2006年我院门诊第3季度皮肤病用药调查分析

目的:了解我院门诊皮肤病的常见病种及其用药情况。方法:运用医院药房计算机网络管理系统对部分皮肤病药物(口服抗组胺药、局部用药物)进行统计分析,抽取皮肤科处方对临床诊断及皮肤病用药进行分析。结果:处方平均金额74.46元,其中41.5%的处方金额在10元~50元之间,新型口服抗组胺药使用较多(销售金额占97.72%),局部用药物以品牌药居多且占据较大的金额比例(超过75%),近半数(48.8%)的患者因皮炎与湿疹及荨麻疹类皮肤病就诊。结论:我院门诊皮肤病用药基本合理。     

我院2015年皮肤科门诊用药分析

目的：了解我院皮肤科门诊用药的现状及发展趋势,为临床合理用药提供参考。方法采用回顾性调查的方法,对我院2015年皮肤科门诊处方中药品的使用数量、金额进行统计分析。结果我院门诊皮肤病用药以口服为主,占总销售金额的75.25％。皮肤科口服药中,复方甘草酸苷片的使用数量最多,匹多莫德分散片销售金额最高。皮肤科外用药中,医院制剂润肤乳膏的使用数量最多。结论我院皮肤科门诊用药基本合理。     

复旦大学附属儿科医院皮肤科门诊用药分析

皮肤病是常见病、多发病，会给患者造成机体不适和心理压力，而对其及时治疗则可明显改善患者的生活质量。目前，国内关于皮肤科用药情况的分析较少，且大多为成人患者的用药数据，至于儿童皮肤科用药分析的报道更少。本文统计复旦大学附属儿科医院2009年1-6月的皮肤科用药资料，探讨儿科医院皮肤科门诊用药规律，为临床合理用药提供依据。     

华山医院皮肤科门诊用药分析

皮肤病是一种威胁人体健康 ,并可直接影响人体美观的疾病 ,它常给病人造成生理上和心理上的压力。对皮肤病用药得当 ,治疗及时 ,能明显地改善病人的生活质量。皮肤科门诊是我院的特色门诊 ,每天前来就诊的病人在 15 0 0～ 2 5 0 0人之多。本文统计了皮肤科门诊半年来用药的资料 ,探讨我院皮肤科门诊用药规律 ,为临床合理用药提供参考。1　资料和方法从 2 0 0 2 - 0 3- 0 1～ 2 0 0 2 - 0 8- 31皮肤科门诊共配处方32 2 6 2 1张 ,总用药金额达 799.17万元 ,平均每天处方数1792张、用药金额 4 .4 4万余元 ,每张处方 2 4 .77元。本文以我院计算…     

2001-2003年皮肤病用药情况分析

目的 了解皮肤病治疗药物的使用现状和发展趋势,以引导临床合理用药和皮肤科国产新药的开发。方法 对本院 2001-2003全年用药品种、金额进行归类统计比较。结果与结论 皮质激素类药、抗变态反应药、抗微生物药仍是皮肤病的 主要用药。抗微生物药排序相对稳定。天然药种类偏少,有广阔的开发前景。     

某院2018～2020年皮肤科外用药使用分析

目的 了解皮肤科外用药的使用情况及用药趋势,为临床合理应用提供一定的参考。方法 选取2018～2020年皮肤科外用药的相关信息,统计其规格、单价、使用数量、销售金额、构成比、排序等数据。结果 三年间皮肤科外用药总增长率为147.16%,抗病毒用药、激素类用药和止痒类药物始终占据销售金额前三位,使用数量最为广泛的为丙酸氟替卡松乳膏、川百止痒洗剂、复方氟米松软膏、夫西地酸乳膏,销售金额排前三位的为盐酸氨酮戊酸外用散、川百止痒洗剂、丙酸氟替卡松乳膏。结论 皮肤科外用药的应用基本合理,临床使用时应根据皮肤病的病因、病理变化和临床特点,正确选择不同种类和剂型的外用药。     

2001-2003年皮肤病用药情况分析

目的了解皮肤病治疗药物的使用现状和发展趋势,以引导临床合理用药和皮肤科国产新药的开发.方法对本院2001-2003全年用药品种、金额进行归类统计比较.结果与结论皮质激素类药、抗变态反应药、抗微生物药仍是皮肤病的主要用药.抗微生物药排序相对稳定.天然药种类偏少,有广阔的开发前景.     

