Duffybender9762

Objective We sought to evaluate long-term relapse rates following lidose-isotretinoin taken without food in patients with severe recalcitrant acne. Design In this single-arm, open-label study, 197 patients received twice-daily lidose-isotretinoin without food for up to 20 weeks. Patients with a 75-percent or higher adherence rate with the protocol-designated dosage and end-of-treatment lesion counts were predefined as the per-protocol (PP) population and evaluated in a 104-week post-treatment period (PTP) to determine the proportion of patients requiring retreatment. Setting Participants were enrolled from 21 sites across the United States. Participants Eligible participants were male or nonpregnant, nonlactating female, aged between 12 to 45 years, weighing 40 to 110 kg, and with no prior exposure to systemic isotretinoin or systemic retinoids. Acne was considered severe enough for treatment if the patient had five or more facial nodule lesions. Measurements Patients were observed to determine whether they required retreatment with isotretinoin or any acne therapy during the PTP. Lesion counts and assessments of acne severity, quality of life, and adverse events were completed. Results Of the 166 patients in the PP population, seven (4.2%; 95% confidence interval [CI] 1.7%-8.5%) were retreated with isotretinoin, 25 (15.1%; 95% CI 10.0%-21.4%) were treated with topical and/or oral nonisotretinoin therapies including over-the-counter therapies or intralesional injections, and 137 (82.5%; 95% CI 75.8%-88.0%) required no retreatment. Isotretinoin retreatment was most common in male patients aged 14 to 18 years. Conclusion Long-term relapse rates for lidose-isotretinoin taken without food for 20 weeks were at the low end of those published for traditional isotretinoin taken with a high-fat/high-calorie meal. ClinicalTrials.gov Registration NCT02457520. All rights reserved.Background Keratosis pilaris (KP) is a common benign follicular disorder for which various topical and laser treatments have been used, with limited efficacy. Objective We evaluated the efficacy of intense pulsed light (IPL) therapy for the reduction of skin roughness, erythema, and hyperpigmentation in Thai subjects with KP. Material and Methods Twenty-four Thai patients with untreated KP on the upper outer arms were enrolled in a randomized, double-blind study. Only one arm of each subject was included and divided into upper and lower parts (25 cm2 per each part). One part was randomized to be treated with IPL using 645 to 950-nm cutoff filter and fluences of 15 to 18 J/cm2, while the other part was treated with sham irradiation. Subjects received four consecutive treatments at four-week intervals. Antera3D was used to measure skin roughness, erythema, and hyperpigmentation at baseline and four weeks after the last treatment. Moreover, clinical outcomes were also evaluated by subject Global Improvement Scorrol after four sessions. All rights reserved.Introduction Systemic therapy for acne can include tetracyclines or, for severe cases, isotretinoin. Concurrent use of tetracyclines and isotretinoin is known to increase the risk of development of pseudotumor cerebri (PTC). Objectives Given their association with PTC when used concomitantly, this study sought to quantify the estimated frequency of the coprescription of isotretinoin and tetracyclines and to assess for trends in the use of isotretinoin and tetracycline for acne as it relates to age, sex, race, insurance, and provider specialty. Methods Data from the National Ambulatory Medical Care Survey were analyzed over the years 2003 to 2013 regarding acne visits with isotretinoin and/or tetracycline prescriptions. Complex-samples logistic regression was used to estimate the effect of demographic variables on prescribing behavior. Results Isotretinoin and tetracyclines were coprescribed in 0.35 percent of visits for acne. learn more Dermatologists prescribed isotretinoin more frequently than nondermatologists. Patients younger than 36 years of age and men were more likely to receive treatment with isotretinoin or a tetracycline. No differences in prescribing patterns were found based on race or survey year. Conclusions Concomitant exposure to tetracyclines and isotretinoin is exceedingly rare. The increased PTC risk associated with their concomitant use is well-known among dermatologists. All rights reserved.Background Topical hyaluronic acid (HA) has shown effectiveness in maintaining skin hydration. Topical creams containing HA are widely available, but their efficacy is limited by their lack of penetration into the skin due to the large molecule size of HA, the result of being formulated into a cream base. Objective In this three-part study (in vitro, ex vivo, and in vivo), molecule sizes, penetration levels, and antiaging qualities of a topical HA facial cream that was formulated using a new technology that micronizes HA molecules (m-HA) were assessed. Methods and Results Particle sizes of m-HA were evaluated using electron microscopy, which showed varying sizes, the smallest of which was 100nm in diameter. The antioxidation capabilities of m-HA were measured using electron spin resonance and were found to be higher than original HA. Skin penetration of the m-HA formulation was evaluated via immunohistochemical staining of porcine skin samples, which demonstrated penetration of the formulation into the stratum corneum and the deep epidermal layers toward the dermis. Antiaging qualities of the m-HA formulation were assessed in an open-label clinical study that included 36 healthy adult women. Skin parameters were measured objectively (e.g., Corneometer, Cutometer) and subjectively via patient questionnaire, results of which indicated significant improvements in facial skin hydration, elasticity, and wrinkle depth. Conclusion The topical HA facial cream with m-HA technology demonstrated penetration into the epidermal skin layer, and, to our knowledge, our formulation is the first HA facial cream to achieve this. Clinical application of the facial cream demonstrated objective and subjective improvements in facial skin quality of healthy adult female subjects. Our results support the use of this new HA facial cream with m-HA technology as an effective antiaging topical therapy. Larger randomized, controlled studies are needed to confirm our findings. All rights reserved.