RESUMO
Introdução: O fotodano intenso e crônico geralmente produz inúmeras queratoses actínicas, sendo importante o tratamento precoce e global da pele acometida. Objetivo: Avaliar a efetividade de dois tratamentos distintos para ceratoses actínicas múltiplas. Métodos: Foram selecionados 5 pacientes com ceratoses actinicas difusas no dorso de mãos e antebraços foram submetidos ao seguinte protocolo: lado A (direito) peeling químico superficial quinzenal com ácido glicólico 70% em gel seguido de solução de 5-fluoracil 5%; lado B (esquerdo) criopeeling mensal. O número de sessões variou de quatro a seis no lado A e de duas a três no lado B, de acordo com o grau de fotodano. Resultados: Todos os pacientes apresentaram resposta clínica satisfatória, com melhora das ceratoses actínicas e de toda área de dano actínico, com boa tolerância dos pacientes ao tratamento, apenas com a ressalva de que ao criopeeling segue-se eritema mais intensoe persistente. Conclusões: As duas terapêuticas utilizadas constituem-se em alternativas válidas e eficazes para tratamento do "campo de cancerização".
Introduction: Chronic and intense photodamage usually produces numerous actinic keratoses, with early and global treatment of the affected skin being of paramount importance. Objective: To evaluate the effectiveness of two different treatments for multiple actinic keratoses. Methods: Five patients were selected Were selected five patients with diffuse, with diffuse actinic keratoses on the dorsum of the hands and forearms. The patients underwent the following protocol: Side A (right): biweekly superficial chemical peeling with 70% glycolic acid in gel, followed by the subsequent application of 5% 5-fluorouracil solution; Side B (left): monthly sessions of cryopeeling. The number of sessions ranged from four to six in Side A and two to three in Side B, according to the degree of photodamage. Results: All patients had a satisfactory clinical response, with improvement of actinic keratoses throughout the whole area of actinic damage, and good tolerance of the treatment among patients. The only exception was that a more intense and persistent erythema arises after the cryopeeling. Conclusions: Both treatments are valid and effective alternatives for the treatment of the field cancerization.
RESUMO
This paper reports an investigation on matrices based on the mucoadhesive polymers hydroxypropylmethylcellulose and sodium alginate, intended for sublingual administration of 1 mg lorazepam (LZ, 7-chloro-5-(2-chlorophenyl)-1,3-dihydro-3-hydroxy-2H-1,4-benzodiazepin-2-one, CAS 846-49-1). The effect of different amounts of three permeation enhancers, cetylpyridinium chloride (CPC), polyethoxylated castor oil (PCO) and polyethylene glycol dodecyl ether (PGDE) on LZ permeation from the matrices was investigated using three models: (a) cultured monolayer of human buccal epithelial cells; (b) hamster cheek pouch mucosa in vitro, and (c) buccal administration to rabbits in vivo. In the first two models the presence of promoters, except when present at the higher concentrations, increased the drug permeation rate. The permeation-reducing effect was rationalized on the basis of micellar complexation of the drug. In the living rabbit (c) model, only CPC at the highest tested concentration was moderately active, while in the cultured cell model activity differences among the enhancers were less evident. Different effects of the promoters in the ex vivo and in vivo models were tentatively explained on the basis of the structural characteristics of the absorbing membranes. The present study, while confirming the efficacy of CPC as promoter in models involving biological membranes, does not provide conclusive data on the validity of the cultured cells model for assessment of buccal drug absorption.