Topical nadifloxacin 1% cream vs. topical erythromycin 4% gel in the treatment of mild to moderate acne

Topical antibiotics are the mainstay of therapy in mild to moderate inflammatory acne. Topical erythromycin is one of the most common prescribed topical antibiotics. Nadifloxacin, another topical antibiotic for acne, was recently introduced into the market in our country. In this study, we compared the efficacies and safety of topical nadifloxacin 1% cream and erythromycin 4% gel in acne. A total of 86 patients with mild to moderate facial acne were randomized into two treatment groups. The efficacies of the drugs were assessed by lesion counts. An acne severity index (ASI) was also calculated. In both groups, there was a significant reduction in lesion counts and ASI scores beginning from the first visit at week 4. This reduction continued throughout the 12-week study period. Both treatments were well tolerated. We conclude that when topically applied, both nadifloxacin 1% cream and erythromycin 4% gel are equally effective and safe treatments for mild to moderate facial acne.     

Clinical and histological evaluation of 1% nadifloxacin cream in the treatment of acne vulgaris in Korean patients

Objectives Nadifloxacin is a fluoroquinolone with broad‐spectrum antibacterial activity. Although it is used as an acne treatment in some European countries, it has not been used to treat Korean acne patients. We aimed to evaluate the clinical efficacy and safety of 1% nadifloxacin cream and the histological changes it incurs when used to treat mild to moderate facial acne in Korean patients. Methods An eight‐week, randomized, prospective, split‐face, double‐blind, vehicle‐controlled trial was performed. All participants were treated with 1% nadifloxacin cream on one‐half of the face and vehicle cream on the other, twice per day for eight weeks. Results At final visits, inflammatory acne lesions were reduced by 70% on nadifloxacin‐treated skin and increased by 13.5% on vehicle‐treated skin; non‐inflammatory acne lesions showed reductions of 48.1 and 10.1%, respectively. A significant difference was observed between the two treatments at four weeks. Histopathological examinations of the acne lesions showed decreased inflammation and interleukin‐8 expression but no change in transforming growth factor‐β expression in nadifloxacin‐treated skin compared with vehicle‐treated skin after eight weeks of treatment. Conclusions Nadifloxacin 1% cream is an effective, safe, and well‐tolerated topical treatment for Korean patients with mild to moderate acne vulgaris. Histopathological changes after nadifloxacin treatment were well correlated with clinical outcomes. Therefore, nadifloxacin can be used as an effective and safe treatment option in the management of mild to moderate acne in Asian subjects.     

光子治疗寻常性痤疮45例疗效观察

目的观察Clear TouchTM丝柔光子痤疮治疗仪治疗寻常性痤疮的疗效。方法将90例寻常性痤疮患者随机分为两组,每组45例,治疗组采用Clear TouchTM丝柔光子痤疮治疗仪治疗,3次/周,对照组予以0.025%维A酸乳膏局部外涂,2次/d,疗程均为2周。结果治疗组有效率为73.33%,对照组为53.33%,两组有效率比较差异有显著性(P(0.01)。结论Clear TouchTM丝柔痤疮光子治疗仪治疗痤疮疗效显著、方便快捷,副反应小,是一种较为理想的治疗方法。     

夫西地酸乳膏联合阿达帕林凝胶治疗寻常痤疮的临床观察

目的评价2%夫西地酸软膏联合0.1%阿达帕林凝胶治疗轻、中度寻常痤疮的临床疗效及安全性。方法寻常痤疮246例,随机分为3组,治疗组98例,采用2%夫西地酸软膏联合0.1%阿达帕林凝胶治疗;对照A组81例,采用1%克林霉素磷酸酯凝胶联合0.1%阿达帕林治疗;对照B组67例,单独使用0.1%阿达帕林凝胶治疗。均连用8周,分别在治疗后第2,4,8周末观察疗效并评价安全性。结果在治疗后第8周,治疗组有效率93.88%,与对照A组(81.48%)相比差异有统计学意义(P=0.010);治疗组Ⅲ级痤疮的有效率93.02%,与对照A组(69.70%)相比差异有统计学意义(P=0.007);疗程结束后,治疗组复发5例,复发率5.10%,远低于2个对照组。单独外用阿达帕林疗效均欠佳,且复发率较高。在治疗过程中,3组均未见明显不良反应。结论 2%夫西地酸软膏联合0.1%阿达帕林凝胶治疗轻、中度寻常痤疮具有疗效较好、复发率低、不良反应少等优点,是较理想的治疗方案。     

