WorldWideScience

Sample records for macroevolutionary topics treatment

  1. Topical treatment of melasma

    Directory of Open Access Journals (Sweden)

    Bandyopadhyay Debabrata

    2009-01-01

    Full Text Available Melasma is a common hypermelanotic disorder affecting the face that is associated with considerable psychological impacts. The management of melasma is challenging and requires a long-term treatment plan. In addition to avoidance of aggravating factors like oral pills and ultraviolet exposure, topical therapy has remained the mainstay of treatment. Multiple options for topical treatment are available, of which hydroquinone (HQ is the most commonly prescribed agent. Besides HQ, other topical agents for which varying degrees of evidence for clinical efficacy exist include azelaic acid, kojic acid, retinoids, topical steroids, glycolic acid, mequinol, and arbutin. Topical medications modify various stages of melanogenesis, the most common mode of action being inhibition of the enzyme, tyrosinase. Combination therapy is the preferred mode of treatment for the synergism and reduction of untoward effects. The most popular combination consists of HQ, a topical steroid, and retinoic acid. Prolonged HQ usage may lead to untoward effects like depigmentation and exogenous ochronosis. The search for safer alternatives has given rise to the development of many newer agents, several of them from natural sources. Well-designed controlled clinical trials are needed to clarify their role in the routine management of melasma.

  2. TOPICAL TREATMENT OF MELASMA

    Science.gov (United States)

    Bandyopadhyay, Debabrata

    2009-01-01

    Melasma is a common hypermelanotic disorder affecting the face that is associated with considerable psychological impacts. The management of melasma is challenging and requires a long-term treatment plan. In addition to avoidance of aggravating factors like oral pills and ultraviolet exposure, topical therapy has remained the mainstay of treatment. Multiple options for topical treatment are available, of which hydroquinone (HQ) is the most commonly prescribed agent. Besides HQ, other topical agents for which varying degrees of evidence for clinical efficacy exist include azelaic acid, kojic acid, retinoids, topical steroids, glycolic acid, mequinol, and arbutin. Topical medications modify various stages of melanogenesis, the most common mode of action being inhibition of the enzyme, tyrosinase. Combination therapy is the preferred mode of treatment for the synergism and reduction of untoward effects. The most popular combination consists of HQ, a topical steroid, and retinoic acid. Prolonged HQ usage may lead to untoward effects like depigmentation and exogenous ochronosis. The search for safer alternatives has given rise to the development of many newer agents, several of them from natural sources. Well-designed controlled clinical trials are needed to clarify their role in the routine management of melasma. PMID:20101327

  3. The topical treatment of psoriasis.

    NARCIS (Netherlands)

    Kerkhof, P.C.M. van de; Vissers, W.H.P.M.

    2003-01-01

    According to the patients, improvement of efficacy, long-term safety and improvement of compliance are needed. The topical treatment has been innovated during the last decade. Most important are the introduction of two new classes of treatments: topical vitamin D(3) analogues and the retinoid tazaro

  4. Topical treatments for cutaneous warts.

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    Kwok, Chun Shing; Gibbs, Sam; Bennett, Cathy; Holland, Richard; Abbott, Rachel

    2012-09-12

    Viral warts are a common skin condition, which can range in severity from a minor nuisance that resolve spontaneously to a troublesome, chronic condition. Many different topical treatments are available. To evaluate the efficacy of local treatments for cutaneous non-genital warts in healthy, immunocompetent adults and children. We updated our searches of the following databases to May 2011: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE (from 2005), EMBASE (from 2010), AMED (from 1985), LILACS (from 1982), and CINAHL (from 1981). We searched reference lists of articles and online trials registries for ongoing trials. Randomised controlled trials (RCTs) of topical treatments for cutaneous non-genital warts. Two authors independently selected trials and extracted data; a third author resolved any disagreements. We included 85 trials involving a total of 8815 randomised participants (26 new studies were included in this update). There was a wide range of different treatments and a variety of trial designs. Many of the studies were judged to be at high risk of bias in one or more areas of trial design.Trials of salicylic acid (SA) versus placebo showed that the former significantly increased the chance of clearance of warts at all sites (RR (risk ratio) 1.56, 95% CI (confidence interval) 1.20 to 2.03). Subgroup analysis for different sites, hands (RR 2.67, 95% CI 1.43 to 5.01) and feet (RR 1.29, 95% CI 1.07 to 1.55), suggested it might be more effective for hands than feet.A meta-analysis of cryotherapy versus placebo for warts at all sites favoured neither intervention nor control (RR 1.45, 95% CI 0.65 to 3.23). Subgroup analysis for different sites, hands (RR 2.63, 95% CI 0.43 to 15.94) and feet (RR 0.90, 95% CI 0.26 to 3.07), again suggested better outcomes for hands than feet. One trial showed cryotherapy to be better than both placebo and SA, but only for hand warts.There was no significant difference in cure rates between

  5. The treatment of rosacea with topical ivermectin.

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    Ali, S T; Alinia, H; Feldman, S R

    2015-04-01

    The treatment of rosacea is challenging because several pathophysiologic processes may be involved, including neurovascular dysregulation and alterations in innate immune status. Demodex mites may play a role in the latter mechanism. Topical ivermectin is a new therapeutic modality which demonstrates antiparasitic and anti-inflammatory properties. This article reviews published evidence related to the efficacy and safety of topical ivermectin. PubMed was utilized to search for key words "topical ivermectin", "ivermectin cream" and "rosacea". Three clinical trials were found that studied topical ivermectin as a treatment option for rosacea. Ivermectin was effective, safe and well tolerated.

  6. Corneal staining after treatment with topical tetracycline

    NARCIS (Netherlands)

    R. Lapid-Gortzak; C.P. Nieuwendaal; A.R. Slomovic; L. Spanjaard

    2006-01-01

    Purpose: The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline. Methods: A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of

  7. Treatment of pediculosis capitis with topical albendazole.

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    Ayoub, Nakhlé; Maatouk, Ismaël; Merhy, Martin; Tomb, Roland

    2012-02-01

    Pediculosis capitis, or head lice infestation, caused by Pediculus humanus capitis, is a common and ubiquitous health concern. Increasing resistance and treatment failures are reported with available topical pediculicides and may prove challenging to manage. Recent data indicate that the oral anti-helmintic agents thiabendazole and albendazole could represent new therapeutic options against pediculosis capitis. We report a novel treatment modality in four patients with head lice who were successfully treated with a topical application of albendazole.

  8. Heart block following topical latanoprost treatment

    Science.gov (United States)

    De Smit, Elisabeth; Theodorou, Maria; Hildebrand, Göran Darius; Bloom, Philip

    2011-01-01

    The authors report a case of second degree heart block associated with topical latanoprost treatment. The authors discuss the possibility of a causative effect as the cessation of this treatment resulted in improvement of the arrhythmia. The authors highlight previous reports and research in humans and animals which demonstrate an association of arrhythmias with prostaglandin analogues. This report draws attention to the possibility that an extremely commonly prescribed topical drug may trigger arrhythmias in susceptible individuals. It is important that prescribers are aware of this possible side-effect. PMID:22679164

  9. Topical Treatment: Basic Rules and Absorbtion

    Directory of Open Access Journals (Sweden)

    Ertuğrul H. Aydemir

    2012-09-01

    Full Text Available Topical treatment, is applied as putting the medicines just on the problemmatic area of the skin. It is useful for avoiding the systemic side effects, decreasing the cost and it also works like an occupying treatment. Absorbtion of active ingredient is a passive process and amount of absorption of active ingredient is affected by the properties of skin area applied and topical medicine itself. Absorption is more thinner, warmer and wetter areas of the skin.. Absorption is much more than needed, in the areas which are eroded and damaged. But, entrance of the topical medicine to the circulation is not useful and may cause systemic effects. Active ingredient in the topical medicine might have a high concentration, lipophilic nature and higher affinity to the skin than the affinity to the vehicle for a better absorbtion. Stages of absorbtion: Adsorbtion, absorbtion (penetration, permeation, resorbtion. Vehicles can be classified as liquids, semi solides and solides, but the classification as monophasic, biphasic and poliphasic is better (basicly mixtures of water-oils-powders.

  10. [Update of the topical treatment of psoriasis].

    Science.gov (United States)

    Carrascosa, J M; Vanaclocha, F; Borrego, L; Fernández-López, E; Fuertes, A; Rodríguez-Fernández-Freire, L; Zulaica, A; Tuneu, A; Caballé, G; Colomé, E; Bordas, X; Hernanz, J M; Brufau, C; Herrera, E

    2009-04-01

    Topical therapy continues to be one of the pillars of psoriasis management. Topical corticosteroids and vitamin D analogs are the drugs of choice during the induction phase, and vitamin D analogs continue to be drugs of choice for maintenance therapy. Tazarotene and dithranol are suitable options in patients with certain, specific characteristics. The calcineurin inhibitors can be considered to be second-line treatment for psoriasis of the face and flexures. The efficacy and safety of the fixed-dose combination of betamethasone and calcipotriol in the induction phase is greater than that of either drug alone. The combination of corticosteroids with salicylic acid achieves better results than corticosteroids in monotherapy. None of the drugs evaluated stands out over the others in all clinical situations, and their use must therefore be individualized in each patient and adjusted according to the course of the disease.

  11. Molecular evolution tracks macroevolutionary transitions in Cetacea.

    Science.gov (United States)

    McGowen, Michael R; Gatesy, John; Wildman, Derek E

    2014-06-01

    Cetacea (whales, dolphins, and porpoises) is a model group for investigating the molecular signature of macroevolutionary transitions. Recent research has begun to reveal the molecular underpinnings of the remarkable anatomical and behavioral transformation in this clade. This shift from terrestrial to aquatic environments is arguably the best-understood major morphological transition in vertebrate evolution. The ancestral body plan and physiology were extensively modified and, in many cases, these crucial changes are recorded in cetacean genomes. Recent studies have highlighted cetaceans as central to understanding adaptive molecular convergence and pseudogene formation. Here, we review current research in cetacean molecular evolution and the potential of Cetacea as a model for the study of other macroevolutionary transitions from a genomic perspective.

  12. Preliminary stop of the TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia (TOPIC) trial

    NARCIS (Netherlands)

    Koeneman, M. M.; Kruse, A. J.; Kooreman, L. F S; zur Hausen, A.; Hopman, A. H N; Sep, S. J S; Van Gorp, T.; Slangen, B. F M; van Beekhuizen, H. J.; van de Sande, A. J M; Gerestein, C. G.; Nijman, H. W.; Kruitwagen, R. F P M

    2017-01-01

    The "TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia" (TOPIC) trial was stopped preliminary, due to lagging inclusions. This study aimed to evaluate the treatment efficacy and clinical applicability of imiquimod 5% cream in high-grade cervical intraepithelial neoplasia (

  13. Histiocytosis X: treatment with topical nitrogen mustard.

    Science.gov (United States)

    Berman, B; Chang, D L; Shupack, J L

    1980-07-01

    The case histories of two elderly patients with cutaneous histiocytosis X treated topically with nitrogen mustard are presented. The cutaneous lesions cleared within 2 to 3 weeks, and remission was maintained with daily topical administration of nitrogen mustard. The clinical impression of improvement was substantiated by light and electron microscopic studies prior to and after therapy.

  14. Assessing adherence factors in patients under topical treatment: development of the Topical Therapy Adherence Questionnaire (TTAQ).

    Science.gov (United States)

    Zschocke, Ina; Mrowietz, Ulrich; Lotzin, Annett; Karakasili, Eleni; Reich, Kristian

    2014-04-01

    Medication adherence rates strongly depend on favorable disease outcomes. It is known that medication adherence rates are lower for topical treatment than for systemic treatment. However, to date no validated instrument for the assessment of adherence factors in topical treatment is available. The aim of this study was to develop a new questionnaire to assess adherence risk factors in topical treatment. The development of the Topical Therapy Adherence Questionnaire (TTAQ) and Patient Preference Questionnaire (PPQ) was based on a systematic literature review, and qualitative patient focus interviews and expert focus groups' input. The psychometric properties and comprehensibility of the TTAQ and PPQ were assessed in a feasibility study with 59 psoriasis patients. Our first preliminary results indicate that the TTAQ and PPQ are psychometrically sound and reliable measures for the assessment of factors influencing topical treatment adherence. The questionnaires are currently being further developed and various parameters (e.g., time point of assessment) are currently being tested in an exploratory pilot study with ca. 2,000 psoriasis patients receiving topical treatment in a European clinical trial. The use of the final versions of TTAQ and PPQ in clinical practice may facilitate the early identification of specific non-adherence factors in patients under topical treatment, which could enable designing and applying adherence-enhancing interventions according to the patient's individual needs.

  15. Topical treatment options for conjunctival neoplasms

    Directory of Open Access Journals (Sweden)

    Jonathan W Kim

    2008-10-01

    Full Text Available Jonathan W Kim, David H AbramsonOphthalmic Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USAAbstract: Topical therapies offer a nonsurgical method for treating conjunctival tumors by delivering high drug concentrations to the ocular surface. Over the past ten years, topical agents have been used by investigators to treat various premalignant and malignant lesions of the conjunctiva, such as primary acquired melanosis with atypia, conjunctival melanoma, squamous intraepithelial neoplasia and squamous cell carcinoma of the conjunctiva, and pagetoid spread of the conjunctiva arising from sebaceous cell carcinoma. Despite the enthusiasm generated by the success of these agents, there are unanswered questions regarding the clinical efficacy of this new nonsurgical approach, and whether a single topical agent can achieve cure rates comparable with traditional therapies. Furthermore, the long-term consequences of prolonged courses of topical chemotherapeutic drugs on the ocular surface are unknown, and the ideal regimen for each of these agents is still being refined. In this review, we present specific guidelines for treating both melanocytic and squamous neoplasms of the conjunctiva, utilizing the available data in the literature as well as our own clinical experience at the Memorial Sloan-Kettering Cancer Center.Keywords: topical therapies, conjunctival neoplasms melanosis, Mitomycin-C, 5-Fluorouracil

  16. Review of topical beta blockers as treatment for infantile hemangiomas.

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    Painter, Sally L; Hildebrand, Göran Darius

    2016-01-01

    The treatment of infantile hemangiomas changed from the use of oral corticosteroids to oral propranolol on the serendipitous discovery of propanolol's clinical effectiveness in 2008. Since then, clinicians have begun to use topical beta blockers--in particular, timolol maleate 0.5% gel forming solution--with good effect. Topical beta blockers are now used for lesions with both deep and superficial components and those that are amblyogenic. When initiated in the proliferative phase of the lesion, the effectiveness of the treatment can be seen within days. There is no consensus on dosing, treatment bioavailability, or clinical assessment of lesions, but these are topics for future research.

  17. Topical macrolide immunomodulators: a role in the treatment of vitiligo?

    NARCIS (Netherlands)

    Tjioe, M.; Vissers, W.H.P.M.; Gerritsen, M.J.P.

    2006-01-01

    Recently, topical macrolide immunomodulators have been successfully introduced in the treatment of atopic dermatitis. With the growing interest in this new line of topical immunosuppressants, research into the efficacy of these medicines in other T-cell-mediated skin diseases, such as psoriasis, lic

  18. Non-adherence to topical treatments for actinic keratosis

    Science.gov (United States)

    Shergill, Bav; Zokaie, Simon; Carr, Alison J

    2014-01-01

    Background There is limited information on the patterns of use, adherence rates, and factors that impact adherence with topical treatments for actinic keratosis (AK). Objectives To establish patterns of use and adherence with topical treatments for AK and to identify treatment-related factors that impact on adherence. Methods A community-based, cross-sectional study was performed using a standardized questionnaire completed online or via telephone interview. Patients were stratified according to the presence of AK lesions on the scalp and/or other extremities; and presence of scarring resulting from treatment. Results This study included 305 patients with AK who were currently using a patient-applied topical therapy for AK or had used one within the previous 12 months. In total, 88% (n = 268/305) of patients were either non-adherent, non-persistent or both non-adherent and non-persistent to topical therapy. Duration of treatment was associated with increasing rates of non-adherence (adjusted odds ratio [OR]; for treatment durations greater than 4 weeks, 2.2, P < 0.01): 52% of patients were non-adherent with 3–4 week treatment duration; 69% of patients with 4–8 week treatment duration; and 71% of patients with 6–12 week treatment duration. There were similar increases in non-persistence with increasing treatment duration (adjusted OR; for treatment durations greater than 4 weeks, 2.1, P < 0.05). Conclusion This study found high rates of non-adherence and non-persistence in patients with AK. Duration of treatment was a significant factor contributing to non-adherence and non-persistence to topical treatments. Patient-applied topical therapies that require less frequent application and have shorter treatment duration may be associated with improved adherence rates. PMID:24379656

  19. Topical bimatoprost for the treatment of eyebrow hypotrichosis.

    Science.gov (United States)

    Schweiger, Eric S; Pinchover, Lisa; Bernstein, Robert M

    2012-01-01

    Topical bimatoprost was FDA approved in December of 2008 for the treatment of eyelash hypotrichosis. Since its approval, some physicians have advocated the use of bimatoprost "off label" for hair growth in other areas, such as the scalp or eyebrows, but there has yet to be published scientific evidence to support this use. We report one of the first cases of significant eyebrow hair growth in a patient after use of topical bimatoprost for eyebrow hypotrichosis.

  20. Successful salvage treatment of Lecythophora mutabilis keratitis with topical voriconazole

    Directory of Open Access Journals (Sweden)

    Bora Yüksel

    2011-09-01

    Full Text Available Fungal keratitis is an important ophthalmic problem in the developing world. Filamentous fungi are the most frequently reported pathogens in fungal keratitis. This report aimed to present a case with Lecythophora mutabilis keratitis that treatment failure was seen with topical and systemic amphotericin B lipid complex. Then she was treated successfully topical voriconazole. J Microbiol Infect Dis 2011;1 (2: 75-77

  1. Successful treatment of Beauveria bassiana fungal keratitis with topical voriconazole.

    Science.gov (United States)

    Ogawa, Akiko; Matsumoto, Yukihiro; Yaguchi, Takashi; Shimmura, Shigeto; Tsubota, Kazuo

    2016-04-01

    We describe a 66-year-old woman who suffered from fungal keratitis after corneal transplantation. The causative organism was identified as Beauveria bassiana on the basis of morphological characteristics and the sequence of the internal transcribed spacer region of the ribosomal RNA gene. The patient was successfully treated with topical voriconazole (VRCZ) use only. We, hereby, present the first report of a case with B. bassiana fungal keratitis that responded to topical antifungal VRCZ treatment.

  2. Efinaconazole topical solution, 10%: formulation development program of a new topical treatment of toenail onychomycosis.

    Science.gov (United States)

    Bhatt, V; Pillai, R

    2015-07-01

    Transungual drug delivery of antifungals is considered highly desirable to treat common nail disorders such as onychomycosis, due to localized effects, and improved adherence resulting from minimal systemic adverse events. However, the development of effective topical therapies has been hampered by poor nail penetration. An effective topical antifungal must permeate through, and under the dense keratinized nail plate to the site of infection in the nail bed and nail matrix. We present here the formulation development program to provide effective transungual and subungual delivery of efinaconazole, the first topical broad spectrum triazole specifically developed for onychomycosis treatment. We discuss the important aspects encompassing the formulation development program for efinaconazole topical solution, 10%, focusing on its solubility in a number of solvents, in vitro penetration through the nail, and in vivo efficacy. Efinaconazole topical solution, 10% is a stable, non-lacquer, antifungal with a unique combination of ingredients added to an alcohol-based formulation to provide low surface tension and good wetting properties. This low surface tension is believed to affect effective transungual delivery of efinaconazole and believed to provide a dual mode of delivery by accessing the nail bed by wicking into the space between the nail and nail plate. © 2015 Wiley Periodicals, Inc. and the American Pharmacists Association.

  3. Macroevolutionary developmental biology: Embryos, fossils, and phylogenies.

    Science.gov (United States)

    Organ, Chris L; Cooper, Lisa Noelle; Hieronymus, Tobin L

    2015-10-01

    The field of evolutionary developmental biology is broadly focused on identifying the genetic and developmental mechanisms underlying morphological diversity. Connecting the genotype with the phenotype means that evo-devo research often considers a wide range of evidence, from genetics and morphology to fossils. In this commentary, we provide an overview and framework for integrating fossil ontogenetic data with developmental data using phylogenetic comparative methods to test macroevolutionary hypotheses. We survey the vertebrate fossil record of preserved embryos and discuss how phylogenetic comparative methods can integrate data from developmental genetics and paleontology. Fossil embryos provide limited, yet critical, developmental data from deep time. They help constrain when developmental innovations first appeared during the history of life and also reveal the order in which related morphologies evolved. Phylogenetic comparative methods provide a powerful statistical approach that allows evo-devo researchers to infer the presence of nonpreserved developmental traits in fossil species and to detect discordant evolutionary patterns and processes across levels of biological organization.

  4. Non-adherence to topical treatments for actinic keratosis

    Directory of Open Access Journals (Sweden)

    Shergill B

    2013-12-01

    Full Text Available Bav Shergill,1 Simon Zokaie,2 Alison J Carr3 1Department of Dermatology, Brighton and Sussex University Hospitals, Elm Grove, Brighton, UK; 2Leo Pharma, Princes Risborough, 3Hamell, London, UK Background: There is limited information on the patterns of use, adherence rates, and factors that impact adherence with topical treatments for actinic keratosis (AK. Objectives: To establish patterns of use and adherence with topical treatments for AK and to identify treatment-related factors that impact on adherence. Methods: A community-based, cross-sectional study was performed using a standardized questionnaire completed online or via telephone interview. Patients were stratified according to the presence of AK lesions on the scalp and/or other extremities; and presence of scarring resulting from treatment. Results: This study included 305 patients with AK who were currently using a patient-applied topical therapy for AK or had used one within the previous 12 months. In total, 88% (n = 268/305 of patients were either non-adherent, non-persistent or both non-adherent and non-persistent to topical therapy. Duration of treatment was associated with increasing rates of non-adherence (adjusted odds ratio [OR]; for treatment durations greater than 4 weeks, 2.2, P < 0.01: 52% of patients were non-adherent with 3–4 week treatment duration; 69% of patients with 4–8 week treatment duration; and 71% of patients with 6–12 week treatment duration. There were similar increases in non-persistence with increasing treatment duration (adjusted OR; for treatment durations greater than 4 weeks, 2.1, P < 0.05. Conclusion: This study found high rates of non-adherence and non-persistence in patients with AK. Duration of treatment was a significant factor contributing to non-adherence and non-persistence to topical treatments. Patient-applied topical therapies that require less frequent application and have shorter treatment duration may be associated with improved

  5. Dose verification after topical treatment of alligator (Alligator mississippiensis) eggs.

    Science.gov (United States)

    Muller, Jennifer K; Scarborough, Janet E; Sepúlveda, María S; Casella, George; Gross, Timothy S; Borgert, Christopher J

    2007-05-01

    Numerous studies have used temperature-dependent sex determination in reptilian eggs to investigate potential developmental effects of exogenously applied substances. However, few studies have measured the dose carried across the eggshell. We report embryonic mortality and internal egg concentrations determined by gas chromatography-mass spectrometry two weeks after exposure of American alligator (Alligator mississippiensis) eggs to chlorinated organic pesticides via injection or topical application. Puncturing the eggshell for injection produced high mortality compared with unpunctured controls; therefore, further evaluation of this method was abandoned. Although higher than controls, mortality was much lower in eggs treated topically than in those injected. Transfer of chemicals across the eggshell was very low, highly variable, and did not correlate with the applied dose after topical application. These results are consistent with previous reports in the literature, casting doubt on whether a reproducible internal dose can be achieved in reptilian eggs by topical treatment.

  6. Successful treatment of periungual warts with topical cidofovir.

    Science.gov (United States)

    Padilla España, Laura; Del Boz, Javier; Fernández Morano, Teresa; Arenas-Villafranca, Javier; de Troya, Magdalena

    2014-01-01

    Periungual warts represent a treatment challenge because of its high recurrence rate and recalcitrance. These are benign lesions produced by the human papilloma virus (HPV) that often do not respond to habitual treatment. Cidofovir is a potent antiviral drug that acts inactivating viral DNA polymerase. Topical cidofovir for the treatment of HPV-related cutaneous and mucous lesions is becoming increasingly common. Our aim was to assess the efficacy and safety of cidofovir cream for the treatment of viral periungual warts. We undertook a retrospective observational study of patients with periungual warts who received treatment with topical cidofovir between January 2010 and December 2013 at the Dermatology Service of the Hospital Costa del Sol, Marbella, Spain. Data were recorded about the rate of treatment response, the adverse effects and recurrences, as well as the characteristics of the patient cohort. We identified 41 patients who had received some previous treatment. The concentration of cidofovir was 3% in all cases, usually applied twice a day (in 37 of the 41 cases). A greater or lesser response was noted in 35 cases. There were six recurrences in the follow-up period. Topical cidofovir seems to be a useful alternative for the therapeutic management of recalcitrant periungual common warts that fail to respond to usual treatment. Our experience with the use of this antiviral agent has been satisfactory, although in our opinion, it should be reserved for specific cases as its economical cost represents an important limitation.

  7. Advances in the topical treatment of acne and rosacea.

    Science.gov (United States)

    Ceilley, Roger I

    2004-01-01

    Acne and rosacea are common skin diseases which may present similarly and both involve inflammation. Both can result in significant cosmetic impairment and lead to quality of life decrements if not optimally treated. The conventional approach for both diseases involves the use of topical therapy to treat inflammatory lesions in combination, when needed, with a systemic or topical antibiotic. An important issue in the management of both diseases at present is the need to reduce antibiotic usage due to the increasing problem of bacterial resistance. One of the emerging treatment paradigms that is becoming increasingly useful as an antibiotic-sparing strategy is the use of procedural therapies in combination with medical management. Such procedural modalities include lasers, intense pulsed light (IPL), and photodynamic therapies (PDT). Topical regimens are used pre-treatment and following physical modalities for maintenance of remission.

  8. Emollients: application of topical treatments to the skin.

    Science.gov (United States)

    Dunning, Gail

    Nurses working in various clinical settings can make a real difference to the clinical effectiveness of topical applications to the skin by increasing their knowledge of the choice and mechanisms involved. This is particularly the case for nurses who are non-medical prescribers when considering first-line therapies for patients with eczema. It is important for all nurses to acknowledge that topical treatments, however simple, are a form of drug therapy and must be given the same considerations for their specific actions whether you are prescribing, applying or reviewing their effect. Emollients have an as important part to play in the treatment of all dry skin conditions. This article focuses on increasing the reader's knowledge of the application of topical emollient therapy, as well as highlighting some practical tips to consider.

  9. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2011-06-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  10. In touch with psoriasis: topical treatments and current guidelines.

    LENUS (Irish Health Repository)

    Murphy, G

    2012-02-01

    This article describes topical therapies and treatment guidelines for psoriasis and is based on a presentation given by the authors at a satellite symposium held during the 19th Congress of the European Academy of Dermatology and Venereology, 6-10 October, 2010, in Gothenburg, Sweden. The highly variable nature of psoriasis and its individual presentation in patients can make it difficult to choose the most appropriate treatment. There are many treatment options, from topical treatment with emollients for very mild psoriasis, to systemic therapy with fumaric acid esters, methotrexate or biologics for severe disease. For the treatment of mild-to-moderate psoriasis, topical therapy is generally the most appropriate and a variety of options, both historical and recent, are available. Newer therapies offer greater convenience and fewer side-effects. Of the more recently available therapies, vitamin D analogues and topical corticosteroids are the two with the greatest proven efficacy in randomized clinical trials. A recent Cochrane review showed the highest efficacy overall with the fixed combination vitamin D analogue (calcipotriol) and corticosteroid (betamethasone dipropionate). Indeed, clinical trials have shown that two-compound calcipotriol\\/betamethasone dipropionate ointment has higher efficacy than calcipotriol or betamethasone dipropionate alone. With regard to safety, two-compound calcipotriol\\/betamethasone dipropionate was shown to be suitable for intermittent long-term treatment of mild-to-moderate psoriasis. The findings of the Cochrane review are reflected in the current treatment guidelines from the USA and Germany regarding the treatment of mild-to-moderate psoriasis. In both these guidelines, which will be discussed in this article, the recommended treatments for this patient group are vitamin D analogues and corticosteroids, particularly when used in combination.

  11. Topical treatment of contact dermatitis by pine processionary caterpillar

    Science.gov (United States)

    Cuevas, Pedro; Angulo, Javier; Giménez-Gallego, Guillermo

    2011-01-01

    Skin contact dermatitis by pine processionary (Thaumetopoea pityocampa) is a public health problem of increasing significance. The authors present here the case of a 65-year-old man who was diagnosed with processionary caterpillar dermatitis. Patient was treated with topical potassium dobesilate 5% cream twice a day for 2 days. An improvement occurred soon after treatment. PMID:22688482

  12. Pentyl Gallate Nanoemulsions as Potential Topical Treatment of Herpes Labialis.

    Science.gov (United States)

    Kelmann, Regina G; Colombo, Mariana; De Araújo Lopes, Sávia Caldeira; Nunes, Ricardo J; Pistore, Morgana; Dall Agnol, Daniele; Rigotto, Caroline; Silva, Izabella Thais; Roman, Silvane S; Teixeira, Helder F; Oliveira Simões, Cláudia M; Koester, Letícia S

    2016-07-01

    Previous studies have demonstrated the antiherpes activity of pentyl gallate (PG), suggesting that it could be a promising candidate for the topical treatment of human herpes labialis. PG low aqueous solubility represents a major drawback to its incorporation in topical dosage forms. Hence, the feasibility of incorporating PG into nanoemulsions, the ability to penetrate the skin, to inhibit herpes simplex virus (HSV)-1 replication, and to cause dermal sensitization or toxicity were evaluated. Oil/water nanoemulsions containing 0.5% PG were prepared by spontaneous emulsification. The in vitro PG distribution into porcine ear skin after topical application of nanoemulsions was assessed, and the in vitro antiviral activity against HSV-1 replication was evaluated. Acute dermal toxicity and risk of dermal sensitization were evaluated in rat model. Nanoemulsions presented nanometric particle size (from 124.8 to 143.7 nm), high zeta potential (from -50.1 to -66.1 mV), loading efficiency above 99%, and adequate stability during 12 months. All formulations presented anti-HSV-1 activity. PG was able to reach deeper into the dermis more efficiently from the nanoemulsion F4. This formulation as well as PG were considered safe for topical use. Nanoemulsions seem to be a safe and effective approach for topically delivering PG in the treatment of human herpes labialis infection.

  13. Tavaborole topical solution, 5% for the treatment of toenail onychomycosis.

    Science.gov (United States)

    Zane, L T; Plattner, J; Chanda, S; Coronado, D; Merchant, T; Alley, M R K; Gupta, A K

    2015-10-01

    Tavaborole topical solution, 5% (tavaborole) is a novel, boron-based, antifungal pharmaceutical agent indicated for treatment of toenail onychomycosis due to the dermatophytes Trichophyton rubrum or Trichophyton mentagrophytes. In preclinical studies, tavaborole effectively penetrated through full-thickness, non-diseased cadaver fingernails, including those with up to four layers of nail polish. Limited systemic absorption was observed following topical application of tavaborole. In phase III clinical trials involving patients with distal subungual onychomycosis affecting 20-60% of a target great toenail, significantly more patients treated with tavaborole versus vehicle achieved completely clear nail with negative mycology following daily application for 48 weeks. Treatment-emergent adverse events reported by at least 1% of patients treated with tavaborole and at a greater frequency versus vehicle included ingrown toenail, exfoliation, erythema and dermatitis. Treatment discontinuations were uncommon. Results from preclinical studies and phase III clinical trials establish tavaborole as a safe and efficacious treatment for toenail onychomycosis.

  14. Review of Topical Treatment of Upper Tract Urothelial Carcinoma

    Directory of Open Access Journals (Sweden)

    Kenneth G. Nepple

    2009-01-01

    Full Text Available A select group of patients with upper tract urothelial carcinoma may be appropriate candidates for minimally invasive management. Organ-preserving endoscopic procedures may be appropriate for patients with an inability to tolerate major surgery, solitary kidney, bilateral disease, poor renal function, small tumor burden, low-grade disease, or carcinoma in situ. We review the published literature on the use of topical treatment for upper tract urothelial carcinoma and provide our approach to treatment in the office setting.

  15. TOPICAL BACTERIAL LYSATES IN PEDIATRIC CHRONIC TONSILLITIS TREATMENT

    Directory of Open Access Journals (Sweden)

    М.М. Polunin

    2011-01-01

    Full Text Available Chronic tonsillitis remains a current problem in pediatric health due to the risk of nonspecific systemic heart, renal and joint diseases. High social significance and prevalence among children call for effective preventive and treatment measures against this disease. Topical bacterial lysates recently have become popular among physicians as safe and effective component of tonsillitis treatment.Key words: chronical tonsillitis, childhood, bacterial lysates. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 176–178

  16. Iatrogenic Cushing's Syndrome Due to Topical Ocular Glucocorticoid Treatment.

    Science.gov (United States)

    Fukuhara, Daisuke; Takiura, Toshihiko; Keino, Hiroshi; Okada, Annabelle A; Yan, Kunimasa

    2017-02-01

    Iatrogenic Cushing's syndrome (CS) is a severe adverse effect of systemic glucocorticoid (GC) therapy in children, but is extremely rare in the setting of topical ocular GC therapy. In this article, we report the case of a 9-year-old girl suffering from idiopathic uveitis who developed CS due to topical ocular GC treatment. She was referred to the ophthalmology department with a complaint of painful eyes, at which time she was diagnosed with bilateral iridocyclitis and started on a treatment of betamethasone sodium phosphate eye drops. Six months after the initiation of topical ocular GC treatment, she was referred to our pediatric department with stunted growth, truncal obesity, purple skin striate, buffalo hump, and moon face. Because her serum cortisol and plasma adrenocorticotropic hormone levels were undetectable, she was diagnosed with iatrogenic CS. After the doses of topical ocular GC were reduced, the clinical symptoms of CS were improved. The fact that the amount of topical ocular GC with our patient was apparently less than that of similar previous cases tempted us to perform genetic analysis of her NR3C1 gene. We found that our patient had a single heterozygous nucleotide substitution in the 3' untranslated region of the NR3C1 gene, which may explain why she developed CS. However, additional investigations are required to determine if our findings can be extrapolated to other patients. In conclusion, clinicians should be aware that even extremely low doses of topical ocular steroid therapy can cause iatrogenic CS. Copyright © 2017 by the American Academy of Pediatrics.

  17. Topical tranexamic acid as a promising treatment for melasma

    Science.gov (United States)

    Ebrahimi, Bahareh; Naeini, Farahnaz Fatemi

    2014-01-01

    Background: In recent times, tranexamic acid (TA) is claimed to have whitening effects especially for ultraviolet-induced hyperpigmentation including melasma. The aim of our study was to evaluate the efficacy and safety of topical solution of TA and compare it with combined solution of hydroquinone and dexamethasone as the gold standard treatment of melasma in Iranian women. Materials and Methods: This was a double-blind split-face trial of 12 weeks which was conducted in Isfahan, Iran. Fifty Iranian melasma patients applied topical solution of 3% TA on one side of the face, and topical solution of 3% hydroquinone + 0.01% dexamethasone on the other side two times a day. The Melasma Area and Severity Index (MASI) and the side effects were evaluated at baseline and every 4 weeks before and after photographs to be compared by a dermatologist were taken. The patient satisfaction was documented at week 12. Results: A repeated measurement analysis was used to evaluate the changes in the MASI score before and after treatments. A significant decreasing trend was observed in the MASI score of both groups with no significant difference between them during the study (P < 0.05). No differences were seen in patients’ and investigator's satisfaction of melasma improvement between two groups (P < 0.05). However, the side effects of hydroquinone + dexamethasone were significantly prominent compared with TA (P = 0.01). Conclusion: This study's results introduce the topical TA as an effective and safe medication for the treatment of melasma. PMID:25422661

  18. Topical phenytoin for the treatment of neuropathic pain

    Directory of Open Access Journals (Sweden)

    Kopsky DJ

    2017-02-01

    Full Text Available David J Kopsky,1 Jan M Keppel Hesselink2 1Institute for Neuropathic Pain, Amsterdam, 2Institute for Neuropathic Pain, Bosch en Duin, the Netherlands Abstract: We developed and tested a new putative analgesic cream, based on the anticonvulsant phenytoin in patients suffering from treatment refractory neuropathic pain. The use of commercial topical analgesics is not widespread due to the facts that capsaicin creams or patches can give rise to side effects, such as burning, and analgesic patches (e.g., lidocaine 5% patches have complex handling, especially for geriatric patients. Only in a few countries, compounded creams based on tricyclic antidepressants or other (co-analgesics are available. Such topical analgesic creams, however, are easy to administer and have a low propensity for inducing side effects. We, therefore, developed a new topical cream based on 5% and 10% phenytoin and described three successfully treated patients suffering from neuropathic pain. All patients were refractory to a number of other analgesics. In all patients, phenytoin cream was effective in reducing pain completely, without any side effects, and the tolerability was excellent. The onset of action of the phenytoin creams was within 30 minutes. Phenytoin cream might become a new treatment modality of the treatment of neuropathic pain. Keywords: phenytoin, topical administration, neuropathic pain, diabetic neuropathy, chemotherapy-induced polyneuropathy, analgesia, drug repositioning

  19. Topical tacrolimus for the treatment of secondary lymphedema

    Science.gov (United States)

    Gardenier, Jason C.; Kataru, Raghu P.; Hespe, Geoffrey E.; Savetsky, Ira L.; Torrisi, Jeremy S.; Nores, Gabriela D. García; Jowhar, Dawit K.; Nitti, Matthew D.; Schofield, Ryan C.; Carlow, Dean C.; Mehrara, Babak J.

    2017-01-01

    Secondary lymphedema, a life-long complication of cancer treatment, currently has no cure. Lymphedema patients have decreased quality of life and recurrent infections with treatments limited to palliative measures. Accumulating evidence indicates that T cells play a key role in the pathology of lymphedema by promoting tissue fibrosis and inhibiting lymphangiogenesis. Here using mouse models, we show that topical therapy with tacrolimus, an anti-T-cell immunosuppressive drug, is highly effective in preventing lymphedema development and treating established lymphedema. This intervention markedly decreases swelling, T-cell infiltration and tissue fibrosis while significantly increasing formation of lymphatic collaterals with minimal systemic absorption. Animals treated with tacrolimus have markedly improved lymphatic function with increased collecting vessel contraction frequency and decreased dermal backflow. These results have profound implications for lymphedema treatment as topical tacrolimus is FDA-approved for other chronic skin conditions and has an established record of safety and tolerability. PMID:28186091

  20. Management of Ocular Surface Tumors: Excision vs. Topical Treatment

    Directory of Open Access Journals (Sweden)

    Sotiria Palioura

    2014-10-01

    Full Text Available Ocular surface squamous neoplasia (OSSN encompasses a range of corneal and conjunctival lesions from intraepithelial dysplasia to invasive squamous cell carcinoma. The mainstay of treatment for OSSN has traditionally been surgical excision with wide margins and cryotherapy. Increasing evidence on the efficacy and safety of medical therapy and the avoidance of surgical complications has made topical chemotherapy increasingly popular among corneal specialists. The most common topical agents used for the treatment of OSSN include mitomycin C, 5-fluorouracil, and interferon a 2b. Herein, we review recent advances in the surgical and medical management of OSSN and discuss advantages and disadvantages of each approach. The role of ultra highresolution optical coherence tomography in the diagnosis and treatment of primary and recurrent OSSN lesions is also discussed.

  1. Therapeutic agents and herbs in topical application for acne treatment.

    Science.gov (United States)

    Kanlayavattanakul, M; Lourith, N

    2011-08-01

    Acne vulgaris suppresses an individual's self-confidence by causing distress with regard to physical appearance, which affects a significant number of individuals during puberty and is delineated by adolescence. Several treatments have been introduced to decrease the aesthetic and psychological problems caused by acne. The topical application of therapeutic agents has been found to be more feasible than hormonal treatment and laser therapy. The ingredients in topical acne treatments, particularly herbs and naturally derived compounds, have received considerable interest as they have fewer adverse effects than synthetic agents. © 2011 The Authors. ICS © 2011 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  2. Topical sirolimus for the treatment of angiofibromas in tuberous sclerosis

    Directory of Open Access Journals (Sweden)

    Salih Levent Cinar

    2017-01-01

    Full Text Available Background: The skin is one of the most affected organs in tuberous sclerosis complex and angiofibromas are seen in almost 80% of such patients. These benign tumors impose a great psycho-social burden on patients. Objective: The aim of the study was to evaluate the effectiveness and tolerability of topical sirolimus for facial angiofibromas in patients with tuberous sclerosis complex. Methods: This was a prospective, single-blinded, cross-over study which involved twelve patients. We investigated the effect and safety of topical 0.1% sirolimus, which was obtained by crushing sirolimus tablets and mixing it with petrolatum. The patients were asked to apply the cream to one side of their face, and vaseline to the other side. The effect of topical sirolimus was evaluated using the “facial angiofibroma severity index.” Results: There was a significant improvement in the redness and extension of the tumors on the sides to which the active ingredient was applied. Some side effects such as itching and irritation occurred in three patients, which were treated with topical hydrocortisone cream. Conclusion: Topical sirolimus appears to be a promising, fairly well tolerated treatment for facial angiofibromas in patients with tuberous sclerosis complex. Although its efficacy diminishes with time, repetitive usage is effective.

  3. The morphology of conjunctiva after long-term antiglaucoma topical treatment

    DEFF Research Database (Denmark)

    Baun, Ole; Heegaard, Steffen; Prause, J.U.

    1995-01-01

    Glaucoma, topical anti-glaucoma treatment, long-term treatment, conjunctival changes, morphological changes......Glaucoma, topical anti-glaucoma treatment, long-term treatment, conjunctival changes, morphological changes...

  4. Topical phenytoin for the treatment of neuropathic pain

    OpenAIRE

    Kopsky,David; Keppel Hesselink, Jan

    2017-01-01

    David J Kopsky,1 Jan M Keppel Hesselink2 1Institute for Neuropathic Pain, Amsterdam, 2Institute for Neuropathic Pain, Bosch en Duin, the Netherlands Abstract: We developed and tested a new putative analgesic cream, based on the anticonvulsant phenytoin in patients suffering from treatment refractory neuropathic pain. The use of commercial topical analgesics is not widespread due to the facts that capsaicin creams or patches can give rise to side effects, such as burning, and analgesic patches...

  5. Topical phenytoin for the treatment of neuropathic pain

    Science.gov (United States)

    Kopsky, David J; Keppel Hesselink, Jan M

    2017-01-01

    We developed and tested a new putative analgesic cream, based on the anticonvulsant phenytoin in patients suffering from treatment refractory neuropathic pain. The use of commercial topical analgesics is not widespread due to the facts that capsaicin creams or patches can give rise to side effects, such as burning, and analgesic patches (e.g., lidocaine 5% patches) have complex handling, especially for geriatric patients. Only in a few countries, compounded creams based on tricyclic antidepressants or other (co-)analgesics are available. Such topical analgesic creams, however, are easy to administer and have a low propensity for inducing side effects. We, therefore, developed a new topical cream based on 5% and 10% phenytoin and described three successfully treated patients suffering from neuropathic pain. All patients were refractory to a number of other analgesics. In all patients, phenytoin cream was effective in reducing pain completely, without any side effects, and the tolerability was excellent. The onset of action of the phenytoin creams was within 30 minutes. Phenytoin cream might become a new treatment modality of the treatment of neuropathic pain. PMID:28280381

  6. Monitoring blood flow and photobleaching during topical ALA PDT treatment

    Science.gov (United States)

    Sands, Theresa L.; Sunar, Ulas; Foster, Thomas H.; Oseroff, Allan R.

    2009-02-01

    Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) is currently used as a clinical treatment for nonmelanoma skin cancers. In order to optimize PDT treatment, vascular shutdown early in treatment must be identified and prevented. This is especially important for topical ALA PDT where vascular shutdown is only temporary and is not a primary method of cell death. Shutdown in vasculature would limit the delivery of oxygen which is necessary for effective PDT treatment. Diffuse correlation spectroscopy (DCS) was used to monitor relative blood flow changes in Balb/C mice undergoing PDT at fluence rates of 10mW/cm2 and 75mW/cm2 for colon-26 tumors implanted intradermally. DCS is a preferable method to monitor the blood flow during PDT of lesions due to its ability to be used noninvasively throughout treatment, returning data from differing depths of tissue. Photobleaching of the photosensitizer was also monitored during treatment as an indirect manner of monitoring singlet oxygen production. In this paper, we show the conditions that cause vascular shutdown in our tumor model and its effects on the photobleaching rate.

  7. Topical treatments of skin pain: a general review with a focus on hidradenitis suppurativa with topical agents.

    Science.gov (United States)

    Scheinfeld, Noah

    2014-07-15

    Hidradenitis Supprurativa (HS) is a painful chronic follicular disease. Few papers have addressed pain control for this debilitating condition. Possible topical agents include tricyclic antidepressants, opioids, anticonvulsants, NSAIDs, NMDA receptor antagonists, local anesthetics and other agents. The first line agents for the topical treatment of the cutaneous pain of HS are diclonefac gel 1% and liposomal xylocaine 4% and 5% cream or 5% ointment. The chief advantage of topical xylocaine is that is quick acting i.e. immediate however with a limited duration of effect 1-2 hours. The use of topical ketamine, which blocks n-methyl-D-aspartate receptors in a non-competitive fashion, might be a useful tool for the treatment of HS pain. Topical doxepin, which available in a 5% commercially preparation (Zonalon®) , makes patients drowsy and is not useful for controlling the pain of HS . Doxepin is available in a 3% or 3.3% concentration (which causes less drowsiness) from compounding pharmacies and can be used in compounded analgesic preparations with positive effect. Topical doxepin is preferred over use of topical amitriptyline because topical doxepin is more effective. Nevertheless, topical amitriptyline increase of the tactile and mechanical nociceptive thresholds and can be used for topical pain control in compound mixture of analgesics . Gabapentin and pregablin can also be used compounded with other agents in topical analgesic preparations with positive topical anesthetic effect. Capsaicin is not useful for topical treatment of the pain of HS. Sometimes compounded of anesthetics medications such as ketamine 10%, bupivacaine 1%, diclofenac 3%, doxepin 3% or 3.3%, and gabapentin 6% can extend the duration of effect so that medication only needs to be used 2 or 3 times a day. Still in my experience the easiest to get and most patient requested agent is topical diclonefac 1% gel.

  8. Topical tranexamic acid as a promising treatment for melasma

    Directory of Open Access Journals (Sweden)

    Bahareh Ebrahimi

    2014-01-01

    Full Text Available Background: In recent times, tranexamic acid (TA is claimed to have whitening effects especially for ultraviolet-induced hyperpigmentation including melasma. The aim of our study was to evaluate the efficacy and safety of topical solution of TA and compare it with combined solution of hydroquinone and dexamethasone as the gold standard treatment of melasma in Iranian women. Materials and Methods: This was a double-blind split-face trial of 12 weeks which was conducted in Isfahan, Iran. Fifty Iranian melasma patients applied topical solution of 3% TA on one side of the face, and topical solution of 3% hydroquinone + 0.01% dexamethasone on the other side two times a day. The Melasma Area and Severity Index (MASI and the side effects were evaluated at baseline and every 4 weeks before and after photographs to be compared by a dermatologist were taken. The patient satisfaction was documented at week 12. Results: A repeated measurement analysis was used to evaluate the changes in the MASI score before and after treatments. A significant decreasing trend was observed in the MASI score of both groups with no significant difference between them during the study (P < 0.05. No differences were seen in patients′ and investigator′s satisfaction of melasma improvement between two groups (P < 0.05. However, the side effects of hydroquinone + dexamethasone were significantly prominent compared with TA (P = 0.01. Conclusion: This study′s results introduce the topical TA as an effective and safe medication for the treatment of melasma.

  9. Topical vitamin A treatment of recalcitrant common warts

    Directory of Open Access Journals (Sweden)

    Gaston Anca

    2012-01-01

    Full Text Available Abstract Background Common warts (verruca vulgaris are benign epithelial proliferations associated with human papillomavirus (HPV infection. Salicylic acid and cryotherapy are the most frequent treatments for common warts, but can be painful and cause scarring, and have high failure and recrudescence rates. Topical vitamin A has been shown to be a successful treatment of common warts in prior informal studies. Case The subject is a healthy, physically-active 30 old female with a 9 year history of common warts on the back of the right hand. The warts resisted treatment with salicylic acid, apple cider vinegar and an over-the-counter blend of essential oils marketed for the treatment of warts. Daily topical application of natural vitamin A derived from fish liver oil (25,000 IU led to replacement of all the warts with normal skin. Most of the smaller warts had been replaced by 70 days. A large wart on the middle knuckle required 6 months of vitamin A treatment to resolve completely. Conclusion Retinoids should be further investigated in controlled studies to determine their effectiveness in treating common warts and the broad range of other benign and cancerous lesions induced by HPVs.

  10. Topical vitamin A treatment of recalcitrant common warts.

    Science.gov (United States)

    Gaston, Anca; Garry, Robert F

    2012-01-17

    Common warts (verruca vulgaris) are benign epithelial proliferations associated with human papillomavirus (HPV) infection. Salicylic acid and cryotherapy are the most frequent treatments for common warts, but can be painful and cause scarring, and have high failure and recrudescence rates. Topical vitamin A has been shown to be a successful treatment of common warts in prior informal studies. The subject is a healthy, physically-active 30 old female with a 9 year history of common warts on the back of the right hand. The warts resisted treatment with salicylic acid, apple cider vinegar and an over-the-counter blend of essential oils marketed for the treatment of warts. Daily topical application of natural vitamin A derived from fish liver oil (25,000 IU) led to replacement of all the warts with normal skin. Most of the smaller warts had been replaced by 70 days. A large wart on the middle knuckle required 6 months of vitamin A treatment to resolve completely. Retinoids should be further investigated in controlled studies to determine their effectiveness in treating common warts and the broad range of other benign and cancerous lesions induced by HPVs.

