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At least 883 records · Page 49Linked to original sources
PubMed1996

A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: a multicenter trial.

BACKGROUND: Adapalene is a new synthetic retinoid analogue developed for the topical treatment of acne vulgaris. OBJECTIVE: The study was designed to compare the efficacy and safety and adapalene gel 0.1% with tretinoin gel 0.025% in the treatment of grade II to II facial acne vulgaris. METHODS: Three hundred twenty-three patients were enrolled in this investigator-masked, randomized, parallel group, multicenter trial. Patients applied the test materials to the entire facial area daily, for a period of 12 weeks. Efficacy and cutaneous tolerance were assessed at baseline and weeks 2,4,8, and 12. Efficacy was determined by investigator counts of noninflammatory open and closed comedones, and inflammatory papules and pustules, as well as global improvement. Cutaneous tolerance was evaluated by erythema, scaling, and dryness, along with burning and pruritus. RESULTS: Staring at weeks 2 and 4, adapalene gel produced numerically greater lesion reductions than did tretinoin gel for all lesion types. At week 12, the mean percent reduction in the different lesion counts was as follow: 49% versus 37% for total lesions (p<0.01); 46% versus 33% for noninflammatory lesions (p=0.02); 48% versus 38% for inflammatory lesions (p=0.06) in adapalene and tretinoin gel treatment groups, respectively. Cutaneous side effects were limited to a mild "retinoid dermatitis" occurring in both treatment groups; however, patients treated with adapalene gel tolerated this therapy significantly better than those treated with tretinoin gel. Laboratory test evaluations (hematology, blood chemistries, urinalysis) were performed in 54 patients before and after 3 months of treatment. No clinically significant changes were observed. CONCLUSION: Adapalene gel 0.1% applied once daily was significantly more effective in reducing acne lesions and was better tolerated than tretinoin gel 0.025% in the treatment of acne vulgaris.

Acne Vulgaris↗
PubMed1996

Fluorescence photography in the evaluation of acne.

BACKGROUND: Quantification of acne remains a challenge. It may be difficult to identify lesions by standard flash photography. Previous studies have shown that foci of light in fluorescence photographs correspond to high protoporphyrin IX production by Propionibacterium acnes in open comedones, follicles, and inflammatory lesions. OBJECTIVE: Our purpose was to study the utility of fluorescence photography for evaluation of acne. METHODS: Forty subjects with mild to moderate acne vulgaris were randomly selected to apply either clindamycin 1% topical solution or vehicle twice daily. Counts of acne lesions and flash and fluorescence photographs were obtained at baseline, and at 4, 8, and 12 weeks. RESULTS: At 12 weeks, the treatment group had a larger percentage change in open comedones, less fluorescence in all areas assessed, and a larger percent decrease in fluorescence than the vehicle group. CONCLUSION: Fluorescence photography appears to be a useful tool to chart the course of acne treatment.

Acne Vulgaris↗
PubMed1996

Improvement of facial acne scars by the 585 nm flashlamp-pumped pulsed dye laser.

BACKGROUND: Hypertrophic or erythematous scars (or both) have remained notoriously difficult to treat because of their persistence or recurrence after traditional therapies. Recently, the 585 nm flashlamp-pumped pulsed dye laser has been shown to be effective in treating similar traumatic and surgical scars. OBJECTIVE: Our purpose was to determine the effectiveness of the 585 nm flashlamp-pumped pulsed dye laser in the specific treatment of facial acne scars. METHODS: Twenty-two patients with erythematous or hypertrophic facial acne scars were included in this Investigational Review Board-approved study. The 585 nm flashlamp-pumped pulsed-dye laser was used to treat scars on half of each patient's face, with the contralateral side used as control. Baseline, 6-week, and 6-month posttreatment photographs, erythema measurements made with reflectance spectrometry, and skin texture analyses were obtained from laser-irradiated and untreated scars. Clinical analyses were performed independently by two "blinded" observers. RESULTS: Significant clinical improvement was observed in laser-irradiated acne scars compared with the untreated (control) scars after one or two 585 nm pulsed-dye laser treatments. Erythema measurements and skin texture analyses of laser-treated scars approximated those obtained in the adjacent normal skin. CONCLUSION: The 585 nm flashlamp-pumped pulsed-dye laser can significantly improve the clinical appearance of erythematous or hypertrophic facial acne scars.

Acne Vulgaris↗
PubMed1996

Treatment of pyogenic granulomas with the 585 nm pulsed dye laser.

BACKGROUND: Current therapeutic alternatives for pyogenic granulomas include surgical excision, electrodesiccation and curettage, cryotherapy, and ablation with CO2 or continuous-wave vascular lasers. OBJECTIVE: Our purpose was to investigate the use of the 585 nm flashlamp-pumped pulsed dye laser (585 nm PDL) for the treatment of pyogenic granulomas in terms of efficacy, advantages in technique, and side effects. METHODS: Eighteen patients with symptomatic pyogenic granulomas in a variety of locations were treated with the 585 nm PDL and examined. RESULTS: Sixteen of 18 treated patients demonstrated both symptomatic and clinical clearing of the lesions with excellent cosmetic results after treatment. The two patients who dropped out after one to two 585 nm PDL treatments were eventually treated successfully with electrodesiccation and curettage. No postoperative complications and no persistent pigmentary changes or scarring were observed. The procedure required no anesthesia, and postoperative care was limited to the application of a topical antibiotic ointment. CONCLUSION: Our experience suggests that treatment of pyogenic granulomas with the 585 nm PDL is a safe, effective, and reasonable alternative to conventional therapy.

Administration, Cutaneous↗
PubMed1996

Leishmaniasis presenting as a dermatomyositis-like eruption in AIDS.

