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Lee YM, Bahrami B, Selva D, Casson RJ, Chan WO. Scoping review of non-surgical treatment options for macular holes. Surv Ophthalmol 2024:S0039-6257(24)00043-2. [PMID: 38677557 DOI: 10.1016/j.survophthal.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/11/2024] [Accepted: 04/22/2024] [Indexed: 04/29/2024]
Abstract
Macular holes (MH) are full-thickness retinal defects affecting central vision. While vitrectomy with inner limiting membrane (ILM) peel is the conventional MH treatment, non-surgical alternatives are gaining interest to mitigate surgical risks. This study conducted a comprehensive literature review and analysis of non-surgical MH management. A systematic literature search was conducted on PubMed, Embase, Scopus, and the Cochrane Library from January 1, 1973, to September 13, 2023. Treatments included laser therapy, carbonic anhydrase inhibitors (CAIs), non-steroidal anti-inflammatories (NSAIDs), steroids (topical, subtenons, peribulbar, intravitreal), intravitreal gas, anti-vascular endothelial growth factors (VEGF) and ocriplasmin injections. Data extraction covered study details, patient characteristics, MH features, treatment outcomes, and recurrence rates. The initial search yielded 3,352 articles, refined to 83 articles which met inclusion criteria following screening. Overall reported anatomical closure rates were 36% with laser photocoagulation, 37% with intravitreal ocriplasmin, 55% with intravitreal gas. Closures were more frequently observed with topical NSAIDs (79%), steroids (84%) and CAIs (73%). Closures were more often observed in patients with smaller MH and in the presence of cystic macular oedema. Although non-surgical MH management approaches show potential for conservative therapy, evidence is limited to support routine use. Stage 1 and traumatic MH may benefit from a short period of observation but the gold standard approach for full-thickness MH remains to be vitrectomy with ILM peel.
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Affiliation(s)
- Yong Min Lee
- Ophthalmology department, Royal Adelaide Hospital, Adelaide SA 5000, Australia; Ophthalmology department, Modbury Hospital, Adelaide SA 5000, Australia; Machine Learning Division, Ophthalmic Research Laboratory, University of Adelaide, Adelaide SA 5005, Australia.
| | - Bobak Bahrami
- Ophthalmology department, Royal Adelaide Hospital, Adelaide SA 5000, Australia
| | - Dinesh Selva
- Ophthalmology department, Modbury Hospital, Adelaide SA 5000, Australia
| | - Robert J Casson
- Ophthalmology department, Royal Adelaide Hospital, Adelaide SA 5000, Australia; Machine Learning Division, Ophthalmic Research Laboratory, University of Adelaide, Adelaide SA 5005, Australia
| | - Weng Onn Chan
- Ophthalmology department, Royal Adelaide Hospital, Adelaide SA 5000, Australia; Machine Learning Division, Ophthalmic Research Laboratory, University of Adelaide, Adelaide SA 5005, Australia
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2
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Mann C, Dreher M, Rothschmidt JN, Staubach P. Burden of impaired sleep and its improvement through topical treatment in psoriasis and atopic dermatitis. J Dtsch Dermatol Ges 2024. [PMID: 38634699 DOI: 10.1111/ddg.15373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 01/11/2024] [Indexed: 04/19/2024]
Abstract
INTRODUCTION Patients with chronic inflammatory skin diseases often suffer from sleep disturbances. However, objective data on sleep architecture, especially to evaluate potential overall influences under therapy, are lacking. PATIENTS AND METHODS Pilot study on sleep quality changes including psoriasis and atopic dermatitis patients before and 2 weeks after intensive topical treatment. In addition to disease activity rating, patient-rated outcomes for itch severity and sleep quality and polygraphy was performed before and after topical therapy. RESULTS 14 psoriasis, eleven atopic dermatitis patients (10 female, 15 male) with a mean age of 49 years were included. Disease activity scores (EASI and PASI) were significantly reduced with topical therapy after 2 weeks (p < 0.001). Pruritus intensity (NRS) showed a significant influence on deep sleep, which resolved after therapy. Insomnia severity significantly decreased (r > 0.50, p < 0.05) and daytime sleepiness showed a significant reduction in 40% of patients. N3 (deep sleep) and REM sleep significantly improved, showing a strong effect (r > 0.50). The apnea-hypopnea index decreased in one of four patients independent of the individual BMI. CONCLUSIONS Through polygraphy, we demonstrated impaired sleep patterns in psoriasis and atopic dermatitis patients with itch as a relevant factor and beyond that, rapid sleep improvement under 2 weeks of topical treatment.
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Affiliation(s)
- Caroline Mann
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Matthias Dreher
- Division of Rheumatology and Clinical Immunology, Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- University Center for Autoimmunity, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Jan-Niklas Rothschmidt
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
| | - Petra Staubach
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
- University Center for Autoimmunity, University Medical Center of the Johannes Gutenberg University, Mainz, Germany
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3
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Camiña-Conforto G, Ivars M, Sarquella-Brugada G, Valera-Dávila C, Salvador H, Rovira C, Baselga E. Phacomatosis pigmentokeratotica: Exploring extracutaneous comorbidities and topical therapy. Pediatr Dermatol 2024. [PMID: 38621679 DOI: 10.1111/pde.15632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 04/06/2024] [Indexed: 04/17/2024]
Abstract
Phacomatosis pigmentokeratotica (PPK) is a RASopathy characterized by the presence of a sebaceous nevus and a papular speckled lentiginous nevus. This case report highlights the associated extracutaneous comorbidities, including life-threatening arrhythmia, and introduces topical rapamycin as a potential therapeutic avenue for sebaceous nevus in PPK patients.
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Affiliation(s)
| | - Marta Ivars
- Department of Dermatology, Inherited Cardiac Diseases and Sudden Death Unit, Barcelona, Spain
| | | | - Carlos Valera-Dávila
- Department of Neurology, Hospital Sant Joan de Déu de Barcelona, Barcelona, Spain
| | - Héctor Salvador
- Department of Pediatric Oncology, Hospital Sant Joan de Déu de Barcelona, Barcelona, Spain
| | - Carlota Rovira
- Department of Pathology, Hospital Sant Joan de Déu de Barcelona, Barcelona, Spain
| | - Eulalia Baselga
- Department of Dermatology, Inherited Cardiac Diseases and Sudden Death Unit, Barcelona, Spain
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Lazar M, Zhang AD, Vashi NA. Topical Treatments in Atopic Dermatitis: An Expansive Review. J Clin Med 2024; 13:2185. [PMID: 38673458 DOI: 10.3390/jcm13082185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Atopic dermatitis (AD) is a common inflammatory skin condition found worldwide. It impacts patient quality of life (QoL) and is thought to arise as an inflammatory response to epidermal barrier dysfunction and hypersensitivity. AD can lead to large out-of-pocket costs and increased healthcare expenses over a lifetime. An analysis of all randomized control trials conducted since 1990 on topical therapies for AD were reviewed, including 207 trials in the final analysis. It was found that an average of 226 patients were enrolled over 2.43 arms. Common topical treatments included corticosteroids, calcineurin inhibitors, JAK inhibitors, and phosphodiesterase inhibitors. The most utilized tools to identify treatment efficacy were the EASI, IGA, SCORAD, and PGA. There was a paucity of data on trials that evaluated efficacy, QoL, and cost of treatment simultaneously. This review highlights the need for comprehensive trials that evaluate multiple aspects of treatment, including financial cost and QoL impact, to ensure each patient has the best treatment modality for the management of their AD.
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Affiliation(s)
- Michelle Lazar
- Department of Dermatology, Boston University School of Medicine, 609 Albany St., J502, Boston, MA 02118, USA
| | - Aurore D Zhang
- Department of Dermatology, Boston University School of Medicine, 609 Albany St., J502, Boston, MA 02118, USA
| | - Neelam A Vashi
- Department of Dermatology, Boston University School of Medicine, 609 Albany St., J502, Boston, MA 02118, USA
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Shao J, Li X, Li Y, Lin J, Huang P. Self-Heating Multistage Microneedle Patch for Topical Therapy of Skin Cancer. Adv Mater 2024; 36:e2308217. [PMID: 38198412 DOI: 10.1002/adma.202308217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/15/2023] [Indexed: 01/12/2024]
Abstract
Topical therapy is a favored route for treating skin cancers, but remain many challenges, such as low delivery efficiency, limited tumor tissue penetration, and unsatisfactory blood circulation. Here, a self-heating microneedle (MN) patch with multilevel structures, including a dissolvable base for rapid drug release, a degradable tip for sustained drug release, and a self-heating substrate is described. The thermally enhanced drug release performance is validated through both in vitro and in vivo experiments. High tumor therapeutic efficacy can be achieved due to the rapid release of 5-fluorouracil, while the sustained release of thymoquinone endows the MN patch with long-term tumor inhibition ability. It is further demonstrated the feasibility of such an MN patch for in vivo topical therapy of cutaneous squamous cell carcinoma with high efficacy, low side effects, and long-term inhibition of recurrence. This self-heating MN patch holds great promise for potential clinical applications, especially for the treatment of skin cancers.
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Affiliation(s)
- Jundong Shao
- Marshall Laboratory of Biomedical Engineering, International Cancer Center, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, 518060, P. R. China
| | - Xingxing Li
- Marshall Laboratory of Biomedical Engineering, International Cancer Center, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, 518060, P. R. China
| | - Yashi Li
- Marshall Laboratory of Biomedical Engineering, International Cancer Center, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, 518060, P. R. China
| | - Jing Lin
- Marshall Laboratory of Biomedical Engineering, International Cancer Center, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, 518060, P. R. China
| | - Peng Huang
- Marshall Laboratory of Biomedical Engineering, International Cancer Center, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, Shenzhen, 518060, P. R. China
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Lo A, Greenzaid JD, Gantz HY, Chodri K, Feldman SR. Clinical pharmacokinetics and pharmacodynamics of topical non-biological therapies for psoriasis patients. Expert Opin Drug Metab Toxicol 2024; 20:235-248. [PMID: 38553411 DOI: 10.1080/17425255.2024.2337749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Psoriasis is a chronic inflammatory cutaneous disease that causes patients psychosocial distress. Topical therapies are utilized for mild-to-moderate disease and for more severe disease in conjunction with systemic therapies. Topical corticosteroids are a cornerstone of treatment for psoriasis, but long-term use can cause stria and cutaneous atrophy and as well as systemic side effects such as topical steroid withdrawal. Non-steroidal topical therapies tend to be safer than topical corticosteroids for long-term use. AREAS COVERED We conducted a literature review on the pharmacokinetic (PK) and pharmacodynamic (PD) properties of topical therapies for psoriasis. We discuss how the PK and PD characteristics of these therapies inform clinicians on efficacy and toxicity when prescribing for patients. EXPERT OPINION Topical corticosteroids, used intermittently, are very safe and effective. Long-term, continuous use of topical corticosteroids can cause systemic side effects. Several generic and newly approved non-steroidal options are available, but no head-to-head studies compare the effectiveness of the generics (vitamin D analogs, tacrolimus, pimecrolimus) against the newer therapies (roflumilast, tapinarof). Patients often do not respond to topical therapies due to poor adherence to treatment regimens. For patients resistant to topical treatment, phototherapy or systemic therapy may be an option.
