夫西地酸乳膏联合阿达帕林凝胶治疗寻常痤疮的疗效

 目的 探讨夫西地酸乳膏联合阿达帕林凝胶治疗寻常痤疮的疗效。方法 选择武警黑龙江总队医院诊治的寻常痤疮患者110例,随机分为对照组和观察组,每组各55例。对照组单独应用阿达帕林凝胶治疗,观察组联合应用夫西地酸乳膏与阿达帕林凝胶,两组均持续治疗4周。比较两组治疗后皮损数量、不良反应、复发率等。结果 治疗4周后,与对照组相比,观察组炎性皮损、非炎性皮损个数明显减少,差异有统计学意义(P＜0.05),两组治疗后不良反应差异无统计学意义。治疗后6个月,观察组的复发率3.64%(2/55)低于对照组14.55%(8/55),差异有统计学意义(P＜0.05)。结论 夫西地酸乳膏联合阿达帕林凝胶治疗寻常痤疮,可明显改善皮损情况,安全性较高,复发率低。     

The third-generation retinoid adapalene triggered DNA damage to induce S-phase arrest in HaCat cells

Epidermal proliferative diseases consisted of a series of common skin diseases, most of which were recurrent chronic skin diseases, and had greatly negative influence on the life quality of patient. Retinoids exhibited vital roles in the treatment of many skin diseases. Our recent study demonstrated that adapalene significantly inhibited the growth of HaCat cells, and the inhibitory activity was stronger than other retinoids, such as all-trans-retinoic acid, acitretin, isotretinoin, tazarotene, and bexarotene. Further study showed that adapalene suppressed the colony formation of HaCat cells, and it dramatically triggered S-phase arrest and apoptosis, rather than G1 phase arrest which was reported in other retinoids in several studies. Additionally, adapalene treatment greatly upregulated the protein expression of DNA damage marker γ-H2AX, which was in accord with the results of the elongation of tail moment by comet electrophoresis analysis. Moreover, DNA damage was triggered and DNA repair was suppressed synchronously with adapalene treatment, which accounted for the mechanism of S-phase arrest induced by adapalene. In summary, our recent work demonstrated that adapalene showed strong anti-proliferation activity in HaCat cells and could be an alternative agent for the epidermal proliferative disease.     

Low‐dose etretinate shows promise in management of punctate palmoplantar keratoderma type 1: Case report and review of the published work

Punctate palmoplantar keratoderma type 1 (PPKP1) is a rare autosomal dominant disorder of keratinization, clinically characterized by punctate keratotic papules affecting the palmoplantar skin. Loss‐of‐function mutations in AAGAB have recently been reported as a cause of PPKP1. Despite the discovery of the genetic cause of PPKP1, pathogenesis‐based therapies are still unavailable. Moreover, little is known about the effectiveness of treatments for PPKP1. In this study, we analyzed a Japanese woman with PPKP1 and identified a novel frame‐shift mutation c.195_198del4 (p.Lys66Phefs*43) in AAGAB. Moreover, low‐dose etretinate was effective in improving the PPKP1 lesions in our patient. Our published work review identified only eight cases of PPKP1 with successful response to topical or systemic treatments. Notably, six of the cases were successfully treated with systemic retinoids. Thus, this study clearly provides further evidence that PPKP1 is caused by AAGAB mutations and that systemic retinoids are the most promising current treatment for PPKP1.     

