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At least 613 records · Page 34Linked to original sources

An observer-blinded study of 1% permethrin creme rinse with and without adjunctive combing in patients with head lice.

OBJECTIVES: To determine if NIX (Warner Lambert Healthcare, Morris Plains, NJ) 1% Permethrin Creme Rinse Lice Treatment (1% PLT) without combing will effectively treat >/=95% of patients on day 2 or on day 15; to determine whether combing influences efficacy. STUDY DESIGN: A randomized, observer-blinded study enrolled 95 infested adults and children. All patients were treated with 1% PLT on day 1 and, if still infested, on day 8. One third of households were randomized to the combing group and two thirds to the no-combing group. Efficacy was assessed by: (1) visual inspection on days 1, 2, 8, 9, and 15 and, (2) shampooing/straining on days 2, 9, and 15. The target efficacy was 95%. RESULTS: In the no-combing group, the lice-free rate was 83.1% on day 2 (95% CI, 71.0-91.6), 45.8% on day 8 (before second treatment) (95% CI, 32.7-59.2), 77.6% on day 9 (95% CI, 64.7-87.5), and 78.3% on day 15 (95% CI, 65.8-87.9). Adjunctive combing did not improve efficacy on any day. CONCLUSIONS: In this population, 1% PLT was significantly less than 95% effective and suggests resistance to 1% PLT. The failure of nit removal combing by nonprofessional caregivers to improve efficacy demonstrates the unreliability of combing as adjunctive treatment in this setting.

Adolescent↗

Short course of oral cyclosporine in lichen planopilaris.

Lichen planopilaris is a rare inflammatory disorder of unclear etiology that causes permanent scalp hair loss. Current treatments for lichen planopilaris are limited and do not alter the eventual outcome of the disease. Oral cyclosporine has been successful in treating severe and refractory lichen planus of the skin, and has produced sustained remission in some patients. We present 3 patients with lichen planopilaris who were treated with a short course of oral cyclosporine and report their clinical features and responses, using a standardized method of patient assessment and 3 specific outcome measures. In all 3 patients alleviation of symptoms, resolution of clinical activity, and halting progression of hair loss was achieved in 3 to 5 months with sustained effect at 12 months after a short course of cyclosporine therapy.

Administration, Oral↗

Scalp psoriasis: synergy between the Malassezia yeasts and skin irritation due to calcipotriol.

To investigate if there is a synergy between the presence of the Malassezia yeasts and the adverse reaction during treatment of scalp psoriasis with calcipotriol scalp solution, patients were treated with itraconazole to reduce the number of Malassezia yeasts. This study was a double-blind, placebo-controlled parallel group study between oral itraconazole or placebo for 8 weeks in patients with scalp psoriasis. After 2 weeks, calcipotriol scalp solution was applied twice daily for 6 weeks. Altogether 137 patients, 67 in the itraconazole group and 70 in the placebo group, comprised the intention-to-treat population. There were 13 (19.4%) patients with local skin irritation in the itraconazole group compared to 33 (47.1%) in the placebo group (p < 0.001). The skin irritation was significantly lower in patients with a low number of cultured Malassezia yeasts (p = 0.017). Thus, when Malasessia was eliminated or the numbers reduced, the irritation produced by calcipotriol was significantly diminished.

Administration, Oral↗

A randomised, single-blind, single-centre clinical trial to evaluate comparative clinical efficacy of shampoos containing ciclopirox olamine (1.5%) and salicylic acid (3%), or ketoconazole (2%, Nizoral) for the treatment of dandruff/seborrhoeic dermatitis.

BACKGROUND: The association between seborrhoeic dermatitis and dandruff and the yeast Malassezia furfur is well recognized. Symptoms include scalp itchiness and scaling. Due to its antimycotic activity, ciclopirox olamine is established as an effective treatment for these scalp conditions. Salicylic acid has keratolytic properties and aids in the removal of scales. OBJECTIVE: To compare the therapeutic efficacy of a shampoo containing 1.5% ciclopirox olamine and 3% salicylic acid (CPO/SA) with Nizoral (2.0% ketoconazole shampoo) in a study involving 154 subjects with dandruff - 70 of whom also had seborrhoeic dermatitis of the scalp. Nizoral is currently a registered treatment for dandruff and seborrhoeic dermatitis. METHODS: The shampoos were used three times week for 4 weeks, with 2-week washout and follow-up periods. Clinical and self-assessments were made throughout treatment and after follow-up (day 43). Within and between-treatment assessments of signs and symptoms were analysed. RESULTS: In the two groups, seborrhoeic dermatitis and dandruff improved significantly throughout treatment, with lower clinical and self-assessment scores at both the end of treatment (day 29) and follow-up (day 43). Only the subjects treated with CPO/SA shampoo showed a significant reduction in the itching of seborrhoeic dermatitis at these times. CONCLUSION: The study demonstrated that both CPO/SA and Nizoral were safe and effective in the treatment of dandruff and seborrhoeic dermatitis.

