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1.
N Engl J Med ; 384(6): 512-520, 2021 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-33567191

RESUMO

BACKGROUND: The tubulin polymerization and Src kinase signaling inhibitor tirbanibulin is being investigated as a topical treatment for actinic keratosis, a precursor of squamous-cell carcinoma. METHODS: In two identically designed double-blind trials, we randomly assigned, in a 1:1 ratio, adults with actinic keratoses on the face or scalp to receive either topical tirbanibulin or vehicle (placebo) ointment. The ointment was applied by the patients to a 25-cm2 contiguous area containing four to eight lesions once daily for 5 consecutive days. The primary outcome was the percentage of patients with a complete (100%) reduction in the number of lesions in the application area at day 57. The secondary outcome was the percentage of patients with a partial (≥75%) reduction in the number of lesions within the application area at day 57. The incidence of recurrence was evaluated at 1 year. Local reactions were scored with the use of 4-point scale (ranging from 0 [absent] to 3 [severe]). RESULTS: A total of 702 patients were enrolled in the two trials (351 patients per trial). Complete clearance in trial 1 occurred in 44% of the patients (77 of 175) in the tirbanibulin group and in 5% of those (8 of 176) in the vehicle group (difference, 40 percentage points; 95% confidence interval [CI], 32 to 47; P<0.001); in trial 2, the percentages were 54% (97 of 178 patients) and 13% (22 of 173), respectively (difference, 42 percentage points; 95% CI, 33 to 51; P<0.001). The percentages of patients with partial clearance were significantly higher in the tirbanibulin groups than in the vehicle groups. At 1 year, the estimated percentage of patients with recurrent lesions was 47% among patients who had had a complete response to tirbanibulin. The most common local reactions to tirbanibulin were erythema in 91% of the patients and flaking or scaling in 82%. Adverse events with tirbanibulin were application-site pain in 10% of the patients and pruritus in 9%, all of which resolved. CONCLUSIONS: In two identically designed trials, tirbanibulin 1% ointment applied once daily for 5 days was superior to vehicle for the treatment of actinic keratosis at 2 months but was associated with transient local reactions and recurrence of lesions at 1 year. Trials comparing tirbanibulin with conventional treatments and that have longer follow-up are needed to determine the effects of tirbanibulin therapy on actinic keratosis. (Funded by Athenex; ClinicalTrials.gov numbers, NCT03285477 and NCT03285490.).


Assuntos
Acetamidas/uso terapêutico , Inibidores Enzimáticos/uso terapêutico , Ceratose Actínica/tratamento farmacológico , Morfolinas/uso terapêutico , Piridinas/uso terapêutico , Acetamidas/efeitos adversos , Administração Tópica , Idoso , Método Duplo-Cego , Inibidores Enzimáticos/efeitos adversos , Face/patologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Morfolinas/efeitos adversos , Pomadas/uso terapêutico , Polimerização/efeitos dos fármacos , Piridinas/efeitos adversos , Couro Cabeludo/patologia , Pele/patologia , Tubulina (Proteína)/metabolismo
2.
J Drugs Dermatol ; 23(1): 1253-1259, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38206142

RESUMO

INTRODUCTION: Most people are living into their sixties and beyond. Fundamental changes in chronologically aged skin have significant and widespread dermatological implications. This review discusses aging-associated alterations in epidermal function leading to xerosis and related pruritus and the benefits of maintaining or restoring a healthy skin barrier using skincare, specifically ceramide-containing skincare.   Methods: A panel of 7 dermatologists convened for a meeting to review aspects of xerosis in mature skin, skin barrier changes, and nuances in the treatment and maintenance of mature skin using gentle cleansers and moisturizers. From the selected literature, 13 statements were drafted. During the meeting, the draft statements underwent the panel's evaluation at a workshop, followed by a plenary discussion adopting 5 statements using evidence from the literature coupled with the panel's opinions and experiences. RESULTS: The exact etiology of xerosis is not entirely understood and likely depends on several genetic and environmental mechanisms. Aging-associated changes in epidermal function include a marked reduction in total lipids in the stratum corneum relative to young skin due to reduced epidermal lipid synthesis. In aging skin, xerosis is significantly associated with pruritus. Studies have shown that lipid-containing skin care, such as a gentle ceramide-containing cleanser and moisturizer, promotes a healthy barrier reducing xerosis and pruritus in individuals with mature skin.  Conclusions: The development of xerosis in mature skin involves several genetic and environmental mechanisms. Skincare, including gentle cleansers and moisturizers, has reduced xerosis and pruritus in mature skin individuals.     J Drugs Dermatol. 2024;23(1):1253-1259.     doi:10.36849/JDD.7560.


