and include precautions regarding certain classes of materials. Recommendations on selecting moisturizing systems are made based on ingredient functionality and the severity of the dry skin condition.

The effectiveness of topical and oral tetracycline for acne.

A group of 135 college students with acne was evaluated in a 12-week, double-blind study comparing placebo, oral tetracycline 0.5 gm daily, and a new topical tetracycline preparation. The topical tetracycline preparation containing n-decyl methyl sulfoxide to enhance penetration, produced statistically significant improvement of acne as compared to placebo after 7, 10, and 12 weeks of treatment. Oral tetracycline, 0.5 gm daily, was statistically significantly more effective for acne than placebo after 4, 7, 10, and 12 weeks of therapy. The placebo group also had marked improvement which may have been related to sun exposure. Emotional stress produced by final examinations had no apparent effect on the patients given placebo, oral, or topical tetracycline. Side effects of the topical tetracycline included a slight yellowish discoloration of the skin in 25% of the subjects and transient stinging or tingling sensation after application in 36%.

Evaluation of ammonium lactate in the treatment of seborrheic keratoses.

A double-blind, paired comparison study was used to evaluate treatment effects of 12% ammonium lactate lotion (Lac-Hydrin) against its vehicle on seborrheic keratoses. Fifty-eight volunteer patients, 37 to 82 years of age, were studied for 16 weeks. The patients had a minimum of two seborrheic keratoses at least 10 cm apart. They applied the medication twice daily. The lesions were evaluated for height, surface characteristics, color, and length with the use of 7X calibrated loupe, a template, skin replicas, and scanning electron microscopy. Lac-Hydrin 12% lotion significantly reduced the height (elevation) of seborrheic keratoses, and two seborrheic keratoses cleared completely; however, there was no statistically significant difference in the length, color, and surface characteristics between the study group and the control group. Skin replicas and scanning electron microscopy can be used to evaluate lesion surface characteristics, dimensions, and therapeutic effects.

Therapeutic activity of lactate 12% lotion in the treatment of ichthyosis. Active versus vehicle and active versus a petrolatum cream.

Lactate 12% lotion was significantly more effective than both its vehicle and a petrolatum-based cream in the treatment of ichthyosis. The treatment regimen was twice-daily application for 4 weeks with evaluations weekly during the treatment period and for 2 weeks after treatment was stopped. Vulgaris, lamellar, sex-linked, Netherton's, and epidermolytic hyperkeratotic forms of ichthyosis were significantly improved by treatment with lactate 12% lotion. This new therapeutic modality expands the scope and extent of ichthyotic conditions that may now be successfully treated.