Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 85
Filtrar
1.
Dermatol Surg ; 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33587385

RESUMO

BACKGROUND: 5-fluorouracil (5-FU) is widely used for treatment of malignant and premalignant skin cancers; however, its use in other common cutaneous conditions has been less widely reported. OBJECTIVE: We investigated the off-label uses of 5-FU beyond malignant and premalignant skin disease. METHODS: We conducted a literature review searching multiple databases to evaluate the evidence for the off-label uses of 5-FU. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first using the Oxford Centre of Evidence-Based Medicine 2011 guidance. RESULTS: We found underlying evidence to support the use of 5-FU for a wide range of noncancerous cutaneous indications including scarring (keloid, hypertrophic), pigmentary disorders (vitiligo, idiopathic guttate hypomelanosis), cutaneous infections (viral warts, molluscum contagiosum), inflammatory dermatoses (Darier's disease, Hailey-Hailey disease and sarcoidosis), and cosmetic indications (photoaging, treatment of filler nodules and granulomas). CONCLUSION: In selected patients, 5-FU can be as effective as more established treatments, with fewer side-effects.

2.
J Cosmet Dermatol ; 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33569876
3.
J Cosmet Dermatol ; 2021 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-33600049

RESUMO

BACKGROUND: Sixty years ago, Ross discussed the use of oral dapsone in the treatment of acne vulgaris. Ross was fundamental in demonstrating the importance of this medication in dermatology. Following this, topical formulations have been used for the treatment of acne vulgaris which has not responded to traditional therapies. We explore the impact that the discovery of dapsone has had on subsequent research and clinical practice and explore the typical doses and side effects of this often sidelined therapy. METHODS: We conducted a review of the literature on the use of dapsone for acne using key terms "acne vulgaris," "dapsone," "isotretinoin," "systemic," "topical" searching databases such as MEDLINE, EMBASE, and PubMed. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first using the Oxford Centre of Evidence-Based Medicine 2011 guidance. RESULTS: Oral dapsone and topical dapsone have been used in acne vulgaris and acne fulminans. Systemic dapsone seems to be less effective than other treatment options, and further research is required to examine the use of the topical formulation for acne vulgaris compared with alternative treatments. CONCLUSION: Dermatologists may wish to consider the use of this long-established medication for the treatment of acne vulgaris. With careful monitoring, oral dapsone is an important alternative therapy where isotretinoin is contraindicated or not tolerated.

4.
5.
Artigo em Inglês | MEDLINE | ID: mdl-33464473

RESUMO

Laser-assisted drug delivery augments the distribution and penetration of topically applied treatments, leading to enhanced delivery and bioavailability. We discuss the therapeutic application of laser-assisted drug delivery in clinical practice in cases of non-melanoma skin cancer, vitiligo, melasma, scarring, and alopecia (female pattern hair loss, male pattern hair loss, alopecia areata) as well as for vaccination, local anaesthesia, analgesia, viral warts, infantile haemangiomas and cosmetic uses, and we review clinical studies that have used this technique over the last decade. Our review shows that the application of laser-assisted drug delivery enhances topical agent efficacy, potentially reducing the agent concentration and duration of topical treatment required. Future research into the use of laser-assisted drug delivery before topical therapies is needed to establish the optimal techniques to enhance drug delivery and thus improve patient outcomes.

7.
9.
J Cosmet Dermatol ; 19(12): 3416, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33051962
10.
J Drugs Dermatol ; 19(10): 993-998, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026763

RESUMO

Hyaluronidase is mostly widely recognized for its off-label use in correction of complications of hyaluronic acid fillers. However, its utility in other aspects of dermatology is less widely acknowledged. We describe the varied uses of hyaluronidase in dermatology and the underlying evidence base for its dermatological indications. This includes its uses in enhancing drug delivery (for local anesthesia, keloid and hypertrophic scars, and for Kaposi’s sarcoma), in the treatment of disorders associated with mucin deposition (myxedema, scleroderma, scleredema, and cutis verticis gyrata) and its potential uses in surgery (as a pre-operative adjuvant in dermatofibrosarcoma protuberans, for periorbital edema, and for hematomas). In select circumstances, hyaluronidase might be more efficacious than more established treatments with fewer adverse effects. We propose hyaluronidase as the latest addition to our global dermatological armamentarium and implore dermatologists to consider its use to enhance their practice. J Drugs Dermatol. 2020;19(10):993-998. doi:10.36849/JDD.2020.5416.