Three patients are described with leishmaniasis and AIDS, with cutaneous lesions mimicking dermatomyositis. Leishmania organisms were observed in great numbers in the dermis of lesional skin biopsy specimens. They were also present inside keratinocytes in all layers of the epidermis in one patient. Skin cultures from all patients and bone marrow culture in patients 1 and 3 revealed Leishmania infantum. Leishmania organisms were also found in nonlesional skin. The absence of proximal symmetric muscle weakness, elevated muscle enzymes, myopathic electromyograms, or characteristic histopathologic and immunologic features of dermatomyositis, and the rapid and complete clearance or marked improvement of the cutaneous lesions after treatment for leishmaniasis, make us consider true dermatomyositis unlikely. We suggest that leishmaniasis be included in the list of diseases capable of inducing a dermatomyositis-like eruption.

AIDS-Related Opportunistic Infections↗
PubMed1996

Folliculosebaceous cystic hamartoma: a clinical pathologic study.

BACKGROUND: Folliculosebaceous cystic hamartoma (FCH) is a recently recognized cutaneous hamartoma comprising follicular, sebaceous, and mesenchymal elements. Only nine cases have been previously reported. OBJECTIVE: The aim of this study was to characterize further the clinical, histologic, and immunohistologic features of FCH. METHODS: The clinical, histologic, and immunohistologic features of eight cases of FCH were evaluated and the literature reviewed. RESULTS: All lesions presented as exophytic papules or nodules on the head, most commonly the central part of the face. Age at onset ranged from 4 to 47 years. The size ranged from 0.5 x 0.4 cm to 1.4 x 1.1 cm. Clinical diagnoses were nevus, neurofibroma, and adnexal tumor. None of the patients had associated Muir-Torre syndrome. The diagnostic microscopic features of infundibular cystic structures with attached sebaceous glands and characteristic stroma were present in all lesions. Many of the stromal spindle cells were CD34 positive. CONCLUSION: FCH is a recently recognized hamartoma of follicular, sebaceous, and mesenchymal elements. Although reported only rarely, its incidence is likely much higher.

Adolescent↗
PubMed1997

Sebaceous adenitis.

A 32-year-old man had an asymptomatic erythematous, annular and circinate eruption on the face for 2 months. Histologic examination revealed sebaceous lobules surrounded by a lymphomonocytic infiltrate and some areas of necrotic sebocytes. The lesions healed without treatment in 1 month. These clinical features can be observed in "neutrophilic sebaceous adenitis," recently described by Renfro et al. The most striking abnormality is the nearly exclusive perisebaceous distribution of the dermal cellular infiltrate with inflammatory cell permeation of the sebaceous epithelium.

Adult↗
PubMed1997

Polarized light photography enhances visualization of inflammatory lesions of acne vulgaris.

BACKGROUND: Polarized light photography has been used to selectively differentiate surface from subsurface features of photoaged skin. OBJECTIVE: Our purpose was to compare acne assessments obtained from clinical evaluations with assessments from photographs obtained with flash photography and with perpendicular polarized light photography. METHODS: Assessments of acne with the Cunliffe scale were made of 32 subjects. Retrospective evaluations of standard and perpendicular polarized light photographs were made in a blinded fashion by a panel of evaluators. RESULTS: Visualization of inflammatory acne lesions was enhanced with perpendicular polarized light photography, with clear delineation of erythematous borders. Acne assessments with the use of a Cunliffe scale were significantly higher (p = 0.001) from perpendicular polarized light photographs than for clinical evaluations. CONCLUSION: Polarized light photography enhances visualization of inflammatory acne lesions in a manner not possible with conventional flash photographs, permitting accurate evaluation of the extent of disease and the effectiveness of therapy.

Acne Vulgaris↗
PubMed1997

Patch testing in children and adolescents: five years' experience and follow-up.

BACKGROUND: Allergic contact dermatitis in children is a significant clinical problem. Little information is available concerning the value of patch testing and the outcome in these children. OBJECTIVE: Our purpose was to assess the value of patch testing in children and the outcome of allergic contact dermatitis in childhood. METHODS: Clinical data on 83 children patch tested during a 5-year period were assessed. Clinical follow-up on 68 subjects was performed. RESULTS: Overall, 41 children had one or more allergic reactions (49%). Reactions to metals, topical preparations, and food additives were common. The clinical outcome at 6 months was significantly better for 36 children with a relevant allergen on patch testing than in 32 with no allergen or no relevant allergen (p = 0.006). CONCLUSION: Patch testing is useful in the management of children suspected of having an allergic contact dermatitis. Patch testing and subsequent allergen avoidance may improve the prognosis in children with a relevant contact allergen.

Administration, Cutaneous↗
PubMed1997

Treatment of melasma with Jessner's solution versus glycolic acid: a comparison of clinical efficacy and evaluation of the predictive ability of Wood's light examination.

BACKGROUND: Melasma can be resistant to topical therapy. OBJECTIVE: Our purpose was to evaluate the efficacy of superficial peels in conjunction with topical tretinoin and hydroquinone in patients with melasma and to evaluate the ability of Wood's light examination to predict response to treatment. METHODS: We measured increased light reflectance in melasma areas with a colorimeter. Clinical observations were scored through an index designed to weigh numerically homogeneity, intensity of color, and area of melasma. RESULTS: Colorimetric analysis showed an average lightening of 3.14 +/- 3.1 on the glycolic acid-treated side and 2.96 +/- 4.84 on the Jessner's solution-treated side. There was no statistically significant difference between the right and left. There was an overall decrease in melasma area and severity of 63%. CONCLUSION: Superficial peels hasten the effects of topical therapy in melasma. Wood's light examination did not help predict response to treatment.

Chemexfoliation↗