Histological effects of tazarotene 0.1% cream vs. vehicle on photodamaged skin: a 6-month, multicentre, double-blind, randomized, vehicle-controlled study in patients with photodamaged facial skin.

BACKGROUND: Topical tazarotene has been shown to offer efficacy in ameliorating multiple effects of photodamage. OBJECTIVES: To evaluate the histological effects of tazarotene cream on photodamaged skin. METHODS: In this multicentre, double-blind, randomized, vehicle-controlled study, 50 patients with photodamaged facial skin (at least mild fine wrinkling and mottled hyperpigmentation, with at least one of these being moderate) were randomized to apply tazarotene 0.1% cream or vehicle cream to their face, once daily for 24 weeks. RESULTS: Blinded assessments showed that tazarotene was less likely than vehicle to be associated with an increase in keratinocytic and melanocytic atypia, and more likely than vehicle to be associated with a reduction in atypia. Between-group comparisons in distribution of change from baseline categories of severity were in favour of tazarotene (P = 0.055 for keratinocytic atypia, P = 0.034 for melanocytic atypia, and P < 0.001 for the number of granular cell layers). Compared with vehicle, tazarotene was associated with an increase in epidermal polarity (P = 0.008) and epidermal thickness (P = 0.012), and a tendency for stratum corneum compaction. Tazarotene was also associated with widened intercellular spaces (reported as epidermal oedema) relative to vehicle (P < 0.001). CONCLUSIONS: Treatment of photodamaged skin with tazarotene is associated with an amelioration of keratinocytic and melanocytic atypia, an improvement in epidermal polarity, and an increase in epidermal thickness.

Granuloma fissuratum masquerading as a skin tumor.

Granuloma fissuratum is a reactive process of the skin usually caused by chronic trauma from ill-fitting eyeglass frames. Its clinical resemblance to malignant tumors makes it important to recognize this benign condition. This case report discuses the diagnosis and management of granuloma fissuratum.

Tinea of the ear mimicking chondritis.

A case of tinea of the pinna, mistaken for chondritis, is presented. Chondritis should be added to the list of diseases that tinea infection may mimic.

Anetoderma.

Anetoderma is a rare cutaneous condition with characteristic clinical features and histopathology. The condition is classified into idiopathic (Jadassohn or Pellizzari type) and atrophic (Schweinger-Buzzi type) concomitant with other diseases, and secondary to infection or drugs.

Current concepts of toxic epidermal necrolysis.

Toxic epidermal necrolysis consists of two distinct clinical entities. The Ritter type, seen mostly in children under age 10, is the severest manifestation of staphylococcal disease. A toxin has been isolated which is postulated to be the cause for clinical lesions. High epidermal necrosis occurs. Treatment is with one of the penicillinase-resistant penicillins, and prognosis is good. The Lyell type is seen mostly in adults, is drug-related, and may be the severest form of the Stevens-Johnson syndrome. Full-thickness epidermal necrosis occurs. Treatment consists of withdrawing the offending drug. Good nursing care is essential. Prognosis is guarded.