11.
Dermatol Ther ; : e14404, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33044042

RESUMO

Intralesional methotrexate (IL-MTX) is a long-established treatment, which is arguably underutilized by dermatologists. We describe the underlying evidence base and practical considerations for its broad range of cutaneous indications, including in cutaneous oncology (keratoacanthomas, squamous cell carcinomas, lymphomas), inflammatory dermatology (nail psoriasis, plaque psoriasis, pyoderma gangrenosum, cutaneous Crohn's disease, amyloidosis), cutaneous infections (viral warts) and for treatment of filler complications. In certain circumstances, IL-MTX can be more efficacious and less invasive than other treatments, with fewer adverse effects. Dermatologists should consider using IL-MTX for a range of recalcitrant cutaneous conditions, particularly for those patients not amenable to surgery or systemic therapy.

12.
Scars Burn Heal ; 6: 2059513120941704, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32922964

RESUMO

Background: The pathophysiology of keloid scars is still not fully understood and a universally reliable effective treatment has not been identified. Pharmacogenetics explores how drug response to a particular therapy can relate to genetic variations. Purpose: To investigate how pharmacogenetics could be applied to keloid scars and the relevance of this to clinical practice. Methods: We reviewed the literature and discuss our current knowledge of pharmacogenomics in the treatment of keloid scars. A literature search was performed using the terms 'Pharmacogenetics', 'Pharmacogenomics', 'Keloid' and 'Scar'. We searched the PubMed, MEDLINE and EMBASE databases to find the relevant articles. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first. Results: Treatments including corticosteroid injections and 5-fluorouracil can be effective in some patients, but less so in others. Polymorphisms of the glucocorticoid receptor and variants of CCL2, YAP1, miR-21-5p and NF-κß might be responsible for different responses to treatments used in keloid scars such as 5-fluorouracil. Small molecule inhibitors might be utilised to target other implicated genes. Conclusion: Pharmacogenetics aims to produce the most efficacious patient outcomes while reducing adverse effects. Understanding the pharmacogenetics of keloid scars could lead to a new era of personalised medicine in the treatment of keloid scars. At present, there is some evidence (level 3b/4) to suggest genetic variations that are responsible to drug response in keloids, but further research in this field is required. Lay summary: The varied response to similar therapeutic treatments in keloids has prompted the consideration of the role of genetic variants on response in the form of pharmacogenetics. Pharmacogenetics refers to drugs and their metabolism and action based on genetic influences. The ideal scenario would involve the selection of treatment based on the individual's specific genetic variants to ensure maximum efficacy with minimal toxicity. Some evidence currently points to genetic variations in some keloid patients that might be of relevance to the treating clinician.

13.
J Cosmet Dermatol ; 2020 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-32857479

RESUMO

Botulinum toxin A (BTXA) is one of the most popular nonsurgical cosmetic procedures worldwide. Overall, this procedure is associated with favorable complications profile. Nevertheless, any medical intervention carries inherent risks. This synopsis systematically reviews adverse effects of aesthetic BTXA for both approved and off-label indications. Based on published data, the approach for prevention and management is discussed.

14.
Dermatol Ther ; : e14211, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32820855
15.
Australas J Dermatol ; 2020 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-32815148

RESUMO

BACKGROUND: The COVID-19 pandemic has disrupted the practice of medicine. Dermatologic laser and energy-based device (EBD) treatments carry a potential risk for the transmission of SARS-CoV-2 both for the patient and the practitioner. These risks include close practitioner to patient proximity, the treatment of higher viral load areas such as the face, the potential for infective bioparticles being carried by generated plumes and aerosols, and the direct contact between device, practitioner and patient. OBJECTIVES: SARS-CoV-2 is a highly infective respiratory pathogen transmitted by respiratory droplets, respiratory/mucosal secretions, medically generated aerosols and via its transfer from contaminated fomites. This requires a review of the appropriateness of infection control protocols in regard to dermatologic laser and energy-based device treatments. METHODS: A critical evaluation of patient skin preparation including skin asepsis, device disinfection, laser and electrosurgical plume management and PPE in regard to SARS-CoV-2 was performed. RESULTS: The adherence to a high standard of skin preparation and asepsis, device disinfection, laser and electrosurgical plume and aerosol management and appropriate PPE should help mitigate or reduce some of the inherent treatment risks. Head and neck treatments along with aerosol and laser plume generating treatments likely carry greater risk. CONCLUSIONS: COVID-19 needs to be considered in the clinic set-up along with the planning, treatment and post-treatment care of patients utilising EBD procedures. Some of these treatment precautions are COVID-19 specific; however, most represent adherence to good infectious disease and established laser and EBD safety precautions.