  11. Topical Treatment of Dermatophytic Lesion on Mice (Mus musculus) Model.

    Science.gov (United States)

    Sharma, Bindu; Kumar, Padma; Joshi, Suresh Chandra

    2011-06-01

    Antidermatophytic potential of three weed plants viz. Tridax procumbens L., Capparis decidua (forsk) Edgew and Lantana camara L. were explored and experimentally induced dermatophytic lesion was topically treated in mice. Microbroth dilution method was carried out for determination of MIC and MFC of different extracts of selected plants. In animal studies, mice were experimentally inoculated with Trichophyton mentagrophytes and infected animals were topically treated with 5 mg/g terbinafine and two concentrations, i.e., 5 and 10 mg/g of test extract ointment. Complete recovery from the infection was observed on 12th day of treatment for reference drug terbinafine (5 mg/g) and 10 mg/g concentration of test extract ointment whereas 5 mg/g concentration of test extract ointment showed complete cure on 16th day of treatment. Fungal burden was also calculated by culturing skin scrapings from infected animals of different groups. Test extract ointment successfully treated induced dermatophytosis in mice without any disease recurrence incidences, thereby indicating efficacy of test extract as an excellent topical antifungal agent for the cure of dermatophytosis.

  12. Successful treatment of hydroquinone-resistant melasma using topical methimazole.

    Science.gov (United States)

    Malek, Joelle; Chedraoui, Adele; Nikolic, Damian; Barouti, Neda; Ghosn, Samer; Abbas, Ossama

    2013-01-01

    Melasma is an acquired hyperpigmentation skin disorder in sun-exposed areas. It occurs almost exclusively over the face, and is most commonly seen in women. Several depigmenting agents have been used for the treatment of melasma among which hydroquinone has been the most widely used due to its efficacy and safety in short-term use. However, hydroquinone is recently reported to be a cytotoxic and mutagenic compound in mammalian cells and is thus banned in several countries. Hydroquinone ban has caused investigators to search for alternative depigmenting agents for the treatment of melasma in recent years. Methimazole is an antithyroid agent orally used in humans since several decades and has been shown that when applied topically, it inhibits melanin synthesis and causes skin depigmentation in lab animals as well as human subjects. Herein, we report two hydroquinone-resistant melasma patients who were successfully treated with methimazole cream. Application of 5% methimazole cream once daily resulted in significant improvement of melasma in both patients after 8 weeks. The efficacy of methimazole for melasma treatment as well as its advantages over other known depigmenting compounds (non-mutagenicity, non-cytotoxicity and high tolerability profile) suggests that topical methimazole should be added to the armamentarium of anti-melasma treatment.

  13. NVC-422 topical gel for the treatment of impetigo.

    Science.gov (United States)

    Iovino, Susan M; Krantz, Kenneth D; Blanco, Daisy M; Fernández, Josefina A; Ocampo, Naomi; Najafi, Azar; Memarzadeh, Bahram; Celeri, Chris; Debabov, Dmitri; Khosrovi, Behzad; Anderson, Mark

    2011-08-15

    Impetigo is a highly contagious bacterial skin infection affecting children worldwide that is caused by the Gram-positive bacteria Staphylococcus aureus, Streptococcus pyogenes, or both. Staphylococcus species can quickly develop drug resistance rendering mupirocin, fusidic acid, and erythromycin ineffective. Preclinical and clinical studies demonstrated that NVC-422 (N, N-dichloro-2, 2-dimethyltaurine) rapidly kills pathogens without the development of drug resistance. 129 patients with clinically diagnosed impetigo were randomized to three dose groups (0.1, 0.5, or 1.5% NVC-422 topical gel) in a study conducted at 2 centers; 125 patients (97%) had microbiologically confirmed infection. Treatment was administered three times a day (TID) for 7 days to all randomized subjects. Response was measured at the completion of treatment (Day 8) and 1 week post treatment (Day 15) by the Skin Infection Rating Scale (SIRS) and by microbiological response. A total of 120 subjects (96%) completed all 7 days of treatment and were assessed at end of treatment (EOT). Clinical response rate at EOT in the PPC population was excellent in each of the dose groups (84.6%, 87.2%, and 92.3% in the 0.1%, 0.5% and 1.5% dose groups respectively). The majority of the infections were caused by S. aureus, alone (106/125, 85%) of which approximately 10% were MRSA. There were no clinical recurrences in any treatment groups. Treatment-emergent adverse events were seen in 5.4% of the subjects (7/129) and were mild to moderate and resolved. NVC-422 topical gel administered TID was well tolerated, with high rates of clinical and microbiological responses for treating impetigo.

  14. Systemic vs. Topical Therapy for the Treatment of Vulvovaginal Candidiasis

    Directory of Open Access Journals (Sweden)

    Sebastian Faro

    1994-01-01

    Full Text Available It is estimated that 75% of all women will experience at least 1 episode of vulvovaginal candidiasis (VVC during their lifetimes. Most patients with acute VVC can be treated with short-term regimens that optimize compliance. Since current topical and oral antifungals have shown comparably high efficacy rates, other issues should be considered in determining the most appropriate therapy. It is possible that the use of short-duration narrow-spectrum agents may increase selection of more resistant organisms which will result in an increase of recurrent VVC (RVVC. Women who are known or suspected to be pregnant and women of childbearing age who are not using a reliable means of contraception should receive topical therapy, as should those who are breast-feeding or receiving drugs that can interact with an oral azole and those who have previously experienced adverse effects during azole therapy. Because of the potential risks associated with systemic treatment, topical therapy with a broad-spectrum agent should be the method of choice for VVC, whereas systemic therapy should be reserved for either RVVC or cases where the benefits outweigh any possible adverse reactions.

  15. Topical minoxidil in the treatment of male erectile dysfunction.

    Science.gov (United States)

    Radomski, S B; Herschorn, S; Rangaswamy, S

    1994-05-01

    Topically applied 2% minoxidil solution has been reported to increase diameter, rigidity and arterial flow to the penis. As a result it has been suggested as a possible treatment for erectile dysfunction. A total of 21 patients received 2% minoxidil for treatment of erectile dysfunction with instructions to apply 1 cc of the solution slowly over the glans penis 20 minutes before intercourse. Average patient age was 52.5 years (range 29 to 65 years). The etiology of the impotence was neurogenic in 8 patients, vascular in 7, psychogenic in 4 and other causes in 2. Two patients also had clinical evidence of venous incompetence and 4 were diabetics. One patient with psychogenic impotence noticed improvement in the duration of erection but no increase in rigidity or size after minoxidil application. One patient with impotence after excision of a Peyronie's plaque reported a rigid erection adequate for intercourse after using minoxidil. This patient subsequently was able to achieve erections without using minoxidil. The remaining 19 patients had no improvement in erectile rigidity, or the ability to obtain or maintain an erection. One patient did notice some mild burning on the glans penis after applying the minoxidil. No other side effects were noted in any patient. These results indicate that 2% topical minoxidil solution is not effective when applied to the penis in the treatment of erectile dysfunction. It is possible that a higher concentration, a different delivery medium or a different chemical composition may yield better results.

  16. Topical alprostadil cream for the treatment of erectile dysfunction.

    Science.gov (United States)

    Becher, Edgardo

    2004-03-01

    Erectile dysfunction (ED) has serious negative consequences on both sexual experience and emotional well being and affects a broad range of age groups. The prevalence of ED is associated with increasing age and has been reported to be as high as 70%. Although the disorder is common and underdiagnosed, its treatment can significantly improve patients' quality of life. Systemic treatment with oral phosphodiesterase type-5 (PDE-5) inhibitors is the current standard of care for patients with ED. Some patients, however, have absolute contraindications for PDE-5 inhibitors. In addition, these agents can be associated with adverse effects. Furthermore, because PDE-5 inhibitors are not as effective in patients who have undergone radical prostatectomy or who have severe vascular disease, a substantial unmet medical need exists among patients who have ED as a result of these conditions. Consequently, PDE-5 inhibitor therapy is associated with a high rate of discontinuation, as are intracavernosal or transurethral therapies, which are inconvenient and invasive. Several studies, including four double-blind, placebo-controlled, Phase II trials, show that alprostadil topical cream is efficacious and well-tolerated in ED in patients with mild-to-severe symptoms, in those undergoing treatment for cardiovascular diseases and diabetes and in otherwise healthy ED patients. Thus, alprostadil topical cream is a potential first-choice alternative for ED in patients who do not respond or who cannot tolerate or do not accept PDE-5 inhibitor therapy.

  17. Treatment of phimosis with topical steroids and foreskin anatomy

    Directory of Open Access Journals (Sweden)

    Tatiana C. Marques

    2005-08-01

    Full Text Available OBJECTIVES: To correlate topical steroidal treatment of stenosed foreskin with the different degrees of glans exposure and the length of time the ointment is applied. MATERIALS AND METHODS: We studied 95 patients with phimosis, divided according to the degree of foreskin retraction. Group A presented no foreskin retraction, group B presented exposure of only the urethral meatus, group C presented exposure of half of the glans, and group D presented exposure of the glans, which was incomplete because of preputial adherences to the coronal sulcus. Patients were submitted to application of 0.05% betamethasone ointment on the distal aspect of the prepuce twice daily for a minimum of 30 days and a maximum of 4 months. RESULTS: Of 95 patients, 10 (10.52% abandoned the treatment and 15 patients in groups C and D were excluded from the study. Among the remaining 70 patients, only 4 patients (5.7% in group A did not obtain adequate glans exposure after treatment. In group A (38 patients, fully retractable foreskins were obtained in 19 patients (50% after 1 month of treatment. In group B (28 patients, fully retractable foreskins were obtained in 18 patients (64.2% after 1 month. CONCLUSIONS: Treatment was successful in 94.2% of patients, irrespective of the type of foreskin anatomy. The improvement may require several months of treatment. Patients with impossibility of urethral meatus exposure present around 10% treatment failure.

  18. Efficacy of Topical Anesthetics in the Treatment of Ingrown Nail

    Directory of Open Access Journals (Sweden)

    Fatma Gülru Erdoğan

    2011-06-01

    Full Text Available Background and Design: One of the reasons for preferring conservative methods for ingrown nails is lack of local anesthesia for the painful step. Moreover, ingrown nail is a painful condition per se. It may be very difficult to intervene patients with high basal pain levels. Here, we aimed to assess the efficacy of topical anesthetics (2.5% lidocaine, 2.5% prilocaine mixture and 20% benzocaine gel by determining basal pain level and pain during and after manipulation in patients with severe pain who applied with ingrown nail complaint.Material and Method: In this study, we included a total of 29 patients (12 male, 17 female who had complaint of ingrown nail and for whom nail brace treatment was planned. The patients were divided randomly into two groups regardless of the stage of ingrown nail: with lidocain-prilocain mixture application and with benzocaine gel application. Benzocaine gel was applied 10 minutes before the procedure and lidocaine-prilocaine mixture was applied under occlusion, 2 hours prior to the procedure. Pain levels were evaluated on a numerical pain rating scale before and after topical anesthesia as well as during and half an hour after the procedure in both groups.Results: Statistical difference was not detected between the pain levels of the two groups before and after topical anesthesia and during and half an hour after the procedure. Regardless of the stage of ingrown nail, the pain levels after topical anesthesia and half an hour after procedure were found to decrease significantly compared to the levels before topical anesthesia in both groups. Pain levels of both groups increased during the procedure and were similar to the basal levels. Considering the stage of ingrown nail, while lidocaine-prilocaine mixture did not decrease pain significantly in the cases with stage 2-3, benzocaine did. Conclusion: Due to ease of application and especially to efficacy in stage 2-3 ingrown nails, 20% benzocaine gel may help in

  19. Culture-directed topical antibiotic treatment for chronic rhinosinusitis

    Science.gov (United States)

    Davis, Greg E.

    2016-01-01

    Background: Topical antibiotics, delivered optimally as high-volume culture-directed sinus irrigations, are being increasingly used for recalcitrant chronic rhinosinusitis (CRS). Their impact on subjective and objective outcome measures, however, is still unclear. Objective: To assess if the use of topical antibiotics in recalcitrant CRS is associated with improved 20-Item Sino-Nasal Outcome Test and Lund-Kennedy endoscopic scores, and to determine the negative posttreatment culture “control” rate. Methods: Patients were included in the study if they met diagnostic criteria for CRS, received high-volume topical antibiotic sinus irrigations twice daily for 1 month, between December 2009 and May 2015, and had undergone endoscopic sinus surgery. The primary outcome was the 20-Item Sino-Nasal Outcome Test score. Secondary outcomes were the Lund-Kennedy endoscopic score and a negative posttreatment culture “control” rate. Paired t-tests were used to compare pre- and posttreatment scores. Patients with cystic fibrosis were analyzed separately. Results: Of the 58 patients included, 47% had nasal polyposis, 57% had asthma, 16% had aspirin sensitivity, and 55% had environmental allergies. The median Lund-Mackay computed tomography score was 11 (interquartile range, 6–16), and the median time to follow-up was 8 weeks (interquartile range, 6–10 weeks). The 20-Item Sino-Nasal Outcome Test scores improved from pre- to posttreatment period, although this was not significant mean 1.5 [confidence interval {CI} 1.3, 1.7] to mean 1.3 [CI 1.1, 1.6]; p = 0.16). Lund-Kennedy endoscopic scores, however, significantly improved from pre- to posttreatment (mean 4.9 [CI 4.3, 5.6] to mean 4.1 [CI 3.5, 4.7]; p = 0.05). Of the 47 patients with complete culture data, 72% had negative posttreatment culture results, defined as “controlled.” Only one patient discontinued treatment, related to discomfort from irrigations. Conclusion: In patients with recalcitrant CRS, the use of

  20. Topical erythromycin-zinc acetate complex lotion versus topical erythromycin gel in treatment of mild to moderate acne vulgaris

    Directory of Open Access Journals (Sweden)

    Hayder R. Al-Hamamy

    2014-10-01

    Full Text Available Introduction: Topical antibiotics are the main step in the treatment of mild to moderate acne vulgaris. Erythromycin is one of the effective topical therapies for this disease. Zinc sulfate 5% solution was reported to be effective in treatment of acne vulgaris and rosacea. Aim: To compare the effectiveness and side effects of topical erythromycin in combination with zinc and erythromycin alone in treatment of mild to moderate acne vulgaris. Material and Methods: This single, blind, therapeutic, comparative study was done in the Department of Dermatology – Baghdad Teaching Hospital, Baghdad, Iraq; from May 2012 – August 2013.Scoring of acne was carried out and the patients were examined every two weeks for 10 weeks of treatment. One month after stopping drugs, patients were evaluated for drug complications and disease recurrence. Eighty patients fulfilling enrollment criteria were included in this study. Patients were divided into two groups: Group A (40 patients treated twice daily with topical erythromycin-zinc complex lotion and Group B (40 patients treated twice daily with topical 2% erythromycin gel. Results: Both topical erythromycin-zinc lotion and erythromycin gel were statistically an effective therapy starting after 6 weeks treatment and up to 4 weeks after stopping treatment. Erythromycin-zinc lotion was more effective and act earlier than erythromycin gel starting from 4 weeks of therapy till the end of treatment (after 10 week and even after 4 weeks after stopping the treatment (p value <0.0001. Conclusions: Erythromycin-zinc complex lotion was an effective and well tolerated topical therapy for mild to moderate inflammatory acne vulgaris and was more effective than erythromycin gel alone.

  1. Topical treatment with propranolol gel as a supplement to the existing treatment of hemangiomas

    Institute of Scientific and Technical Information of China (English)

    Markus Schneider; Andreas Reimer; Hansjoerg Cremer; Peter Ruef

    2014-01-01

    Background: Systemic treatment with propranolol is proven to be effective for patients with hemangiomas with less side-effect. We used a propranolol gel for topical use on hemangiomas. Methods: In this retrospective study, we analyzed 148 patients who had been treated topically with propranolol gel for 12 weeks. We analyzed the data of patients and clinically gave each hemangioma a "hemangioma score" to determine the treatment success. Results: In 147 of the 148 patients, strong signs of resolution under treatment included lightening, paling, and less vascularization. The hemangioma score showed a signifi cant decrease during the treatment. Relevant serum levels of propranolol were not found. Adverse effects were rare and not related to propranolol. Conclusion: Topical treatment with propranolol gel is suitable for specific hemangiomas in addition to cryotherapy and systemic treatment with propranolol.

  2. Topical treatment (part two: Vehicles, nature and functions

    Directory of Open Access Journals (Sweden)

    Ertuğrul H. Aydemir

    2012-12-01

    Full Text Available Vehicles of topical medicines support the treatment with their physical effects, in addition to their carrying function. Different types of vehicles are composed of various mixtures of three main elements: water (hydrophilic bases, oil and powder. If a vehicle includes only one element, it is called monophasic, if two, biphasic, and if more than two, then it is termed polyphasic. According to the type of utilization, they may be classified as “liquids, semisolids and solids”. Liquids are solutions (monophasic-hydrophilic, colloids (in classic type monophasic, suspensions (biphasic, liquid oils (monophasic, liniments (biphasic and liquid emulsions (W/O-O/W. Semisolids including creams, ointments (pomades, pastes, foams and seras is the most commonly used group. All semisolids are biphasic or polyphasic except for some ointments which are pure semisolid oil (such as petrolatum. The group of solids includes only powders which are very bad vehicle and used only for prophylaxis.

  3. Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch

    OpenAIRE

    Lionberger, David R; Brennan, Michael J.

    2010-01-01

    David R Lionberger1, Michael J Brennan21Southwest Orthopedic Group, Houston, TX, USA; 2Department of Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP) in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs), diclofenac, and DETP in patients with ac...

  4. Costs of topical treatment of pressure ulcer patients

    Directory of Open Access Journals (Sweden)

    Cynthia Carolina Duarte Andrade

    2016-04-01

    Full Text Available Abstract OBJECTIVE To evaluate the costs of a topical treatment of pressure ulcer (PU patients in a hospital unit for treatment of chronic patients in 2014. METHOD This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. RESULTS Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources. Dressings applied in sacral PUs had longer application times. CONCLUSION This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies.

  5. Geologic constraints on the macroevolutionary history of marine animals.

    Science.gov (United States)

    Peters, Shanan E

    2005-08-30

    The causes of mass extinctions and the nature of taxonomic radiations are central questions in paleobiology. Several episodes of taxonomic turnover in the fossil record, particularly the major mass extinctions, are generally thought to transcend known biases in the geologic record and are widely interpreted as distinct macroevolutionary phenomena that require unique forcing mechanisms. Here, by using a previously undescribed compilation of the durations of sedimentary rock sequences, I compare the rates of expansion and truncation of preserved marine sedimentary basins to rates of origination and extinction among Phanerozoic marine animal genera. Many features of the highly variable record of taxonomic first and last occurrences in the marine animal fossil record, including the major mass extinctions, the frequency distribution of genus longevities, and short- and long-term patterns of genus diversity, can be predicted on the basis of the temporal continuity and quantity of preserved sedimentary rock. Although these results suggest that geologically mediated sampling biases have distorted macroevolutionary patterns in the fossil record, preservation biases alone cannot easily explain the extent to which the sedimentary record duplicates paleobiological patterns. Instead, these results suggest that the processes responsible for producing variability in the sedimentary rock record, such as plate tectonics and sea-level change, may have been dominant and consistent macroevolutionary forces throughout the Phanerozoic.

  6. Effectiveness and safety of topical tacrolimus in treatment of vitiligo

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    Ghasem Rahmatpour Rokni

    2017-01-01

    Full Text Available Vitiligo is one of the most primitive well-known dermatoid disorders with different suggested therapies. Therefore, this study investigated the efficiency and safety of topical tacrolimus in treatment of patients with vitiligo. This study was a clinical randomized designed study pre- post-test method, has been conducted on thirty cases with vitiligo who have referred to polyclinic and dermatology clinic. Participant′s evaluated and demographic information recorded in designed checklist. In the next stage, the disease activity scored by vitiligo index disease activity system. Photography and depigmentation percent has recorded before treatment and further in 4 th , 8 th , 12 th , 16 th , 20 th , and 24 th weeks. Finally, gathered data compared through SPSS-20 software. The final sample comprised 30 persons including: 12 men (40% and 18 women (60%. The average of patient′s age in this study was 26/13 ΁ 18/20 (2-76-year-old. Eleven persons was ≤15 years old and rest was older than 15. Sixty-six lesions have funded in patients that maximum has accrued on face and neck (37/87% and trunk (21/21%. In addition, minimum of lesions is related to genitalia (9/09%. In the in 4 th , 8 th , 12 th , 16 th weeks, improvement in face and neck had increased significantly, into the past weeks. In the 20 th and 24 th weeks, the improvement has increased although it was not significant enhancement. Also about trunk, in the 4 th week the improvement does not have significant increasing in compare to the past week. In the eighth, 12 th , 16 th , 20 th , and 24 th weeks the improvement has been increased significantly in compare to the past weeks. Although in the case of limbs and genitalia, the improvement was lower. There was no significant difference between male and females and age. Although the improvement was, slow in older persons. Study results, has presented applying topical tacrolimus in vitiligo, particularly in face and neck, could be effective and

  7. Treatment of cutaneous tumors with topical 5% imiquimod cream

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    Sabrina Sisto Alessi

    2009-01-01

    Full Text Available INTRODUCTION: There are various approaches to the treatment of cutaneous tumors; one of them is treatment with imiquimod, a synthetic toll-like receptor agonist with a low molecular weight that offers a topical, noninvasive, and non-surgical therapeutic option. The main objective of our study was to provide data on 89 patients who used a 5% imiquimod cream for the treatment of cutaneous tumors at the Cutaneous Oncology Group of the Dermatology Department of Hospital das Clinicas from 2003 to 2008. MATERIALS AND METHODS: Here, we present our experience in the treatment of 123 cutaneous tumors of various types, including basal cell carcinoma (BCC, squamous cell carcinoma (SCC, Bowen's disease, erythroplasia of Queyrat, Paget's disease, and trichoepithelioma, with 5% imiquimod cream from 2003 to 2008 in the Cutaneous Oncology Group of the Dermatology Department of Hospital das Clinicas. Patients were divided into two separate groups according to their diagnosis and comorbidities; these comorbidities included epidermodysplasia verruciformis, xeroderma pigmentosum, albinism, basal cell nevus syndrome, Brooke-Spiegler syndrome, HIV, chronic lymphocytic leukemia, B-cell lymphoma, and kidney transplantation. Treatment duration, response to imiquimod, follow-up, recurrence, and local and systemic reactions associated with use of the drug were analyzed. Epidemiological data were obtained and cure rates were calculated. RESULTS: The ratio of women to men was 1.28:1, and the mean age was 63.1 years. Tumors were located mainly on the face, back, trunk, and legs. For patients with comorbidities, the overall cure rate was 38%. These specific patients demonstrated cure rates of 83.5% for superficial BCC and 50% for Bowen's disease. Aggressive BCC and superficial and nodular BCC did not present a good response to treatment. Trichoepitheliomas and nodular BCC showed a partial response, and erythroplasia of Queyrat showed a complete response. For patients without

  8. An innovative approach to the topical treatment of acne

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    Sparavigna A

    2015-04-01

    Full Text Available Adele Sparavigna, Beatrice Tenconi, Ileana De Ponti, Laura La PennaDermIng srl, Clinical Research and Bioengineering Institute, Monza, MB, ItalyAbstract: Acne is characterized by primary lesions on the face, chest, and back, and by a variety of other signs and symptoms. In particular, acne inflammatory lesions result from Propionibacterium acnes colonization and are of particular relevance as they can cause permanent scarring. Acne also causes significant psychological morbidity in affected patients. Products currently available for the treatment of acne include systemic and topical treatments. As these products can cause severe side effects, new, innovative therapies are needed. Farmaka Acne Cream (FAC is a novel, film-forming cream developed to treat mild and moderate acne. In vitro studies have demonstrated that FAC is as effective as 5% benzoyl peroxide in inhibiting growth of P. acnes. In 32 subjects with mild or moderate acne, FAC reduced all the major signs and symptoms of the disease. These included itching, erythema, and scaling, as well as reductions in the numbers of papules, pustules, and open and closed comedones. Acne severity improved in 38% of subjects, while none worsened. FAC was found to be effective in controlling sebum secretion, and was non-comedogenic. Most subjects (90% reported tolerability as good or very good, while clinical efficacy and cosmetic acceptability were judged as good. For assessment of contact sensitization and photosensitization, FAC was applied daily to the backs of 29 subjects in two symmetric areas for 10 days. Using a solar stimulator, one minimal erythema dose was delivered to one side of the back from days 11 to 13. The four different subareas of treated/untreated and irradiated/nonirradiated and combinations thereof were compared. No cases of contact sensitization or photosensitization were observed, and FAC is considered safe for use in intense sunlight. In vitro and in vivo studies provide

  9. Costs of topical treatment of pressure ulcer patients.

    Science.gov (United States)

    Andrade, Cynthia Carolina Duarte; Almeida, Cláudia Fernanda Dos Santos Calixto de; Pereira, Walkíria Euzébio; Alemão, Márcia Mascarenhas; Brandão, Cristina Mariano Ruas; Borges, Eline Lima

    2016-04-01

    To evaluate the costs of a topical treatment of pressure ulcer (PU) patients in a hospital unit for treatment of chronic patients in 2014. This is an activity-based costing study. This method encompasses the identification, measurement and pricing of physical and human resources consumed for dressings. Procedure costs varied between BRL 16.41 and BRL 260.18. For PUs of the same category, of near areas and with the same type of barrier/adjuvant, the cost varied between 3.5% and 614.6%. For most dressings, the cost increased proportionally to the increase of the area and to the development of PU category. The primary barrier accounted for a high percentage of costs among all items required to the application of dressings (human and material resources). Dressings applied in sacral PUs had longer application times. This study allowed us to understand the costs involved in the treatment of PUs, and it may support decision-makers and other cost-effectiveness studies. Realizar uma avaliação do custo do tratamento tópico de pacientes com úlceras por pressão (UP), em uma unidade hospitalar de atendimento a pacientes crônicos no ano de 2014. Trata-se de um estudo de custos baseado no Sistema de custeio Baseado em Atividades. Este método contempla a identificação, mensuração e precificação dos recursos físicos e humanos consumidos para a realização de curativos. Os custos dos procedimentos variaram de R$16,41 a R$260,18. Para UP de mesma categoria, de áreas aproximadas e mesmo tipo de cobertura/adjuvante, a variação entre os custos foi de 3,5% a 614,6%. Para a maioria dos curativos, o custo aumentou proporcionalmente ao aumento da área e à progressão da categoria das UP. A cobertura primária representou elevado percentual nos custos entre todos os itens necessários para realizar os curativos (recursos humanos e materiais). Os curativos realizados nas UP sacrais foram os que apresentaram maiores tempos para execução. Este estudo permitiu conhecer os

  10. Successful treatment of Fusarium keratitis with cornea transplantation and topical and systemic voriconazole.

    NARCIS (Netherlands)

    Klont, R.R.; Eggink, C.A.; Rijs, A.J.M.M.; Wesseling, P.; Verweij, P.E.

    2005-01-01

    A case of invasive Fusarium keratitis in a previously healthy male patient was treated successfully with cornea transplantation and systemic and topical voriconazole after treatment failure with topical amphotericin B and systemic itraconazole. Topical voriconazole was well tolerated, and, in conjun

  11. Topical minoxidil in the treatment of alopecia areata.

    Science.gov (United States)

    Fenton, D A; Wilkinson, J D

    1983-01-01

    A modified double blind crossover study was performed to assess the effect of 1% topical minoxidil as compared with placebo in 30 patients with alopecia areata and alopecia totalis. The active preparation produced a highly significant incidence of hair regrowth. A cosmetically acceptable response was noted in 16 patients. No side effects were seen. The study confirmed that topical minoxidil will induce new hair growth in alopecia areata but that it is less likely to do so in more severe and extensive disease. Furthermore, patients with alopecia universalis and totalis may not respond at all. Nevertheless, as compared with other drugs minoxidil applied topically is relatively non-toxic, is easy to use, and has no systemic or local side effects. Images p1016-a PMID:6412929

  12. Worldwide Utilization of Topical Remedies in Treatment of Psoriasis

    DEFF Research Database (Denmark)

    Svendsen, Mathias Tiedemann; Jeyabalan, Janithika; Andersen, Klaus Ejner

    2017-01-01

    OBJECTIVE: To review published literature describing the global use of topical antipsoriatics. MATERIAL AND METHODS: Search for English-language articles in Embase, Pubmed, PsycINFO, and Cochrane Library. RESULTS: Fifty-four selected publications were found, describing psoriasis patients' use...

  13. Efficacy of combination of glycolic acid peeling with topical regimen in treatment of melasma.

    Science.gov (United States)

    Chaudhary, Savita; Dayal, Surabhi

    2013-10-01

    Various treatment modalities are available for management of melasma, ranging from topical and oral to chemical peeling, but none is promising alone. Very few studies are available regarding efficacy of combination of topical treatment with chemical peeling. Combination of chemical peeling and topical regimen can be a good treatment modality in the management of this recalcitrant disorder. To assess the efficacy of combination of topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling in the treatment of melasma in Indian patients. Forty Indian patients of moderate to severe epidermal variety melasma were divided into two groups of 20 each. One Group i.e. peel group received topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling and other group i.e. control group received topical regimen (2% hydroquinone, 1% hydrocortisone, 0.05% tretinoin). There was an overall decrease in MASI from baseline in 24 weeks of therapy in both the groups (P value glycolic acid peel with topical regimen showed early and greater improvement than the group which was receiving topical regimen only. This study concluded that combining topical regimen (2% hydroquinone, 1% hydrocortisone and 0.05% tretinoin) with serial glycolic acid peeling significantly enhances the therapeutic efficacy of glycolic acid peeling. The combination of glycolic acid peeling with the topical regimen is a highly effective, safe and promising therapeutic option in treatment of melasma.

  14. Successful topical treatment of focal epithelial hyperplasia (Heck's disease) with interferon-beta.

    Science.gov (United States)

    Steinhoff, M; Metze, D; Stockfleth, E; Luger, T A

    2001-05-01

    We report the successful topical treatment of focal epithelial hyperplasia (Heck's disease) with interferon-beta (Fiblaferon gel). Topical treatment with interferon-beta appears to be an effective, simple, non-invasive, cheap and low-risk alternative to other invasive or surgical therapeutic modalities.

  15. Topical treatment in vitiligo and the potential uses of new drug delivery systems

    Directory of Open Access Journals (Sweden)

    Garg Bhawna

    2010-01-01

    Full Text Available Vitiligo is a psychologically devastating condition. Topical therapy is employed as first-line treatment in localized vitiligo. Currently, several topical agents are available in many forms viz. methoxsalen (solution and cream, trioxsalen (solution, corticosteroids (gel, cream, ointment and solution and calcineurin inhibitors (ointment and cream. Although topical therapy has an important position in vitiligo treatment, side-effects or poor efficacy affect their utility and patient compliance. Novel drug delivery strategies can play a pivotal role in improving the topical delivery of various drugs by enhancing their epidermal localization with a concomitant reduction in their side-effects and improving their effectiveness. The current review emphasizes the potential of various phospholipid based carriers viz. liposomes, transferosomes, ethosomes, lipid emulsions, solid lipid nanoparticles and organogels in optimizing and enhancing the topical delivery of anti-vitiligo agents, whilst reducing the side effects of drugs commonly used in its topical treatment.

  16. TOPical Imiquimod treatment of high-grade Cervical intraepithelial neoplasia (TOPIC trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Koeneman, M M; Kruse, A J; Kooreman, L F S; Zur Hausen, A; Hopman, A H N; Sep, S J S; Van Gorp, T; Slangen, B F M; van Beekhuizen, H J; van de Sande, M; Gerestein, C G; Nijman, H W; Kruitwagen, R F P M

    2016-02-20

    Cervical intraepithelial neoplasia (CIN) is the premalignant condition of cervical cancer. Whereas not all high grade CIN lesions progress to cervical cancer, the natural history and risk of progression of individual lesions remain unpredictable. Therefore, high-grade CIN is currently treated by surgical excision: large loop excision of the transformation zone (LLETZ). This procedure has potential complications, such as acute haemorrhage, prolonged bleeding, infection and preterm birth in subsequent pregnancies. These complications could be prevented by development of a non-invasive treatment modality, such as topical imiquimod treatment. The primary study objective is to investigate the efficacy of topical imiquimod 5% cream for the treatment of high-grade CIN and to develop a biomarker profile to predict clinical response to imiquimod treatment. Secondary study objectives are to assess treatment side-effects, disease recurrence and quality of life during and after different treatment modalities. The study design is a randomized controlled trial. One hundred forty women with a histological diagnosis of high-grade CIN (CIN 2-3) will be randomized into two arms: imiquimod treatment during 16 weeks (experimental arm) or immediate LLETZ (standard care arm). Treatment efficacy will be evaluated by colposcopy with diagnostic biopsies at 20 weeks for the experimental arm. Successful imiquimod treatment is defined as regression to CIN 1 or less, successful LLETZ treatment is defined as PAP 1 after 6 months. Disease recurrence will be evaluated by cytology at 6, 12 and 24 months after treatment. Side-effects will be evaluated using a standardized report form. Quality of life will be evaluated using validated questionnaires at baseline, 20 weeks and 1 year after treatment. Biomarkers, reflecting both host and viral factors in the pathophysiology of CIN, will be tested at baseline with the aim of developing a predictive biomarker profile for the clinical response to

  17. Assessment of topical versus oral ivermectin as a treatment for head lice.

    Science.gov (United States)

    Ahmad, Hesham M; Abdel-Azim, Eman S; Abdel-Aziz, Rasha T

    2014-01-01

    Many medications are available for treatment of pediculosis capitis including ivermectin. Our aim is to compare the efficacy and safety of topical versus oral ivermectin in treatment of pediculosis capitis. Sixty-two patients with proved head lice infestation were included and divided into group I (31 patients; received single topical application of 1% ivermectin) and group II (31 patients; received single dose of oral ivermectin). Treatment was repeated after 1 week for nonresponders. At 1 week after treatment, the eradication rates and improvement of pruritus were significantly higher among patients who received topical than oral ivermectin. When a second treatment, topical or oral, was given to nonresponders, the cure rates of infestation and pruritus was 100% and 97% among patients treated with topical and oral ivermectin, respectively with no significant difference between the two groups. This study suggests that both topical and oral ivermectin demonstrate high efficacy and tolerability in treatment of pediculosis capitis. However, a single treatment with topical ivermectin provides significantly higher cure of infestation and faster relief of pruritus than oral ivermectin. In addition, whether topical or oral ivermectin is used to treat head lice, a second dose is required in some cases to ensure complete eradication. © 2014 Wiley Periodicals, Inc.

  18. The Effectiveness of Topical Pimecrolimus in the Treatment of Oral Lichen Planus

    Directory of Open Access Journals (Sweden)

    Mehmet Kamil Mülayim

    2016-12-01

    Full Text Available Objectives: Oral lichen planus (OLP is a chronic inflammatory disorder of unknown etiology that affects the skin and the mucosa, especially the oral mucosa. Several therapeutic agents have been investigated for the treatment of OLP. All agents used in the OLP therapy are palliative. Potent topical steroids are used as the conventional therapy for OLP. Since side-effects or steroid resistance may be encountered, alternative treatments may be necessary. This study aimed to evaluate the efficacy and safety of the topical pimecrolimus in the treatment of OLP. Methods: Seventeen patients with OLP were recruited into this study. Topical pimecrolimus 1% cream was applied twice a day to the affected areas. Patients were followed up for 3-6 months. Photographs of the lesions were taken and analyzed for areas of ulceration, erythema, and reticulation in every clinical examination. Results: We found that topical pimecrolimus 1% cream was an effective treatment for OLP. Two patients could not complete the treatment protocol because of the side effects such as local irritation and nausea. Conclusion: Topical pimecrolimus may be a valuable second treatment choice for patients with steroid-related side-effects or steroid-resistant OLP. However further randomized controlled studies have to be conducted to compare conventional treatment of topical corticosteroid with topical pimecrolimus.

  19. Durable remission of folliculotropic mycosis fungoides achieved with a combined topical treatment with cytarabine and carmustine.

    Science.gov (United States)

    Heisig, Monika; Maj, Joanna; Szepietowski, Jacek C; Reich, Adam

    2016-01-01

    Folliculotropic mycosis fungoides (MF) is an uncommon subtype of MF which has a more aggressive natural history and is more resistant to treatment than other forms of MF. In this article, an innovative method of treatment is presented. We describe a successful use of topical cytarabine combined with topical carmustine in a patient with a folliculotropic MF. Based on our patient history we suggest this method as an effective therapy option for patients with folliculotropic MF unresponsive to other forms of treatment.

  20. Treatment of angiofibromas in tuberous sclerosis complex: the effect of topical rapamycin and concomitant laser therapy.

    Science.gov (United States)

    Park, Jin; Yun, Seok-Kweon; Cho, Yong-Sun; Song, Ki-Hun; Kim, Han-Uk

    2014-01-01

    Facial angiofibromas are the most troublesome cutaneous manifestations of the tuberous sclerosis complex and are difficult to treat. Lasers are most commonly used to treat these skin lesions, but results are disappointing with frequent recurrences. Recently, treatment of facial angiofibromas with topical rapamycin has been reported to yield promising results. We observed the need of laser ablation in addition to topical rapamycin to get best results for the treatment of angiofibromas in 4 cases. The result showed that topical rapamycin ointment was enough when the papules were yet small in size, i.e. less than a few millimeters, but additional laser ablation was needed for large papules approximately larger than 4 mm. Considering the natural course of facial angiofibromas, we believe that topical rapamycin can be best used in childhood patients. In adults, topical rapamycin was useful for treating the still present small papules and for preventing recurrences after laser treatment.

  1. EVALUATION OF THERAPEUTIC EFFICIENCY OF TOPICAL CLOTRIMAZOLE AND TOPICAL MICONAZOLE IN THE TREATMENT OF OTOMYCOSIS- A PROSPECTIVE STUDY

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    Channabasawaraj B Nandyal

    2015-06-01

    Full Text Available Background: Otomycosis a Superficial Fungal Infection of the External auditory canal causes lot of misery to the Patient with tendency of recurrence. Many Antifungals are used for treatment with different percentage of success; still a standard regime is not firmly established. So this study is undertaken to evaluate Therapeutic efficiency of Topical Clotrimazole and Miconazole in treating Otomycosis. Materials and Methods: Present study was conducted on 156 clinically diagnosed cases of Otomycosis. Ear discharge was collected. Identification of fungi was done by standard protocol. Out of 156 cases 135 cases produced positive fungal isolates which were taken for further studies. Cases underwent thorough cleaning in Infected Ear. 1% Clotrimazole Ear drop was used in 70 cases and 1% Miconazole in 65 cases for 1 week and followed up for 1 week to 2 months for clearance or recurrence. Results: Clotrimazole showed good response Symptomatically and Mycological clearance within one week in 66 cases. Persistence of disease to 2-4 weeks in 4 cases and no recurrence within 2 months of follow up with minimal side effects, Where as Miconazole showed good response within one week in 54 cases, 9 cases had persistence of disease to 2-4 weeks and 2 cases had recurrence, burning sensation in 9 patients and 1 case developed allergy and discontinued treatment. Conclusion: Topical Clotrimazole is more Effective, Safe and well tolerated with better Symptomatic relief, Mycological clearance and low relapse rate compared to Topical Miconazole. [Natl J Med Res 2015; 5(2.000: 145-149

  2. Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma : a single blind, non-inferiority, randomised controlled trial

    NARCIS (Netherlands)

    Arits, Aimee H. M. M.; Mosterd, Klara; Essers, Brigitte A. B.; Spoorenberg, Eefje; Sommer, Anja; De Rooij, Michette J. M.; van Pelt, Han P. A.; Quaedvlieg, Patricia J. F.; Krekels, Gertruud A. M.; van Neer, Pierre A. F. A.; Rijzewijk, Joris J.; van Geest, Adrienne J.; Steijlen, Peter M.; Nelemans, Patty J.; Kelleners-Smeets, Nicole W. J.

    Background Superficial basal-cell carcinoma is most commonly treated with topical non-surgical treatments, such as photodynamic therapy or topical creams. Photodynamic therapy is considered the preferable treatment, although this has not been previously tested in a randomised control trial. We

  3. Photodynamic therapy versus topical imiquimod versus topical fluorouracil for treatment of superficial basal-cell carcinoma : a single blind, non-inferiority, randomised controlled trial

    NARCIS (Netherlands)

    Arits, Aimee H. M. M.; Mosterd, Klara; Essers, Brigitte A. B.; Spoorenberg, Eefje; Sommer, Anja; De Rooij, Michette J. M.; van Pelt, Han P. A.; Quaedvlieg, Patricia J. F.; Krekels, Gertruud A. M.; van Neer, Pierre A. F. A.; Rijzewijk, Joris J.; van Geest, Adrienne J.; Steijlen, Peter M.; Nelemans, Patty J.; Kelleners-Smeets, Nicole W. J.

    2013-01-01

    Background Superficial basal-cell carcinoma is most commonly treated with topical non-surgical treatments, such as photodynamic therapy or topical creams. Photodynamic therapy is considered the preferable treatment, although this has not been previously tested in a randomised control trial. We asses

  4. Clinical efficacy and safety of topical versus oral ivermectin in treatment of uncomplicated scabies.

    Science.gov (United States)

    Ahmad, Hesham M; Abdel-Azim, Eman S; Abdel-Aziz, Rasha T

    2016-01-01

    Many medications are available for scabies treatment including oral and topical ivermectin. However, studies comparing these two forms as a scabies treatment are few. This study compares efficacy and safety of topical versus oral ivermectin as scabies treatment. The study included 62 confirmed uncomplicated scabies patients, divided into: Group I (32 patients, received topical ivermectin) and Group II (30 patients, received oral ivermectin). Patients were assessed, clinically and by KOH smear at 1, 2 and 4 weeks. Treatment was repeated after one week in patients with persistent infection. Adverse events were recorded. Most patients (87.5% and 73.5% in group I and group II respectively) were symptom free after a single treatment. A second treatment was required in 4 patients of group I and 8 patients of group II. However, 2 weeks after treatment symptoms and signs completely resolved in all cases with no recurrence at 4 weeks. This study suggests that both topical and oral ivermectin are safe and equally effective in treatment of uncomplicated scabies. Single treatment, whether topical or oral, is associated with high cure rate in a week post treatment. However, repeating treatment after one week may be required to achieve 100% cure.

  5. Intra-anal condyloma: surgical or topical treatment?

    Science.gov (United States)

    Dianzani, Caterina; Pierangeli, Alessandra; Avola, Alessandra; Borzomati, Domenico; Persichetti, Paolo; Degener, Anna Marta

    2008-12-15

    Human Papillomavirus infections are the strongest risk factors for genital cancer and are the causative agents of anogenital warts. Although the viral types associated with condylomata usually do not cause carcinoma, in women with a history of these lesions there is an increased risk of intraepithelial neoplasia and cancer. Generally the lesions are not life-threatening, but they provoke significant morbidity, are difficult to treat, and are a source of psychosocial stress. Thus, condylomata represent not only a health problem for the patient but also an economic burden for the society. Considering the individual episodes of care, men experience a longer duration of the lesions and incur greater costs than women. We report a case of a male patient with external and intra-anal condyloma resistant to laser therapy. Initially, surgical intervention appeared required because of florid and intra-anal growth. HPV DNA testing and sequencing revealed the presence of HPV 6. After initial discomfort, the lesions were successfully cleared with topical imiquimod 5 percent cream therapy.

  6. Is geographic variation within species related to macroevolutionary patterns between species?

    Science.gov (United States)

    Fisher-Reid, M C; Wiens, J J

    2015-08-01

    The relationship between microevolution and macroevolution is a central topic in evolutionary biology. An aspect of this relationship that remains very poorly studied in modern evolutionary biology is the relationship between within-species geographic variation and among-species patterns of trait variation. Here, we tested the relationship between climate and morphology among and within species in the salamander genus Plethodon. We focus on a discrete colour polymorphism (presence and absence of a red dorsal stripe) that appears to be related to climatic distributions in a common, wide-ranging species (Plethodon cinereus). We find that this trait has been variable among (and possibly within) species for >40 million years. Furthermore, we find a strong relationship among species between climatic variation and within-species morph frequencies. These between-species patterns are similar (but not identical) to those in the broadly distributed Plethodon cinereus. Surprisingly, there are no significant climate-morphology relationships within most other polymorphic species, despite the strong between-species patterns. Overall, our study provides an initial exploration of how within-species geographic variation and large-scale macroevolutionary patterns of trait variation may be related. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary Biology.

  7. [Types of topical treatment for peripheral neuropathic pain : Mechanism of action and indications].

    Science.gov (United States)

    Baron, R; Mahn, F

    2010-08-01

    The term "peripheral neuropathic pain syndromes" summarizes several chronic pain syndromes, which can occur focally or generalized in the peripheral nervous system in the course of an impairment of afferent neurons. Controlled clinical trials gave distinct indications for systemic treatments with antidepressants, anticonvulsants and opioid analgesics in several neuropathic pain syndromes. In addition to these systemic therapies, there are also two topical treatment options: topical application of lidocaine and capsaicin. An important cause of sensitization phenomena of afferent nociceptors is the upregulation of sodium channels and thermosensor channels. In the context of a partial nerve lesion that leaves behind partially preserved or regenerated afferent nerve fibres, just these channels could be used as target structures for topical medications. Topically applied drugs are absorbed systemically only in minute quantities, so systemic side effects are negligible. Pharmacological interactions with systematically acting substances are also virtually absent; thus, topically applied substances are especially appropriate for add-on therapy in addition to systemic pain medication.

  8. Comparison of Topical Nifedipine With Oral Nifedipine for Treatment of Anal Fissure: A Randomized Controlled Trial

    OpenAIRE

    Golfam, Farzaneh; Golfam, Parisa; Golfam, Babak; Pahlevani, Puyan

    2014-01-01

    Background: Medical sphincterotomy has gained popularity as a treatment for anal fissure. Calcium channel blockers in topical forms could also be appropriate with low adverse effects. Objectives: This was a prospective randomized controlled trial to compare topical and oral nifedipine in the treatment of chronic anal fissure. Patients and Methods: A prospective randomized controlled trial was conducted at two centers of Shahed University. One hundred and thirty patients with chronic anal fiss...

  9. Comparative Efficacy of Topical Pertmehrin, Crotamiton and Sulfur Oint-ment in Treatment of Scabies

    OpenAIRE

    Celestyna Mila-Kierzenkowska; Alina Woźniak; Ewa Krzyżyńska-Malinowska; Lucyna Kałużna; Roland Wesołowski; Wojciech Poćwiardowski; Marcin Owcarz

    2017-01-01

    Background:  Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to com­pare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment.Methods: Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one wee...

  10. Successful Treatment of Refractory Wart with a Topical Activated Vitamin D in a Renal Transplant Recipient

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    Luciano Moscarelli

    2011-01-01

    Full Text Available Warts are benign proliferations of the skin and mucosa caused by infection with human papillomavirus. They are commonly treated with destructive modalities such as cryotherapy with liquid nitrogen, local injection of bleomycin, electrocoagulation, topical application of glutaraldehyde, and local and systemic interferon-β therapy. These treatment modalities often cause pain and sometimes scarring or pigmentation after treatment. We herein report a case with a right index finger wart, which was successfully treated with a topical activated vitamin D.

  11. Functional assessment and treatment of perseverative speech about restricted topics in an adolescent with Asperger syndrome.

    Science.gov (United States)

    Fisher, Wayne W; Rodriguez, Nicole M; Owen, Todd M

    2013-01-01

    A functional analysis showed that a 14-year-old boy with Asperger syndrome displayed perseverative speech (or "restricted interests") reinforced by attention. To promote appropriate speech in a turn-taking format, we implemented differential reinforcement (DR) of nonperseverative speech and DR of on-topic speech within a multiple schedule with stimuli that signaled the contingencies in effect and who was to select the topic. Both treatments reduced perseverative speech, but only DR of on-topic speech increased appropriate turn taking during conversation. Treatment effects were maintained when implemented by family members and novel therapists. © Society for the Experimental Analysis of Behavior.

  12. A STUDY ON TOPICAL CALCIUM DOBESILATE FOR THE TREATMENT OF LIMITED PLAQUE PSORIASIS

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    Neerja Puri

    2013-07-01

    Full Text Available Introduction: Topical dobesilate offers the potential for treatment of plaque psoriasis without atrophy or other local side effects associated with the use of topical corticosteroids. Fibroblast growth factor (FGF-mediated pathways participate in many of the cellular events implicated in the pathogenesis of psoriasis. Thus, targeting FGF signals may be potentially therapeutic. Aims: To study the efficacy of topical calcium dobesilate for the treatment of 50 patients of limited plaque psoriasis. Methods: For the present study, fifty clinically diagnosed cases of psoriasis with limited number of plaques ( 0.05.

  13. Topical diclofenac in the treatment of osteoarthritis of the knee

    OpenAIRE

    Niklas Schuelert; Russell, Fiona A.; McDougall, Jason J

    2011-01-01

    Niklas Schuelert, Fiona A Russell, Jason J McDougallDepartment of Physiology and Pharmacology, University of Calgary, Calgary, AB, CanadaAbstract: Osteoarthritis (OA) is a common disease that affects millions of people worldwide. As there is no cure for OA, drug treatment to relieve symptoms is the main form of management. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac are the most commonly used drugs to treat knee OA pain. Unfortunately, these agents are associated with gas...

  14. Before hierarchy: the rise and fall of Stephen Jay Gould's first macroevolutionary synthesis.

    Science.gov (United States)

    Dresow, Max W

    2017-06-01

    Few of Stephen Jay Gould's accomplishments in evolutionary biology have received more attention than his hierarchical theory of evolution, which postulates a causal discontinuity between micro- and macroevolutionary events. But Gould's hierarchical theory was his second attempt to supply a theoretical framework for macroevolutionary studies-and one he did not inaugurate until the mid-1970s. In this paper, I examine Gould's first attempt: a proposed fusion of theoretical morphology, multivariate biometry and the experimental study of adaptation in fossils. This early "macroevolutionary synthesis" was predicated on the notion that parallelism and convergence dominate the history of higher taxa, and moreover, that they can be explained in terms of adaptation leading to mechanical improvement. In this paper, I explore the origins and contents of Gould's first macroevolutionary synthesis, as well as the reasons for its downfall. In addition, I consider how various developments during the mid-1970s led Gould to identify hierarchy and constraint as the leading themes of macroevolutionary studies-and adaptation as a macroevolutionary red herring.

