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1.
Dermatol Ther ; : e13280, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32083770

RESUMO

Isotretinoin is a safe and useful medication for acne management. Adverse effects are mostly related to cutaneous and mucous membranes. We present a case of a 24-year-old female patient who was on treatment with Isotretinoin for acne vulgaris grade 4. After 6 months of treatment, the patient presented with localized patch of hair loss. Beginning of alopecia areata (AA) in patients with acne vulgaris could be regarded as a side effect of retinoids due to anti-acne therapy. The exact mechanism by which retinoids cause hair loss is not known. This article is protected by copyright. All rights reserved.

2.
Dermatol Ther ; : e13261, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32043684

RESUMO

Malignant melanoma is an oncologic disease, whose current management among others includes surgical and immunological therapy. According to the current recommendations of the American Joint Committee on Cancer, the surgical excision of the primary tumor should be performed in two operative sessions, which has several consequences. The following paper will present and discuss six cases of pigmented lesions and the advantages of the one-step melanoma surgery in their management.

3.
Expert Opin Drug Saf ; 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32067513

RESUMO

Introduction: Vitiligo is an acquired depigmenting skin disorder adversely affecting the patient's quality of life. Despite the presence of several treatment modalities, ranging from medical to physical to surgical options, none is curative. Each modality has its own drawbacks and side effects. Thus, the treatment modality needs to be tailored for each individual patient taking into consideration the disease characteristics and also its efficacy and safety to obtain a favourable risk-benefit ratio.Areas covered: This review highlights the different treatment modalities utilized in vitiligo up until November 4, 2019 along with their adverse effects and contraindications, if any.Expert opinion: All the medications have their own adverse effects and contraindications. We have included the most commonly used topical corticosteroids, which may result in striae, cutaneous atrophy and tachyphylaxis, to the recently introduced biologics, which may induce hypersensitivity reactions, systemic toxicities and even malignancies. However, more long-term studies are needed to assess the safety of these medications, especially the newer ones, to provide a safe and effective treatment for this disorder.

5.
Dermatol Ther ; : e13251, 2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32022958

RESUMO

Isotretinoin is a first-generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti-inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date-unlimited PubMed search, from inception till December 2019, using the following search terms: "low-dose isotretinoin" and "dermatology," "isotretinoin and safety," "isotretinoin, off-label uses," "isotretinoin and male fertility," "isotretinoin, iPLEDGE system," aiming to deliver a therapeutic update relevant to clinical practice. All English-language articles were considered with no limitation based on the articles' type. Low-dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.

6.
Expert Opin Emerg Drugs ; : 1-18, 2020 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-31958256

RESUMO

Introduction: Vitiligo is a relatively common autoimmune depigmenting disorder of the skin. There has been a great advance in understanding the pathological basis, which has led to the development and utilization of various new molecules in treating vitiligo. This review aims at a comprehensively describing the treatments available and the emerging treatment aspects and the scope for future developments.Areas covered: This study comprehensively summarizes the current concepts in the pathogenesis of vitiligo with special focus on the cytokine and signaling pathways, which are the targets for newer drugs. JAK kinase signaling pathways and the cytokines involved are the focus of vitiligo treatment in current research, followed by antioxidant mechanisms and repigmenting mechanisms. Topical immunosuppressants may be an alternative to steroids in localized vitiligo. Newer repigmenting agents like basic fibroblast growth factors, afamelanotide have been included and a special emphasis is laid on the upcoming targeted immunotherapy.Expert opinion: The treatment of vitiligo needs to be multimodal with emphasis on targeting different limbs of the pathogenesis. Topical and oral JAK inhibitors are the most promising new class of drugs currently available for treating vitiligo and acts best in conjunction with NB-UVB.

7.
J Cosmet Dermatol ; 19(3): 570-573, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31889407

RESUMO

BACKGROUND: Cosmetic surgery and esthetic procedures have become a billion dollar industry owing to the ever-growing demand of the population to stay young. The injectable treatments including fillers and botulinum toxin have become highly popular because of their quick, predictable and lasting results in the management of facial wrinkles and rejuvenation. Although these treatment modalities are relatively safe, they are associated with certain side effects. AIMS: In this review, we will focus on the complications of fillers and botulinum toxin. PATIENTS/METHODS: The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles. Only articles available in English were considered for this review. RESULTS: Brow ptosis and asymmetry are common adverse effects of botulinum toxin while the most common adverse effects associated with fillers are the local injection related effects manifesting as erythema, edema, pain, and ecchymosis. CONCLUSION: It is important that the treating physician is well verse with the various fillers and botulinum toxin complications and their management as some of the complications can be severely debilitating.