Assuntos
Prurido , Higiene da Pele , Pele , Idoso , Humanos , Ceramidas , Epiderme , Prurido/etiologia , Prurido/terapia
3.
J Drugs Dermatol ; 23(3): SF400676s3-SF400676s14, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38443134

RESUMO

Integrated skin care is defined as the complementary use of topical treatments to nonsurgical facial rejuvenation procedures, such as lasers and radiofrequency microneedling devices, to produce pleasing aesthetic results. Real-world experience from expert dermatologists is invaluable in guiding patient treatment plans, as there are limited clinical trials on the efficacy of integrated skincare regimens. The SkinCeuticals (New York, NY) Phyto Corrective gel (botanical serum-containing corrective gel) contains a lightweight botanical serum that hydrates, calms, and soothes skin. It contains antioxidant and anti-inflammatory ingredients derived from plant and fruit extracts, making it an appealing option for adjunctive treatment of post-procedure erythema and swelling.  J Drugs Dermatol. 2024;23:3(Suppl 2):s3-s14.


Assuntos
Indução Percutânea de Colágeno , Rejuvenescimento , Humanos , Antioxidantes , Ácido Dioctil Sulfossuccínico , Estética , Lasers , Fenolftaleína
4.
J Drugs Dermatol ; 23(5): 338-346, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38709702

RESUMO

BACKGROUND: The Patient-Reported Outcomes in Actinic Keratosis (PROAK) study evaluated patient- and clinician-reported outcomes (PRO; ClinRO) during 24 weeks of follow-up among adult patients with actinic keratosis (AK) on the face or scalp who were administered tirbanibulin 1% ointment in real-world community practices in the United States.  Methods: Quality of life (QoL) was assessed by Skindex-16 at week (W) 8. Additionally, effectiveness (Investigator Global Assessment [IGA]), PRO and ClinRO (Treatment Satisfaction Questionnaire for Medication and Expert Panel Questionnaire), safety, and tolerability were assessed at W8 and W24. RESULTS: The safety population included 300 patients; the full analysis set included 290 patients (278 patients at W24). At W8, a statistically significant difference (P<0.03) was observed for Skindex-16 domains in all assessed subgroups. Clinicians and patients reported high global satisfaction (mean [SD] scores of 74.9 [23.9] and 72.0 [24.6], respectively) at W24. Overall skin appearance improved from baseline to W24 (83.6% clinicians; 78.5% patients). IGA success (IGA score of 0-1) was achieved by 71.9% of patients at W24 with a similar % at W8 (73.8%) suggesting a stable effectiveness over time. About 5% of patients reported at least one adverse event, 4% reported at least one serious adverse event and no patients reported serious adverse drug reactions. At W8, the most frequently reported local skin reactions were mild/moderate erythema (47.6%) and flaking/scaling (49.6%). CONCLUSIONS: Treatment with tirbanibulin demonstrated effectiveness in the management of AK lesions and a favorable safety and tolerability profile. Furthermore, QoL was improved as early as W8, and both patients and clinicians reported high levels of treatment satisfaction, independently of patients' characteristics. J Drugs Dermatol. 2024;23(5):338-346. doi:10.36849/JDD.8264.


