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1.
J Cosmet Dermatol ; 23(2): 479-485, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37782679

RESUMO

OBJECTIVE: To evaluate the clinical efficacy of peeling with a microemulsion formulation containing 1% retinoic acid. MATERIALS AND METHODS: After development of the product, 60 patients with melasma were randomly divided into three groups (n = 20): Group 1-application of conventional 1% retinoic acid peeling (RA 1%). Group 2-application of 1% retinoic acid peeling in microemulsion (RA 1%M). Group 3-Application of placebo. The groups were submitted to four peeling sessions, fortnightly on Days 0, 15, 30, and 45, and analyzed at the time intervals of 0, 15, 30, 45, and 60 days. Evaluation was made by using the Melasma Area and Severity Index (MASI) and Melasma Quality of Life (MelasquoL) instrument. Hemato-biochemical parameters were also evaluated at Days 0 and 60. After obtaining the results, normality was evaluated by means of the Kolmogorov-Smirnov test and afterwards, the following tests were applied: Friedman statistical (to test the effect of the treatments on the MASI index); Wilcoxon, (for comparison between pairs to test the effect of treatments on the MelasQoL index); Kruskal-Wallis, (to test the differences between the groups); and Mann-Whitney, (comparisons between treatments). The level of significance adopted was 5% (α = 0.05). RESULTS: The three groups presented a significant reduction in the MASI index, indicating the effect of all the treatments on reducing the melasma (p < 0.001). A significant reduction in the stains was observed with the use of retinoic acid peeling delivered in microemulsion (62%) when compared with the conventional peeling with 1% retinoic acid in a conventional vehicle (26%) and the placebo (12%). There was also a significant reduction in the MelasQoL index (sum of all the aspects) in the three groups, indicating the effect of all the treatments, including the placebo, on the overall quality of life of those with melasma. However, RA 1%M the treatment that promoted the greatest effect on the quality of life of individuals. In percentage terms, the RA 1%M provided a mean reduction of 30% in the MelasQoL index, against 13% of the conventional treatment and only 4% of the placebo. When the hemato-biochemical parameters were compared on Days 0 and 60, there were no significant changes in the results. CONCLUSION: The chemical peeling performed with RA 1%M was effective for the treatment of melasma, and was shown to be superior to the peeling performed with retinoic acid in a conventional vehicle, in reducing the stains and improving the quality of life of patients.


Assuntos
Melanose , Tretinoína , Humanos , Tretinoína/uso terapêutico , Ceratolíticos/uso terapêutico , Qualidade de Vida , Resultado do Tratamento , Melanose/tratamento farmacológico
2.
Molecules ; 28(20)2023 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-37894698

RESUMO

Acne vulgaris stands out as the most prevalent skin disorder among teenagers and young adults, causing physical discomfort and considerable economic and psychological burdens on individuals and society. A wide range of topical and systemic therapies are available in acne treatment. Chemical peeling is a skin resurfacing technique designed to rebuild healthy skin using exfoliating substances, a simple and affordable process with various dermatological uses. Chemical peels, classified as superficial, medium, and deep, have been utilized for acne vulgaris and multiple other skin issues. In these chemical peels, a diverse range of chemical substances is employed, each with its unique mode of action. Among these, α-hydroxy and ß-hydroxy acids have gathered attention for their efficacy in reducing acne lesions and enhancing overall skin appearance. Acids, such as salicylic acid, glycolic acid, or lactic acid, are commonly used in chemical peels due to their exfoliating and sebum-regulating properties. Despite the widespread use of these acids, there exists a lack of consensus regarding the most effective acid type and concentration for treating acne-prone skin. This review aims to bridge this knowledge gap by evaluating the effectiveness and safety of various organic acids used in chemical peels specifically for acne-prone skin. The findings of this comprehensive bibliographic review indicate that organic acid-based chemical peels represent effective and safe treatment options for individuals with acne-prone skin. Their adaptability sets these treatments apart; the choice of organic acid can be tailored to meet individual patient needs and tolerability levels. This personalized approach ensures that patients receive optimal care while minimizing the risks associated with the treatment. As research in this field progresses, it is anticipated that a more nuanced understanding of the ideal acid type and concentration will emerge, further enhancing the efficacy and safety of chemical peels for acne-prone skin.


