Comparative Study of the Use of Trichloroacetic Acid and Phenolic Acid in the Treatment of Atrophic-Type Acne Scars.

BACKGROUND: Many therapies involving varying degrees of complexity have been used to treat acne scars, but none is considered the gold standard treatment. OBJECTIVE: A comparative evaluation of 88% phenol and 90% trichloroacetic acid (TCA) applied using the chemical reconstruction of skin scars (CROSS) technique. MATERIALS AND METHODS: A nonrandomized, single-blinded self-controlled clinical trial was conducted among patients with ice pick-type and boxcar-type atrophic acne scars. Using 88% phenol on the left hemiface and 90% TCA on the right hemiface was adopted as the standard practice of the CROSS technique. The dermatological quality of life index (DLQI) questionnaire, acne scar grading scale Échelle d´Evaluation Clinique des Cicatrices d'Acne (ECCA), and evaluation of improvement were performed pretreatment and post-treatment. RESULTS: Regarding ECCA, significant differences were found in pretreatment and post-treatment (p < .001). Regarding tolerance to pain, it was found that the discomfort felt with 90% TCA was significantly less than that felt with 88% phenol (p = .020). Regarding the quality of life measured with the DLQI, the results showed that the mean score in post-treatment assessment was significantly lower than that in the pretreatment assessment (p < .05). Hypochromia and enlargement scar were only seen after the use of 90% TCA. CONCLUSION: This study confirmed the efficacy of both TCA and phenol for treating such scars, with less severe complications from the use of phenol.

Novel antiplatelet activity of protocatechuic acid through the inhibition of high shear stress-induced platelet aggregation.

Bleeding is the most common and serious adverse effect of currently available antiplatelet drugs. Many efforts are being made to develop novel antithrombotic agents without bleeding risks. Shear stress-induced platelet aggregation (SIPA), which occurs under abnormally high shear stress, plays a crucial role in the development of arterial thrombotic diseases. Here, we demonstrate that protocatechuic acid (PCA), a bioactive phytochemical from Lonicera (honeysuckle) flowers, selectively and potently inhibits high shear (>10,000 s(-1))-induced platelet aggregation. In isolated human platelets, PCA decreased SIPA and attenuated accompanying platelet activation, including intracellular calcium mobilization, granule secretion, and adhesion receptor expression. The anti-SIPA effect of PCA was mediated through blockade of von Willebrand factor binding to activated glycoprotein Ib, a primary and initial event for the accomplishment of SIPA. Conspicuously, PCA did not inhibit platelet aggregation induced by other endogenous agonists like collagen, thrombin, or ADP that are important in both pathological thrombosis and normal hemostasis. Antithrombotic effects of PCA were confirmed in vivo in a rat arterial thrombosis model, where PCA significantly delayed the arterial occlusion induced by FeCl(3). Of particular note, PCA did not increase bleeding times in a rat tail transection model, whereas conventional antiplatelet drugs, aspirin, and clopidogrel substantially prolonged it. Collectively, these results suggest that PCA may be a novel antiplatelet agent that can prevent thrombosis without increasing bleeding risks.

Study on the anaphylactoid of three phenolic acids in Honeysuckle.

ETHNOPHARMACOLOGICAL RELEVANCE: Chlorogenic acid (CA) is one of the major ingredients in Honeysuckle which exhibits anticancer, antibacterial, antiviral, hypoglycemic and anti-HIV activities. However, with the frequent emergence of anaphylactoid reactions of traditional Chinese medicine (TCM) injections which contains Honeysuckle in recent years, many researchers found that CA exhibited allergenicity. AIM OF THE STUDY: To explore the changes of content of CA, neochlorogenic acid (NCA) and cryptochlorogenic acid (CCA) during the preparation of Honeysuckle and evaluate the anaphylactoid of these three ingredients. MATERIALS AND METHODS: Two extracts of Honeysuckle were prepared by different methods and the content of CA, NCA and CCA were determined by high performance liquid chromatography (HPLC) analysis. Guinea pig and mast cells RBL-2H3 were utilized as the animal and cell model to investigate the anaphylactoid of these three ingredients. RESULTS: The content of CA decreased while CCA and NCA increased during the preparation of Honeysuckle. In vitro and in vivo studies showed that CA and CCA could significantly increase the plasma serotonin and ß-hexosaminidase levels in guinea pigs and induce the degranulation of RBL-2H3 cell, while NCA did not show such properties. In addition, CAA had a stronger effect than CA. CONCLUSION: We believed that both CA and CCA could cause anaphylactoid reaction while NCA could not. Moreover, the anaphylactoid of CCA is higher than CA. Our result demonstrated that CA is not the only cause of anaphylactoid reactions of TCM injections which contains Honeysuckle.

Nifuroxazide in acute diarrhoea: OTC preparation. Irrational.

(1) Nifuroxazide, an intestinal antibacterial agent, is now available in France, without a prescription, for the treatment of acute diarrhoea in adults. (2) According to the only available comparative randomised trial, there is no effect on dehydration. Relative to a placebo, the mean number of stools is reduced by about one per day during the first two days of treatment, with no significant difference thereafter.

Nifuroxazide-induced acute pancreatitis: a new side-effect for an old drug?

We report the case of a middle-aged woman who developed a typical picture of acute pancreatitis together with systemic features of immunoallergy after the intake of two capsules (200 mg) of nifuroxazide. Even if acute pancreatitis is a rare adverse event of nitrofuran derivative therapy, nifuroxazide-induced pancreatitis as not been previously described. As suggested by associated systemic features, the disease is likely of immunoallergic origin.

Photosensitivity and allergy to aromatic lichen acids, Compositae oleoresins and other plant substances.