8.
J Cosmet Dermatol ; 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31922345

RESUMO

BACKGROUND: Pruritus is the most common complaint encountered in dermatological practice. It is estimated that up to 4% of the world population suffers from chronic itch. Chronic pruritus can be associated with both cutaneous or systemic conditions. While a plethora of treatments attempt to address itch, most carry risk of significant adverse events with chronic use; thus, there exists an unmet need to develop safe treatments for chronic pruritus. A recent study demonstrated that a novel extract from Saccharomyces cerevisiae, that is, Baker's yeast, blocks various histamine receptors as well as inhibits numerous inflammatory cytokines. METHODS: Given the long-term safety profile of Baker's yeast, we set to investigate the efficacy of the novel extract in the treatment of chronic pruritus. KEY RESULTS: In our study, we demonstrated that within 30 minutes, the novel extract significantly reduced itch when compared to a placebo lotion (P = .0020). CONCLUSIONS: To our knowledge, this is the first study demonstrating that a novel extract from Saccharomyces cerevisiae can provide rapid and sustained itch relief to chronic pruritus patients.

9.
Dermatol Ther ; 33(1): e13194, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31846144

RESUMO

In this study, we report our multicentric experience of synthetic medical certified polyamide hair implants in male androgenetic, female menopausal, and chronic alopecia. Biofibre hair implantation was performed by means of a standardized, mini-invasive technique followed by regular postoperative care along 3 years. From May 2015, 278 patients were enrolled and 253 completed the trial; 202 men (79.9%) versus 51 women (20,1%). The average age was 43(± 4.29); 179 patients (70.1%) had taken previous treatments for alopecia. We evaluated efficacy (as judged by Hamilton scale grading, covered area percent, surgeon, and patient's subjective evaluation) and safety (as judged by adverse events). The overall scalp surface restored with artificial hair (mm2 spaced) and pre-postoperative general customers' satisfaction (by Hamilton scale grading) are reported, showing a significant (98,14%) subjective and objective improvement of the self-image. Twenty-two cases (8.75%) declared minor side effects generally counteracted by topical or short course systemic antibiotic and anti-inflammatory treatment. The average number of implanted fibers was 2,295 (SD 2.805; SE 200.9) ranging from 300 to 16,000. The average duration of pain and tenderness at the implant area was 2.2 days (SD 4.096; SE 0.2933) ranging from 1 to 20 days. A diagrammatic comparison of the Hamilton scale grading before and after the trial showed a dramatic improvement with the majority of the patients being in Hamilton grade II after implantation.

10.
Dermatol Ther ; 33(1): e13200, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31854482

RESUMO

We present a 32-year-old man with successful treatment and remission of mycosis fungoides of both axillae in 2016 after PUVA therapy and systemic and local administration of corticosteroids. Subsequently, in 2017, the patient also achieved remission of a T-cell CD 30 positive, ALK-1 negative large-cell lymphoma of a retroperitoneal and inguinal lymph node after chemotherapy and radiotherapy. One year later, in 2018, the patient presented to our clinic with progression of skin lesions in both axillary areas and the appearance of а tumor in the right gluteal region.Dermatological examination showed livid-to-erythematous, partly sclerotic plaques in the right inguinal area, cutis laxa-like plaque formations in the right axillary region with similar but less-developed changes in the left axillary fold, a solitary subcutaneous tumor formation affecting the entire right gluteal region, and enlarged, palpable lymph nodes in the right para-axillary area. Biopsies were obtained from an axillary lesion and the surgically removed axillary lymph nodes, and histological examination revealed changes of granulomatous slack skin in the axilla and reactive inflammatory changes in the lymph nodes. Histology of gluteal tissue showed a "foreign body" type of reaction with sarcoid-like features, where the patient in the past have been injected with anabolic and steroidal drugs. Herein we describe a patient with simultaneous occurrence of granulomatous slack skin type mycosis fungoides and a sarcoid-like reaction. The question remains open whether this represents the so-called sarcoidosis-lymphoma syndrome or, more likely, granulomatous slack skin MF associated with a sarcoid-like reaction of "foreign body" type. The possibility that disturbance of tissue homeostasis by incorporation of certain adjuvants within injections (for example) in the past might have been an inducer of cutaneous T cell lymphoma and sarcoidosis/sarcoid like lesions seems reasonable but also speculative.

12.
Acta Dermatovenerol Alp Pannonica Adriat ; 28(4): 169-171, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31855270

RESUMO

INTRODUCTION: Medical treatment of androgenetic alopecia (AGA) is mainly limited to pharmacological and surgical interventions. Patients' desire for noninvasive and non-systemic treatments has accelerated research into medical devices that can promote hair growth. Low-level laser therapy (LLLT) was the first such device. However, its success has been limited by contradictory and often controversial efficacy claims. Work previously performed in animal models of AGA has demonstrated the viability of the wound repair mechanism as a potential treatment modality. This study therefore explores the use of a non-ablative radio frequency (RF) device in the treatment of AGA. METHODS: A single blindedstudy compared a non-ablative RF device versus a sham device in 24 men with AGA. Each subject received four treatments over the 12-week study. RESULTS: In this preliminary study of 24 AGA patients treated with a novel RF device, we demonstrated that 54% showed a clinical response. Furthermore, among patients that underwent four or more treatment sessions, 40% experienced a 30% or more increase in hair counts compared to baseline. CONCLUSIONS: If validated in a larger cohort, non-ablative RF may prove to be an important clinical tool in the treatment of AGA.