Adapalene gel 0.1% vs ketoconazole cream 2% and their combination in treatment of pityriasis versicolor: A randomized clinical study

Pityriasis versicolor (PV) is a chronic superficial fungal infection. Management using azole drugs leads to drug resistance. The present study aimed to compare the clinical outcome of 0.1% adapalene gel vs 2% ketoconazole cream and their combination in PV. This randomized double‐blinded study was conducted on 90 PV patients divided into three equal groups. GI was treated with topical ketoconazole 2% cream twice daily and placebo, GII was treated with topical 0.1% adapalene gel twice daily and placebo and GIII was treated with topical combination of 0.1% adapalene gel (at night) and ketoconazole 2% cream (in the morning). All patients received medications for 4 weeks. Evaluation was done at 2 and 4 weeks and included clinical assessment, laboratory assessment, and patient satisfaction. We found that after 4 weeks of treatment, all groups showed significant improvement. There was better response in GIII in terms of lower rate of positive potassium hydroxide staining, higher rate of significantly improved cases and higher rate of well‐satisfied patients. However, the difference fell short of statistical significance. We concluded that a combination of adapalene gel and ketoconazole cream is very effective in treatment of PV with no or mild side effects.     

Study of the usefulness of moisturizers on adherence of acne patients treated with adapalene

The efficacy of adapalene for acne treatment has been established. However, because of local adverse reactions, a fair number of patients discontinue adapalene treatment before experiencing its effects. To examine the usefulness of moisturizers concomitant with adapalene on adherence to treatment and its therapeutic effects in patients, 100 patients with mild to severe acne vulgaris were randomly assigned to one of two groups: group A, in which patients received adapalene in combination with a moisturizer (heparinoid); or group B, in which treatment consisted of adapalene alone and was converted to combination therapy with a moisturizer if local adverse reactions occurred that made adherence to treatment difficult. After 4 weeks of treatment, we compared the proportion of patients who adhered to therapy until the end of week 4, the number of treatment dropouts, and changes in the number of inflammatory eruptions and comedones between the groups. All of the patients in group A and 70% in group B continued the initial therapy until the end of week 4. In group B, three patients withdrew their consent and one patient stopped attending follow‐up visits. The treatment period with the initial therapy was significantly elongated by the concomitant use of a moisturizer. No adverse effect of the use of a moisturizer was observed on the number of comedones and inflammatory eruptions. The concomitant use of a moisturizer with adapalene from the beginning of treatment did not affect its therapeutic effects and helped to improve adherence to treatment with adapalene.     

420nm强脉冲光联合阿达帕林凝胶治疗中度寻常痤疮的疗效观察

目的探讨中度寻常痤疮患者联合使用420nm强脉冲光以及阿达帕林凝胶进行治疗的临床疗效。方法挑选我院收治的中度寻常痤疮患者100例进行随机分组,一组为治疗组(50例),联合使用420nm强脉冲光以及阿达帕林凝胶进行治疗,另一组为对照组(50例),单纯使用阿达帕林凝胶进行治疗。结果治疗8周后,治疗组有效率(88%)比对照组(40%)高,治疗组Ⅱ级的有效率(92.59%)比对照组Ⅱ级(56%)高,治疗组Ⅲ级的有效率(82.61%)也比对照组Ⅲ级(24%)高;差异均明显,均具有统计学意义(均P <0.05)。结论中度寻常痤疮患者联合使用420nm强脉冲光以及阿达帕林凝胶进行治疗的临床疗效显著,安全性高。     

Clindamycin phosphate 1.2%/benzoyl peroxide 3% fixed‐dose combination gel versus topical combination therapy of adapalene 0.1% gel and clindamycin phosphate 1.2% gel in the treatment of acne vulgaris in Japanese patients: A multicenter,randomized, investigator‐blind,parallel‐group study

