A comparison of metronidazole 1% cream and pimecrolimus 1% cream in the treatment of patients with papulopustular rosacea: a randomized open-label clinical trial.

BACKGROUND: There are various treatment options available for rosacea, depending on the subtype, but treatment is still generally unsatisfactory. Some reports have indicated beneficial effects of topical pimecrolimus. AIM: To compare the efficacy and safety of pimecrolimus 1% cream and metronidazole 1% cream in the treatment of patients with papulopustular rosacea (PR). METHODS: A group of 49 patients with PR was investigated in this single-centre, randomized, open-label study. Patients were randomly assigned treatment with either pimecrolimus 1% cream or metronidazole 1% cream for 12 weeks. Response was evaluated by the inflammatory lesion count, the severity of facial erythema and telangiectasia, Physician's Global Assessment (PGA), and safety and tolerability at baseline and at weeks 3, 6, 9 and 12. RESULTS: In total, 48 patients completed the study. Both treatments were very effective in the treatment of PR. There were no significant differences between the treatments in inflammatory lesion counts, overall erythema severity scores and PGA evaluated from baseline to week 12 (P > 0.05). Neither treatment produced any clinically relevant improvement in telangiectasia. CONCLUSION: Pimecrolimus cream is no more efficacious than metronidazole cream in the treatment of PR.

Serum cytokine and chemokine profiles in patients with alopecia areata.

BACKGROUND: Most evidence supports the role of altered T cell-mediated immunity in the pathogenesis of alopecia areata (AA). Tough cytokines and chemokines play an important role in the immune process of AA, their expressions have been examined in limited studies. OBJECTIVE: To determine serum cytokine levels of TNF-α, IL-6, and IL-23, and some of the Th1-(CXCL9), Th2-(CCL17), and Th17-associated (CCL20 and CCL27) chemokines in patients with AA. METHODS: Forty patients with AA and 40 healthy controls were enrolled in the study. Serum concentrations of cytokines and chemokines were measured using enzyme-linked immunoassay techniques. RESULTS: The mean serum levels of TNF-α, IL-6, IL-23, CXCL9, CCL17, CCL20, and CCL27 in AA patients were significantly higher than in the controls. However, with logistic regression analyses, only CCL17 and CCL27 levels showed a positive relationship, and IL-23 levels showed a negative relationship, with the presence of AA. Furthermore, serum CCL27 levels were positively correlated with AA severity. CONCLUSION: This study suggests that CCL17 and CCL27 may have an aggravating effect, whereas IL-23 may have a protective effect for the development of AA. Additionally, serum CCL27 levels may be useful as marker of disease severity.

Recurrent lupus vulgaris following repeated BCG (Bacillus Calmette Guèrin) vaccination.

We report a case of lupus vulgaris following BCG (Bacillus Calmette Guèrin) vaccination on the right shoulder. The patient had a history of lupus vulgaris on his left shoulder that developed following BCG vaccination and was treated successfully eight years ago.

Purine catabolic enzymes and nitric oxide in patients with recurrent aphthous ulceration.

OBJECTIVES: Recurrent aphthous ulceration (RAU) is one of the most common oral mucosal disorders found in humans. Although the exact etiology of RAU is unkown, local and systemic conditions, and genetic, immunologic, and infectious factors all have been identified as potential etiopathogenic agents. The aim of our study was to compare serum xanthine oxidase (XO) and adenosine deaminase (AD) activities, and malondialdehyde (MDA), nitric oxide (NO) and uric acid (UA) levels in a group of patients affected by RAU and in a group of healthy controls. SUBJECTS AND METHODS: A total of 26 patients with minor RAU were included in the study. Twenty-six healthy volunteers were selected to form the control group. AD and XO activities, and UA, NO, and MDA levels were studied in the serum samples of all patients and controls. RESULTS: Serum XO and AD activities, and MDA, NO, and UA levels were significantly higher in RAU patients than in controls. CONCLUSION: Increased XO and AD activities, NO and UA levels and lipid peroxidation were thought to take part in the pathogenesis of RAU. Hence the effects of XO inhibitors in the treatment of RAU should be evaluated in future studies.

Oxidant-antioxidant enzymes and lipid peroxidation in generalized vitiligo.

Vitiligo is a common pigmentary disorder of the skin with selective destruction of melanocytes. The pathogenetic mechanisms in vitiligo have not been completely clarified. The aim of our investigation was to evaluate the oxidative stress in the pathogenesis of generalized vitiligo. Twenty-seven patients with generalized vitiligo and 24 phototype-, age-, and sex-matched healthy controls were included in this study. We analysed serum levels of malondialdehyde (MDA), nitric oxide (NO), and serum activities of superoxide dismutase (SOD) and xanthine oxidase (XO) in the patients with vitiligo and in the controls. We found significantly higher levels of MDA and XO activity (P < 0.001 and P < 0.05, respectively), and a significantly lower level of serum SOD activity (P < 0.05) in patients with vitiligo compared with the controls. However, the increase in the level of serum NO was insignificant (P > 0.05). These results suggest that lipid peroxidation of cellular membrane of melanocytes by free radicals may have a significant role in the pathogenesis of generalized vitiligo.