Administration, Cutaneous↗

Topical nitrogen mustard ointment with occlusion for Langerhans' cell histiocytosis of the scalp.

BACKGROUND: Topical nitrogen mustard solution has been used as an effective alternative to corticosteroids for the treatment of cutaneous eruptions of Langerhans' cell histiocytosis (LCH). When used as an ointment under occlusion, nitrogen mustard may still be effective and possess less risk of unwanted side effects. METHODS: A patient with scalp LCH was treated topically with nitrogen mustard ointment 0.01% under occlusion. RESULTS: The lesions cleared in 3 weeks without irritation. CONCLUSION: Topical nitrogen mustard ointment 0.01% under occlusion is a well-tolerated, non-irritating treatment for scalp LCH.

Administration, Cutaneous↗

Tufted hair folliculitis: complete enduring response after treatment with rifampicin.

BACKGROUND: A 47-year-old woman presented with erythematous lesions with papules and pustules on her parieto-occipital region that had been present for 8 months. Areas of sclero-atrophic alopecia were evident, whereas at different points tufted hair shafts were coming out from single dilatated follicular ostia. Before our observation, an antibiotic oral therapy with tetracyclines and local with erythromycin had been administered to the patient, with partial improvement and relapse on its suspension. METHODS: Bacterial culture from pustules showed the development of Staphylococcus aureus. A skin biopsy was done. According to clinical and histopathological findings a diagnosis of tufted hair folliculitis was made and a treatment with oral rifampicin was started at the dosage of 450 mg twice per day. RESULTS: After 3 weeks of therapy, the pustular lesions regressed completely and after a follow-up of 1 year no relapse was observed. CONCLUSIONS: Rifampicin is one of the best active antibiotics against S. aureus, which seems to play a role in the pathogenesis of tufted hair folliculitis. Our results, if further confirmed, may suggest a role for rifampicin either for the control of the pustular phase of this rare disorder or to prevent its relapses for a long time.

Anti-Bacterial Agents↗

Fluocinolone acetonide topical oil for scalp psoriasis.

Numerous preparations that are available for the treatment of psoriasis of the scalp contain high potency steroids, such as betamethasone dipropionate lotion or clobetasol propionate solution. Of special interest is a currently marketed oil preparation that contains the steroid fluocinolone acetonide (0.01%), classified as low potency (Class 6) steroid. Because the combination of emollients in the vehicle base are present to aid in softening the stratum corneum and allow penetration of the steroid component into the lower skin layer, it was thought this preparation would be an efficient treatment for psoriasis of the scalp. This study was designed to demonstrate the efficacy, tolerance and safety of fluocinolone acetonide 0.01% in oil, compared to its vehicle, for the treatment of scalp psoriasis. This was a randomized, double-blind, vehicle-controlled multi-center study in patients with moderate to severe scalp psoriasis. At the completion of the treatment period (21 days) all signs of psoriasis had improved in both treatment groups, the improvements in the FA group being significantly greater compared to those in the vehicle-treated group. The results of the physician global assessments of improvement in the signs of psoriasis from baseline confirmed the findings. Significantly more patients in the FA group had a good or better improvement from baseline compared to the number in the vehicle-treated group. The results of this study conclusively show that FA in an oil base that aids in the softening of the skin and allows penetration of the steroid into the stratum corneum, is an effective treatment for psoriasis of the scalp. This study also showed that the vehicle alone causes an improvement in the signs of psoriasis, but that the addition of 0.1% of the low potency steroid, fluocinolone acetonide, leads to a significantly better improvement.

Administration, Topical↗

Clobetasol propionate shampoo 0.05% and calcipotriol solution 0.005%: a randomized comparison of efficacy and safety in subjects with scalp psoriasis.

BACKGROUND: Scalp involvement in psoriatic patients represents a common issue. Treatment of the hairy skin requires adequate pharmaceutical formulations; hence, a new specific shampoo formulation of clobetasol propionate 0.05% was developed by Galderma R&D, Inc. METHODS: For this multicenter, randomized, investigator-masked, parallel group study, 151 subjects with moderate to severe scalp psoriasis were randomized to 4 weeks of treatment with clobetasol propionate shampoo or calcipotriol solution. RESULTS: Clobetasol propionate demonstrated significantly superior efficacy to calcipotriol solution (total severity score: mean difference 0.51, 95% CI 0.05-0.97, p = 0.028; global severity score: mean difference 0.43, 95% CI 0.08-0.78, p = 0.016). Adverse events were more common in the calcipotriol group than in the clobetasol propionate shampoo group. Telangiectasia and skin atrophy did not differ significantly between treatments; however, a burning sensation was significantly more common in the calcipotriol solution group. CONCLUSIONS: Short contact therapy of scalp psoriasis with this new shampoo formulation of clobetasol propionate was significantly more effective and better tolerated than calcipotriol solution for the treatment of scalp psoriasis.

Administration, Topical↗