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Affiliation(s)
- Angela Lo
- University of Central Florida College of Medicine, Orlando, FL, USA
| | - Jonathan D Greenzaid
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Hannah Y Gantz
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kamran Chodri
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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7
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Mungo C, Adewumi K, Adoyo E, Zulu G, Goraya SK, Ogollah C, Omoto J, Ferrari RM, Rahangdale L. "There is nothing that can prevent me from supporting her:" men's perspectives on their involvement and support of women's use of topical therapy for cervical precancer treatment in Kenya. Front Oncol 2024; 14:1360337. [PMID: 38532929 PMCID: PMC10964769 DOI: 10.3389/fonc.2024.1360337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/16/2024] [Indexed: 03/28/2024] Open
Abstract
Purpose Cervical cancer disproportionately impacts women in low- and middle-income countries (LMICs). The World Health Organization's (WHO) 90/70/90 strategy aims to eliminate cervical cancer by 2030 by increasing HPV vaccination coverage to 90%, screening 70% of eligible women, and effectively treating 90% of those with abnormal results by 2030, potentially preventing 62 million deaths in LMICs. LMICs, however, struggle with limited access to cervical precancer treatment, in part due to a lack of trained professionals and weak health systems. Effective non-surgical, self-administered, which have demonstrated efficacy in high-income countries, could bridge the treatment gap in LMICs and may be more scalable and cost-effective than provider-administered therapies. To inform feasibility studies in LMICs, data are needed on the role of male partners in influencing the acceptability and uptake of self-administered topical therapies, including their support of recommended abstinence and contraception guidelines associated with these therapies. Methods Between November 2022 and April 2023, we conducted five focus group discussions (FGDs) with men aged 25 to 65 years in Kenya to explore their perspective and perceived support regarding their female partners using topical self-administered therapies for cervical precancer treatment. The FGDs were moderated by local qualitative research assistants and conducted in local languages, transcribed, coded, and analyzed using qualitative description. Results Thirty-nine male participants meeting the eligibility criteria participated in five FGDs. The mean age of participants was 42.5 years. Most participants, 79.5%, had a female partner with a history of cervical precancer treatment, 5.1% did not, and 15.4% were unsure of their female partner's prior precancer treatment history. The study aimed to assess men's support of their female partners' use of topical therapies for treating cervical precancer. We find that male participants strongly express acceptance and willingness to support their wives or partners in using such therapies, if available. Reported supportive behavior included permitting the use of the therapies and support of maintaining abstinence during the recommended times. Additionally, participants desired male involvement in clinic and community-based education about topical therapies to facilitate widespread support. Conclusion The use of self-administered topical therapies for cervical precancer treatment, if supported by efficacy studies in LMICs, may support achieving the WHO's 2030 goal of 90% treatment access. We find that with adequate education, men express overwhelming support of their female partner's use of topical therapies, including adherence to abstinence and contraception guidelines.
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Affiliation(s)
- Chemtai Mungo
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Konyin Adewumi
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Graham Zulu
- University of Denver, Denver, CO, United States
| | - Supreet Kaur Goraya
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Jackton Omoto
- Department of Obstetrics and Gynecology, Maseno University School of Medicine, Kisumu, Kenya
| | - Renée M. Ferrari
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lisa Rahangdale
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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8
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Thamm JR, Welzel J, Schuh S. Diagnosis and therapy of actinic keratosis. J Dtsch Dermatol Ges 2024. [PMID: 38456369 DOI: 10.1111/ddg.15288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/28/2023] [Indexed: 03/09/2024]
Abstract
Actinic keratosis (AK) is considered a chronic and recurring in situ skin neoplasia, with a possible transformation into invasive squamous cell carcinoma (SCC). Among others, predominant risk factors for development of AK are UV-light exposure and immunosuppression. Basal epidermal keratinocyte atypia (AK I) and proliferation (PRO score) seem to drive malignant transformation, rather than clinical appearance of AK (Olsen I-III). Due to the invasiveness of punch biopsy, those histological criteria are not regularly assessed. Non-invasive imaging techniques, such as optical coherence tomography (OCT), reflectance confocal microscopy (RCM) and line-field confocal OCT (LC-OCT) are helpful to distinguish complex cases of AK, Bowen's disease, and SCC. Moreover, LC-OCT can visualize the epidermis and the papillary dermis at cellular resolution, allowing real-time PRO score assessment. The decision-making for implementation of therapy is still based on clinical risk factors, ranging from lesion- to field-targeted and ablative to non-ablative regimens, but in approximately 85% of the cases a recurrence of AK can be observed after a 1-year follow-up. The possible beneficial use of imaging techniques for a non-invasive follow-up of AK to detect recurrence or invasive progression early on should be subject to critical evaluation in further studies.
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Affiliation(s)
- Janis Raphael Thamm
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Julia Welzel
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology and Allergology, University Hospital Augsburg, Augsburg, Germany
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9
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Axler E, Lipner SR. Antifungal Selection for the Treatment of Onychomycosis: Patient Considerations and Outcomes. Infect Drug Resist 2024; 17:819-843. [PMID: 38463386 PMCID: PMC10922011 DOI: 10.2147/idr.s431526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/24/2024] [Indexed: 03/12/2024] Open
Abstract
Onychomycosis, a common fungal nail infection, affects >20% of adults over age 60 and >50% of people over age 70. Onychomycosis may cause pain, psychosocial problems, and secondary infections, therefore meriting treatment. This review describes the range of treatment modalities, including FDA-approved systemic drugs and topical therapies. Additionally, new and emerging oral and topical therapies are discussed. We emphasize the importance of tailoring onychomycosis therapy to individual patient characteristics, comorbidities, preferences, extent of nail involvement, and fungal species, such that physicians may optimize treatment outcomes, patient satisfaction, and safety.
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Affiliation(s)
- Eden Axler
- Weill Cornell Medicine, Department of Dermatology, New York, NY, 10021, USA
| | - Shari R Lipner
- Weill Cornell Medicine, Department of Dermatology, New York, NY, 10021, USA
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10
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Polubothu S, Riachi M, Stadnik P, Ogunbiyi O, Brändli-Wälchli R, Cullup T, Sebire NJ, Pittman A, Kinsler VA. Inflammatory linear verrucous epidermal nevus should be genotyped to direct treatment and genetic counseling. J Am Acad Dermatol 2024:S0190-9622(24)00342-6. [PMID: 38360177 DOI: 10.1016/j.jaad.2024.01.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/15/2024] [Accepted: 01/31/2024] [Indexed: 02/17/2024]
Affiliation(s)
- Satyamaanasa Polubothu
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK; Mosaicism and Precision Medicine Laboratory, The Francis Crick Institute, London, UK; Paediatric Dermatology, Great Ormond St Hospital for Children, London, UK
| | - Melissa Riachi
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK; Mosaicism and Precision Medicine Laboratory, The Francis Crick Institute, London, UK
| | - Paulina Stadnik
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK
| | - Olumide Ogunbiyi
- Paediatric Pathology, Great Ormond St Hospital for Children, London, UK
| | | | - Thomas Cullup
- North Thames Genomic Laboratory Hub, Great Ormond Street Hospital, London, UK
| | - Neil J Sebire
- Paediatric Pathology, Great Ormond St Hospital for Children, London, UK
| | - Alan Pittman
- Genetics Research Centre (A.P.), St George's University of London, London, UK
| | - Veronica A Kinsler
- Genetics and Genomic Medicine, UCL GOS Institute of Child Health, London, UK; Mosaicism and Precision Medicine Laboratory, The Francis Crick Institute, London, UK; Paediatric Dermatology, Great Ormond St Hospital for Children, London, UK.
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11
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Mairal A, Mehrotra S, Kumar A, Maiwal R, Marsal J, Kumar A. Hyaluronic Acid-Conjugated Thermoresponsive Polymer-Based Bioformulation Enhanced Wound Healing and Gut Barrier Repair of a TNBS-Induced Colitis Injury Ex Vivo Model in a Dynamic Perfusion Device. ACS Appl Mater Interfaces 2024; 16:5382-5400. [PMID: 38266010 DOI: 10.1021/acsami.3c14113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Impairment of intestinal epithelium is a typical feature of inflammatory bowel disease (IBD) that causes leakage of bacteria and antigens from the intestinal lumen and thus results in persistent immune activation. Hence, healing and regeneration of the damaged gut mucosa is a promising therapeutic approach to achieve deep remission in IBD. Currently, available systemic therapies have moderate effects and are often associated with numerous side effects and malignancies. In this study, we aimed to develop a topical therapy by chemically conjugating a temperature-responsive polymer, i.e., poly(N-isopropylacrylamide), along with hyaluronic acid to obtain a sprayable therapeutic formulation that upon colon instillation adheres to the damaged gut mucosa due to its temperature-induced phase transition and mucoadhesive properties. An ex vivo adhesion experiment demonstrates that this therapeutic formulation forms a thin physical coating on the mucosal lining at a physiological temperature within 5 min. Physicochemical characterization of (P(NIPAM-co-NTBAM)-HA) established this formulation to be biocompatible, hemo-compatible, and non-immunogenic. Prednisolone was encapsulated within the polymer formulation to achieve maximum therapeutic efficacy in the case of IBD-like conditions as assessed in a custom-fabricated perfusion-based ex vivo model system. Histological analysis suggests that the prednisolone-encapsulated polymer formulation nearly restored the mucosal architecture after 2,4,6-trinitrobenzenesulfonic acid-induced damage. Furthermore, a significant (p ≤ 0.001) increase in mRNA levels of Muc-2 and ZO-1 in treated groups further confirmed the mucosal epithelial barrier restoration.