Assuntos
Ceratose Actínica , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Qualidade de Vida , Humanos , Ceratose Actínica/tratamento farmacológico , Ceratose Actínica/diagnóstico , Masculino , Feminino , Estados Unidos , Idoso , Pessoa de Meia-Idade , Resultado do Tratamento , Idoso de 80 Anos ou mais , Administração Cutânea , Pomadas , Seguimentos , Adulto , Inquéritos e Questionários/estatística & dados numéricos
5.
J Drugs Dermatol ; 23(8): 674-679, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39093643

RESUMO

BACKGROUND: Acne vulgaris is a complex, multifactorial, inflammatory skin condition. Although frequently presented at dermatology clinics, the literature on adult acne is scarce, particularly concerning skin barrier function and management. We aimed to provide insights into the role of skin barrier integrity in adult acne patients and the role of cleansers and moisturizers as adjunctive to treating and maintaining adult acne.   Methods: A panel of eight dermatologists who treat adult patients with acne developed a consensus paper on the role of skin barrier function and skin care in adult acne management. The modified Delphi method comprised a face-to-face meeting and online follow-up to discuss the results of a scoping literature review. Drawing from their experience and opinions, they agreed on seven consensus statements.   Results: Epidermal barrier dysfunction plays a vital role in acne pathogenesis and asymmetrically impacts adult female acne. Erythema, pruritus, peeling, and xerosis are common adverse effects of first-line acne treatment options and, if not appropriately counseled and managed, can exacerbate, leading to regimen nonadherence and poor patient experience and outcomes. CONCLUSION: Improving patient knowledge of comprehensive acne treatments, including quality adjunctive cleansers and moisturizers, may maximize regimen efficacy and provide patients with personalized and successful acne treatment and maintenance tools. J Drugs Dermatol. 2024;23(8):674-679.     doi:10.36849/JDD.8471.


Assuntos
Acne Vulgar , Higiene da Pele , Humanos , Acne Vulgar/terapia , Acne Vulgar/tratamento farmacológico , Higiene da Pele/métodos , Adulto , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/uso terapêutico , Feminino , Técnica Delphi , Consenso
6.
Aesthet Surg J ; 44(5): 527-536, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-37966371

RESUMO

BACKGROUND: In an evaluator-blinded, randomized controlled trial, the hyaluronic acid soft-tissue filler VYC-20L injectable gel was safe and effective for correcting volume deficits and retrusion in the chin. OBJECTIVES: The objective of this subanalysis was to compare responder rates obtained with photographic vs live assessments. METHODS: Participants were randomized 3:1 to VYC-20L treatment or a 6-month, no-treatment control period followed by optional treatment. Responder rates (≥1-point improvement from baseline on the validated Allergan Chin Retrusion Scale [ACRS]) obtained with photographic assessments and live assessments at Month 6 were compared. Prespecified subgroup analyses compared responder rates by baseline ACRS severity, filler volume, cannula usage, and investigation site. RESULTS: VYC-20L was effective for chin augmentation as evaluated with both live and photographic assessments. The ACRS responder rates at Month 6 were 91.8% with live assessments and 56.3% with photographic assessments. Consistently higher response rates were observed by live vs photographic assessment regardless of baseline ACRS severity, filler volume, cannula usage, and investigation site. CONCLUSIONS: Live assessment of ACRS response after VYC-20L treatment resulted in higher responder rates than photographic assessment, supporting the use of live assessment for this indication to approximate real-world clinical practice.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Humanos , Ácido Hialurônico/efeitos adversos , Queixo , Fotografação , Preenchedores Dérmicos/efeitos adversos , Resultado do Tratamento
7.
Dermatol Surg ; 49(2): 124-129, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-36728061

RESUMO

BACKGROUND: Although there are evidence-based guidelines for actinic keratosis management, selecting a cost-effective field therapy is challenging because of limited studies comparing cost, efficacy, and adherence among treatments. OBJECTIVE: To review the literature on field-directed therapies for actinic keratosis, comparing efficacy, cost, and adherence data for topical and in-office treatments. MATERIALS AND METHODS: PubMed, Embase, Web of Science, and Google Scholar databases were searched from October 2020 to March 2021 for articles on field therapy for actinic keratosis. Total cost per regimen was estimated using wholesale acquisition cost package prices and Medicare coverage rates for May 2021. Effective cost was approximated by dividing total cost by complete response rate. RESULTS: Efficacy data for various field therapies range widely, and long-term follow-up is limited. Cross-study comparisons are challenging because of heterogeneity of studies. Field-directed therapy with topical 5-fluorouracil and photodynamic therapy have similar effective cost. Adherence may significantly affect real-world efficacy and long-term clearance; this would favor shorter duration topical regimens or in-office procedures. CONCLUSION: Standardization of future studies examining efficacy of field treatments for actinic keratosis will allow comparison across treatments. In-office treatments such as photodynamic therapy represent a cost-effective alternative to topical therapies with comparable efficacy.