Assuntos
Acne Vulgar , Abrasão Química , Adolescente , Adulto Jovem , Humanos , Ceratolíticos/uso terapêutico , Ceratolíticos/farmacologia , Acne Vulgar/tratamento farmacológico , Ácido Salicílico/farmacologia , Abrasão Química/métodos , Pele
4.
J Dermatolog Treat ; 34(1): 2147391, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36382987

RESUMO

BACKGROUND: Excessive sebum production is a factor in acne development. Tazarotene 0.045% lotion has demonstrated reductions in acne lesions and acne-induced sequelae. OBJECTIVE: Evaluate efficacy, changes in skin oiliness, and safety with tazarotene 0.045% lotion in participants with moderate-to-severe acne and oily skin. METHODS: In two phase 3, double-blind, 12-week studies (NCT03168321; NCT03168334), participants aged ≥ 9 years with moderate-to-severe acne were randomized 1:1 to once-daily tazarotene 0.045% lotion or vehicle lotion (N = 1614). This pooled, post hoc analysis included only participants self-categorized with oily skin at baseline on the Acne-Specific Quality of Life questionnaire item 19 (scores: 0 [extremely oily] to 6 [not at all oily]). Inflammatory/noninflammatory lesion counts, treatment success, skin oiliness, treatment-emergent adverse events (TEAEs), and cutaneous safety/tolerability were evaluated. RESULTS: In all participants with oily skin (n = 793), tazarotene provided greater reductions in inflammatory/noninflammatory lesions (p < 0.001, both) and greater treatment success rates versus vehicle (p < 0.01) at week 12. Over two-thirds of polymeric lotion-treated participants had subjective skin oiliness reductions by week 12, with around a third reporting 'low/not' oily skin. Tazarotene TEAE rates were similar to the overall population. CONCLUSIONS: Once-daily treatment with tazarotene 0.045% polymeric emulsion lotion may help improve patient-perceived skin oiliness in those with moderate-to-severe acne.


Assuntos
Acne Vulgar , Fármacos Dermatológicos , Humanos , Tretinoína/uso terapêutico , Ceratolíticos/uso terapêutico , Qualidade de Vida , Índice de Gravidade de Doença , Creme para a Pele/uso terapêutico , Acne Vulgar/tratamento farmacológico , Acne Vulgar/patologia , Administração Cutânea , Resultado do Tratamento , Método Duplo-Cego , Emulsões , Fármacos Dermatológicos/efeitos adversos
7.
Am J Clin Dermatol ; 23(6): 853-867, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35960486

RESUMO

The term 'inherited ichthyosis' refers to a heterogeneous group of mendelian disorders of cornification that involve the integument with varying degrees of scaling. The management of ichthyosis poses a challenge for most physicians. Treatment options proposed in the literature include moisturizers, topical keratolytics, topical and systemic vitamin D analogues, and topical and systemic retinoids; however, some of these modalities are less reliable than others. Despite the therapeutic impasse imposed by the options above, the emergence of pathogenesis-based treatments along with novel gene therapies appear promising and hold the potential to halt or even revert disorders that arise from single genetic mutations, although research is still quite lacking in this domain. Hence, this review aims to highlight the various treatment modalities available for the management of the cutaneous manifestations of non-syndromic inherited ichthyosis, with an added emphasis on pathogenesis-targeted therapies.


Assuntos
Ictiose , Humanos , Ictiose/genética , Ictiose/terapia , Ceratolíticos/uso terapêutico , Mutação , Retinoides/uso terapêutico , Vitamina D
8.
J Drugs Dermatol ; 21(8): 833-837, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35946971

RESUMO

Scalp involvement is seen in a majority of individuals with psoriasis, a chronic autoimmune skin disease with variable phenotypes. Occasionally, isolated scalp involvement is observed; and this causes significant psychosocial morbidity. Management of scalp psoriasis is difficult, in part due to the difficulty of applying topical agents and its refractory nature. Various treatment options are available with variable efficacy. Topical agents include topical steroids, keratolytics, tar and anthralin compounds, vitamin D analogues, and vitamin A derivatives. The combination treatment of topical betamethasone and calcipotriene is the most effective topical therapy. Systemic agents include conventional agents such as methotrexate, cyclosporine, and oral retinoids. Biologics offer a greater efficacy, with near complete or complete clearance of the scalp. In this article we review the published literature on adult and scalp psoriasis to highlight its treatment. Articles published in peer-reviewed journals were included for qualitative analysis of the literature, including reviews, clinical trials, case series, case reports published in the electronic database (MEDLINE/PubMed) through June 2021, cross references of respective articles, and trials from clinicaltrials.gov. J Drugs Dermatol. 2022;21(8):833-837. doi:10.36849/JDD.6498.