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Affiliation(s)
- Ayushi Mairal
- Department of Biological Sciences and Bioengineering; Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
| | - Shreya Mehrotra
- Department of Biological Sciences and Bioengineering; Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
- Centre for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
| | - Anupam Kumar
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, Delhi, India
| | - Rakhi Maiwal
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi 110070, Delhi, India
| | - Jan Marsal
- Department of Clinical Sciences, Lund University and Skåne University Hospital, SE-22185 Lund, Sweden
| | - Ashok Kumar
- Department of Biological Sciences and Bioengineering; Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
- Centre for Environmental Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
- The Mehta Family Centre for Engineering in Medicine, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
- Centre for Nanosciences, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
- Centre of Excellence for Orthopedics and Prosthetics, Gangwal School of Medical Sciences and Technology, Indian Institute of Technology Kanpur, Kanpur 208016, UP, India
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Elmets CA, Menter A, Malik S, Castillo DA. Response to letter to the editor "It's time to consider a new topical algorithm for psoriasis". J Am Acad Dermatol 2024; 90:e83. [PMID: 37821054 DOI: 10.1016/j.jaad.2023.08.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 10/13/2023]
Affiliation(s)
- Craig A Elmets
- Department of Dermatology, University of Alabama, Birmingham, Alabama
| | | | - Sameer Malik
- American Academy of Dermatology, Rosemont, Illinois
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13
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Astrada A, Pamungkas RA, Abidin KR. Advancements in Managing Wound Biofilm: A Systematic Review and Meta-analysis of Randomized Controlled Trials on Topical Modalities. Foot Ankle Spec 2024:19386400231225708. [PMID: 38282327 DOI: 10.1177/19386400231225708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Despite numerous available agents claiming anti-biofilm properties on wounds, the substantiating evidence remains inconclusive. This study aimed to assess the immediate impact of topical wound treatments on wound biofilm and healing outcomes in acute and chronic ulcers. We comprehensively searched PubMed, ClinicalTrials.gov, and Google Scholar. In addition, eligible gray literature was incorporated. English-language randomized controlled trials (RCTs), observational, cohort, and case-control studies targeting biofilm prevention, inhibition, or elimination across diverse wound types were included. Primary outcomes included biofilm presence and elimination, supplemented by secondary outcomes encompassing reduced wound size, complete closure, and diminished infection indicators. Bacterial load reduction and biofilm presence were also assessed. Twenty-eight articles met the inclusion criteria. Various modalities were identified, including biofilm-visualization techniques, such as wound blotting and handheld autofluorescence imaging. Pooled analysis for the primary outcomes was infeasible due to limited eligible studies and data-reporting challenges. As for the secondary outcomes, the pooled analysis for complete surgical wound closure (2 RCTs, yielding n=284) and presence of surgical site infections/inflammation (2 RCTs, yielding n=284) showed no significant difference, with a log odds ratio (LOD) of 0.58 (95% confidence interval [CI]: -.33, 1.50) and LOD -0.95 (95% CI: -3.54, 1.64; τ2 = 2.32, Q = 2.71, P = .10), respectively. Our findings suggest insufficient evidence to support anti-biofilm claims of topical modalities. Clinicians' skill appears to play a pivotal role in biofilm elimination and wound healing enhancement, with potential optimization through visual-guided techniques, such as wound blotting and autofluorescence imaging. More rigorous clinical trials are warranted to ascertain the efficacy of these techniques.Level of Evidence: Therapeutic, 1A.
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Affiliation(s)
- Adam Astrada
- School of Nursing, Faculty of Health Sciences, Esa Unggul University, Jakarta Barat, Indonesia
| | - Rian Adi Pamungkas
- School of Nursing, Faculty of Health Sciences, Esa Unggul University, Jakarta Barat, Indonesia
- School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Khoirul Rista Abidin
- Department of Medical Laboratory Technology, Politeknik 'Aisyiyah Pontianak, Pontianak City, Indonesia
- Department of Biotechnology, Postgraduate School, Padjadjaran University, Indonesia
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14
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Mahoney MJ, Gaddis KJ, Polcari IC. Chronic Crusted Plaque after Skin Injury. J Pediatr 2024; 264:113771. [PMID: 37838285 DOI: 10.1016/j.jpeds.2023.113771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023]
Affiliation(s)
| | - Kevin J Gaddis
- Department of Dermatology, University of Minnesota, Minneapolis, MN
| | - Ingrid C Polcari
- Department of Pediatrics, University of Minnesota, Minneapolis, MN; Division of Pediatric Dermatology, Department of Dermatology, University of Minnesota, Minneapolis, MN
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15
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Mungo C, Adewumi K, Adoyo E, Zulu G, Goraya SK, Ogollah C, Omoto J, Ferrari RM, Rahangdale L. "There is nothing that can prevent me from supporting her:" Men's perspectives on their involvement and support of women's use of topical therapy for cervical precancer treatment in Kenya. medRxiv 2023:2023.12.22.23300455. [PMID: 38234805 PMCID: PMC10793535 DOI: 10.1101/2023.12.22.23300455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Purpose Cervical cancer disproportionately impacts women in low- and middle-income countries (LMICs). The World Health Organization's (WHO) 90/70/90 strategy aims to eliminate cervical cancer by 2030 by increasing HPV vaccination coverage to 90%, screening 70% of eligible women, and effectively treating 90% of those with abnormal results by 2030, potentially preventing 62 million deaths in LMICs. LMICs, however, struggle with limited access to cervical precancer treatment, in part due to a lack of trained professionals and weak health systems. Effective non-surgical, self-administered, which have demonstrated efficacy in high-income countries, could bridge the treatment gap in LMICs and may be more scalable and cost-effective than provider-administered therapies. To inform feasibility studies in LMICs, data are needed on the role of male partners in influencing the acceptability and uptake of self-administered topical therapies, including their support of recommended abstinence and contraception guidelines associated with these therapies. Methods Between November 2022 and April 2023, we conducted five focus group discussions (FGDs) with men aged 25 to 65 years in Kenya to explore their perspective and perceived support regarding their female partners using topical self-administered therapies for cervical precancer treatment. The FGDs were moderated by local qualitative research assistants and conducted in local languages, transcribed, coded, and analyzed using qualitative description. Results Male participants in the FGDs strongly expressed acceptance and willingness to support their wives or partners in using topical therapies for cervical precancer treatment, if available. Reported supportive behavior included permitting the use of the therapies and support of maintaining abstinence during the recommended times. Additionally, participants desired male involvement in clinic and community-based education about topical therapies to facilitate widespread support. Conclusion The use of self-administered topical therapies for cervical precancer treatment, if supported by efficacy studies in LMICs, may support achieving the WHO's 2030 goal of 90% treatment access. We find that with adequate education, men express overwhelming support of their female partner's use of topical therapies, including adherence to abstinence and contraception guidelines.
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Affiliation(s)
- Chemtai Mungo
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Konyin Adewumi
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | | | | | - Supreet Kaur Goraya
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | | | - Jackton Omoto
- Department of Obstetrics and Gynecology, Maseno University School of Medicine, Kisumu, Kenya
| | - Renée M. Ferrari
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Lisa Rahangdale
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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16
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Desravines N, Hsu CH, Mohnot S, Sahasrabuddhe V, House M, Sauter E, O’Connor S, Bauman JE, Chow HHS, Rahangdale L. Feasibility of 5-fluorouracil and imiquimod for the topical treatment of cervical intraepithelial neoplasias (CIN) 2/3. Int J Gynaecol Obstet 2023; 163:862-867. [PMID: 37431689 PMCID: PMC10782812 DOI: 10.1002/ijgo.14983] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/06/2023] [Accepted: 06/16/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To determine the feasibility (as measured by tolerability and safety) and efficacy of topical 5-fluorouracil (5-FU) and imiquimod for the treatment of cervical intraepithelial neoplasia (CIN) 2/3. METHODS This pilot prospective study was conducted in women aged 18-45 years with p16+ CIN 2/3. Participants underwent an 8-week alternating regimen of self-applied 5% 5-FU on weeks 1, 3, 5, and 7 and physician-applied imiquimod on weeks 2, 4, 6, and 8. Adverse events (AEs) were collected by symptom diary and clinical exam. Feasibility was measured by tolerability and safety (AEs) of the study intervention. Tolerability was assessed as the number of participants able to apply 50% or more of the treatment doses. The safety outcome was calculated as the number of participants who experienced "specified AEs" defined as possibly, probably, or definitely related grade 2 or worse AE or grade 1 genital AEs (blisters, ulcerations, or pustules) lasting more than 5 days. The efficacy of the intervention was determined by histology and high-risk human papillomavirus (hrHPV) testing was done after treatment. RESULTS The median age of the 13 participants was 27 ± 2.9 years. Eleven (84.61%) participants applied 50% or more of the treatment. All participants reported grade 1 AEs; 6 (46.15%) reported grade 2 AEs; and 0 reported grade 3/4 AEs. Three (23.08%) participants had specified AEs. Histologic regression to normal or CIN 1 among those completing 50% or more of the treatment doses was observed in 10 (90.91%) participants, and 7 (63.63%) tested negative for hr-HPV at the end of the study. CONCLUSIONS Topical treatment for CIN 2/3 with 5-FU/imiquimod is feasible, with preliminary evidence of efficacy. Topical therapies need further investigation as adjuncts or alternatives to surgical therapy for CIN 2/3.
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Affiliation(s)
- Nerlyne Desravines
- Johns Hopkins School of Medicine, Department of Gynecology and Obstetrics, Baltimore, MD, USA
| | | | | | - Vikrant Sahasrabuddhe
- Breast and Gynecologic Cancer Research Group, Division of Cancer Prevention, Bethesda, MD, USA
| | - Margaret House
- Breast and Gynecologic Cancer Research Group, Division of Cancer Prevention, Bethesda, MD, USA
| | - Edward Sauter
- Breast and Gynecologic Cancer Research Group, Division of Cancer Prevention, Bethesda, MD, USA
| | - Siobhan O’Connor
- University of North Carolina Department of Pathology and Laboratory Medicine, Chapel Hill, NC, USA
| | | | | | - Lisa Rahangdale
- University of North Carolina Department of Obstetrics and Gynecology, Chapel Hill, NC, USA
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17
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Prados-Carmona A, Prados-Carmona JJ, Ruiz-Villaverde R, Navarro-Triviño FJ. Multiple minute digitate hyperkeratosis: 10 years from Caccetta's algorithm. A case report and narrative review. J Dtsch Dermatol Ges 2023; 21:1447-1454. [PMID: 37840359 DOI: 10.1111/ddg.15186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/18/2023] [Indexed: 10/17/2023]
Abstract
To date, the clinical appearance and histological features of multiple minute digitate hyperkeratosis have been well characterized. However, there is no consensus on its treatment. After a comprehensive search of the databases MEDLINE, EMBASE, Web of Science, and the Cochrane Library and Database of Systematic Reviews, we have summarized the available clinical evidence regarding the therapeutic approaches already reported for this entity since its first description in 1967. Additional publications were identified within the references of retrieved papers. Sixty-five articles have been revised, resulting in a total of 73 compatible cases. The histopathological features and different classifications used through history have also been considered, updating and completing the available knowledge. Ultimately, we propose topical treatment with 5 % 5-fluorouracil formulated with 10 % salicylic acid as a potential treatment that has been used successfully in a 51-year-old woman at our facility. Further research in form of prospective or comparative studies is encouraged for a better conceptualization of the therapeutics of this disease.