0.1%他扎罗汀乳膏短时接触治疗寻常痤疮的疗效观察

［目的］对比观察及评价0.1%他扎罗汀乳膏短时接触治疗与常规每日一次治疗轻中度寻常型痤疮的疗效和安全性。［方法］采用前瞻性开放性对照观察,选用重庆华邦公司0.1%他扎罗汀乳膏局部外用面部轻中度痤疮,短时接触疗法为每晚1次,5分钟后洗去,常规疗法为每晚1次过夜,疗程均为8周,于第1、2、4、8周进行复诊随访。短时接触治疗组为52例,常规治疗组为49例。［结果］第8周时0.1%他扎罗汀短时接触治疗组有效率为69.1%,常规治疗组有效率为75.1%,X2=6.501,P=0.09＞0.05,两组疗效之间无显著统计学差异。不良反应发生率短时接触治疗组为21.2%,常规治疗组为44.9%,X2=8.538,P=0.036＜0.05,两组不良反应发生率有显著统计学差异,短时接触治疗组明显低于常规治疗组。［结论］他扎罗汀短时接触治疗寻常型痤疮安全、有效,值得临床推广应用。     

维胺酯胶囊和全反式维A酸霜治疗寻常痤疮临床疗效观察

目的:观察维胺酯胶囊和全反式维A酸霜(商品名:迪维霜)治疗寻常痤疮的疗效。方法:将寻常痤疮患者随机分成3组,A组口服维胺酯胶囊,外用0.025%迪维霜;B组外用0.025%迪维霜;C组口服多西环素(商品名:强力霉素),外用硫磺炉甘石洗剂。均各治疗6周。结果:A组对丘疹和脂溢的疗效优于B组和C组(P<0.05),对粉刺的疗效优于C组(P<0.001),对脓疱的疗效优于B组(P<0.05),对结节囊肿的疗效3组差异无显著性;综合疗效A组优于B组和C组(P<0.05);A组中中度痤疮患者的效果优于B组和C组(P<0.05),但对轻度痤疮3组差异无显著性。结论:口服维胺酯胶囊联合外用迪维霜治疗轻、中度痤疮疗效较好。     

Topical methyl aminolaevulinate photodynamic therapy for treatment of facial acne vulgaris: results of a randomized, controlled study

BACKGROUND: There is a need for alternative treatments for moderate to severe acne vulgaris. Preliminary experience suggests that topical methyl aminolaevulinate photodynamic therapy (MAL-PDT) may have potential. OBJECTIVES: To investigate the efficacy and tolerability of MAL-PDT for treatment of moderate inflammatory facial acne. PATIENTS/METHODS: Thirty patients aged 15-28 years with moderate to severe acne were included in a blinded, prospective, randomized, placebo-controlled multicentre study. Each side of each patient's face was randomly assigned to treatment with MAL (160 mg g1) or placebo cream, applied for 3 h prior to illumination. A second treatment was given 2 weeks later. On each occasion, patients assessed the intensity of pain using a 10-cm visual analogue scale. Inflammatory and noninflammatory acne lesions were counted at baseline and 4 and 10 weeks after the last PDT treatment. The investigator assessed the global severity of acne at baseline (seven patients had severe acne on at least one side of the face) and each study visit using a six-point rating scale. Data were analysed on an intention-to-treat basis, including all 30 patients. RESULTS: There was a statistically significant greater reduction in the total inflammatory lesion count with MAL-PDT compared with placebo PDT at week 12; median reduction 54% [95% confidence interval (CI) 35-64%] vs. 20% (95% CI 8-50%), P = 0.0006. MAL-PDT was associated with more pain than placebo PDT, although intensity varied across centres and was reduced with repeated treatment. Local adverse events were consistent with this treatment modality. CONCLUSIONS: MAL-PDT is effective in the treatment of moderate to severe inflammatory facial acne. Further studies are warranted to optimize this promising procedure.     

Treatment of melasma (chloasma) by local application of a steroid cream.

15 patients with melasma were treated with betamethasone 17-valerate in a cream base containing DMSO. One patient with secondary pigmentation was also entered in the trial. In nine patients results were favourable and in three results were moderate. This effect could be ascribed to the steroid.     

