0.05%地奈德乳膏联合0.025%维A酸乳膏治疗手部慢性湿疹疗效观察

目的观察0.05%地奈德乳膏联合0.025%维A酸乳膏治疗手部慢性湿疹的临床疗效和安全性。方法将124例患者分为治疗组和对照组,治疗组予0.05%地奈德乳膏联合0.025%维A酸乳膏外用;对照组予丁酸氢化可的松联合0.025%维A酸乳膏外用,均连续治疗2周。结果疗程结束后2周时两组的治疗指数显著下降,治疗组的治愈率67.19%,有效率90.63%,对照组分别为48.33%和71.67%,两组患者有效率差异有统计学意义(P<0.01),且均未见严重不良反应。结论 0.05%地奈德乳膏联合0.025%维A酸乳膏治疗手部慢性湿疹的临床治愈率高,不良反应发生率低,是一种安全有效的治疗方法。     

0.05%地奈德乳膏治疗三种常见皮肤病的疗效观察

目的评价0.05%地奈德乳膏治疗特应性皮炎、脂溢性皮炎及寻常性银屑病的临床疗效及安全性。方法采用开放式研究。分别应用0.05%地奈德、1%丁酸氢化可的松及0.1%糠酸莫米松乳膏治疗特应性皮炎、脂溢性皮炎及寻常性银屑病。对患者治疗前后红斑、糜烂、浸润、丘疹、渗出/结痂、瘙痒及皮损面积的总积分进行评价。结果治疗2周后,地奈德组的临床疗效明显优于丁酸氢化可的松组,差异有显著性(P<0.05),两组均未见明显不良反应;地奈德组的疗效与糠酸莫米松组相当(P>0.05),但后者有1例出现瘙痒,1例出现红斑加重。结论应用0.05%地奈德乳膏治疗特应性皮炎、脂溢性皮炎及寻常性银屑病疗效可靠,临床使用安全。     

卤米松乳膏联合维A酸乳膏治疗掌跖脓疱病疗效观察

目的观察卤米松乳膏联合维A酸乳膏治疗掌跖脓疱病的疗效及安全性。方法采用随机对照法将45例患者分为两组,治疗组23例,外用卤米松乳膏2次/d,同时每晚外用0.1%维A酸乳膏1次;对照组22例,仅外用卤米松乳膏,用法同治疗组,疗程均为8周,治疗结束后判定疗效。结果治疗组治疗2周、4周和8周时的有效率分别为17.39%,60.87%和82.61%,优于对照组的9.09%,27.27%和54.54%。两组患者治疗4周和8周时的有效率差异有统计学意义(P均<0.05)。且两组均未见严重不良反应。结论外用卤米松乳膏联合维A酸乳膏治疗掌跖脓疱病疗效好,安全性高。     

2%夫西地酸乳膏多中心治疗细菌性皮肤病的疗效和安全性观察

目的评价2%夫西地酸乳膏治疗细菌性皮肤病的临床疗效与安全性。方法多中心、开放性试验;外用2%夫西地酸乳膏,2次/d,疗程为7天。结果共有73例细菌性皮肤病纳入研究,其中41例(56.16%)痊愈,29例(39.73%)显效,3例(4.11%)好转,无效0例;有效率为95.89%;治疗结束时未见不良反应。结论2%夫西地酸乳膏外用治疗细菌性皮肤病时,具有良好的临床疗效和安全性。     

0.05%地奈德软膏联合8-甲氧补骨脂素治疗面部白癜风疗效观察

目的：评价0.05%地奈德软膏联合8-MOP（8-甲氧补骨脂素）治疗颜面部白癜风的临床疗效及安全性。方法：60例颜面部的白癜风患者分3组,第一组患者（18例）单用8-MOP,第二组（19例）单用0.05%地奈德软膏,第三组患者（即联合用药组,23例）采用8-MOP和0.05%地奈德软膏联合治疗,治疗后12周评价疗效。结果：3组有效率分别为53.84%,57.89%和73.91%,实验组的临床疗效明显优于两对照组,差异有统计学意义（P均〈0.05）。3组不良反应发生率分别为50.00%,21.05%和4.34%,其中实验组与两对照组相比,不良反应发生率明显减少。结论：0.05%地奈德软膏联合8-MOP治疗颜面部白癜风疗效好,不良反应发生率低。     

Treatment of Anogenital Warts in Children with Topical 0.05% Podofilox Gel and 5% Imiquimod Cream

A retrospective analysis of 25 infants and young children with anogenital warts was performed by chart review and telephone interview. Fifteen of 17 patients treated with podofilox 0.5% gel and 6 of 8 patients treated with imiquimod 5% cream improved or cleared with therapy. Only one patient stopped treatment because of irritation. Our experience suggests that these agents can be used safely and effectively in young children. Controlled prospective studies should be undertaken to further evaluate the use of podofilox and imiquimod in the treatment of symptomatic anogenital warts in children.     

Topical Retinoids: Therapeutic Mechanisms in the Treatment of Photodamaged Skin

Retinoids are a group of substances comprising vitamin A and its natural and synthetic derivatives. Retinoids were first used in dermatology in 1943 by Straumfjord for acne vulgaris. Since that time, retinoids have been utilized in the management and treatment of various skin conditions, including photoaging. Photodamage of the skin occurs as a consequence of cumulative exposure to solar ultraviolet radiation (UVR) and is characterized by deep wrinkles, easy bruising, inelasticity, mottled pigmentation, roughness, and telangiectasias. The mechanism of UVR-induced photodamage is multifactorial. Retinoids have demonstrated efficacy in the treatment of photoaged skin. Indeed, understanding the pathophysiology of photoaging and the molecular mechanism of retinoids can not only provide insight into the effects retinoids can exert in treating photoaging but also provide the rationale for their use in the treatment of other dermatologic diseases.     

Safety, Efficacy, and Dosage of 1% Pimecrolimus Cream for the Treatment of Atopic Dermatitis in Daily Practice

Introduction: Although several controlled clinical trials have demonstrated the efficacy and good tolerability of 1% pimecrolimus cream for the treatment of atopic dermatitis, the results of these trials may not apply to real-life usage. The objective of this study was to evaluate the safety and efficacy of a pimecrolimus-based regimen in daily practice. Methods: This was a 6-month, open-label, multicenter study in 947 patients aged ≥3 months with atopic dermatitis of all severities. The investigators incorporated 1% pimecrolimus cream into patients’ standard treatment protocols on the basis of their clinical diagnosis. Use of topical corticosteroids was allowed at the discretion of the physician. Safety and tolerability were evaluated by monitoring adverse events. Efficacy was evaluated by recording changes in the Investigators’ Global Assessment scores and pruritus scores at each visit. Results: No clinically unexpected adverse events were reported. The discontinuation rate for adverse events was 2.3%. The disease improvement rate was 53.7% at week 1 and 66.9% at week 24. The pimecrolimus-based regimen was particularly effective for the treatment of lesions involving the face (improvement rate: 61.9% at week 1 and 76.7% at week 24). The greatest therapeutic response was experienced by pediatric patients with mild or moderate disease. Nonetheless, 64% and 65% of infants and children, respectively, with severe/very severe facial disease at baseline were clear/almost clear of signs of atopic dermatitis on their face at week 24. In patients aged <18 years, most of the improvement occurred within the first week of treatment, while in adults a progressive improvement was observed over the entire study period. Worsening of disease by the end of the study occurred in 9.5% of patients and was most frequent in adults (12.6%). The discontinuation rate for unsatisfactory therapeutic effect was 4.8%. The mean number of treatment days was 135.6 (SD 53.2). The mean drug consumption (non-US centers only) was 4.2g per treatment day. Drug consumption decreased over time as disease improved. In total, 47% of patients who completed the study never used topical corticosteroids over 6 months. Conclusion: In daily practice, incorporation of 1% pimecrolimus cream into patients’ standard treatment regimen is well tolerated and improves atopic dermatitis in approximately two-thirds of patients. Disease improvement is particularly evident on the face. The greatest therapeutic response is experienced by pediatric patients with mild or moderate disease. In these patients, most of the improvement is observed within 1 week from the start of treatment.     

外用0.5% MITF-siRNA霜治疗黄褐斑临床疗效及安全性观察

目的观察MITF-siRNA霜外用治疗黄褐斑的临床疗效及安全性。方法经临床诊断为黄褐斑的33例患者给予外用MITF-siRNA霜治疗,2次/d,并用MicroskinⅡ多功能偏振光皮肤镜图像分析系统对治疗前后黄褐斑皮损进行客观测量,通过测量L×,A×,B×值并计算ITAo值以评价局部外用siRNA霜的治疗效果。结果经MITF-siRNA霜外用治疗12周后,有效率90.3%,治疗前后ITAo值显著改善(P0.01)。观察过程中仅有1例局部出现红斑,停用至红斑消退后,继续外用siRNA霜后达到显效。结论局部外用MITF-siRNA霜可以显著淡化色斑,疗效确切且安全性好。     

The Efficacy and Safety of 4-n-butylresorcinol 0.1% Cream for the Treatment of Melasma: A Randomized Controlled Split-face Trial

Background

Melasma is a common acquired symmetrical hypermelanosis that occurs on sun-exposed areas, and it is frequently observed among women. Various treatment modalities have been tried, but none are completely satisfactory. 4-n-butylresorcinol, which is a resorcinol derivative that has an inhibitory effect on both tyrosinase and tyrosinase-related protein-1, was introduced in 1995 and it has received increasing attention as a new hypopigmenting agent. However, the hypopigmenting effect of 4-n-butylresorcinol in human subjects has only been shown in a few studies.

Objective

The aim of this study was to investigate the hypopigmenting efficacy and safety of 4-n-butylresorcinol 0.1% cream for the treatment of melasma.

Methods

Twenty patients with melasma were enrolled to this randomized, double-blind, vehicle-controlled, split-face comparative study. The patients were instructed to apply 4-n-butylresorcinol 0.1% cream or vehicle to each side of the face twice daily for 8 weeks. Mexameter measurements were performed along with photography at baseline, 4 weeks and 8 weeks. Adverse events were observed and recorded throughout the study.

Results

All the patients completed the study. Mexameter measurements demonstrated that the melanin index of the treated side showed a significant decrease when compared with that of the vehicle-treated side after 4 weeks (p=0.006) and after 8 weeks (p<0.0005). All the adverse reactions were mild and transient.

Conclusion

4-n-butylresorcinol 0.1% cream showed rapid efficacy and it was well tolerated when used for the treatment of melasma.     

0.05%地奈德乳剂治疗内源性湿疹的临床研究

目的　评价 0 .0 5 %地奈德乳剂治疗内源性湿疹包括特应性皮炎 3周的疗效和安全性。方法　入组包括特应性皮炎在内的内源性湿疹 84例 ,采用随机、双盲、基质对照、平行组对比研究 ,受试者外涂药物于受累区域 ,2次 /d ,连续治疗 3周。结果　试验组靶皮损总积分 (TSS)由治疗前 8.3 1± 1.85降至 1.19± 1.69,TSS改善 84.99% ;对照组TSS由 8.43± 1.67降至 3 .10± 2 .2 4,TSS改善 63 .5 4%。试验组与对照组靶皮损各项观察指标均得到改善 ,但试验组的改善优于对照组。总体改善评价试验组总有效率为 80 .95 % ,对照组为 5 2 .3 8% ,两组比较差异有显著性 (P <0 .0 5 )。　结论　 0 .0 5 %地奈德乳剂治疗内源性湿疹的临床治愈率、总体疗效优于基质 ,且不良反应发生率低 ,是一种安全有效的外用皮质类固醇激素。     

5%过氧苯甲酰凝胶联合0.025%维A酸乳膏治疗寻常痤疮疗效观察

目的观察5%过氧苯甲酰凝胶和0.025%维A酸乳膏联合治疗寻常痤疮的疗效。方法治疗组34例,5%过氧苯甲酰凝胶和0.025%维A酸乳膏联合治疗,对照组33例,0.025%维A酸乳膏治疗,共8周。疗程结束观察疗效。结果治疗组有效率91.18%,对照组为66.67%,两组差异有显著性(P<0.05)。结论5%过氧苯甲酰凝胶和0.025%维A酸乳膏联合治疗痤疮的疗效满意。     

Efficacy and Safety of Terbinafine Hydrochloride 1% Cream vs. Sertaconazole Nitrate 2% Cream in Tinea Corporis and Tinea Cruris: A Comparative Therapeutic Trial

Context:

To the best of our knowledge, till date no study comparing the efficacy and safety of terbinafine hydrochloride 1% cream and sertaconazole nitrate 2% cream has been done in localized tinea corporis and tinea cruris.

Aims:

This clinical trial was carried out to study and compare the efficacy of topical terbinafine hydrochloride 1% cream and sertaconazole nitrate 2% cream in localized tinea corporis and tinea cruris and to know the adverse effects of these antifungal creams.

Settings and Design:

In this prospective, single blind, randomized control trial with two arms, patient were randomized into two groups Group A (treatment with terbinafine cream) and Group B (treatment with sertaconazole cream). A total of 38 patients were enrolled for the study, 20 patients in group A and 18 patients in group B. But five patients of group A and three patients of group B were lost for follow-ups. Therefore sample size was of 30 patients with 15 patients in group A and group B each.

Materials and Methods:

Patients in group A and B were treated with twice daily topical 1% terbinafine hydrochloride and 2% sertaconazole nitrate cream respectively for a total duration of three weeks. Clinical improvement in signs and symptoms of each clinical parameter, namely itching, erythema, papules, pustules, vesicles, and scaling were graded weekly and clinical cure was assessed. KOH mount and culture was done weekly up to 3 weeks to access mycological cure. Fungal culture was done on Sabouraud''s dextrose agar with chloramphenicol and cycloheximide.

Statistical Analysis Used:

Statistical analysis was done using students paired and unpaired t-tests from the data obtained.

Results:

Comparison between Group A and Group B for complete cure (clinical and mycological) showed that at the end of 3 weeks both terbinafine and sertaconazole groups had 100% complete cure. When the two groups were compared for complete cure, at the end of 1^st and 2^nd week, statistically non-significant results were observed (P = 0.461 and P = 0.679 respectively). However, at the end of 2^nd week, complete cure rate for terbinafine was 80% as compared to 73.35% for sertaconazole with no statistical significance. In both Group A and Group B, clinically significant local side effects like erythema, swelling, stinging sensation, or increased itching were not noticed. A majority of our patients in both the group showed Trichophyton rubrum followed by Trichophyton mentagrophytes growth on culture. In Group A, 11 patients showed growth of T. rubrum, 2 patients showed growth of T. mentagrophytes, and 1 patient had only KOH test positive. In Group B, 10 patients revealed growth of T. rubrum, followed by growth of T. mentagrophytes in 3 and Microsporum canis in 2 patients. The therapeutic response is more or less same in infection with different species.

Conclusions:

The newer fungistatic drug sertaconazole nitrate 2% cream was as effective as terbinafine hydrochloride 1% cream which is one of the fungicidal drugs, though terbinafine hydrochloride 1% cream has higher rates of complete cure at the end of 2 weeks as compared to sertaconazole nitrate 2% cream. Both the drugs showed good tolerability with no adverse effects.     

萘替芬酮康唑乳膏治疗面部脂溢性皮炎疗效观察

目的 探讨萘替芬酮康唑乳膏和复方乳酸乳膏混合外涂治疗面部脂溢性皮炎的临床疗效和安全性。方法 将65例面部脂溢性皮炎患者随机分成两组,治疗组33例,将适量萘替芬酮康唑乳膏和复方乳酸乳膏1:1放于洗净的手掌,混合调匀,再均匀涂于面部皮损处;对照组32例,将适量曲安奈德尿素乳膏和复方乳酸乳膏以1:1按上法均匀涂于面部皮损处。疗程均为4周,每2周复诊1次,观察疗效和不良反应。结果 治疗第2,4周后,两组症状总积分均较治疗前显著下降,差异有统计学意义(P<0.05);治疗组有效率分别为72.73%和78.13%,对照组分别为81.82%和87.50%,差异均无统计学意义(P均>0.05)。结论 外涂萘替芬酮康唑乳膏与外涂曲安奈德尿素乳膏治疗面部脂溢性皮炎疗效均满意且相当,但外涂萘替芬酮康唑乳膏更安全,无糖皮质激素乳膏外用的不良反应。     

Comparative Assessment of the Efficacy and Safety of Sertaconazole (2%) Cream Versus Terbinafine Cream (1%) Versus Luliconazole (1%) Cream In Patients with Dermatophytoses: A Pilot Study

Background:

Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that would provide greater symptomatic relief and hence would be beneficial in improving the quality of life for the patient with dermatophytoses.

Aims and Objectives:

To compare efficacy and safety of sertaconazole, terbinafine and luliconazole in patients with dermatophytoses.

Materials and Methods:

83 patients with tinea corporis and tinea cruris infections were enrolled in this multicentre, randomized, open label parallel study. The initial ‘Treatment Phase’ involved three groups receiving either sertaconazole 2% cream applied topically twice daily for four weeks, terbinafine 1% cream once daily for two weeks, luliconazole 1% cream once daily for two weeks. At the end of treatment phase, there was a ‘Follow-up Phase’ at end of 2 weeks, where the patients were assessed clinically and mycologically for relapse.

Results:

Of the 83 patients, 62 completed the study, sertaconazole (n = 20), terbinafine (n = 22) and luliconazole (n = 20). The primary efficacy variables including change in pruritus, erythema, vesicle, desquamation and mycological cure were significantly improved in all the three groups, as compared to baseline, in the Treatment and Follow-up phase. Greater proportion of patients in sertaconazole group (85%) showed resolution of pruritus as compared to terbinafine (54.6%); and luliconazole (70%), (P < 0.05 sertaconazole vs terbinafine). There was a greater reduction in mean total composite score (pruritus, erythema, vesicle and desquamation) in sertaconazole group (97.1%) as compared to terbinafine (91.2%) and luliconazole (92.9%). All groups showed equal negative mycological assessment without any relapses. All three study drugs were well tolerated. Only one patient in sertaconazole group withdrew from the study due to suspected allergic contact dermatitis.

Conclusion:

Sertaconazole was better than terbinafine and luliconazole in relieving signs and symptoms during study and follow up period. At the end of ‘Treatment Phase’ and ‘Follow-up’ Phase, all patients showed negative mycological assessment in all three treatment groups suggesting no recurrence of the disease.     

1%盐酸布替萘芬乳膏治疗浅部真菌病临床观察

目的：评价1％盐酸布替萘芬乳膏治疗浅部真菌病的临床疗效及安全性，并与1％联苯苄唑凝胶进行比较。方法：对83例浅部真菌病患者进行治疗，其中治疗组43例，外用1％盐酸布替萘芬乳膏，每日1次；对照组40例，外用1％联苯苄唑凝胶，每日1次，体股癣疗程2周，手足癣4周。分别于停药及停药2周时观察记录患者的临床表现及治疗效果。结果：1％盐酸布替萘芬乳膏和1％联苯苄唑凝胶临床疗效相似，停药时临床总有效率分别为90．7％和90．0％，真菌总清除率为93．0％和90．0％；停药2周时临床总有效率分别为97．7％和92．5％，真菌总清除率为100．0％和92．5％。不良反应少。结论：1％盐酸布替萘芬乳膏治疗浅部真菌病疗效显著且安全。     

2%夫西地酸乳膏治疗细菌感染性皮肤病临床观察

目的评价2%夫西地酸乳膏治疗细菌感染性皮肤病的疗效和安全性。方法60例细菌感染性皮肤病患者,治疗组30例外擦2%夫西地酸乳膏,2～3次/d;对照组30例外擦2%莫匹罗星软膏,3次/d,疗程7天。结果治疗组有效率86.6%;对照组有效率90.0%,两组疗效差异无显著性(P>0.05)。治疗期间未出现不良反应。结论2%夫西地酸乳膏与莫匹罗星软膏对各种感染性皮肤病均有较好疗效,安全性高,患者依从性好。