Hexamidine isethionate: a sensitizer in topical pharmaceutical products and cosmetics.
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Origin of epidermal urea and the therapeutical possibilities are shown: the waterbinding, keratolytic, epidermal thinning, antipruriginous, and the penetrating-supporting effects. Our clinical studies revealed mild to moderate eczemas and psoriasis capitis to be treated with a 10% urea-, 1% hydrocortisone cream. A 10% urea cream is well indicated for mild palmar and plantar hyperkeratotic dermatitis, the after treatment of contact dermatitis, and senile atrophic skin. Serious hyperkeratotic palmar dermatitis gives better results when handled alternately with triamcinolone-acetonid cream and a 10% urea cream.
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Topical photodynamic therapy (PDT) using the methyl ester of 5-aminolaevulinic acid (MAL) is an effective therapy for actinic keratoses and Bowen's disease. Thin and moderate thickness facial actinic keratoses respond best, with clearance rates equivalent or superior (depending on protocol) to current therapy, and with notably superior cosmetic outcome. Patients with areas of field cancerization and organ transplant recipients may particularly benefit from topical MA-PDT. The response rate of Bowen's disease to MAL-PDT is also at least equivalent to cryotherapy and 5-fluorouracil, again with superior cosmesis. Patients with large or multiple lesions of Bowen's disease or those in whom standard therapy, including surgery, is relatively contraindicated may particularly benefit from PDT.
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In a double-blind, cross-over trial with Tigason and placebo, the parameters of palmoplantar pustulosis underwent significant changes during the retinoid therapy. A hand-over effect was clearly indicated during the placebo period and several patients experienced long-lasting remissions.