"中药"不亮"西药"亮--一季度皮肤科用药市场分析

告别严冬,迎来了春暖花开.季节温度的变化,使人们的皮肤又开始经历"考验".春季是皮肤病高发期,也是皮肤科用药的销售旺季.让我们看看2004年第一季度皮肤科用药的全国销售情况.     

2001—2003年皮肤病用药情况分析

目的 了解皮肤病治疗药物的使用现状和发展趋势，以引导临床合理用药和皮肤科国产新药的开发。方法 对本院2001-2003全年用药品种、金额进行归类统计比较。结果与结论 皮质激素类药、抗变态反应药、抗微生物药仍是皮肤病的主要用药。抗微生物药排序相对稳定。天然药种类偏少，有广阔的开发前景。     

某中心皮肤科外用制剂利用情况调查

摘 要 目的：了解皮肤科外用制剂的使用情况和剂型结构。方法：对该中心2010～2011年皮肤科外用制剂品种、数量和金额数据进行分析。结果：乳膏剂、贴剂、溶液剂3个剂型用量占皮肤科外用制剂总用量的91.32%,其用药金额占皮肤科外用制剂总用药金额的83.07%;用量排序前10位的品种用量占皮肤科外用制剂总用量的86.38%;用药金额排序前10位的品种用药金额占皮肤科外用制剂总用药金额的90.17%;皮肤科外用制剂以含激素类、激素+抗菌药、抗真菌类3类为主体,占皮肤科外用制剂总用量的86.47%。结论：该中心皮肤科外用制剂剂型多样,应用范围广,基本满足皮肤病患者的用药需求。     

Applications of tacrolimus for the treatment of skin disorders

During the last decades, systemic and topical glucocorticosteroids assumed a dominant role in immunosuppressive therapy in dermatology. However, their administration is limited because of numerous adverse effects. Consequently, there is a large need for alternative non-steroidal anti-inflammatory therapeutics with a superior risk/benefit ratio. In recent years, a new class of anti-inflammatories, the macrolide lactones, has attracted special interest.During the last decade, a member of this class, tacrolimus, proved to be a powerful suppressor of the immune system. Introduced into clinical practice to prevent allograft rejection, it is now routinely used in organ transplantation. Recently, several placebo-controlled multicenter studies showed the therapeutic efficiency of systemic and topical tacrolimus in common inflammatory skin diseases such as psoriasis and atopic eczema.Short-term tacrolimus ointment therapy disclosed significant efficacy vs. placebo and a safety profile with only few local side effects in patients with atopic eczema. Further clinical trials including greater extent of exposure (experienced by children), and comparison between tacrolimus ointment and glucocorticosteroids are being conducted and the results will show whether this drug opens a new era in the treatment of inflammatory skin disorders. The aim of this review is to summarize the current knowledge regarding the pharmacokinetic properties, adverse effects and therapeutic indications of tacrolimus in dermatology.     

烟酰胺在皮肤科的应用进展

烟酰胺是皮肤科的常用药,主要用作烟酰胺或烟酸缺乏引起的糙皮病等。近年来,一些试验研究及临床用药发现烟酰胺可用于更加广泛的适应证,例如系统用药治疗天疱疮,局部用于治疗痤疮,降低色素沉着以及调节皮肤光免疫反应等。本文综述了烟酰胺在皮肤科的应用新进展。     

A case of an adverse reaction to topical 5-fluorouracil in irradiated skin

A 73-year-old Caucasian male was treated in the dermatology clinic for squamous cell carcinoma (SCC) of the scalp by Mohs micrographic surgery. The patient subsequently received radiation therapy because of possible calvarium invasion. Approximately 2 years later, the patient developed Bowen's disease within the previously irradiated skin flap. The lesion was treated with topical 5-fluorouracil (5-FU) twice daily for 4 weeks, and subsequently developed a 2 x 2 cm full-thickness ulceration with exposed calvarium.     