Assuntos
Ceratose Actínica , Fotoquimioterapia , Idoso , Humanos , Estados Unidos , Ceratose Actínica/tratamento farmacológico , Medicare , Fotoquimioterapia/métodos , Fluoruracila/uso terapêutico , Resultado do Tratamento
8.
J Am Acad Dermatol ; 87(2): 373-374.e5, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35439607

RESUMO

BACKGROUND: Actinic keratoses (AKs) are rough scaly patches that arise on chronically UV-exposed skin and can progress to keratinocyte carcinoma. OBJECTIVE: In 2021, the American Academy of Dermatology published guidelines to assist in clinical decision-making for the management of AK. The purpose of this focused guideline update is to incorporate recently available evidence on the use of topical tirbanibulin to treat AK. METHODS: A multidisciplinary work group conducted a systematic review to evaluate data on the use of tirbanibulin for AK and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading a clinical recommendation. The graded recommendation was voted on to achieve consensus. RESULTS: Two trials were identified, and analysis of the evidence resulted in 1 recommendation. LIMITATIONS: This analysis is based on the best available evidence at the time it was conducted. Long-term efficacy and safety data are not currently available. CONCLUSIONS: A strong recommendation for the use of topical tirbanibulin to join the currently recommended list of topical therapies for AK was made on the basis of the available evidence.


Assuntos
Ceratose Actínica , Acetamidas , Humanos , Ceratose Actínica/tratamento farmacológico , Ceratose Actínica/patologia , Morfolinas , Piridinas , Pele/patologia
9.
J Am Acad Dermatol ; 85(4): e209-e233, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33820677

RESUMO

BACKGROUND: Actinic keratoses (AK) are rough scaly patches that arise on chronically ultraviolet-exposed skin and can progress to keratinocyte carcinoma. OBJECTIVE: This analysis examined the literature related to the management of AK to provide evidence-based recommendations for treatment. Grading, histologic classification, natural history, risk of progression, and dermatologic surveillance of AKs are also discussed. METHODS: A multidisciplinary Work Group conducted a systematic review to address 5 clinical questions on the management of AKs and applied the Grading of Recommendations, Assessment, Development, and Evaluation approach for assessing the certainty of the evidence and formulating and grading clinical recommendations. Graded recommendations were voted on to achieve consensus. RESULTS: Analysis of the evidence resulted in 18 recommendations. LIMITATIONS: This analysis is based on the best available evidence at the time it was conducted. The pragmatic decision to limit the literature review to English language randomized trials may have excluded data published in other languages or limited identification of relevant long-term follow-up data. CONCLUSIONS: Strong recommendations are made for using ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery. Conditional recommendations are made for the use of photodynamic therapy and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.


Assuntos
Ceratose Actínica , Fotoquimioterapia , Diclofenaco/uso terapêutico , Fluoruracila/uso terapêutico , Humanos , Imiquimode/uso terapêutico , Ceratose Actínica/tratamento farmacológico
10.
J Am Acad Dermatol ; 85(4): 945-955, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34111497

