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Biomedical subjects

A Kligman

Publications and source records attributed to A Kligman.

14 recordsLinked to original sources
PubMed2001

New photographic techniques for clinical evaluation of acne.

Clinical evaluation of acne is usually based on direct visual assessment and ordinary flash photography, both of which are compromised by viewer subjectivity. It is difficult to accurately assess individual acne lesions and to observe early response to therapy. Standard flash photography has inherent limitations owing to the physics of light; it does not permit consistent visualization of subtle cutaneous characteristics like erythema or microcomedones, and it tends to blur distinctions between active inflammatory lesions and older hyperpigmented macules. Over the last decade there has been increasing interest in newer techniques aimed at increasing the accuracy and objectivity of acne evaluation. These include parallel-polarized light photography, cross (or perpendicular)-polarized light photography, videomicroscopy, and fluorescence photography. This article will review the advances of the past decade and summarize new techniques to evaluate acne lesions. Moreover, findings of a study that evaluated the course of individual acne lesions and the effects of adapalene gel 0.1% on inflammatory and non-inflammatory acne lesions will be viewed. In this study, the use of parallel-polarized and cross-polarized photography, in combination with videomicroscopy and sebum production measurement, provided objective, detailed information on the evolution of different variable acne lesions and their response to adapalene gel 0.1%. Adapalene treatment produced rapid resolution of inflammatory and non-inflammatory lesions, and inhibited formation of new lesions. Sebum secretion rates also declined during treatment. Use of the new assessment techniques proved to be a valuable, non-invasive and reliable method of assessing acne vulgaris and its response to treatment.

Acne Vulgaris↗
PubMed1996

Treatment of photodamaged skin with trichloroacetic acid and topical tretinoin.

BACKGROUND: Photodamaged skin typically displays lentigines, actinic keratoses, wrinkles, and textural alteration. Chemical peeling has been used to treat these, but few controlled studies have been performed to determine its efficacy. OBJECTIVE: Our purpose was to compare the efficacy of a medium-depth chemical peel with and without tretinoin before and after treatment. METHODS: Sixteen men with actinic damage including actinic keratoses were treated with a 40% trichloroacetic acid(TCA) chemical peel. Half were pretreated for 6 weeks with topical tretinoin; they also used tretinoin after the peel. Photographs were obtained at baseline and at 6 weeks and 6 months after treatment. Changes in specific features were rated by a panel of three examiners. RESULTS: Some improvement was noted in all patients. More rapid and even frosting was observed in the patients pretreated with tretinoin. Solar lentigines, actinic keratoses, and skin texture were the features of photoaging most affected; wrinkles were least affected. No statistically significant difference was found between patients treated with TCA and tretinoin (before and after peel) and those with TCA alone. CONCLUSION: A medium-depth chemical peel with 40% TCA alone produced moderate improvement in some manifestations of actinic damage but had little effect on wrinkles. Treatment with tretinoin before and after TCA did not significantly enhance the efficacy of the peel.

Administration, Cutaneous↗
PubMed1990

Stratum corneum lipid removal by surfactants: relation to in vivo irritation.

The relationship between the in vivo irritation potential of sodium lauryl sulfate (SLS) and linear alkyl benzene sulfonate (LAS) and the ability of these two surfactants to remove lipid from the stratum corneum (SC) in vitro were investigated. Either surfactant removes detectable levels of lipids only above its critical micelle concentration (CMC). At high concentrations the surfactants removed only very small amounts of cholesterol, free fatty acid, the esters of those materials, and possibly squalene. SLS and LAS have been shown, below the CMC, to bind to and irritate the SC. Thus, clinical irritation provoked by SLS or LAS is unlikely to be directly linked with extraction of SC lipid. The milder forms of irritation--dryness, tightness, roughness--may involve both surfactant binding to and denaturation of keratin as well as disruption of lipid. Our findings challenge earlier assumptions that surfactants' degreasing of the SC is involved in the induction of erythema.

Alkanesulfonates↗
PubMed1990

Seasonal modulation of sebum excretion.

It is currently agreed that ambient temperature influences the sebum excretion rate. By using the Sebutape technique we have confirmed this concept, which is related to an increased delivery of sebum to the surface of the skin without an increment in the number of active sebaceous follicles.

Adult↗
PubMed1987

Topical tretinoin: indications, safety, and effectiveness.

Topical tretinoin has been used for a number of years to treat patients with acne vulgaris. This paper reviews some of the newer uses of tretinoin, including treatment of patients with photoaging of the skin, premalignant lesions, dry-eye disorders, and its use after dermabrasion.

Acne Vulgaris↗
PubMed1979

Steroid analysis of human apocrine secretion.

Analysis of the secretion of the human apocrine gland has shown the presence of dehydroepiandrosterone and androsterone sulfates, two androgen steroids previously identified in axillary sweat. These steroid sulfates were characterized by the gas chromatographic/mass spectrometric analysis of the odorous steroids formed on direct injection of the apocrine secretion into the host gas chromatographic injector. No spectral evidence was found for the presence of the delta16-androgen steroids which have axillary-like odors and have also been reported in axillary sweat. Cholesterol was the major steroid component of the secretion.

Adult↗
PubMed1979

Topical methoxsalen administration and sunlamp fluorescent irradiation in psoriasis.

Analysis of standard fluorescent sunlamps (Westinghouse) indicates that in addition to UVB (290 to 320 nm), a considerable amount of UVA (320 to 400 nm) is also present in their emissions. Since the benefits of topical psoralen administration and UVA have already been demonstrated, and prior experience by ourselves and others with UVB has indicated that some psoriasis benefited from UVB alone, localized areas and plaques of 20 patients were treated with topical administration of psoralens and fluorescent sunlamp bulbs to determine if such a light source with this emission spectrum would be advantageous. Results indicated a total resolution in 17 of 20 patients after an average of 18 treatments. Adverse blistering phototoxic reactions and excessive hyperpigmentation were not encountered. The UVB erythema response of normal skin served as the guide to light dosage in the same manner as administration of the Goeckerman regimen. Therefore, the use of psoralens was very effective when combined with fluorescent sunlamp irradiation; however, the potential risks of photocarcinogenicity makes this treatment experimental and should be reserved for recalcitrant cases.

Administration, Topical↗
PubMed1975

Acne mechanica.

The term acne mechanica designates local exacerbations due to pressure, friction, rubbing, squeezing, or stretching. Examples are given of various physical traumata that provoke lesions in acne patients. The precipitating causes of stress are diverse, they include articles of clothing (tight straps and belts), recreational accouterments (football shoulder pads), or occupational pressure (rubbing of back in truck drivers). Sealing acne-bearing skin under adhesive for two weeks regularly induced new inflammatory lesions, which derived from the rupture of microcomedones that are not visible to the naked eye.

Acne Vulgaris↗