Nano-lipoidal carriers of tretinoin with enhanced percutaneous absorption,photostability, biocompatibility and anti-psoriatic activity

Tretinoin (TRE) is a widely used retinoid for the topical treatment of acne, psoriasis, skin cancer and photoaging. Despite unmatchable efficacy, it is associated with several vexatious side effects like marked skin erythema, peeling and irritation, eventually leading to poor patient compliance. Its photo-instability and high lipophilicity also pose challenges in the development of a suitable topical product. The present study, therefore, aims to develop biocompatible lipid-based nanocarriers of TRE to improve its skin delivery, photostability, biocompatibility and pharmacodynamic efficacy. The TRE-loaded liposomes, ethosomes, solid lipid nanoparticles (SLNs) and nanostructured lipidic carriers (NLCs) were prepared and characterized for micromeritics, surface charge, percent drug efficiency and morphology. Bioadhesive hydrogels of the developed systems were also evaluated for rheological characterization, photostability, ex vivo skin permeation and retention employing porcine skin, and anti-psoriatic activity in mouse tail model. Nanoparticulate carriers (SLNs, NLCs) offered enhanced photostability, skin transport and anti-psoriatic activity vis-à-vis the vesicular carriers (liposomes, ethosomes) and the marketed product. However, all the developed nanocarriers were found to be more biocompatible and effective than the marketed product. These encouraging findings can guide in proper selection of topical carriers among diversity of such available carriers systems.     

盐酸奥洛他定在皮肤科的应用进展

盐酸奥洛他定是第二代新型组胺H1受体拮抗药。临床上用于过敏性鼻炎、慢性荨麻疹、特应性皮炎等的治疗。近年来研究发现,其对特应性皮炎中化学因子、斑秃中趋化因子、外用免疫抑制剂引起的皮肤刺激、少汗症等方面具有调节作用,这可能拓展其在皮肤科的相关临床应用研究。已有的临床研究数据进一步论证了奥洛他定临床应用的安全有效性。     

Liposomes in topical photodynamic therapy

INTRODUCTION: Topical photodynamic therapy (PDT) refers to topical application of a photosensitizer onto the site of skin disease which is followed by illumination and results in death of selected cells. The main problem in topical PDT is insufficient penetration of the photosensitizer into the skin, which limits its use to superficial skin lesions. In order to overcome this problem, recent studies tested liposomes as delivery systems for photosensitizers. AREAS COVERED: This paper reviews the use of different types of liposomes for encapsulating photosensitizers for topical PDT. Liposomes should enhance the photosensitizers' penetration into the skin, while decreasing its absorption into systemic circulation. Only few photosensitizers have currently been encapsulated in liposomes for topical PDT: 5-aminolevulinic acid (5-ALA), temoporfin (mTHPC) and methylene blue. EXPERT OPINION: Investigated liposomes enhanced the skin penetration of 5-ALA and mTHPC, reduced their systemic absorption and reduced their cytotoxicity compared with free drugs. Their high tissue penetration should enable the treatment of deep and hyperkeratotic skin lesions, which is the main goal of using liposomes. However, liposomes still do not attract enough attention as drug carriers in topical PDT. In vivo studies of their therapeutic effectiveness are needed in order to obtain enough evidence for their potential clinical use as carriers for photosensitizers in topical PDT.     

A needle-free approach for topical immunization: antigen delivery via vesicular carrier system(s)

Topical immunization (TI) is novel and needle free strategy involving vaccine delivery through topical application of antigen and adjuvant(s) directly or via a suitable carrier system on intact skin. Anatomy and physiology of skin attracts scientists in developing topical carrier system(s) for enhanced delivery of bioactive(s). Numerous techniques i.e. physical, chemical and vesicular carrier systems have been exploited for topical immunization. The present review discuss various vesicular systems i.e. liposomes, niosomes, transfersomes, vesosomes etc. for the efficient topical delivery of various immunogens along with comparative points of their merit(s) in TI. The mechanism of permeation of bioactive(s) through skin route via these carriers to the immune system for development of both cellular and humeral immunity has also been discussed. Moreover, the effect of composition and type of carrier system on type of immunity induced has also been focused to develop new effective carrier system(s) for topical immunization.     

Does lactobionic acid affect the colloidal structure and skin moisturizing potential of the alkyl polyglucoside-based emulsion systems?