RESUMO

BACKGROUND: Actinic keratoses (AK) are rough scaly patches that arise on chronically ultraviolet-exposed skin and can progress to keratinocyte carcinoma. Treatment options for AK include topical medications, photodynamic therapy, cryosurgery, and laser ablation. OBJECTIVE: This executive summary provides a synopsis of the 18 evidence-based recommendations for the treatment of AK detailed in the Guidelines of Care for the Management of Actinic Keratosis. METHODS: A multidisciplinary workgroup conducted a systematic review to address 5 clinical questions on the management of AKs and applied the Grading of Recommendations Assessment, Development and Evaluation approach for assessing the certainty of the evidence and formulating and grading clinical recommendations. Graded recommendations were voted on to achieve consensus. RESULTS: Analysis of the evidence resulted in 18 recommendations, suggesting there are several effective treatments available for AK. LIMITATIONS: The analysis informing the recommendations was based on the best available evidence at the time it was conducted. The results of future studies may necessitate a revision of current recommendations. CONCLUSIONS: Strong recommendations are presented for using ultraviolet protection, topical imiquimod, topical 5-fluorouracil, and cryosurgery. Conditional recommendations are presented for the use of photodynamic therapy and diclofenac for the treatment of AK, both individually and as part of combination therapy regimens.


Assuntos
Ceratose Actínica , Criocirurgia , Fluoruracila/uso terapêutico , Humanos , Imiquimode/uso terapêutico , Ceratose Actínica/tratamento farmacológico , Fotoquimioterapia , Guias de Prática Clínica como Assunto
11.
Dermatol Surg ; 46(8): 1086-1091, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31634252

RESUMO

BACKGROUND: This report synthesizes 12 years of postmarket surveillance data (PMSD) for polymethylmethacrylate (PMMA)-collagen gel dermal filler. OBJECTIVE: To present PMMA-collagen gel PMSD findings on real-world safety. METHODS: Postmarket surveillance data were collected from January 2007 to December 2018 and evaluated to determine the overall adverse event (AE) complaint rate, the nature of reported AEs, and whether the complaint included on-label, off-label, both, or unknown areas. RESULTS: In the 12 years examined, 754,229 PMMA-collagen gel syringes were distributed worldwide, and 839 product-related complaints (including those classified as unknown) resulted in an overall complaint rate of 0.11%. The 3 most frequent primary complaints in AE reports were lump/bump (309/839, 37%), nodule (152/839, 18%), and swelling (138/839, 16%). Histologically confirmed granuloma accounted for 17/839 complaints (2.0%; overall complaint rate of 0.002%), and histologically unconfirmed granuloma accounted for 66/839 complaints (8%; overall rate of 0.009%). There were 666 complaints representing AEs related to off-label injection in which the periocular area was most frequently represented. CONCLUSION: Although a limiting factor across all PMSD is voluntary reporting and resultant underrepresentation of AEs, the PMSD reported here are consistent with safety findings from US clinical studies in more than 1,500 patients with up to 5 years of follow-up.


Assuntos
Colágeno/efeitos adversos , Edema/induzido quimicamente , Granuloma/induzido quimicamente , Naftalenos/efeitos adversos , Polímeros/efeitos adversos , Dermatopatias/induzido quimicamente , Preenchedores Dérmicos , Combinação de Medicamentos , Face , Géis , Humanos , Uso Off-Label/estatística & dados numéricos , Vigilância de Produtos Comercializados/estatística & dados numéricos
12.
J Drugs Dermatol ; 19(9): 874-880, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33026749

RESUMO

OBJECTIVE: To demonstrate the efficacy and safety of adding fixed-dose combination calcipotriene 0.005% plus betamethasone dipropionate 0.064% (Cal/BD) foam to oral apremilast in treating moderate plaque psoriasis. METHODS: A 16-week, investigator-blinded study in patients with moderate psoriasis (Physician’s Global Assessment [PGA] score of 3). Patients were randomized 1:1 to Cal/BD foam plus apremilast or vehicle foam plus apremilast for 4 weeks, followed by 8 weeks of apremilast monotherapy, and then 4 weeks of combination therapy as in the original randomization schedule. Efficacy assessments – Psoriasis Area and Severity Index (PASI), PGA, body surface area (BSA), visual analog scale (VAS) for pruritus, and quality of life (QoL) – and safety were evaluated at weeks 1, 2, 3, 4, 12, and 16. RESULTS: 28 subjects were enrolled (mean age, 64 years; 67.9% males). Cal/BD foam plus apremilast group achieved statistically significantly greater improvement than vehicle foam plus apremilast in PASI75 (50% vs 7%; P=.003), PGA score of “clear” or “almost clear” (43% vs 7%; P=.001), and VAS score (2 vs 5; P=.0079) at week 4. BSA and QoL improvements were also observed. Most efficacy assessments worsened after withdrawing Cal/BD foam for 8 weeks but recovered after reinitiating Cal/BD foam from week 12 to week 16. Cal/BD foam plus apremilast appeared to be safe and well tolerated. CONCLUSIONS: In the treatment of moderate plaque psoriasis, Cal/BD foam plus apremilast provided more benefits than with apremilast alone. These improvements appeared to be lost when Cal/BD foam was withdrawn but recovered when Cal/BD foam was reinitiated. J Drugs Dermatol. 2020;19(9):874-880. doi:10.36849/JDD.2020.5020.