Assuntos
Fármacos Dermatológicos , Psoríase , Dermatoses do Couro Cabeludo , Administração Tópica , Betametasona , Fármacos Dermatológicos/uso terapêutico , Humanos , Ceratolíticos/uso terapêutico , Psoríase/diagnóstico , Psoríase/tratamento farmacológico , Couro Cabeludo , Dermatoses do Couro Cabeludo/diagnóstico , Dermatoses do Couro Cabeludo/tratamento farmacológico , Resultado do Tratamento
10.
Clin Exp Dermatol ; 47(4): 743-747, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34773296

RESUMO

Cutaneous amyloidosis can be a part of a systemic disease or can result from a localized process limited to the skin. It usually presents as pruritic hyperpigmented macules, papules or nodules, which are notoriously resistant to treatment. We performed a hospital-based pilot case series to assess the efficacy and safety of sequential salicylic acid (SA) and glycolic acid (GA) chemical peels. Patients underwent sequential chemical peel therapy with SA 20% and GA 35% used alternately each week for a total of 6 weeks. At subsequent follow-up visits, good clinical outcome and long-term maintenance was observed. This study highlights the promising role of chemical peels in this difficult and distressing disorder.


Assuntos
Amiloidose Familiar , Abrasão Química , Humanos , Ceratolíticos/uso terapêutico , Ácido Salicílico/uso terapêutico , Resultado do Tratamento
13.
Clin Dermatol ; 39(4): 688-694, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34809773

RESUMO

Plantar warts are among the most common skin conditions and are classically resistant to treatment. To perform an evidence-based evaluation of the efficacy and safety of available treatment options for plantar warts, we conducted a systematic review of PubMed and Cochrane databases to identify large interventional and observational studies involving more than 100 patients who were treated for plantar warts from inception to October 2020. We identified only nine contributions meeting our inclusion criteria (N ≥ 100), representing 1,657 adult and pediatric patients with plantar warts. Treatments included in this review were topical keratolytic agents, cryotherapy, laser therapies, and intralesional and systemic treatments. Our evidence-based review of the larger studies suggests keratolytic agents and destructive treatments, in particular salicylic acid and cryotherapy, remain the primary treatments for plantar warts. Treatment with pulsed dye laser had the lowest rate of recurrence. Newer treatments and intralesional treatments were not represented owing to lack of large studies involving these modalities.


Assuntos
Dermatologia , Verrugas , Adulto , Criança , Crioterapia , Humanos , Ceratolíticos/uso terapêutico , Ácido Salicílico/uso terapêutico , Resultado do Tratamento , Verrugas/terapia
16.
J Cosmet Dermatol ; 20 Suppl 2: 2-6, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34318988

RESUMO

BACKGROUND: Acne vulgaris is a common skin condition affecting the pilosebaceous unit of the skin characterized by the presence of comedones, papules, pustules, nodules, and cysts, which might result in permanent scars. It commonly affects adolescents, but it can occur in any age-group with the second group of incidence in young women in their 30s. Acne vulgaris can highly affect a person's quality of life. Therefore, it is necessary to act against it to prevent emotional impact and long-term complications. AIM: This study aimed to demonstrate the efficacy of a chemical peel in combination with a home care-exfoliating and purifying product in improving mild and moderate acne. METHODS: The study included 45 patients with mild-to-moderate acne. Patients were treated with a chemical peel containing a mix of salicylic acid, pyruvic acid, and retinoic acid once every 3 weeks for 4 times, plus a home care treatment after the healing process. Michaelson's acne severity score, Subject Global Aesthetic Improvement Scale, and Face Skin Q questionnaire were used to evaluate patients' skin improvement and patients' satisfaction. RESULTS: All patients have shown improvement in skin lesions after 4 sessions of chemical peel according to Michaelson's acne severity score and Subject Global Aesthetic Improvement Score. Face Skin Q questionnaire demonstrated an improved quality of life in all treated patients. CONCLUSION: The combination of salicylic acid-based chemical peel plus exfoliating home care treatment appears to be a very good strategy against acne. Therefore, the physician may use this combination as an effective treatment for patients dealing with acne vulgaris.


