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PubMed1984

Retinoids: a review.

The retinoids are synthetic derivatives of vitamin A. Isotretinoin (13-cis-retinoic acid) is now being widely used in the United States for severe acne and etretinate is available in Europe and other countries for psoriasis. These drugs are also effective for a number of other skin diseases. This is an attempt to review basic knowledge of retinoids with which the practicing dermatologist should be familiar, to review the current status of studies, and to speculate on the present and future roles of these drugs in dermatology.

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↗
PubMed1983

Areolar gland discharge in adolescent females.

Two Tanner stage IV adolescent females with secretion of material from the areolar glands of the breast are described. This report, as well as previous case reports, indicates that the condition is benign in the presence of an otherwise unremarkable physical examination. In contrast to galactorrhea, which must be evaluated completely, areolar gland discharge appears to be a curiosity that may be as rare as the number of case reports would suggest. It appears to warrant nothing more than careful observation.

Adolescent↗
PubMed1986

Pilosebaceous physiology in relation to hirsutism and acne.

PSAs, with few exceptions, consist of a piliary and a sebaceous component. In androgen-sensitive areas, each has the capacity to develop into either a terminal hair follicle or a sebaceous follicle depending upon its location. Without androgen, there is no development of the sexual hair follicle or sebaceous gland. Androgens appear to promote sexual hair growth by recruiting a population of PSAs that have preset genetic sensitivity to initiate the production of terminal hairs. The site of action of androgens within the PSA is unclear. There are indications that androgens may act at more than one site in a system that requires two-way reciprocal interaction between dermal and epithelial cells for the generation of hair growth. Growth hormone appears to exert an important synergism with androgen in affecting the PSA, seemingly through the mediation of insulin-like growth factors. Hirsutism is due to an increased density of growing terminal hairs. The majority of cases of moderately severe hirsutism in women are due to hyperandrogenaemia, as are half the cases of mild hirsutism and about one-quarter of the cases of mild acne vulgaris. We advocate reserving the term idiopathic hirsutism or idiopathic acne for those patients in whom excessive growth of terminal hair or acne is not explained by androgen excess. We believe that highly variable sensitivity to androgen within the population explains both idiopathic hirsutism and cryptic hyperandrogenaemia; that is, these disorders lie at opposite ends of the normal spectrum of sensitivity to androgen. The biological basis for the variations in responsiveness of PSAs to androgens is unknown. The regression of hirsutism induced by antiandrogen treatment is characterized by the growth of hairs that are more vellus in character, i.e. smaller and less medullated.

Acne Vulgaris↗
PubMed2000

Field observations of the host-parasite relationship associated with the common horse bot fly, Gasterophilus intestinalis.

Behavior of Gasterophilus intestinalis (Diptera: Gasterophilidae) was observed in the laboratory and field over a period of 10 years. Mating occurred in a frenzied manner as flies emerged from pupae. Males attempted to copulate with females that had not fully emerged from the pupal case. Mating was never observed in the field or near the horse. Observations suggest that fecal piles of the horse are used as the mating site for the newly hatched flies. Activation of host-seeking behavior was found to occur early and remain throughout the life span of the adult as it sought multiple hosts for oviposition. Evidence is presented supporting the use of olfaction and vision in finding the host. Interest by flies in shadows and linear high-contrast objects was observed. Methods used by the flies to maintain close proximity with the host are discussed including flight with the host and avoidance of host defenses. Recapture methods were successful in determining the time taken to reestablish at the host, and extent of travel to the host. The presence of kairomone(s) within horse secretions is suspected.

Animals↗