Assuntos
Betametasona/análogos & derivados , Calcitriol/análogos & derivados , Fármacos Dermatológicos/administração & dosagem , Prurido/tratamento farmacológico , Psoríase/tratamento farmacológico , Talidomida/análogos & derivados , Administração Cutânea , Administração Oral , Adulto , Aerossóis , Idoso , Idoso de 80 Anos ou mais , Betametasona/administração & dosagem , Betametasona/efeitos adversos , Calcitriol/administração & dosagem , Calcitriol/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Combinação de Medicamentos , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/diagnóstico , Prurido/imunologia , Psoríase/complicações , Psoríase/diagnóstico , Psoríase/imunologia , Qualidade de Vida , Índice de Gravidade de Doença , Talidomida/administração & dosagem , Talidomida/efeitos adversos , Resultado do Tratamento , Escala Visual Analógica
13.
Dermatol Surg ; 45(12): 1570-1579, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30807389

RESUMO

BACKGROUND: Microneedling and soft-tissue filler injections have been used independently to improve acne scarring. The effectiveness of a combined approach using microneedling followed by polymethylmethacrylate (PMMA)-collagen gel has not been carefully studied. OBJECTIVE: The goal of this study was to assess the effectiveness and safety of microneedling alone versus microneedling followed by injection of PMMA-collagen gel filler for correction of atrophic facial acne scars. METHODS: We conducted a multicenter, open-label, randomized, prospective study on subjects with distensible atrophic acne scars in the face to determine whether microneedling with PMMA-collagen gel is a superior acne scar treatment over microneedling alone. Forty-four subjects received 3 microneedling treatments over a 12-week period followed by randomization to treatments with PMMA-collagen gel (treatment group) or no further treatment (control group). RESULTS: At 24 weeks, the treatment group achieved a statistically significant improvement in acne scores over microneedling alone. The improvement continued at 36 weeks. At 24 weeks, the treatment group showed a strong trend in improvement on the Physician Global Aesthetic Improvement Scale compared with microneedling alone.


Assuntos
Cicatriz/terapia , Colágeno/administração & dosagem , Preenchedores Dérmicos/administração & dosagem , Agulhas , Polimetil Metacrilato/administração & dosagem , Acne Vulgar/complicações , Adulto , Idoso , Atrofia/diagnóstico , Atrofia/etiologia , Atrofia/terapia , Cicatriz/diagnóstico , Cicatriz/etiologia , Colágeno/efeitos adversos , Terapia Combinada/efeitos adversos , Terapia Combinada/métodos , Preenchedores Dérmicos/efeitos adversos , Face , Feminino , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Polimetil Metacrilato/efeitos adversos , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
14.
J Drugs Dermatol ; 18(7): s178-182, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31336414

