Comparison between lymecycline with multidrug therapy and standard multidrug regimen (WHO-MDT) in the treatment of multibacillary leprosy patients: a retrospective cohort study.

BACKGROUND: Hansen's disease or leprosy is a chronic, infectious disease that has locally and globally afflicted all populations. Despite standard treatment with multidrug therapy (WHO-MDT), the incidence of drug resistance has been an increasingly prevalent global problem in leprosy management. This study compared the effectiveness between lymecycline with WHO-MDT and standard WHO-MDT in leprosy treatment. METHODS: The research is a retrospective cohort study at a tertiary hospital from January 2011 to July 2021. Pre- and post-treatment bacillary index, presence of new lesions, nerve function impairment, and leprosy reactions were obtained through chart review. RESULTS: The results showed a significant difference in bacteriological index (BI) in both groups at the end of the treatment. However, a higher reduction in BI was noted for the lymecycline group. For the group that took WHO-MDT alone, BI decreased by 0.7 (P < 0.001) whereas patients who took lymecycline and WHO-MDT had a BI difference of 3 (P < 0.001) upon completion of treatment. A significant decrease in the recurrence of lesions (P = 0.006) and nerve function impairment (P = 0.038) was also noted in the lymecycline group whereas there was no significant difference in leprosy reactions between the two groups. CONCLUSION: Lymecycline 600 mg daily for 3 months can be used as an adjunct in cases of leprosy resistance and treatment failure among multibacillary patients. Lymecycline significantly reduced bacillary index, recurrence of skin lesions, and nerve function impairment through its possible immunomodulatory, antiapoptotic, and neuroprotective effects.

Expert consensus on holistic skin care routine: Focus on acne, rosacea, atopic dermatitis, and sensitive skin syndrome.

BACKGROUND: Treatment, cleansing, moisturizing, and photoprotection are four major components of holistic skin care for dermatological conditions. While treatment (T) is recognized as a key component in the management of dermatological conditions, there is a lack of practical guidance on the adjunctive role of cleansing, moisturizing, and photoprotection ("CMP"). Limited patient knowledge, confusion over product selection, and lack of guidance on how to choose and use CMP skin care products (in conjunction with pharmacological therapy) are the main barriers to establishing a holistic skin care routine for dermatological conditions. AIMS: This study aimed to review current clinical evidence, identify gaps, and provide practical guidance on conceptualization and implementation of CMP routine in the management of sensitive skin due to underlying acne, atopic dermatitis, or rosacea, including conditions with idiopathic causes referred to as idiopathic sensitive skin syndrome. METHODS: An expert panel comprising of 10 dermatologists from Australia, China, Hong Kong, Taiwan, India, Indonesia, Philippines, Singapore, South Korea, and Thailand convened to develop consensus statements on holistic skin care in acne, rosacea, atopic dermatitis, and idiopathic sensitive skin syndrome using the Delphi approach. RESULTS: Consensus was defined as ≥80% of panel rating statement as ≥8 or median rating of ≥8. The final statements were collated to develop consensus recommendations on holistic skin care. CONCLUSION: A dermatologist-guided holistic skin care routine is essential to improve patient confidence and reduce confusion over product selection. The consensus recommendations presented here highlight the importance of cleansing, moisturization, and photoprotection in holistic skin care and how it can be utilized as a communication tool for physicians and patients to achieve overall better patient compliance, satisfaction, and treatment outcomes.

A descriptive study on the treatment strategies for melasma used in the Philippines

OBJECTIVE: To investigate the different treatment modalities employed for melasma by practicing dermatologists in the Philippines. BACKGROUND: Melasma is a prevalent skin condition among Filipinos due to our skin type and climate. To date, no local studies have been done investigating the different treatment regimens practiced/ employed by Filipino dermatologists in treating melasma. METHODS: This is a descriptive study investigating the different treatment strategies used by Filipino dermatologists using a questionnaire.The questionnaires were given to practicing Filipino dermatologists personally during conferences and conventions held in 2005 as well as to the different Philippine Dermatological Society accredited training institutions and private clinics of the doctors. The total sample size was 117. RESULTS: Melasma is frequently seen among Fitzpatrick skin type IV (50%),females, 41-50 year-old age group (50%) and commonly on the cheeks (98%). Grade 2 severity melasma was often seen by 75% of the respondents. The top 3 topical depigmenting agents of choice are tretinoin, hydroquinone and combination therapy. Microdermabrasion was preferred by 43.5% of the respondents over laser. Once combination treatment regimens fail, laser treatment more than doubled to 28.7%. Vitamin C (37.7%) and glutathione (31.6%) are the most common oral maintenance therapy given by the respondents. Half of all the respondents advise continuous maintenance therapy while a third of them advise maintenance for a year. The most common side effect of melasma treatment is erythema according to 51% of the respondents followed largely by hyperpigmentation (23%) and scaling (22%). More than half of the dermatologists surveyed stop the treatment regimen when side effects are observed. Almost all respondents advise patients to use sunblock daily and majority of respondents prescribe both UVB and UVA sunblocks.