  15. Topical Tacrolimus with Custom Trays in the Treatment of Severe Oral cGVHD Refractory to a Potent Topical Steroid Therapy: A Case Report

    Science.gov (United States)

    Brown, Ronald S.; Edwards, Dean; Walsh-Chocolaad, Tracey; Childs, Richard W.

    2012-01-01

    Background The authors present a case demonstrating the success of topical tacrolimus (TAC) therapy with custom trays in the treatment of oral chronic graft versus host disease (cGVHD). The 41 year-old male patient initially responded to topical steroid therapy (clobetasol propionate 0.05% ointment) applied both topically and with flexible carrier trays, but later became refractory to this potent topical agent. Topical TAC therapy with flexible carrier trays and systemic prednisone therapy was initiated. Results The patient responded favorably with the change to topical TAC therapy with custom trays (and oral prednisone). His oral cGVHD lesions resolved within a period of four weeks. The improvement has remained stable at 14 month follow-up. Clinical Implications This is the first case reported with regard to the successful resolution of steroid recalcitrant cGVHD successfully treated with topical TAC with custom trays. PMID:23102802

  16. Effects of massage treatment combined with topical cactus and aloe on puerperal milk stasis.

    Science.gov (United States)

    Meng, Shan; Deng, Qingchun; Feng, Chunyu; Pan, Yinglian; Chang, Qing

    2015-01-01

    Puerperal milk stasis is one of the most common puerperal complication that directly affects breastfeeding. Massage treatment with topical cactus and aloe for puerperal milk stasis might be a superior treatment, and it does not affect breastfeeding. The intervention group was treated with massages with cactus and aloe cold compresses, and the control group was treated with massage treatment or cactus and aloe cold compresses alone. We evaluated the efficacies of the treatments through comparisons of the feeding patterns, hardness, and pain after treatment between the three groups. We found that breastfeeding rates were significantly increased in the massage combine with combined with cactus and aloe cold compress group (P massage combine with combined with cactus and aloe cold compress group than in the massage or cold compress group (P Massage treatment with topical cactus and aloe topical effectively improved the pain status, hard lump of puerperal milk stasis and increase breastfeeding rate.

  17. Macroevolutionary diversity of amniote limb proportions predicted by developmental interactions.

    Science.gov (United States)

    Young, Nathan M

    2013-11-01

    Mammals, birds, and reptiles exhibit a remarkable diversity of limb proportions. These evolved differences are thought to reflect selection for biomechanical, postural, and locomotor requirements primarily acting on independent variation in later fetal and postnatal segmental growth. However, earlier conserved developmental events also have the potential to impact the evolvability of limb proportions by limiting or biasing initial variation among segments. Notably, proximo-distal patterning of the amniote limb through activation-inhibition dynamics predicts that initial proportions of segments should exhibit both tradeoffs between stylopod and autopod and a diagnostic reduction in variance of the zeugopod. Here it is demonstrated that this developmental "design rule" predicts patterns of macroevolutionary diversity despite the effects of variation in segmental growth over ontogeny, lineage-specific differences in phylogenetic history, or functional adaptation. These results provide critical comparative evidence of a conserved Turing-like mechanism in proximo-distal limb segmentation, and suggest that development has played a previously unrecognized role in the evolvability of limb proportions in a wide range of amniote taxa.

  18. [Effectiveness of topical autologous serum treatment in neurotrophic keratopathy].

    Science.gov (United States)

    Guadilla, A M; Balado, P; Baeza, A; Merino, M

    2013-08-01

    To evaluate the effectiveness of 20% autologous serum as a treatment for neurotrophic keratopathy. A longitudinal, observational and descriptive study was performed on 19 patients (22 eyes) with neurotrophic keratopathy in different stages of Mackie's classification. The following variables were evaluated on the first visit, and then 4 months later: best corrected visual acuity (BCVA), subjective patient symptomatology (faces scale), Schirmer's test without anesthesia (mm), tear film break-up time (BUT) (sg) and healing of the epithelial defect (weeks). The Wilcoxon signed-rank test was used for the statistical analysis of the data. A symptomatic improvement was observed in 100% of the cases, and a 71% improvement in best corrected visual acuity (Pplasma rich in growth factors, may be more effective than the application of 20% autologous serum, due to their greater effect on cell proliferation. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  19. Methemoglobinemia in postchemotherapy stomatitis topical treatment: 2 pediatric cases.

    Science.gov (United States)

    Kaczorowska-Hac, Barbara; Stefanowicz, Joanna; Stachowicz-Stencel, Teresa; Kozlowska, Marta; Adamkiewicz-Drozynska, Elzbieta; Balcerska, Anna

    2012-03-01

    Methemoglobinemia is a rare congenital or acquired disease of increased blood methemoglobin concentration. We documented 2 cases of children suffering from neuroblastoma whose postchemotherapy anemia, leucopenia, and stomatitis were complicated by methemoglobinemia after using a formulary oral gel (7.5% benzocaine, doxycycline, nystatin, glycerin). The complication resulted in hospital treatment. Percutaneous oxygen saturation remained at 85% and 87% despite administration of 100% oxygen through a nonrebreather mask. Arterial blood gas analysis showed an oxygen saturation of 98% and 97%, respectively. Spectroscopic measurement showed methemoglobin concentration of 42% and 35.5%, respectively. After red blood cell transfusion and oral ascorbic acid in case 1 and methylene blue in case 2, the patients' condition improved. Although the benzocaine gel is not in use in several medical systems, it should be considered as a possible reason for methemoglobinemia.

  20. Comparative Evaluation Of Topical Preparations In Treatment of Melasma

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    Pandhi Roma

    2002-01-01

    Full Text Available Fifty patients of melasma were randomly taken up for the study and were divided into five treatment groups of 10 patients each. Patients of these groups received clobetasol propionate 0.05% (group I, tretinoin 0.025% (group II, hydroquinone 2% (group III, bebzoyl peroxide 5% (group IV and glycolic acid 10% (group V. Pretreatment evolution was done with MASI (melasma area severity index scoring and photographic records. Patients were treated for 3 months and the preparations were found to be equally compatible to our patients. However, effectiveness on an average was higher for clobetasol (80% and tretinoin (62%, though hydroquinone (48%, benzoyal peroxide (41% and glycolic acid (30% also showed fairly good results. Our study broadens the therapeutic spectrum of melasm by using agents with different mechanisms of action.

  1. Biologic therapy with or without topical treatment in psoriasis: what does the current evidence say?

    Science.gov (United States)

    Jensen, J Daniel; Delcambre, Macey Renault; Nguyen, Gloria; Sami, Naveed

    2014-10-01

    Biologic therapy represents a relatively new class of drugs which have revolutionized the treatment of psoriasis and are used with increasing frequency in order to control this chronic, systemic inflammatory disease. However, it is unclear what role there is for combination therapy of biologics with traditional topical agents. The purpose of this article is to assess the literature on the role of topical agents as adjuvants to biological treatments in the treatment of psoriasis and identify areas for further research. A MEDLINE search was performed in order to identify English-language publications from 1996 to 2014 examining combination biologic therapy with topical medications in the treatment of psoriasis. Data from these clinical studies are summarized and the outcomes are discussed. In general, the addition of adjuvant topical therapy to systemic biologic therapy allowed for a reduction in dosage and side effects of both agents, maintenance of initial response to biologics, treatment of recalcitrant lesions in partial responders, and potential acceleration of response to biologic therapies. The current data, though limited, suggest that using topical therapies as adjunct treatment to biologics is a well tolerated and effective means of controlling psoriasis and improving quality of life for patients. However, the treating physician should remain attentive to signs of adverse events and seek opportunities to reduce the dose or treatment frequency during chronic use.

  2. The efficacy of topical ivermectin versus malation 0.5% lotion for the treatment of scabies.

    Science.gov (United States)

    Goldust, Mohamad; Rezaee, Elham

    2013-05-06

    Objective: There are different medications for the treatment of scabies but the treatment of choice is still controversial. This study aimed at comparing the efficacy of topical ivermectin versus malation 0.5% lotion for the treatment of scabies. Methods: In total, 340 patients with scabies were enrolled, and randomized into two groups: the first group received 1% ivermectin applied topically to the affected skin and the second group received topical malation 0.5% lotion and were told to apply this twice with 1 week interval. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Results: Two application of topical ivermectin provided a cure rate of 67.6% at the 2-week follow-up, which increased to 85.2% at the 4-week follow-up after repeating the treatment. Treatment with two applications of malation 0.5% lotion was effective in 44.1% of patients at the 2-week follow-up, which increased to 67.6% at the 4-week follow-up after this treatment was repeated. Conclusion:Two application of ivermectin was as effective as single applications of malation 0.5% lotion at the 2-week follow-up. After repeating the treatment, ivermectin was superior to malation 0.5% lotion at the 4-week follow up.

  3. The role of topical moxifloxacin, a new antibacterial in Europe, in the treatment of bacterial conjunctivitis.

    Science.gov (United States)

    Benitez-Del-Castillo, Jose; Verboven, Yves; Stroman, David; Kodjikian, Laurent

    2011-01-01

    This article discusses current practice in the treatment of conjunctivitis and how the use of topical moxifloxacin can increase therapeutic effectiveness, reduce treatment failures and, consequently, be cost effective and reduce the societal burden of the disorder. Current practice and effectiveness data were derived from the literature. Data on healthcare utilization as a result of treatment failure were collected by survey and the cost of treatment was defined using national costings. A decision-analytic model to assess cost effectiveness was developed and the impact on the healthcare budget was calculated to define the health economic impact. Bacterial conjunctivitis represents a significant health problem and accounts for an estimated 1-1.5% of primary-care consultations. The disorder is highly contagious and causes a substantial healthcare and societal burden. Bacterial conjunctivitis is generally self-limiting, resolving within 1-2 weeks. However, the use of antibacterials significantly improves clinical and microbiological remission, shortens symptom duration, and enables more effective use of healthcare resources, compared with placebo. From a health economic perspective this benefits the healthcare system and society, since fewer healthcare resources are needed and the adult affected, or the parent/caregiver of the child affected, can return to full work capacity sooner, reducing loss of productivity. Treatment strategies vary significantly between countries. Most patients are first seen in primary care, where 'wait-and-see', lubrification and antiseptic or antibacterial treatment is provided. In Europe, when antibacterials are prescribed most general practitioners (GPs) prescribe a broad-spectrum topical antibacterial. The most commonly used drugs are chloramphenicol and fusidic acid, with fluoroquinolones rarely reported as first-line treatment by GPs. At the specialist (ophthalmologist) level, or for second-line treatment at the GP level, topical

  4. Successful treatment of ligneous conjunctivitis with topical fresh frozen plasma in an infant

    Directory of Open Access Journals (Sweden)

    Zuhal Özen Tunay

    2015-10-01

    Full Text Available ABSTRACTA 6-month-old female infant presented to our clinic with bilateral eyelid swelling, yellowish-white membranes under both lids, and mucoid ocular discharge. Her aunt had similar ocular problems that were undiagnosed. The conjunctival membranes were excised and histopathological investigation of these membranes showed ligneous conjunctivitis. Further, laboratory examination revealed plasminogen deficiency. A good response was observed to topical fresh frozen plasma (FFP treatment without systemic therapy, and the membranes did not recur during the treatment. Topical FFP treatment may facilitate rapid rehabilitation and prevent recurrence in patients with ligneous conjunctivitis.

  5. Successful topical treatment of hand warts in a paediatric patient with tea tree oil (Melaleuca alternifolia).

    Science.gov (United States)

    Millar, B Cherie; Moore, John E

    2008-11-01

    Tea tree oil (TTO) (Melaleuca alternifolia) has been used recently as an effective topical application for the treatment of skin infections due to a variety of aetiological microbial agents, including mainly bacterial infections. We detail the first report in the peer-reviewed literature of the successful treatment with TTO of a paediatric patient with warts on her right middle finger. TTO was applied topically once daily to the lesions for 12 days, with a successful outcome, including complete re-epithelization of the infected areas. The case highlights the potential use of TTO in the treatment of common warts due to human papilloma virus.

  6. Demodex folliculorum and topical treatment: acaricidal action evaluated by standardized skin surface biopsy.

    Science.gov (United States)

    Forton, F; Seys, B; Marchal, J L; Song, A M

    1998-03-01

    A standardized skin surface biopsy was performed in 34 patients suffering from skin diseases with high Demodex folliculorum density (Dd) > 5D/cm2 before, during and after topical treatment. The patients were randomized into six comparable groups to study six topical treatments: metronidazole 2%, permethrin 1%, sublimed sulphur 10%, lindane 1%, crotamiton 10% and benzyl benzoate (BB) 10%. Their acaricidal activity was measured according to three criteria: (i) for each treatment, decrease of Dd to under the normal threshold (crotamiton was demonstrated by the second criterion. An important irritating effect was observed with BB and sulphur.

  7. Successful treatment of ligneous conjunctivitis with topical fresh frozen plasma in an infant.

    Science.gov (United States)

    Tunay, Zuhal Özen; Özdemir, Özdemir; Acar, Damla; Gül, Ece; Akbay, Serap

    2015-01-01

    A 6-month-old female infant presented to our clinic with bilateral eyelid swelling, yellowish-white membranes under both lids, and mucoid ocular discharge. Her aunt had similar ocular problems that were undiagnosed. The conjunctival membranes were excised and histopathological investigation of these membranes showed ligneous conjunctivitis. Further, laboratory examination revealed plasminogen deficiency. A good response was observed to topical fresh frozen plasma (FFP) treatment without systemic therapy, and the membranes did not recur during the treatment. Topical FFP treatment may facilitate rapid rehabilitation and prevent recurrence in patients with ligneous conjunctivitis.

  8. Topical pyruvic acid (70% versus topical salicylic acid (16.7% compound in treatment of plantar warts: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Zabihollah Shahmoradi

    2015-01-01

    Conclusion: Topical pyruvic acid and compound salicylic acid had the same efficacy and complications in treating plantar warts. Decision for choosing the treatment can be made based on the costs and individual factors as well as patients preferences.

  9. Topical Silicone Sheet Application in the Treatment of Hypertrophic Scars and Keloids.

    Science.gov (United States)

    Westra, Iris; Pham, Hth; Niessen, Frank B

    2016-10-01

    Objective: Since the early 1980s, topical silicone sheets have been used in the treatment of hypertrophic scars and keloids.This study aimed to determine the optimal duration and application of these sheets. Design: multi-centered therapeutic study. Setting and participants: A total of 224 patients were included in this study; 205 patients with hypertrophic scars and 19 patients with keloids. Patients received treatment with a topical silicone sheet. Treated scars varied in age, ranging from two weeks to 62 years and treatment time ranged from one month to 16 months. Assessment of the scars was performed by the use of standardized study forms and digital photography. Measurements: Skin therapists objectively assessed the scars on its color, thickness, and elasticity. Patients themselves subjectively assessed their perception of their scar and their experience with the usage of the topical silicone sheet. Results: After applying the topical silicone sheet, all scars, regardless of type of scar and maturity, improved significantly in color, thickness, and elasticity. Conclusion: In this study, treatment with the topical silicone sheet showed significant improvement on both hypertrophic scars and keloids. Best results were reached when the silicone sheet was applied at least four hours per day.

  10. Effectiveness and safety of topical emollients in the treatment of PUVA-induced pruritus.

    Science.gov (United States)

    Turan, Enver; Gurel, Mehmet Salih; Erdemir, Asli Turgut; Usta, Murat; Kutlu, Nurdan Seda; Yurt, Nurdan

    2013-01-01

    In this study we tried to assess the efficacy of topical emollients in the treatment of patients with PUVA-induced pruritus. 41 patients over 18 years of age, who received PUVA treatment in the phototherapy unit, were included in the study. Patients were randomly divided into two groups; Group I was administered with a 4% urea lotion and Group II was administered with liquid petrolatum. The follow-up period was minimum 4 weeks. During the first 2 weeks, patients were administered topical emollients and received PUVA treatment together. The next 2 weeks, they continued PUVA treatment without any medication. When time-dependent changes in the visual analogue scale scores for pruritus of both groups were considered, both treatment methods were found to be remarkably successful (p emollients were found to be effective in the treatment of PUVA-induced pruritus. Both forms of medication can be successfully administered and increase the patient's compliance with medication.

  11. Proliferative and necrotizing otitis externa in a kitten: successful treatment with intralesional and topical corticosteroid therapy

    Science.gov (United States)

    MOMOTA, Yutaka; YASUDA, Junya; IKEZAWA, Mitsutaka; SASAKI, Jun; KATAYAMA, Masaaki; TANI, Kenji; MIYABE, Masahiro; ONOZAWA, Eri; AZAKAMI, Daigo; ISHIOKA, Katsumi; SAKO, Toshinori

    2016-01-01

    Proliferative and necrotising otitis externa (PNOE) is a very rare disease affecting the ear canals and concave pinnae of kittens. This report describes a 5-month-old cat with PNOE. Histopathological examination confirmed the diagnosis. Treatment was initiated with local injection of methylprednisolone acetate into the lesions. The cat was subsequently treated with clobetasol propionate cream, a potent topical glucocorticoid ointment. The cat showed marked improvement. While topical treatment with tacrolimus, an immunosuppressive agent, is reported to be an effective therapy, to the best of our knowledge, this is the first report to treat PNOE with local corticosteroid therapy. PMID:27570137

  12. STUDY ON USE OF TOPICAL DILTIAZEM VERSUS TOPICAL GLYCERYL TRINITRATE (GTN IN THE TREATMENT OF CHRONIC ANAL FISSURE: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Madhu Lata

    2014-10-01

    Full Text Available OBJECTIVE: To compare the efficacy, associated side effects in short term as well as long term use of topical Diltiazem and topical GTN in the management of chronic anal fissure. MATERIAL AND METHODS: Out patients records of 231 patients with chronic anal fissure who reported to hospital from August 2011 to August 2014 and treated were randomly selected for both types of management of which 118 patients had received topical 2% diltiazem and 113 were treated with 0.2% glyceryl trinitrate topical ointment thrice daily for 6 weeks. They were assessed at the time of presentation, then at the end of 1st week, 3rd week and at the end of 6th week of treatment. Records of patients with anal fissure due to other diseases like inflammatory bowel disease, malignancy, sexually transmitted diseases, previous treatment with local ointment or surgery, patients who required anal surgery for any concurrent disease like hemorrhoids, pregnant women, patients with significant cardiovascular conditions and patients who did not turned up for follow up were excluded. Signs and symptoms and side-effects were noted at the given time. RESULTS: The study results are comparable to national figures and other studies. CONCLUSION: Topical application of both the ointments, 2% Diltiazem and 0.2% Glyceryl trinitrate observed to be quite effective in treatment of chronic fissure in Ano. However, topical Diltiazem is preferred to topical glyceryl trinitrate due to its lesser side effects and long term better control

  13. Environmental changes define ecological limits to species richness and reveal the mode of macroevolutionary competition.

    Science.gov (United States)

    Ezard, Thomas H G; Purvis, Andy

    2016-08-01

    Co-dependent geological and climatic changes obscure how species interact in deep time. The interplay between these environmental factors makes it hard to discern whether ecological competition exerts an upper limit on species richness. Here, using the exceptional fossil record of Cenozoic Era macroperforate planktonic foraminifera, we assess the evidence for alternative modes of macroevolutionary competition. Our models support an environmentally dependent macroevolutionary form of contest competition that yields finite upper bounds on species richness. Models of biotic competition assuming unchanging environmental conditions were overwhelmingly rejected. In the best-supported model, temperature affects the per-lineage diversification rate, while both temperature and an environmental driver of sediment accumulation defines the upper limit. The support for contest competition implies that incumbency constrains species richness by restricting niche availability, and that the number of macroevolutionary niches varies as a function of environmental changes.

  14. Topical Treatment for Orbital Capillary Hemangioma in an Adult Using a β-Blocker Solution

    Directory of Open Access Journals (Sweden)

    Ken Ohnishi

    2014-02-01

    Full Text Available Purpose: To report a case of orbital capillary hemangioma in an adult who was successfully treated with topical timolol maleate 0.5% solution. Methods: Case report. Results: A 43-year-old female presented both superficial and deep orbital capillary hemangioma. Topical timolol maleate was applied twice daily. The superficial lesions have nearly disappeared after 1 year of treatment. The deeper lesions have also been reduced in size according to MRI. Conclusion: We report an adult patient with a relatively large orbital capillary hemangioma who was successfully treated with a topical β-blocker solution. This treatment might be applicable for orbital capillary hemangiomas, regardless of the patient's age, because of its effectiveness and safety.

  15. Tempo and mode in the macroevolutionary reconstruction of Darwinism.

    Science.gov (United States)

    Gould, S J

    1994-07-19

    Among the several central meanings of Darwinism, his version of Lyellian uniformitarianism--the extrapolationist commitment to viewing causes of small-scale, observable change in modern populations as the complete source, by smooth extension through geological time, of all magnitudes and sequences in evolution--has most contributed to the causal hegemony of microevolution and the assumption that paleontology can document the contingent history of life but cannot act as a domain of novel evolutionary theory. G. G. Simpson tried to combat this view of paleontology as theoretically inert in his classic work, Tempo and Mode in Evolution (1944), with a brilliant argument that the two subjects of his title fall into a unique paleontological domain and that modes (processes and causes) can be inferred from the quantitative study of tempos (pattern). Nonetheless, Simpson did not cash out his insight to paleontology's theoretical benefit because he followed the strict doctrine of the Modern Synthesis. He studied his domain of potential theory and concluded that no actual theory could be found--and that a full account of causes could therefore be located in the microevolutionary realm after all. I argue that Simpson was unduly pessimistic and that modernism's belief in reductionistic unification (the conventional view of Western intellectuals from the 1920s to the 1950s) needs to be supplanted by a postmodernist commitment to pluralism and multiple levels of causation. Macro- and microevolution should not be viewed as opposed, but as truly complementary. I describe the two major domains where a helpful macroevolutionary theory may be sought--unsmooth causal boundaries between levels (as illustrated by punctuated equilibrium and mass extinction) and hierarchical expansion of the theory of natural selection to levels both below (gene and cell-line) and above organisms (demes, species, and clades). Problems remain in operationally defining selection at non-organismic levels

  16. Treatment of scabies: the topical ivermectin vs. permethrin 2.5% cream.

    Science.gov (United States)

    Goldust, Mohamad; Rezaee, Elham; Raghifar, Ramin; Hemayat, Sevil

    2013-01-01

    Human scabies is caused by an infestation of the skin by the human itch mite (Sarcoptes scabiei va. hominis). It is commonly treated with topical insecticides, but the treatment of choice is still controversial. The aim of this study is to compare the efficacy of topical ivermectin vs. permethrin 2.5% cream for the treatment of scabies. In total, 380 patients with scabies were enrolled, and randomized into two groups: the first group received 1% ivermectin applied topically to the affected skin at a dose of 400 microg/kg, repeated once the following week, while the second group received permethrin 2.5% cream and were told to apply this twice at one week intervals. Treatment was evaluated at intervals of 2 and 4 weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Two applications of topical ivermectin provided a cure rate of 63.1% at the 2-week follow-up, which increased to 84.2% at the 4-week follow-up after repeating the treatment. Treatment with two applications of permethrin 2.5% cream with a 1-week interval between them was effective in 65.8% of patients at the 2-week follow-up, which increased to 89.5% at the 4-week follow-up after this treatment was repeated. Two application of ivermectin was as effective as two applications of permethrin 2.5% cream at the 2-week follow-up. After repeating the treatment, ivermectin was as effective as permethrin 2.5% cream at the 4-week follow up.

  17. [Usefulness of topical cidofovir treatment for recalcitrant molluscum contagiosum in immunocompromised children].

    Science.gov (United States)

    Guérin, M; Lepêcheur, V; Rachieru-Sourisseau, P; Réguerre, Y; Pellier, I; Martin, L

    2012-11-01

    Molluscum contagiosum (MC) is common and often numerous and recalcitrant in immunocompromised children. The response to available treatments is frequently unsatisfactory. Cidofovir is a nucleoside analog of the deoxycytidine antiviral drug approved for the intravenous treatment of cytomegalovirus retinitis in AIDS patients. We report four cases of children, 5-8 years old, who developed extensive MC in the context of chemotherapy for acute lymphoid leukemia and who were treated with a cream containing cidofovir 1%. In all patients, the lesions began to regress within 2 to 4 months. For three patients, complete regression was observed in 7 to 9 months, and the children remained clear of recurrence. For one patient, partial regression was obtained after 17 months of treatment. No side effects have been observed. Treatment of MC in immunocompromised children is difficult because the usual treatments are inappropriate. Successful use of either topically or intralesionally administered cidofovir in several virally induced cutaneous diseases has been demonstrated and recently documented in the treatment of MC in immunocompromised adults. Conversely, its use in children is not documented. Although intravenous use of cidofovir may lead to severe adverse effects, one single case of a systemic side effect has been reported after topical use at a greater concentration, but no changes in laboratory data were observed. Topical cidofovir offers an effective and well-tolerated therapeutic alternative option for the treatment of MC in immunosuppressed children.

  18. The efficacy of topical and oral ivermectin in the treatment of human scabies.

    Science.gov (United States)

    Panahi, Yunes; Poursaleh, Zohreh; Goldust, Mohamad

    2015-01-01

    Scabies is an itchy skin condition caused by the microscopic mite Sarcoptes scabei. The itching is caused by an allergic reaction to the mites. The treatment of choice is still controversial. It is commonly treated with topical insecticides. The aim of this study was to assess the efficacy of topical and oral ivermectin in the treatment of human scabies. We searched electronic databases (Cochrane Occupational Safety and Health Review Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE (Ovid), Pubmed, EMBASE, LILACS, CINAHL, Open Grey and WHO ICTRP) up to September 2014. Randomized controlled trials (RCTs) or cluster RCTs which compared the efficacy of ivermectin with other medications in the treatment of scabies. Interventions could be compared to each other, or to placebo or to no treatment. The author intended to extract dichotomous data (developed infection or did not develop infection) for the effects of interventions. We intended to report any adverse outcomes similarly. It has been sated that ivermectin was as effective as permethrin in the treatment of scabies. In comparison to other medications such as lindane, benzyl benzoate, crotamiton and malathion, ivermectin was more effective in the treatment of scabies. Ivermectin is an effective and cost-comparable alternative to topical agents in the treatment of scabies infection.

  19. Treatment of corneal squamous cell carcinoma using topical 1% 5-fluorouracil as monotherapy.

    Science.gov (United States)

    Dorbandt, Daniel M; Driskell, Elizabeth A; Hamor, Ralph E

    2016-05-01

    The purpose of this report is to discuss the use of topical 1% 5-fluorouracil as a sole therapy for canine corneal squamous cell carcinoma (SCC). A 12-year-old castrated male pug was evaluated for a well-demarcated, central, 3 mm in diameter, pale pink, raised, right corneal mass. An incisional biopsy was obtained using a #64 beaver blade after topical anesthesia and without sedation. A definitive diagnosis of corneal SCC was obtained after histopathologic evaluation of the biopsy. Topical 1% 5-fluorouracil ointment was applied to the right eye four times daily for 2 weeks followed by no treatment for 2 weeks, then treatment again twice daily for 2 weeks. The cornea remained free of recurrence 10 months after cessation of treatment. In dogs affected with corneal SCC, topical 1% 5-fluorouracil monotherapy may be a viable and cost-effective treatment option with minimal side effects. This chemotherapy agent may also have an effect on corneal pigmentation. Chronic cyclosporine therapy did not contribute to the pathogenesis of corneal SCC in the case described.

  20. Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen (Final)

    Science.gov (United States)

    EPA announced the availability of the final report, Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen. This report is a starting point to determine what is known and what needs to be known about selected nanomaterials as par...

  1. Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen (Final)

    Science.gov (United States)

    EPA announced the availability of the final report, Nanomaterial Case Studies: Nanoscale Titanium Dioxide in Water Treatment and in Topical Sunscreen. This report is a starting point to determine what is known and what needs to be known about selected nanomaterials as par...

  2. Treatment of common and plane warts in children with topical viable Bacillus Calmette-Guerin.

    Science.gov (United States)

    Salem, Ahmed; Nofal, Ahmad; Hosny, Doaa

    2013-01-01

    Treatment of verrucae in children is difficult and may be painful using traditional methods, especially if they are multiple or on the face. The objective of the current study was to evaluate the efficacy and safety of topical application of viable Bacillus Calmette-Guérin (BCG) in a paste formula as a new immunotherapeutic modality in the treatment of common and plane warts in children. The present study included 80 children with common and plane warts at different sites on the body. They were divided into two groups. Group A (40 patients) received topical viable BCG and group B (40 patients) received topical saline as control. All patients and controls had received a previous vaccination of BCG. BCG was applied once weekly for six consecutive weeks. Patients who had partial or no response received another course of treatment for another 6 weeks. Follow-up was at 6 months to detect any recurrences. A highly significant difference was found between the therapeutic response of common and plane warts to BCG and saline (placebo) (p warts and 45% of patients with plane warts. No response was detected in the control group. No recurrences or side effects were observed in the BCG group. Topical immunotherapeutic BCG is a new, effective, safe treatment option for children with common and plane warts. © 2012 Wiley Periodicals, Inc.

  3. Topical application of Semelil (ANGIPARSTM in treatment of pressure ulcers: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Shamimi Nouri K

    2008-04-01

    Full Text Available Pressure ulcers are one of the major health care problems and results in a substantial amount of burden for both patients and health services. The aim of this study was to appraise effectiveness of topical Semelil (ANGIPARSTM, a naive herbal extract, in pressure ulcers As a randomized controlled clinical trial, 18 patients with pressure ulcers were recruited from Vali-e-Asr hospital, Medical Sciences/ University of Tehran, Iran. Nine patients received topical Semelil (ANGIPARSTM during hospitalization and nine other patients received conventional treatment. Baseline characteristics of the topical and control groups did not differ across demographic, clinical and functional measures. The mean surface areas of the ulcers were reduced 48.2 ± 85.3 cm2 (78.3% and 2.8± 6.2 cm² (6.3% in the treatment and control groups, respectively (p=0.000.From the results of this study it may be concluded that the use of topical Semelil (ANGIPARSTM with conventional treatment is more effective than those of only conventional treatment for patients with pressure ulcers.

  4. Topical application of Mitomycin C in the treatment of granulation tissue after Canal Wall Down mastoidectomy

    Directory of Open Access Journals (Sweden)

    Alireza Karimi-Yazdi

    2013-03-01

    Full Text Available Introduction: Otorrhea and granulation tissue in Canal Wall Down mastoidectomy (CWD is the common problem in cholesteatoma removal and leads to many discomfort for both the patient and the physician. The main objective in CWD is creating the dry cavity, so the topical antibiotic and acetic acid in variable saturations are used for this purpose. In this study we evaluate the effectiveness of topical MMC and chemical cautery by acetic acid.   Materials and Methods: Study population consists of 50 patients with cholesteatoma whom underwent CWD. All patient allocated randomly in two study groups, MMC and acetic acid. After 3 weeks, the first visit is planned, extension of granulation tissue and dryness of cavity are evaluated and topical drugs are used in blind fashion. MMC in 4% and acetic acid in 12.5% saturation are applied. Other visits are completed at next month and 3 months later.   Results: Both methods are effective in treatment of granulation tissue. In each group both treatment were effective too but MMC was more effective than acid acetic in the treatment of granulation tissue after 4 weeks.   Conclusion: Based on our findings, it is clear that topical MMC is very effective in the treatment of granulation tissue and in CWD. It results in dry cavity much better than acetic acid without any complication. 

  5. Topical Pimecrolimus as a New Optional Treatment in Cutaneous Sarcoidosis of Lichenoid Type

    Directory of Open Access Journals (Sweden)

    Antonella Tammaro

    2014-01-01

    Full Text Available We report the case of cutaneous sarcoidosis of lichenoid type successfully treated with pimecrolimus. For the first time in the literature, we propose the use of this topical calcineurin inhibitor for the treatment of the cases refractory to common therapy regimens.

  6. Randomised controlled trial of topical kanuka honey for the treatment of rosacea

    NARCIS (Netherlands)

    Braithwaite, Irene; Hunt, Anna; Riley, Judith; Fingleton, James; Kocks, Janwillem; Corin, Andrew; Helm, Colin; Sheahan, Davitt; Tofield, Christopher; Montgomery, Barney; Holliday, Mark; Weatherall, Mark; Beasley, Richard

    2015-01-01

    OBJECTIVE: To investigate the efficacy of topical 90% medical-grade kanuka honey and 10% glycerine (Honevo) as a treatment for rosacea. DESIGN: Randomised controlled trial with blinded assessment of primary outcome variable. SETTING: Outpatient primary healthcare population from 5 New Zealand sites.

  7. PECULIARITIES OF A TOPICAL TREATMENT OF INFLAMMATORY DISEASES OF ENT-ORGANS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    S.A. Ivanichkin

    2011-01-01

    Full Text Available Nowadays infectious-inflammatory diseases of ENT-organs take one of the leading positions among pediatric acute pathology including that of infants. Despite abundant information upon etiology and pathogenesis of these diseases there are still questions regarding the most effective therapeutic schemes. This article contains information about peculiarities of pediatric ENT inflammatory diseases treatment. Special attention is paid to the problem of topical treatment of pediatric infectious-inflammatory ENT-diseases. It also includes discussion of benefits and drawbacks of various treatment options and medications used in this field.Key words: pharyngitis, tonsillitis, topical treatment, lozenges. (Voprosy sovremennoi pediatrii — Current Pediatrics. — 2011; 10 (6: 72–76.

  8. Topical clobetasol for the treatment of toxic epidermal necrolysis: study protocol for a randomized controlled trial

    OpenAIRE

    2015-01-01

    Background Toxic epidermal necrolysis (TEN) is a rare systemic allergic drug eruption with high patient mortality. Currently, no established treatments have been shown to be effective for TEN beyond supportive care. Prior studies of systemic corticosteroids have yielded conflicting data, with some showing a possible benefit and others reporting in increased mortality. However, topical steroids have shown promise for treatment of ocular sequelae of TEN, such as scarring and vision loss. We hav...

  9. Successful Treatment of Cutaneous Botryomycosis with a Combination of Minocycline and Topical Heat Therapy

    Directory of Open Access Journals (Sweden)

    Masaya Ishibashi

    2012-05-01

    Full Text Available Cutaneous botryomycosis is a chronic focal infection characterized by a granulomatous inflammatory response to bacterial pathogens such as Staphylococcus aureus. Treatment requires antibiotic therapy and may also require surgical debridement. We employed topical heat therapy and oral minocycline. The lesions became flattened and pigmented after 1 month. We consider that this simple treatment can be an effective and harmless complementary therapy for cutaneous botryomycosis.

  10. A case of lichen planus pigmentosus that was recalcitrant to topical treatment responding to pigment laser treatment.

    Science.gov (United States)

    Han, Xiuhui Debra; Goh, Chee Leok

    2014-01-01

    Lichen planus pigmentosus is a rare variant of lichen planus for which no effective treatment is currently available. Patients usually present with hyperpigmented, dark brown macules on sun-exposed areas or flexural folds. Here we describe a 50-year-old Chinese woman who had biopsy-confirmed lichen planus pigmentosus that was recalcitrant to a variety of topical treatments, but responded to treatment with a pigment laser.

  11. Resina Draconis as a topical treatment for pressure ulcers: A systematic review and meta-analysis.

    Science.gov (United States)

    Xu, Jiaqi; Xiong, Tian; Yang, Ying; Li, Jie; Mao, Jing

    2015-01-01

    In recent years, a number of studies have reported on Resina Draconis (RD) as a topical treatment for pressure ulcers. To evaluate these studies, we performed a systematic review and meta-analysis aimed to examine the efficacy of RD for pressure ulcers. We searched eight electronic databases to identify randomized controlled trials in which RD treatment was compared with other topical treatment of pressure ulcers from 1980 to 2014. Selection of studies, study appraisal, data extraction and analysis were undertaken using standard methods. Fourteen randomized controlled trials were included involving 618 patients. The results of the meta-analysis showed that, RD treatment was significantly associated with a higher healing rate for pressure ulcers (risk ratio 2.07, 95% confidence intervals 1.73-2.48, p < 0.001). The results of descriptive analysis showed that, compared with the control group, RD treatment shortened healing time. As for safety, adverse reactions had not been reported. These results suggest that RD can improve the healing rate for pressure ulcers and shorten the healing time, compared with other topical treatments. However, due to limited quality and quantity of the included studies, this conclusion needs to be proved by more high quality studies.

  12. Effect of topical steroid treatment on idiopathic granulomatous mastitis: clinical and radiologic evaluation.

    Science.gov (United States)

    Gunduz, Yasemin; Altintoprak, Fatih; Tatli Ayhan, Lacin; Kivilcim, Taner; Celebi, Fehmi

    2014-01-01

    Idiopathic granulomatous mastitis (IGM) is a rare inflammatory, noncaseating, chronic granulomatous benign disease. The etiology of IGM is still unknown. It is postulated to be an autoimmune localized response. The use of a course of oral steroids provides an important regression of breast mass and skin lesions. Topical corticosteroids are used to treat many skin diseases, but no study is available on the sole use of topical steroids for treating IGM. Eleven women with IGM were treated with topical steroid and evaluated using mammography, ultrasonography, and dynamic MRI. At the end of the 12th week, patients were clinically and radiologically evaluated for the regression of breast and skin lesions. Pre- and post-treatment time-intensity curve patterns (TICs) were also compared. During the topical steroid treatment, the inflammation signs in the affected breast had markedly disappeared, the fistulas had become inactive, and the fistula orifices and/or skin erosions had closed in nine patients. The median follow-up period was 17 months (range: 12-48 months). Recurrence was observed in two patients (2/11) at 5 and 8 months, which were treated again topically. The inflammatory findings of the breast skin completely resolved after 8 weeks of treatment, and no side effects or steroid-related complications occurred. In the pretreatment period, TICs from enhancing areas showed a Type 1 pattern in three cases, a Type 2 pattern in five cases, and a Type 3 pattern in three cases. After topical steroid treatment, TIC was not changed only in one patient (Type 2). Type 1 patterns were determined in seven cases and Type 2 patterns in two cases. In addition, in two patients, TICs were not determined due to complete healing. Our MRI findings showed that topical steroid therapy may be useful because it affects mammary parenchyma as well as mammary skin. Further studies with a greater number of patients are needed to determine the topical steroid therapy dosing and duration, and

  13. [Treatment of surgical wound dehiscence by topical negative pressure therapy: Clinical case].

    Science.gov (United States)

    Fresno-García, Carmen; Alconero-Camarero, Ana Rosa; Fernández-Carro, Belén

    2015-01-01

    Topical negative pressure therapy is an alternative treatment for complex wounds that consists of the direct application of sub-atmospheric pressure, obtaining a number of effects that are beneficial for tissues, promoting the healing of both acute and chronic wounds and complementing surgical procedures. We report the case of a 75 year old man diagnosed with surgical wound dehiscence after a femorotibial bypass graft, who was hospitalized again with the aim to perform the implantation of a topical negative pressure therapy in the infected wound. We designed a care plan for this patient following the steps of the scientific method and basing ourselves on the NANDA, NIC, and NOC taxonomies.

  14. Wickerhamomyces anomalus fungal keratitis responds to topical treatment with antifungal micafungin.

    Science.gov (United States)

    Kamoshita, Mamoru; Matsumoto, Yukihiro; Nishimura, Kazuko; Katono, Yasuhiro; Murata, Mitsuru; Ozawa, Yoko; Shimmura, Shigeto; Tsubota, Kazuo

    2015-02-01

    We describe a 91-year-old woman who suffered from fungal keratitis after corneal transplantation. The causative organism was identified as Wickerhamomyces anomalus (formerly Pichia anomala or Hansenula anomala) on the basis of morphological characteristics and the sequence of the internal transcribed spacer region of the ribosomal RNA gene. The patient was successfully treated with topical micafungin (MCFG) only. We present the first report of a case of W. anomalus fungal keratitis that responded to topical treatment with the antifungal MCFG.

  15. Successful Treatment of Granuloma Faciale with Topical Tacrolimus: A Case Report and Immunohistochemical Study

    Directory of Open Access Journals (Sweden)

    Gen-ichi Tojo

    2012-07-01

    Full Text Available We report the case of a 55-year-old Japanese patient with granuloma faciale (GF successfully treated with topical tacrolimus and describe the immunohistochemical study. Immunohistochemical staining revealed that the patient’s granuloma contained CD3+, CD4+, CD8+, CD68+ and CD163+ cells. Interestingly, these cells contained granulysin+ T cells and lacked Foxp3high+ regulatory T cells. In addition, the macrophages were mainly CD163+, which suggested that the alternatively activated macrophage is one of the main components of GF. In summary, the present data shed light on the granuloma-composing cells and possible mechanisms in the treatment of GF with topical tacrolimus.

  16. Controlled clinical trial of oral and topical diethylcarbamazine in treatment of onchocerciasis.

    Science.gov (United States)

    Taylor, H R; Greene, B M; Langham, M E

    1980-05-03

    In a double-blind controlled clinical trial comparing the safety and efficacy of oral diethylcarbamazine citrate (DEC) with topical DEC for the treatment of onchocerciasis twenty men with moderate skin-snip microfilarial counts received daily therapy for 1 week, then weekly therapy for the rest of 6 months. The number of microfilariae per skin snip dropped quickly to 2% of initial levels and remained at low levels in those receiving oral DEC, and to 20% of initial levels in patients treated with DEC lotion. Side-effects in both groups included lymphadenopathy, fever, pruritus, rash, proteinuria, and chorioretinitis; they were commoner with topical DEC.

  17. Identification of key research needs for topical therapy treatment of psoriasis - a consensus paper by the International Psoriasis Council.

    Science.gov (United States)

    Wu, J J; Lynde, C W; Kleyn, C E; Iversen, L; van der Walt, J M; Carvalho, A; Kirby, B; Bissonnette, R

    2016-07-01

    In this age of expanding choices of therapy for psoriasis, topical therapies still play an important part in the management of patients. There are many knowledge gaps in topical therapy for psoriasis with regard to efficacy and safety as well as various combinations including topical therapy with phototherapy or with systemic agents. Councillors of the International Psoriasis Council comprised a topical therapy working group to describe these gaps in order to help direct future research endeavours. Herein, we present the results of this analysis, discuss topical agents in clinical development and the attributes of the ideal topical treatment for psoriasis.

  18. Topical corticosteroids in the treatment of acute sunburn - A randomized, double-blind clinical trial

    DEFF Research Database (Denmark)

    Faurschou, A.; Wulf, Hans Chr.

    2008-01-01

    Objective: To examine the effect of topical corticosteroid treatment on acute sunburn. Design: Randomized, double-blind clinical trial. Setting: University dermatology department. Patients: Twenty healthy volunteers with Fitzpatrick skin types I (highly sensitive, always burns easily, tans...... minimally) through III (sun-sensitive skin, sometimes burns, slowly tans to light brown). Intervention: Seven 34-cm(2) areas were marked on the upper aspect of the back of each participant. An untreated area was tested to determine UV sensitivity. Two areas were treated with excess amounts (2 mg/cm(2......) was determined by the following equation: SIF=MED(minimal erythema dose) on treated skin/MED on nontreated skin. An SIF greater than 1 indicated an effect of topical corticosteroids in sunburn relief. Results: The SIFs in the areas treated with either topical corticosteroid 30 minutes before UV-B exposure...

  19. [Effectiveness of mesoglycan topical treatment of leg ulcers in subjects with chronic venous insufficiency].

    Science.gov (United States)

    La Marca, G; Pumilia, G; Martino, A

    1999-09-01

    Aim of the present comparative clinical study was to demonstrate the efficacy of the topical application of mesoglycan, a profibrinolytic agent, for healing of leg ulcers in patients with chronic venous insufficiency. Forty patients, observed in our outpatients department, with venous leg ulcers have been randomized in two groups of twenty subjects, each treated with topical application of mesoglycan (1 or 2 vials/day) or vegetal stimulins and followed for two months, with controls after 15, 30 and 60 days. At the end of the observation period, ulcer healing rate was 95% in the mesoglycan group, while a lower healing rate was obtained in the stimulins group (80%). The present study confirms previous clinical experiences with mesoglycan and suggests its application in the topical treatment of venous ulcers.

  20. Topical versus systemic diclofenac in the treatment of temporo-mandibular joint dysfunction symptoms.

    Science.gov (United States)

    Di Rienzo Businco, L; Di Rienzo Businco, A; D'Emilia, M; Lauriello, M; Coen Tirelli, G

    2004-10-01

    The most frequent symptom of craniomandibular dysfunction is pain in the preauricular area or in the temporo-mandibular joint, usually localized at the level of the masticatory musculature. Patients sometimes also complain of reflect otalgia, headaches and facial pain. Osteoarthrosis is a frequent degenerative debilitating chronic disorder that can affect the temporomandibular joint. It causes pain and articular rigidity, a reduction in mobility, and radiological alterations are visible in stratigraphy. The aim of this study was to compare the efficacy of a topically applied non-steroid anti-inflammatory drug that has recently become commercially available (diclofenac sodium in a patented carrier containing dimethyl sulfoxide, that favours transcutaneous absorption) which is commonly used to alleviate pain in knee or elbow joints, versus oral diclofenac, in the treatment of symptoms of temporomandibular joint dysfunction. Dysfunction of the temporomandibular joint was diagnosed in 36 adult patients. The patients were randomized in two age- and gender -matched groups. Group A (18 patients) received oral diclofenac sodium administered after a meal in 50-mg tablets twice a day for 14 days. Group B (18 patients) received 16 mg/ml topical diclofenac (diclofenac topical solution, 10 drops 4 times a day for 14 days). All patients completed a questionnaire at the start and end of therapy. Patients were asked to quantify on a graded visual analogue scale and to reply to questions about the pain and tenderness of the temporomandibular joint and the functional limitation of mouth opening. Patients were also requested to report side-effects of the treatment. All patients showed relief from pain after treatment: the difference between the two groups was not significant (p > 0.05). Post-treatment, 16 patients of group A had epigastralgic symptoms. Three patients treated with topical diclofenac showed a modest irritation of the temporomandibular joint region, and disappeared

  1. Comparative efficacy and patient preference of topical anaesthetics in dermatological laser treatments and skin microneedling

    Directory of Open Access Journals (Sweden)

    Yi Zhen Chiang

    2015-01-01

    Full Text Available Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA ® , 4% tetracaine gel (Ametop TM and 4% liposomal lidocaine gel (LMX4 ® in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval pain score of 5 (±2.58; 3.66-6.46 with Ametop TM , 4.38 (±2.53; 2.64-4.89 with EMLA ® and 3.91 (±1.95; 2.65-4.76 with LMX4 ® . There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4 ® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures.

  2. Comparative Efficacy and Patient Preference of Topical Anaesthetics in Dermatological Laser Treatments and Skin Microneedling

    Science.gov (United States)

    Chiang, Yi Zhen; Al-Niaimi, Firas; Madan, Vishal

    2015-01-01

    Background: Topical anaesthetics are effective for patients undergoing superficial dermatological and laser procedures. Our objective was to compare the efficacy and patient preference of three commonly used topical anaesthetics: (2.5% lidocaine/2.5% prilocaine cream (EMLA®), 4% tetracaine gel (Ametop™) and 4% liposomal lidocaine gel (LMX4®)) in patients undergoing laser procedures and skin microneedling. Settings and Design: This was a prospective, double-blind study of patients undergoing laser and skin microneedling procedures at a laser unit in a tertiary referral dermatology centre. Materials and Methods: All 29 patients had three topical anaesthetics applied under occlusion for 1 hour prior to the procedure, at different treatment sites within the same anatomical zone. A self-assessment numerical pain rating scale was given to each patient to rate the pain during the procedure and each patient was asked to specify their preferred choice of topical anaesthetic at the end of the procedure. Statistical Analysis: Parametric data (mean pain scores and frequency of topical anaesthetic agent of choice) were compared using the paired samples t-test. A P-value of ≤0.05 was considered as statistically significant. Results and Conclusions: Patients reported a mean (±SD; 95% confidence interval) pain score of 5 (±2.58; 3.66-6.46) with Ametop™, 4.38 (±2.53; 2.64-4.89) with EMLA® and 3.91 (±1.95; 2.65-4.76) with LMX4®. There was no statistically significant difference in pain scores between the different topical anaesthetics. The majority of patients preferred LMX4® as their choice of topical anaesthetic for dermatological laser and skin microneedling procedures. PMID:26644737

  3. Topical honey for the treatment of diabetic foot ulcer: A systematic review.

    Science.gov (United States)

    Kateel, Ramya; Adhikari, Prabha; Augustine, Alfred J; Ullal, Sheetal

    2016-08-01

    Topical honey has been used for the treatment of wound since ancient time. But the medical evidence proving it is limited. Hence a systematic review was planned. An exhaustive literature search was done in PUBMED, COCHRANE, GOOGLE using 'topical honey', 'diabetic foot ulcer', 'chronic wounds' as key words. Literature search showed total of five clinical trials and about ten observational studies in various part of world. Out of five clinical trials three concluded that honey dressing is better than conventional dressing, all the clinical trials proved safety of honey for the treatment of diabetic foot ulcer. Observational studies included total of 320 patients which also showed safety of honey but efficacy cannot be considered from observational studies. This review showed that honey dressing is safer for treatment of diabetic foot ulcer but there is insufficient good quality data to realistically conclude on the efficacy of honey on diabetic foot ulcers.

  4. Treatment of ligneous conjunctivitis with amniotic membrane transplantation and topical cyclosporine

    Directory of Open Access Journals (Sweden)

    Ozlem Yalcin Tok

    2012-01-01

    Full Text Available Ligneous conjunctivitis (LC is a rare form of bilateral chronic recurrent disease in which thick membranes form on the palpebral conjunctiva and other mucosal sites. We report the clinical features and describe the management of two cases. Case 1 was an 8-month-old patient with bilateral membranous conjunctivitis. Case 2 was a 5-year-old patient with unilateral membranous conjunctivitis, esotropia, mechanical ptosis and complicated cataract, and had been treated with a number of medications. Histological investigation of the membrane in both cases showed LC. Treatments with amniotic membrane transplantation and institution of topical cyclosporine have shown good response. There has been complete resolution of the membranes with no recurrence at the end of 40- and 28-month follow-ups, respectively. No treatment related side effects were seen. Thus, it appears that amniotic membrane transplantation and topical cyclosporine are effective alternatives for the treatment of LC.