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Affiliation(s)
| | | | | | - Francisco José Navarro-Triviño
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
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18
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Prados-Carmona A, Prados-Carmona JJ, Ruiz-Villaverde R, Navarro-Triviño FJ. Multiple Minute Digitate Hyperkeratosis: 10 Jahre nach Caccettas Algorithmus. Fallbericht und narrative Übersicht. J Dtsch Dermatol Ges 2023; 21:1447-1455. [PMID: 38082527 DOI: 10.1111/ddg.15186_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/18/2023] [Indexed: 12/18/2023]
Abstract
ZusammenfassungDas klinische Erscheinungsbild und die histologischen Merkmale der Multiple Minute Digitate Hyperkeratosis sind bereits gut charakterisiert. Es besteht jedoch kein Konsens über die Behandlung dieser Erkrankung. Nach einer umfassenden Recherche in den Datenbanken MEDLINE, EMBASE, Web of Science und der Cochrane Library and Database of Systematic Reviews haben wir die vorliegenden klinischen Daten zu den therapeutischen Ansätzen zusammengefasst, die für diese Entität seit ihrer Erstbeschreibung im Jahr 1967 publiziert wurden. Zusätzliche Veröffentlichungen wurden in den Referenzen der gefundenen Artikel identifiziert. Fünfundsechzig Artikel wurden durchgesehen, sodass sich insgesamt 73 kompatible Fälle ergaben. Die histopathologischen Merkmale und die verschiedenen Klassifizierungen, die im Laufe der Zeit verwendet wurden, wurden ebenfalls berücksichtigt. Letztendlich schlagen wir die topische Behandlung mit 5% 5‐Fluorouracil in Kombination mit 10% Salicylsäure als eine mögliche Behandlung vor, die bei einer 51‐jährigen Frau in unserer Einrichtung erfolgreich angewendet wurde. Weitere Forschung in Form von prospektiven oder vergleichenden Studien werden empfohlen, um ein besseres Konzept für die Therapie dieser Krankheit zu entwickeln.
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Affiliation(s)
| | | | | | - Francisco José Navarro-Triviño
- Department of Contact Eczema and Immunoallergic Diseases, Dermatology, Hospital Universitario San Cecilio, Granada, Spain
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19
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Bagel J, Gold LS, Del Rosso J, Johnson S, Yamauchi P, Brown PM, Bhatia N, Moore AY, Tallman AM. Tapinarof cream 1% once daily for the treatment of plaque psoriasis: Patient-reported outcomes from the PSOARING 3 trial. J Am Acad Dermatol 2023; 89:936-944. [PMID: 37172733 DOI: 10.1016/j.jaad.2023.04.061] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Tapinarof cream 1% once daily demonstrated significant efficacy versus vehicle and was well tolerated in two 12-week, phase 3 pivotal trials in adults with mild-to-severe plaque psoriasis. OBJECTIVE To assess long-term, health-related quality of life and patient satisfaction with tapinarof. METHODS Patients completing the 12-week trials were eligible for 40 weeks of open-label tapinarof based on Physician Global Assessment score in PSOARING 3, with a 4-week follow-up. Dermatology Life Quality Index was assessed at every visit; Patient Satisfaction Questionnaire responses were assessed at week 40 or early termination. RESULTS Seven hundred sixty-three (91.6%) eligible patients enrolled; 78.5% completed the Patient Satisfaction Questionnaire. DLQI scores improved and were maintained. By week 40, 68.0% of patients had a DLQI of 0 or 1, indicating no impact of psoriasis on health-related quality of life. Most patients strongly agreed or agreed with all Patient Satisfaction Questionnaire questions assessing confidence in tapinarof and satisfaction with efficacy (62.9%-85.8%), application ease and cosmetic elegance (79.9%-96.3%), and preference for tapinarof versus prior psoriasis therapies (55.3%-81.7%). LIMITATIONS Open-label; no control; may not be generalizable to all forms of psoriasis. CONCLUSIONS Continued and durable improvements in health-related quality of life, high rates of patient satisfaction, and positive perceptions of tapinarof cream were demonstrated.
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Affiliation(s)
- Jerry Bagel
- Psoriasis Treatment Center of New Jersey, East Windsor, New Jersey.
| | - Linda Stein Gold
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan
| | - James Del Rosso
- JDR Dermatology Research/Thomas Dermatology, Las Vegas, Nevada
| | | | - Paul Yamauchi
- Dermatology Institute & Skin Care Center, Santa Monica, California
| | | | - Neal Bhatia
- Therapeutics Clinical Research, San Diego, California
| | - Angela Yen Moore
- Arlington Center for Dermatology, Arlington Research Center, Arlington, Texas; Baylor University Medical Center, Dallas, Texas
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20
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Pera Calvi I, R Marques I, Cruz SA, Mesquita YLL, Padrao EMH, Souza RM, Brown A, Caçador DGV, Poppe LM, Lopes Almeida Gomes L. Safety and efficacy of topical nitric oxide-releasing berdazimer gel for molluscum contagiosum clearance: A systematic review and meta-analysis of randomized controlled trials. Pediatr Dermatol 2023; 40:1060-1063. [PMID: 37721050 DOI: 10.1111/pde.15419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/05/2023] [Indexed: 09/19/2023]
Abstract
Molluscum contagiosum (MC) is a contagious infection that, although benign, can become an aesthetic burden and lead to other opportunistic infections, secondary dermatitis, and self-isolation. Currently, several treatment options are available for MC, including the newly investigated nitric oxide-releasing berdazimer gel, leading this review to evaluate randomized controlled trials (RCT) comparing berdazimer gel with a vehicle for treating MC. The meta-analysis included three reports and four RCT involving 1854 patients, with 1106 (59.6%) randomized to receive berdazimer. Our findings suggest that berdazimer is effective in the management of MC lesions, but the increased clearance of lesions and reduction of scarring must be weighed against the potential for topical adverse effects, particularly when considering the use of this therapy in pediatric patients.
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Affiliation(s)
- Izabela Pera Calvi
- Division of Medicine, Immanuel Kant Baltic Federal University, Kaliningrad, Kaliningrad, Russia
| | - Isabela R Marques
- Division of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sara A Cruz
- Division of Medicine, Immanuel Kant Baltic Federal University, Kaliningrad, Kaliningrad, Russia
| | | | - Eduardo M H Padrao
- Internal Medicine Division, University of Connecticut, Farmington, Connecticut, USA
| | - Rafaela M Souza
- Dermatology Division, La Paz University Hospital, Madrid, Spain
| | - Andrew Brown
- Internal Medicine Division, University of Connecticut, Farmington, Connecticut, USA
| | - Danielle G V Caçador
- Dermatology Division, Institute of Research and Medical Education (IPEMED) Faculty of Medical Sciences, São Paulo, São Paulo, Brazil
| | - Lidia M Poppe
- Dermatology Division, Praxis Dr. Poppe & Kollegen, Bad Kissingen, Bavaria, Germany
| | - Lais Lopes Almeida Gomes
- Dermatology Division, Cutaneous Biology Research Center (CBRC), Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
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21
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Elston DM. Letter from the Editor: Aggressive malignancy in the setting of erosive pustular dermatosis of the scalp. J Am Acad Dermatol 2023; 89:905. [PMID: 37499983 DOI: 10.1016/j.jaad.2023.07.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Affiliation(s)
- Dirk M Elston
- Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina.
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22
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Prajapati S, Kontzias C, Feldman SR. The Impact Accountability Has on Adherence to Moisturizer Treatment in Atopic Patients With Xerosis. J Cutan Med Surg 2023; 27:538-539. [PMID: 37489931 DOI: 10.1177/12034754231188433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Affiliation(s)
- Stuti Prajapati
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Christina Kontzias
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA
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23
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Kontzias C, Zaino M, Feldman SR. Tretinoin 0.1% and Benzoyl Peroxide 3% Cream for the Treatment of Facial Acne Vulgaris. Ann Pharmacother 2023; 57:1088-1093. [PMID: 36639853 DOI: 10.1177/10600280221147338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To assess the efficacy, safety, and clinical application of tretinoin 0.1%-benzoyl peroxide 3% cream for the topical treatment of acne vulgaris. DATA SOURCES A systematic review of the literature was performed using the terms Twyneo OR tretinoin and benzoyl peroxide OR S6G5T-3 in MEDLINE (PubMed) and EMBASE. ClinicalTrials.gov was searched to obtain completed clinical trial results not published elsewhere. STUDY SELECTION AND DATA EXTRACTION All human studies published in English prior to November 2022 related to pharmacology, clinical trials, safety, and efficacy were evaluated for inclusion. DATA SYNTHESIS In two 12-week, phase 3, randomized, vehicle-controlled clinical trials, tretinoin 0.1%-benzoyl peroxide 3% cream significantly reduced inflammatory and noninflammatory facial acne lesions and significantly improved Investigator Global Assessment (IGA) rating to clear or almost clear. The cream has a suitable safety profile, with application site pain and dryness as the most common adverse events. RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE IN COMPARISON TO EXISTING AGENTS Tretinoin-BPO had similar IGA success compared to other topical retinoid and retinoid-BPO treatments for acne vulgaris. Compared to individual tretinoin and benzoyl peroxide therapy, the combination product streamlines application, which will improve medication adherence; however, the cost of tretinoin-BPO cream may be prohibitive. CONCLUSIONS Tretinoin 0.1%-benzoyl peroxide 3% cream is safe and effective for the treatment of moderate-to-severe acne. Long-term trial data on efficacy and tolerability are not yet available.
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Affiliation(s)
- Christina Kontzias
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mallory Zaino
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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24
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Kontzias C, Prajapati S, Feldman SR. Greater Disease Severity and Reduced Quality of Life are Not Associated With Treatment Adherence in Atopic Patients With Xerosis. J Cutan Med Surg 2023; 27:534-536. [PMID: 37493272 DOI: 10.1177/12034754231188435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Affiliation(s)
- Christina Kontzias
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Stuti Prajapati
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA
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25
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O'Toole A, Gooderham M. Topical Roflumilast for Plaque Psoriasis. Skin Therapy Lett 2023; 28:1-4. [PMID: 37734074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Roflumilast is a highly selective phosphodiesterase-4 inhibitor for the treatment of plaque psoriasis. Topical roflumilast 0.3% cream, approved by the US FDA and Health Canada for use in adolescents and adults, has proven efficacy and tolerability. It is non-steroidal, administered once-daily, and highly potent, with a unique delivery formulation. It can be used on most body areas, including the sensitive intertriginous regions and face. Herein, we review the safety and efficacy of roflumilast 0.3% cream, as demonstrated in clinical trials.