13.
Dermatol Ther ; : e13175, 2019 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-31758835

RESUMO

Numerous studies have demonstrated that the pigmentation of iris and around the eyelid is a common side effect of latanoprost, a prostaglandin F2alpha analogue used in the treatment of glaucoma. Hence, the authors decided to study the effectiveness of topical latanoprost on vitiligo patches around the eyelid. In this randomized, double-blind, clinical trial study, 31 patients with vitiligo vulgaris and focal vitiligo involving the eyelids were evaluated. Patients were randomly divided into two groups. First group received topical latanoprost gel twice daily for 12 weeks, whereas the second group received placebo with the same protocol. To evaluate severity of the disease the VIDA rating system was used. Serial photos of the patches were taken to compare and evaluate the repigmentation percentage of the patches. The patients in both groups had almost similar VIDA score (p > .05). First group showed improved pigmentation, whereas participants in the second group did not show any improvement in the pigmentation. The group treated with latanoprost showed significant reduction in the symptoms of the disease, whereas those treated with placebo did not show any alteration (p > .05). No significant complications were observed in either groups. Latanoprost proved effective in treating vitiligo disease involving eyelids.

14.
Antioxidants (Basel) ; 8(11)2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31752190

RESUMO

Although the role of reactive oxygen species-mediated (ROS-mediated) signalling in physiologic and pathologic skin conditions has been proven, no data exist on the skin cells ROS-mediated communication. Primary fibroblasts were obtained from lesional and non-lesional skin of psoriatic patients. ROS, superoxide anion, calcium and nitric oxide levels and lipoperoxidation markers and total antioxidant content were measured in fibroblasts. NADPH oxidase activity and NOX1, 2 and 4 expressions were assayed and NOX4 silencing was performed. Fibroblasts and healthy keratinocytes co-culture was performed. MAPK pathways activation was studied in fibroblasts and in co-cultured healthy keratinocytes. Increased intracellular calcium, •NO and ROS levels as well as an enhanced NADPH oxidase 4 (NOX4)-mediated extracellular ROS release was shown in lesional psoriatic vs. control fibroblasts. Upon co-culture with lesional fibroblasts, keratinocytes showed p38 and ERK MAPKs pathways activation, ROS, Ca2+ and •NO increase and cell cycle acceleration. Notably, NOX4 knockdown significantly reduced the observed effects of lesional fibroblasts on keratinocyte cell cycle progression. Co-culture with non-lesional psoriatic and control fibroblasts induced slight cell cycle acceleration, but notable intracellular ROS accumulation and ERK MAPK activation in keratinocytes. Collectively, our data demonstrate that NOX4 expressed in dermal fibroblasts is essential for the redox paracrine regulation of epidermal keratinocytes proliferation.

15.
Dermatol Ther ; 32(6): e13119, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31606942

RESUMO

The eyes are an important component of facial aesthetics. They are in the center of an anatomical area of the face very important for rejuvenation procedures, the so-called "periorbital region." The appearance of the eyes therefore decisively influences the perception of the aesthetics and aging of the entire face. In juvenile age, the skin of the periocular area is elastic and tonic, without sun damage; the eyebrow is full, well defined, and not descending; there is a clear and visible fold of the upper eyelid, with minimal dermatochalasis; the lower eyelid is tense and well positioned. The aim of this preliminary study is to define a protocol for the use of plasma technology in the treatment of aging signs of the periorbital region. The protocol is aimed to provide predictable, constant, and safe results.

16.
Dermatol Ther ; 32(6): e13104, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31587447

RESUMO

Isotretinoin (ISO) is a first-generation retinoid discovered in 1952 and approved by the FDA for the treatment of nodulocystic acne in 1982. The anti-inflammatory properties of ISO have found its use in disorders other than acne. ISO can create psychiatric problems, including depression and suicidal ideation. These neuropsychiatric problems are very similar to disorders secondary to hyperhomocysteinemia (HHcy), vitamin B12, and folic acid (vitamin B9) deficiencies. Given that previous literature suggested folate supplementation improved the efficacy of traditional antidepressant medications, clinicians may wish to consider folate supplementation for patients with depression or possible depressive symptoms, such as acne patients with genetic susceptibility. Brain-derived neurotrophic factor may be a cytokine-specific screening biomarker in immune-based antidepressive therapy.

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