  5. Scar prevention and remodeling: a review of the medical, surgical, topical and light treatment approaches.

    Science.gov (United States)

    Kerwin, Leonard Y; El Tal, Abdel Kader; Stiff, Mark A; Fakhouri, Tarek M

    2014-08-01

    Cosmetic, functional, and structural sequelae of scarring are innumerable, and measures exist to optimize and ultimately minimize these sequelae. To evaluate the innumerable methods available to decrease the cosmetic, functional, and structural repercussions of scarring, pubMed search of the English literature with key words scar, scar revision, scar prevention, scar treatment, scar remodeling, cicatrix, cicatrix treatment, and cicatrix remodeling was done. Original articles and reviews were examined and included. Seventy-nine manuscripts were reviewed. Techniques, comparisons, and results were reviewed and tabulated. Overall, though topical modalities are easier to use and are usually more attractive to the patient, the surgical approaches still prove to be superior and more reliable. However, advances in topical medications for scar modification are on the rise and a change towards medical treatment of scars may emerge as the next best approach. Comparison studies of the innumerable specific modalities for scar revision and prevention are impossible. Standardization of techniques is lacking. Scarring, the body's natural response to a wound, can create many adverse effects. At this point, the practice of sound, surgical fundamentals still trump the most advanced preventative methods and revision techniques. Advances in medical approaches are available, however, to assist the scarring process, which even the most advanced surgical fundamentals will ultimately lead to. Whether through newer topical therapies, light treatment, or classical surgical intervention, our treatment armamentarium of scars has expanded and will allow us to maximize scar prevention and to minimize scar morbidity.

  6. A Comparative Clinical Trial of Topical Triamcinolone (Adcortyle and a Herbal Solution for the Treatment of Minor Aphthous Stomatitis

    Directory of Open Access Journals (Sweden)

    F Rad

    2010-10-01

    The aim of this study was to compare the therapeutic effect of topical Myrtus communis (myrtle solution with topical triamcinolone (Adcortyle in the treatment of minor apotheosis. Materials & Methods: This clinical-trial study was conducted at Kurdistan University of Medical Sciences in 2009. 100 patients were randomly assigned into 2 groups. The 1st group received topical myrtle solution. The 2nd group received topical trimcinolone (Adcortyle. After one week, patients' declaration about time of the recovery of the pain and deterioration of oral lesion was recorded. The gathered data was then analyzed using the SPSS statistical software using t-test and chi-square. Results: After treatment, both groups showed response to topical medications with no significant difference between them (p>0.05. Conclusion: results of this study showed that topical myrtle solution is effective in the treatment of minor aphthous stomatitis and its therapeutic effect is comparable with topical triamcinolone (Adcortyle.

  7. Topical anaesthetic effects on skin vasculature with potential implications for laser treatment.

    Science.gov (United States)

    Tollan, Clare Josephine; MacLaren, William; Mackay, Iain R

    2016-05-01

    Laser treatment of vascular lesions is affected by parameters including the diameter and depth of the vessels and flow within the vessels. Topical anaesthetics are in common use prior to laser treatment but may have effects on vessel parameters and, subsequently, the efficacy of laser treatment. Eleven patients with capillary vascular malformations were investigated for vessel diameter before and after elective application of a topical anaesthetic, Eutectic Mixture of Local Anaesthetics (EMLA) (AstraZeneca) or Ametop (S&N Health), prior to pulsed dye laser treatment. EMLA contains 2.5% lidocaine ad 2.5% prilocaine, and Ametop gel contains 4% tetracaine. Patients' capillary malformations were assessed using confocal laser scanning microscopy (CLSM) (Vivascope 1500 Mavig GmbH, Munich). Six of the 11 patients recruited had EMLA topical anaesthetic, and five had Ametop. Four hundred twenty-one diameters were measured. The mean vessel diameter was 50.87 μm. Previous laser treatments undergone by each patient were noted to exclude this as a confounding variable, and no significant difference was found between topical anaesthetic groups. Statistical calculations were made using GenStat and Minitab. There is no evidence that Ametop affects mean diameter (p value is 0.361). EMLA reduces the mean diameter of vessels (p = 0.002), with a 27% reduction in post-EMLA diameter. This study demonstrates that the use of EMLA cream has a statistically significant reduction vessel diameter. As it is known that vessel diameter is important for the response of laser treatment, the use of EMLA may affect outcome.

  8. How do disease perception, treatment features, and dermatologist–patient relationship impact on patients assuming topical treatment? An Italian survey

    Directory of Open Access Journals (Sweden)

    Burroni AG

    2015-02-01

    Full Text Available Anna Graziella Burroni,1 Mariella Fassino,2 Antonio Torti,3 Elena Visentin4 1IRCCS University Hospital San Martino, IST National Institute for Cancer Research, Genoa, Italy; 2Department of Psychology, Specialization School in Clinical Psychology, University of Turin, Turin, Italy; 3Dermatology practice, Milan, Italy; 4HTA and Scientific Support, CSD Medical Research Srl, Milan, Italy Background: Psoriasis largely affects daily activities and social interactions and has a strong impact on patients’ quality of life. Psoriatic patients have different attitudes toward their condition. Topical medications are essential for the treatment of psoriasis, but the majority of patients do not adhere to these therapies. Objective: The history of treatment success or failure seems to influence patient attitude toward topical therapy. Therefore, it is important to understand the psychological, experiential, and motivational aspects that could be critical for treatment adherence, and to describe the different attitudes toward topical treatment. Furthermore, the physician–patient relationship and the willingness to trust the dermatologist may have a substantial role in encouraging or discouraging patients’ attitudes toward topical therapy. Methods: A survey was designed to collect aspects that could be relevant to understanding different patient attitudes toward psoriasis and its treatments. A total of 495 self-administered questionnaires compiled by psoriatic patients were analyzed from 20 Italian specialized hospital centers in order to provide a nationwide picture. Results: Psoriatic patients have different perceptions and experiences in relation to their condition: half of them consider psoriasis as a disease, while the other half consider psoriasis as a disorder or a nuisance. Topical therapy is the most widely used treatment, even though it is not considered the most effective one and often perceived to be cosmetic. The main findings are: 1

  9. Topical ivermectin versus crotamiton cream 10% for the treatment of scabies.

    Science.gov (United States)

    Goldust, Mohamad; Rezaee, Elham; Raghiafar, Ramin

    2014-07-01

    Scabies, known colloquially as the 7-year itch, is a contagious skin infection that occurs among humans and other animals. The treatment of choice is still controversial. The aim of this study was to compare the efficacy and safety of topical ivermectin vs. crotamiton cream 10% for the treatment of scabies. In total, 340 patients with scabies were enrolled, and randomized into two groups. The first group received 1% ivermectin applied topically to the affected skin. The dose employed was 400 μg/kg, repeated once the following week, and the second group received crotamiton 10% cream and were told to apply this twice daily for five consecutive days. Treatment was evaluated at intervals of two and four weeks, and if there was treatment failure at the 2-week follow-up, treatment was repeated. Two applications of topical ivermectin provided a cure rate of 64.7% at the 2-week follow-up, which increased to 82.3% at the 4-week follow-up after repeating the treatment. Treatment with single applications of crotamiton cream 10% was effective in 41.2% of patients at the 2-week follow-up, which increased to 64.7% at the 4-week follow-up after this treatment was repeated. Ivermectin was quite safe in our cases. Two applications of ivermectin were as effective as single applications of crotamiton 10% cream at the 2-week follow-up. After repeating the treatment, ivermectin was superior to crotamiton cream 10% at the 4-week follow-up.

  10. Surgery combined with topical photodynamic therapy for the treatment of squamous cell carcinoma of the lip.

    Science.gov (United States)

    Wang, Yuanyuan; Yang, Yadong; Yang, Yunchuan; Lu, Yuangang

    2016-06-01

    Due to the unique location of the squamous cell carcinoma (SCC) of the lip, using a single method such as extended resection or radiotherapy probably causes morphological and functional defects. So we used surgery combined with topical photodynamic therapy (PDT) to treat SCC of the lip. Under local anesthesia with 5% lidocaine, the hyperplastic and ulcerative SCC of the lip were curetted and assisted by topical PDTs after surgery. The 20% 5-aminolevulinic acid cream was used as a photosensitizer and applied evenly to the surface of the tumor lesion for 4h. Then the lesion site was irradiated with a 635-nm laser at 120J/cm(2). A total of five PDTs were performed postoperatively at an interval of 2 weeks. Photos were taken before and after every PDT to compare the skin lesions, treatment effects, and side effects. A long-term follow-up was undertaken to observe tumor recurrence. After surgery combined with five topical PDTs, the SCC of the lip disappeared without the compromised morphology of the lip, significant side effects, or tumor recurrence in one-year follow-up. Surgery combined with topical PDT can reduce the excision size of tumors and play a positive role in the treatment of tumors of special locations.

  11. Central chorioretinopathy associated with topical use of minoxidil 2% for treatment of baldness.

    Science.gov (United States)

    Scarinci, Fabio; Mezzana, Paolo; Pasquini, Paola; Colletti, Michelle; Cacciamani, Andrea

    2012-06-01

    Minoxidil is one of the drugs approved for the treatment of androgenetic alopecia. This article presents a case of central serous chorioretinopathy after application of topical minoxidil solution. We examined a 37-year-old man who complained of a positive relative scotoma, metamorphopsia and impaired dark adaptation involving the right eye. The patient reported an 8 month history of daily topical use but denied previous treatment with other drugs. Dilated fundus examination of right eye revealed central swelling located over the macula. Optical coherence tomography showed the presence of subretinal fluid. Fluorescein angiography disclosed one focal hyperfluorescent spot in the foveal area with minimal pigmentary changes limitated to that area. The patient was diagnosed with central serous chorioretinopathy (CSC) potentially related to an 8 month topical minoxidil solution administration. One month after the drug was discontinued, normal findings were found upon reexamination. The patient reported no previous episode of CSC. Major systemic side effects from topical solution of minoxidil are rare. To our knowledge, this is the first reported case of a central serous chorioretinopathy associated with long-term use of this drug.

  12. A universal driver of macroevolutionary change in the size of marine phytoplankton over the Cenozoic.

    Science.gov (United States)

    Finkel, Z V; Sebbo, J; Feist-Burkhardt, S; Irwin, A J; Katz, M E; Schofield, O M E; Young, J R; Falkowski, P G

    2007-12-18

    The size structure of phytoplankton assemblages strongly influences energy transfer through the food web and carbon cycling in the ocean. We determined the macroevolutionary trajectory in the median size of dinoflagellate cysts to compare with the macroevolutionary size change in other plankton groups. We found the median size of the dinoflagellate cysts generally decreases through the Cenozoic. Diatoms exhibit an extremely similar pattern in their median size over time, even though species diversity of the two groups has opposing trends, indicating that the macroevolutionary size change is an active response to selection pressure rather than a passive response to changes in diversity. The changes in the median size of dinoflagellate cysts are highly correlated with both deep ocean temperatures and the thermal gradient between the surface and deep waters, indicating the magnitude and frequency of nutrient availability may have acted as a selective factor in the macroevolution of cell size in the plankton. Our results suggest that climate, because it affects stratification in the ocean, is a universal abiotic driver that has been responsible for macroevolutionary changes in the size structure of marine planktonic communities over the past 65 million years of Earth's history.

  13. Macroevolutionary Immunology: A Role for Immunity in the Diversification of Animal life.

    Science.gov (United States)

    Loker, Eric S

    2012-01-01

    An emerging picture of the nature of immune systems across animal phyla reveals both conservatism of some features and the appearance among and within phyla of novel, lineage-specific defense solutions. The latter collectively represent a major and underappreciated form of animal diversity. Factors influencing this macroevolutionary (above the species level) pattern of novelty are considered and include adoption of different life styles, life histories, and body plans; a general advantage of being distinctive with respect to immune defenses; and the responses required to cope with parasites, many of which afflict hosts in a lineage-specific manner. This large-scale pattern of novelty implies that immunological phenomena can affect microevolutionary processes (at the population level within species) that can eventually lead to macroevolutionary events such as speciation, radiations, or extinctions. Immunologically based phenomena play a role in favoring intraspecific diversification, specialization and host specificity of parasites, and mechanisms are discussed whereby this could lead to parasite speciation. Host switching - the acquisition of new host species by parasites - is a major mechanism that drives parasite diversity and is frequently involved in disease emergence. It is also one that can be favored by reductions in immune competence of new hosts. Mechanisms involving immune phenomena favoring intraspecific diversification and speciation of host species are also discussed. A macroevolutionary perspective on immunology is invaluable in today's world, including the need to study a broader range of species with distinctive immune systems. Many of these species are faced with extinction, another macroevolutionary process influenced by immune phenomena.

  14. Effect of psoriasis activity and topical treatment on serum lipocalin-2 levels.

    Science.gov (United States)

    Baran, A; Świderska, M; Myśliwiec, H; Flisiak, I

    2017-03-01

    Psoriasis has been considered as systemic disorder. Lipocalin-2 might be a link between psoriasis and its comorbidities. Aim of the study was to investigate the associations between serum lipocalin-2 levels and the disease activity, markers of inflammation or metabolic disturbances and changes after topical treatment in psoriatic patients. Thirty-seven individuals with active plaque-type psoriasis and 15 healthy controls were recruited. Blood samples were collected before and after 14 days of therapy. Serum lipocalin-2 concentrations were examined by enzyme-linked immunosorbent assay. The results were correlated with Psoriasis Area and Severity Index (PASI), body mass index (BMI), inflammatory and biochemical markers, lipid profile and with effectiveness of topical treatment. Lipocalin-2 serum levels were significantly increased in psoriatic patients in comparison to the controls (p = 0.023). No significant correlations with indicators of inflammation, nor BMI or PASI were noted. A statistical association between lipocalin-2 and low-density lipoprotein-cholesterol was shown. After topical treatment serum lipocalin-2 level did not significantly change (p = 0.9), still remaining higher than in the controls, despite clinical improvement. Lipocalin-2 might be a marker of psoriasis and convey cardiovascular or metabolic risk in psoriatic patients, but may not be a reliable indicator of inflammation, severity of psoriasis nor efficacy of antipsoriatic treatment.

  15. Outcome and recurrence in treatment of phimosis using topical betamethasone in children in Hong Kong.

    Science.gov (United States)

    Ku, Wai-Hung; Chiu, Becky S-K; Huen, Kwai-Fun

    2007-01-01

    To study the efficacy of treating phimosis with topical steroid, and its long-term outcome and side effects. We also looked into the effect of daily retraction and cleansing of prepuce on preventing recurrence of phimsosis. This prospective study comprised 138 boys who were prescribed 0.05% betamethasone ointment (Diprocel) during 1 August 2001-31 July 2004. Five boys were excluded because of non-compliance. Of the remaining 133 boys, 108 were followed-up and assessed. Age ranged from 0.03 to 12.9 years (mean=3.38, SD=2.79). The number of treatment course received, short-term and long-term outcome, side effects and the effect of daily foreskin retraction were studied. The success rate of first treatment course was 81.5%, and 60.2% of boys remained free from phimosis upon latest assessment. The follow-up period ranged from 0.4 to 4.4 years (mean=2.45, SD=0.90). There were no side effects noted. We found a significant and linear relationship between daily foreskin retraction and sustained resolution of phimosis. Topical steroid is an effective and safe treatment for phimosis, especially when combined with a good hygiene practice of the foreskin with daily cleansing and retraction. A trial of topical steroid treatment should be offered upon considering circumcision.

  16. Treatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline

    Institute of Scientific and Technical Information of China (English)

    Aysegul; Arman; Duriye; Deniz; Demirseren; Tamer; Takmaz

    2015-01-01

    AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints.METHODS: One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline.RESULTS: Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes(P <0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs(P =0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group(P <0.05).CONCLUSION: Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage.

  17. Early, patient-initiated treatment of herpes labialis with topical 10% acyclovir.

    OpenAIRE

    Spruance, S. L.; Crumpacker, C S; Schnipper, L E; Kern, E. R.; Marlowe, S; Arndt, K A; Overall, J C

    1984-01-01

    To determine whether topical acyclovir in polyethylene glycol could reduce the severity of herpes simplex labialis if applied immediately after onset of a recurrence, 10% acyclovir in polyethylene glycol ointment or polyethylene glycol alone was prospectively dispensed to 352 patients in a double-blind, randomized trial. Sixty-nine subjects initiated treatment in the prodrome (57%) or erythema (43%) stage and were followed by clinical and virological criteria. The healing time (6.0 days), max...

  18. Ethosomes Loaded with Cryptotanshinone for Acne Treatment through Topical Gel Formulation

    OpenAIRE

    Zhenwei Yu; Hongyan Lv; Gang Han; Ke Ma

    2016-01-01

    The aim of this study was to develop ethosomes loaded with cryptotanshinone (CPT) and formulate them as a topical gel for the treatment of acne. Ethosomes were prepared and evaluated for vesicle size, CPT loading and encapsulation efficiency. Optimized ethosomes were formulated as Carbomer 974 gels and compared with conventional hydroethanolic gels for transdermal permeation and skin deposition in vitro. The anti-acne activity and skin irritation of the gel was investigated in rabbits. Optimi...

  19. Doppler laser imaging predicts response to topical minoxidil in the treatment of female pattern hair loss.

    Science.gov (United States)

    McCoy, J; Kovacevic, M; Situm, M; Stanimirovic, A; Bolanca, Z; Goren, A

    2016-01-01

    Topical minoxidil is the only drug approved by the US FDA for the treatment of female pattern hair loss. Unfortunately, following 16 weeks of daily application, less than 40% of patients regrow hair. Several studies have demonstrated that sulfotransferase enzyme activity in plucked hair follicles predicts topical minoxidil response in female pattern hair loss patients. However, due to patients’ discomfort with the procedure, and the time required to perform the enzymatic assay it would be ideal to develop a rapid, non-invasive test for sulfotransferase enzyme activity. Minoxidil is a pro-drug converted to its active form, minoxidil sulfate, by sulfotransferase enzymes in the outer root sheath of hair. Minoxidil sulfate is the active form required for both the promotion of hair regrowth and the vasodilatory effects of minoxidil. We thus hypothesized that laser Doppler velocimetry measurement of scalp blood perfusion subsequent to the application of topical minoxidil would correlate with sulfotransferase enzyme activity in plucked hair follicles. In this study, plucked hair follicles from female pattern hair loss patients were analyzed for sulfotransferase enzyme activity. Additionally, laser Doppler velocimetry was used to measure the change in scalp perfusion at 15, 30, 45, and 60 minutes, after the application of minoxidil. In agreement with our hypothesis, we discovered a correlation (r=1.0) between the change in scalp perfusion within 60 minutes after topical minoxidil application and sulfotransferase enzyme activity in plucked hairs. To our knowledge, this is the first study demonstrating the feasibility of using laser Doppler imaging as a rapid, non-invasive diagnostic test to predict topical minoxidil response in the treatment of female pattern hair loss.

  20. Treatment of allergic rhinoconjunctivitis: a review of the role of topical levocabastine

    Directory of Open Access Journals (Sweden)

    R. Gerth van Wijk

    1995-01-01

    Full Text Available Lcocabastine is an extremely potent and highly selective H1-receptor antagonist which has been specifically developed as eye drops and nasal spray for the treatment of allergic rhinoconjunctivitis. Clinical experience to date suggests that this topical antihistamine is at least as effective as other current first-line therapeutic approaches for the treatment of this condition, including oral H1-receptor antagonists and sodium cromoglycate. Onset of action is rapid, with clinical effects apparent within minutes of instillation. Moreover, duration of action is sufficiently long to permit a convenient twice-daily dosing regimen. Topical levocabastine is well tolerated with an adverse-effect profile comparable with that of placebo and sodium cromoglycate. As might be expected from the route of drug administration, application site reactions are the most frequent adverse effect associated with levocabastine eye drops and nasal spray with an incidence comparable with that seen in placebotreated controls. The availability of effective and well-tolerated topical antihistamines, such as levocabastine, is an important advance which broadens the range of therapeutic approaches available for the clinical management of allergic rhinoconjunctivitis. Levocabastine appears to be an attractive alternative to oral antihistamines as a first-line therapeutic option for the treatment of this atopic condition.

  1. Modelling topical photodynamic therapy treatment including the continuous production of Protoporphyrin IX

    Science.gov (United States)

    Campbell, C. L.; Brown, C. T. A.; Wood, K.; Moseley, H.

    2016-11-01

    Most existing theoretical models of photodynamic therapy (PDT) assume a uniform initial distribution of the photosensitive molecule, Protoporphyrin IX (PpIX). This is an adequate assumption when the prodrug is systematically administered; however for topical PDT this is no longer a valid assumption. Topical application and subsequent diffusion of the prodrug results in an inhomogeneous distribution of PpIX, especially after short incubation times, prior to light illumination. In this work a theoretical simulation of PDT where the PpIX distribution depends on the incubation time and the treatment modality is described. Three steps of the PpIX production are considered. The first is the distribution of the topically applied prodrug, the second in the conversion from the prodrug to PpIX and the third is the light distribution which affects the PpIX distribution through photobleaching. The light distribution is modelled using a Monte Carlo radiation transfer model and indicates treatment depths of around 2 mm during daylight PDT and approximately 3 mm during conventional PDT. The results suggest that treatment depths are not only limited by the light penetration but also by the PpIX distribution.

  2. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series

    Directory of Open Access Journals (Sweden)

    Jaeger M

    2016-08-01

    Full Text Available Marie Jaeger,1,* Moti Harats,1,* Rachel Kornhaber,2 Uri Aviv,1 Amir Zerach,1 Josef Haik1,3 1Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel; 2School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia; 3Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel *These authors contributed equally to this work. Abstract: Hypergranulation tissue (or also known as overgranulation may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal®. All five cases underwent surgical debridement and split-skin ­grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied ­topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3–41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds

  3. Onychomycosis does not always require systemic treatment for cure: a trial using topical therapy.

    Science.gov (United States)

    Friedlander, Shiela Fallon; Chan, Yuin C; Chan, Yiong H; Eichenfield, Lawrence F

    2013-01-01

    Standard teaching dictates that systemic therapy is required for treatment of onychomycosis. It is unknown whether topical antifungal therapy is effective for pediatric nail infections. This prospective, randomized, double-blind, vehicle-controlled study was conducted in the Pediatric Dermatology Research Unit at Rady Children's Hospital to determine whether topical antifungal therapy is efficacious for pediatric onychomycosis. Forty patients ages 2 to 16 years with nonmatrix onychomycosis were randomized 1:3 to ciclopirox lacquer or vehicle lacquer. Ciclopirox lacquer or vehicle was applied daily for 32 weeks, with weekly removal of the lacquer and mechanical trimming. Those with poor response were crossed over to active drug at week 12. Thirty-seven patients completed the 32-week study, and follow-up data were collected 1 year after completion of the study from 24 patients. Mycologic cure, effective treatment, and complete cure were assessed, as well as adverse events and effect on quality of life. Mycologic cure was 70% in the treated group and 20% in the vehicle arm (p = 0.03) at week 12. At end of the study (week 32), 77% of treated patients achieved mycologic cure and 71% effective treatment, compared with 22% of the control group. Ninety-two percent of those who were cured and followed for 1 year remained clear. Topical antifungal lacquer (ciclopirox) can be an effective option for children with nonmatrix onychomycosis. Pediatric onychomycosis does not always require systemic therapy and responds better to topical therapy than does adult disease.

  4. Clinical observations on the treatment of infantile hemangiomas with topical imiquimod 5% cream

    Institute of Scientific and Technical Information of China (English)

    Zhengtuan Guo; Guowei Li; Quan Xu; Ya Gao; Peng Li; Xiansheng Zhang; Yitao Duan; Xinkui Guo; Baijun Zheng

    2009-01-01

    Objective: To observe the efficacy and safety of topical imiquimod 5% cream in the treatment of uncomplicated infantile hemangiomas (IHs). Methods: A total of 68 IHs were treated with topical imiquimod 5% cream. Among them, 36 were superficial, 22 were mixed, and 10 were deep. The size of IHs ranged from 1.0 cm × 1.5 cm to an area of a whole forearm. All the hemangiomas were in a proliferative stage. Imiquimod was applied 3 times weekly in 44 patients and 5 times weekly in 24 patients for up to 36 weeks. Results: All superficial IHs improved, and 18 achieved complete clinical resolution, 10 had excellent improvement, 5 showed moderate improvements, and 3 patients displayed minimal improvement. Two mixed IHs showed excellent improvement, 3 showed moderate improvement and 5 manifested minimal improvements. The remaining 12 mixed IHs and all deep IHs did not respond to the therapy. The total incidence of local adverse events was 58.82%(40/68), which included erythema or edema, local itching, incrustation or peeling, erosion or ulceration,although most of these were mild to moderate reactions and did not affect the treatment. Scarring occurred in 2 mixed IHs. No systemic side effects developed. Conclusion: Imiquimod 5% cream may be a safe and effective alternative for the treatment of superficial IHs and some mixed IHs in which the superficial component predominates. An appropriate treatment duration for proliferative IHs treated with this therapy may be 24 weeks. Some local adverse events, such as crusting and erosion with possible scarring potential may occur and should be addressed by prompt, but temporary, discontinuation of the imiquimod. Topical imiquimod 5% cream can be prudently used in the treatment of IHs larger than 5.0 cm × 5.0 cm in newborns and infants less than 6 months of age. To our knowledge, this is the largest IH group treated with imiquimod that has been reported in the literature to date.

  5. Treatment of labial adhesion with topical estrogen and correlation with serum estradiol level

    Directory of Open Access Journals (Sweden)

    Safaian B

    2013-05-01

    Full Text Available Background: Serum estradiol level is a controversial prognostic factor in the outcome of labial adhesion. The aim of this study was to evaluate serum estradiol levels and topical estrogen response in patients with labial adhesion.Methods: A prospective interventional study was conducted among girls with labial adhesion that referred to Pediatrics clinic in Taleghani University Hospital, Gorgan city, Iran in 2011. One hundred patients entered the study. The diagnosis was conducted by clinical examination of vestibule area. Inclusion criteria were, three months to eight years old prepuberty girls, no ambiguous genitalia, lack of vulvovaginitis symptoms, labial adhesion more than twenty five percent, no history of previous topical estrogen treatment since two weeks ago and previous incomplete treatment. The patients who did not use proper amount and duration of drug and also with adverse drug reactions during treatment period were excluded from the study. Results: The maximum frequency of labial adhesion was in the group of less than one year old. The minimum frequency of labial adhesion was in the 7-8 years old group. Eighty six patients had complete or partial remission. No evidence of an improvement was observed in fourteen children. Severity of adhesions did not worsen in our patients. Serum estradiol levels were lower in patients who had a positive response to treatment. There were significant differences in serum estradiol levels between full or relative improvement with no improvement groups (P=0.044.Conclusion: Findings of this study showed that the labial adhesion patients with low serum estradiol level had better treatment response after using topical estrogen.

  6. Efficacy of Topical Mesenchymal Stem Cell Therapy in the Treatment of Experimental Dry Eye Syndrome Model

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    Emrullah Beyazyıldız

    2014-01-01

    Full Text Available Purpose. The current study was set out to address the therapeutic efficacy of topically applied mesenchymal stem cells (MSCs on dry eye syndrome (DES induced by benzalkonium chloride (BAC in rats. Methods. Rats were divided into two groups just after establishment of DES. Eye drops containing either bromodeoxyuridine labeled MSCs (n=9 or phosphate buffer solution (n=7 were topically applied once daily for one week. Schirmer test, break-up time score, ocular surface evaluation tests, and corneal inflammatory index scoring tests were applied to all rats at baseline and after treatment. All rats were sacrificed after one week for histological and electron microscopic analysis. Results. Mean aqueous tear volume and tear film stability were significantly increased in rats treated with MSCs (P<0.05. Infiltration of bromodeoxyuridine labeled MSCs into the meibomian glands and conjunctival epithelium was observed in MSCs treated rats. Increased number of secretory granules and number of goblet cells were observed in MSCs treated rats. Conclusion. Topical application of MSCs could be a safe and effective method for the treatment of DES and could potentially be used for further clinical research studies.

  7. Efficacy and safety of topical herbal medicine treatment on recurrent aphthous stomatitis: a systemic review.

    Science.gov (United States)

    Li, Chun-Lei; Huang, He-Long; Wang, Wan-Chun; Hua, Hong

    2016-01-01

    This study aimed to evaluate the efficacy and safety of topical treatment with natural herbal medicines on recurrent aphthous stomatitis (RAS). Nine electronic databases were searched to identify the randomized controlled trials and clinical controlled trials that reported the potential effect of natural herbal medicines on RAS published in Chinese or English. Ulcer size and duration, and remission of pain were assessed as main outcome measures. The methodological quality of the studies was evaluated using the Cochrane Handbook for Systemic Review of Interventions and Rev Man software. Thirteen trials with a total of 1,515 patients were included in the present analysis, which showed that topical treatment with natural herbal medicines seemed to benefit RAS patients by reducing ulcer size, shortening ulcer duration, and relieving pain without severe side effects. In conclusion, there is some evidence of the efficacy of topically applied natural herbal medicines with regards to improved RAS outcome measures and fewer side effects. However, given the limitations of this study, the evidence remains insufficient. Well-designed and high-quality randomized controlled trials are required for further exploration.

  8. Efficacy of Argentine propolis formulation for topical treatment of canine otitis externa

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    L.A Lozina

    2010-12-01

    Full Text Available The therapeutic effects of Argentine propolis ear drop formulation on canine otitis externa were evaluated. Forty-eight dogs with symptoms of otitis externa were randomly assigned to double-blinded, controlled clinical trial to evaluate the efficacy of topical formulation with propolis versus a topical placebo in the treatment of otitis externa. The propolis preparation and placebo were administrated into both external ear canals, twice daily for 14 days. Throughout the study, clinical examination and microbiological analysis of dogs ear exudates were made. The most frequent microorganisms isolated in culture media were: Malassezia pachydermatis (54.2%, Staphylococcus aureus (43.8%, coagulase-negative Staphylococcus (25.0%, Pseudomonas aeruginosa (20.8%, Candida albicans (18.8%, Proteus mirabilis (16.7%, Streptococcus spp. (16.7%, Enteroccocus faecalis (12.5%, Escherichia coli (12.5%, Staphylococcus intermedius (6.3%, Klebsiella spp. (4.2%, andCandida glabrata (2.1%. Whereas the control group did not recover from the infectious ear disease, the propolis preparation exhibited antimicrobial activity against most of the microorganisms isolated from samples of the treated group. In addition, no propolis-adverse effects were observed. This allowed propolis-treated patients to show a significant improvement of the clinical parameters. Thus, this new Argentine propolis ear drop formulation may be used for topical treatment of otitis externa in dogs.

  9. Modern wound care - practical aspects of non-interventional topical treatment of patients with chronic wounds.

    Science.gov (United States)

    Dissemond, Joachim; Augustin, Matthias; Eming, Sabine A; Goerge, Tobias; Horn, Thomas; Karrer, Sigrid; Schumann, Hauke; Stücker, Markus

    2014-07-01

    The treatment of patients with chronic wounds is becoming increasingly complex. It was therefore the aim of the members of the working group for wound healing (AGW) of the German Society of Dermatology (DDG) to report on the currently relevant aspects of non-interventional, topical wound treatment for daily practice. -Beside necessary procedures, such as wound cleansing and débridement, we describe commonly used wound dressings, their indications and practical use. Modern antiseptics, which are currently used in wound therapy, usually contain polyhexanide or octenidine. Physical methods, such as negative-pressure treatment, are also interesting options. It is always important to objectify and adequately treat pain symptoms which often affect these patients. Modern moist wound therapy may promote healing, reduce complications, and improve the quality of life in patients with chronic wounds. Together with the improvement of the underlying causes, modern wound therapy is an important aspect in the overall treatment regime for patients with chronic wounds.

  10. Topical analgesic added to paraffin enhances paraffin bath treatment of individuals with hand osteoarthritis.

    Science.gov (United States)

    Myrer, Joseph William; Johnson, Aaron Wayne; Mitchell, Ulrike H; Measom, Gary J; Fellingham, Gilbert W

    2011-01-01

    To compare treating patients with symptomatic hand osteoarthritis (OA) with paraffin baths only (PO) (100% wax) or paraffin baths 80% wax with 20% topical analgesic (PTA). Subjects met criteria of the American College of Rheumatology for classifying symptomatic hand OA and had a Dreiser's index score >5 points. Current and average pain at rest and with movement was assessed with visual analogue scales. Hand function was assessed by the functional index for hand OA (FIHOA). Both groups had a significant reduction in their 'current' pain 15 min after the first and twelfth treatments compared to pre-treatment but there was no difference between groups (t = 0.10, p > 0.05). The PTA group had greater improvement over the 12 treatment sessions for their pain at rest (t = 2.92, p paraffin produced significantly greater pain relief at rest and during movement than paraffin baths alone after 12 treatments. Additionally, the PTA group experienced greater improved hand function.

  11. Trigeminal postherpetic neuralgia responsive to treatment with capsaicin 8 % topical patch: a case report.

    Science.gov (United States)

    Sayanlar, Jennifer; Guleyupoglu, Nilufer; Portenoy, Russell; Ashina, Sait

    2012-10-01

    Postherpetic neuralgia has been variably defined but is generally understood to be pain that persists for longer than a few months after an attack of herpes zoster. Pain persists for years in approximately 10 % of those afflicted with acute herpes zoster. The likelihood of postherpetic neuralgia increases with older age, severity of the zoster, trigeminal location, and other factors. Postherpetic neuralgia is a neuropathic pain and treatment usually involves sequential trials of topical and systemic drugs; a variety of other therapies may be considered in refractory cases. A new topical capsaicin 8 % patch has been approved for this indication based on the positive studies in patients with non-trigeminal postherpetic neuralgia. Experience with the use of the capsaicin 8 % patch for trigeminal distribution neuralgia is lacking. We report a case of trigeminal postherpetic neuralgia which was safely and effectively treated with capsaicin 8 % patch.

  12. Interaction of counseling rapport and topics discussed in sessions with methadone treatment clients.

    Science.gov (United States)

    Joe, George W; Simpson, D Dwayne; Rowan-Szal, Grace A

    2009-01-01

    Therapeutic rapport between counselors and clients in drug user treatment has been shown to be an important predictor of follow-up outcomes. This naturalistic study investigated the relationship of counseling rapport to drug-related topics discussed in counseling sessions in a sample of 330 clients and nine counselors. These voluntary clients had been admitted to a private, for-profit outpatient methadone treatment in Texas between September 1995 and August 1997 and received no-fee services for a year for participation in this study. The data were gathered using forms in the TCU community treatment assessments (www.ibr.tcu.edu) that measured intake information, counseling session topics, and counselor evaluation of the client. A majority were males, Hispanic, had a pending legal status and the average age was 39. Co-occurring drug dependence for these heroin users included cocaine (38%) and alcohol (31%). The results supported the hypothesis that higher rapport would be associated with addressing clients in a more "supportive approach" that emphasized relapse prevention and strengths-building while lower rapport would be associated with a punitive counseling style that stressed program rules and compliance. The influences of client background, counselor differences, and during-treatment positive urines were also examined. Although counselors differed in their general manner of dealing with clients, each also showed flexibility determined in part by client behavior (such as continued cocaine use). The findings indicate that focusing on constructive solutions is the preferred counseling approach.

  13. A double-blind randomised clinical trial of the treatment of otitis externa using topical steroid alone versus topical steroid-antibiotic therapy.

    Science.gov (United States)

    Abelardo, E; Pope, L; Rajkumar, K; Greenwood, R; Nunez, D A

    2009-01-01

    The objective of the study was to determine if the addition of topical antibiotic increases the efficacy of topical steroid in controlling otitis externa. A double-blind randomised controlled trial was performed from February 2003 to April 2005 in an otolaryngology emergency clinic (acute urban teaching hospital) in the United Kingdom. Patients were followed up for 2 weeks. Forty-five adults with otitis externa based on the presence of oedema, discharge or debris in the outer ear canal were recruited. The patients were randomised to one of the two treatment groups, namely using betamethasone sodium phosphate 0.1% (Vista-Methasone) or betamethasone sodium phosphate 0.1% with neomycin sulphate 0.5% (Vista-Methasone N), and were instructed to use the trial medication at three drops three times a day for 2 weeks. Subjects' visual analogue symptom scores (blockage, pain, discharge, and itching) for otitis externa pre-treatment (day 0) and post-treatment (day 15), percentage changes in visual analogue symptom scores as a result of treatment, proportion of patients whose symptom scores failed to improve or deteriorated on treatment were analysed. The two experimental arms demonstrated statistically similar presenting symptom scores at recruitment (mean symptom scores of 19.2 for betamethasone group and 28.7 for betamethasone-neomycin group). The mean symptom score change in response to treatment was 82.8 and 47.8% in the betamethasone-neomycin and betamethasone-alone groups, respectively. There was no statistically significant difference between the groups in median percentage symptom score change in response to treatment. All patients in the betamethasone-neomycin group showed symptom improvement but in the betamethasone alone group, five patients got worse (Fishers exact, P = 0.05). Topical antibiotic-steroid combination therapy is superior to steroid-alone treatment for symptomatic control of otitis externa.

  14. Topical Rosiglitazone Treatment Improves Ulcerative Colitis by Restoring Peroxisome Proliferator-Activated Receptor-gamma Activity

    DEFF Research Database (Denmark)

    Pedersen, G.; Brynskov, Jørn

    2010-01-01

    and functional activity in human colonic epithelium and explored the potential of topical treatment with rosiglitazone (a PPAR gamma ligand) in patients with ulcerative colitis. METHODS: Spontaneous and rosiglitazone-mediated PPAR gamma and adipophillin expression (a gene transcriptionally activated by PPAR...... gamma) were measured by reverse transcriptase PCR in colonic biopsies and isolated epithelial cells from patients with ulcerative colitis and controls. Fourteen patients with active distal ulcerative colitis were randomized to either rosiglitazone (4 mg) or mesalazine (1 g) enema treatment once daily...... in epithelial cells from inflamed mucosa in vitro. Rosiglitazone enema treatment was well tolerated and reduced the Mayo ulcerative colitis score from 8.9 to 4.3 (P

  15. Novel drug delivery systems in topical treatment of psoriasis: Rigors and vigors

    Directory of Open Access Journals (Sweden)

    Katare Om

    2010-01-01

    Full Text Available Psoriasis is a chronic inflammatory skin disorder that may drastically impair the quality of life of a patient. Among the various modes of treatments for psoriasis, topical therapy is most commonly used in majority of patients. The topical formulations based on conventional excipients could serve the purpose only to a limited extent. With the advent of newer biocompatible and biodegradable materials like phospholipids, and cutting-edge drug delivery technologies like liposomes, solid lipid nanoparticles (SLNs, microemulsions, and nanoemulsions, the possibility to improve the efficacy and safety of the topical products has increased manifold. Improved understanding of the dermal delivery aspects and that of designing and developing diverse carrier systems have brought in further novelty in this approach. Substantial efforts and the consequent publications, patents and product development studies on the subject are the matter of interest and review of this article. However, majority of the work is related to the preclinical studies and demands further clinical assessment in psoriasis patients.

  16. Topical Medical Cannabis (TMC): A new treatment for wound pain-Three cases of Pyoderma Gangrenosum.

    Science.gov (United States)

    Maida, Vincent; Corban, Jason

    2017-08-14

    Pain associated with integumentary wounds is highly prevalent yet it remains an area of significant unmet need within healthcare. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, non-invasive, self-administered, and display rapid onset of analgesia. Extracts derived from the cannabis plant have been applied to wounds for thousands of years. The discovery of the human endocannabinoid system and its dominant presence throughout the integumentary system provides a valid and logical scientific platform to consider the use of topical cannabinoids for wounds. We are reporting a prospective case series of 3 patients with Pyoderma Gangrenosum (PG) that were treated with Topical Medical Cannabis (TMC) compounded in non-genetically modified organic sunflower oil. Clinically significant analgesia that was associated with reduced opioid utilization was noted in all 3 cases. TMC has the potential to improve pain management in patients suffering from wounds of all classes. Copyright © 2017. Published by Elsevier Inc.

  17. Comparative Efficacy of Topical Pertmehrin, Crotamiton and Sulfur Oint-ment in Treatment of Scabies

    Directory of Open Access Journals (Sweden)

    Celestyna Mila-Kierzenkowska

    2017-04-01

    Full Text Available Background:  Scabies is an ectoparasitic infection, which occurs because of direct skin-to skin contact. The ideal treatment modality is still unclear and further research on this topic is warranted. The aim of the study was to com­pare the efficacy and safety of the topical scabicides: permethrin, crotamiton and sulfur ointment.Methods: Fifty four patients with diagnosed scabies were randomly divided into three treatment groups. The first group received 5% permethrin cream twice with one week interval, the patients from the second group were given crotamiton lotion for two days twice with one week interval, while the third group received 10% sulfur ointment for two or three weeks. All patients were followed up at 1, 2 and 4 weeks intervals.Results: At one-week follow up the cure rate was significantly higher at permethrin-treated group when compared to crotamiton group (P< 0.001 and sulfur group (P< 0.001. At the end of two-week interval, the cure rate at perme­thrin group was 100%, while at crotamiton group, 66.7% and in sulfur group 38.9% (P< 0.001. At 4-week follow up the applied treatment was effective in all studied individuals.Conclusion: The topical application of permethrin, crotamiton and sulfur was equally efficacious at 4-week follow up, however permethrin cream showed faster improvement at first and second follow up. Acquiring permethrin is considered as expensive option and crotamiton lotion seems to be cost-less alternative to this cream.

  18. Fractional carbon-dioxide (CO2) laser-assisted topical therapy for the treatment of onychomycosis.

    Science.gov (United States)

    Bhatta, Anil Kumar; Keyal, Uma; Huang, Xin; Zhao, Jing Jun

    2016-05-01

    Inability of topical medications to penetrate via nail plate brings a great challenge to clinicians in treating onychomycosis. Furthermore, oral medications are not appropriate for all patients because of drug interactions, adverse effects, and contraindications. We sought to evaluate the clinical efficacy of fractional carbon-dioxide laser-assisted topical therapy for onychomycosis. In total, 75 patients with 356 onychomycotic nails confirmed by mycologic examination were included in this study. All the affected nails received 3 sessions of laser therapy at 4-week intervals and once-daily application of terbinafine cream for 3 months. In all, 94.66% and 92% of the treated patients were potassium hydroxide and culture negative, respectively, after 3 months of treatment. However, only 84% and 80% were potassium hydroxide and culture negative, respectively, at 6 months of follow-up. Using Scoring Clinical Index for Onychomycosis electronic calculator, 73.33% of the patients scored higher than 6 and 26.66% of the patients scored 6 or less. Those who scored more than 6 were evaluated clinically and 98.18% of them showed response to treatment at 3 months and 78.18% of them at 6 months of follow-up. Lack of control group and short duration of follow-up are limitations. Fractional carbon-dioxide laser therapy combined with topical antifungal was found to be effective in the treatment of onychomycosis. However, randomized clinical studies are needed before it can be widely used in clinics. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  19. Microsporidial Stromal Keratitis: Successful Treatment with Topical Voriconazole and Oral Itraconazole

    Science.gov (United States)

    Kim, James; Shenoy, Sudhir; Chévez-Barrios, Patricia; Kapur, Manuj

    2016-01-01

    We report a case of microsporidial stromal keratitis successfully treated with topical voriconazole and oral itraconazole. A 30-year-old Hispanic male construction worker who wears contacts lenses presented with left eye erythematous, epiphora, and mild pain increasing over few days after failing previous antibiotics treatment. His best corrected visual acuity in the left eye was count fingers at three feet, and the slit lamp examination showed 3+ conjunctival injection, a circular central corneal ulcer 3.2 mm in diameter, stromal thinning, and an anterior chamber with white cells, flair, and 0.1 mm hypopyon. A cornea punch biopsy identified microsporidial organisms with some features suggestive of Vittaforma corneae. After treatment with topical voriconazole and oral itraconazole for eight weeks, the patient had complete resolution with no recurrence for over 12 months of follow-up. To our knowledge, this is the first reported case of successful treatment of microsporidial stromal keratitis with antifungals. PMID:28123915

  20. Topical steroid is effective for the treatment of phimosis in young children.

    Science.gov (United States)

    Sookpotarom, Paiboon; Porncharoenpong, Suchat; Vejchapipat, Paisarn

    2010-01-01

    The purpose of the present study was to evaluate the effects of non-operative treatment using topical steroids on phimosis in infants and young children. Between June 2003 and May 2005, the parents of the children with phimosis were instructed to apply and massage the phimotic skin with 0.05% betamethasone valerate cream twice daily for 2 months. During non-operative treatment, the patients whose parents were not satisfied with the results would undergo circumcision. Ninety-two phimotic boys with an average age of 32.62 months (range, 1 to 144 months) were enrolled for steroid application. Of the 92 patients, 79 (85.9%) were satisfied with their results. The other 13 patients whose outcomes clinically improved but did not satisfy their parents finally underwent circumcision. Histologically, circumcised skins of patients initially receiving steroid therapy revealed markedly interstitial edema and slightly increased vasculature. There were no systemic side effects or significant dermal atrophy in the present study. Topical steroid treatment for phimosis is successful in young children. This therapeutic approach is a safe, easy, and inexpensive alternative to circumcision.

  1. Treatment of focal epithelial hyperplasia with topical imiquimod: report of three cases.

    Science.gov (United States)

    Yasar, Sirin; Mansur, Ayse Tulin; Serdar, Zehra Asiran; Goktay, Fatih; Aslan, Canan

    2009-01-01

    Focal epithelial hyperplasia (Heck disease) is a rare disorder caused by specific types of HPV. It mainly involves oral mucosa and children are affected more frequently. It may persist for years, producing a significant reduction in quality of life. Several treatment modalities such as surgical excision, laser ablation, cryotherapy, electrocauterization, topical, intralesional, systemic interferon, and systemic retinoic acid have been used with inconsistent results and many side effects. Here we report three children of Turkish origin with focal epithelial hyperplasia successfully treated with imiquimod 5% cream. No serious side effects were observed and recurrence did not occur during the 1-year follow-up period.

  2. Rosacea: part II. Topical and systemic therapies in the treatment of rosacea.

    Science.gov (United States)

    Two, Aimee M; Wu, Wiggin; Gallo, Richard L; Hata, Tissa R

    2015-05-01

    Although rosacea's impact on physical health is limited, it has profound effects on a person's psychological well-being. Therefore, treating rosacea can greatly affect a person's quality of life. Patient education regarding trigger avoidance and skin care techniques such as moisturizing and sun protection are important non-pharmacologic first steps in treating rosacea. Pharmacologic interventions range from topical to systemic medications, with the ideal medication choice dependent on the symptoms and severity of each individual patient. Despite this variety of therapeutic options, none of these therapies are completely curative, and therefore further research into the pathophysiology of rosacea is required in order to create more targeted and efficacious treatment options.

  3. Microemulsion-Based Topical Hydrogels of Tenoxicam for Treatment of Arthritis.

    Science.gov (United States)

    Goindi, Shishu; Narula, Manleen; Kalra, Atin

    2016-06-01

    Tenoxicam (TNX) is a non-steroidal anti-inflammatory drug (NSAID) used for the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, backache and pain. However, prolonged oral use of this drug is associated with gastrointestinal adverse events like peptic ulceration, thus necessitating its development as topical formulation that could obviate the adverse effects and improve patient compliance. The present study was aimed at development of microemulsion-based formulations of TNX for topical delivery at the affected site. The pseudoternary phase diagrams were developed and microemulsion formulations were prepared using Captex 300/oleic acid as oil, Tween 80 as surfactant and n-butanol/ethanol as co-surfactant. Optimized microemulsions were characterized for drug content, droplet size, viscosity, pH and zeta potential. The ex vivo permeation studies through Laca mice skin were performed using Franz diffusion cell assembly, and the permeation profile of the microemulsion formulation was compared with aqueous suspension of drug and drug incorporated in conventional cream. Microemulsion formulations of TNX showed significantly higher (p < 0.001) mean cumulative percent permeation values in comparison to conventional cream and suspension of drug. In vivo anti-arthritic and anti-inflammatory activity of the developed TNX formulations was evaluated using various inflammatory models such as air pouch model, xylene-induced ear edema, cotton pellet granuloma and carrageenan-induced inflammation. Microemulsion formulations were found to be superior in controlling inflammation as compared to conventional topical dosage forms and showed efficacy equivalent to oral formulation. Results suggest that the developed microemulsion formulations may be used for effective topical delivery of TNX to treat various inflammatory conditions.

  4. Therapeutic Effects of Topical Minoxidil or Rosemary and the Combination of Both on the treatment of Alopecia areata

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Lohrasb

    2015-02-01

    Full Text Available Background & Objectives: Considering the prevalence of Alopecia areata, , failure of treatment, and the unknown pathogenesis of this illness, a comparative study was performed by using topical Minoxidil 2% and topical rosemary solution alone and in combination to treatment this disease. Materials & Methods: This study is a clinical trial performed on 200 patients with Alopecia areata referring to Hamzeh clinic of Fasa during the years 2012 and 2013. They were divided into four groups by random permutation, each group contained 50 patients. Group one received the combination of topical Minoxidil 2% and topical rosemary, group two received only topical Minoxidil 2% solution, group three received only topical rosemary solution and the fourth group, the case-control group, did not receive any medication and were just advised to rub the site of the disease for the same period of time. The patients were under observation for one year. Results: The Results of this investigation showed that the best remissions after treatments were as follow (respectively: combination of topical Minoxidil 2% and topical rosemary (27 patient=54 %, Minoxidil 2% solution (23 patients =46%, rosemary solution (21 patients =42%, and case- control group (9 patients =18%. These results showed that despite better response to the combination of rosemary and Minoxidil solutions in comparison to the two other treated groups, the changes were minimal and statistically insignificant (P-value =0.0411. Conclusion: Using the combination of both rosemary and Minoxidil is more effective than the individual one on treatment of Alopecia areata.

