1
|
Docampo-Simón A, Beltrá-Picó I, Sánchez-Pujol MJ, Fuster-Ruiz-de-Apodaca R, Selva-Otaolaurruchi J, Betlloch I, Pascual JC. Topical 15% Resorcinol Is Associated with High Treatment Satisfaction in Patients with Mild to Moderate Hidradenitis Suppurativa. Dermatology 2021; 238:82-85. [PMID: 33887735 DOI: 10.1159/000515450] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 02/24/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Topical 15% resorcinol is commonly used in clinical practice for the treatment of nodules and abscesses in patients with hidradenitis suppurativa (HS). It has been shown to be clinically effective in some small studies, but data on satisfaction perceived by patients are lacking. The Treatment Satisfaction Questionnaire for Medication (TSQM) version 1.4 is a validated measure of patient satisfaction, evaluating four domains: effectiveness, side effects, convenience, and global satisfaction. Our objective was to obtain data from HS patients regarding resorcinol treatment satisfaction and its relationship with clinical and epidemiological variables. METHODS We performed a cross-sectional study providing TSQM version 1.4 questionnaires to HS patients who had been prescribed topical resorcinol during the previous 24 months. RESULTS Ninety-two patients answered the questionnaire. Eighty-five out of 92 (92.4%) were Hurley II and 7 Hurley I. The mean total score was 317.5 out of 400 (71.0 points in effectiveness, 93.6 in side effects, 79.3 in convenience, and 73.2 in global satisfaction). Total score was higher in men than in women (329.7 vs. 311.6, p = 0.026) and higher scores on convenience were seen in patients who were not overweight or obese (86.9 vs. 77.1, p = 0.016). Most patients (65, 70.6%) denied having any side effect. 78 (84.8%) of the patients would recommend the treatment. CONCLUSION The results of this study suggest that HS patients treated with resorcinol 15% are very satisfied with this treatment.
Collapse
Affiliation(s)
| | - Iván Beltrá-Picó
- Department of Pharmacy, Alicante University General Hospital, Alicante, Spain
| | | | | | | | - Isabel Betlloch
- Department of Dermatology, Alicante University General Hospital, Alicante, Spain
| | - José Carlos Pascual
- Department of Dermatology, Alicante University General Hospital, Alicante, Spain
| |
Collapse
|
2
|
Grada A, Feldman SR, Bragazzi NL, Damiani G. Patient-reported outcomes of topical therapies in actinic keratosis: A systematic review. Dermatol Ther 2021; 34:e14833. [PMID: 33527673 PMCID: PMC8047920 DOI: 10.1111/dth.14833] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/07/2021] [Accepted: 01/21/2021] [Indexed: 02/01/2023]
Abstract
Patients' perspectives on actinic keratosis treatments may have an impact on treatment adherence and, therefore, therapeutic outcomes. We performed a systematic review to assess patients' perspectives of topical, field‐directed treatments for actinic keratoses. A literature search was conducted, and 14 studies were identified encompassing 4433 patients. Only four studies were focused on face and/or scalp, which are the locations that typically impact patients' quality of life. Four studies were clinical trials. One study utilized a validated patient‐reported outcomes (PRO) instrument specifically developed for actinic keratosis. In general, treatment adherence and patient satisfaction were better with shorter‐duration treatment regimens such as ingenol mebutate gel. Imiquimod improved quality of life in one study but not in another. No data was available on topical piroxicam. The findings underscore the need for effective and well‐tolerated, short‐duration topical treatment for actinic keratosis.