RESUMO

Seborrheic keratosis (SK) is an extremely common benign cutaneous lesion that often appears on individuals older than the age of 50. SK lesions can appear in numerous clinical variations, but typically, SKs present with a well-demarcated, "stuck-on" appearance having a waxy or keratotic surface. Even though SK lesions are usually benign, many individuals elect for SK treatment or removal due to cosmetic concerns. One study regarding SK appearance reported that 61% of women tried to conceal the appearance of the SKs by using certain hairstyles, make-up, and clothes. Conventional treatment for SK lesions ranges from cryosurgery to curettage. Although these removal methods are effective for SK treatment, each method contains a potential for side effects such as pigmentation changes, scarring, and discomfort before and after the procedure. Due to many of these concerns, patients prefer topical treatments for SKs, which has led to a new emerging topical containing hydrogen peroxide topical solution 40% (HP40; Eskata™). Here, we report the methods and results from an HP40 treatment for two individuals, each over 70 years old. Application of the topical solution was performed on each target SK, up to four times, with a 20-second application and 1 minute between applications. The two participants reported moderate success of HP40 in the removal of their SKs with minimal adverse effects. J Drugs Dermatol. 2019;18(7 Suppl):s178-182.


Assuntos
Peróxido de Hidrogênio/administração & dosagem , Ceratose Seborreica/tratamento farmacológico , Oxidantes/administração & dosagem , Administração Cutânea , Idoso , Feminino , Humanos , Masculino , Pescoço , Soluções , Tórax , Resultado do Tratamento
16.
J Cosmet Dermatol ; 23 Suppl 3: 1-11, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39291679

RESUMO

BACKGROUND: Medical aesthetic procedures for facial rejuvenation with laser and energy-based devices (EBDs) are rapidly increasing. The following cases highlight real-life experience using a multi-modality system with various handpieces that combine intense pulsed light (IPL), laser hair removal (808 diode), high-intensity focused ultrasound (HIFU), radiofrequency microneedling (RFM), and thermal radiofrequency (RF) for antiaging and rejuvenation treatment. Laser and RFM treatments may improve skin conditions by inducing cutaneous changes that remodel the skin matrix. METHODS: Six physicians who treat patients for skin rejuvenation reported on clinical cases from their practice using a multi-modality system with various handpieces. RESULTS: During the meeting, the advisors discussed 15 cases and agreed to select seven patients with different ages and skin phototypes receiving various treatments for photodamage of the face, neck, and décolleté. The advisors discussed why they selected the case, previous treatment, type of treatment, results, and clinical pearls. CONCLUSION: Sharing best practices in medical aesthetics using combination treatments on a single multi-modality energy-based device such as laser and MRF for facial, neck, and chest skin may support healthcare providers treating patients for skin rejuvenation to improve clinical outcomes.


Assuntos
Técnicas Cosméticas , Face , Ablação por Ultrassom Focalizado de Alta Intensidade , Terapia de Luz Pulsada Intensa , Agulhas , Rejuvenescimento , Envelhecimento da Pele , Humanos , Envelhecimento da Pele/efeitos da radiação , Feminino , Pessoa de Meia-Idade , Técnicas Cosméticas/instrumentação , Terapia de Luz Pulsada Intensa/métodos , Terapia de Luz Pulsada Intensa/instrumentação , Terapia Combinada/métodos , Ablação por Ultrassom Focalizado de Alta Intensidade/métodos , Ablação por Ultrassom Focalizado de Alta Intensidade/instrumentação , Ablação por Ultrassom Focalizado de Alta Intensidade/efeitos adversos , Adulto , Terapia por Radiofrequência/métodos , Idoso , Pescoço , Masculino , Resultado do Tratamento , Indução Percutânea de Colágeno
17.
J Clin Aesthet Dermatol ; 17(5): 30-33, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38779376

RESUMO

Seborrheic dermatitis (SD) is a chronic inflammatory skin condition that commonly involves the scalp, and thus, affects a diverse demographic with varying hair care needs. Current SD treatments are limited based on optimized formulation, efficacy, adverse events, and lack of placebo-controlled trials. A novel roflumilast foam formulation has emerged as a promising therapeutic option optimally designed for use on the scalp and other hair-bearing areas. We conducted a comprehensive assessment of beauty industry standards, confirming the foam formulation's alignment with industry guidelines and exclusion of potentially harmful ingredients. In addition, consultation with an expert dermatologist panel yielded a strong endorsement, underscoring a high level of confidence in prescribing the foam across diverse hair and skin types.