Adapalene 0.1% (ADA) with clindamycin phosphate 1.2% (CLNP; ADA + CLNP) and the fixed‐dose combination containing CLNP and benzoyl peroxide 3% (CLNP/BPO 3%) are strongly recommended for the early treatment of acne vulgaris in Japan. Here, we compare the early efficacy and safety of CLNP/BPO 3% with Japanese standard topical use of ADA + CLNP in the treatment of acne vulgaris. In this phase IV, multicenter study, 351 patients were randomized to receive CLNP/BPO 3% or ADA + CLNP for 12 weeks. The primary end‐point was percentage change from baseline in total lesion (TL) counts at week 2. Secondary end‐points included the percentage change from baseline in TL, inflammatory and non‐inflammatory lesion (IL and non‐IL) counts, Investigator's Static Global Assessment (ISGA), quality of life (QoL [Skindex‐16]) and patient preference. Local tolerability scores and adverse events were also recorded. CLNP/BPO 3% provided a significantly greater percentage reduction from baseline in TL compared with ADA + CLNP at week 2, and week 4. Compared with ADA + CLNP, CLNP/BPO 3% was superior at reducing IL (but not non‐IL) over weeks 2–12, was more effective at improving patient QoL and ISGA, and scored higher in patient‐preference assessments. Both treatments were well tolerated; adverse drug reactions occurred more frequently in patients receiving ADA + CLNP (37%) than in those receiving CLNP/BPO 3% (17%). In conclusion, CLNP/BPO 3% showed greater efficacy for the early treatment of acne vulgaris in Japan, with a more favorable safety profile compared with ADA + CLNP.     

Use of adapalene in alopecia areata: Efficacy and safety of mometasone furoate 0.1% cream versus combination of mometasone furoate 0.1% cream and adapalene 0.1% gel in alopecia areata

Alopecia areata (AA) is an autoimmune disease characterized by non‐cicatricial hair loss. No definitive therapy currently exists for AA. To compared the efficacy and safety of the mometasone furoate 0.1% cream alone with the mometasone furoate 0.1% cream plus adapalene 0.1% gel in treatment of AA. Twenty patients with AA and with mean age of 27.4 ± 9.2 years were enrolled. Patches with a diameter of < 5 cm were treated with mometasone furate 0.1% cream (M), and patches with a diameter of ≥5 cm were treated with mometasone furate 0.1% cream plus adapalene 0.1% gel (M + D) for a period of 12 weeks. Hair regrowth was evaluated using a Re‐growth score (RGS). Mean RGSs of M + D group were higher than M group for 4th week (2.60 vs. 1.45); 8th week (3.85 vs. 2.40) and 12th week (4.40 vs. 3.30). Mean percentages of hair re‐growth in M + D group were statistically higher than M group for 4th (50.2% vs. 23.5%), 8th (78.5% vs. 50.7%), and 12th week (90.5% vs. 71%). Study revealed the efficacy and safety of adapalene and mometasone furoate combination in AA. Adapalene can be used as a new therapeutic modality in AA.     

New photographic techniques for clinical evaluation of acne

Clinical evaluation of acne is usually based on direct visual assessment and ordinary flash photography, both of which are compromised by viewer subjectivity. It is difficult to accurately assess individual acne lesions and to observe early response to therapy. Standard flash photography has inherent limitations owing to the physics of light; it does not permit consistent visualization of subtle cutaneous characteristics like erythema or microcomedones, and it tends to blur distinctions between active inflammatory lesions and older hyperpigmented macules. Over the last decade there has been increasing interest in newer techniques aimed at increasing the accuracy and objectivity of acne evaluation. These include parallel‐polarized light photography, cross (or perpendicular)‐polarized light photography, videomicroscopy, and fluorescence photography. This article will review the advances of the past decade and summarize new techniques to evaluate acne lesions. Moreover, findings of a study that evaluated the course of individual acne lesions and the effects of adapalene gel 0.1% on inflammatory and non‐inflammatory acne lesions will be viewed. In this study, the use of parallel‐polarized and cross‐polarized photography, in combination with videomicroscopy and sebum production measurement, provided objective, detailed information on the evolution of different variable acne lesions and their response to adapalene gel 0.1%. Adapalene treatment produced rapid resolution of inflammatory and non‐inflammatory lesions, and inhibited formation of new lesions. Sebum secretion rates also declined during treatment. Use of the new assessment techniques proved to be a valuable, non‐invasive and reliable method of assessing acne vulgaris and its response to treatment.