Collapse
Affiliation(s)
- Ayman Grada
- R&D and Medical Affairs, Almirall (US), Exton, PA, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Nicola Luigi Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Ontario, Canada
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy.,Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy.,Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| |
Collapse
|
3
|
Pavel TI, Chircov C, Rădulescu M, Grumezescu AM. Regenerative Wound Dressings for Skin Cancer. Cancers (Basel) 2020; 12:cancers12102954. [PMID: 33066077 PMCID: PMC7601961 DOI: 10.3390/cancers12102954] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/09/2020] [Accepted: 10/11/2020] [Indexed: 12/12/2022] Open
Abstract
Skin cancer is considered the most prevalent cancer type globally, with a continuously increasing prevalence and mortality growth rate. Additionally, the high risk of recurrence makes skin cancer treatment among the most expensive of all cancers, with average costs estimated to double within 5 years. Although tumor excision is the most effective approach among the available strategies, surgical interventions could be disfiguring, requiring additional skin grafts for covering the defects. In this context, post-surgery management should involve the application of wound dressings for promoting skin regeneration and preventing tumor recurrence and microbial infections, which still represents a considerable clinical challenge. Therefore, this paper aims to provide an up-to-date overview regarding the current status of regenerative wound dressings for skin cancer therapy. Specifically, the recent discoveries in natural biocompounds as anti-cancer agents for skin cancer treatment and the most intensively studied biomaterials for bioactive wound dressing development will be described.
Collapse
Affiliation(s)
- Teodor Iulian Pavel
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, RO-060042 Bucharest, Romania; (T.I.P.); (C.C.); (A.M.G.)
| | - Cristina Chircov
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, RO-060042 Bucharest, Romania; (T.I.P.); (C.C.); (A.M.G.)
| | - Marius Rădulescu
- Department of Inorganic Chemistry, Physical Chemistry and Electrochemistry, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, 1–7 Polizu Street, 011061 Bucharest, Romania
- Correspondence: ; Tel.: +40-21-402-3997
| | - Alexandru Mihai Grumezescu
- Department of Science and Engineering of Oxide Materials and Nanomaterials, Faculty of Applied Chemistry and Materials Science, University Politehnica of Bucharest, RO-060042 Bucharest, Romania; (T.I.P.); (C.C.); (A.M.G.)
| |
Collapse
|
4
|
Ezzedine K, Painchault C, Brignone M. Use of complete clearance for assessing treatment efficacy for 5-fluorouracil interventions in actinic keratoses: how baseline lesion count can impact this outcome. JOURNAL OF MARKET ACCESS & HEALTH POLICY 2020; 8:1829884. [PMID: 33133432 PMCID: PMC7580760 DOI: 10.1080/20016689.2020.1829884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/18/2020] [Accepted: 09/21/2020] [Indexed: 06/11/2023]
Abstract
Background: Many trials in actinic keratoses (AK) use complete clearance rate (100% reduction in number of lesions) as the primary endpoint. We explore limitations (predominantly baseline factors) associated with this outcome. Objective: This analysis assessed the effect of baseline lesion count on complete clearance rate using randomized controlled trials (RCTs) that evaluated 5-fluorouracil (5-FU) formulations, alone or with 10% salicylic acid solution, in patients with AK. Methodology: Correlation between baseline lesion count and complete clearance rate at week 8 was assessed using Pearson's coefficient. Results: Five RCTs assessing 5-FU (4%, 5%, or 0.5% in 10% salicylic acid solution) in 1,080 patients with AK were included. Mean lesion count at baseline ranged from 8.1 to 21.2 lesions per patient. Complete clearance rate was negatively associated with number of lesions at baseline. Correlation between mean number of lesions at baseline and complete clearance rate was strong (r2 = 0.94) and statistically significant (p < 0.001). Conclusion: This analysis showed that, in a homogenous set of trials, complete clearance rates achieved with 5-FU interventions are inversely related to number of lesions at baseline. These findings highlight the limits of restricting treatment evaluation to complete clearance rate and the relevance of alternative measures.
