RESUMEN
Free radicals have long been studied as a contributor to aging and disease processes. Endogenous production of radicals from cellular metabolism and exogenous sources from ultraviolet radiation and pollution can damage the skin on the cellular and tissue levels. Although the body possesses an elegant defense system to prevent radical damage, this innate system can be overwhelmed and lead to a state of oxidative stress or immunosuppression, and can even trigger carcinogenesis. Topical supplementation of antioxidants can provide additional protection to neutralize reactive oxygen species from both endogenous and exogenous sources. This review will discuss our current understanding of the mechanisms of free radical damage and evaluate the potential benefit of topical antioxidants in sunscreens and skin care products.
Asunto(s)
Antioxidantes/fisiología , Envejecimiento de la Piel/fisiología , Luz Solar , Animales , Ácido Ascórbico/fisiología , Radicales Libres/metabolismo , Humanos , Terapia de Inmunosupresión , Peroxidación de Lípido , Mitocondrias/metabolismo , Estrés Oxidativo , Especies Reactivas de Oxígeno/metabolismo , Luz Solar/efectos adversos , Vitamina E/fisiologíaRESUMEN
Nonlaser localized narrowband (290-315 nm) UVB phototherapy was tested in 10 subjects with localized psoriasis. Treatments were given 2 to 3 times weekly. Four patients did not complete the planned 25-treatment course. Of the remaining 6 patients, all reached greater than 90% clearing of their disease. Localized nonlaser UVB phototherapy is another option for the treatment of localized psoriasis.
Asunto(s)
Psoriasis/radioterapia , Terapia Ultravioleta , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psoriasis/patología , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
BACKGROUND: Combination treatment in psoriasis may be common, logical, and appropriate, even if not well tested or well documented by clinical trials. While oral retinoids such as acitretin can be used as monotherapy, efficacy can be further augmented by combination use with other agents. Similarly, because of its safety profile, acitretin can be added in low doses to help patients who have not achieved adequate control with other psoriasis treatments. OBJECTIVE: The purpose of this study was to assess how oral retinoids are used in combination with other drugs to treat psoriasis. METHODS: We assessed the use of acitretin and other oral retinoids for the treatment of psoriasis using two sources of information: nationally representative survey data from the National Ambulatory Medical Care Survey (NAMCS) and local data obtained by chart review of 518 patients seen in a university dermatology clinic. RESULTS: In the NAMCS, oral retinoids were prescribed with other psoriasis medications at 71% of visits. In the chart review, combination use was even more frequent (96% of subjects were on combination treatment) and included combinations of acitretin with topicals, phototherapy, and other systemic treatments. Adverse events were reported in 53% of patients treated with acitretin, although none were severe. CONCLUSION: Use of acitretin in combination with many other psoriasis treatments is a common practice. Mucocutaneous side effects of oral retinoids are common but with appropriate dosing are generally mild.