18.
J Cosmet Dermatol ; 23 Suppl 4: 1-9, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39291701

RESUMO

INTRODUCTION: Real-world experience using an allograft adipose matrix (AAM) (Renuva) is presented as a series of seven cases demonstrating successful use of the matrix by nine expert cosmetic physicians across the United States. AAM is donated tissue that is aseptically processed without terminal irradiation into a transplantable adipose matrix that functions as a natural, versatile, and nonimmunogenic cushioning and volume-restoring tissue. When injected, the adipose matrix is replaced with the body's own fat cells and provides the cellular scaffold required for volume restoration and retention. METHODS: Nine expert dermatologists were selected to share and discuss real-world patient cases using AAM. The experts discussed a variety of cases and selected 7 cases that demonstrated successful, novel use of AAM to present in this manuscript. RESULTS: Experts agreed that the novel AAM is an easy-to-use, effective, and safe alternative to traditional fillers and fat grafting. CONCLUSION: The use of the AAM is recommended for the face, hands, and other adipose tissue-containing parts of the body. The presented real-world cases provide guidance on how to identify ideal candidates to ensure optimal volume restoration results.


Assuntos
Tecido Adiposo , Técnicas Cosméticas , Face , Mãos , Humanos , Tecido Adiposo/transplante , Feminino , Pessoa de Meia-Idade , Adulto , Masculino , Aloenxertos , Resultado do Tratamento , Transplante Homólogo , Idoso
19.
JAAD Int ; 16: 192-198, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39040844

RESUMO

Background: Current assessments on topical treatment attributes in actinic keratosis (AK) do not evaluate safety, effectiveness, and satisfaction from both clinician and patient perspectives, creating an unmet need for more comprehensive AK-specific measures that fully capture the patient experience. Objective: To develop an actinic keratosis-specific expert panel questionnaire (AK-EPQ) of patient-reported outcomes and clinician-reported outcomes for use in research studies. Methods: Using interviews of patients with AK and targeted literature reviews, a 9-person consensus panel of dermatologists with expertise in AK treatment was convened to develop the AK-EPQ to assess AK-specific patient-reported outcomes and clinician-reported outcomes. Results: Nine expert advisers achieved consensus on 11 AK-EPQ items that encompass patient and clinician perspectives of treatment-related local skin reactions, clinical and cosmetic outcomes associated with AK, and satisfaction with treatment; the AK-EPQ will be first implemented in the Patient-Reported Outcomes for Actinic Keratosis study (NCT05260073). Limitations: The AK-EPQ does not directly measure quality of life, although it can be used with validated quality of life instruments. Conclusion: The newly developed AK-EPQ elicits insights into the patient and clinician experience with AK treatments. Comparative probing of these perspectives may help optimize precision medicine in AK treatment.

20.
Dermatol Ther (Heidelb) ; 14(2): 271-284, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38194021

RESUMO

Rosacea is a common, chronic inflammatory disease characterized by both fluctuating and fixed heterogeneous signs such as facial erythema, papules/pustules, telangiectasia, acute vasodilation (flushing), and phymatous changes, and symptoms such as cutaneous stinging and burning. The shift to a phenotype-based approach to rosacea management has improved the consistency of recommendations across recent published guidelines. Consistent and thorough guidance for the classification, diagnosis, and management of the disease is difficult, as the mechanisms underlying the development of rosacea are still not completely understood nor universally accepted. Here, we provide a critical review of current published guidance, and gaps in the knowledge and management of rosacea. We present the recently approved microencapsulated benzoyl peroxide as an effective topical treatment option for papulopustular rosacea. Benzoyl peroxide (BPO) has been used in acne management for many years; however, many clinicians perceive treatment of rosacea with any BPO formulation to be counterintuitive because of concerns of potential skin irritation, while the lack of an accepted mechanism of action on rosacea pathophysiology means that others may be hesitant to use BPO as a treatment. Minocycline foam 1.5% is also an option for the treatment of inflammatory lesions in rosacea, with a decreased risk of systemic adverse events compared with oral minocycline.

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