  5. Treatment and prevention of paronychia using a new combination of topicals: report of 30 cases.

    Science.gov (United States)

    Gianni, C

    2015-08-01

    Moderate and chronic paronychia is a common disease affecting the hand. Treatment can be effective but the affection is often recurrent, especially as an occupational disease. Moreover, this condition may be complicated by a Candida spp or by bacterial infections. Therefore, general preventive measures can be useful in maintaining health. The aim of this study was to investigate the efficacy and tolerability of a new combination of topical medications in the treatment and prevention of moderate and chronic paronychia. This formulation includes an insulating polymer (Syn-cell barrier), two topical antifungals (octopirox and climbazole) and a molecule with anti-inflammatory activity (corticoid-like repair). Thirty adult subjects (age, 16-78 years; 24 females and 6 males) affected by moderate or chronic paronychia, with or without nail alterations, were evaluated. Included in the study were patients with allergic contact dermatitis (8), irritant contact dermatitis (19), psoriatic paronychia (2 patients), lichen planus of the nails (1 patient). Sometimes Candida spp or bacteria overlapped with paronychia (16 patients positive for Candida spp and 4 patients with bacterial paronychia), sometimes infectious paronychia was not associated with dermatitis of the hands. All 30 subjects were treated with a new cream formulation, three applications per day for 2 months. In 8 patients with proven and severe candidiasis of the nails, oral fluconazole 100 mg was added for 20 days. All patients with bacterial perionyxis took clarithromycin 500 mg twice daily for six days. Patients were then followed for 8 weeks. After two months of treatment, 26 patients responded to therapy. In particular, the treatment evaluation at the end of the follow-up period showed a clinical cure in 46.6% (14 patients), improvement in 40% (12 patients), and failure in 13.4% (4 patients). There was a side effect (moderate skin irritation) in 2 patients, but the drug was not discontinued. Results of the

  6. Comparative Study of Professional vs Mass Market Topical Products for Treatment of Facial Photodamage.

    Science.gov (United States)

    Reich, Hilary; Wallander, Irmina; Schulte, Lacie; Goodier, Molly; Zelickson, Brian

    2016-01-01

    Many over the counter topical products claim to reverse the signs of cutaneous photo-damage. To date, the two most studied ingredients for improving the texture, tone, and pigmentation of the skin are topical retinoids and hydroquinone. This split face study compares a mass market skincare regimen with a prescription skin care regimen for improvement in photo damaged skin. Twenty-seven subjects with moderate photo damaged facial skin were enrolled. Each subject was consented and assigned with the mass market anti-aging system (Treatment A) to one side of the face and the prescription anti-aging system (Treatment B or Treatment C) to the other side of the face. Treatment B contained 13 subjects whom did not use 0.025% Retinol cream. Treatment C contained 14 subjects who used a 0.025% Retinol Cream. Subjects had 4 visits over 12 weeks for digital photography and surveys. Photographs were evaluated by blinded physicians. Physician objective analysis showed all three systems to have a statistically significant clinical improvement in photoaged skin seen in as little as 4 weeks of use. Participant's surveys rated the mass market system higher than both of the professional systems for visible skin changes, ease of use, and likelihood to recommend to a friend. Twelve of twenty-seven subjects preferred the mass market system for overall improvement while twelve thought each system gave the same improvement. This study demonstrates that a mass marketed skin care system can give similar clinical improvements in photo-aged skin as a professionally dispensed prescription system and the majority of participants preferred the mass-marketed system.

  7. Evaluation of topical potassium hydroxide solution for treatment of plane warts

    Directory of Open Access Journals (Sweden)

    Khalil I Al-Hamdi

    2012-01-01

    Full Text Available Background: Plane wart is a common dermatological disease that is caused by human papilloma virus; although the rate of spontaneous recovery is high, it usually takes a long time to occur. Many modalities of treatments have been used but none of them proved to be uniformly effective. Potassium hydroxide (KOH solution is a well-known keratolytic agent with many dermatological uses. Objective: To evaluate the efficacy and tolerability of topical KOH solution in the treatment of plane warts. Materials and Methods: A total of 250 patients with plane warts, consulting the department of Dermatology and Venereology of Basra Teaching Hospital between March 2008 and October 2009, were enrolled in this opened therapeutic trial study. Patients were divided into two age and sex cross-matched equal groups; patients in group (A were treated with topical 5% KOH solution once at night, while patients in group (B were treated with topical 10% KOH solution once nightly. Only 107 patients from group (A and 95 patients from group (B completed the study, while the remainders were defaulted for unknown reasons. The patients were evaluated at second and fourth week to assess the cure rates and side effects, those patients who showed complete cure were followed up for 3 months to detect any recurrence. Results: At the end of second week, 9.3% of group (A patients showed complete disappearance of their warts, vs 66.3% of group (B patients. At the end of fourth week, 80.3% of group (A patients showed complete response in comparison with 82.1% of group (B patients. The side effects for the treating solution in both concentrations include itching, burning sensation, erythema, and temporary dyspigmentations, that were reported in 77.6% of group (A patients in comparison with 90.5% of group (B patients. Recurrence rate was reported in 5.8% of group (A patients vs 5.1% of group (B patients during the three months period of follow-up. Conclusions: Topical KOH solution is

  8. Visualization and Treatment of Subclinical Actinic Keratoses with Topical Imiquimod 5% Cream: An Observational Study

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    Daisy Kopera

    2014-01-01

    Full Text Available Background. Imiquimod 5% is licensed for the treatment of external genital warts, superficial basal cell carcinoma, and actinic keratosis (AK and is being used experimentally in various other dermato-oncological conditions. Objective. This observational study shall show that nonmelanoma skin cancer can be detected at its earliest subclinical stage by its reaction with imiquimod and can be cleared by finishing the course of treatment. Material and Methods. In this single arm trial 15 patients with chronically sun-exposed skin who had no clinical evidence of AK were treated with 5% imiquimod cream on the face or scalp for 4 weeks three times per week. Results. During treatment, all patients developed multiple areas with mild to moderate inflammatory skin reactions, such as erythema, induration, and scaling. Biopsies obtained from 12 patients prior to treatment revealed no malignancies. However, in cases with more pronounced inflammation during treatment, targeted biopsies indicated very early malignant alterations. Conclusion. Topical imiquimod treatment of chronically sun-exposed skin without overt clinical signs of AK is able to detect subclinical actinic keratoses (SAK and to completely clear the lesions, even before they can be clinically diagnosed as AK. In such patients, imiquimod might be able to prevent the evolution of SCC.

  9. Expert recommendations: the use of the fixed combination calcipotriol and betamethasone dipropionate gel for the topical treatment of psoriasis.

    Science.gov (United States)

    Daudén, E; Bewley, A; Lambert, J; Girolomoni, G; Cambazard, F; Reich, K

    2014-05-01

    Treatment non-adherence is a general challenge and a complex problem. It is a key factor that impacts the 'real-life' effectiveness of topical treatments for chronic disorders, such as psoriasis. Here, we provide our expert opinion on the real-life effectiveness of topical psoriasis treatment, using the fixed combination gel (Daivobet(®) gel; calcipotriol plus betamethasone dipropionate) as a case study. The fixed combination gel is a first-line topical treatment for mild-to-moderate psoriasis, developed to be the gold-standard therapy for psoriasis patients. This fixed combination gel is an effective and well-tolerated topical psoriasis treatment that the majority of our patients prefer to the ointment formulation. We assessed our real-life experience and considered any gaps between daily practice and clinical trials data. We recommend a multifaceted approach to improve real-life effectiveness and bridge the gap between investigational trials and treatment reality and propose the following recommendations: (1) educate primary healthcare providers on how to effectively manage topical psoriasis treatment and the patients who use the treatment; (2) educate the patient on why treatment needs to be maintained, even when symptoms improve; and (3) provide a supportive environment that will not allow the patient to feel abandoned. A patient-centric approach may improve adherence, which will lead to patients receiving more effective treatment for psoriasis.

  10. BACTERIAL LYSATES FOR TOPICAL APPLICATION IN PREVENTION AND TREATMENT OF CHRONIC TONSILLITIS AMONG CHILDREN

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    T.I. Garashchenko

    2006-01-01

    Full Text Available The authors have carried on the research of the influence Imudon exerts (during topical application on the run of chronic tonsillitis among 48 children aged between 5 and 10 years old, being dispensary registrants. The sublingual application of a medicine 6 pills daily within 20 days demonstrated the frequency reduction of chronic tonsillitis acerbations by 2.9 times, as well as the reduction of total need in systemic antibacterial treatment by 10 times. Apart from that, the frequency of S. pyogenes group a exposure reduced by 3 times. The researchers noticed the tendency to normalization of pharynx biocenosis. Thus, Imudon may be recommended for the daily courses of treatment to the people, suffering from chronic tonsillitis, palatine tonsil auxesis and recurrent tonsillo-pharyngites.Key words: chronic tonsillitis, children, prevention, bacterial lysates.

  11. Some topical problems in the diagnosis and treatment of back pain

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    B M Doronin

    2010-01-01

    Full Text Available Back pain is a topical problem for both a general practitioner and a neurologist because of not only the high rate of this syndrome, but also its differential diagnosis problems. As any clinical syndrome, back pain should be differentiated from very many other diseases. This is primarily determined by the tactics of the management and treatment of a patient with neck-and-chest or low back pain. Today the diagnosis of spinal osteochondrosis may be rather common as that of exclusion. A meticulous neurological examination is of importance when diagnosing back pain. A premium is also placed upon X-ray and neuroimaging studies. When back pain is treated, it is necessary to take into account the intensity of pain syndrome, its proneness to chronicity, the individual personality traits, and concomitant visceral involvement and to use both drug and non-drug treatments, among which remedial exercises and psychotherapy are considered most effective.

  12. Functionalized gold nanoparticles for topical delivery of methotrexate for the possible treatment of psoriasis.

    Science.gov (United States)

    Bessar, Hagar; Venditti, Iole; Benassi, Luisa; Vaschieri, Cristina; Azzoni, Paola; Pellacani, Giovanni; Magnoni, Cristina; Botti, Elisabetta; Casagrande, Viviana; Federici, Massimo; Costanzo, Antonio; Fontana, Laura; Testa, Giovanna; Mostafa, Fawzia Farag; Ibrahim, Samia Ali; Russo, Maria Vittoria; Fratoddi, Ilaria

    2016-05-01

    Gold nanoparticles (AuNPs) represent an effective choice for topical drug delivery systems thanks to their small size, general non-toxicity, ease of functionalization and high surface to volume ratio. Even if systemic, methotrexate still plays an important role in psoriasis treatment: its topical use shows insufficient percutaneus penetration owing to limited passive diffusion, high molecular weight and dissociation at physiological pH. The aim of our study was to design a new drug delivery nanocarrier for Methotrexate and to improve its solubility, stability and biodistribution. AuNPs were on purpose prepared with a hydrophilic stabilizing layer, in order to improve the colloidal stability in water. Water-soluble gold nanoparticles functionalized by sodium 3-mercapto-1-propansulfonate (Au-3MPS) were prepared and loaded with methotrexate (MTX). The loading efficiency of MTX on Au-3MPS was assessed in the range 70-80%, with a fast release (80% in one hour). The release was studied up to 24h reaching the value of 95%. The Au-3MPS@MTX conjugate was fully characterized by spectroscopic techniques (UV-vis, FTIR) and DLS. Preliminary toxicity tests in the presence of keratinocytes monolayers allowed to assess that the used Au-3MPS are not toxic. The conjugate was then topically used on C57BL/6 mouse normal skin in order to trace the absorption behavior. STEM images clearly revealed the distribution of gold nanoparticles inside the cells. In vitro studies showed that Methotrexate conjugated with Au-3MPS is much more efficient than Methotrexate alone. Moreover, DL50, based on MTT analysis, is 20 folds reduced at 48 h, by the presence of nanoparticles conjugation. UV-vis spectra for in vivo tracing of the conjugate on bare mouse skin after 24h of application, show increased delivery of Methotrexate in the epidermis and dermis using Au-3MPS@MTX conjugate, compared to MTX alone. Moreover we observed absence of the Au-3MPS in the dermis and in the epidermis, suggesting that

  13. Topical application of ALA PDT for the treatment of moderate to severe acne vulgaris

    Science.gov (United States)

    Wang, Xiu-Li; Wang, Hong-Wei; Zhang, Ling-Lin; Su, Lina; Guo, Ming-Xia; Huang, Zheng

    2009-06-01

    Objectives: To evaluate the effectiveness of topical 5-aminolevulinic acid (ALA)- medicated photodynamic therapy (ALA PDT) for the treatment of moderate to severe acne vulgaris. Methods: Sixteen Chinese patients with moderate to severe facial acne were treated with 1-3 courses of ALA PDT. ALA cream (3%) was freshly prepared and applied to acne lesions for 3-4 h. The lesions were irradiated by a 635 nm diode laser at dose levels of 60 - 80 J/cm2 at 100 mW/cm2. Clinical assessments were conducted before and after treatment up to 3 months. Results: All patents showed response to ALA PDT. Complete clearance was seen in 10 patients (62.5%) and partial clearance in 6 patients (37.5%). One case showed recurrence after complete clearance at 2 months and another two showed recurrence after complete clearance at 3 months. However, the number of new lesions were significantly reduced. Adverse effects were minimal. Conclusions: The results of this preliminary clinical study is encouraging. ALA PDT is a simple, safe and useful therapeutic option for the treatment of moderate to severe acne. Further studies to evaluate the treatment with a larger number of patients and for a longer period of follow-up are needed.

  14. Healing of chronic cutaneous wounds by topical treatment with basic fibroblast growth factor.

    Science.gov (United States)

    Fu, Xiaobing; Shen, Zuyao; Guo, Zhenrong; Zhang, Mingliang; Sheng, Zhiyong

    2002-03-01

    To evaluate the safety and efficacy of topical application of recombinant bovine basic fibroblast growth factor (rbFGF) on the healing of chronic cutaneous wounds. Twenty-eight patients with thirty-three chronic cutaneous wounds resulting from trauma, diabetes mellitus, pressure sore and radiation injuries were enrolled in this prospective, open-label crossover trial. Prior to treatment with rbFGF, all wounds failed to heal with conventional therapies within 4 weeks. All wounds were locally treated with rbFGF at a dose of 150 AU/cm(2). Healing time and the quality of wounds were used to evaluate the efficacy of the treatment. Healing of all chronic wounds was expedited. During the study, eighteen wounds completely healed within 2 weeks, four healed within 3 weeks, and another eight completely healed within 4 weeks. Only three wounds failed to heal within 4 weeks, but healed at 30, 40 and 42 days after treatment with rbFGF. Thus, compared with conventional therapies, the effective rate of rbFGF treatment within 4 weeks was 90.9%. Histological assessment showed more abundant capillary sprouts or tubes and that fibroblasts were differentiated in wounds treated with rbFGF. No adverse side effects related to basic fibroblast growth factor were observed. Our results indicate that rbFGF could be used to accelerate healing in chronic wounds. It is our belief that this may be a more effective method of chronic wound management.

  15. Technical aspects of laser treatment for acute retinopathy of prematurity under topical anesthesia

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    Jalali Subhadra

    2010-01-01

    Full Text Available Retinopathy of prematurity (ROP is a significant cause of childhood blindness. The criteria for laser therapy have been revised from threshold ROP to include the earlier stage of high-risk prethreshold ROP. Laser photocoagulation is an established technique for the treatment of ROP. However, the detailed procedure and techniques for laser photocoagulation have not yet been published. Adequate and appropriate laser photocoagulation for ROP is different from the application of lasers in adult retinal vascular diseases, and many ophthalmologists need to be trained in this technique if the outreach of ROP treatment programs is to improve. Laser under topical anesthesia has been practiced in India as a preferred modality especially due to logistics and risks of general anesthesia in these pre-term babies. We discuss the details of the technique as practiced at tertiary care ophthalmic hospitals in India, so that the nuances in treatment parameters and clinical decision-making can be usefully applied to ophthalmic practice. This will ultimately lead to safe and effective treatment delivery in ROP.

  16. Technical aspects of laser treatment for acute retinopathy of prematurity under topical anesthesia.

    Science.gov (United States)

    Jalali, Subhadra; Azad, Rajvardhan; Trehan, Hemant Singh; Dogra, Mangat Ram; Gopal, Lingam; Narendran, Venkatapathy

    2010-01-01

    Retinopathy of prematurity (ROP) is a significant cause of childhood blindness. The criteria for laser therapy have been revised from threshold ROP to include the earlier stage of high-risk prethreshold ROP. Laser photocoagulation is an established technique for the treatment of ROP. However, the detailed procedure and techniques for laser photocoagulation have not yet been published. Adequate and appropriate laser photocoagulation for ROP is different from the application of lasers in adult retinal vascular diseases, and many ophthalmologists need to be trained in this technique if the outreach of ROP treatment programs is to improve. Laser under topical anesthesia has been practiced in India as a preferred modality especially due to logistics and risks of general anesthesia in these pre-term babies. We discuss the details of the technique as practiced at tertiary care ophthalmic hospitals in India, so that the nuances in treatment parameters and clinical decision-making can be usefully applied to ophthalmic practice. This will ultimately lead to safe and effective treatment delivery in ROP.

  17. Nanostructured lipid carrier based topical gel of Ganoderma Triterpenoids for frostbite treatment.

    Science.gov (United States)

    Shen, Cheng-Ying; Dai, Ling; Shen, Bao-De; Zhou, Xu; Bai, Jin-Xia; Xu, He; Lv, Qing-Yuan; Han, Jin; Yuan, Hai-Long

    2015-06-01

    The objective of this study was to prepare nanostructured lipid carrier (NLC)-based topical gel of Ganoderma Triterpenoids (GTs) and evaluate their effects on frostbite treatment. GT-NLCs was prepared by the high pressure homogenization method and then characterized by morphology and analyses of particle size, zeta potential, entrapment efficiency (EE), and drug loading (DL). The NLCs was suitably gelled for skin permeation studies in vitro and pharmacodynamic evaluation in vivo, compared with the GT emulgel. The GT-NLC remained within the colloidal range and was uniformly dispersed after suitably gelled by carbopol preparation. Transmission electron microscopy (TEM) study showed GT-NLCs was spherical in shape. The EE (%) and DL (%) could reach up to (81.84 ± 0.60)% and (2.13 ± 0.12)%, respectively. The result of X-ray diffractograms (XRD) showed that GTs were in an amorphous state in the NLC-gel. In vitro permeation studies through rat skin indicated that the amount of GTs permeated through skin of GT-NLCs after 24 h was higher than that of GT emulsion, and GT-NLCs increased the accumulative amounts of GTs in epidermis 7.76 times greater than GT emulsion. GT-NLC-gel was found to possess superior therapeutic effect for frostbite, compared with the GT emulgel. The NLC based topical gel of GTs could improve -their therapeutic effect for frostbite.

  18. Efficacy of topical atorvastatin for the treatment of pressure ulcers: a randomized clinical trial.

    Science.gov (United States)

    Farsaei, Shadi; Khalili, Hossein; Farboud, Effat Sadat; Karimzadeh, Iman; Beigmohammadi, Mohammad Taghi

    2014-01-01

    To evaluate the effects of topical atorvastatin on the healing process of pressure ulcers in critically ill patients. Randomized, double-blind, placebo-controlled clinical trial. Medical-surgical intensive care unit of a university-affiliated teaching hospital in Tehran, Iran. One hundred four patients with stage I or II pressure ulcers, graded according to the 2-digit Stirling Pressure Sore Severity Scale. Patients were randomized to receive topical atorvastatin 1% ointment (51 patients [atorvastatin group]) or placebo ointment (53 patients [control group]) applied once/day to pressure ulcers for 14 days in addition to standard care for pressure ulcers. The efficacy of each treatment was assessed on days 7 and 14. Efficacy was determined based on the degree of healing of the existing pressure ulcer by using the 2-digit Stirling scale. The baseline stage of the pressure ulcers did not differ significantly between the control and atorvastatin groups. However, the mean ± SD stage of pressure ulcers significantly decreased in the atorvastatin group compared with the control group on day 7 (0.97 ± 0.76 vs 1.74 ± 0.75, pulcers in the atorvastatin group were significantly declined compared with the control group after 7 days (5.55 ± 4.55 vs 9.41 ± 5.03 cm², ppressure ulcers in critically ill patients. © 2013 Pharmacotherapy Publications, Inc.

  19. Topical metronidazole and clotrimazole in the treatment of vulvo-vaginal infections during pregnancy

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    Lorenzo Pradelli

    2007-03-01

    Full Text Available Vulvo-vaginal infections are the most common gynaecological pathologies seen in clinical practice. While being predominantly benign, although disturbing, in non pregnant women, their presence during pregnancy has been associated with peri-natal and obstetric complications. The opportunity to prevent these adverse outcomes, especially prematurity and low birth weight, has to be cautiously balanced against the potential to induce fetal toxicity, inherently related to the continuous exchanges among maternal and fetal blood that occurs in the placenta. In this paper, a brief overview of the evidence regarding efficacy, safety and utility during pregnancy of topical clotrimazole and metronidazole, whose combined spectrum covers the great majority of the involved pathogens, is provided. These antimicrobials, especially when applied topically, are highly effective and have been used in pregnant women for many years without evidence of adverse outcomes; in conclusion it appears that they hold an adequate risk-to-benefit ratio and represent valid therapeutic options in the treatment of vulvo-vaginal infections during pregnancy.

  20. Topical PDT in the Treatment of Benign Skin Diseases: Principles and New Applications

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    Miri Kim

    2015-09-01

    Full Text Available Photodynamic therapy (PDT uses a photosensitizer, light energy, and molecular oxygen to cause cell damage. Cells exposed to the photosensitizer are susceptible to destruction upon light absorption because excitation of the photosensitizing agents leads to the production of reactive oxygen species and, subsequently, direct cytotoxicity. Using the intrinsic cellular heme biosynthetic pathway, topical PDT selectively targets abnormal cells, while preserving normal surrounding tissues. This selective cytotoxic effect is the basis for the use of PDT in antitumor treatment. Clinically, PDT is a widely used therapeutic regimen for oncologic skin conditions such as actinic keratosis, squamous cell carcinoma in situ, and basal cell carcinoma. PDT has been shown, under certain circumstances, to stimulate the immune system and produce antibacterial, and/or regenerative effects while protecting cell viability. Thus, it may be useful for treating benign skin conditions. An increasing number of studies support the idea that PDT may be effective for treating acne vulgaris and several other inflammatory/infective skin diseases, including psoriasis, rosacea, viral warts, and aging-related changes. This review provides an overview of the clinical investigations of PDT and discusses each of the essential aspects of the sequence: its mechanism of action, common photosensitizers, light sources, and clinical applications in dermatology. Of the numerous clinical trials of PDT in dermatology, this review focuses on those studies that have reported remarkable therapeutic benefits following topical PDT for benign skin conditions such as acne vulgaris, viral warts, and photorejuvenation without causing severe side effects.

  1. Efficacy of Topical 1% Oxiconazole Cream in the Treatment of Dermatophytosis

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    Md Tawhidul Islam

    2014-05-01

    Full Text Available Background: Dermatophytosis is a geographically widespread group of fungal infections. Tinea corporis and tinea cruris are the most common dermatophytoses in Bangladesh. Oxiconazole has recently been introduced in Bangladesh in the treatment of dermatophytoses. Objective: To evaluate the efficacy of topical 1% oxiconazole cream once daily in the treatment of tinea corporis and tinea cruris. Materials and Methods: A clinical trial was carried out in the department of Dermatology and Venereology, Jalalabad Ragib-Rabeya Medical College Hospital, Sylhet on 81 patients with tinea corporis and/or tinea cruris. The patients were instructed to apply 1% oxiconazole cream once daily for 2 weeks with clinical assessment made at weekly intervals during treatment period. Results: The mean age of the patients was 32.5 ± 10.5 years, with tinea corporis in 47 (58.0% patients and tinea cruris in 34 (42.0%. The mean clinical assessment score declined from 6.6 ± 1.3 at baseline to 3.9 ± 1.2 at week 1, 0.9 ± 1.3 at week 2 and 0.7 ± 1.1 at week 4. Reduction of clinical assessment score from baseline to end of the treatment period was statistically significant (p<0.001. The improvement of clinical score was from baseline to 41.6% at week 1, 89.3% at week 2 and 91.5% at week 4. Improvement of clinical score from baseline to end of the treatment period was statistically significant (p<0.001. Global response was clear in 55 (67.9% patients, good in 25 (30.9% patients and fair in 1(1.2% patient. Clinical efficacy was cure in 55 (67.9% patients, improvement in 25 (30.9% and failure in 1(1.2% patient. Conclusion: Once daily topical administration of oxiconazole cream is highly effective in the treatment of superficial fungal infections of the skin.

  2. Development and characterization of nanocarriers for topical treatment of psoriasis by using combination therapy.

    Science.gov (United States)

    Parnami, Nupur; Garg, Tarun; Rath, Goutam; Goyal, Amit K

    2014-12-01

    Psoriasis is an autoimmune, chronic, inflammatory skin disease characterized by epidermal hyperplasia, proliferation of blood vessels, and infiltration of leukocytes in dermis and epidermis. Several immunosuppressants such as methotrexate (MXT) and cyclosporine are used but they are associated with adverse effects due to down regulation of immune system. Numerous approaches have been explored to overcome the problems of conventional topical system such as high frequency of application, impermeability to skin barrier, and limited efficacy. Photodynamic therapy is another non-invasive technique currently used for skin diseases. The combination of two drugs is also commonly observed to achieve more effective therapy. In the present study, antipsoriatic activity of niosomal formulations for the treatment of psoriasis in combination with narrow and broad band UV radiation had been explored in experimental animal model.

  3. Use of topical lidocaine in the treatment of muscle tension dysphonia.

    Science.gov (United States)

    Dworkin, J P; Meleca, R J; Simpson, M L; Garfield, I

    2000-12-01

    This investigation explored the potential usefulness of topical lidocaine in the treatment of muscle tension dysphonia. Three patients with this disorder, who were previously unresponsive to standard voice therapy, were treated with lidocaine. In each case, the outcome was prompt, clinically significant, and sustained. Persistently high-pitched and shrill vocal quality was converted to near normal voice patterns within 15 minutes after transcricothyroid membrane lidocaine injection. We suggest that this temporary and simple laryngeal and tracheal anesthetic technique may have helped to break the perverse cycle of hyperactive glottal and supraglottal muscle contractions evident in each of these patients during phonation efforts. We discuss the possible sensorimotor mechanism of action of this therapeutic technique.

  4. Topical Rosiglitazone Treatment Improves Ulcerative Colitis by Restoring Peroxisome Proliferator-Activated Receptor-gamma Activity

    DEFF Research Database (Denmark)

    Pedersen, G.; Brynskov, Jørn

    2010-01-01

    OBJECTIVES: Impaired epithelial expression of peroxisome proliferator-activated receptor-gamma (PPAR gamma) has been described in animal colitis models and briefly in patients with ulcerative colitis, but the functional significance in humans is not well defined. We examined PPAR gamma expression...... and functional activity in human colonic epithelium and explored the potential of topical treatment with rosiglitazone (a PPAR gamma ligand) in patients with ulcerative colitis. METHODS: Spontaneous and rosiglitazone-mediated PPAR gamma and adipophillin expression (a gene transcriptionally activated by PPAR...... for 14 days. RESULTS: PPAR gamma expression was fourfold reduced in epithelial cells from inflamed compared with uninflamed mucosa and controls. Adipophillin levels were decreased in parallel. Rosiglitazone induced a concentration-dependent increase in adipophillin levels and restored PPAR gamma activity...

  5. Topical alprostadil in the treatment of Female Sexual Arousal Disorder: a pilot study.

    Science.gov (United States)

    Islam, A; Mitchel, J; Rosen, R; Phillips, N; Ayers, C; Ferguson, D; Yeager, J

    2001-01-01

    This study evaluated the efficacy and safety of three doses of topical alprostadil USP (prostaglandin E1) cream in 8 patients with Female Sexual Arousal Disorder (FSAD). Each patient was administered a single intravaginal dose of placebo followed by escalating intravaginal doses of the active drug at 2-week intervals. Alprostadil's effectiveness in enhancing subjective and physiological arousal during visual sexual stimulation was supported by patient ratings and physician assessments of vaginal erythema and transudate volume. Photoplethysmography measurement of vaginal pulse amplitude was not able to demonstrate treatment sensitivity in the present study. Adverse events included mild cases of vaginal itching and burning. The data support further investigation of the use of alprostadil for FSAD.

  6. Efficacy of octenidine dihydrochloride and 2-phenoxyethanol in the topical treatment of inflammatory acne.

    Science.gov (United States)

    Mayr-Kanhäuser, Sigrid; Kränke, Birger; Aberer, Werner

    2008-09-01

    With the increase in antibiotic-resistant strains of microorganisms in acne lesions, the search for alternative treatment methods has become important. We studied the efficacy of a combination of the antiseptic substances octenidine dihydrochloride and 2-phenoxyethanol (O/P) in mild to moderate inflammatory acne vulgaris. Thirty patients were instructed to apply O/P once or twice daily for a 6-week treatment period. Determination of efficacy included the numerical documentation of inflammatory and non-inflammatory lesions within defined regions of the face by the investigator, and photodocumentation of the clinical picture as well as the fluorescence pattern under Wood's light. Twenty-four patients completed the study. The number of papules and pustules decreased more than 50% in seventeen and nineteen patients, respectively. Acne lesions worsened in only one patient. Mild adverse reactions (erythema, burning, and scaling) were seen in two patients. Therefore, O/P was highly effective in treating inflammatory lesions of facial acne, but there was no essential efficacy in the non-inflammatory primary acne lesions. Topical O/P is a good and cost-effective alternative in the treatment of mild to moderate inflammatory acne lesions and may allow reduced application of anti-acne antibiotics to prevent development of resistance.

  7. Efficacy of topical azelaic acid gel in the treatment of mild-moderate acne vulgaris

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    Iraji Fariba

    2007-01-01

    Full Text Available Background: Twenty percent azelaic acid gel is recommended as a topical treatment for acne due to its favorable profile. Aim: Our objective in this study was to evaluate the efficacy of 20% azelaic acid gel in the treatment of mild to moderate acne vulgaris. Methods: This was a double blind, randomized clinical trial. Sixty patients with mild to moderate acne vulgaris were selected randomly to receive either azelaic acid gel or the vehicle gel alone. Patients were followed up every 15 days for a period of 45 days. The number of lesions and the acne severity index (ASI were recorded and compared using Student′s t-test. Results: Total lesion count was reduced by 60.6% and 19.9% by azelaic acid gel and the placebo respectively (P =0.002. ASI was reduced by 65.2% and 21.3% by azelaic acid gel and the placebo respectively (P =0.001, i.e., azelaic acid gel was 3.06 times more effective than the placebo in reducing ASI. Conclusion: Azelaic acid gel can be used as an effective treatment in mild to moderate acne vulgaris.

  8. Efficacy of a single topical application of Advantage Multi (= Advocate) Topical Solution (10% imidocloprid + 2.5% moxidectin) in the treatment of dogs experimentally infected with Crenosoma vulpis.

    Science.gov (United States)

    Conboy, Gary; Hare, Jonathan; Charles, Sam; Settje, Terry; Heine, Josef

    2009-08-01

    Crenosoma vulpis is a metastrongylid lungworm of canids causing chronic respiratory disease in dogs in parts of North America and Europe. The objective of this study was to determine the efficacy of imidacloprid 10% + moxidectin 2.5% (Advantage Multi/Advocate Topical Solution) against C. vulpis infection in experimentally infected dogs. Eighteen beagles (9 M, 9 F) were each given 100 infective third-stage larvae of C. vulpis. The 16 dogs (8 M, 8 F) with the highest faecal larval counts were stratified by gender and larval counts and randomly assigned to a treatment group. Group 1 received placebo only; group 2 was given a single topical treatment of Advantage Multi/Advocate (10 mg/kg imidacloprid/2.5 mg/kg moxidectin) at 4 weeks PI. Dogs were euthanised at 8 weeks PI and the lungs were removed and examined for the presence of adult worms by lung flush. The mean (geometric) number for adult C. vulpis recovered in untreated dogs was 70.0 (range 58 to 87) compared with 0.0 in animals treated with Advantage Multi/Advocate. The resulting efficacy against C. vulpis was 100%. The number of C. vulpis was significantly lower for treated dogs than the burden shown in the untreated group (p = 0.003).

  9. Original article title: "Comparison of therapeutic efficacy of topical corticosteroid and oral zinc sulfate-topical corticosteroid combination in the treatment of vitiligo patients: a clinical trial"

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    Omidian Mohammad

    2011-03-01

    Full Text Available Abstract Background Vitiligo is the most prevalent pigmentary disorder which occurs worldwide, with an incidence rate between 0.1-4 percent. It is anticipated that the discovery of biological pathways of vitiligo pathogenesis will provide novel therapeutic and prophylactic targets for future approaches to the treatment and prevention of vitiligo. The purposes of this study were evaluating the efficacy of supplemental zinc on the treatment of vitiligo. Methods This randomized clinical trial was conducted for a period of one year. Thirty five patients among 86 participants were eligible to entrance to the study. The patients in two equal randomized groups took topical corticosteroid and combination of oral zinc sulfate-topical corticosteroid. Results The mean of responses in the corticosteroid group and the zinc sulfate-corticosteroid combination group were 21.43% and 24.7%, respectively. Conclusion Although, the response to corticosteroid plus zinc sulfate was more than corticosteroid, there was no statistically significant difference between them. It appeared that more robust long-term randomized controlled trials on more patients, maybe with higher doses of zinc sulfate, are needed to fully establish the efficacy of oral zinc in management of vitiligo. Trial Registration chiCTRTRC10000930

  10. Comparing the effects of cryotherapy with nitrous oxide gas versus topical corticosteroids in the treatment of oral lichen planus

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    Dariush Amanat

    2014-01-01

    Conclusion: Cryotherapy with nitrous oxide gas is as effective as topical triamcinolone acetonide in the treatment of OLP with no systemic side effects and needs less patient compliance. It can be considered as an alternative or adjuvant therapy in OLP patients to reduce the use of treatments with adverse effects.

  11. Combination treatment of oral terbinafine with topical terbinafine and 10% urea ointment in hyperkeratotic type tinea pedis.

    Science.gov (United States)

    Shi, Tian-Wei; Zhang, Jiang-An; Zhang, Xian-Wei; Yu, Hong-Xing; Tang, Yong-Bo; Yu, Jian-Bin

    2014-09-01

    Hyperkeratotic-type tinea pedis is chronic and recalcitrant to topical antifungal agents. Some topical antifungal agents are effective; however, long duration of therapy is required, which often reduce the treatment compliance of patients. To seek for short period therapy of hyperkeratotic type tinea pedis, in this study, we observed the efficacy and safety of treatment of topical terbinafine and 10% urea ointment combined oral terbinafine. Participants with hyperkeratotic type tinea pedis were randomly assigned to two groups. Patients in group I were treated with oral terbinafine for 2 weeks and topical terbinafine and 10% urea ointment for 4 weeks, whereas in group II, only the above topical agents were applied for 12 weeks. Clinical improvement rates and fungal eradication rates were compared between the two groups at 24 weeks after the initiation of treatment. The group I had stopped the topical therapy 8 weeks earlier than group II. There were no significant differences in mycological eradication rates and clinical improvement rates between the two groups, besides, no major side effects were noted in both groups. The short combination therapy with oral terbinafine was effective and safe; it should be a valuable option for patients with hyperkeratotic type tinea pedis.

  12. The preventive Role of Topical Timolol in Treatment of Migraine Headaches

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    M Etemadifar

    2005-09-01

    Full Text Available Background: There are many various hypotheses about pathophysiology of migraine headaches. One of them is autonomic nervous system disturbance, but the exact location of the disturbance is not well known. Since most of migraine attacks are accompanied with a retro-orbital pain, we assessed the efficacy and safety of topical Timolol on blockage of β adrenergic receptors for preventing migraine headaches. Methods: In a clinical trial study, 43 migraine patients (7 male and 36 female were studied in two neurology clinics in Isfahan. Timolol maleate (5% eye drop prescribed twice a day. The patients visited weekly for the first 4 weeks; then 8th and 12th week after the beginning of treatment, and the duration and frequency of attacks were evaluated. The severity of headache measured subjectively. Results: The patients were aged 14 to 54 years, with mean age of 34.2 years and mean disease duration of 9.5 years before the study. They had 13.1 headache days per month. After treatment, the frequency of attacks reached to 3.4 attacks per month. The mean duration of each attack were 16.4 hours before treatment and 2.1 hours after treatment by using Timolol eye drop which were significantly different (P<0.001. The severity and duration of attacks also decreased after 12 weeks. None of them have reported adverse events after using it. Conclusion: Timolol maleate eye drop is an effictive, well-tolerated, safe, and easy-to-use prophylactic antimigraine medication. Key Words: Migraine headaches; Autonomic nervous system; Timolol

  13. A STUDY OF EFFICACY OF TOPICAL INSULIN THERAPY IN THE TREATMENT OF CHRONIC DIABETIC FOOT ULCERS

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    Mahidhar Reddy

    2015-08-01

    Full Text Available Chronic wounds are an economic burden to the patient as they put him out of work and consume quality working days. Local insulin therapy is an innovative method in wound care which accelerates wound healing by increasing angiogenesis and granulation tissue formation. This study aims to evaluate its efficacy. OBJECTIVES: To study the efficacy of topical use of insulin in terms of (1 Rate of wound healing (2 Hospital stay. MATERIALS AND METHODS: This is a prospective study carried out in a tertiary health care center in 46 patients after taking informed and written consent. All patients who were satisfying inclusion and exclusion criteria were randomised into two groups A and B. Local insulin therapy was given to group A and normal saline dressing were done to group B. Size and depth were recorded at the start of the treatment and every week thereafter during the period of study. Strict glycemic control was maintained. Results were compared at complete wound healing or at the end of 8 weeks which was earlier. RESULTS: Improvement of the wound in the form of diameter and depth is seen. Significantly increased proliferation of granulation tissue is noticed in most of the patients belonging to group A, that is who received local insulin therapy. CONCLUSION: Local insulin therapy appears to be an efficacious method in the treatment of chronic diabetic foot ulcers and is safe and effective without any systemic side effects. It significantly reduces the hospital stay

  14. Ethosomes Loaded with Cryptotanshinone for Acne Treatment through Topical Gel Formulation.

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    Yu, Zhenwei; Lv, Hongyan; Han, Gang; Ma, Ke

    2016-01-01

    The aim of this study was to develop ethosomes loaded with cryptotanshinone (CPT) and formulate them as a topical gel for the treatment of acne. Ethosomes were prepared and evaluated for vesicle size, CPT loading and encapsulation efficiency. Optimized ethosomes were formulated as Carbomer 974 gels and compared with conventional hydroethanolic gels for transdermal permeation and skin deposition in vitro. The anti-acne activity and skin irritation of the gel was investigated in rabbits. Optimized ethosomes had an average vesicle size of 69.1 ± 1.9 nm with CPT loading and encapsulation efficiency of 0.445 ± 0.007 mg/mL and 40.31 ± 0.67%, respectively. The transdermal flux and skin deposition of the optimized ethosomal gel were 2.5- and 2.1-times those of conventional gels. The ethosomal gel revealed better anti-acne effect with only slight skin irritation. This study demonstrates that ethosomal formulation is an effective dermal delivery system for CPT, and that CPT ethosomal gels are promising future acne treatments.

  15. Ethosomes-based topical delivery system of antihistaminic drug for treatment of skin allergies.

    Science.gov (United States)

    Goindi, Shishu; Dhatt, Bhavnita; Kaur, Amanpreet

    2014-01-01

    Cetirizine is indicated for the treatment of allergic conditions such as insect bites and stings, atopic and contact dermatitis, eczema, urticaria. This investigation deals with development of a novel ethosome-based topical formulation of cetirizine dihydrochloride for effective delivery. The optimised formulation consisting of drug, phospholipon 90 G™ and ethanol was characterised for drug content, entrapment efficiency, pH, vesicular size, spreadability and rheological behaviour. The ex vivo permeation studies through mice skin showed highest permeation flux (16.300 ± 0.300 µg/h/cm(2)) and skin retention (20.686 ± 0.517 µg/cm(2)) for cetirizine-loaded ethosomal vesicles as compared to conventional formulations. The in vivo pharmacodynamic evaluation of optimised formulation was assessed against oxazolone-induced atopic dermatitis (AD) in mice. The parameters evaluated were reduction in scratching score, erythema score, skin hyperplasia and dermal eosinophil count. Our results suggest that ethosomes are effective carriers for dermal delivery of antihistaminic drug, cetirizine, for the treatment of AD.

  16. Ethosomes Loaded with Cryptotanshinone for Acne Treatment through Topical Gel Formulation.

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    Zhenwei Yu

    Full Text Available The aim of this study was to develop ethosomes loaded with cryptotanshinone (CPT and formulate them as a topical gel for the treatment of acne. Ethosomes were prepared and evaluated for vesicle size, CPT loading and encapsulation efficiency. Optimized ethosomes were formulated as Carbomer 974 gels and compared with conventional hydroethanolic gels for transdermal permeation and skin deposition in vitro. The anti-acne activity and skin irritation of the gel was investigated in rabbits. Optimized ethosomes had an average vesicle size of 69.1 ± 1.9 nm with CPT loading and encapsulation efficiency of 0.445 ± 0.007 mg/mL and 40.31 ± 0.67%, respectively. The transdermal flux and skin deposition of the optimized ethosomal gel were 2.5- and 2.1-times those of conventional gels. The ethosomal gel revealed better anti-acne effect with only slight skin irritation. This study demonstrates that ethosomal formulation is an effective dermal delivery system for CPT, and that CPT ethosomal gels are promising future acne treatments.

  17. A new generation of topical chronic wound treatments containing specific MMP inhibitors

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    Shrivastava R

    2014-09-01

    Full Text Available Ravi Shrivastava, Nathalie Cucuat, Monika Rousse, Thomas Weigand, Pedro Neto, Claire Janicot, Christiane Shrivastava VITROBIO Research Institute, Issoire, France Purpose: Incidence of chronic wounds is constantly rising worldwide, but all currently available treatments are intended either to provide symptomatic relief or to assist cicatrization to some extent, but not to directly stimulate cellular growth. Physiologically, chronic wound healing simply requires cell growth to fill the injured cavity. To grow, our cells need to attach onto a cushion, called extracellular matrix (ECM, secreted by the mother cells and composed of multiple proteins. Recent scientific works prove that the concentration of certain matrix metalloproteinases (MMPs is extremely high in all chronic wounds and, because of their proteolytic nature, some MMPs completely degrade the ECM, hindering cell attachment and cell growth. The aim of this study was to identify, neutralize, and eliminate these MMPs from the wound surface so as to design an effective treatment for chronic wounds. Methods: Acute and chronic models of human epithelial and fibroblast cells were prepared on a defined ECM cushion in vitro and MMPs were added in the culture medium to identify the MMPs causing ECM disintegration for each cell type. ECM-degrading MMPs were then incubated with selected procyanidin-rich plant extracts (PCDs and cell growth was reanalyzed. Results: It was observed that: 1 multiple MMPs are involved in cellular matrix destruction; 2 ECM-destroying MMPs are specific with respect to cell type; and 3 specific PCDs may bind and neutralize selected MMPs. Conclusion: Topical application of specific plant PCDs to selectively neutralize ECM-destroying MMPs in acute and chronic wounds represents a novel approach for the treatment of superficial and deep skin wounds. Keywords: extra cellular matrix (ECM, matrix metalloproteinases, procyanidins (PCDs, tannins, ulcers

  18. First-year treatment costs among new initiators of topical prostaglandin analogs: pooled results

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    Jordana K Schmier

    2010-05-01

    Full Text Available Jordana K Schmier1, David W Covert21Managing Scientist, Exponent Inc., Alexandria, VA, USA; 2Associate Director, Health Economics, Alcon Research Ltd., Ft. Worth, TX, USAObjective: To estimate first-year treatment costs among new initiators of topical prostaglandin analogs in a managed care population.Research design and methods: A model was developed to estimate first-year medical costs. Model inputs were based on weighted results from three previous studies. Treatment patterns were derived from a claims database analysis. Published studies were used to estimate visit-related resource use. Costs were obtained from standard sources.Results: Across studies, 27,809 patients met study criteria, 44.2% of whom remained on their index therapy for 12 months. Adjunctive therapy was needed in 22.5%, 18.5%, and 11.9% of bimatoprost, latanoprost, and benzalkonium chloride (BAK-free travoprost patients, respectively. Median days to initiating adjunctive therapy were 64, 67, and 127 for bimatoprost, latanoprost, and BAK-free travoprost patients. Estimated first-year medical costs were $1,945, $1,803, and $1,730 for patients initiating therapy with bimatoprost, latanoprost, and BAK-free travoprost. Findings were consistent through sensitivity analysis.Conclusions: A BAK-free prostaglandin analog may permit longer duration of monotherapy and be associated with lower first-year treatment costs. Use of a claims database and the selection of new initiators of prostaglandin analogs limit the ability to project findings to all glaucoma patients.Keywords: costs and cost analysis, drug therapy, combination, glaucoma, prostaglandin analogs

  19. Investigation of an angiogenesis-promoting topical treatment for diabetic wounds using multimodal microscopy (Conference Presentation)

    Science.gov (United States)

    Li, Joanne; Bower, Andrew J.; Arp, Zane A.; Olson, Eric; Holland, Claire; Chaney, Eric J.; Marjanovic, Marina; Boppart, Stephen A.

    2016-02-01

    Impaired skin wound healing is a significant co-morbid condition of diabetes that is caused by poor microcirculation among other factors. Hypoxia-inducible factors (HIFs) are transcription factors that mediate the effects of decreased levels of oxygen in biological environments. Inducing mild hypoxia in the tissue could promote angiogenesis, a critical step in the wound healing process in diabetic wounds. To investigate the relationship between hypoxia and diabetic wound healing, a topical treatment consisting of a HIF-activating prolyl-hydroxylase inhibitor was administered to the wounded skin of diabetic (db/db) mice. Studies were conducted in accordance with the GSK Policy on the Care, Welfare and Treatment of Laboratory Animals and were reviewed at GSK or by the ethical review process at the institution where the work was performed. The wounded area was tracked in vivo for 28 days utilizing a custom-built multimodal microscopy system. An increase in vascular density around the wounds of treated animals was observed using phase-variance optical coherence tomography (PV-OCT), in comparison to normal controls. In addition, second harmonic generation (SHG) and fluorescence lifetime imaging microscopy (FLIM) were utilized to examine the collagen regeneration and cellular metabolic activity, respectively, in the wounded skin. The utilization of these light based methods can follow metabolic and morphologic changes in the wound healing process in ways not possible with current evaluation processes. Insights demonstrated in these studies could lead to new endpoints for evaluation of the efficacy of drugs and lead to more direct ways of detecting patient response to treatment.

  20. Use of topical imiquimod in the treatment of VIN: a case report and review of the literature

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    Chelsea Grimes, BS, MS

    2016-03-01

    Full Text Available Vulvar intraepithelial neoplasia (VIN is a premalignant disease of the vulvar squamous epithelium. Standard treatment for VIN lesions is surgical excision. Alternative therapeutic options for conservative treatment have been sought by patients to prevent disfigurement and to preserve sexual function. We present such a patient in whom topical imiquimod was used with a successful outcome. Imiquimod is effective in the treatment of VIN, as well as convenient, self-administered, and generally well tolerated.

  1. Special topical approach to the treatment of acne. Suppression of sweating with aluminum chloride in an anhydrous formulation.

    Science.gov (United States)

    Hurley, H J; Shelley, W B

    1978-12-01

    A new topical approach to acne treatment--the use of aluminum chloride hexahydrate in anhydrous ethanol (ACAE)--was studied in 141 patients. Using sequential treatment schedules, paired comparison techniques, and various concentrations of ACAE, we established maximal efficacy with minimal local irritation for the 6.25% strength solution. Clinical efficacy and lack of toxicity of this formulation were confirmed by the additional clinical study of 65 patients. The antiperspirant and antibacterial actions of 6.25% ACAE solution were then verified on acne skin areas. It is postulated that the clinical improvement in acne that follows the topical use of ACAE results from one or both of these actions.

  2. Successful treatment of giant basal cell carcinoma with topical imiquimod 5% cream with long term follow-up

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    M Chun-Guang

    2014-01-01

    Full Text Available The use of the topical Imiquimod 5% cream offers a noninvasive, nonsurgical, and an effective option for the treatment of primary small (5 cm BCC with topical Imiquimod 5% cream are rare. We present our experience in the treatment of two giant tumors (6 × 8 cm 2 , 5.2 × 4.2 cm 2 of BCC on the face with Imiquimod 5% cream, 2 to 3 days/week for 12 weeks. Both the tumors were cured with clinical and pathological evidence, one with 6-year follow-up and the other with 3.5-year follow-up.

  3. The first 50Myr of dinosaur evolution: macroevolutionary pattern and morphological disparity.

    Science.gov (United States)

    Brusatte, Stephen L; Benton, Michael J; Ruta, Marcello; Lloyd, Graeme T

    2008-12-23

    The evolutionary radiation of dinosaurs in the Late Triassic and Early Jurassic was a pivotal event in the Earth's history but is poorly understood, as previous studies have focused on vague driving mechanisms and have not untangled different macroevolutionary components (origination, diversity, abundance and disparity). We calculate the morphological disparity (morphospace occupation) of dinosaurs throughout the Late Triassic and Early Jurassic and present new measures of taxonomic diversity. Crurotarsan archosaurs, the primary dinosaur 'competitors', were significantly more disparate than dinosaurs throughout the Triassic, but underwent a devastating extinction at the Triassic-Jurassic boundary. However, dinosaur disparity showed only a slight non-significant increase after this event, arguing against the hypothesis of ecological release-driven morphospace expansion in the Early Jurassic. Instead, the main jump in dinosaur disparity occurred between the Carnian and Norian stages of the Triassic. Conversely, dinosaur diversity shows a steady increase over this time, and measures of diversification and faunal abundance indicate that the Early Jurassic was a key episode in dinosaur evolution. Thus, different aspects of the dinosaur radiation (diversity, disparity and abundance) were decoupled, and the overall macroevolutionary pattern of the first 50Myr of dinosaur evolution is more complex than often considered.