Sixteen patients with verified light sensitivity to both UVB and UVA wavebands showed allergic reactions to various lichen plants (Parmelia spp., Hypogymnia spp., Pseudovernia spp., Cladonia spp., Platismatia spp., Physcia spp., Umbilicaria spp. and Cetraria spp.). Among the aromatic lichen compounds, atranorin was observed to be the most frequently involved allergen, but also several other isolated lichen acids were immunologically active: d-usnic, evernic, stictic, fumarprotocetraric, lobaric, salazinic, diffractaic and physodic/physodalic acid. Several patients showed allergy to other plant substances from other sources such as seven different species from the Compositae family, alantolactone, balsam of Peru, colophony and wood tars. Sensitivity to known photosensitizers was observed in four patients. Aromatic lichen acids are UV-absorbing substances and several are evidently able to photosensitize human skin.

Contact allergy to atranorin in lichens and perfumes.

Atranorin, one of the most common lichen substances, gave positive patch test reactions in eight subjects (1%) in a routine series. These subjects also reacted to fumarprotocetraric acid and some of them to evernic acid. Stictic acid and usnic acid gave negative reactions. The lichen oak moss Evernia prunastri and an oak moss perfume gave positive reactions. Thin-layer chromatography and a spot test indicated that atranorin is present in oak moss perfumes which are made from oak moss and tree moss. Contact with oak moss perfumes and lichens in nature may cause atranorin allergy. None of the eight subjects had a history of light sensitivity or atopy and none had chronic facial eczema.

Allergy to lichen acids in a fragrance.

A 48-year-old clerical officer with a recurrent facial eruption had positive patch test reactions to nickel, fragrance mix and lichen acid mix. On testing to individual ingredients of fragrance mix and lichen acid mix, she had 2+ reactions to oak moss, which is thought to be the main allergen in fragrance mix, and to usnic acid, which is one of a number of lichen acids comprising oak moss. Avoidance of fragrance use resulted in clearing of the eruption but, subsequently, an acute vesicular flare on her face and hands occurred after exposure to lichen on garden shrubs.

The sensitizing capacity of atranorin.

The allergenic potential of the aromatic lichen substance atranorin has been investigated by means of the guinea pig maximization test of Magnusson & Kligman. Sensitivity was induced in 30% of the animals, which corresponds to a moderate allergenic capacity (grade III). This is in agreement with the clinically-observed frequency of 1.5% among our patients. A modified photoallergy test on the same animals was performed, but irradiation did not increase the number of positive reactions. 4 patients with proven contact sensitivity to atranorin, evernic, usnic or physodic acid, were examined with different dilutions from 0.001 to 0.1%. Irradiation of the test series did not provoke any clear-cut photoallergic reaction.

Photosensitivity and allergy to aromatic lichen acids, Compositae oleoresins and other plant substances.

Sixteen patients with verified light sensitivity to both UVB and UVA wavebands showed allergic reactions to various lichen plants (Parmelia spp., Hypogymnia spp., Pseuodovernia spp., Cladonia spp., Platismatia spp., Physcia spp., Umbilicaria spp. and Cetraria spp.). Among the aromatic lichen compounds, atranorin was observed to be the most frequently involved allergen but also several other isolated lichen acids were immunologically active: d-usnic, evernic, stictic, fumarprotocetraric, lobaric, salazinic, diffractaic and physodic/physodalic acid. Several patients showed allergy to other plant substances from other sources such as seven different species from the Compositae family, alantolactone, balsam of Peru, colophony and wood tars. Sensitivity to known photosensitizers was observed in four patients. Aromatic lichen acids are UV-absorbing substances and several are evidently able to photosensitive human skin.

In vitro stimulation of lymphocytes in patients with chronic urticaria induced by additives and food.

We studied the stimulation of lymphocytes in 258 patients with urticaria and/or angioedema using a series of food extracts and additives. Of this group, 238 revealed a positive response index (RI). There was a positive RI to additives in 18.4% of the cases, to food extracts in 35.2% and to both extracts and additives in 46.6% of the cases. A positive RI to both aspirin and tartrazine was revealed in 25% and to all the additives tested in 11% of the cases. Diets from which food extracts and additives were excluded achieved total remission in 159 (61.1%), partial remission in fifty-seven cases (22%) and no remission in forty-two (16.2).

Challenge test battery in chronic urticaria.

The use of a battery of challenge tests in the routine investigations of patients with chronic urticaria has an important place, demonstrating an exacerbating factor in over half the patients. Diets designed to reduce the ingestion of the substances concerned are associated with clearing or considerable improvements in 75% of the patients treated.

Fetal toxicity and hypocalcemia induced by acetylsalicylic acid analogues.

In the present study, we investigated a correlation of fetotoxicity induced by salicylic acid (SA) analogues to their hypocalcemic effect. Among of SA analogues, acetylsalicylic acid, salicylaldehyde, salicyl-alcohol, methyl salicylate and SA evoked a hypocalcemia in rats and mice but the other analogues had no effect by their single administration. The additional administration of dihydroxybenzoic acids elicited the hypocalcemia following the fetal toxicities induced by SA analogues paralleled to that of their hypocalcemic effect. A hypocalcemic effect was induced only by the benzoic acids with hydroxy group existing in ortho-position.

Granulomatous lung disease in children by aspiration of medications.

Post mortem examinations of 8 infants, 11 d to 5 months old and one 12 year old girl, demonstrated foreign bodies in the lungs which could be identified as orally administered drugs: cholestyramine (Questran) and phenobarbital (Luminal, Gardenal) or phenydantin-components. The microscopic changes caused by such deposits and the histologic methods of identifying medicines are presented. The authors point to the role of aspiration in deposit formation and to the pseudomiliary granulomatous nature of subsequent changes. It is proposed to define the alterations as a separate form of aspiratory lesion in children.