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Affiliation(s)
- Ashley O'Toole
- SKiN Centre for Dermatology, Peterborough, ON, Canada
- Probity Medical Research, Waterloo, ON, Canada
- Queen's University, Kingston, ON, Canada
| | - Melinda Gooderham
- SKiN Centre for Dermatology, Peterborough, ON, Canada
- Probity Medical Research, Waterloo, ON, Canada
- Queen's University, Kingston, ON, Canada
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26
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Marafini I, De Cristofaro E, Salvatori S, Calabrese E, Lolli E, Monteleone I, Franchi L, Ciccocioppo R, Glick G, Opipari A, Monteleone G. Niclosamide Enema for Active Distal Ulcerative Colitis: A Phase 1, Open-Label Study. Inflamm Bowel Dis 2023:izad125. [PMID: 37478412 DOI: 10.1093/ibd/izad125] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Oral and rectal formulations of 5-aminosalicylic acid are the first-line therapy for mild-to-moderate, distal ulcerative colitis (UC), but such a treatment is not effective in one-third of patients. Niclosamide is a small molecule, developed and approved as an orally administered drug to treat helminthic infections, with an excellent safety profile. Preclinical work showed that niclosamide is an anti-inflammatory agent, thereby providing the rationale to explore its safety and efficacy in patients with UC. This phase 1, open-label trial was aimed at assessing the safety of niclosamide formulated as an enema in patients with mild-to-moderate, distal UC, who relapsed on maintenance therapy with oral and/or rectal 5-aminosalicylic acid. METHODS Seventeen patients with active UC received niclosamide enema (150 mg/60 mL) twice a day for 6 weeks. The primary endpoint was the safety of niclosamide treatment. Secondary endpoints included clinical remission and improvements in endoscopic Mayo/histologic scores. Endoscopic remission percentages exclude participants meeting criteria at baseline for endoscopic remission. RESULTS Niclosamide was well tolerated by all 17 patients that were enrolled and treated. No serious adverse event was registered. Fifteen mild adverse events were registered in 6 patients and considered to be unrelated to the treatment. Clinical remission was achieved in 10 (59%) of 17 patients. Improvements of endoscopic Mayo score and histologic Geboes score were seen in 7 (58%) of 12 and 7 (41.2%) of 17 patients, respectively. CONCLUSIONS Niclosamide enema treatment is safe and well tolerated. Niclosamide improves clinical symptoms and endoscopic/histologic signs of UC; however, appropriately designed placebo-controlled clinical trials are required to confirm efficacy.
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Affiliation(s)
- Irene Marafini
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Elena De Cristofaro
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Silvia Salvatori
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Emma Calabrese
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Elisabetta Lolli
- Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy
| | - Ivan Monteleone
- University of Michigan, Ann Arbor, MI, USA
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | | | - Gary Glick
- University of Michigan, Ann Arbor, MI, USA
| | | | - Giovanni Monteleone
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- Gastroenterology Unit, Policlinico Universitario Tor Vergata, Rome, Italy
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Marchegiani A, Spaterna A, Fruganti A, Cerquetella M. Exploring fluorescent light energy as management option for canine superficial bacterial folliculitis. Front Vet Sci 2023; 10:1155105. [PMID: 37332738 PMCID: PMC10272430 DOI: 10.3389/fvets.2023.1155105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Superficial bacterial folliculitis (SBF) represents a common dermatological diagnosis in dogs that can be successfully managed with either topical and/or systemic treatments. In the present study we evaluated the efficacy of a fluorescent light energy (FLE) device as sole management for SBF. The same FLE device has been shown, as adjunct therapy to systemic antibiotic or alone, to effectively control clinical manifestation of interdigital furunculosis. Twenty dogs were randomized to receive FLE once (six dogs) or twice (six dogs) weekly in comparison with oral anti-biotic (eight dogs) until complete healing. FLE regimen was able to significantly reduce the time needed to clinical resolution for oral antibiotic, supporting owners' compliance and welfare of dogs.
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Ninosu N, Hoelker S, Kappenstein M, Buettner S, Peitsch WK, Schaarschmidt ML. Treatment satisfaction of patients with psoriasis with topical therapy in a real-world setting: unmet need for higher effectiveness. J DERMATOL TREAT 2023; 34:2200570. [PMID: 37026416 DOI: 10.1080/09546634.2023.2200570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
BACKGROUND Topical medication is the mainstay for treatment of mild psoriasis. However, dissatisfaction with topicals is common and rates of non-adherence are high. Assessing patients' perspectives can help to identify unmet needs. OBJECTIVE Our aim was to investigate satisfaction of patients with psoriasis with topical therapy and to determine influencing factors. METHODS Patients were recruited from the Department of Dermatology, University Medical Center Mannheim, Germany. Satisfaction was assessed using the Treatment Satisfaction Questionnaire for Medication version 1.4 with the domains effectiveness, side effects, convenience, and global satisfaction (scale 0-100 each). The impact of sociodemographic and disease characteristics was determined by multivariate regression. RESULTS Averaged across the cohort (n = 122, mean age 52.5 years, 58.2% male), the side effects domain had the highest mean satisfaction score (89.7), followed by convenience (72.5), global satisfaction (60.8) and effectiveness (55.0). Comparing specific medications, combinations of corticosteroids and vitamin D analogues were rated best in effectiveness. Treatment satisfaction was influenced by age, partnership, ability to apply topicals independently, disease-related quality-of-life impairment, sole or adjunctive use of topicals and pruritus. CONCLUSIONS Participants were particularly satisfied with safety but rather dissatisfied with effectiveness of topicals. Topical therapy should be adapted to individual needs with special attention to effectiveness.
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Affiliation(s)
- Nadia Ninosu
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Suna Hoelker
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Max Kappenstein
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - Sylvia Buettner
- Department for Biomathematics and Medical Statistics, Faculty of Medicine Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Wiebke K Peitsch
- Department of Dermatology and Phlebology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Marthe-Lisa Schaarschmidt
- Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
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Tavakoli MR, Faraji M, Sam S, Ghasempour A, Rezaei M, Langarizadeh MA, Karami-Mohajeri S. Erectile dysfunction from mechanisms to medicines with a focus on the application of topical Minoxidil. Sex Med Rev 2023; 11:114-123. [PMID: 36857310 DOI: 10.1093/sxmrev/qead001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Erectile dysfunction (ED), for multifactorial reasons, is one of the biggest current quandaries among men worldwide and results in other complications such as reduced quality of life of the patient and his sexual partner, impotence, and psychiatric problems. OBJECTIVES Understanding of disease etiology, penile anatomy, erectile physiology, therapeutic mechanisms, and effective molecular pathways all play key roles in determining a therapeutic approach. This project is based on the study of topical minoxidil's effectiveness in treating ED. METHODS To perform a comprehensive overview of the subject, we performed a triple-keyword combination search to assess recent studies of ED. RESULTS The most common formulation used in these studies was 2% minoxidil solution. Except for cases studied in paralytic patients, topical treatment with minoxidil appears to elicit a mild erectile response; however, this finding is insufficient to confirm the effectiveness of this topical treatment. CONCLUSIONS Although evidence to confirm the therapeutic properties of minoxidil in ED is limited, combination therapy and the use of modern formulations of minoxidil are promising options for treating ED in the future.
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Affiliation(s)
- Marziye Ranjbar Tavakoli
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Faraji
- Department of Pharmaceutical Biotechnology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Sanaz Sam
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Ghasempour
- Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoud Rezaei
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Amin Langarizadeh
- Department of Medicinal Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Somayyeh Karami-Mohajeri
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
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De Seta F, Ianniello P, Carlucci S, Nappi L, Sorrentino F, Stabile G. New Topical Therapy for Provoked Vestibulodynia: Improvement of Psychological and Sexual Well-Being. Int J Environ Res Public Health 2023; 20:1931. [PMID: 36767294 PMCID: PMC9915117 DOI: 10.3390/ijerph20031931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Vulvodynia is a vulvar discomfort that occurs in the absence of any specific, clinically identifiable disorder. Few therapies have shown to be effective for the treatment of vulvodynia. In our recently published study, we tested a drug-free gel in women affected by vulvar vestibulitis. It is a cosmetic gel which acts locally without any metabolic, pharmacological or immunological effect. In order to further promote the validity of this new product, in this manuscript we analyzed the results obtained from the administration of four questionnaires in the same two groups of women affected by PVD and treated with a placebo and the new product. The questionnaires used: Female Sexual Function Index Scoring (FSFI), Female Sexual Distress Scale (FSDS), Hospital Anxiety and Depression Scale (HADS), and health-related quality of life measured by SF-36 (SF-36). The results obtained by this current analysis showed that the new gel has also proven benefits on women's quality of life and sexual function, including improvements in arousal, desire, orgasm and satisfaction.
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Affiliation(s)
- Francesco De Seta
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy
| | - Patrizia Ianniello
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34100 Trieste, Italy
| | - Stefania Carlucci
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy
| | - Guglielmo Stabile
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, 34100 Trieste, Italy
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Zhang M, Hong S, Sun X, Zhou Y, Luo Y, Liu L, Wang J, Wang C, Lin N, Li X. Exploration of and insights into advanced topical nanocarrier systems for the treatment of psoriasis. Front Med (Lausanne) 2022; 9:1017126. [PMID: 36590975 PMCID: PMC9797688 DOI: 10.3389/fmed.2022.1017126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Psoriasis is a chronic inflammatory skin disease with an underlying autoimmune pathogenesis that has brought great distress to patients. Current treatment options include topical therapy, systemic therapy, and phototherapy. By disrupting the stratum corneum, nanocarriers have unique advantages in allowing drug carriers to be tailored to achieve targeted drug delivery, improve efficacy, and minimize adverse effects. Furthermore, despite their limited success in market translatability, nanocarriers have been extensively studied for psoriasis, owing to their excellent preclinical results. As topical formulations are the first line of treatment, utilize the safest route, and facilitate a targeted approach, this study, we specifically describes the management of psoriasis using topical agents in conjunction with novel drug delivery systems. The characteristics, advantages, weaknesses, and mechanisms of individual nanocarriers, when applied as topical anti-psoriatic agents, were reviewed to distinguish each nanocarrier.