  4. Macroevolutionary emergence of bathymetric gradients in molluscan metacommunity turnover (NE Atlantic)

    Science.gov (United States)

    Tomasovych, Adam; Dominici, Stefano; Zuschin, Martin; Merle, Didier

    2014-05-01

    Although marine invertebrate lineages turn over at a higher rate in onshore than in offshore environments at macroevolutionary time scales, it remains unclear whether this pattern scales down to shorter time scales and whether it is linked to different sensitivity of onshore and offshore environments to climatic changes. We show that while turnover of molluscan metacommunities significantly declines with increasing depth between the tropical Eocene habitats and warm-temperate Pliocene habitats (>10 Myr) in the NE Atlantic Province, it does not change with depth at shorter time scales - within Eocene and Pliocene (families and by an onshore expansion of genera and families that were frequent in offshore in the Eocene. Even when higher temporal climatic variation in shallower environments is counteracted by evolution favoring generalists at shorter scales, lineages inhabiting shallower environments should be less buffered against long-term regional-scale climatic fluctations that exceed the range of short-term climatic variability. We hypothesize that bathymetric differences in macroevolutionary turnover emerge only when assessed over temporal scales exceeding several Myr.

  5. Macroevolutionary speciation rates are decoupled from the evolution of intrinsic reproductive isolation in Drosophila and birds.

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    Rabosky, Daniel L; Matute, Daniel R

    2013-09-17

    The rate at which speciation occurs varies greatly among different kinds of organisms and is frequently assumed to result from species- or clade-specific factors that influence the rate at which populations acquire reproductive isolation. This premise leads to a fundamental prediction that has never been tested: Organisms that quickly evolve prezygotic or postzygotic reproductive isolation should have faster rates of speciation than organisms that slowly acquire reproductive isolation. We combined phylogenetic estimates of speciation rates from Drosophila and birds with a method for analyzing interspecific hybridization data to test whether the rate at which individual lineages evolve reproductive isolation predicts their macroevolutionary rate of species formation. We find that some lineages evolve reproductive isolation much more quickly than others, but this variation is decoupled from rates of speciation as measured on phylogenetic trees. For the clades examined here, reproductive isolation--especially intrinsic, postzygotic isolation--does not seem to be the rate-limiting control on macroevolutionary diversification dynamics. These results suggest that factors associated with intrinsic reproductive isolation may have less to do with the tremendous variation in species diversity across the evolutionary tree of life than is generally assumed.

  6. Successful treatment of infundibulofolliculitis with topical tretinoin. Report of a case

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    Seema Srinivasa

    2012-07-01

    Full Text Available First described in 1968 by Hitch and Lund. Disseminated and Recurrent infundibulofolliculitis (DRIF is an uncommon eruption characterized by recurrent, pruritic follicular papules commonly seen on the trunk and proximal extremities. Rarely limited to the neck. It is much more common in black population but has also been reported in other ethnicities including Caucasians. Its etiology has constantly been debated with a few authors describing it as a variant of atopic dermatitis while others have refuted the same as a family history of atopy is not present. Various others have classified DRIF as variants of follicular eczema, along with lichen spinulosus and juxtaclavicular beaded lines. Its treatment also varies with different authors claiming response to steroids, isotretinoin, UVA therapy, keratolytics and tetracyclines. We describe a case of localized infundibulofolliculitis of the neck diagnosed in a 21 year old female who was successfully treated with a course of topical tretinoin 0.025%. The presenting history, clinical findings, biopsy results and available literature are reviewed.

  7. Topical phospho-sulindac (OXT-328) is effective in the treatment of non-melanoma skin cancer.

    Science.gov (United States)

    Cheng, Ka Wing; Mattheolabakis, George; Wong, Chi C; Ouyang, Nengtai; Huang, Liqun; Constantinides, Panayiotis P; Rigas, Basil

    2012-10-01

    Phospho-sulindac (P-S, OXT-328), a novel sulindac derivative, has shown superior anticancer efficacy and safety compared to sulindac. In this study, we investigated the efficacy of topical P-S hydrogel in the treatment of non-melanoma skin cancer in preclinical models. P-S is a potent inhibitor of A431 epidermoid carcinoma in vitro and achieves this effect by inhibiting cell proliferation and inducing apoptosis. The anticancer efficacy of topical and oral P-S was further evaluated in mice bearing A431 intradermal xenografts. Compared to the controls, topical P-S hydrogel inhibited the A431 xenografts by 70.5% (p500 nmol/g tumor tissue) of intact P-S in the tumors, accounting for 92.5% of the total metabolites in the A431 xenografts. This local delivery of high levels of intact P-S to the A431 xenografts is an important contributor to the potent activity of topical P-S and no local or systemic side effects were noted in the treatment group. Thus, topical P-S is a promising treatment modality against non-melanoma skin cancer and merits further evaluation.

  8. Successful treatment of plasma cell cheilitis with topical tacrolimus: report of two cases.

    Science.gov (United States)

    Hanami, Yuka; Motoki, Yoshikazu; Yamamoto, Toshiyuki

    2011-02-15

    Plasma cell cheilitis is an uncommon chronic inflammatory dermatitis that presents with flat to slightly elevated erosive erythematous plaques. It is histologically characterized by plasma cell infiltrates into the mucosa. Other than the lip, genital areas are often involved, which is called plasma cell balanitis or vulvitis. Plasma cell cheilitis is sometimes resistant to conventional topical corticosteroid therapy. Other choices include oral griseofulvin, topical cyclosporine, and intralesional corticosteroid injection, all of which occasionally fail to produce satisfactory results. Recent reports show that topical calcineurin inhibitors are effective for plasma cell cheilitis, balanitis, and vulvitis. However, there are so far only 2 reports of plasma cell cheilitis successfully treated with topical pimecrolimus and tacrolimus. We present herein two cases of plasma cell cheilitis, in which topical tacrolimus showed beneficial effects, suggesting that this immunomodulatory agent is a promising option for plasma cell cheilitis.

  9. Treatment of Retinopathy of Prematurity with topical ketorolac tromethamine: a preliminary study

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    Cafferata Maria

    2004-08-01

    Full Text Available Abstract Background Retinopathy of Prematurity (ROP is a common retinal neovascular disorder of premature infants. It is of variable severity, usually heals with mild or no sequelae, but may progress to blindness from retinal detachments or severe retinal scar formation. This is a preliminary report of the effectiveness and safety of a new and original use of topical ketorolac in preterm newborn to prevent the progression of ROP to the more severe forms of this disease. Methods From January 2001 to December 2002, all fifty nine preterm newborns with birthweight less than 1250 grams or gestational age less than 30 weeks of gestational age admitted to neonatal intensive care were eligible for treatment with topical ketorolac (0.25 milligrams every 8 hours in each eye. The historical comparison group included all 53 preterm newborns, with the same inclusion criteria, admitted between January 1999 and December 2000. Results Groups were comparable in terms of weight distribution, Apgar score at 5 minutes, incidence of sepsis, intraventricular hemorrhage and necrotizing enterocolitis. The duration of oxygen therapy was significantly longer in the control group. In the ketorolac group, among 43 children that were alive at discharge, one (2.3% developed threshold ROP and cryotherapy was necessary. In the comparison group 35 children survived, and six child (17% needed cryotherapy (Relative Risk 0.14, 95%CI 0.00 to 0.80, p = 0.041. Adjusting by duration of oxygen therapy did not significantly change these results. Adverse effects attributable to ketorolac were not detected. Conclusions This preliminary report suggests that ketorolac in the form of an ophthalmic solution can reduce the risk of developing severe ROP in very preterm newborns, without producing significant adverse side effects. These results, although promising, should be interpreted with caution because of the weakness of the study design. This is an inexpensive and simple intervention that

  10. Formulation of cidofovir improves the anti-papillomaviral activity of topical treatments in the CRPV/rabbit model.

    Science.gov (United States)

    Christensen, Neil D; Cladel, Nancy M; Hu, Jiafen; Balogh, Karla K

    2014-08-01

    Current topical treatments for papillomas use ablative, cytotoxic and immunomodulating strategies and reagents. However, the effectiveness of topical treatments using different formulations has not been examined in preclinical models or clinical trials. The purpose of this study was to determine whether formulation of the small molecule acyclic nucleoside, cidofovir (CDV), could lead to improved therapeutic endpoints following topical treatment of papillomas using the cottontail rabbit papillomavirus (CRPV)/rabbit model. Different formulations with a set dose of 1% cidofovir were tested to establish comparative data. The results demonstrated that anti-papilloma treatments with topical CDV were greatly enhanced when formulated versus unformulated. Best results were obtained with CDV formulated in cremophor, then in Carbomer 940, and then in DMSO. Further studies indicated that effective formulations led to complete cures of papillomas at dilutions less than 0.3% CDV. These studies together with previous observations demonstrated that unformulated CDV under the same treatment regime required doses of 2% to achieve cures demonstrating that much less compound can be used when properly formulated.

  11. Histological observation of goblet cells following topical rebamipide treatment of the human ocular surface: A case report.

    Science.gov (United States)

    Kase, Satoru; Shinohara, Toshiya; Kase, Manabu

    2015-02-01

    The topical administration of rebamipide (Mucosta®), an antiulcer agent, clinically increases the mucin level of tear film. The aim of this study was to report the histological changes of goblet cells following the topical administration of rebamipide to a patient with nevus of the lacrimal caruncle. A 62-year-old male exhibited a pigmented nodule located in the lacrimal caruncle in the left eye. An excisional biopsy and subsequent surgical resection were conducted at the caruncle, prior to and three months after topical rebamipide administration. Histologically, a biopsy specimen revealed a pigmented nevus beneath the caruncle epithelium containing a few goblet cells [4 cells/high power field (HPF)]. A few nevus cells were present at the surgical margin. By contrast, the secondary resected specimen obtained three months after the initiation of topical rebamipide treatment revealed the epithelium and nevus, where numerous goblet cells were present (28 cells/HPF), and mucin-like substances were markedly secreted from the goblet cells. Topical rebamipide markedly increased the number of goblet cells and stimulated the secretion of mucin-like substances in the caruncular tissue of a human patient. These results suggest that topical rebamipide is useful in patients following surgery and/or biopsy to support tissue repair of the ocular surface.

  12. Partitioning, persistence, and accumulation in digested sludge of the topical antiseptic triclocarban during wastewater treatment.

    Science.gov (United States)

    Heidler, Jochen; Sapkota, Amir; Halden, Rolf U

    2006-06-01

    The topical antiseptic agent triclocarban (TCC) is a common additive in many antimicrobial household consumables, including soaps and other personal care products. Long-term usage of the mass-produced compound and a lack of understanding of its fate during sewage treatment motivated the present mass balance analysis conducted at a typical U.S. activated sludge wastewater treatment plant featuring a design capacity of 680 million liters per day. Using automated samplers and grab sampling, the mass of TCC contained in influent, effluent, and digested sludge was monitored by isotope dilution liquid chromatography (tandem) mass spectrometry. The average mass of TCC (mean +/- standard deviation) entering and exiting the plant in influent (6.1 +/- 2.0 microg/L) and effluent (0.17 +/- 0.03 microg/ L) was 3737 +/- 694 and 127 +/- 6 g/d, respectively, indicating an aqueous-phase removal efficiency of 97 +/- 1%. Tertiary treatment by chlorination and sand filtration provided no detectable benefit to the overall removal. Due to strong sorption of TCC to wastewater particulate matter (78 +/- 11% sorbed), the majority of the TCC mass was sequestered into sludge in the primary and secondary clarifiers of the plant. Anaerobic digestion for 19 days did not promote TCC transformation, resulting in an accumulation of the antiseptic compound in dewatered, digested municipal sludge to levels of 51 +/- 15 mg/kg dry weight (2815 +/- 917 g/d). In addition to the biocide mass passing through the plant contained in the effluent (3 +/- 1%), 76 +/- 30% of the TCC input entering the plant underwent no net transformation and instead partitioned into and accumulated in municipal sludge. Based on the rate of beneficial reuse of sludge produced by this facility (95%), which exceeds the national average (63%), study results suggest that approximately three-quarters of the mass of TCC disposed of by consumers in the sewershed of the plant ultimately is released into the environment by application

  13. Topical glyceryl trinitrate treatment of chronic patellar tendinopathy : a randomised, double-blind, placebo-controlled clinical trial

    NARCIS (Netherlands)

    Steunebrink, Mirjam; Zwerver, Johannes; Brandsema, Ruben; Groenenboom, Petra; van den Akker-Scheek, Inge; Weir, Adam

    2013-01-01

    Objectives To assess if continuous topical glyceryl trinitrate (GTN) treatment improves outcome in patients with chronic patellar tendinopathy when compared with eccentric training alone. Methods Randomised double-blind, placebo-controlled clinical trial comparing a 12-week programme of using a GTN

  14. Immunosuppressive macrolides of the type FK 506: a novel class of topical agents for treatment of skin diseases?

    Science.gov (United States)

    Meingassner, J G; Stütz, A

    1992-06-01

    The immunosuppressive macrolide antibiotics FK 506 and rapamycin were tested for topical activity in experimental allergic contact dermatitis of farm pigs. This species was used because pig skin, in comparison to rodent skin, resembles human skin more closely. For comparison, cyclosporine A (CyA), which is orally but not topically active in patients with skin disease, dexamethasone, and clobetasol propionate were used. Treatment was performed twice, 30 min and 6 h after elicitation of challenge reaction. Topical application of 0.4 to 0.04% FK 506 caused a pronounced inhibition of inflammatory skin reactions of hypersensitivity to dinitrofluorobenzene. The treatment response was similar to the activity of 0.13% clobetasole. Dexamethasone (1.2%) was less active than clobetasol. In contrast, rapamycin and CyA were inactive at concentrations of 1.2 and 10%, respectively. Because the pig data on corticosteroids and cyclosporine A are in agreement with clinical findings, these studies indicate that immunosuppressive macrolides of the type FK 506 may be useful drugs for the topical treatment of human skin diseases that respond to local corticosteroids and oral treatment with cyclosporine A.

  15. Photodynamic therapy with topical methyl- and hexylaminolevulinate for prophylaxis and treatment of UV-induced SCC in hairless mice

    DEFF Research Database (Denmark)

    Togsverd-Bo, Katrine; Lerche, Catharina M; Poulsen, Thomas;

    2010-01-01

    Hexyl aminolevulinate (HAL) is a long-chained 5-aminolevulinic acid-ester that has been proposed as a novel photosensitizing agent to methyl aminolevulinate (MAL) in topical photodynamic therapy (PDT). The more lipophilic HAL, may improve treatment outcome for non-melanoma skin cancer....

  16. Topical glyceryl trinitrate treatment of chronic patellar tendinopathy : a randomised, double-blind, placebo-controlled clinical trial

    NARCIS (Netherlands)

    Steunebrink, Mirjam; Zwerver, Johannes; Brandsema, Ruben; Groenenboom, Petra; van den Akker-Scheek, Inge; Weir, Adam

    Objectives To assess if continuous topical glyceryl trinitrate (GTN) treatment improves outcome in patients with chronic patellar tendinopathy when compared with eccentric training alone. Methods Randomised double-blind, placebo-controlled clinical trial comparing a 12-week programme of using a GTN

  17. Photodynamic therapy with topical methyl- and hexylaminolevulinate for prophylaxis and treatment of UV-induced SCC in hairless mice

    DEFF Research Database (Denmark)

    Togsverd-Bo, Katrine; Poulsen, Thomas; Wulf, Hans Christian

    2010-01-01

    Hexyl aminolevulinate (HAL) is a long-chained 5-aminolevulinic acid-ester that has been proposed as a novel photosensitizing agent to methyl aminolevulinate (MAL) in topical photodynamic therapy (PDT). The more lipophilic HAL, may improve treatment outcome for non-melanoma skin cancer....

  18. First-year treatment costs among new initiators of topical prostaglandin analogs

    Directory of Open Access Journals (Sweden)

    Jordana K Schmier

    2009-11-01

    Full Text Available Jordana K Schmier1, David W Covert2, Alan L Robin3,41Exponent Inc., Alexandria, VA, USA; 2Health Economics, Alcon Research Ltd., Fort Worth, TX, USA; 3Department of Ophthalmology, University of Maryland, Baltimore, MD, USA; 4Wilmer Eye Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USAObjective: To estimate first-year costs among new initiators of topical prostaglandin analogs in a managed care population.Research design and methods: We developed a model to estimate first-year direct medical costs. We derived treatment patterns from a claims database analysis. Published studies were used to estimate visit-related resource use. Costs were obtained from standard sources.Results: The database analysis identified 9,063 patients meeting study criteria, 41% (n = 3,672 of whom remained on their initial prostaglandin therapy for 12 months after initiation. Adjunctive intraocular pressure lowering therapy was needed in 20.7%, 16.5%, 13.9%, and 8.9% of bimatoprost, latanoprost, travoprost, and BAK-free travoprost patients, respectively. Median numbers of days to the first prescription filled for adjunctive therapy (if required were 69.5, 67.0, 123.0, and 158.5 for patients initiating on bimatoprost, latanoprost, travoprost, and BAK-free travoprost. Total estimated first-year costs were $1,457, $1,360, $1,278, and $1,307 for patients initiating therapy with bimatoprost, latanoprost, travoprost, and BAK-free travoprost. Findings were consistent through sensitivity analysis.Conclusions: A BAK-free prostaglandin analog may permit longer duration of monotherapy and be associated with lower first-year direct medical costs. Use of a claims database and the selection of new initiators of prostaglandin analogs limit projecting findings to all glaucoma patients.Keywords: costs and cost analysis, drug therapy, combination, glaucoma, prostaglandin analogs

  19. Treatment of Onychomycosis with Efinaconazole 10% Topical Solution and Quality of Life

    OpenAIRE

    Tosti, Antonella; Elewski, Bom E.

    2014-01-01

    Objective: To evaluate the benefits of efinaconazole topical solution, 10% on quality of life in onychomycosis patients. Methods: An analysis of 1,655 patients, aged 18 to 70 years, randomized to receive efinaconazole topical solution, 10%, or vehicle from two identical multicenter, double-blind, vehicle-controlled, 48-week studies evaluating safety and efficacy. The primary endpoint was complete cure rate (0% clinical involvement of target toenail, and both negative potassium hydroxide exami...

  20. Direct variable cost of the topical treatment of stages III and IV pressure injuries incurred in a public university hospital.

    Science.gov (United States)

    Chacon, Julieta M F; Blanes, Leila; Borba, Luis G; Rocha, Luis R M; Ferreira, Lydia M

    2017-05-01

    to estimate the direct variable costs of the topical treatment of stages III and IV pressure injuries of hospitalized patients in a public university hospital, and assess the correlation between these costs and hospitalization time. Forty patients of both sexes who had been admitted to the São Paulo Hospital, São Paulo, SP, Brazil, from 2011 to 2012, with pressure injuries in the sacral, ischial or trochanteric region were included. The patients had a total of 57 pressure injuries in the selected regions, and the lesions were monitored daily until patient release, transfer or death. The quantities and types of materials, as well as the amount of professional labor time spent on each procedure and each patient were recorded. The unit costs of the materials and the hourly costs of the professional labor were obtained from the hospital's purchasing and human resources departments, respectively. Spearman's correlation coefficient and the Mann-Whitney and Kruskal-Wallis tests were used for the statistical analyses. The mean topical treatment costs for stages III and IV PIs were significantly different (US$ 854.82 versus US$ 1785.35; p = 0.004). The mean topical treatment cost of stages III and IV pressure injuries per patient was US$ 1426.37. The mean daily topical treatment cost per patient was US$ 40.83. There was a significant correlation between hospitalization time and the total costs of labor and materials (p < 0.05). There was no significant difference between hospitalization time periods for stages III and IV pressure injuries (40.80 days and 45.01 days, respectively; p = 0.834). The mean direct variable cost of the topical treatment for stages III and IV pressure injuries per patient in this public university hospital was US$ 1426.37. Copyright © 2016. Published by Elsevier Ltd.

  1. Assessing the performance of a soy methyl ester -polystyrene topical treatment to extend the service life of concrete structures

    Science.gov (United States)

    Thomas, D'Shawn G.

    Experimental results show that soy methyl ester (SME), a derivative of soy bean oil, along with the incorporation of polystyrene (PS) is a non-toxic, biodegradable and renewable material that can be used effectively as a topical concrete surface treatment. While, concrete sealants and topical surface treatments can be used to extend to durability of concrete structures, it is difficult to predict the durability of concrete structures sealed with a sealant or topical surface treatment. This is due to a lack of necessary model inputs that can be used to address the durability of concrete structures treated with these materials. In general, this thesis expands upon previous research in exploring the use of SME-PS blends as a topical treatment used to enhance concrete durability and presents a sound theoretical framework for modeling the durability of concrete structures topically treated with SME-PS using Fick's 2nd Law of diffusion. Using experimental data generated in this study, fluid transport tests have been carried out to investigate how SME-PS changes fluid absorption and chloride ingress into concrete. The results show that the diffusion of chloride ions into concrete treated with SME-PS can be modeled by using a fractional amount (in this case 60% is recommended) of the value of Cs that is used for conventional concrete when Fick 2 nd Law is used. This is critically important from a design and cost prospective, since tests do not need to be conducted with SME-PS to determine the benefits of surface treatment.

  2. Are the metabolomic responses to folivory of closely related plant species linked to macroevolutionary and plant-folivore coevolutionary processes?

    Energy Technology Data Exchange (ETDEWEB)

    Rivas-Ubach, Albert [Environmental Molecular Sciences Laboratory, Pacific Northwest National Laboratory, Richland Washington 99354 USA; CREAF, Cerdanyola del Vallès 08913 Catalonia Spain; Hódar, José A. [Grupo de Ecología Terrestre, Departamento de Biología Animal y Ecología, Facultad de Ciencias, Universidad de Granada, 18071 Granada Spain; Sardans, Jordi [CREAF, Cerdanyola del Vallès 08913 Catalonia Spain; CSIC, Global Ecology Unit CREAF-CEAB-CSIC-UAB, Cerdanyola del Vallès 08913 Catalonia Spain; Kyle, Jennifer E. [Biological Sciences Division, Pacific Northwest National Laboratory, Richland Washington 99354 USA; Kim, Young-Mo [Biological Sciences Division, Pacific Northwest National Laboratory, Richland Washington 99354 USA; Oravec, Michal [Global Change Research Centre, Academy of Sciences of the Czech Republic, Bĕlidla 4a CZ-603 00 Brno Czech Republic; Urban, Otmar [Global Change Research Centre, Academy of Sciences of the Czech Republic, Bĕlidla 4a CZ-603 00 Brno Czech Republic; Guenther, Alex [Department of Earth System Science, University of California, Irvine California 92697 USA; Peñuelas, Josep [CREAF, Cerdanyola del Vallès 08913 Catalonia Spain; CSIC, Global Ecology Unit CREAF-CEAB-CSIC-UAB, Cerdanyola del Vallès 08913 Catalonia Spain

    2016-06-02

    The debate whether the coevolution of plants and insects or macroevolutionary processes (phylogeny) is the main driver determining the arsenal of molecular defensive compounds of plants remains unresolved. Attacks by herbivorous insects affect not only the composition of defensive compounds in plants but the entire metabolome (the set of molecular metabolites), including defensive compounds. Metabolomes are the final products of genotypes and are directly affected by macroevolutionary processes, so closely related species should have similar metabolomic compositions and may respond in similar ways to attacks by folivores. We analyzed the elemental compositions and metabolomes of needles from Pinus pinaster, P. nigra and P. sylvestris to determine if these closely related Pinus species with different coevolutionary histories with the caterpillars of the processionary moth respond similarly to attacks by this lepidopteran. All pines had different metabolomes and metabolic responses to herbivorous attack. The metabolomic variation among the pine species and the responses to folivory reflected their macroevolutionary relationships, with P. pinaster having the most divergent metabolome. The concentrations of phenolic metabolites were generally not higher in the attacked trees, which had lower concentrations of terpenes, suggesting that herbivores avoid individuals with high concentrations of terpenes. Our results suggest that macroevolutionary history plays important roles in the metabolomic responses of these pine species to folivory, but plant-insect coevolution probably constrains those responses. Combinations of different evolutionary factors and trade-offs are likely responsible for the different responses of each species to folivory, which is not necessarily exclusively linked to plant-insect coevolution.

  3. Colloidal carriers of isotretinoin for topical acne treatment: skin uptake, ATR-FTIR and in vitro cytotoxicity studies.

    Science.gov (United States)

    Gürbüz, Aslı; Özhan, Gül; Güngör, Sevgi; Erdal, M Sedef

    2015-09-01

    Acne vulgaris is the chronical, multifactorial and complex disease of the pilosebaceous unit in the skin. The main goal of the topical therapy in acne is to target the drug to epidermal and deep dermal regions by minimizing systemic absorption . Isotretinoin, a retinoic acid derivative, is the most effective drug in acne pathogenesis. Because systemic treatment may cause many side effects, topical isotretinoin treatment is an option in the management of acne. However, due to its high lipophilic character, isotretinoin tends to accumulate in the upper stratum corneum, thus its penetration into the lower layers is limited, which restricts the efficiency of topical treatment. Microemulsions are fluid, isotropic, colloidal drug carriers that have been widely studied as drug delivery systems. The percutaneous transport of active agents can be enhanced by microemulsions when compared with their conventional formulations. The purpose of this study was to evaluate microemulsions as alternative topical carriers for isotretinoin with an objective to improve its skin uptake. After in vitro permeation studies, the dermal penetration of isotretinoin from microemulsions was investigated by tape stripping procedure. Confocal laser scanning microscopy provided insight about the localization of the drug in the skin. The interaction between the microemulsion components and stratum corneum lipids is studied by ATR-FTIR spectroscopy. The relative safety of the microemulsions was assessed in mouse embryonic fibroblasts using MTT viability test. The results indicate that microemulsion-based novel colloidal carriers have a potential for enhanced skin delivery and localization of isotretinoin.

  4. Pentalinon andrieuxii root extract is effective in the topical treatment of cutaneous leishmaniasis caused by Leishmania mexicana

    Science.gov (United States)

    Lezama-Dávila, Claudio M.; Pan, Li; Isaac-Márquez, Angelica P.; Terrazas, Cesar; Oghumu, Steve; Isaac-Márquez, Ricardo; Pech-Dzib, MY; Barbi, Joseph; Calomeni, Edward; Parinandi, Narasimham; Kinghorn, A. Douglas; Satoskar, Abhay R.

    2014-01-01

    Cutaneous leishmaniasis (CL) manifests as localized skin lesions, which lead to significant tissue destruction and disfigurement. In the Yucatan Peninsula, Mayan traditional healers use Pentalinon andrieuxii Muell.-Arg. (Apocynaceae) roots for the topical treatment of CL. Here, we studied the effect of P. andrieuxii root hexane extract (PARE) on the parasites and host cells in vitro and examined its efficacy in the topical treatment of CL caused by L. mexicana. PARE exhibited potent antiparasitic activity in vitro against promastigotes as well as amastigotes residing in macrophages. Electron microscopy of PARE-treated parasites revealed direct membrane damage. PARE also activated NF-κB and enhanced IFN-γR and MHC class II expression and TNF-α production in macrophages. In addition, PARE induced production of the Th1 promoting cytokine IL-12 in dendritic cells as well as enhanced expression of the co-stimulatory molecules CD40, CD80 and CD86. In vivo studies showed that L. mexicana-infected mice treated by topical application of PARE resulted in the significant reduction in lesion size and parasite burden compared to controls. These findings indicate that PARE could be used as an alternative therapy for the topical treatment of CL. PMID:24347110

  5. New topical treatment of vulvodynia based on the pathogenetic role of cross talk between nociceptors, immunocompetent cells, and epithelial cells

    Directory of Open Access Journals (Sweden)

    Keppel Hesselink JM

    2016-10-01

    Full Text Available J M Keppel Hesselink,1 D J Kopsky,2 N Sajben3 1Institute for Neuropathic Pain, Bosch en Duin, 2Institute for Neuropathic Pain, Amsterdam, The Netherlands; 3Scripps Memorial Hospital La Jolla, La Jolla, CA, USA Abstract: Topical treatments of localized neuropathic pain syndromes in general are mostly neglected, mainly due to the fact that most pain physicians expect that a topical formulation needs to result in a transdermal delivery of the active compounds. On the basis of the practical experience, this study brings forth a new, somewhat neglected element of the vulvodynia pathogenesis: the cross talk between the nerve endings of nociceptors, the adjacent immunocompetent cells, and vaginal epithelial cells. Insight into this cross talk during a pathogenic condition supports the treatment of vulvodynia with topical (compounded creams. Vulvodynia was successfully treated with an analgesic cream consisting of baclofen 5% together with the autacoid palmitoylethanolamide 1%, an endogenous anti-inflammatory compound. In this review, data is presented to substantiate the rationale behind developing and prescribing topical products for localized pain states such as vulvodynia. Most chronic inflammatory disorders are based on a network pathogenesis, and monotherapeutic inroads into the treatment of such disorders are obsolete. Keywords: vulva, cream, autacoid, mast cell, pain, analgesia, pathogenesis, baclofen, palmitoylethanolamide

  6. Comparative evaluation of topical 10% potassium hydroxide and 30% trichloroacetic acid in the treatment of plane warts

    Directory of Open Access Journals (Sweden)

    Sandhaya Jayaprasad

    2016-01-01

    Full Text Available Background: Warts are benign proliferations of skin and mucosa caused by the human papillomavirus (HPV. Plane warts are caused by HPV types 3, 10, 28, and 41, occurring mostly in children and young adults. Among the treatment modalities, topical application of trichloroacetic acid (TCA is age old. Potassium hydroxide (KOH has a keratolytic effect on virus-infected cells. It is less irritating, less painful, less scar forming, and can be safely used in children too. Hence, it could be a better topical agent in the treatment of plane warts. Aims and Objectives: To compare the safety and efficacy of topical 10% KOH with 30% TCA in the treatment of plane warts. Materials and Methods: Sixty consecutive patients with plane warts were randomly assigned into two arms of thirty patients each; arm A received topical 10% KOH and arm B received topical 30% TCA as a once weekly application until the complete clearance of warts or a maximum period of 12 weeks. Results: Statistically no significant difference (P = 0.07 was found between the objective therapeutic response to 10% KOH and 30% TCA at the end of study (12 weeks. However, subjective response to 10% KOH was better and statistically significant (P = 0.03. There was no recurrence of warts seen on follow-up for 3 months of complete responders in both the arms. Conclusion: 10% KOH is found to be equally effective in the treatment of plane warts compared to 30% TCA with the advantage of faster onset of action and tendency of completely clearing warts with fewer side effects.

  7. Treatment of vitiligo vulgaris with the combination therapy of topical steroid and vitamin D3 compound

    Directory of Open Access Journals (Sweden)

    Yoko Konishi

    2012-06-01

    Full Text Available We reported here two cases of vitiligo vulgaris successfully treated with the combination therapy of topical steroid and vitamin D3 compound and currently maintained by vitamin D3 analog without any adverse effects: skin atrophy, striae or telangiectasia on the exposed areas. The best-known mechanism of topical vitamin D3 analog is the enhancement of keratinocytes differentiation and anti-proliferative effects. Vitamin D3 analog is also reported to suppress T-cell mediated immunity, T-cell skin recruitment, and skin infiltration via down-regulating cutaneous lymphocyte antigen expression. Furthermore, vitamin D3 compounds are known to influence melanocyte maturation and differentiation and also to up-regulate melanogenesis. Autoreactive lymphocytes against melanocytes are one of the causes. Topical vitamin D3 analog may control vitiligo itself, however stronger immunosuppressive effects of topical corticosteroid may contribute to rapid re-pigmentation suppressing auto-reactive lymphocytes. The topical combination therapy is a simple, effective and safe option for vitiligo vulgaris in sun-exposed areas.

  8. Topical cyclosporin as an alternative treatment for vision threatening blepharokeratoconjunctivitis: a case report

    Directory of Open Access Journals (Sweden)

    Ismail AS

    2012-06-01

    Full Text Available Abdul-Salim Ismail,1,2 Rohana Taharin,2 Zunaina Embong11Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 2Department of Ophthalmology, Hospital Pulau Pinang, Jalan Resindensi, Pulau Pinang, MalaysiaAbstract: Here, a case of vision threatening blepharokeratoconjunctivitis that responded well to topical cyclosporin is reported. A 9-year-old Malay girl with a history of bilateral blepharokeratoconjunctivitis was regularly treated with lid scrubbing using diluted baby shampoo, fusidic acid gel, and topical steroids as well as an intermittent course of oral doxycycline for the past year. She developed acute onset bilateral eye redness associated with poor vision in her right eye. Both eyes showed marked diffuse hyperemic conjunctiva with corneal vascularization. The presence of corneal vascularization obscured the visual axis in the right eye. The condition did not improve with regular intensive lid hygiene using diluted baby shampoo, fusidic acid gel, and topical steroids. She was started on topical cyclosporin A 0.5% every 6 hours. There was a dramatic regression of corneal vascularization after 3 days on topical cyclosporin, with marked improvement in visual acuity. This is a single case in which cyclosporin improved the status of the ocular surface. A large cohort study is required to justify its effectiveness in treating blepharokeratoconjunctivitis and to test its potential as an alternative immunosuppressive agent in comparison to conventional corticosteroids.Keywords: blepharokeratoconjunctivitis, cyclosporin

  9. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension: new clinical observations.

    Science.gov (United States)

    Belcaro, G; Cesarone, M R; Dugall, M

    2004-01-01

    Aescin + essential phospholipids (AEPL) topical gels are used for local treatment of venous and microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with AEPL. Active ingredients are escinate and essential phospholipids (EPL). The aim of this new study was the evaluation of the efficacy of the effects of AEPL gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Patients were assessed measuring skin flux with laser-Doppler flowmetry (LDF). After 2 weeks of local treatment, all individual values (100%) were significantly decreased (p < 0.05), indicating an improvement in the microcirculation. In all treated patients, flux decreased at least 30% (indicating a decrease in the level of venous microangiopathy) (p < 0.05). Considering these observations, topical treatment with AEPL in areas of venous microangiopathy is beneficial, can prevent ulceration, and improves the skin healing processes.

  10. Efficacy of laser phototherapy in comparison to topical clobetasol for the treatment of oral lichen planus: a randomized controlled trial

    Science.gov (United States)

    Dillenburg, Caroline Siviero; Martins, Marco Antonio Trevizani; Munerato, Maria Cristina; Marques, Márcia Martins; Carrard, Vinícius Coelho; Filho, Manoel Sant'Ana; Castilho, Rogério Moraes; Martins, Manoela Domingues

    2014-06-01

    Oral lichen planus (OLP) is a relatively common chronic mucocutaneous inflammatory disease and a search for novel therapeutic options has been performed. We sought to compare the efficacy of laser phototherapy (LPT) to topical clobetasol propionate 0.05% for the treatment of atrophic and erosive OLP. Forty-two patients with atrophic/erosive OLP were randomly allocated to two groups: clobetasol group (n=21): application of topical clobetasol propionate gel (0.05%) three times a day; LPT group (n=21): application of laser irradiation using InGaAlP diode laser three times a week. Evaluations were performed once a week during treatment (Days 7, 14, 21, and 30) and in four weeks (Day 60) and eight weeks (Day 90) after treatment. At the end of treatment (Day 30), significant reductions in all variables were found in both groups. The LPT group had a higher percentage of complete lesion resolution. At follow-up periods (Days 60 and 90), the LPT group maintained the clinical pattern seen at Day 30, with no recurrence of the lesions, whereas the clobetasol group exhibited worsening for all variables analyzed. These findings suggest that the LPT proved more effective than topical clobetasol 0.05% for the treatment of OLP.

  11. Extinction intensity, selectivity and their combined macroevolutionary influence in the fossil record.

    Science.gov (United States)

    Payne, Jonathan L; Bush, Andrew M; Chang, Ellen T; Heim, Noel A; Knope, Matthew L; Pruss, Sara B

    2016-10-01

    The macroevolutionary effects of extinction derive from both intensity of taxonomic losses and selectivity of losses with respect to ecology, physiology and/or higher taxonomy. Increasingly, palaeontologists are using logistic regression to quantify extinction selectivity because the selectivity metric is independent of extinction intensity and multiple predictor variables can be assessed simultaneously. We illustrate the use of logistic regression with an analysis of physiological buffering capacity and extinction risk in the Phanerozoic marine fossil record. We propose the geometric mean of extinction intensity and selectivity as a metric for the influence of extinction events. The end-Permian mass extinction had the largest influence on the physiological composition of the fauna owing to its combination of high intensity and strong selectivity. In addition to providing a quantitative measure of influence to compare among past events, this approach provides an avenue for quantifying the risk posed by the emerging biodiversity crisis that goes beyond a simple projection of taxonomic losses.

  12. Topical and systemic anticoagulation in the treatment of absent or compromised venous outflow in replanted fingertips.

    Science.gov (United States)

    Han, S K; Lee, B I; Kim, W K

    2000-07-01

    Adequate venous repair is not always possible in fingertip replantation. We have used topical and systemic anticoagulation for fingertip replantation to overcome venous congestion in cases without venous repair or in cases in which there is obstruction of a repaired vein. Our technique consists of continuous external bleeding via a stab incision on the paraungal area and dripping heparinized saline solution at the incision site to maintain external bleeding. From July 1985 to December 1993, 157 fingers in 140 patients with complete amputation of the fingertip were replanted at Korea University Guro Hospital. Of these, 74 fingers in 68 patients were managed by topical and systemic anticoagulation due to the impossibility of repair or obstruction of a repaired vein. The overall survival rate of the fingertip replantations was 76%; that of the topical and systemic anticoagulation group was 64%.

  13. Extreme Postnatal Scaling in Bat Feeding Performance: A View of Ecomorphology from Ontogenetic and Macroevolutionary Perspectives.

    Science.gov (United States)

    Santana, Sharlene E; Miller, Kimberly E

    2016-09-01

    Ecomorphology studies focus on understanding how anatomical and behavioral diversity result in differences in performance, ecology, and fitness. In mammals, the determinate growth of the skeleton entails that bite performance should change throughout ontogeny until the feeding apparatus attains its adult size and morphology. Then, interspecific differences in adult phenotypes are expected to drive food resource partitioning and patterns of lineage diversification. However, Formal tests of these predictions are lacking for the majority of mammal groups, and thus our understanding of mammalian ecomorphology remains incomplete. By focusing on a fundamental measure of feeding performance, bite force, and capitalizing on the extraordinary morphological and dietary diversity of bats, we discuss how the intersection of ontogenetic and macroevolutionary changes in feeding performance may impact ecological diversity in these mammals. We integrate data on cranial morphology and bite force gathered through longitudinal studies of captive animals and comparative studies of free-ranging individuals. We demonstrate that ontogenetic trajectories and evolutionary changes in bite force are highly dependent on changes in body and head size, and that bats exhibit dramatic, allometric increases in bite force during ontogeny. Interspecific variation in bite force is highly dependent on differences in cranial morphology and function, highlighting selection for ecological specialization. While more research is needed to determine how ontogenetic changes in size and bite force specifically impact food resource use and fitness in bats, interspecific diversity in cranial morphology and bite performance seem to closely match functional differences in diet. Altogether, these results suggest direct ecomorphological relationships at ontogenetic and macroevolutionary scales in bats.

  14. ATOPIC DERMATITIS IN CHILDREN — MODERN CLINICAL AND PATHOGENETIC ASPECTS OF DISEASES AND APPROACH TO THE TOPICAL TREATMENT

    Directory of Open Access Journals (Sweden)

    N.P. Toropova

    2009-01-01

    Full Text Available Atopic dermatitis in children is widespread disease and difficult medical and social problem. The article presents a literature data and authors’ own experience on scientific studies and treatment of patients with atopic dermatitis during 50 years. The analysis of pathogenesis and treatment of children with atopic dermatitis was performed, and data on safety of modern medications for topical use, containing glucocorticoids, in children from early age were presented in this article.Key words: children, atopic dermatitis, perinatal pathology, serum IgE, external treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(5:98-105

  15. Topical herbal remedies for treatment of joint pain according to Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    A. Ziaei

    2016-07-01

    Full Text Available Joint pain is one of the most common complaints with many possible causes.Some medicines used for joint pain relief such as NSAIDs have substantial and frequent side effects. Topical route possibly reduces adverse reactions by maximizing local delivery and minimizing systemic toxicity. Throughout history, plants have been the most important sources of medicines for human health and Iranian Traditional Medicine (ITM is well known for its extensive use of herbal medicines to treat diseases accompanied with joint pain for centuries. In the present study, the plants used topically for relieving joint pain in ITM were searched. Moreover, their pharmacological effectiveness in modern medicine was reviewed. The terms “Waja mafasil” (joint pain, “Waja-ol-mafasil” (joint pain, “Irq-on-nasa” (sciatica, “Waja-ol-warik” (coxalgia, ‘Waja-ol-zahr” (back pain, “Waja-ol-rakbah” (knee pain and “Niqris” (gout were searched in three important Iranian traditional books including “Canon”, “Al-Hawi” and “Tohfat al-mu’minin” and topical preparations introduced as “Tela” and “Zemad” were selected. The scientific literatures were searched for their effectiveness related to the analgesic and anti-inflammatory activities. Thirty five plants were selected on the basis of their topical use to relief joint pain. Among these plants, 22 species have been found to exhibit anti-inflammatory and analgesic activities.

  16. Treatment of osteoarthritis of the knee with a topical diclofenac solution: a randomised controlled, 6-week trial [ISRCTN53366886

    Directory of Open Access Journals (Sweden)

    Thomas Lisa M

    2005-08-01

    Full Text Available Abstract Background Topical NSAIDs have been proven to relieve the symptoms of osteoarthritis (OA in short-term studies (2 weeks. To justify its chronic use, efficacy of a topical NSAID over a longer term of study should be demonstrated. The efficacy and safety of a topical diclofenac solution over a 6-week treatment course in symptomatic primary OA of the knee was investigated. Methods 216 men and women, age 40–85 years, with radiologically confirmed primary OA of the knee and a flare of pain at baseline following discontinuation of prior therapy were enrolled into this double-blind study. Participants applied either a topical diclofenac solution (Pennsaid® or vehicle control solution (carrier with no diclofenac; 40 drops 4 times daily directly to the painful knee(s, without massage, for 6 weeks. Pre-planned primary efficacy outcome measures included the core continuous variables pain relief and improved physical function measured by the Western Ontario and McMaster Universities (WOMAC LK3.1 OA Index, and improved patient global assessment (PGA. Secondary efficacy measure was reduced stiffness. Safety assessments included adverse events and vital signs. Results The topical diclofenac group had a significantly greater mean change in score (final minus baseline compared to the vehicle control group for pain (-5.2 vs. -3.3, p = 0.003, physical function (-13.4 vs. -6.9, p = 0.001, PGA (-1.3 vs. -0.7, p = 0.0001 and stiffness (-1.8 vs. -0.9, p = 0.002. The mean difference between treatment arms (95% confidence interval [CI] was 1.9 (0.7 to 3.2, 6.5 (2.5 to 10.5, 0.6 (0.2 to 0.9, and 0.9 (0.3 to 1.4, respectively. Safety analyses showed that topical diclofenac caused skin irritation, mostly minor local skin dryness, in 42/107 (39%, leading to discontinuation of treatment in 5/107 (5% participants. Conclusion This topical diclofenac solution demonstrated relief at 6 weeks of the symptoms of primary osteoarthritis of the knee.

  17. Topical antifungal-corticosteroid combination therapy for the treatment of superficial mycoses: conclusions of an expert panel meeting.

    Science.gov (United States)

    Schaller, Martin; Friedrich, Markus; Papini, Manuela; Pujol, Ramon M; Veraldi, Stefano

    2016-06-01

    Superficial fungal infections affect 20-25% of people worldwide and can cause considerable morbidity, particularly if an inflammatory component is present. As superficial fungal infections can be diverse, the treatment should be tailored to the individual needs of the patient and several factors should be taken into account when deciding on the most appropriate treatment option. These include the type, location and surface area of the infection, patient age, degree of inflammation and underlying comorbidities. Although several meta-analyses have shown that there are no significant differences between the numerous available topical antifungal agents with regard to mycological cure, agents differ in their specific intrinsic properties, which can affect their clinical use. The addition of a corticosteroid to an antifungal agent at the initiation of treatment can attenuate the inflammatory symptoms of the infection and is thought to increase patient compliance, reduce the risk of bacterial superinfection and enhance the efficacy of the antifungal agent. However, incorrect use of antifungal-corticosteroid therapy may be associated with treatment failure and adverse effects. This review summarises available treatment options for superficial fungal infections and provides general treatment recommendations based on the consensus outcomes of an Expert Panel meeting on the topical treatment of superficial mycoses.

  18. Combined intrastromal injection of amphotericin B and topical fluconazole in the treatment of resistant cases of keratomycosis: a retrospective study.

    Science.gov (United States)

    Nada, Waled Mahdy; Al Aswad, Mahmoud A; El-Haig, Wael M

    2017-01-01

    To evaluate the efficacy of combination therapy of a single intrastromal injection of amphotericin B and topical fluconazole in resistant cases of fungal keratitis, and also topical amphotericin B as monotherapy in terms of the duration of the recovery period and toxic drug effects. This retrospective 2-year study reviewed 68 cases of unilateral fungal keratitis diagnosed by clinical features and positive laboratory culture results. Forty-one cases were resistant and did not respond to monotherapy with an antifungal agent. Thus, they were treated with a single intrastromal injection of amphotericin B in addition to topical fluconazole as combined antifungal therapy, representing group A. Twenty-seven cases were treated with topical amphotericin B as antifungal monotherapy, representing group B. Topical atropine 1% and different antibiotic eye drops were added to the antifungal agents in both groups. Follow-up of patient records was performed monitoring cure rate, duration of recovery period, and toxic drug effects such as pain, burning sensation, and corneal melting. The results revealed that group A, treated with combination therapy, showed recovery of 34 cases (82.9%) with a mean duration of 24±6.42 days, significantly different from group B which showed recovery of 16 cases (59.3%) with a mean duration of 39.66±13.6 days. Group A also showed less manifestation of drug toxicity than group B. Combined intrastromal injection of amphotericin B and topical fluconazole can provide a good modality in the treatment of resistant cases of fungal keratitis, exhibiting highly potent antifungal effects, shorter recovery period, and reduced corneal toxicity.

  19. Topical treatment with coenzyme Q10-containing formulas improves skin's Q10 level and provides antioxidative effects.

    Science.gov (United States)

    Knott, Anja; Achterberg, Volker; Smuda, Christoph; Mielke, Heiko; Sperling, Gabi; Dunckelmann, Katja; Vogelsang, Alexandra; Krüger, Andrea; Schwengler, Helge; Behtash, Mojgan; Kristof, Sonja; Diekmann, Heike; Eisenberg, Tanya; Berroth, Andreas; Hildebrand, Janosch; Siegner, Ralf; Winnefeld, Marc; Teuber, Frank; Fey, Sven; Möbius, Janne; Retzer, Dana; Burkhardt, Thorsten; Lüttke, Juliane; Blatt, Thomas

    2015-01-01

    Ubiquinone (coenzyme Q10, Q10) represents an endogenously synthesized lipid-soluble antioxidant which is crucial for cellular energy production but is diminished with age and under the influence of external stress factors in human skin. Here, it is shown that topical Q10 treatment is beneficial with regard to effective Q10 replenishment, augmentation of cellular energy metabolism, and antioxidant effects. Application of Q10-containing formulas significantly increased the levels of this quinone on the skin surface. In the deeper layers of the epidermis the ubiquinone level was significantly augmented indicating effective supplementation. Concurrent elevation of ubiquinol levels suggested metabolic transformation of ubiquinone resulting from increased energy metabolism. Incubation of cultured human keratinocytes with Q10 concentrations equivalent to treated skin showed a significant augmentation of energy metabolism. Moreover, the results demonstrated that stressed skin benefits from the topical Q10 treatment by reduction of free radicals and an increase in antioxidant capacity.

  20. Low-Dose Topical 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Different Severity of Acne Vulgaris.

    Science.gov (United States)

    Tao, Shi-Qin; Li, Fei; Cao, Lei; Xia, Ru-Shan; Fan, Hua; Fan, Ying; Sun, Hui; Jing, Cheng; Yang, Li-Jia

    2015-12-01

    The objective of this article is to investigate the effectiveness and safety of photodynamic therapy (PDT) with 3.6 % topical aminolevulinic acid (ALA) and a short incubation time with red light in moderate to severe acne. One hundred and thirty-six patients with moderate to severe acne were treated with 3.6 % topical ALA-PDT for three sessions with an interval of 2 weeks. Patients were evaluated for efficacy and safety on week 2, 4, 6, 8, and 12 after the initial treatment. Most patients showed apparent clearance of acne lesions at the treated site after three sessions. The effective treatment rates were increased after the multiple therapies. The clinical outcomes are the best at 4 weeks after the final treatment. The total effectiveness rate and cure rate of the low-dose ALA-PDT procedure is 92.65 and 47.06 %, respectively. Thirty-one patients and nineteen patients showed apparent exacerbation of acne lesions before the 2nd and 3rd treatment, respectively, but all of them showed good or excellent improvement after a three-course treatment. A few patients showed mild relapse including papules and comedos at 8 weeks after the final treatment. No significant differences are found in the effects of different acne severity and different genders. Adverse reactions are mild and transient. A 3.6 % topical ALA-PDT with a short time incubation with red light is a simple and an effective treatment option for moderate to severe acne with mild side effects in Chinese people.

  1. Building a diagnostic algorithm on localized neuropathic pain (LNP) and targeted topical treatment: focus on 5% lidocaine-medicated plaster

    Science.gov (United States)

    Casale, Roberto; Mattia, Consalvo

    2014-01-01

    Within the broad definition of neuropathic pain, the refinement of clinical diagnostic procedures has led to the introduction of the concept of localized neuropathic pain (LNP). It is characterized by consistent and circumscribed area(s) of maximum pain, which are associated with negative or positive sensory signs and/or spontaneous symptoms typical of neuropathic pain. This description outlines the clinical features (currently lacking in guidelines and treatment recommendations) in patients for whom topical targeted treatment with 5% lidocaine-medicated plaster is suggested as first-line therapy. Few epidemiologic data are present in the literature but it is generally estimated that about 60% of neuropathic pain conditions are localized, and therefore identifiable as LNP. A mandatory clinical criterion for the diagnosis of LNP is that signs and symptoms must be present in a clearly identified and defined area(s). Cartographic recordings can help to define each area and to assess variations. The diagnosis of LNP relies on careful neurological examination more than on pain questionnaires, but it is recognized that they can be extremely useful for recording the symptom profiles and establishing a more targeted treatment. The most widely studied frequent/relevant clinical presentations of LNP are postherpetic neuralgia, diabetic neuropathy, and neuropathic postoperative pain. They successfully respond to treatment with 5% lidocaine-medicated plaster with equal if not better pain control but with fewer side effects versus conventional systemic treatments. Generally, the more localized the pain (ie, the area of an A4 sheet of paper) the better the results of topical treatment. This paper proposes an easy-to-understand algorithm to identify patients with LNP and to guide targeted topical treatments with 5% lidocaine medicated plaster. PMID:24790451

  2. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies.