Combined 0.1% retinaldehyde/ 6% glycolic acid cream in prophylaxis and treatment of acne scarring

BACKGROUND: Acne often results in permanent, badly tolerated, difficult to treat scars. OBJECTIVE: To evaluate the efficacy and safety of a 0.1% retinaldehyde/6% glycolic acid (RALGA) cream at preventing and treating acne scarring in patients previously treated for moderate acne. METHODS: A double-blind vehicle-controlled study was conducted in 145 patients randomized to apply RALGAor vehicle cream every evening for 3 months. Global scarring score and patient's assessment of global efficacy, then residual acne lesions, quality of life and tolerance were evaluated at inclusion and each month until study completion. RESULTS: Global scarring score, number of inflammatory lesions and comedones significantly improved in each group from day 28 (p<0.0001). Number of inflammatory lesions were significantly decreased only in the RALGA group. RALGA cream was more efficient than vehicle on scarring after 3 months in compliant patients (p=0.007) due to erythema and hyperpigmentation improvement. CONCLUSION: RALGA cream is efficient at preventing and treating acne scarring in patients with moderate acne.     

夫西地酸乳膏联合多磺酸黏多糖乳膏治疗寻常痤疮疗效观察

目的观察夫西地酸乳膏联合多磺酸黏多糖乳膏治疗轻中度寻常痤疮的临床疗效及不良反应。方法采用随机方法将123例轻中度寻常痤疮患者分为2组,试验组联合应用夫西地酸乳膏和多磺酸黏多糖乳膏,对照组用阿达帕林凝胶,疗程6周,观察2组患者的治疗结果和不良反应。结果试验组有效率85.91%,对照组有效率71.15%,试验组有效率高于对照组,差异有统计学意义(P0.05),2组均未见明显不良反应发生。结论夫西地酸乳膏联合多磺酸黏多糖乳膏治疗寻常痤疮临床疗效确切,安全性高。     

The treatment of acne fulminans: a review of 25 cases

The treatment of acne fulminans has been difficult. It is difficult to perform a controlled treatment trial due to the rarity of the complication. However, it is possible to compare four different therapeutic regimens which have evolved with time in the management of 25 patients over a period of 25 years. Oral antibiotics produced a slow response in the resolution of acne and systemic symptoms. The addition of a systemic steroid produced a quick resolution of systemic features, but the time until resolution of the acne was longer than when it was used in combination with oral isotretinoin. The protocols which used a combination of prednisolone and isotretinoin led to faster control of systemic features as well as clearance of acne when compared with other protocols. This was particularly so if the oral steroid was used sooner rather than later. We conclude that the preferred treatment of acne fulminans is oral prednisolone 0.5-1 mg/kg daily for 4-6 weeks (thereafter slowly reduced to zero) with oral isotretinoin being added to the regimen at the fourth week, initially at 0.5 mg/kg daily and gradually increased to achieve complete clearance.     

Efficacy of combined topical treatment of acne vulgaris with adapalene and nadifloxacin: a randomized study

Topical retinoid and antibiotic combination therapy is an integral part of acne treatment and is considered the appropriate first-line therapy according to the Japanese guideline for moderate and severe acne. In this combination, clindamycin or doxycycline are mostly used as antibiotics, but there have been no reports on the effectiveness of nadifloxacin, a widely used antibiotic in Japan and European countries for acne, in combination with topical retinoid. To confirm the efficacy and safety of adapalene gel and nadifloxacin cream in the treatment of Japanese patients with acne vulgaris, a total of 50 patients were randomized to the two groups, the combination therapy and the adapalene monotherapy, and each therapy was tested for 8 weeks. The percentage reduction in the number of inflammatory acne lesions was evaluated and the safety was monitored through adverse events. The combination of adapalene gel and nadifloxacin cream produced a significantly higher reduction in the inflammatory lesions at 2 weeks (P = 0.047) and at 8 weeks (P = 0.011) after the starting than did adapalene gel monotherapy. The combination did not elevate the side effects of erythema and scale scores, but rather significantly depressed erythema at 1 week. This study showed the efficacy and safety of the combination therapy of nadifloxacin cream with adapalene gel for the inflammatory acne.     