Collapse
Affiliation(s)
- Khaled Ezzedine
- Department of Dermatology, University Hospital Henri Mondor, Créteil, France
| | | | - Melanie Brignone
- Market access and HEOR department, Pierre Fabre, Boulogne-Billancourt, France
| |
Collapse
|
5
|
Schmitz L, Hansen JB, Bastian M, Larsson T, Stockfleth E. Treatment responder analysis in actinic keratosis: can it lead the way to individualized choice of treatment? J DERMATOL TREAT 2019; 32:411-417. [PMID: 31469026 DOI: 10.1080/09546634.2019.1662879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND It is unclear if there are any distinct AK patient populations that might respond best to a given treatment. OBJECTIVE To identify if a distinct subgroup of patients with AK might respond better to treatment with ingenol mebutate (IngMeb) versus diclofenac sodium (DS). METHODS Complete clearance of AK and mean lesion reduction at end of first treatment course and week 17 were evaluated within subgroups. RESULTS 502 patients (255 IngMeb; 247 DS) were included in the analysis. At week 17, complete clearance was achieved by more patients treated with IngMeb versus DS within the majority of patient subgroups, including patients with <6 lesions and ≥6 lesions at baseline, aged ≥65 years, males, females, Fitzpatrick skin types II and III, and facial lesions. Mean lesion reduction at week 17 was greater with IngMeb than DS within the same subgroups, and in patients with scalp lesions. CONCLUSIONS This responder analysis did not identify any distinct population that responded more optimally than others with IngMeb or DS. More patients achieved complete clearance and higher lesion reduction of AK with IngMeb compared with DS in most subgroups.
Collapse
Affiliation(s)
- Lutz Schmitz
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| | | | | | | | - Eggert Stockfleth
- Department of Dermatology, Faculty of Medicine, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
6
|
Nakahara T, Fujita H, Arima K, Taguchi Y, Motoyama S, Furue M. Treatment satisfaction in atopic dermatitis relates to patient-reported severity: A cross-sectional study. Allergy 2019; 74:1179-1181. [PMID: 30593669 DOI: 10.1111/all.13712] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- T. Nakahara
- Division of Skin Surface Sensing; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
- Department of Dermatology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| | | | | | | | | | - M. Furue
- Department of Dermatology; Graduate School of Medical Sciences; Kyushu University; Fukuoka Japan
| |
Collapse
|
7
|
Lang BM, Peveling-Oberhag A, Zimmer S, Wegner J, Sohn A, Grabbe S, Staubach P. Effective treatment of disseminated superficial actinic porokeratosis with chemical peels - customary treatment for a rare disease. J DERMATOL TREAT 2019; 31:744-748. [PMID: 31018713 DOI: 10.1080/09546634.2019.1610551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Disseminated superficial actinic porokeratosis (DSAP) is a rare dermatologic disorder of the epidermis. Often misdiagnosed as chronic UV-damage or actinic keratoses, patients are treated for years with different therapeutic options with little success. Current treatment options include imiquimod, ingenol mebutate, cryosurgery, photodynamic therapy and topical or systemic therapy with retinoids. Since those approaches show only little success or come along with major side effects, therapeutic alternatives are strongly requested. Methods: We report a series of five female patients with history of DSAP that were successfully treated with chemical peels. Results: All patients suffered from the disease for 14.4 years on average and all were refractory to at least two therapeutic options, mostly imiquimod and topical tretinoin. Patients were treated with glycolic acid 50% and salicylic acid 25% in a two-layer-technique. After a mean of three cycles every 6 weeks a clear reduction in lesion was assessed by physicians. Patients were highly satisfied with outcome and rare occurrence of side effects as assessed by TSQM questionnaire. Conclusion: Chemical peels are safe and well tolerated treatment options for patients with refractory porokeratosis. As characteristic for chronic diseases, frequent repetition of treatment is needed in order to control disease activity.