Assuntos
Acne Vulgar , Abrasão Química , Acne Vulgar/tratamento farmacológico , Adolescente , Feminino , Humanos , Ceratolíticos/uso terapêutico , Qualidade de Vida , Ácido Salicílico/uso terapêutico , Resultado do Tratamento
17.
J Drugs Dermatol ; 20(6): 608-615, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34076400

RESUMO

BACKGROUND: Two identical phase 3 trials (NCT03168321 and NCT03168334) and pooled post hoc analyses have established efficacy and safety of a polymeric tazarotene 0.045% lotion formulation in patients with moderate-to-severe acne. Presented here are post hoc analyses that further examine efficacy and safety of tazarotene 0.045% lotion by age and sex. METHODS: Patients aged ≥ 9 years with moderate-to-severe acne (score 3 or 4 on the Evaluator's Global Severity Score [EGSS]) were equally randomized to once-daily tazarotene 0.045% lotion or vehicle lotion for 12 weeks. Efficacy outcomes included inflammatory/noninflammatory lesion counts and treatment success (proportion of participants achieving ≥ 2-grade reduction from baseline in EGSS and score of 0 [clear] or 1 [almost clear]). Adolescent and adult females (n=1,013) and males (n=529) were subdivided into 3 age groups: 13­19, 20­29, and ≥30 years. RESULTS: At week 12, large least-squares mean percent reductions in inflammatory and noninflammatory lesions were observed across all 3 tazarotene-treated age groups in males and females (range, -50.2% to -64.8%). Treatment success rates ranged from 23.6% to 38.4%. Across all efficacy assessments, significant differences between tazarotene and vehicle (P<0.05) were generally observed in the younger male and female participants (13­19 and 20­29). No notable age-related patterns were found for safety outcomes, though tazarotene-treated males of all age groups reported fewer adverse events than females. CONCLUSIONS: Tazarotene 0.045% lotion is efficacious and well tolerated in female and male adolescents and adults with moderate-to-severe acne. J Drugs Dermatol. 2021;20(6):608-615. doi:10.36849/JDD.6070.


Assuntos
Acne Vulgar , Acne Vulgar/diagnóstico , Acne Vulgar/tratamento farmacológico , Administração Cutânea , Adolescente , Adulto , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Ceratolíticos/uso terapêutico , Masculino , Ácidos Nicotínicos , Qualidade de Vida , Índice de Gravidade de Doença , Creme para a Pele , Resultado do Tratamento , Adulto Jovem
18.
Oncology (Williston Park) ; 35(5): 272-276, 2021 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-33998784

RESUMO

A man, age 45 years, was diagnosed with intermediate-risk stage IV clear cell renal carcinoma (lung and lymph node metastases). He was prescribed first-line systemic treatment with sunitinib (Sutent) 50 mg per day (each cycle: 4 weeks on, 2 weeks off). Upon day 22 of his second sunitinib cycle, he came to the oncology clinic complaining of difficulty walking due to bilateral sole pain. He described initial tingling sensations, which then became burning and painful, with symmetrical erythema and edema of the soles, without blisters. These turned into painful plaques with yellowish discoloration and hyperkeratosis on pressure-bearing areas. He denied fever or other symptoms. The pain limited his instrumental activities of daily living, but not his self-care activities of daily living. Total body skin examination disclosed hyperkeratotic plaques on the undersurface of the great toes and heels of both feet, predominantly at sites of pressure; no blisters, crusts, ulcers, or fissures were found. No relevant findings were found upon physical examination of his hands, mucosae, and scalp. A diagnosis of grade 2 hand-foot skin reaction (HFSR) was made.


Assuntos
Antineoplásicos/efeitos adversos , Carcinoma de Células Renais/tratamento farmacológico , Síndrome Mão-Pé/patologia , Neoplasias Renais/tratamento farmacológico , Sunitinibe/efeitos adversos , Corticosteroides/uso terapêutico , Antineoplásicos/uso terapêutico , Síndrome Mão-Pé/tratamento farmacológico , Humanos , Ceratolíticos/uso terapêutico , Masculino , Pessoa de Meia-Idade , Sunitinibe/uso terapêutico
20.
Dermatol Online J ; 27(4)2021 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-33999577

RESUMO

Subcorneal pustular dermatosis is a rare chronic relapsing bullous neutrophilic dermatosis. Because it can be associated with monoclonal gammopathy of undetermined significance and multiple myeloma, screening for these conditions is necessary. Herein, we present a case of subcorneal pustular dermatosis, with concurrent monoclonal gammopathy of undetermined significance, successfully treated with acitretin.


Assuntos
Imunoglobulina G , Gamopatia Monoclonal de Significância Indeterminada/complicações , Dermatopatias Vesiculobolhosas/complicações , Acitretina/uso terapêutico , Adulto , Feminino , Humanos , Imunoglobulina A , Imunoglobulina M , Ceratolíticos/uso terapêutico , Masculino , Neutrófilos , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/imunologia , Dermatopatias Vesiculobolhosas/patologia
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