异维A酸红霉素凝胶治疗寻常痤疮的多中心随机对照临床研究

目的 比较异维A酸红霉素凝胶与阿达帕林凝胶治疗轻中度寻常痤疮的疗效和安全性。方法 多中心、开放、随机、平行对照研究。按照中国痤疮治疗指南痤疮严重程度标准入选轻、中度（Ⅰ ~ Ⅲ级）寻常痤疮患者192例,纳入疗效分析169例,安全性分析190例。试验组86例,外用异维A酸红霉素凝胶;对照组83例,外用阿达帕林凝胶,均为每晚1次,共用药6周。在基线、治疗2、4和6周时分别记录患者白头粉刺、黑头粉刺、炎性丘疹、脓疱数,评价各时间点患者痤疮严重程度,同时记录皮肤局部耐受性以及其他不良反应。结果 随着治疗时间延长,两组的有效率逐渐提高,总体病情严重程度改善。在治疗6周时,试验组总有效率为51.16%,对照组为40.96%,两组差异无统计学意义（P > 0.05）;但在治疗4周及6周时,试验组患者脓疱及炎性皮损的疗效优于对照组（P < 0.05）,同时试验组痤疮分级较对照组低（P < 0.01）。两组不良反应类似,均表现为局部刺激,可耐受。结论 异维A酸红霉素凝胶治疗轻、中度寻常痤疮总有效率与阿达帕林凝胶类似,对于炎性损害疗效优于阿达帕林凝胶,并且对患者总体严重程度降低更快。     

Comparison of mometasone furoate 0.1% cream and hydrocortisone 1.0% cream in the treatment of childhood atopic dermatitis

We conducted a 6-week randomized, blinded study that compared mometasone furoate 0.1% cream, applied once daily, and hydrocortisone 1.0% cream, applied twice daily, in 48 children with moderate to severe atopic dermatitis. Mometasone furoate, a moderate-potency steroid, produced significantly greater improvement than the low-potency hydrocortisone used twice daily. The difference in therapeutic response was particularly evident in patients with involvement of more than 25% of their body surface area. Morning plasma cortisol levels were assayed before treatment, after 1 week of therapy, and at the end of the clinical trial. Plasma cortisol levels were transiently suppressed in one child who was treated with hydrocortisone and in none of the children treated with mometasone.     

三子祛痘营养霜治疗寻常痤疮的临床疗效观察

目的探讨三子祛痘营养霜治疗寻常痤疮的临床疗效和安全性。方法将101例寻常痤疮患者随机分为两组,治疗组采用三子祛痘营养霜,对照组采用玫芦消痤膏,每晚1次,疗程4周,分别于用药开始后2,4,8周复诊,观察疗效。结果治疗组于用药开始后2,4,8周的有效率分别为3.85%,21.15%和69.23%;对照组分别为8.16%,34.69%和65.31%,两组有效率比较差异无统计学意义(P>0.05)。结论三子祛痘营养霜治疗寻常痤疮疗效显著,毒副作用小,是一种较为理想的蒙药药妆品。     

An extension of a multicenter,randomized, split‐face clinical trial evaluating the efficacy and safety of chromophore gel‐assisted blue light phototherapy for the treatment of acne

A variety of laser/light‐based devices have been reported to be effective for the treatment of acne, yet no long‐term data on efficacy and safety have been published. A first 12‐week clinical trial (“Main trial”) recently demonstrated that the KLOX BioPhotonic System, an LED blue light device using photo‐converter chromophores, can significantly improve moderate and severe facial acne vulgaris with an excellent safety profile. This Extension trial followed the Main trial, using the same BioPhotonic System, with the same dose and instructions for use, on patients having already completed treatment in the Main trial. Main objectives of this open‐label long‐term extension 12‐week study were to evaluate the efficacy of the KLOX BioPhotonic System on the untreated hemiface during the Main trial, as well as the duration of response on the hemiface treated during the first 12‐week Main trial. Despite their young age (mean age: 21.6 years) and their 12‐week participation in the Main trial, 49 (54.4%) of the total number of patients who participated in the Main trial enrolled in this additional 12‐week Extension trial. Baseline grading of acne was performed with the Investigator's Global Assessment (IGA) scale. For each patient, the hemiface randomly selected as a control during the Main trial received 6 weeks of treatment (twice weekly) and was then followed up for an additional 6 weeks. The first hemiface treated in the Main trial was consequently observed throughout the Extension trial, allowing for a further 12‐week assessment of outcomes (total 24 weeks). In light of an additional 12 weeks of treatment on the contralateral face, the patient compliance rate was excellent, with 91.9% of the total number of patients receiving at least 80% of the treatments. Patients with a baseline IGA grade of 2 (mild) on the treated hemiface demonstrated a success rate of 58.3 and 66.7% at weeks 6 and 12, respectively. At these same time points, subjects with a baseline IGA grade of 3 (moderate) demonstrated a success rate of 81.8 and 90.0%. Patients with a baseline IGA grade of 4 (severe) demonstrated a success rate of 100% at both week 6 and week 12. When evaluating the originally treated hemifaces from the Main trial, the rate of return to baseline at 24 weeks was calculated to be 15.5%. This latter outcome confirmed the long duration of effect following treatment. The patient safety profile was also excellent, with very few related adverse events. The BioPhotonic System, which is comprised of LED blue light phototherapy and photo‐converter chromophores, provides long‐term efficacy and safety in the treatment of acne vulgaris, with a rate of compliance above what is generally observed in a young population of patients suffering from acne vulgaris, especially in light of sequential enrollment in a study treating one hemiface.     

5-氨基酮戊酸光动力疗法治疗痤疮

目的 探索5-氨基酮戊酸光动力疗法（ALA-PDT）治疗中、重度痤疮的安全性及有效性。方法 将70例中、重度痤疮患者随机分为两组。治疗组35例,给予ALA-PDT治疗,每2周治疗1次,共治疗1 ~ 3次;对照组35例,口服异维A酸胶囊治疗,共服用6周。在治疗第2、4、6周对两组患者进行疗效判断和比较。结果 35例接受ALA-PDT治疗的患者经过1 ~ 3次治疗后（第2、4、6周）,总有效率达97.1%;对照组于6周时总有效率为80.0%,治疗组疗效明显优于对照组（P < 0.05）。另外,ALA-PDT组复发程度明显轻于对照组,且病情控制时间明显延长。ALA-PDT组有个别患者局部出现暂时性色素沉着,但无瘢痕发生。结论 ALA-PDT是一种简单、高效、不良反应轻微的治疗中、重度痤疮的新疗法。     

Efficacy of pimecrolimus 1% cream in the long term management of atopic hand dermatitis. A double-blind RCT

Background: Efficacy and steroid sparing effects of pimecrolimus 1 % cream in atopic dermatitis have been shown recently, but there is no data on efficacy in long term management of atopic hand dermatitis. This study aims to investigate the efficacy of pimecrolimus 1 % cream as maintenance therapy in patients suffering from atopic hand dermatitis. Patients and Methods: A double‐blind vehicle controlled study in 40 adult patients with atopic hand dermatitis (IGA < 3) comparing the efficacy of twice daily application of pimecrolimus 1 % cream given as maintenance treatment versus vehicle over a 8 week period after clinical response (IGA < 2) to a 1–3 week pre‐treatment with mometasone fuorate 0.1 % was performed. Primary endpoint was the time to relapse (IGA > 3). Results: Thirty‐six out of 40 patients were randomised to receive either pimecrolimus 1 % (P) or vehicle cream (V). The number of patients with stable remission in patients randomised to pimecrolimus (53.8 %) and vehicle (43.8 %) did not achieve statistical significance between the groups (p = 0.41). Subgroup analysis of patients with initially moderate dermatitis (IGA = 3, n = 20) showed a trend towards a better outcome for the pimecrolimus group (stable remission P = 81.8 % versus V = 55.6 %) (p = 0.244). Conclusions: Pimecrolimus 1 % cream twice daily was not superior to vehicle in the sequential maintenance therapy of atopic hand dermatitis, but efficacy in moderate forms should be investigated in further studies.     

1450nm激光联合外用药物治疗中度寻常性痤疮疗效观察

目的:评价1450nm激光联合外用药物治疗中度寻常性痤疮的疗效和安全性。方法:采用随机对照的临床试验。A组采用1450nm激光治疗,同时外用1%克林霉素磷酸酯溶液剂和0.025%维A酸乳膏治疗,B组口服维胺酯联合外用药物治疗同A组,C组单纯使用外用药物治疗。治疗2、4和6周末观察疗效及不良反应。结果:A组疗效与B组疗效无显著差异,A、B组与C组疗效均有显著差异。结论:1450nm激光联合外用药治疗中度寻常性痤疮疗效较好,与口服维胺酯联合外用药治疗疗效相当,且无明显不良反应。     

枇杷清肺饮(变化)对寻常痤疮复发的治疗和预防

目的评价枇杷清肺饮(变化)治疗和/或预防寻常痤疮复发的作用。方法共入选74例患者,采用随机分组的方法,先分层,然后随机分为两组。试验组39例,采用枇杷清肺饮(变化)中药汤剂内服治疗;对照组35例,采用0.1%维A酸乳膏和/(或)1%克林霉素凝胶治疗,均观察8周。结果70例患者按要求完成试验,其中试验组36例,对照组34例。总皮损计数经4周和8周治疗后,两组皮损变化差异有显著性意义(P<0.05),试验组有效率为84.62%,复发2例,复发率为5.13%;对照组有效率为62.86%,复发7例,复发率为20.00%,两组有效率和复发率差异有显著性意义(P均<0.05)。结论枇杷清肺饮(变化)对寻常痤疮复发的治疗和预防有效。