    Science.gov (United States)

    Eichenfield, Lawrence F; Tom, Wynnis L; Berger, Timothy G; Krol, Alfons; Paller, Amy S; Schwarzenberger, Kathryn; Bergman, James N; Chamlin, Sarah L; Cohen, David E; Cooper, Kevin D; Cordoro, Kelly M; Davis, Dawn M; Feldman, Steven R; Hanifin, Jon M; Margolis, David J; Silverman, Robert A; Simpson, Eric L; Williams, Hywel C; Elmets, Craig A; Block, Julie; Harrod, Christopher G; Smith Begolka, Wendy; Sidbury, Robert

    2014-07-01

    Atopic dermatitis is a common and chronic, pruritic inflammatory skin condition that can affect all age groups. This evidence-based guideline addresses important clinical questions that arise in its management. In this second of 4 sections, treatment of atopic dermatitis with nonpharmacologic interventions and pharmacologic topical therapies are reviewed. Where possible, suggestions on dosing and monitoring are given based on available evidence. Copyright © 2014 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  3. Fractional Laser-Assisted Topical Imiquimod 5% Cream Treatment for Recalcitrant Common Warts in Children: A Pilot Study.

    Science.gov (United States)

    Park, Sung-Min; Kim, Gun-Wook; Mun, Je-Ho; Song, Margaret; Kim, Hoon-Soo; Kim, Byung-Soo; Kim, Moon-Bum; Ko, Hyun-Chang

    2016-12-01

    Conventional treatments for warts like cryotherapy are limited by the pain during procedures, especially in pediatric patients. Imiquimod is a topical immune response modifier, but the thick stratum corneum of common warts prevents drug permeation through skin. To evaluate the efficacy and safety of fractional laser/topical 5% imiquimod cream for the treatment of warts in children. Eleven pediatric patients with multiple recalcitrant common warts were included. Lesions were treated using an ablative fractional 2,940-nm Er:YAG laser at 1- or 2-week interval. After each laser treatment session, imiquimod 5% cream was self-applied once daily 5 days a week. Response and adverse effects were assessed 2 weekly until complete clearance or up to maximum of 48 weeks. Pain during fractional laser was assessed using a visual analogue scale (0-10). Eight of the 11 (72.7%) children experienced complete clearance. Mean duration was 29.7 (16-48) weeks, and the mean number of fractional laser was 17.5 (8-37). No significant adverse effect was observed. Pain visual analogue scale during fractional laser was 2.4 (1-4) compared to 6.2 (5-8) during cryotherapy. This pilot study indicates that fractional laser-assisted topical imiquimod may provide benefit for recalcitrant warts in children.

  4. Efficacy and safety of 5% minoxidil topical foam in male pattern hair loss treatment and patient satisfaction.

    Science.gov (United States)

    Hasanzadeh, Hournaz; Nasrollahi, Saman Ahmad; Halavati, Nader; Saberi, Maryam; Firooz, Alireza

    2016-09-01

    Male pattern hair loss is widespread around the world. Its prevalence indicates the importance of finding the best treatment modalities. This study evaluates the efficacy and safety of minoxidil 5% topical foam in male pattern hair loss treatment and patient satisfaction. This study was a before-and-after trial on 17 male patients with male pattern hair loss. Subjects were instructed to apply one capful (1 ml) of minoxidil 5% topical foam on the scalp daily for 6 months. Efficacy was assessed through hair counts, subject assessment, and global photographic review. Seventeen male volunteers were recruited, and three volunteers were withdrawn; 14 participated in the trial for 16 weeks, and 12 continued up to 24 weeks. The average hair count with a camera at week 16 (181.87 ± 52.42) and week 24 (194.58 ± 62.82) and with an eye count at week 16 (62.57 ± 15.28) and week 24 (69.91 ± 15.61) increased significantly compared to the baseline after intervention. This study confirmed that minoxidil 5% topical foam is a safe and effective treatment for MPHL. The effect of it is evident after 24 weeks of use.

  5. Topical treatment of melanoma metastases with imiquimod, plus administration of a cancer vaccine, promotes immune signatures in the metastases.

    Science.gov (United States)

    Mauldin, Ileana S; Wages, Nolan A; Stowman, Anne M; Wang, Ena; Olson, Walter C; Deacon, Donna H; Smith, Kelly T; Galeassi, Nadedja; Teague, Jessica E; Smolkin, Mark E; Chianese-Bullock, Kimberly A; Clark, Rachael A; Petroni, Gina R; Marincola, Francesco M; Mullins, David W; Slingluff, Craig L

    2016-10-01

    Infiltration of cancers by T cells is associated with improved patient survival and response to immune therapies; however, optimal approaches to induce T cell infiltration of tumors are not known. This study was designed to assess whether topical treatment of melanoma metastases with the TLR7 agonist imiquimod plus administration of a multipeptide cancer vaccine will improve immune cell infiltration of melanoma metastases. Eligible patients were immunized with a vaccine comprised of 12 melanoma peptides and a tetanus toxoid-derived helper peptide, and imiquimod was applied topically to metastatic tumors daily. Adverse events were recorded, and effects on the tumor microenvironment were evaluated from sequential tumor biopsies. T cell responses were assessed by IFNγ ELIspot assay and T cell tetramer staining. Patient tumors were evaluated for immune cell infiltration, cytokine and chemokine production, and gene expression. Four eligible patients were enrolled, and administration of imiquimod and vaccination were well tolerated. Circulating T cell responses to the vaccine was detected by ex vivo ELIspot assay in 3 of 4 patients. Treatment of metastases with imiquimod induced immune cell infiltration and favorable gene signatures in the patients with circulating T cell responses. This study supports further study of topical imiquimod combined with vaccines or other immune therapies for the treatment of melanoma.

  6. Comparative efficacy of topical 5% 5-fluorouracil with electrosurgery in treatment of warts

    Directory of Open Access Journals (Sweden)

    Dogra Alka

    2006-01-01

    Full Text Available Warts are common dermatologicals disorder which are dificult to treat. In the present study the efficacy of topical 5% 5-fluorouracil was evaluated in various types of warts and compared with the conventional electrosurgical method which included both electrodessication and electrofulguration. 50 patients clinically diagnosed as warts were enrolled. 25 patients were treated with topical 5% 5-fluorouracil applied for 4 hrs twice daily for 3 weeks, while another 25 were treated with electrosurgery. It was observed that electrosurgery yielded better initial results than 5-fluorouracil (72 and 52% respectively, but at the end of 6 months, the results were favourable for 5-fluorouracil as compared to electrosurgery (44 and 36% respectively. This was due to the signficantly low recurrence rate with 5-fluorouracil in contrast to electrosurgery (8 and 48% respectively. Though electrosurgery yielded quicker initial results but 5-fluorouracil was better as long term measurer because of its significantly lower recurrence rates.

  7. Non-hormonal topical treatment of vulvovaginal atrophy: an up-to-date overview.

    Science.gov (United States)

    Sinha, A; Ewies, A A A

    2013-06-01

    Vulvovaginal atrophy-related symptoms exert a negative impact on the quality of life of up to 50% of postmenopausal women. Many of them decline to use topical vaginal estrogen, which is the standard effective therapy, due to the adverse publicity over recent years, and seek for alternatives. Further, there are no safety studies to support the use of topical vaginal estrogen in breast cancer survivors, and it is considered as contraindicated by many health-care professionals. Vaginal moisturizers and lubricants as well as regular sexual activity may be helpful to such women. Vaginal moisturizers may have an equivalent efficacy to topical vaginal estrogen and should be offered to women wishing to avoid the use of hormonal therapy. Lubricants are usually used during sexual intercourse to provide temporary relief from vaginal dryness and dyspareunia; however, they have no long-term therapeutic effects. We provide in this systematic review up-to-date information, for women and health-care professionals, about the use, safety and efficacy of the available vaginal moisturizers and lubricants.

  8. Formulation and evaluation of topical herbal gel for the treatment of arthritis in animal model

    Directory of Open Access Journals (Sweden)

    Rajasekaran Aiyalu

    Full Text Available ABSTRACT The objective of the study is to formulate and evaluate a topical herbal gel containing Cardiospermum halicacabum and Vitex negundo leaf extracts for their anti-arthritic activity in rats. Twelve herbal gel formulations were prepared using 1.5% of gelling agents carbopol 934 (F1-F6 and carbopol 940 (F6-F12 and they were evaluated for physical appearance, net content, viscosity, extrudability, pH, spreadability, in vitro diffusion profile and primary skin irritation tests. The stability study for the topical herbal gel formulation was done as per ICH guidelines and anti-arthritic activity was evaluated by Freund's Complete Adjuvant (FCA induced arthritis method. Assessment of body weight, paw volume, hematological and biochemical parameters, histopathological examination and In vitro determination of serum biomarkers were also carried out. Formulated gels were homogenous, stable and complied with the guidelines. Among the formulations, F4 showed better release (98.4 % characteristics than other formulations. No erythema or edema was observed in the skin irritation test confirming the gel was non-toxic and safe. Topical application of the herbal gel F4 containing carbopol 934 displayed significant (p < 0.001 anti-arthritic activity compared to diseased rats. Reduction in paw volume, no agglutination in C - reactive protein and rheumatic factor, reduction in TNF level, regaining of normal hematological, and biochemical parameters, reduction in spleen and thymus weight and histopathological examination supported the anti-arthritic activity of the gel formulation.

  9. Enhanced topical delivery of tetrandrine by ethosomes for treatment of arthritis.

    Science.gov (United States)

    Fan, Chao; Li, Xinru; Zhou, Yanxia; Zhao, Yong; Ma, Shujin; Li, Wenjing; Liu, Yan; Li, Guiling

    2013-01-01

    The purpose of this work was to explore the feasibility of ethosomes for improving the antiarthritic efficacy of tetrandrine by topical application. It was found that tetrandrine was a weak base (pK(a) = 7.06) with pH-dependent partition coefficient. The spherical-shaped ethosomes were prepared by pH gradient loading method. Ex vivo permeation and deposition behavior demonstrated that the drug flux across rat skin and deposition of the drug in rat skin for ethosomes was 2.1- and 1.7-fold higher than that of liposomes, respectively. Confocal laser scanning microscopy confirmed that ethosomes could enhance the topical delivery of the drug in terms of depth and quantity compared with liposomes. The ethosomes were shown to generate substantial enhancement of therapeutic efficacy of tetrandrine on Freund's complete adjuvant-induced arthritis with regard to liposomes. These results indicated that ethosomes would be a promising carrier for topical delivery of tetrandrine into and across the skin.

  10. Enhanced Topical Delivery of Tetrandrine by Ethosomes for Treatment of Arthritis

    Directory of Open Access Journals (Sweden)

    Chao Fan

    2013-01-01

    Full Text Available The purpose of this work was to explore the feasibility of ethosomes for improving the antiarthritic efficacy of tetrandrine by topical application. It was found that tetrandrine was a weak base (pKa=7.06 with pH-dependent partition coefficient. The spherical-shaped ethosomes were prepared by pH gradient loading method. Ex vivo permeation and deposition behavior demonstrated that the drug flux across rat skin and deposition of the drug in rat skin for ethosomes was 2.1- and 1.7-fold higher than that of liposomes, respectively. Confocal laser scanning microscopy confirmed that ethosomes could enhance the topical delivery of the drug in terms of depth and quantity compared with liposomes. The ethosomes were shown to generate substantial enhancement of therapeutic efficacy of tetrandrine on Freund’s complete adjuvant-induced arthritis with regard to liposomes. These results indicated that ethosomes would be a promising carrier for topical delivery of tetrandrine into and across the skin.

  11. Increasing efficacy and reducing side effects in treatment of chronic anal fissures: A study of topical diazepam therapy.

    Science.gov (United States)

    Hang, Minh Tuan H; Smith, Betsy E; Keck, Carson; Keshavarzian, Ali; Sedghi, Shahriar

    2017-05-01

    This is a single institution nonexperimental study intended to analyze the therapeutic efficacy of topical diazepam in treating symptoms of chronic anal fissures.Anal fissures are a common cause of anal pain. Conventional treatments include nonsteroidal anti-inflammatory drugs, topical creams, such as nitroglycerin and nifedipine, and surgery. However, these treatments are usually suboptimally efficacious or have deterring side effects.Patients at an outpatient community center with a diagnosis of a chronic anal fissure were prescribed either topical 2% (n = 19) or 4% (n = 18) diazepam cream between January 2013 and February 2015. We retrospectively analyzed their responses to treatment.All 19 patients using 2% diazepam cream experienced a positive response in pain, whereas 47.4% experienced a complete response, with a numerical rating scale (NRS) score of 0 (0-10). Eighty-eight percent of patients using 4% dose had a positive response in pain, whereas 23.5% experienced a complete response. Ninety-four percent of patients using 2% dose had a positive response in anal bleeding, whereas 68.8% experienced a complete response with an anal bleeding score (ABS) of 2 (2-9). Ninety-four percent of patients using 4% dose had a positive response in anal bleeding, whereas 64.7% experienced a complete response. Only 1 patient reported a side effect from diazepam cream-perianal pruritus.Both 2% and 4% topical diazepam provided significant pain and bleeding relief from chronic anal fissures that were refractory to conventional therapies. There were insignificant differences when assessing independent comparisons for pain and bleeding between the doses.

  12. Comparison of Safety and Efficacy of Oral Azithromycin-Topical Adapalene Versus Oral Doxycycline-Topical Adapalene in the Treatment of Acne Vulgaris and Determination of the Effects of These Treatments on Patients’ Quality of Life

    Directory of Open Access Journals (Sweden)

    Serap Kayhan

    2012-09-01

    Full Text Available Background and Design: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit. Oral antibiotics and topical retinoids are effective in the treatment of acne.Materials and Methods: In this study, 60 patients with moderate acne vulgaris were evaluated; the patients were randomized into two equal groups. The groups were matched with respect to age, gender and clinical severity of acne. The patients in group 1 received oral azithromycin (500 mg daily on 3 consecutive days per week and the patients in group 2 received doxycycline (100 mg daily for 12 weeks. Topical adapalene gel was added to the systemic treatment in both groups. Clinical evaluation was performed at baseline and at the end of first, second and third months. Side effects were recorded. Quality of life in patients was measured with Skindex-29 and Acne Quality of Life Scale before treatment and at the end of third month. Results: At the end of the treatment, the patients in the two treatment groups had clinical improvement of more than 50%. Twenty-one patients in the azithromycin-adapalene group and 23 patients in the doxycycline-adapelene group had more than 80% clinical improvement. There was not any statistically significant difference in the clinical efficacy between the two combinations. Both treatment regimens were safe with minimal side effects. There was statistically significant difference in Skindex-29 and Acne Quality of Life Scale scores at baseline and at the end of the treatment (p0.05. Conclusion: Both treatments were efficient and safe. There was significant improvement in quality of life scale scores in both groups.

  13. Physicochemical stability of a new topical timolol 0.5% gel formulation for the treatment of infant hemangioma.

    Science.gov (United States)

    Merino-Bohórquez, V; Casas, M; Caracuel, F; Cameán, M; Fernández-Anguita, M J; Ramírez-Soto, G; Lucero, M J

    2015-01-01

    Infant hemangioma (IH) is the most common tumor in infants, which affects 5-10% of white children. It is a tumor of vascular origin that appears in the first months of life. The indication for the treatment of the IH is not approved in the datasheet of the product, however it has been used in the infant hemangioma by topical administration as an alternative to oral propranolol, avoiding the main problems of the oral route (bradycardia and hypotension). The objective of this work is to study the physical and chemical (HPLC stability indicating method) stability of a 0.5% timolol gel for topical application during 60 days (considering the stability limit as 90% of initial concentration of timolol maleate). The gel was prepared with a polyacrylic acid derivative and the physical stability of the system was studied by visual control, rheological and mechanical characterization. The studied formulation guarantees the correct dose administering and stability after 60 days stored at 25 ± 2 °C and light protected (tube of aluminum). We have developed an easy topical gel for the treatment of infant hemangioma with physical and chemical stability higher than those provided by the majority of hospitals.

  14. Enhanced Topical Delivery of Tetrandrine by Ethosomes for Treatment of Arthritis

    OpenAIRE

    Chao Fan; Xinru Li; Yanxia Zhou; Yong Zhao; Shujin Ma; Wenjing Li; Yan Liu; Guiling Li

    2013-01-01

    The purpose of this work was to explore the feasibility of ethosomes for improving the antiarthritic efficacy of tetrandrine by topical application. It was found that tetrandrine was a weak base (pK a = 7.06) with pH-dependent partition coefficient. The spherical-shaped ethosomes were prepared by pH gradient loading method. Ex vivo permeation and deposition behavior demonstrated that the drug flux across rat skin and deposition of the drug in rat skin for ethosomes was 2.1- and 1.7-fold highe...

  15. Topical alprostadil (PGE1) for the treatment of female sexual arousal disorder: in-clinic evaluation of safety and efficacy.

    Science.gov (United States)

    Heiman, Julia R; Gittelman, Marc; Costabile, Raymond; Guay, Andre; Friedman, Alice; Heard-Davison, Amy; Peterson, Craig; Dietrich, John; Stephens, Darby

    2006-03-01

    This multi-center, randomized, placebo-controlled, crossover design study evaluated the effects of a topical alprostadil solution for the treatment of female sexual arousal disorder (FSAD). A total of 79 naturally or surgically post menopausal women with FSAD were treated with either 100 or 400 micrograms of alprostadil solution and placebo, delivered on separate clinic visits in random order. Study drug was applied to the external genitalia and was followed by 30 minutes of visual sexual stimulation. Study evaluations included investigator assessments of genital vasocongestion and patient assessments of physical and emotional sexual arousal, and sexual satisfaction. Genital vasocongestion in response to PGE1 was significantly greater than placebo (p alprostadil. Topical alprostadil was well tolerated with no reports of significant systemic side effects. The most common adverse event was mild, transient genital burning typically alprostadil should be further researched as a potentially appropriate on-demand therapeutic choice for women experiencing FSAD.

  16. Current topics in the treatment of prostate cancer with low-dose-rate brachytherapy.

    Science.gov (United States)

    Stock, Richard G; Stone, Nelson N

    2010-02-01

    The treatment of prostate cancer with low dose rate prostate brachytherapy has grown rapidly in the last 20 years. Outcome analyses performed in this period have enriched understanding of this modality. This article focuses on the development of a real-time ultrasound-guided implant technique, the importance of radiation dose, trimodality treatment of high-risk disease, long-term treatment outcomes, and treatment-associated morbidity.

  17. Topical treatment of all-trans retinoic acid inhibits murine melanoma partly by promoting CD8(+) T-cell immunity.

    Science.gov (United States)

    Yin, Wei; Song, Yan; Liu, Qing; Wu, Yunyun; He, Rui

    2017-10-01

    All-trans retinoic acid (atRA), the main biologically active metabolite of vitamin A, has been implicated in immunoregulation and anti-cancer. A recent finding that vitamin A could decrease the risk of melanoma in humans indicates the beneficial role of atRA in melanoma. However, it remains unknown whether topical application of atRA could inhibit melanoma growth by influencing tumour immunity. We demonstrate topical application of tretinoin ointment (atRA as the active ingredient) effectively inhibited B16F10 melanoma growth. This is accompanied by markedly enhanced CD8(+) T-cell responses, as evidenced by significantly increased proportions of effector CD8(+) T cells expressing granzyme B, tumour necrosis factor-α, or interferon-γ, and Ki67(+) proliferating CD8(+) T cells in atRA-treated tumours compared with vaseline controls. Furthermore, topical atRA treatment promoted the differentiation of effector CD8(+) T cells in draining lymph nodes (DLN) of tumour-bearing mice. Interestingly, atRA did not affect tumoral CD4(+) T-cell response, and even inhibited the differentiation of interferon-γ-expressing T helper type 1 cells in DLN. Importantly, we demonstrated that the tumour-inhibitory effect of atRA was partly dependent on CD8(+) T cells, as CD8(+) T-cell depletion restored tumour volumes in atRA-treated mice, which, however, was still significantly smaller than those in vaseline-treated mice. Finally, we demonstrated that atRA up-regulated MHCI expression in B16F10 cells, and DLN cells from tumour-bearing mice had a significantly higher killing rate when culturing with atRA-treated B16F10 cells. Hence, our study demonstrates that topical atRA treatment effectively inhibits melanoma growth partly by promoting the differentiation and the cytotoxic function of effector CD8(+) T cells. © 2017 John Wiley & Sons Ltd.

  18. A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds

    Science.gov (United States)

    Akhmetova, Alma; Allan, Iain U.; Illsley, Matthew J.; Nurgozhin, Talgat; Mikhalovsky, Sergey

    2016-01-01

    The process of wound healing is often accompanied by bacterial infection or critical colonization, resulting in protracted inflammation, delayed reepithelization, and production of pungent odors. The malodor produced by these wounds may lower health-related quality of life and produce psychological discomfort and social isolation. Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases. For example, charcoal-based materials have been incorporated into dressing for direct adsorption of the responsible gases. In addition, multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection. This review describes options for controlling malodor in chronic wounds, the benefits and drawbacks of each topical agent, and their mode of action. We also discuss the use of subjective odor evaluation techniques to assess the efficacy of odor-controlling therapies. The perspectives of employing novel biomaterials and technologies for wound odor management are also presented. PMID:27684356

  19. The role of topical 5% acyclovir and 1% hydrocortisone cream (Xerese™) in the treatment of recurrent herpes simplex labialis.

    Science.gov (United States)

    Hull, Christopher M; Brunton, Stephen

    2010-09-01

    Recurrent herpes simplex labialis (HSL), also known as orofacial herpes or cold sores, is a common clinical presentation of herpes simplex virus (HSV) infection. It may manifest as painful, distressing, and cosmetically displeasing vesicles on the lips, nose, and nasal septum. Although oral or topical treatment with antiviral agents can reduce the replication of HSV-1, the primary benefits of antiviral therapies for recurrent HSL have been limited to modest reductions in healing time; they do not mitigate the accompanying immune-mediated response of the host to the virus. The addition of a topical corticosteroid to an antiviral cream has been hypothesized to improve the clinical outcome of HSL by decreasing the HSV-related immune-mediated inflammatory skin reaction. A recently developed topical cream containing 5% acyclovir and 1% hydrocortisone (AHC) in a novel cream vehicle has been shown to be safe and effective for the early treatment of recurrent HSL in immunocompetent adult and adolescent patients. In a well-controlled clinical trial, AHC cream significantly reduced the frequency of both ulcerative and nonulcerative recurrences (ie, the prevention of vesicular HSL lesions). Treatment was well tolerated, and there was no evidence of emergence of viral resistance to acyclovir with the addition of hydrocortisone. The AHC cream significantly reduced the recurrence of ulcerative and nonulcerative HSL lesions and shortened healing time with early treatment compared with acyclovir 5% cream and vehicle (placebo) cream. Herpes simplex labialis may not typically be considered a serious medical condition; however, the importance of treating HSL should not be overlooked, considering the continuous increase of the viral pool in the general population and the potential psychological and social consequences of the condition when left untreated.

  20. Evaluation of anti-cellulite efficacy: a topical cosmetic treatment for cellulite blemishes - a multifunctional formulation.

    Science.gov (United States)

    Sparavigna, Adele; Guglielmini, Giancarlo; Togni, Stefano; Cristoni, Aldo; Maramaldi, Giada

    2011-01-01

    Cellulite is thought to affect 80-90% of postpubertal women, and is considered much of a cosmetic concern by the large majority of them. In this study, the objective was to assess the efficacy of a topical cosmetic product containing various active ingredients of botanical origin on cellulite blemishes on female volunteers affected by fat accumulations, as well as by slight-to-moderate cellulite in the lower limbs. The assessment was performed by means of various objective evaluations, including contact thermography, morphometric measures of thigh circumference, and microcirculation evaluation. The obtained results indicate that the use of synergistic botanical standardized extracts, through the exploitation of different mechanisms of action and acting on different biological targets, provides visible and measurable results in the improvement of cellulite signs and symptoms.

  1. Building a diagnostic algorithm on localized neuropathic pain (LNP and targeted topical treatment: focus on 5% lidocaine-medicated plaster

    Directory of Open Access Journals (Sweden)

    Casale R

    2014-04-01

    Full Text Available Roberto Casale,1,2 Consalvo Mattia31Department of Clinical Neurophysiology and Pain Rehabilitation Unit, Foundation “Salvatore Maugeri”, Research and Care Institute, IRCCS, Pavia, Italy; 2EFIC Montescano Pain School, Montescano, Italy; 3Department of Medical-Surgical Sciences, Section of Anaesthesia, Intensive Care and Pain Medicine, Faculty of Medicine and Pharmacy, Sapienza University of Rome, ItalyAbstract: Within the broad definition of neuropathic pain, the refinement of clinical diagnostic procedures has led to the introduction of the concept of localized neuropathic pain (LNP. It is characterized by consistent and circumscribed area(s of maximum pain, which are associated with negative or positive sensory signs and/or spontaneous symptoms typical of neuropathic pain. This description outlines the clinical features (currently lacking in guidelines and treatment recommendations in patients for whom topical targeted treatment with 5% lidocaine-medicated plaster is suggested as first-line therapy. Few epidemiologic data are present in the literature but it is generally estimated that about 60% of neuropathic pain conditions are localized, and therefore identifiable as LNP. A mandatory clinical criterion for the diagnosis of LNP is that signs and symptoms must be present in a clearly identified and defined area(s. Cartographic recordings can help to define each area and to assess variations. The diagnosis of LNP relies on careful neurological examination more than on pain questionnaires, but it is recognized that they can be extremely useful for recording the symptom profiles and establishing a more targeted treatment. The most widely studied frequent/relevant clinical presentations of LNP are postherpetic neuralgia, diabetic neuropathy, and neuropathic postoperative pain. They successfully respond to treatment with 5% lidocaine-medicated plaster with equal if not better pain control but with fewer side effects versus conventional systemic

  2. Does competition drive character differences between species on a macroevolutionary scale?

    Science.gov (United States)

    Monroe, Melanie J

    2012-11-01

    Sympatric sister species generally have a degree of phenotypic differentiation that allows them to coexist. It has been well documented that phenotypic similarity results, through resource competition, in one of two major outcomes: local extinction of either competitor or character displacement. Limiting similarity suggests that there is a maximum degree of phenotypic niche overlap with which similar species may coexist. Breaching that maximum would result in exclusion. Character displacement, on the other hand, implies that the species differentiate phenotypically so that resource competition is reduced to the point where coexistence is possible. While it has been suggested that these theories have the potential to accelerate (character displacement) or limit phenotypic evolution (competitive exclusion) on microevolutionary time scales, their effects on macroevolution remain under-studied. If competition accelerates evolution on a macroevolutionary scale, one would expect that phenotypic diversity increases as novel species 'push aside' existing species. On the other hand, one might also expect that phenotypic evolution comes to a halt as novel species are trapped in the (ever decreasing) phenotypic space not yet occupied by existing species, except at the extremes of the phenotypic spectrum. Studying the current geographical ranges of more than 3000 extant species representing 29 mammalian families and their respective body masses, I found little evidence of competition accelerating body size differentiation between species. © 2012 The Author. Journal of Evolutionary Biology © 2012 European Society For Evolutionary Biology.

  3. Common functional targets of adaptive micro- and macro-evolutionary divergence in killifish.

    Science.gov (United States)

    Whitehead, Andrew; Zhang, Shujun; Roach, Jennifer L; Galvez, Fernando

    2013-07-01

    Environmental salinity presents a key barrier to dispersal for most aquatic organisms, and adaptation to alternate osmotic environments likely enables species diversification. Little is known of the functional basis for derived tolerance to environmental salinity. We integrate comparative physiology and functional genomics to explore the mechanistic underpinnings of evolved variation in osmotic plasticity within and among two species of killifish; Fundulus majalis harbours the ancestral mainly salt-tolerant phenotype, whereas Fundulus heteroclitus harbours a derived physiology that retains extreme salt tolerance but with expanded osmotic plasticity towards the freshwater end of the osmotic continuum. Common-garden comparative hypo-osmotic challenge experiments show that F. heteroclitus is capable of remodelling gill epithelia more quickly and at more extreme osmotic challenge than F. majalis. We detect an unusual pattern of baseline transcriptome divergence, where neutral evolutionary processes appear to govern expression divergence within species, but patterns of divergence for these genes between species do not follow neutral expectations. During acclimation, genome expression profiling identifies mechanisms of acclimation-associated response that are conserved within the genus including regulation of paracellular permeability. In contrast, several responses vary among species including those putatively associated with cell volume regulation, and these same mechanisms are targets for adaptive physiological divergence along osmotic gradients within F. heteroclitus. As such, the genomic and physiological mechanisms that are associated with adaptive fine-tuning within species also contribute to macro-evolutionary divergence as species diversify across osmotic niches. © 2013 John Wiley & Sons Ltd.

  4. Macroevolutionary patterns of ultraviolet floral pigmentation explained by geography and associated bioclimatic factors.

    Science.gov (United States)

    Koski, Matthew H; Ashman, Tia-Lynn

    2016-07-01

    Selection driven by biotic interactions can generate variation in floral traits. Abiotic selection, however, also contributes to floral diversity, especially with respect to patterns of pigmentation. Combining comparative studies of floral pigmentation and geography can reveal the bioclimatic factors that may drive macroevolutionary patterns of floral color. We create a molecular phylogeny and measure ultraviolet (UV) floral pattern for 177 species in the Potentilleae tribe (Rosaceae). Species are similar in flower shape and visible color but vary in UV floral pattern. We use comparative approaches to determine whether UV pigmentation variation is associated with geography and/or bioclimatic features (UV-B, precipitation, temperature). Floral UV pattern was present in half of the species, while others were uniformly UV-absorbing. Phylogenetic signal was detected for presence/absence of pattern, but among patterned species, quantitative variation in UV-absorbing area was evolutionarily labile. Uniformly UV-absorbing species tended to experience higher UV-B irradiance. Patterned species occurring at higher altitudes had larger UV-absorbing petal areas, corresponding with low temperature and high UV exposure. This analysis expands our understanding of the covariation of UV-B irradiance and UV floral pigmentation from within species to that among species, and supports the view that abiotic selection is associated with floral diversification among species.

  5. Microevolutionary, macroevolutionary, ecological and taxonomical implications of punctuational theories of adaptive evolution.

    Science.gov (United States)

    Flegr, Jaroslav

    2013-01-16

    Punctuational theories of evolution suggest that adaptive evolution proceeds mostly, or even entirely, in the distinct periods of existence of a particular species. The mechanisms of this punctuated nature of evolution suggested by the various theories differ. Therefore the predictions of particular theories concerning various evolutionary phenomena also differ.Punctuational theories can be subdivided into five classes, which differ in their mechanism and their evolutionary and ecological implications. For example, the transilience model of Templeton (class III), genetic revolution model of Mayr (class IV) or the frozen plasticity theory of Flegr (class V), suggests that adaptive evolution in sexual species is operative shortly after the emergence of a species by peripatric speciation--while it is evolutionary plastic. To a major degree, i.e. throughout 98-99% of their existence, sexual species are evolutionarily frozen (class III) or elastic (class IV and V) on a microevolutionary time scale and evolutionarily frozen on a macroevolutionary time scale and can only wait for extinction, or the highly improbable return of a population segment to the plastic state due to peripatric speciation.The punctuational theories have many evolutionary and ecological implications. Most of these predictions could be tested empirically, and should be analyzed in greater depth theoretically. The punctuational theories offer many new predictions that need to be tested, but also provide explanations for a much broader spectrum of known biological phenomena than classical gradualistic evolutionary theories.

  6. Macroevolutionary patterns of glucosinolate defense and tests of defense-escalation and resource availability hypotheses.

    Science.gov (United States)

    Cacho, N Ivalú; Kliebenstein, Daniel J; Strauss, Sharon Y

    2015-11-01

    We explored macroevolutionary patterns of plant chemical defense in Streptanthus (Brassicaceae), tested for evolutionary escalation of defense, as predicted by Ehrlich and Raven's plant-herbivore coevolutionary arms-race hypothesis, and tested whether species inhabiting low-resource or harsh environments invest more in defense, as predicted by the resource availability hypothesis (RAH). We conducted phylogenetically explicit analyses using glucosinolate profiles, soil nutrient analyses, and microhabitat bareness estimates across 30 species of Streptanthus inhabiting varied environments and soils. We found weak to moderate phylogenetic signal in glucosinolate classes and no signal in total glucosinolate production; a trend toward evolutionary de-escalation in the numbers and diversity of glucosinolates, accompanied by an evolutionary increase in the proportion of aliphatic glucosinolates; some support for the RAH relative to soil macronutrients, but not relative to serpentine soil use; and that the number of glucosinolates increases with microhabitat bareness, which is associated with increased herbivory and drought. Weak phylogenetic signal in chemical defense has been observed in other plant systems. A more holistic approach incorporating other forms of defense might be necessary to confidently reject escalation of defense. That defense increases with microhabitat bareness supports the hypothesis that habitat bareness is an underappreciated selective force on plants in harsh environments.

  7. Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609 for Treatment of Herpes Labialis: a systematic review

    Directory of Open Access Journals (Sweden)

    MARIA INÊS DA ROSA

    2015-08-01

    Full Text Available We performed a systematic review with the objective of verifying the efficacy of topical use 5% Acyclovir-1% Hydrocortisone cream compared to the placebo group for herpes simplex labialis treatment. We performed a literature search using MEDLINE, Embase, BIOSIS, LILACS, Scopus, Grey literature, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS from 1990 to June 2014. We reported the outcomes using relative risk (RR with 95% confidence intervals. The literature search yielded 180 potentially relevant publications. Reviews of the reference lists yielded two further citations. Among these papers, two were considered eligible for inclusion in this review. Both trials included 1,213 patients. A meta-analysis of these studies showed a RR = 0.77, (95% CI 0.70-0.86; p<0.001.This result suggests that an early episodic treatment with the combination of an antiviral and a steroid is beneficial for herpes simplex labialis treatment.

  8. Solid Lipid Nanoparticles Loaded with Retinoic Acid and Lauric Acid as an Alternative for Topical Treatment of Acne Vulgaris.

    Science.gov (United States)

    Silva, Elton Luiz; Carneiro, Guilherme; De Araújo, Lidiane Advíncula; Trindade, Mariana de Jesus Vaz; Yoshida, Maria Irene; Oréfice, Rodrigo Lambert; Farias, Luis de Macêdo; De Carvalho, Maria Auxiliadora Roque; Dos Santos, Simone Gonçalves; Goulart, Gisele Assis Castro; Alves, Ricardo José; Ferreira, Lucas Antônio Miranda

    2015-01-01

    Topical therapy is the first choice for the treatment of mild to moderate acne and all-trans retinoic acid is one of the most used drugs. The combination of retinoids and antimicrobials is an innovative approach for acne therapy. Recently, lauric acid, a saturated fatty acid, has shown strong antimicrobial activity against Propionibacterium acnes. However, topical application of retinoic acid is followed by high incidence of side-effects, including erythema and irritation. Solid lipid nanoparticles represent an alternative to overcome these side-effects. This work aims to develop solid lipid nanoparticles loaded with retinoic acid and lauric acid and evaluate their antibacterial activity. The influence of lipophilic stearylamine on the characteristics of solid lipid nanoparticles was investigated. Solid lipid nanoparticles were characterized for size, zeta potential, encapsulation efficiency, differential scanning calorimetry and X-ray diffraction. The in vitro inhibitory activity of retinoic acid-lauric acid-loaded solid lipid nanoparticles was evaluated against Propionibacterium acnes, Staphylococcus aureus and Staphylococcus epidermidis. High encapsulation efficiency was obtained at initial time (94 ± 7% and 100 ± 4% for retinoic acid and lauric acid, respectively) and it was demonstrated that lauric acid-loaded-solid lipid nanoparticles provided the incorporation of retinoic acid. However, the presence of stearylamine is necessary to ensure stability of encapsulation. Moreover, retinoic acid-lauric acid-loaded solid lipid nanoparticles showed growth inhibitory activity against Staphylococcus epidermidis, Propionibacterium acnes and Staphylococcus aureus, representing an interesting alternative for the topical therapy of acne vulgaris.

  9. Chronic suppurative otitis media due to nontuberculous mycobacteria: A case of successful treatment with topical boric acid.

    Science.gov (United States)

    Lefebvre, Marie-Astrid; Quach, Caroline; Daniel, Sam J

    2015-07-01

    Nontuberculous mycobacteria (NTM) are an increasingly recognized cause of chronic suppurative otitis media in children with tympanostomy tubes. Treatment of this condition is difficult and typically requires a combination of systemic antibiotics and surgical debridement. We present the first case of a 2-year-old male with chronic suppurative otitis media due to NTM who failed systemic antibiotic therapy and was successfully managed with topical boric acid powder. This report highlights the challenges involved in treating this infection, and introduces boric acid as a potentially valuable component of therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents.

    Science.gov (United States)

    Tsatsos, Michael; MacGregor, Cheryl; Athanasiadis, Ioannis; Moschos, Marilita M; Hossain, Parwez; Anderson, David

    2016-12-01

    Ophthalmic herpes simplex viral keratitis is responsible for a range of ocular manifestations from superficial epithelial disease to stromal keratitis and endotheliitis. The Herpetic Eye Disease Study has guided the management of herpetic eye disease for almost twenty years, but newer medications such as valacyclovir are now available and are considered to have better bioavailability than acyclovir. In this review, we examine the existing evidence on the pathogenesis of different ophthalmic herpes simplex viral keratitis disease modalities and the role of oral and topically administered antiviral drugs in the treatment of herpes simplex viral keratitis.

  11. Discovering treatment pattern in Traditional Chinese Medicine clinical cases by exploiting supervised topic model and domain knowledge.

    Science.gov (United States)

    Yao, Liang; Zhang, Yin; Wei, Baogang; Wang, Wei; Zhang, Yuejiao; Ren, Xiaolin; Bian, Yali

    2015-12-01

    In Traditional Chinese Medicine (TCM), the prescription is the crystallization of clinical experience of doctors, which is the main way to cure diseases in China for thousands of years. Clinical cases, on the other hand, describe how doctors diagnose and prescribe. In this paper, we propose a framework which mines treatment patterns in TCM clinical cases by exploiting supervised topic model and TCM domain knowledge. The framework can reflect principle rules in TCM and improve function prediction of a new prescription. We evaluate our method on 3090 real world TCM clinical cases. The experiment validates the effectiveness of our method.

  12. Treatment of Verrucous Carcinoma of the Lower Lip with Topical Imiquimod (Aldara®) and Debulking Therapy

    Science.gov (United States)

    Kwon, Hyok Bu; Choi, Yun Seok; Lee, Joon Ho; Jin, Sang Yun; Kim, Beom Joon; Lee, Seung Ho

    2011-01-01

    Verrucous carcinoma is an unusual, non-metastasizing, distinct variant of squamous cell carcinoma composed of four subtypes according to the site of occurrence: oral type, anogenital type, plantar type, and other cutaneous sites. Oral type verrucous carcinoma usually shows slow progression with a low incidence of metastases. Treatment of verrcous carcinoma is challenging; multiple medical and surgical therapies are often attempted, with limited success. We reported on 2 cases of verrucous carcinoma of the lip treated with topical imiquimod and debulking therapy. PMID:22028577

  13. Comparison of topical methyl aminolevulinate photodynamic therapy with cryotherapy or Fluorouracil for treatment of squamous cell carcinoma in situ: Results of a multicenter randomized trial.

    NARCIS (Netherlands)

    Morton, C.; Horn, M.; Leman, J.; Tack, B.; Bedane, C.; Tjioe, M.; Ibbotson, S.; Khemis, A.; Wolf, P.

    2006-01-01

    OBJECTIVE: To compare the efficacy, tolerability, and cosmetic outcome of photodynamic therapy (PDT) using topical methyl aminolevulinate with cryotherapy or topical fluorouracil for treatment of squamous cell carcinoma in situ. DESIGN: Randomized, placebo-controlled study, with follow-up at 3 and 1

  14. [Methodology and didactics of training children and adolescents in topical treatment of atopic dermatitis].

    Science.gov (United States)

    Ponseti, J; Dimopulos, U; Hübscher, W

    1998-11-01

    There are increasing numbers of education programmes for children and young people with atopic dermatitis. These also include directions for the treatment of atopic dermatitis. However, the methods to be followed and the treatment to be applied are usually not clearly defined or explained. Presented are the key aspects of the local treatment of atopic dermatitis to be taught to children. The introduction of a basic therapeutic concept helps sort out which are the best preparations to use, some with and others without active ingredients. The interactions between basic care, active ingredients and skin conditions are explained in such a way that children can understand them.

  15. Comparison of topical tramadol and ketamine in pain treatment after tonsillectomy.

    Science.gov (United States)

    Tekelioglu, Umit Y; Apuhan, Tayfun; Akkaya, Akcan; Demirhan, Abdullah; Yildiz, Isa; Simsek, Tugce; Gok, Uzeyir; Kocoglu, Hasan

    2013-06-01

    The primary objective of this study is to evaluate the effects of topically applied ketamine or tramadol on early postoperative pain scores in children undergoing tonsillectomy. The secondary aim of the study is to assess nausea, vomiting, difficulty in swallowing, and sore throat characteristics of the patients. Tonsillectomy surgery is frequently associated with postoperative pain, which usually requires substantial consumption of analgesics including opioids. Safe and effective post-tonsillectomy pain control is still a clinical dilemma, in spite of the use of various surgical and anesthetic techniques. A total of 60 children, aged between 4 and 10 years, scheduled for tonsillectomy, were randomly assigned to one of three groups. Study drugs were administered to both tonsillar fossae for 5 min. In 5 ml artificial saliva, Group K (n = 20) received 0.4 ml (20 mg) ketamine and Group T (n = 20) received 0.8 ml tramadol HCl solution. Group C (n = 20) received only 5 ml saline as a control. Ramsay Sedation Scale and FACES PRS Score, nausea, vomiting, difficulty in swallowing, and sore throat were evaluated. There was no difference among the groups in terms of baseline characteristics, including age, sex, and ASA profile (P > 0.05 for all). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, respiratory rate, and saturation of peripheral oxygen (SpO2 ) values were not significantly different among the groups in all time points (P > 0.05 for all). There was a statistically significant difference among the groups according to Ramsay Sedation Scales in 40th minute (P sore throat in 5th and 10th minute (P sore throat characteristics was different between the Group T and Group K in all time points. Topical tramadol and ketamine seem to be safe, effective, and easy analgesic approach for decreasing tonsillectomy pain. © 2013 Blackwell Publishing Ltd.

  16. Reduction of scar formation in full-thickness wounds with topical celecoxib treatment.

    Science.gov (United States)

    Wilgus, Traci A; Vodovotz, Yael; Vittadini, Elena; Clubbs, Elizabeth A; Oberyszyn, Tatiana M

    2003-01-01

    Adult wound repair occurs with an initial inflammatory response, reepithelialization, and the formation of a permanent scar. Although the inflammatory phase is often considered a necessity for successful adult wound healing, fetal healing studies have shown the ability to regenerate skin and to heal wounds in a scarless manner in the absence of inflammation. The cyclooxygenase-2 (COX-2) enzyme, a known mediator of inflammation, has been shown to contribute to a variety of inflammatory conditions and to the development of cancer in many organs. To examine the role of COX-2 in the wound healing process, incisional wounds were treated topically with the anti-inflammatory COX-2 inhibitor celecoxib. Acutely, celecoxib inhibited several parameters of inflammation in the wound site. This decrease in the early inflammatory phase of wound healing had a significant effect on later events in the wound healing process, namely a reduction in scar tissue formation, without disrupting reepithelialization or decreasing tensile strength. Our data suggest that in the absence of infection, adult wound healing is able to commence with decreased inflammation and that anti-inflammatory drugs may be used to improve the outcome of the repair process in the skin by limiting scar formation.

  17. EXPERIENCE OF SEA WATER HYPERTONIC SOLUTION APPLICATION FOR TOPICAL TREATMENT OF CHRONIC TONSILLITIS

    Directory of Open Access Journals (Sweden)

    E.P. Karpova

    2006-01-01

    Full Text Available The study examined the effectiveness of sea water hypertonic solution (Aqua Maris troath and oral cavity spray, Jadran, Croatia medication to treat chronic tonsillitis of the compensated form on 84 children aged between 5 and 15. All children had their tonsil lacunae rinsed in a day № 6–8. 64 children had them rinsed with the sea water hypertonic solution (main group, while 20 children had them rinsed with the nitrofural solution (comparison group. Treatment effectiveness was determined according to dynamics of main symptoms (odynophagia, dysphagia, hyperemia and mucosa infiltration of pillars of the fauces, as well as the degree of tonsil bacterial number before and after treatment (by the 14th day. The dynamic analysis of subjective data during treatment revealed more significant and positive changes among the children of the main group if compared with patients from the comparison group. After treatment the researchers noticed reduction of tonsil bacterial number among 90,62% of children from the main group, whereas this rate made up 60% in the comparison group. Acquired data allowed recommending this medication for the multimodality therapy of infant adenoid disease.Key words: chronic tonsillitis, treatment, children, sea water hypertonic solution.

  18. Therapeutic effect of topical application of curcumin during treatment of radiation burns in a mini-pig model.

    Science.gov (United States)

    Kim, Joongsun; Park, Sunhoo; Jeon, Byung-Suk; Jang, Won-Seok; Lee, Sun-Joo; Son, Yeonghoon; Rhim, Kyung-Jin; Lee, Soong In; Lee, Seung-Sook

    2016-12-30

    Curcumin protects the skin against radiation-induced epidermal damage and prevents morphological changes induced by irradiation skin, thereby maintaining the epidermal thickness and cell density of basal layers. In this study, the effects of topical curcumin treatment on radiation burns were evaluated in a mini-pig model. Histological and clinical changes were observed five weeks after radiation exposure to the back (⁶⁰Co gamma-radiation, 50 Gy). Curcumin was applied topically to irradiated skin (200 mg/cm²) twice a day for 35 days. Curcumin application decreased the epithelial desquamation after irradiation. Additionally, when compared to the vehicle-treated group, the curcumin-treated group showed reduced expression of cyclooxygenase-2 and nuclear factor-kappaB. Furthermore, irradiation prolonged healing of biopsy wounds in the exposed area, whereas curcumin treatment stimulated wound healing. These results suggest that curcumin can improve epithelial cell survival and recovery in the skin and therefore be used to treat radiation burns.

  19. Topical delivery and in vivo antileishmanial activity of paromomycin-loaded liposomes for treatment of cutaneous leishmaniasis.

    Science.gov (United States)

    Carneiro, Guilherme; Santos, Delia C M; Oliveira, Monica C; Fernandes, Ana P; Ferreira, Luciana S; Ramaldes, Gilson A; Nunan, Elziria A; Ferreira, Lucas A M

    2010-03-01

    The present study aimed to evaluate the potential of liposomes loaded with paromomycin (PA), an aminoglycoside antibiotic associated with poor skin penetration, for the topical treatment of cutaneous leishmaniasis (CL). Fluid liposomes were prepared and characterized for particle size, zeta potential, and drug entrapment. Permeation studies were performed with two in vitro models: intact and stripped skin. The antileishmanial activity of free and liposomal PA was evaluated in BALB/c mice infected by Leishmania (L.) major. Drug entrapment ranged from 10 to 14%, and the type of vesicle had little influence on this parameter. Particle size and polydispersity index of the vesicles composed by phosphatidylcholine (PC) and PC/cholesterol (Chol) ranged from of 516 to 362 nm and 0.7 to 0.4, respectively. PA permeation across intact skin was low, regardless of the formulation tested, while drug penetration into skin (percent of the applied dose) from PC (7.2 +/- 0.2%) and PC/Chol (4.8 +/- 0.2%) liposomes was higher than solution (1.9 +/- 0.1%). PA-loaded liposomes enhanced in vitro drug permeation across stripped skin and improved the in vivo antileishmanial activity in experimentally infected mice. Our findings suggest that the liposomes represent a promising alternative for the topical treatment of CL using PA.

  20. Topical imiquimod treatment of cutaneous vascular disorders in pediatric patients: clinical evaluation on the efficacy and safety

    Institute of Scientific and Technical Information of China (English)

    Xiao-hong MAO; Jian-you WANG; Jian-liang YAN

    2012-01-01

    Objective:To evaluate the clinical effect of topical imiquimod treatment on cutaneous vascular disorders in pediatric patients.Methods:A retrospective investigation was conducted in 25 pediatric patients with cutaneous vascular disorders,including 19 infantile hemangiomas (IHs) (12 superficial/7 mixed type),5 nevus flammeus (NF),and 1 pyogenic granuloma (PG).Imiquimod 5% cream was applied every other day for 4 to 16 weeks (average 9.6weeks).Results:Of the 19 IHs treated,an overall efficacy of 52.6% was achieved,with a clinical resolution rate of 15.8%,excellent rate of 26.3%,and moderate rate of 10.5%.The superficial type responded the best at 66.7%,while the mixed type showed only 28.6% effectiveness,which was predominantly from their superficial parts.No obvious response was noted in the 5 patients with NF.Side effects were observed in 78.9% of the patients,mostly mild to moderate local irritations and occasionally severe reactions such as thick crusting and ulceration.Systemic side events were observed in 4 IH patients including fever and digestive tract reactions.No recurrence was observed during the follow-up examination.Conclusions:Topical imiquimod could be an alternative option for the treatment of uncomplicated superficial IHs with satisfactory tolerability.