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Affiliation(s)
- Miao Zhang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Seokgyeong Hong
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoying Sun
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Yaqiong Zhou
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Ying Luo
- Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Liu Liu
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Chunxiao Wang
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Naixuan Lin
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xin Li
- Department of Dermatology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Institute of Dermatology, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China,*Correspondence: Xin Li,
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Belamkar A, Harris A, Zukerman R, Siesky B, Oddone F, Verticchio Vercellin A, Ciulla TA. Sustained release glaucoma therapies: Novel modalities for overcoming key treatment barriers associated with topical medications. Ann Med 2022; 54:343-358. [PMID: 35076329 PMCID: PMC8794062 DOI: 10.1080/07853890.2021.1955146] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness. The disease has conventionally been characterized by an elevated intraocular pressure (IOP); however, recent research has built the consensus that glaucoma is not only dependent on IOP but rather represents a multifactorial optic neuropathy. Although many risk factors have been identified ranging from demographics to co-morbidities to ocular structural predispositions, IOP is currently the only modifiable risk factor, most often treated by topical IOP-lowering medications. However, topical hypotensive regimens are prone to non-adherence and are largely inefficient, leading to disease progression in spite of treatment. As a result, several companies are developing sustained release (SR) drug delivery systems as alternatives to topical delivery to potentially overcome these barriers. Currently, Bimatoprost SR (DurystaTM) from Allergan plc is the only FDA-approved SR therapy for POAG. Other SR therapies under investigation include: bimatoprost ocular ring (Allergan) (ClinicalTrials.gov identifier: NCT01915940), iDose® (Glaukos Corporation) (NCT03519386), ENV515 (Envisia Therapeutics) (NCT02371746), OTX-TP (Ocular Therapeutix) (NCT02914509), OTX-TIC (Ocular Therapeutix) (NCT04060144), and latanoprost free acid SR (PolyActiva) (NCT04060758). Additionally, a wide variety of technologies for SR therapeutics are under investigation including ocular surface drug delivery systems such as contact lenses and nanotechnology. While challenges remain for SR drug delivery technology in POAG management, this technology may shift treatment paradigms and dramatically improve outcomes.
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Affiliation(s)
- Aditya Belamkar
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alon Harris
- Department of Opthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ryan Zukerman
- Department of Opthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Opthalmology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Brent Siesky
- Department of Opthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Thomas A Ciulla
- Indiana University School of Medicine, Indianapolis, IN, USA.,Vitreoretinal Medicine and Surgery, Midwest Eye Institute, Indianapolis, IN, USA
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Gallo G, Mastorino L, Barilà D, Cattel F, Panzone M, Quaglino P, Ribero S, Dapavo P. Topical cyclosporine hydrogel preparation: A new therapeutic option in the treatment of nail psoriasis. Dermatol Ther 2022; 35:e15917. [PMID: 36214268 DOI: 10.1111/dth.15917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/19/2022] [Accepted: 10/05/2022] [Indexed: 11/29/2022]
Abstract
Nail psoriasis is a chronic nail disorder that commonly affects psoriatic patients causing severe distress despite the limited body surface area. Treatments for nail psoriasis are limited, as nails are often difficult to treat with topical therapies, and among different systemic agents responses are unpredictable. We carried out a prospective study in order to analyze the effectiveness and tolerability of topical cyclosporine hydrogel ointment in nail psoriasis. Three patients, for a total of 44 nails, were treated with topical cyclosporine hydrogel ointment. All nails were evaluated, before starting the treatment, every 28 days and after 12 weeks of therapy, by the same dermatologists, through clinical and onychoscopic evaluations. The patients were also asked to assess on the compliance with product use. Complete response (CR) was observed in 2 of 3 patients; a partial response (PR) was observed in the other patient. Overall, 24 of 44 nails had CR and 20 had a PR. Cyclosporine hydrogel ointment has shown efficacy and safety in the treatment of nail psoriasis. The product has also been shown to be stable in composition, easy to apply and not discomfortable for the patient.
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Affiliation(s)
- Giuseppe Gallo
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Luca Mastorino
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Diego Barilà
- Department of Pharmaceutical Science and Technology, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Francesco Cattel
- Department of Pharmaceutical Science and Technology, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Michele Panzone
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
| | - Paolo Dapavo
- Dermatology Clinic, Department of medical sciences, University of Turin, Turin, Italy
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Swindell WR, Bojanowski K, Chaudhuri RK. Isosorbide Fatty Acid Diesters Have Synergistic Anti-Inflammatory Effects in Cytokine-Induced Tissue Culture Models of Atopic Dermatitis. Int J Mol Sci 2022; 23:ijms232214307. [PMID: 36430783 PMCID: PMC9696169 DOI: 10.3390/ijms232214307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/08/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022] Open
Abstract
Atopic dermatitis (AD) is a chronic disease in which epidermal barrier disruption triggers Th2-mediated eruption of eczematous lesions. Topical emollients are a cornerstone of chronic management. This study evaluated efficacy of two plant-derived oil derivatives, isosorbide di-(linoleate/oleate) (IDL) and isosorbide dicaprylate (IDC), using AD-like tissue culture models. Treatment of reconstituted human epidermis with cytokine cocktail (IL-4 + IL-13 + TNF-α + IL-31) compromised the epidermal barrier, but this was prevented by co-treatment with IDL and IDC. Cytokine stimulation also dysregulated expression of keratinocyte (KC) differentiation genes whereas treatment with IDC or IDL + IDC up-regulated genes associated with early (but not late) KC differentiation. Although neither IDL nor IDC inhibited Th2 cytokine responses, both compounds repressed TNF-α-induced genes and IDL + IDC led to synergistic down-regulation of inflammatory (IL1B, ITGA5) and neurogenic pruritus (TRPA1) mediators. Treatment of cytokine-stimulated skin explants with IDC decreased lactate dehydrogenase (LDH) secretion by more than 50% (more than observed with cyclosporine) and in vitro LDH activity was inhibited by IDL and IDC. These results demonstrate anti-inflammatory mechanisms of isosorbide fatty acid diesters in AD-like skin models. Our findings highlight the multifunctional potential of plant oil derivatives as topical ingredients and support studies of IDL and IDC as therapeutic candidates.
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Affiliation(s)
- William R. Swindell
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Correspondence:
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Paller AS, Browning J, Parish LC, Bunick CG, Rome Z, Bhatia N. Safety, tolerability, and efficacy of a novel topical isotretinoin formulation for the treatment of X-linked or lamellar congenital ichthyosis: Results from a phase 2a proof-of-concept study. J Am Acad Dermatol 2022; 87:1189-1191. [PMID: 35271936 DOI: 10.1016/j.jaad.2022.02.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/10/2022] [Accepted: 02/21/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Amy S Paller
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John Browning
- University of Texas Health Science Center, San Antonio, Texas
| | | | | | - Zachary Rome
- Timber Pharmaceuticals, Basking Ridge, New Jersey; Patagonia Pharmaceuticals, Fairfield, Connecticut
| | - Neal Bhatia
- Therapeutics Clinical Research, San Diego, California
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Lanza M, Leone A, Scognamiglio G, Serra L, Iodice CM, Melillo P, Simonelli F. Evaluation of the Efficacy Duration of Topical Therapies in Eyes with Primary Open-Angle Glaucoma. J Clin Med 2022; 11:jcm11206166. [PMID: 36294484 PMCID: PMC9605467 DOI: 10.3390/jcm11206166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To investigate the efficacy interval of the topical therapies available for primary open-angle glaucoma (POAG) and the ocular and systemic features potentially associated. Methods: This retrospective study included 190 patients with POAG undergoing first topical therapy, throughout a follow-up of 15 years. The patients started one topical intraocular pressure (IOP)-lowering drug within single molecules such betablockers, prostaglandin or dorzolamide, or fixed combinations such as betablockers + prostaglandin, betablockers + dorzolamide, or betablockers + brimonidine. Efficacy duration was measured as the time between the start of the therapy and the change due to IOP increase or visual field worsening. For each patient, ocular and systemic features and comorbidities were analysed to detect any significant correlation with the length of effectiveness of every drug used. Results: The molecules explored showed some discrepancies in terms of mean duration of efficacy; however, no significant differences were demonstrated (p > 0.05). Furthermore, when evaluating the overall cohort, no systemic or ocular features correlated significantly with the effectiveness of the molecules explored. However, the same analysis carried out upon stratifying the different groups according to the IOP-lowering drops they received, demonstrated that the drug efficacy could be influenced by several ocular and systemic features. Conclusion: Data observed in this study suggest that there is no difference in using one of the medications evaluated as first choice of treatment of POAG if the patients are accurately evaluated and the most recent guidelines are adopted.
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Abstract
Background: Since medication absorption through the skin and eye tissue seems similar, commercially available eye-drops could be used to treat skin diseases when topical therapies are unavailable or unaffordable. The FDA-approved and off-label applications of various eye drops used as topical treatments in dermatological clinical practice were highlighted in this review.Methodology: A thorough PubMed and Google Scholar library search using various combinations of the keywords (Eye drop, ocular solution, conjunctival installation, and skin diseases, topical, local, beta-blockers, prostaglandin, cyclosporin, apraclonidine, atropine, oxymetazoline).Results and conclusions: Based on the findings of the studies reviewed, timolol is highly recommended for infantile hemangioma and other vascular skin conditions such as angiomas, Kaposi sarcoma, acne, rosacea, and wound healing. Bimatoprost is a drug that can be used to treat hypotrichosis of any kind, as well as mild localized alopecia areata and leukoderma. Oxymetazoline ispromising for treating facial erythema. We recommend apraclonidine for mild upper eyelid ptosis induced botulinum neurotoxin. We don't recommend atropine for hyperhidrosis, although it can help with hydrocystomas and pruritis produced by syringomas. Tobramycin will need to be tested in RCTs before it can be confirmed as a viable alternative to systemic treatments for treating green nail syndrome.
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Affiliation(s)
- Sameh Magdy Sarsik
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Heba Saed El-Amawy
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Knapp C, Vaz L, Onoday H, Small A. Dual treatment of cutaneous leishmaniasis with topical amphotericin B and photodynamic therapy in a pediatric patient. Pediatr Dermatol 2022; 39:761-763. [PMID: 35636952 DOI: 10.1111/pde.15042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/09/2022] [Indexed: 11/29/2022]
Abstract
Cutaneous leishmaniasis is a parasitic infection that can result in scarring, contributing to significant morbidity when a cosmetically sensitive area is involved. We report a case of a 13-year-old boy with cutaneous leishmaniasis involving the face and arm. He was treated with a combination of photodynamic therapy as well as topical amphotericin with a cosmetically satisfying outcome. This combination of noninvasive treatment regimens has not been reported to our knowledge and merits further study in the pediatric population.