Moisturizing creams are the most prescribed products in dermatology, essential in maintaining healthy skin as well as in the topical treatment of some diseases. The irritation potential of commonly used emulsifiers and moisturizing ingredients, but also their mutual interactions, could affect the functionality and safety of those dermopharmaceutics. The aim of this study was to promote moisturizing alkyl polyglucoside (APG)-based emulsion as vehicle for lactobionic acid (LA), advantageous representative of the alphahydroxyacids (AHAs)-multifunctional moisturizers, assessing the safety for use (in vitro acute skin irritation test using cytotoxicity assay compared with in vivo data obtained using skin bioengineering methods) and in vivo moisturizing capacity (bioengineering of the skin). In order to investigate possible interactions between APG mild natural emulsifier-based emulsion and LA, a deeper insight into the colloidal structure of the placebo and the emulsion with LA was given using polarization and transmission electron microscopy, rheology, thermal and texture analysis. This study showed that APG-based emulsions could be promoted as safe cosmetic/dermopharmaceutical vehicles and carriers for extremely acidic and hygroscopic AHA class of actives (specifically LA); prospective safety for human use of both APG and LA with the correlation between in vivo and in vitro findings was shown. However, it was revealed that LA strongly influenced the colloidal structure of the emulsion based on APGs and promoted the formation of lamellar structures which reflects onto the mode of water distribution within the cream. The advantageous skin hydrating potential of LA-containing emulsion vs. placebo was unlikely to be achieved, pointing that emulsions stabilized by lamellar liquid crystalline structures probably are not satisfying carriers for highly hygroscopic actives in order to reach the full moisturizing potential. Safe and effective use on dry skin is presumed.     

Functional characterisation of novel analgesic product based on self-regulating drug carriers

We compared a new formulation of ketoprofen (Diractin) based on ultradeformable vesicle (Transfersome) carriers with conventional topical gels with the drug (Gabrilen; Togal Mobil Gel; Fastum). Depending on water concentration, between a few percent and >95% of ketoprofen in Diractin is associated with the vesicles. The low free drug concentration on open skin (1-3%) minimises ketoprofen diffusion from Diractin through the organ, keeping effective permeability coefficient for the product (even after increase to approximately 3.5 x 10(-3) cm h(-1) at 24h) below that of conventional gels ( approximately 0.3-2.1 x 10(-1) cm h(-1)). The carrier's stress-responsiveness enables constriction crossing without vesicle breakdown. The carrier stiffening upon dilution, e.g. in tissues below the skin's diffusive barrier, helps avoiding the drug uptake in cutaneous blood capillaries. Diractin therefore can deposit ketoprofen in deep subcutaneous tissues, which the drug from conventional gels reaches mainly via systemic circulation. In vitro efficacy of daily drug delivery through skin is < or =1.6% for conventional topical NSAID gels and merely approximately 0.05% for Diractin. In contrast, in vivo ketoprofen transport by ultradeformable carriers through non-occluded skin into living pigs' subcutaneous muscles is 5-14x better than for conventional gels. Locally targeted drug transport by the self-regulating, ultradeformable vesicles is thus clearly non-diffusive and quite efficient.     

Liposomes in topical photodynamic therapy

Introduction: Topical photodynamic therapy (PDT) refers to topical application of a photosensitizer onto the site of skin disease which is followed by illumination and results in death of selected cells. The main problem in topical PDT is insufficient penetration of the photosensitizer into the skin, which limits its use to superficial skin lesions. In order to overcome this problem, recent studies tested liposomes as delivery systems for photosensitizers.

Areas covered: This paper reviews the use of different types of liposomes for encapsulating photosensitizers for topical PDT. Liposomes should enhance the photosensitizers' penetration into the skin, while decreasing its absorption into systemic circulation. Only few photosensitizers have currently been encapsulated in liposomes for topical PDT: 5-aminolevulinic acid (5-ALA), temoporfin (mTHPC) and methylene blue.

Expert opinion: Investigated liposomes enhanced the skin penetration of 5-ALA and mTHPC, reduced their systemic absorption and reduced their cytotoxicity compared with free drugs. Their high tissue penetration should enable the treatment of deep and hyperkeratotic skin lesions, which is the main goal of using liposomes. However, liposomes still do not attract enough attention as drug carriers in topical PDT. In vivo studies of their therapeutic effectiveness are needed in order to obtain enough evidence for their potential clinical use as carriers for photosensitizers in topical PDT.