Collapse
Affiliation(s)
- Berenice M Lang
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| | | | - Sebastian Zimmer
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| | - Joanna Wegner
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| | - Anna Sohn
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| | - Stephan Grabbe
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| | - Petra Staubach
- Department of Dermatology, University Medicine Mainz, Mainz, Germany
| |
Collapse
|
8
|
Fonda-Pascual P, Alegre-Sánchez A, Harto-Castaño A, Moreno-Arrones OM, Pérez-García B, González-Morales ML, Pindado-Ortega C, Gilaberte-Calzada Y, Aguilera J, Jaen-Olasolo P, Fernández-Guarino M. Low-level light-assisted photodynamic therapy using a wearable cap-like device for the treatment of actinic keratosis of the scalp. Photodiagnosis Photodyn Ther 2018; 25:136-141. [PMID: 30508663 DOI: 10.1016/j.pdpdt.2018.11.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 10/16/2018] [Accepted: 11/02/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Daylight photodynamic therapy (dlPDT) is a painless and increasingly cost-effective treatment for actinic keratosis (AK). New protocols avoid incubation, minimizing pain and adverse events. However, it is time-consuming and dependent on specific weather conditions. In patients with AK of the scalp, we evaluated the efficacy of indoor photodynamic therapy (PDT) using a wearable low-level light therapy (LLLT) device, without pre-incubation with a photosensitizing agent. METHODS In this pilot study, 27 patients with thin and moderately thick AK (Olsen Grades I-II) underwent a single 15-minute session of LLLT using a wearable cap-like device immediately after application of methyl-aminolevulinate (MAL) cream, with no prior preparation of the affected area. Treatment efficacy was quantified by measuring the reduction in AK lesion number and the AK quality of life (AKQoL) score. All AK lesions were mapped at baseline for follow-up 2 months later. Paired pre/post scalp biopsies from 5 patients were analysed using histological and immunohistochemical techniques (p53, p27, cyclin D1, p63, and Ki67 expression). Data were analysed using the Wilcoxon signed-rank test. RESULTS In all patients we observed a global reduction in the number of AK lesions (71%; p < 0.0001) and AKQoL score (from 5.6 to 4.4; p = 0.034) 2 months after treatment. Histology and immunohistochemistry of skin biopsies from 5 patients also revealed marked improvements after LLLT. No patients reported any pain during treatment. CONCLUSION PDT using LLLT is a rapid, painless, and efficacious modality for the treatment of AK.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - José Aguilera
- Dermal Photobiology Laboratory, Medical Research Center, School of Medicine, University of Malaga, E-29071, Málaga, Spain.
| | | | | |
Collapse
|
9
|
Skroza N, Bernardini N, Proietti I, Potenza C. Clinical utility of ingenol mebutate in the management of actinic keratosis: perspectives from clinical practice. Ther Clin Risk Manag 2018; 14:1879-1885. [PMID: 30323610 PMCID: PMC6174892 DOI: 10.2147/tcrm.s145779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Actinic keratoses (AKs) are epidermal cutaneous neoplasia observed predominantly in middle-aged and older subjects with mainly photo type I and photo type II on sun-exposed surfaces as a result of DNA damage. AKs have historically been characterized as being "precancerous"; however, now it is considered by many authors a carcinoma in situ that can persist or progress to invasive squamous cell carcinoma (SCC) with metastatic potential. Despite the advances in the recognition of typical clinic, dermoscopic and histologic patterns, currently it is not yet possible to predict which AKs will progress to SCC. For this reason, early diagnosis and effective therapy are recommended based on cost/risk/benefit analysis. Current treatment consists of lesion-directed or field-directed therapies or a combination of both. Among the topical field therapies, ingenol mebutate stands out for its therapeutic efficacy, both as directed lesion therapy and as field directed therapy. The aim of this review is to demonstrate the utility of ingenol mebutate in the management of AK in daily clinical practice and to highlight data from real world in order to confirm evidence from pivotal studies. In order to explore clinical data from real world, PubMed searches were performed with the search terms "clinical data ingenol mebutate" and "real world ingenol mebutate". The hits were examined for relevant articles using defaults criteria. The timeframe for the sample search started from the first publication on this topic in 2008 up to now. A total of 23 articles were found using the keywords specified above. The overview points out a low number of real-life studies on the effectiveness and tolerability of this novel treatment due to short period of clinical experience for its recent approval. Further real-life studies are required in order to better identify the efficacy, safety and adherence of the drug on a larger population.
Collapse
Affiliation(s)
- Nevena Skroza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy,
| | - Nicoletta Bernardini
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy,
| | - Ilaria Proietti
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy,
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, Fiorini Hospital, Polo Pontino, 04019 Terracina, Italy,
| |
Collapse
|