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Affiliation(s)
- Calvin Knapp
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - Louise Vaz
- Division of Pediatric Infectious Disease, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon, USA
| | - Heather Onoday
- Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA
| | - Alison Small
- Departments of Dermatology and Pediatrics, Doernbecher Children's Hospital, Oregon Health and Science University, Portland, Oregon, USA
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Cantisani C, Rossi R, Nisticò SP, Vitiello M, Farnetani F, Bennaro L, Pellacani G. Management of patients with giant basal cell carcinoma during SARS COV2 outbreak in Italy. Transl Biophotonics 2022; 4:e202200009. [PMID: 35942364 PMCID: PMC9350373 DOI: 10.1002/tbio.202200009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most frequently occurring type of all cancers, and represents 80% of all skin cancer. The estimated lifetime risk for BCC in the white population is between 33% and 39% for men and 23% and 28% for women. Its incidence doubles every 25 years and is increasing in the young population. Death is uncommon and seems to decrease in the last years, probably due to early and better diagnosis. BCC arises from abnormal and uncontrolled growth of basal cells. It is a slow-growing tumor, therefore usually curable at an early stage with surgery or alternative treatment, such as cryotherapy, laser, photodynamic therapy, retinoids and topical agent like 5-Fluorouracil cream, imiquimod cream, and so forth. Topical treatment of superficial basocellular carcinoma is a viable option, when surgery is not an advisable treatment, especially in the case of giant basocellular carcinoma. In this subtype, imiquimod 5% cream can be a safe and effective treatment, but there are few reports in available literature. We present our case series of eight patients with superficial giant basocellular carcinoma successfully treated with imiquimod 5% cream, which showed clinical improvement after 8 weeks of treatment.
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Affiliation(s)
- Carmen Cantisani
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
| | - Raimondo Rossi
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
| | | | - Martina Vitiello
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
| | | | - Luigi Bennaro
- Department of Health SciencesMagna Grecia UniversityCatanzaroItaly
| | - Giovanni Pellacani
- Department of Dermatology and Venereology, UOC of Dermatology, Policlinico Umberto I HospitalSapienza Medical School of RomeRomeItaly
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El-Khalawany M, Nouh AH, Kadah AS, Elsheikh M, Said M. Evaluation of safety and efficacy of topical 4% Nicotinamide in treatment of psoriasis; among a representative sample of Egyptians (An analytical observational study). Dermatol Ther 2022; 35:e15734. [PMID: 35882993 DOI: 10.1111/dth.15734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/27/2022] [Accepted: 07/23/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess and evaluate the efficacy and safety of Nicotinamide 4% topical formulation for the treatment of mild to moderate psoriasis. METHOD This study was conducted on 60 patients aged 18 to 65 years, with mild to moderate psoriasis Vulgaris. 4% Nicotinamide in a cold cream base was used twice daily for 12 weeks. RESULTS Nicotinamide 4% topical treatment shows satisfactory results, more in males than in females. Some patients report disturbing irritation (burning, itching, and redness) upon the usage of topical Nicotinamide treatment and were advised to wash out the treated area after 1 hr of cream application, which solved the issue. No other adverse effects of treatment were reported by patients during the study period. LIMITATIONS Unicentral base, a limited amount of sample size, and 12 weeks duration of therapy and follow-up period, which may not be sufficient to demonstrate the complete therapeutic properties and side effects of using nicotinamide as a long-term treatment for psoriasis. CONCLUSIONS This study reveals statistically reliable evidence of the positive impact of topical 4% Nicotinamide preparation used alone on the treatment of psoriasis with minimal side effects. Thus, we can conclude that topical Nicotinamide preparation may be a good adjuvant to the current treatment regimens used alone or alternate currently used topical therapeutical regimens if used in combination. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Mohamed El-Khalawany
- Professor of Dermatology and Venereology, Faculty of Medicine, Al Azhar University
| | - Ahmed H Nouh
- Lecturer of Dermatology and Venereology, Faculty of Medicine, Al Azhar University
| | - Ahmed S Kadah
- Lecturer fellow of dermatology and venereology -Al-Hussin university hospital, Al-Azhar university
| | - Maged Elsheikh
- Departement of Dermatology and Venereology, Military Medical Academy
| | - Marwa Said
- Assistant professor of Dermatology and Venereology, Faculty of Medicine for Girls, Al-Azhar University (Cairo)
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Rob F, Hugo J, Saláková M, Šmahelová J, Gkalpakiotis S, Boháč P, Tachezy R. Prevalence of genital and oral HPV infection among psoriasis patients on biologic therapy. Dermatol Ther 2022; 35:e15735. [PMID: 35883191 DOI: 10.1111/dth.15735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/11/2022] [Accepted: 07/24/2022] [Indexed: 11/28/2022]
Abstract
Current knowledge about human papillomavirus (HPV) infection in psoriasis patients treated with biologics is limited. In this study we evaluated the prevalence of oral and genital HPV infection in psoriasis patients treated with biologics or topical therapy for at least 6 months. The presence of HPV DNA in oral rinse and genital smears was evaluated. In total, 267 patients who met the inclusion criteria and agreed to participate were enrolled: 110 (41.2%) on topical therapy, 84 (31.5%) on anti-TNF-alpha therapy, 31 (11.6%) on anti-IL-12/23 therapy and 42 (15.7%) on anti-IL-17 therapy. The presence of genital HPV infection was detected in 34.6% of men receiving anti-TNF-α treatment, in 25.0% of patients on anti-IL-12/23 and 18.8% of patients on anti-IL-17 therapy. The difference in prevalence was not statistically different from men on topical treatment (26.3%). Prevalence of oral HPV infection was higher across all of the biologic groups (11.9% for anti-TNF-α, 12.9% for anti-IL-12/23 and 19.0% for anti-IL-17) compared to patients on topical therapy (7.3%), but statistically significant only for anti-IL-17 (p<0.05). The presence of oral HPV infection in patients treated with biologics was significantly higher (44.0%) in patients on long-term biologic treatment (>8 years) compared to patients taking biologics for a shorter period (9.1%; p<0.01). Our results suggest that patients on biologics for psoriasis have a higher prevalence of oral HPV infection compared to patients on topical treatment. Long-term treatment with biologics seems to be associated with a higher prevalence of oral HPV infection, independent of previous conventional immunosuppressive therapy. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Filip Rob
- Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic
| | - Jan Hugo
- Dermatovenereology Department, Third Faculty of Medicine, Charles University, Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Martina Saláková
- Department of Genetics and Microbiology; Faculty of Science, Charles University, Biocev, Prague, Czech Republic.,National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Jana Šmahelová
- Department of Genetics and Microbiology; Faculty of Science, Charles University, Biocev, Prague, Czech Republic.,National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Spyridon Gkalpakiotis
- Dermatovenereology Department, Third Faculty of Medicine, Charles University, Kralovske Vinohrady University Hospital, Prague, Czech Republic
| | - Petr Boháč
- Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka, Prague, Czech Republic
| | - Ruth Tachezy
- Department of Genetics and Microbiology; Faculty of Science, Charles University, Biocev, Prague, Czech Republic.,National Reference Laboratory for Papillomaviruses and Polyomaviruses, Institute of Hematology and Blood Transfusion, Prague, Czech Republic
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Boytsov NN, Gorritz M, Wang X, Malatestinic WN, Wade RL, Goldblum OM. The current treatment landscape in adult atopic dermatitis in the United States: results from a cross-sectional real-world study. J DERMATOL TREAT 2022; 33:1707-1717. [PMID: 33752555 DOI: 10.1080/09546634.2021.1898530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND This study describes the current treatment landscape in adult atopic dermatitis (AD), overall and by disease severity. METHODS Adult patients with an AD diagnosis in dermatology-specific electronic medical records during 2018 were identified and linked to an administrative claims database. Disease severity was determined using Physician's Global Assessment (PGA). Written and dispensed prescriptions, within and between class cycling for AD therapies occurring in 2018 were assessed. RESULTS In total, 4,364 patients were included. Among patients with available PGA, 43.2% had clear-to-mild, 37.3% had moderate, and 19.6% had severe disease. Most patients (71.0%) had written prescriptions for topical therapies only in 2018. Among the patients with claims for topical therapies alone, 80.7% used topical corticosteroids only. Within and between class cycling was observed in 33.7% and 12.8% of topical users, respectively. In patients with systemic therapy (40.6%), nearly 84.9% also used topical therapy, 25.8% cycled within systemic drug classes, and 24.8% cycled between systemic drug classes. Overall, cycling was more prevalent in patients with more severe disease. CONCLUSION Cycling within and between both topical and systemic drug classes was more common in patients with more severe disease, indicating difficulty of managing these patients and highlighting a need for more treatment options.
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Affiliation(s)
| | | | - Xin Wang
- IQVIA, Inc., Plymouth Meeting, PA, USA
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Cortés-Correa C, Piquero-Casals J, Chaparro-Reyes D, Garré Contreras A, Granger C, Peñaranda-Contreras E. Facial Seborrheic Dermatitis in HIV-Seropositive Patients: Evaluation of the Efficacy and Safety of a Non-Steroidal Cream Containing Piroctone Olamine, Biosaccharide Gum-2 and Stearyl Glycyrrhetinate - A Case Series. Clin Cosmet Investig Dermatol 2022; 15:483-488. [PMID: 35330623 PMCID: PMC8940309 DOI: 10.2147/ccid.s344807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/02/2022] [Indexed: 12/04/2022]
Abstract
Facial seborrheic dermatitis is common in HIV-positive patients, and the presence of facial lesions can affect quality of life. The management and control of lesions can be frustrating for both physicians and patients. In this pilot clinical study, we clinically evaluated the effectiveness of a topical non-steroidal cream in treating mild to moderate facial seborrheic dermatitis in 20 HIV-positive patients. The patients applied a twice-a-day topical cream containing zinc PCA, piroctone olamine, hydroxyphenyl propamidobenzoic acid, biosaccharide gum-2, and stearyl glycyrrhetinate for 12 weeks with no topical or oral antifungal or corticosteroid treatment. Signs and symptoms and tolerance were assessed before, during, and at the end of treatment. All of the patients showed clinical improvement after 4 and 12 weeks of treatment. None of the patients had no response to treatment, and no adverse effects were reported. No rescue therapy with corticosteroids was needed. The patients reported a very noticeable improvement in their skin which contributed to high compliance with the protocol requirement.
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Affiliation(s)
| | - Jaime Piquero-Casals
- Department of Dermatology, Dermik, Multidisciplinary Dermatology Clinic, Barcelona, Spain
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Fawzy M, ElKholy B. A practical guide to the safety of topical medications for the pediatric population. Dermatol Ther 2022; 35:e15377. [PMID: 35156280 DOI: 10.1111/dth.15377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/17/2022] [Accepted: 02/11/2022] [Indexed: 11/28/2022]
Abstract
Prescribing topical therapy for a child could be a challenging matter. This is due to the higher susceptibility of children to local and systemic side effects of topical drugs than adults. Herein, we provide clinicians with a practical guide regarding the side effects, precautions, and lower age limit of commonly prescribed topical medications for the pediatric population.
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Affiliation(s)
- Manal Fawzy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Basma ElKholy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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45
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Lis-Święty A, Frątczak A. Proactive therapy: new perspectives for long-term topical treatment of psoriasis. Dermatol Ther 2022; 35:e15364. [PMID: 35133689 DOI: 10.1111/dth.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/10/2021] [Accepted: 02/03/2022] [Indexed: 11/29/2022]
Abstract
Mild to moderate psoriasis is most often treated with topical therapy. The article reviews literature on topical treatments that have been assessed in clinical trials and real-life studies lasting at least 12 months. Calcipotriol/bethamethasone dipropionate foam in maintenance treatment following the induction phase can improve efficacy and safety of topical therapy in psoriatic patients. Introduction of new topical nonsteroidal drugs and the wider use of proactive therapy seem to be crucial to achieve satisfactory long-term outcomes in psoriasis. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Anna Lis-Święty
- Chair and Department of Dermatology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Frątczak
- Chair and Department of Dermatology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
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Abstract
Treatment of inflammatory pathology of the nasal cavity at the present stage requires a doctor to clearly understand the physiological mechanisms that implement the main functions of the mucous membrane of the nasal cavity and upper respiratory tract. One of the most important processes that ensure the normal functioning of the respiratory tract is mucociliary clearance. Violations of its work leads to stagnation of mucus and the development of inflammation not only in the nasal cavity, but also in the lower respiratory tract and middle ear cavities. The authors of the article consider the main etiological factors and mechanisms of the pathogenesis of inflammatory diseases of the nasal cavity, discuss approaches to the treatment of these conditions. The authors conclude that in conditions of acute and chronic inflammation of the nasal mucosa, accompanied by the secretion of thick viscous mucus, the most effective topical use of the combined preparation, which includes acetylcysteine, tuaminoheptane and sodium hyaluronate. This combination has both mucolytic, vasoconstrictive and protective effects, which increases the effectiveness of the drug and the adherence of patients to therapy.
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Affiliation(s)
- A V Gurov
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - M A Yushkina
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - O M Doronina
- Pirogov Russian National Research Medical University, Moscow, Russia
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
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Walia C, Rallan NS, Premkumar A, Roy S. Clinical Evaluation of Efficacy of Triamcinolone Acetonide with Tacrolimus in the Management of Oral Lichen Planus: A Pilot Prospective Observational Study. Contemp Clin Dent 2022; 13:236-241. [PMID: 36213860 PMCID: PMC9533377 DOI: 10.4103/ccd.ccd_899_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/06/2021] [Accepted: 02/10/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Lichen planus (LP) is a relatively common chronic, mucocutaneous disease of autoimmune origin, involves oral mucosa, skin, scalp, nails, and genital mucosa. The prevalence of oral LP (OLP) varies worldwide, commonly seen in middle-aged and elderly people. It usually presents as symmetrical and bilateral or multiple lesions with burning sensation (BS) sometimes accompanied by pain. Corticosteroids and calcineurin inhibitors have shown promising results in the treatment of OLP, but its chronic course and unpredictable exacerbations/remission continues to result in a high degree of morbidity. The study aimed to evaluate the efficacy of intralesional triamcinolone acetonide (injection TA) combined with topical application of TA orabase and Tacrolimus (TAC) ointment for symptomatic cases of OLP. MATERIALS AND METHODS The prospective study included 52 symptomatic OLP patients to receive (0.5 ml) intralesional injection of TA once a week for the first 4 weeks followed by one injection in the 6th week along with TA mucosal paste (0.1%.) and TAC ointment (0.03%) in tapering dose till 8th week. The subjective symptoms including BS and pain were assessed on a 10 cm visual analog scale (VAS) and objective signs like size and site of the lesion were scored according to criterion scale modified by Thongprasom et al. Differences were compared after 8 weeks treatment course and follow-up observations were performed at 20th week to record any recurrent lesion. RESULTS 41 patients (78.8%) had complete remission of disease and 11 (21%) had shown partial improvement. The VAS scores for BS and pain improved significantly. Improvement was also noted with decrease in the average size of active lesions and the number of sites with treatment. The relapse was seen in 17 patients (41%) in the 20th week. CONCLUSION TA combined with TAC is a valuable therapeutic option for the treatment of symptomatic OLP. Our findings suggest that patients have shown statistically significant improvement.
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Affiliation(s)
- Cheshta Walia
- Department of Oral and Maxillofacial Pathology, Buraydah Private College, College of Dentistry and Pharmacy, Buraydah, Saudi Arabia,Address for correspondence:Dr. Cheshta Walia, Department of Oral and Maxillofacial Pathology, Buraydah Private College, College of Dentistry and Pharmacy, Buraydah 31717, Saudi Arabia. E-mail:
| | - Neelakshi Singh Rallan
- Department of Oral Pathology and Microbiology, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Anu Premkumar
- Department of Oral Medicine and Radiology, Dr. Syamala Reddy Dental College, Hospital and Research Centre, Bengaluru, Karnataka, India
| | - Sudip Roy
- Department of Orthodontics and Dentofacial Orthopedics, Buraydah Private College, College of Dentistry and Pharmacy, Buraydah, Saudi Arabia
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Asif AH, Kaliyadan F, Gite VV, Al-Dhubiab BE, Nanjappa SH, Meravanige G, Sreeharsha N. Standardization of topical preparations for finger-tip unit-Awareness and attitudes among pharmacists and dermatologists and suggestions to improve standardization of topical drug dosing-A two-phase cross-sectional survey. J Cosmet Dermatol 2021; 21:3555-3560. [PMID: 34919337 DOI: 10.1111/jocd.14663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Standardization of topical therapy dosage is important to ensure optimum use and dosage of topical medications. One of the concepts frequently used in the standardization of topical treatment is the Finger-tip unit (FTU). While practitioners, both dermatologists and pharmacists, are generally aware of FTU, practical use is less. OBJECTIVES We aimed to evaluate views and practices related to FTU among both dermatology and pharmacy faculty and to elicit and validate suggestions for improving standardization. METHODS We surveyed a group of Dermatologists and Pharmacists-in two phases-in phase 1 (n = 44), an electronic survey was used as a tool to understand their practices regarding FTU, and to obtain suggestions regarding standardization of topical medication delivery. In phase 2 (n = 40), the main suggestions for improvement were resent to the group to rate and validate the same. RESULTS The awareness of FTU was high among the experts, but practical use of the FTU for patient counselling was less frequent. The group gave suggestions to standardize applications. All these suggestions got high ratings on both feasibility and possible effectiveness in the second phase, with the highest rating being for the suggestion of "Placing QR codes on ointment/cream tubes which link to websites with educational materials/ videos on FTU/topical drug dosing." CONCLUSION Awareness regarding FTU is high among both dermatologists and pharmacists, however practical use is less. Strategies to improve standardization of topical drug dosing can be formulated through collaboration involving both dermatologists and pharmacists.
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Affiliation(s)
- Afzal Haq Asif
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Feroze Kaliyadan
- Department of Dermatology, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Vikas V Gite
- School of Chemical Sciences, Kavayitri Bahinabai Chaudhari North Maharashtra University, Jalgaon, India
| | - Bandar E Al-Dhubiab
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | | | - Girish Meravanige
- Department of Biomedical Sciences, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nagaraja Sreeharsha
- Department of Pharmaceutical Sciences, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia.,Department of Pharmaceutics, Vidya Siri College of Pharmacy, Bangalore, India
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Rudnicka L, Olszewska M, Goldust M, Waśkiel-Burnat A, Warszawik-Hendzel O, Dorożyński P, Turło J, Rakowska A. Efficacy and Safety of Different Formulations of Calcipotriol/Betamethasone Dipropionate in Psoriasis: Gel, Foam, and Ointment. J Clin Med 2021; 10:jcm10235589. [PMID: 34884291 PMCID: PMC8658256 DOI: 10.3390/jcm10235589] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/11/2022] Open
Abstract
Preparations containing calcipotriol combined with betamethasone dipropionate (in the forms of ointment, gel, and foam) are available for the topical treatment of psoriasis. This review summarizes the differences in the efficacy and safety of these formulations, as well as the preferences of patients with various forms of psoriasis (plaque, scalp, and nail psoriasis). It has been documented that foams provide higher bioavailability, resulting in increased efficacy in plaque psoriasis compared to ointments and gels. Gels or foams are preferred by patients for their different practical qualities (e.g., gels for “easy application”, and foams for “immediate relief”). The available data indicate that ointments may be the most effective formulation in nail psoriasis, and gels are preferred by patients with scalp psoriasis because of their cosmetic features. Treatment with a foam formulation is associated with a lower number of medical appointments compared to treatment with an ointment and with a lower probability of developing indications for systemic treatment. The safety profiles of foams, ointments, and gels are comparable, with the most common adverse effect being pruritus at the application site (in 5.8% of the patients). A long-term proactive maintenance therapy markedly reduces the number of relapses and is likely to close the gap between topical and systemic treatment in psoriasis.
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Affiliation(s)
- Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
- Correspondence: ; Tel.: +48-225021324; Fax: +48-228242200
| | - Małgorzata Olszewska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
| | - Mohamad Goldust
- Department of Dermatology, University Medical Center of the Johannes Gutenberg University, 55122 Mainz, Germany;
| | - Anna Waśkiel-Burnat
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
| | - Olga Warszawik-Hendzel
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
| | - Przemysław Dorożyński
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, 02-097 Warsaw, Poland; (P.D.); (J.T.)
| | - Jadwiga Turło
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, 02-097 Warsaw, Poland; (P.D.); (J.T.)
| | - Adriana Rakowska
- Department of Dermatology, Medical University of Warsaw, 02-008 Warsaw, Poland; (M.O.); (A.W.-B.); (O.W.-H.); (A.R.)
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Abstract
Primary open-angle glaucoma (POAG) is among the most common causes of irreversible loss of visual functions, its early diagnosis and treatment present great difficulties. POAG development involves many mechanical, hemodynamic and metabolic factors. The main approach to its treatment is reduction and normalization of the intraocular pressure (IOP), starting with local antihypertensive therapy. But since glaucoma requires life-long management, lengthy topical therapy can itself become the cause of many serious issues. Most often, they include achieving consistent normalization of IOP, systemic and local adverse events, difficulties with patient compliance, decreased quality of life, increased risks of the glaucoma surgeries. Ophthalmological practice and research continue to demonstrate the need for changing the paradigm of POAG treatment.
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Affiliation(s)
- V P Erichev
- Research Institute of Eye Diseases, Moscow, Russia
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