16.
17.
Australas J Dermatol ; 2020 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-32761824

RESUMO

Rosacea is a common skin condition characterised by erythema, papules and pustules. Increasing evidence suggests that the gut-skin axis is implicated in the pathogenesis of rosacea. Sufficient evidence exists to support the notion that the gut microbiome plays a role in the inflammatory cutaneous response and there appear to be associations with small intestinal bacterial overgrowth and Helicobacter pylori infection. A dysbiotic microbiome and an innate immune system dysregulation contribute to the pathophysiology of rosacea, and further exploration of their roles is warranted. Greater understanding of this condition and the effect of the gut-skin axis could allow for more efficacious and timely treatment. This article reviews our current findings and understanding in the skin and gut relationship in rosacea.

18.
J Dermatolog Treat ; : 1-11, 2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32730109

RESUMO

Azelaic acid has numerous pharmacological uses in dermatology. Its anti-inflammatory and anti-oxidant properties are thought to correlate with its efficacy in papulopustular rosacea and acne vulgaris, amongst other cutaneous conditions. We conducted a review of the literature on the use of azelaic acid in dermatology using key terms 'acne', 'azelaic acid', 'dermatology', 'melasma', 'rosacea', searching databases such as MEDLINE, EMBASE and PubMed. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first using the Oxford Center of Evidence-Based Medicine 2011 guidance. This review found the strongest evidence supporting the use of azelaic acid in rosacea, followed by its use off-label in melasma followed by acne vulgaris. Weaker evidence is currently available to support the use of azelaic acid in several other conditions such as hidradenitis suppurativa, keratosis pilaris and male androgenic alopecia. Azelaic acid, as a monotherapy or in combination, could be an effective first-line or alternative treatment, which is well-tolerated and safe for a range of dermatological conditions.

19.
Dermatol Ther ; : e14095, 2020 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-32720446

RESUMO

Disorders of facial hyperpigmentation including melasma, postinflammatory hyperpigmentation and solar lentigines are common cutaneous conditions which can have a huge impact on patients' quality of life and often prove difficult to treat. The nascent market of cosmeceutical options provides a potentially safer and efficacious alternative for treating these challenging conditions. These can be used alone or in combination with other established treatments. Many cosmeceutical products are thought to work through inhibition of tyrosinase, a key enzyme of melanogenesis. We discuss the mode of action and provide an up-to-date review of the underlying evidence base for the top 10 cosmeceutical products for hyperpigmentation and melasma. Possible safer and more efficacious cosmeceutical therapies we discuss include thiamidol, kojic acid, vitamin C, arbutin, retinol, nicotinamide, ferulic acid, resorcinol, licorice root extract, and soy.

20.
Dermatol Ther ; : e13976, 2020 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-32633449

RESUMO

Rosacea is a common inflammatory skin disease characterized by erythema, episodes of flushing, and inflammatory lesions. It typically affects the face and is more prevalent among fair skin individuals affecting women more than men. Various treatments are available for rosacea with light-based therapies commonly used in the management of erythema. The use of intradermal botulinum toxin type-A has been reported to be beneficial in the treatment of rosacea-associated erythema and flushing with good results and a low side-effect profile. In this article, we present our experience on the successful combination of both pulsed dye laser and intradermal botulinum toxin type-A in erythema and flushing in 20 rosacea patients. In addition to subjective improvement, we measured the degree of erythema using a 3D Antera camera in order to quantify our results. We demonstrated high efficacy and satisfaction rate with this combined approach and a low side-effect profile. To our knowledge, the combination of laser and intradermal botulinum toxin in the management of rosacea has not been previously reported.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA