Acne vulgaris

Peripherally active androgens control cellular functions by binding to androgen receptors. Follicular keratinocytes and sebocytes are target cells for androgens, which, directly or indirectly, stimulate keratinocyte proliferation and the volume of sebaceous glands as well as the sebum secretion rate. Acne often begins with the adrenarche, namely with the up- regulation of adrenal synthesis of dehydroepiandrosterone sulfate, a hormone that is upstream to testosterone. The majority of acne patients exhibit normal levels of circulating androgens, while sebaceous glands from acne regions exhibit a stronger sensitivity to androgens than the sebaceous glands from other parts of the body. Hormone-like active lipids, hormones in diet and neuropeptides may also play a role in the development of acne lesions. The target of antiandrogen treatment of the skin is mainly the sebaceous gland and the primary effect is sebostasis.     

Trichophyton-rubrum-Syndrom mit Tinea axillaris als Teilmanifestation

Trichophyton-rubrum-Infektionen werden weltweit beschrieben. In den letzten Jahren wird Trichophyton rubrum auch an anderen K?rperpartien als der Fu?sohle, den Zehenn?geln und der Leiste h?ufiger nachgewiesen. Wir berichten über einen Patienten, dessen Trichophytoninfektion sich auf die Oberschenkel, den Inguinalbereich, die Hüftregion, das Abdomen, den linken Unterarm und die Achselh?hlen ausbreitete. Unl?ngst sind solche Hautver?nderungen in der Literatur als chronisches Dermatophytosesyndrom zusammengefa?t worden. Anhand unseres Patienten stellen wir diese neue Entit?t erstmals in der deutschsprachigen Literatur vor und diskutieren die Stellung des chronischen Dermatophytosesyndroms im Zusammenhang mit den gel?ufigen Trichophyton rubrum-Infektionen.     

Cyproterone Acetate Loading to Lipid Nanoparticles for Topical Acne Treatment: Particle Characterisation and Skin Uptake

Purpose Topical cyproterone acetate (CPA) treatment of skin diseases should reduce side effects currently excluding the use in males and demanding contraceptive measures in females. To improve skin penetration of the poorly absorbed drug, we intended to identify the active moiety and to load it to particulate carrier systems. Materials and Methods CPA metabolism in human fibroblasts, keratinocytes and a sebocyte cell line as well as androgen receptor affinity of native CPA and the hydrolysis product cyproterone were determined. CPA 0.05% loaded solid lipid nanoparticles (SLN), nanostructured lipid carriers (NLC), a nanoemulsion and micropheres were characterized for drug-particle interaction and CPA absorption using human skin ex-vivo. Results Native CPA proved to be the active agent. Application of CPA attached to SLN increased skin penetration at least four-fold over the uptake from cream and nanoemulsion. Incorporation into the lipid matrix of NLC and microspheres resulted in a 2–3-fold increase in CPA absorption. Drug amounts within the dermis were low with all preparations. No difference was seen in the penetration into intact and stripped skin. Conclusion With particulate systems topical CPA treatment may be an additional therapeutic option for acne and other diseases of the pilosebaceous unit.     

Management der Acne vulgaris: Fokus auf Clindamycin und Zink

Topical antibiotics, especially clindamycin, are well-accepted in the treatment of mild to moderate acne. Combinations of clindamycin and other agents such as benzoyl peroxide, retinoids or zinc, are possibly superior to clindamycin monotherapy regarding efficacy and tolerability with the combination 1% clindamycin/5% benzoyl peroxide being particularly well-supported by evidence. Moreover, a recent study has shown that patients themselves prefer a complex of zinc acetate/clindamycin phosphate.     

Drug Targeting by Solid Lipid Nanoparticles for Dermal Use

Long term topical glucocorticoid treatment can induce skin atrophy by the inhibition of fibroblasts. We, therefore, looked for the newly developed drug carriers that may contribute to a reduction of this risk by an epidermal targeting. Prednicarbate (PC, 0.25%) was incorporated into solid lipid nanoparticles of various compositions. Conventional PC cream of 0.25% and ointment served for reference. Local tolerability as well as drug penetration and metabolism were studied in excised human skin and reconstructed epidermis. With the latter drug recovery from the acceptor medium was about 2% of the applied amount following PC cream and ointment but 6.65% following nanoparticle dispersion. Most interestingly, PC incorporation into nanoparticles appeared to induce a localizing effect in the epidermal layer which was pronounced at 6 h and declined later. Dilution of the PC-loaded nanoparticle preparation with cream (1:9) did not reduce the targeting effect while adding drug-free nanoparticles to PC cream did not induce PC targeting. Therefore, the targeting effect is closely related to the PC-nanoparticles and not a result of either the specific lipid or PC adsorbance to the surface of the formerly drug free nanoparticles. Lipid nanoparticle-induced epidermal targeting may increase the benefit/risk ratio of topical therapy.     

Synergistische Effekte der Antimykotika Terbinafin und Itraconazol

Ohne Zusammenfassung Eingegangen am 16. Juli 1998 Angenommen am 26. August 1998