  1. Topical treatment of CIN 2+ by cidofovir: results of a phase II, double-blind, prospective, placebo-controlled study.

    Science.gov (United States)

    Van Pachterbeke, C; Bucella, D; Rozenberg, S; Manigart, Y; Gilles, C; Larsimont, D; Vanden Houte, K; Reynders, M; Snoeck, R; Bossens, M

    2009-10-01

    Randomized controlled trial evaluating a topical treatment for cervical intraepithelial neoplasia 2 and 3 (CIN 2+) using cidofovir. Fifty-three women with a biopsy-proven CIN 2+ were randomly assigned, 6 weeks before their planned conisation, either 3 applications of 3 ml 2% cidofovir in Intrasite gel in a cervical cap or a placebo (the same volume of Intrasite alone). A cervical sample for high-risk types of human papillomaviruses (HPV) (Hybrid Capture 2 or HC2) was taken before treatment and before conisation. The cone was submitted for pathological examination, and subsequently, along with the initial biopsy, to in situ hybridization (ISH) for high-risk HPV. Forty-eight patients were treated and followed according to the protocol, (23 cidofovir, and 25 placebo). Fourteen of the 23 cones were free of any CIN (60.8%) in the cidofovir group. Only 5 of 25 cones were free of any CIN (20%) in the placebo group (ptreatment with cidofovir, at this point, cannot replace conisation, but it is a promising candidate for topical chemotherapy of CIN 2+ lesions; a larger prospective randomized study is needed to confirm our results.

  2. Study on Vip protein expression in psoriatic epidermis with the topical treatment of capsaicin ointment

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the mechanism of capsaicin in treating active psoriasis vulgaris. Methods: VIP protein in active psoriatic lesions before and 30 days after the treatment of capsaicin ointment was detected by immunohistochemistry. Results:There was positive expression of VIP in all layers of psoriatic lesions epidermis (95.5 % ), but after the treatment of capsaicin ointment,there was nearly no expression of VIP protein in epidermis(22.2% ). Conclusion: Capsaicin inhibits proliferation and induces the differentiation of keratinocytes through down-regulating the expression of VIP in psoriatic epidermis.

  3. Treatment of chronic regional pain syndrome type 1 with palmitoylethanolamide and topical ketamine cream: modulation of nonneuronal cells

    Directory of Open Access Journals (Sweden)

    Keppel Hesselink JM

    2013-03-01

    Full Text Available Jan M Keppel Hesselink,1 David J Kopsky21Institute for Neuropathic Pain, Bosch en Duin, The Netherlands; 2Institute for Neuropathic Pain, Amsterdam, The NetherlandsAbstract: Chronic regional pain syndrome (CRPS can be intractable to treat and patients sometimes suffer for many years. Therefore, new treatment strategies are needed to alleviate symptoms in CRPS patients. This case report describes a patient suffering from intractable CRPS type 1 for 13 years. Due to her swollen painful feet and left knee she is wheelchair-bound. The combination of palmitoylethanolamide and ketamine 10% cream reduced her pain by more than 50% after 1 month of treatment, and a marked reduction in swelling and skin discoloration was noticed. Furthermore, she could walk independently again and she experienced no side effects. Thus, palmitoylethanolamide and topical ketamine could be a combination therapy option for treating CRPS patients.Keywords: palmitoylethanolamide, ketamine, cream, CRPS, endocannabinoid, sudeck, mast cells

  4. Efficacy of Topical 5% Acyclovir-1% Hydrocortisone Cream (ME-609) for Treatment of Herpes Labialis: a systematic review.

    Science.gov (United States)

    Rosa, Maria Inês da; Souza, Suéli L; Farias, Bruna F de; Pires, Patrícia D S; Dondossola, Eduardo R; dos Reis, Maria Eduarda F

    2015-08-01

    We performed a systematic review with the objective of verifying the efficacy of topical use 5% Acyclovir-1% Hydrocortisone cream compared to the placebo group for herpes simplex labialis treatment. We performed a literature search using MEDLINE, Embase, BIOSIS, LILACS, Scopus, Grey literature, the Cochrane Central Register of Controlled Trials, the ISI Web of Science and IBECS from 1990 to June 2014. We reported the outcomes using relative risk (RR) with 95% confidence intervals. The literature search yielded 180 potentially relevant publications. Reviews of the reference lists yielded two further citations. Among these papers, two were considered eligible for inclusion in this review. Both trials included 1,213 patients. A meta-analysis of these studies showed a RR = 0.77, (95% CI 0.70-0.86; pherpes simplex labialis treatment.

  5. The efficacy of Achilles millefolium topical gel along with intralesional injection of glucantime in the treatment of acute cutaneous leishmaniasis major

    Directory of Open Access Journals (Sweden)

    Fariba Jaffary

    2014-01-01

    Conclusions: Given the result of the present study, there is no significant difference in cure rates of lesions between yarrow and placebo topical gels as an adjuvant drugs with intralesional glucantime in treatment of acute cutaneous leishmanial lesions.

  6. Formulation and characterization of solid lipid nanoparticles loaded Neem oil for topical treatment of acne

    Directory of Open Access Journals (Sweden)

    V. Vijayan

    2013-01-01

    Conclusion: The result concluded that Neem oil loaded solid lipid nanoparticles with more lecithin content in their colloid exhibit sustained effect which satisfactorily produced the antibacterial action on Acne microbes. Therefore Neem oil loaded SLN was used successfully for prolonged treatment of Acne.

  7. Managing Early Childhood Caries with Atraumatic Restorative Treatment and Topical Silver and Fluoride Agents

    Directory of Open Access Journals (Sweden)

    Duangporn Duangthip

    2017-10-01

    Full Text Available Early childhood caries (ECC is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the great majority of ECC was left untreated. Untreated caries progresses into the dental pulp, causing pain and infection. It can spread systemically, affecting a child’s growth, development and general health. Fundamental caries management is based on the conventional restorative approach. Because preschool children are too young to cope with lengthy dental treatment, they often receive dental treatment under general anaesthesia from a specialist dentist. However, treatment under general anaesthesia poses a life-threatening risk to young children. Moreover, there are few dentists in rural areas, where ECC is prevalent. Hence, conventional dental care is unaffordable, inaccessible or unavailable in many communities. However, studies showed that the atraumatic restorative treatment had a very good success rate in treating dentine caries in young children. Silver diamine fluoride is considered safe and effective in arresting dentine caries in primary teeth. The aim of this paper is to review and discuss updated evidence of these alternative approaches in order to manage cavitated ECC.

  8. Topical (pour-on) ivermectin in the treatment of canine scabies.

    OpenAIRE

    Paradis, M.; de Jaham, C; Pagé, N

    1997-01-01

    The efficacy of a pour-on formulation of ivermectin at 500 micrograms/kg body weight applied on the dorsum on days 1 and 15 was evaluated in 90 dogs from a shelter, naturally infested with Sarcoptes scabiei. This very practical form of treatment was successful in eradicating scabies from this shelter.

  9. [Imiquimod for the topical treatment of focal epithelial hyperplasia (Heck disease) in a child].

    Science.gov (United States)

    Maschke, Jan; Brauns, Tilmann C; Goos, Manfred

    2004-10-01

    Focal epithelial hyperplasia (FEH) or Heck disease is a rare skin disease caused by human papilloma viruses (HPV). The case of a 9-year old boy is presented to demonstrate the successful treatment of massive FEH with 5% imiquimod cream. Initially, the patient had noticed several separate papules, which spread and developed into multiple peri- and intraoral papillomatous nodules. The lesions were treated with carbon dioxide laser destruction. However, multiple, skin-coloured papillomatous nodules were found on the tongue, buccal mucosa and lips 1.5 years later. Treatment with imiquimod was initiated, because the patient suffered tremendously from the disease. 5% imiquimod cream was applied 3 times per week. Regression of lesions was obvious after 1 month of treatment. Complete clearance was achieved after 2 additional months of treatment and no recurrence was detected over a follow-up period of 5 months. Our case points out the clinical value of imiquimod for the non-traumatic and almost painless therapy of HPV-induced skin diseases in children.

  10. Treatment of simple bone cysts by topical infiltrations of methylprednisolone acetate: Technique and results

    Energy Technology Data Exchange (ETDEWEB)

    Carrata, A.; Garbagna, P.; Mapelli, S.; Zucchi, V.

    1983-02-01

    The authors report their experience in the percutaneous treatment of simple bone cysts by intra-cystic local infiltrations of methylprednisolone acetate. In particular, the method adopted, the evolution of the radiologic picture and the results, achieved are described. Sixty patients were successfully treated without complications or surgery.

  11. Use of topical liposomes containing meglumine antimoniate (Glucantime) for the treatment of L. major lesion in BALB/c mice.

    Science.gov (United States)

    Kalat, S A Moosavian; Khamesipour, A; Bavarsad, N; Fallah, M; Khashayarmanesh, Z; Feizi, E; Neghabi, K; Abbasi, A; Jaafari, M R

    2014-08-01

    Treatment of cutaneous leishmaniasis (CL) is a dream for the patients, health care authorities and scientists. The aim of this study was to develop a topical liposomal meglumine antimoniate (MA, Glucantime™) (Lip-MA) formulation and evaluate the therapeutic effects of the preparation on lesion induced by Leishmania major in BALB/c mice. Liposomes containing 22.5% MA (6.4% Sb(+5)) with and without oleic acid (LMA-OA and LMA) were formulated using fusion method plus homogenization and characterized for the size and encapsulation efficiency. The penetration of MA from the LMA-OA and LMA formulations through and into the skin was checked in vitro using Franz diffusion cells fitted with mouse skin at 37°C for 8h. The in vitro permeation data showed that almost 1.5% of formulations applied in the mouse skin were penetrated and the amount retained in the skin was about 65%. The 50% effective dose of LMA and LMA-OA against amastigotes of L. major was 46.36 and 41.01 μg/ml, respectively. LMA or LMA-OA was used topically twice a day for 4 weeks to treat the lesion induced by L. major in susceptible BALB/c mice. The results showed a significantly (Pliposomes or phosphate-buffered saline (PBS). The spleen parasite burden was significantly (Pliposomes or PBS at the end of the treatment period. However, when the treatment was stopped, the lesion size progressed and spleen parasite burden increased in LMA and LMA-OA groups, but still was significantly less than the control groups (Pliposomes containing MA might be an appropriate choice for clinical trials for the treatment of CL.

  12. Successful Treatment of Severe Tungiasis in Pigs Using a Topical Aerosol Containing Chlorfenvinphos, Dichlorphos and Gentian Violet

    Science.gov (United States)

    Mutebi, Francis; von Samson-Himmelstjerna, Georg; Feldmeier, Hermann; Waiswa, Charles; Bukeka Muhindo, Jeanne; Krücken, Jürgen

    2016-01-01

    Background In endemic communities, zoonotic tungiasis, a severe skin disease caused by penetrating female sand fleas, is a public health hazard causing significant human and animal morbidity. No validated drugs are currently available for treatment of animal tungiasis. Due to the reservoir in domestic animals, integrated management of human and animal tungiasis is required to avert its negative effects. Methods and principal findings A topical aerosol containing chlorfenvinphos 4.8%, dichlorphos 0.75% and gentian violet 0.145% licensed to treat tick infestations, myiasis and wound sepsis in animals in the study area, was tested for its potential tungicidal effects in a randomized controlled field trial against pig tungiasis in rural Uganda. Animals with at least one embedded flea were randomized in a treatment (n = 29) and a control (n = 26) group. One week after treatment, 58.6% of the treated pigs did not show any viable flea lesion whereas all control pigs had at least one viable lesion. After treatment the number of viable lesions (treated median = 0, overall range = 0–18 vs. control median = 11.5, range = 1–180) and the severity score for estimating acute pathology in pig tungiasis (treated median = 1, range = 0–3.5 vs. control median = 7, range = 0–25) were significantly lower in treated than in control pigs (p < 0.001). In the treatment group the median number of viable flea lesions decreased from 8.5 to 0 (p < 0.001). Similarly, the median acute severity score dropped from 6 to 1 (p < 0.001). Every pig in the treatment group showed a decrease in the number of viable fleas and tungiasis-associated acute morbidity while medians for both increased in the control group. Conclusions The study demonstrates that a topical treatment based on chlorfenvinphos, dichlorphos and gentian violet is highly effective against pig tungiasis. Due to its simplicity, the new approach can be used for the treatment of individual animals as well as in mass campaigns. PMID

  13. Extending an evidence hierarchy to include topics other than treatment: revising the Australian 'levels of evidence'.

    Science.gov (United States)

    Merlin, Tracy; Weston, Adele; Tooher, Rebecca

    2009-06-11

    judge the likelihood of bias in individual studies evaluating interventional, diagnostic accuracy, prognostic, aetiologic or screening topics. Detailed quality appraisal of these individual studies, as well as grading of the body of evidence to answer each clinical, research or policy question, can then be undertaken as required.

  14. Treatment of atrophic scars with fractionated CO2 laser facilitating delivery of topically applied poly-L-lactic acid.

    Science.gov (United States)

    Rkein, Ali; Ozog, David; Waibel, Jill S

    2014-06-01

    Atrophic scars represent a loss of collagen and a challenging reconstructive dilemma with disappointing traditional treatments. To study the safety and efficacy of the treatment of atrophic scars using an ablative fractionated CO2 laser and topical poly-L-lactic acid (PLLA) immediately after to improve atrophic scars. This was an uncontrolled, institutional review board-approved, prospective study evaluating the treatment of atrophic scars. Four blinded dermatologists evaluated a total of 20 photographs taken at baseline and 3 months after the laser and PLLA treatments using the Modified Manchester Scar Scale. Four criteria were evaluated: (1) overall improvement, (2) improvement in scar atrophy, (3) improvement in scar color/dyschromia mismatch, and (4) improvement in scar contour. All 4 observers accurately identified 76 of the 80 "before" and "after" photographs. Therefore, the blinded evaluating physicians agreed that at the 3-month follow-up visit, 95% of the scars had improved. Each criterion demonstrated an average improvement of at least 33%. The combination of using an ablative fractional CO2 laser and PLLA in the treatment of atrophic scars has a synergistic effect on their inherent properties in up-regulating new collagen synthesis to improve atrophic scars.

  15. Combination of PDT and topical angiogenic inhibitor for treatment of port wine stain (PWS) birthmarks: a novel approach

    Science.gov (United States)

    Yuan, Kaihua; Huang, Qiaobing; Huang, Zheng

    2009-06-01

    Port wine stain (PWS) birthmarks are a congenital cutaneous vascular malformation involving ecstatic post-capillary venules. Current standard treatment for PWS is the pulsed dye laser (PDL). Vascular-targeted photodynamic therapy (PDT) has been used for the treatment of PWS in China since the early 1990's. Both can achieve a certain degree of color blanching in various types of PWS lesions. However, the majority of PWS lesions require multiple treatments. Some PWS lesions can recur or become darker after successful treatment. Recently, it has been proposed that this phenomenon might be initiated by neoangiogenesis that can be caused by treatment via wound healing response. The combined use of photothermolysis and a topical application of an angiogenic inhibitor such as Imiquimod and Rapamycin, were evaluated in several pilot studies. It is well-known that PDT can induce various host immune responses VEGF overexpression. Recent clinical data also show that improved clinical outcomes are obtained through the combination of ocular PDT and anti-VEGF therapy. This article will discuss rationales and implications of using such a combination modality and highlight recent progress based on our clinical experience and published data.

  16. BACTERIAL LYSATES MIXTURE FOR THE TOPICAL ADMINISTRATION IN PROPHYLAXIS AND TREATMENT OF CHRONIC TONSILLITIS IN CHILDREN

    Directory of Open Access Journals (Sweden)

    T.I. Garashchenko

    2009-01-01

    Full Text Available Chronic tonsillitis is the infectious and allergic disease; the main clinical symptom of this disease is chronic inflammation of palatine tonsils. The prevalence of chronic tonsillitis is up to 10% among adults and 15% — among children. Undoubtedly, the prevention of exacerbations of chronic tonsillitis is difficult task. Its significant component is immunocorrection with elements of vaccinal process, because tonsils themselves are the part of forming immune system of a child. Imudon can be recommended for the inclusion to the yearly prophylactic treatment courses in patients with chronic tonsillitis, hypertrophy of palatine tonsils and recurrent tonsillopharyngitis.Key words: children, chronic tonsillitis, prophylaxis, treatment, bacterial lysates mixture.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(6:109-112

  17. Topical issues of treatment of degenerate scoliosis at adults at the present stage (review

    Directory of Open Access Journals (Sweden)

    D. A. Mikhaylov

    2014-01-01

    Full Text Available Degenerative scoliosis is a prevalent issue among the aging population. Controversy remains over the role of surgical intervention in patients with this disease. Authors carry out the review of literature data, consider various approaches of surgical treatment depending on a stage of a disease and extent of deformation, including a decompression, instrumented posterior spinal fusion, an anterior spinal fusion, and osteotomy. These treatment options are based on clinical analysis, radiographic analysis of the mechanical stability of the deformity, given pain generators, and necessary sagittal balance. The high potential complication rates appear to be outweighed by the eventual successful clinical outcomes in patients suitable for operative intervention. This approach has had favorable outcomes and could help resolve the controversy.

  18. Coevolution: a history of the macroevolutionary approach to studying host-parasite associations.

    Science.gov (United States)

    Klassen, G J

    1992-08-01

    The year 1991 marked 100 yr of coevolution research. I have reviewed the first 90 yr of this history. Three chronological phases are apparent: recognition of predictable associations among hosts and their parasites; search for patterns of association and their underlying causes, emphasizing either correlated biogeographic patterns or correlated phylogenies; and development of objective and repeatable methodologies for reconstructing and interpreting these patterns of association. Von Ihering, an outspoken anti-Darwinian, was undoubtedly the first to recognize and make use of predictable host-parasite associations. Kellogg and Fahrenholz, however, had more profound influence on subsequent generations, but in different directions. Kellogg attempted to meld natural selection with speciation by isolation. He also considered host specificity a component of coevolution, important but variable. His work laid the foundation for future research concentrated on biogeographic interpretations of host-parasite relationships. This emphasis and Metcalf's failed attempts to provide adequate mechanisms for reconstructing phylogenies reduced the biogeographic approach to an empirical research program in the hands of Manter. Fahrenholz, on the other hand, exposed to a strong anti-Darwinian sentiment, emphasized the importance of strict host specificity. This led to Eichler's formulation of the first 3 coevolutionary rules and the conclusion that host specificity was not a component but the cause of coevolution and ultimately the tautology inherent in the phylogenetic approach. All had to rely on 1 assumption, that host and parasite phylogenies were reflected in the taxonomic hierarchy. Hennig criticized this assumption and provided a method whereby phylogenies are reconstructed independently. Brooks melded this new phylogenetic method (cladistics) with an equally new biogeographic method (vicariance biogeography), providing the foundations for the modern macroevolutionary approach to

  19. Microevolutionary, macroevolutionary, ecological and taxonomical implications of punctuational theories of adaptive evolution

    Directory of Open Access Journals (Sweden)

    Flegr Jaroslav

    2013-01-01

    Full Text Available Abstract Punctuational theories of evolution suggest that adaptive evolution proceeds mostly, or even entirely, in the distinct periods of existence of a particular species. The mechanisms of this punctuated nature of evolution suggested by the various theories differ. Therefore the predictions of particular theories concerning various evolutionary phenomena also differ. Punctuational theories can be subdivided into five classes, which differ in their mechanism and their evolutionary and ecological implications. For example, the transilience model of Templeton (class III, genetic revolution model of Mayr (class IV or the frozen plasticity theory of Flegr (class V, suggests that adaptive evolution in sexual species is operative shortly after the emergence of a species by peripatric speciation – while it is evolutionary plastic. To a major degree, i.e. throughout 98-99% of their existence, sexual species are evolutionarily frozen (class III or elastic (class IV and V on a microevolutionary time scale and evolutionarily frozen on a macroevolutionary time scale and can only wait for extinction, or the highly improbable return of a population segment to the plastic state due to peripatric speciation. The punctuational theories have many evolutionary and ecological implications. Most of these predictions could be tested empirically, and should be analyzed in greater depth theoretically. The punctuational theories offer many new predictions that need to be tested, but also provide explanations for a much broader spectrum of known biological phenomena than classical gradualistic evolutionary theories. Reviewers This article was reviewed by Claus Wilke, Pierre Pantarotti and David Penny (nominated by Anthony Poole.

  20. Macroevolutionary dynamics and historical biogeography of primate diversification inferred from a species supermatrix.

    Directory of Open Access Journals (Sweden)

    Mark S Springer

    Full Text Available Phylogenetic relationships, divergence times, and patterns of biogeographic descent among primate species are both complex and contentious. Here, we generate a robust molecular phylogeny for 70 primate genera and 367 primate species based on a concatenation of 69 nuclear gene segments and ten mitochondrial gene sequences, most of which were extracted from GenBank. Relaxed clock analyses of divergence times with 14 fossil-calibrated nodes suggest that living Primates last shared a common ancestor 71-63 Ma, and that divergences within both Strepsirrhini and Haplorhini are entirely post-Cretaceous. These results are consistent with the hypothesis that the Cretaceous-Paleogene mass extinction of non-avian dinosaurs played an important role in the diversification of placental mammals. Previous queries into primate historical biogeography have suggested Africa, Asia, Europe, or North America as the ancestral area of crown primates, but were based on methods that were coopted from phylogeny reconstruction. By contrast, we analyzed our molecular phylogeny with two methods that were developed explicitly for ancestral area reconstruction, and find support for the hypothesis that the most recent common ancestor of living Primates resided in Asia. Analyses of primate macroevolutionary dynamics provide support for a diversification rate increase in the late Miocene, possibly in response to elevated global mean temperatures, and are consistent with the fossil record. By contrast, diversification analyses failed to detect evidence for rate-shift changes near the Eocene-Oligocene boundary even though the fossil record provides clear evidence for a major turnover event ("Grande Coupure" at this time. Our results highlight the power and limitations of inferring diversification dynamics from molecular phylogenies, as well as the sensitivity of diversification analyses to different species concepts.

  1. Current state of chronic wound care in Kazakhstan: focus on topical treatments

    Directory of Open Access Journals (Sweden)

    Alma Akhmetova

    2015-02-01

    Full Text Available Background — The presence of chronic hard-to-heal wounds significantly affects patients’ quality of life causing pain, discomfort, decrease of mobility and consequently leads to social isolation and depression. This type of wound is more prevalent among older population. It has been estimated that up to 1-2% of the world population have this condition. The treatment of hard-to-heal wounds is expensive and long-term process, and, stresses healthcare systems of every country. Unfortunately, limited information is available about the situation with chronic wounds in Kazakhstan as the statistical data on such patients is not monitored and not registered in this country. Methods — The search was conducted by using available electronic sources, including Google Scholar, PubMed, Web of Sciences, Medline, Wiley Online Library, and Cochrane Library databases as well as hard copy versions of peer-reviewed publications in Russian, Kazakh, and English languages. Results — We have identified and analyzed current situation with wound care in the Republic of Kazakhstan. Research has demonstrated a variety of types of treatments utilized in the country, particularly the treatment of the diabetic foot.It also indicates the lack of statistics on wound care. Conclusions — The review highlights the mechanisms of wound healing process, methods for wound care, and encompasses the information available on wound healing in Republic of Kazakhstan. The article emphasizes the necessity of establishing the systemic monitoring of wound care and formation of electronic database. Apart from that, the importance of developing and manufacturing of domestic novel wound treatments have been also stressed out.

  2. Pathogenesis and therapeutic approaches for improved topical treatment in localized scleroderma and systemic sclerosis.

    Science.gov (United States)

    Badea, I; Taylor, M; Rosenberg, A; Foldvari, M

    2009-03-01

    SSc is a chronic progressive disorder of unknown aetiology characterized by excess synthesis and deposition of collagen and other extracellular matrix components in a variety of tissues and organs. Localized scleroderma (LS) differs from SSc in that with LS only skin and occasionally subcutaneous tissues are involved. Although rarely life threatening, LS can be disfiguring and disabling and, consequently, can adversely affect quality of life. There is no known effective treatment for LS, and various options, including, as examples, corticosteroids and other immunomodulatory agents, ultraviolet radiation and vitamin D analogues, are of unproven efficacy. Clinical trials evaluating combination therapy such as corticosteroids with MTX or UVA1 exposure with psoralens have not been established as consistently effective. New immunomodulators such as tacrolimus and thalidomide are also being evaluated. A better understanding of the molecular and cellular mechanisms of LS has led to evaluation of new treatments that modulate profibrotic cytokines such as TGF-beta and IL-4, regulate assembly and deposition of extracellular matrix components, and restore Th1/Th2 immune balance by administering IL-12 or IFN-gamma. IFN-gamma acts by directly inhibiting collagen synthesis and by restoring immune balance. In this review, we evaluate current and future treatment options for LS and cutaneous involvement in SSc. Recent advances in therapy focus mainly on anti-fibrotic agents. Delivery of these drugs into the skin as the target tissue might be a key factor in developing more effective and safer therapy.

  3. The Effect of Topical Nifedipine in Treatment of Chronic Anal Fissure

    Directory of Open Access Journals (Sweden)

    Farzaneh Golfam

    2010-10-01

    Full Text Available Chronic anal fissure is the most common cause of anal pain associated with internal anal sphincter hypertonia. Reduction of hypertonocity is a special treatment for fissure healing. For this purpose chronic anal fissures were conventionally treated by anal dilatation or by lateral sphincterotomy. However, both of these methods may cause a degree of incontinence in some patients. The uptake of medical therapies that create a reversible chemical sphincterotomy has recently become widespread. The aim of this prospective clinical trial study was to assess the effectiveness of nifedipine in healing anal fissure, a calcium channel blocker that reduces sphincter pressure. A single-blind randomized comparative trial was setup to compare traditional treatment with stool softeners and 2% lidocaine cream against 0.5% nifedipine cream for 4 weeks. 110 patients were included in this study, 60 patients in the nifedipine group and 50 patients in the control group and the therapeutic outcome and side effects were recorded. Healing had occurred in 70% of patients in the nifedipine group and in 12% of patients in the control group after 4 weeks treatment (P

  4. Bimatoprost Topical

    Science.gov (United States)

    Topical bimatoprost is used to treat hypotrichosis (less than the normal amount of hair) of the eyelashes by promoting ... growth of longer, thicker, and darker lashes. Topical bimatoprost is in a class of medications called prostaglandin ...

  5. Underground Coal Thermal Treatment: Task 6 Topical Report, Utah Clean Coal Program

    Energy Technology Data Exchange (ETDEWEB)

    Smith, P.J.; Deo, M.; Edding, E.G.; Hradisky, M.; Kelly, K.E.; Krumm, R.; Sarofim, Adel; Wang, D.

    2014-08-15

    The long-term objective of this task is to develop a transformational energy production technology by in- situ thermal treatment of a coal seam for the production of substitute natural gas and/or liquid transportation fuels while leaving much of the coal’s carbon in the ground. This process converts coal to a high-efficiency, low-greenhouse gas (GHG) emitting fuel. It holds the potential of providing environmentally acceptable access to previously unusable coal resources. This task focused on three areas: Experimental. The Underground Coal Thermal Treatment (UCTT) team focused on experiments at two scales, bench-top and slightly larger, to develop data to understand the feasibility of a UCTT process as well as to develop validation/uncertainty quantification (V/UQ) data for the simulation team. Simulation. The investigators completed development of High Performance Computing (HPC) simulations of UCTT. This built on our simulation developments over the course of the task and included the application of Computational Fluid Dynamics (CFD)- based tools to perform HPC simulations of a realistically sized domain representative of an actual coal field located in Utah. CO2 storage. In order to help determine the amount of CO2 that can be sequestered in a coal formation that has undergone UCTT, adsorption isotherms were performed on coals treated to 325, 450, and 600°C with slow heating rates. Raw material was sourced from the Sufco (Utah), Carlinville (Illinois), and North Antelope (Wyoming) mines. The study indicated that adsorptive capacity for the coals increased with treatment temperature and that coals treated to 325°C showed less or similar capacity to the untreated coals.

  6. Topical treatment with Tong-Luo-San-Jie Gel alleviates bone cancer pain in rats

    Science.gov (United States)

    Wang, Juyong; Zhang, Ruixin; Dong, Changsheng; Jiao, Liying; Xu, Ling; Liu, Jiyong; Wang, Zhengtao; Ying, Qi Liang Mao; Fong, Harry; Lao, Lixing

    2012-01-01

    Ethnopharmacological relevance The herbal analgesic gel Tong-Luo-San-Jie (TLSJ) and its modifications are used in traditional Chinese medicine to manage cancer pain. However, its mechanisms are still unknown. Aim of the study To investigate the effects and mechanisms of TLSJ gel on bone cancer pain in a rat model. Materials and Methods A bone cancer pain rat model was established by inoculating Walker 256 rat carcinoma cells directly into the right tibial medullary cavity of Sprague-Dawley rats (150–170 g); Phosphate buffered saline (PBS) tibial inoculation was used as control. Cancer-bearing rats were treated twice a day with external TLSJ gel (0.5 g/cm2/day) or inert gel control for 21 days (n=10/group). Behavioral tests such as mechanical threshold and paw withdrawal latency (PWL) were carried out. Osteoclastic activities were determined and carboxyterminal pyridinoline cross-linked type I collagen telopeptides (ICTP) and bone-specific alkaline phosphatase (BAP) concentrations were detected with ELISA after treatment. Adverse effects were monitored, and biochemical and histological tests were performed in naïve rats treated with local TLSJ gel for six weeks. Results TLSJ treatment significantly restored bone cancer-induced decrease of PWL and mechanical threshold compared to inert gel. It also decreased the level of blood serum ICTP and BAP and inhibited osteoclast activities. No adverse effects or abnormal biochemical and histological changes were detected after TLSJ treatment. Conclusion The present study shows that TLSJ significantly inhibits bone cancer-induced thermal and mechanical sensitization. It suggests that the gel may be useful in managing cancer pain and that it may act by inhibiting osteoclastic activity. PMID:22960543

  7. Formulation and characterization of solid lipid nanoparticles loaded Neem oil for topical treatment of acne

    Institute of Scientific and Technical Information of China (English)

    V. Vijayan; Shaik Aafreen; S. Sakthivel; K. Ravindra Reddy

    2013-01-01

    Objective:To investigate the treatment of acne and pimples as well as improves skin elasticity by solid lipid nanoparticles(SLNs) loadedNeem oil.Method:Neem oil as a natural agent was incorporated intoSLNs prepared by double emulsification method using different concentration of lecithin andTween80.The characteristics ofSLNs with different concentration of lipid were investigated.Result:The average particlesize ofNeem oil loadedSLNs decreased with increasing concentration of surfactant.SLNs of(221.6±2.0) nm with aPolydispersity index of (0.948±0.040) were obtained at higher concentration of lipid and surfactant.High entrapment efficiency of82.10% revealed the ability of solid lipid nanoparticles to incorporate a high quantity ofNeem oil.Furthermore the stability ofSLNs indicated with negligible drug leakage after3 weeks.Conclusion:The result concluded thatNeem oil loaded solid lipid nanoparticles with more lecithin content in their colloid exhibit sustained effect which satisfactorily produced the antibacterial action onAcne microbes.ThereforeNeem oil loadedSLN was used successfully for prolonged treatment ofAcne.

  8. Topical Colchicine Gel versus Diclofenac Sodium Gel for the Treatment of Actinic Keratoses: A Randomized, Double-Blind Study

    Science.gov (United States)

    Faghihi, Gita; Iraji, Fariba; Behfar, Shadi; Abtahi-Naeini, Bahareh

    2016-01-01

    Introduction. Actinic keratoses (AKs), a premalignant skin lesion, are a common lesion in fair skin. Although destructive treatment remains the gold standard for AKs, medical therapies may be preferable due to the comfort and reliability .This study aims to compare the effects of topical 1% colchicine gel and 3% diclofenac sodium gel in AKs. Materials and Methods. In this randomized double-blind study, 70 lesions were selected. Patients were randomized before receiving either 1% colchicine gel or 3% diclofenac sodium cream twice a day for 6 weeks. Patients were evaluated in terms of their lesion size, treatment complications, and recurrence at 7, 30, 60, and 120 days after treatment. Results. The mean of changes in the size was significant in both groups both before and after treatment ( 0.05). No case of erythema was seen in the colchicine group, while erythema was seen in 22.9% (eight cases) of patients in the diclofenac sodium group (p = 0.005). Conclusions. 1% colchicine gel was a safe and effective medication with fewer side effects and lack of recurrence of the lesion. PMID:27689135

  9. Recent approval of Xerese in Canada: 5% acyclovir and 1% hydrocortisone topical cream in the treatment of herpes labialis.

    Science.gov (United States)

    Nguyen, H P; Stiegel, K R; Downing, C; Stiegel, K R

    2014-01-01

    Herpes labialis is a frequently occurring viral infection of the lips and oral mucosa. Recurring lesions are induced by viral reactivation and replication, but the symptoms leading to morbidity, such as pain and inflammation, are immune-mediated. The introduction of 5% acyclovir/1% hydrocortisone in a topical cream (Xerese™) represents a therapeutic strategy directed at both of these pathogenic processes. Applied at the onset of prodromal symptoms, this combination treatment has a good safety profile and is more effective in reducing healing time than antiviral or anti-inflammatory agents alone. Although it was US FDA-approved for herpes labialis in 2009, Xerese™ has only recently been approved for use in Canada in October 2013. Herein, we review the basic science and clinical studies that support the efficacy of this topical combination acyclovir-hydrocortisone product in treating herpes labialis and examine its safety profile, as well as touch upon other therapies that have been shown to be effective in treating this common viral condition.

  10. Thermosensitive chitosan-based hydrogel as a topical ocular drug delivery system of latanoprost for glaucoma treatment.

    Science.gov (United States)

    Cheng, Yung-Hsin; Tsai, Tung-Hu; Jhan, Yong-Yu; Chiu, Allen Wen-hsiang; Tsai, Kun-Ling; Chien, Chian-Shiu; Chiou, Shih-Hwa; Liu, Catherine Jui-lin

    2016-06-25

    Ocular hypertension is a major risk factor for the development and progression of glaucoma. Frequent and long-term application of latanoprost often causes undesirable local side effects, which are a major cause of therapeutic failure due to loss of persistence in using this glaucoma medical therapy. In the present study, we developed a thermosensitive chitosan-based hydrogel as a topical eye drop formulation for the sustained release of latanoprost to control ocular hypertension. The developed formulation without preservatives may improve compliance and possibly even efficacy. The results of this study support its biocompatibility and sustained-release profile both in vitro and in vivo. After topical application of latanoprost-loaded hydrogel, triamcinolone acetonide-induced elevated intraocular pressure was significantly decreased within 7 days and remained at a normal level for the following 21 days in rabbit eyes. This newly developed chitosan-based hydrogel may provide a non-invasive alternative to traditional anti-glaucoma eye drops for glaucoma treatment.

  11. Role of topical emollients and moisturizers in the treatment of dry skin barrier disorders.

    Science.gov (United States)

    Lodén, Marie

    2003-01-01

    children. In double-blind studies moisturizers with urea have been shown to reduce TEWL in atopic and ichthyotic patients. Urea also makes normal and atopic skin less susceptible against irritation to sodium laurilsulfate. Treatments improving the barrier function may reduce the likelihood of further aggravation of the disease. In order to have optimum effect it is conceivable that moisturizers should be tailored with respect to the epidermal abnormality. New biochemical approaches and non-invasive instruments will increase our understanding of skin barrier disorders and facilitate optimum treatments. The chemistry and function of dry skin and moisturizers is a challenging subject for the practicing dermatologist, as well as for the chemist developing these agents in the pharmaceutical/cosmetic industry.

  12. Treatment of Sweat gland carcinoma with Topical Aminolevulinic Acid Photodynamic therapy: An effective treatment method to improve surgical outcomes.

    Science.gov (United States)

    He, Xian; Yang, Yadong; Yang, Yang; Wang, Yuanyuan; Wang, Wensheng; Song, Yanying; Zeng, Yongfang; Yang, Yunchuan; Zhang, Xingcun; Li, Guoling; Gao, Yang; Lu, Yuangang

    2017-03-01

    Sweat gland carcinoma is an extremely rare skin cancer, which is hard to diagnose and completely resect without causing functional and cosmetic problems. Moreover, the high rate of recurrence is hard to handle in the treatment of sweat gland carcinoma. Photodynamic therapy is a novel treatment protocol which can selectively destroy tumor cells with good functional and cosmetic outcomes. This is a case about a 53 years old patient with sweat gland carcinoma on his right foot, which received surgery and photodynamic therapy. There is no recurrence one year after treatment of surgery and photodynamic therapy. Excision combined with photodynamic therapy during operation is a promising strategy towards tumors which are hard to resect thoroughly and have a high risk of recurrence. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. Pharmacology of topical prostaglandin F2 α analogs and their place in the treatment of glaucoma in small animals.

    Science.gov (United States)

    Maślanka, T

    2015-04-01

    A distinguishing feature of the most common types of glaucoma is an increased intra-ocular pressure (IOP), which has a damaging effect on optic nerve axons, leading to the progressive loss of retinal ganglion cells. Therefore, IOP-lowering medications are the mainstay of glaucoma therapy. Topical prostaglandin F2 α analogs (PGAs) are a relatively new class of ocular hypotensive drugs, which have made a huge impact on the treatment of glaucoma in dogs. This study summarizes the current state of knowledge on the mechanism of action of these agents and their effect on IOP in dogs and cats. It also discusses potential harmful side effects of PGAs and presents contemporary opinions about their role and place in the medical management of glaucoma in small animals.

  14. Ethosomes: a novel delivery system for antifungal drugs in the treatment of topical fungal diseases.

    Science.gov (United States)

    Bhalaria, M K; Naik, Sachin; Misra, A N

    2009-05-01

    Aim of this work was to prepare and characterize fluconazole (FLZ) encapsulated ethosomes, incorporate it in suitable dermatological base, and asses its comparative clinical efficacy in the treatment of Candidiasis patients against liposomal gel, marketed product and hydroethanolic solution of the drug. Drug encapsulated ethosomes and liposomes were prepared and optimized by "Hot" method technique and lipid film hydration technique. Vesicular carriers were characterized for % entrapment efficiency, particle size and shape, in vitro drug diffusion study, mean % reduction in dimension of Candidiasis lesion and stability study by using suitable analytical technique. Vesicle size and drug entrapment efficiency of the optimized ethosomes and liposomes were found to be 144 +/- 6.8 nm and 82.68% and 216 +/- 9.2 nm and 68.22% respectively. Microscopic examinations suggest ethosomes to be multilamellar spherical vesicles with a smooth surface. The differential scanning calorimetry results suggest high fluidity of the ethosomes than liposomes. In vitro drug diffusion studies demonstrated that % drug diffused from ethosomes was nearly twice than liposomes and three times higher than the hydroethanolic solution across rat skin. From the clinical evaluation, the developed novel delivery system demonstrated enhanced antifungal activity compared to liposomal formulation, marketed formulation and hydroethanolic solution of the drug.

  15. Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia.

    Science.gov (United States)

    Roberts, Janet; Desai, Nisha; McCoy, John; Goren, Andy

    2014-01-01

    Two percent topical minoxidil is the only US Food and Drug Administration-approved drug for the treatment of female androgenetic alopecia (AGA). Its success has been limited by the low percentage of responders. Meta-analysis of several studies reporting the number of responders to 2% minoxidil monotherapy indicates moderate hair regrowth in only 13-20% of female patients. Five percent minoxidil solution, when used off-label, may increase the percentage of responders to as much as 40%. As such, a biomarker for predicting treatment response would have significant clinical utility. In a previous study, Goren et al. reported an association between sulfotransferase activity in plucked hair follicles and minoxidil response in a mixed cohort of male and female patients. The aim of this study was to replicate these findings in a well-defined cohort of female patients with AGA treated with 5% minoxidil daily for a period of 6 months. Consistent with the prior study, we found that sulfotransferase activity in plucked hair follicles predicts treatment response with 93% sensitivity and 83% specificity. Our study further supports the importance of minoxidil sulfation in eliciting a therapeutic response and provides further insight into novel targets for increasing minoxidil efficacy.

  16. Aczone, a topical gel formulation of the antibacterial, anti-inflammatory dapsone for the treatment of acne.

    Science.gov (United States)

    Scheinfeld, Noah

    2009-05-01

    Allergen Inc has launched Aczone, a topical gel formulation of the antibacterial, anti-inflammatory agent dapsone, for the potential treatment of acne vulgaris. Oral dapsone has demonstrated efficacy in acne, but was associated with severe side effects such as anemia, which was particularly serious in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Aczone was developed to overcome this limitation, and is formulated using solvent-microparticle technology for improved absorption and action and for fewer side effects. In a phase I clinical trial, systemic exposure to dapsone was 126-fold lower following treatment with Aczone compared with oral dapsone. Aczone significantly reduced lesion counts in patients with acne in phase III trials, and was particularly effective in reducing inflammatory lesions. In a phase IV trial, Aczone was safely applied to patients with G6PD deficiency without inducing anemia. Phase IV trials in patients with acne were ongoing at the time of publication to assess safety and to compare Aczone monotherapy with combinations of Aczone and other anti-acne therapeutics. At the time of publication, Allergen was also developing Aczone for the treatment of rosacea; the drug was undergoing phase II trials for this indication. Aczone appears to be a novel promising anti-acne therapeutic option, particularly for patients with inflammatory acne.

  17. Evolving therapeutic strategies for premature ejaculation: The search for on-demand treatmenttopical versus systemic

    Science.gov (United States)

    Morales, Alvaro

    2012-01-01

    Premature ejaculation (PE) is a common sexual dysfunction affecting 20% to 30% of men worldwide. Definitions of PE vary, but it is typically characterized by short intravaginal ejaculatory latency time (IELT) with concomitant sexual dissatisfaction and distress. PE may be lifelong or acquired, but its etiology remains unclear. Treatment of PE typically involves pharmacotherapy, particularly when lifelong. Although there are numerous reports on the off-label use of selective serotonin reuptake inhibitors (SSRIs) and other compounds, only 2 treatments have been evaluated in randomized controlled phase 3 clinical trials: PSD502 and dapoxetine (SSRI). Both significantly improved IELT and patient-reported outcome domains of ejaculatory control, sexual satisfaction, and distress as measured by the index of premature ejaculation (IPE), compared with placebo. They constitute the focus of this review. Evidence demonstrated that PSD502, dapoxetine and other SSRIs all significantly improve the symptoms of PE. Systemic use of SSRIs presents risks associated with the known pharmacology of this class. PSD502 allows for topical on-demand treatment applied applied immediately before intercourse, and is not associated with systemic adverse events. PMID:23093633

  18. Limited efficacy of topical recombinant feline interferon-omega for treatment of cats with acute upper respiratory viral disease.

    Science.gov (United States)

    Ballin, Anne C; Schulz, Bianka; Helps, Christopher; Sauter-Louis, Carola; Mueller, Ralf S; Hartmann, Katrin

    2014-12-01

    Despite a lack of controlled studies confirming its efficacy, recombinant feline interferon-omega (rfeIFN-ω) is used in the treatment of feline upper respiratory tract disease (FURTD), which is usually caused by feline calicivirus (FCV) or feline herpesvirus-1 (FHV-1). The aims of the present study were to investigate whether administration of rfeIFN-ω improves clinical signs in cats with acute FURTD and whether this treatment reduces shedding of FCV. Thirty-seven cats affected with acute FURTD were recruited into a prospective, randomised, placebo-controlled, double-blinded clinical trial. The presence of FCV and/or FHV-1 was determined by performing quantitative polymerase chain reaction (qPCR) on oropharyngeal and conjunctival swabs. Cats were randomly assigned to treatment groups, receiving either placebo or rfeIFN-ω (2.5 MU/kg) subcutaneously, followed by 0.5 MU topically at 8-h intervals via the conjunctiva, intranasally, and orally for 21 days. All cats received additional treatment with antibiotics, expectorants, and inhalation of nebulised physiological saline with camomile. Clinical signs and FCV shedding were evaluated over 42 days. All cats demonstrated improvement in clinical signs during the course of the study, with no significant difference in any of the assessed variables when comparing the two groups. FCV copy numbers decreased more rapidly in cats receiving rfeIFN-ω. Treatment with rfeIFN-ω was not effective in ameliorating clinical signs of acute viral FURTD compared to placebo, but might accelerate a reduction in FCV load in infected cats.

  19. Radical treatment of extensive nevoid hyperkeratosis of the areola and breast with surgical excision after mild response to topical agents: A case report

    Directory of Open Access Journals (Sweden)

    Ilaria Tocco-Tussardi, MD

    2016-01-01

    Conclusion: Indications for surgical treatment of NHNA can be: unsatisfying response to topical agents; young patients who want to restore the aesthetic appearance of the breast; and patients with concomitant indication for corrective surgery of the breast. Advantages are: predictable time of healing; predictable final result; radical excision of the affected tissue; and possibility of histologic analysis of the whole areola. In rare cases of lesions extending to the breast, preliminary treatment with topical agents can limit the extent of excision. Management and treatment should always be tailor-made for each individual case.

  20. [Topical therapy of rosacea].

    Science.gov (United States)

    Schöfer, H

    2013-07-01

    Metronidazole and azelaic acid are the only topical medications approved for rosacea. All other topical treatments for rosacea and its special forms are used off-label. Topical steroids are not indicated in rosacea, because of their side effects (induction of steroid rosacea, high risk of facial skin atrophy, and high risk of rebound after cessation of therapy). Topical as well as systemic steroids are allowed only as initial and short term therapy for acute forms of rosacea (e.g. rosacea fulminans). Papular and pustular rosacea is the major indication for topical therapy. Sebaceous gland and connective tissue hyperplasia in glandular-hypertrophic rosacea as well as erythema in erythematous rosacea do not respond well to topical measures. A new active substance, the alpha-2-adrenoreceptor agonist brimonidine, will be approved soon for the topical treatment of erythema in rosacea. All severe forms of rosacea should initially be treated with a combination of topical and systemic agents. After improvement of the clinical symptoms, topical treatment alone is usually adequate to maintain the control.

  1. Endoscopic Resection and Topical 5-Fluorouracil as an Alternative Treatment to Craniofacial Resection for the Management of Primary Intestinal-Type Sinonasal Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Simon Mackie

    2010-01-01

    Conclusion. Trans-nasal endoscopic resection and topical 5-Fluorouracil could potentially offer an acceptable alternative treatment to the standard of cranio-facial resection. This should be investigated in trials with a longer followup period than this paper in order to directly compare the two treatment modalities.

  2. Topical combination of diclofenac, calcipotriol, and difluoromethylornithine has beneficial effects comparable to 5-fluorouracil for the treatment of non-melanoma skin cancer in mice

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2014-01-01

    Non-melanoma skin cancer (NMSC) is the most common form of skin cancer. Owing to the significant adverse effects of existing treatments, alternatives are needed. The aim of this study was to evaluate the use of topically administered combination therapy and 5-flurouracil (5-FU) for the treatment...

  3. Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses.

    Science.gov (United States)

    Cousty, M; Tricaud, C; De Beauregard, T; Picandet, V; Bizon-Mercier, C; Tessier, C

    2016-01-09

    The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques.

  4. Topical adapalene in the treatment of plantar warts; Randomized comparative open trial in comparison with cryo-therapy

    Directory of Open Access Journals (Sweden)

    Ramji Gupta

    2015-01-01

    Full Text Available Background: Various therapeutic modalities, which are available for treating plantar wart, have not been successful every time. Aims: To evaluate topical adapalene under occlusion in the treatment of plantar warts and compare it with cryo-therapy. Materials and Methods: 50 patients with 424 plantar warts were included in this single center, two arm, prospective, randomized, control, open study. Patients were allocated randomly into two groups consisting of 25 patients each. Group A patients having 299 plantar warts were treated using adapalene gel 0.1% under occlusion while Group B patients having 125 warts were treated using cryo-therapy. All the patients were evaluated weekly till the clearance of all the warts and the results compared. Result: All the warts of 25 patients of Group A that were treated using adapalene gel 0.1% cleared in 36.71 ± 19.24 (55.95-17.47 days except those in one patient. In Group B, warts in all except one treated by cryo-therapy cleared in 52.17 ± 30.06 (82.23-22.11 days. There were no side effects like scar formation, irritation, erythema, or infections with adapalene group while in the cryo group scar was seen in 2 patients, pain in 24, erythema in 10, and infection in 3 patients. Conclusion: Adapalene gel 0.1% under occlusion is an effective, safe and easy to use treatment for plantar warts and may help clear lesions faster than cryo-therapy.

  5. Actikerall™ (5-Fluorouracil 0.5% and Salicylic Acid 10%) Topical Solution for Patient-directed Treatment of Actinic Keratoses.

    Science.gov (United States)

    Nguyen, H P; Rivers, J K

    2016-05-01

    Actinic keratosis (AK), a common cutaneous lesion with the potential to transform into squamous cell carcinoma, has traditionally been treated with ablative and/or surgical procedures. Recently, a topical formulation combining 0.5% 5-fluorouracil with 10% salicylic acid (5-FU-SA) was introduced in Europe under the trade name Actikerall™ for the treatment of grade I/II AKs. In a single randomized phase III trial, 5-FU-SA was shown to be superior to diclofenac 3% gel in hyaluronic acid, as measured by the histological clearance of one defined lesion (72% vs. 59.1%) and by complete clinical clearance (55.4% vs. 32.0%). 5-FU-SA should be applied once daily to a total area of up to 25 cm(2), which may include the lesion(s) and a small area of surrounding skin (rim of healthy skin should not exceed 0.5 cm), for up to 12 weeks. The most common side effects are local inflammation and pruritus at the application site, and no serious adverse effects have been reported to date. Now commercially available in Canada, 5-FU-SA represents a patientapplied therapeutic option for the treatment of both overt and subclinical AKs.

  6. Randomized clinical trial comparing 5% and 1% topical minoxidil for the treatment of androgenetic alopecia in Japanese men.

    Science.gov (United States)

    Tsuboi, Ryoji; Arano, Osamu; Nishikawa, Tooru; Yamada, Hidekazu; Katsuoka, Kensei

    2009-08-01

    Minoxidil is efficacious in inducing hair growth in patients with androgenetic alopecia by inducing hair follicles to undergo transition from the early to late anagen phase. Although the efficacy of 1% topical minoxidil has been confirmed in Japan, no controlled study of 5% topical minoxidil has been conducted using male Japanese subjects. The objective of this trial was to verify the superiority in clinical efficacy of 5% topical minoxidil to 1% topical minoxidil in a double-blind controlled study with male, Japanese androgenetic alopecia patients as the subjects. The trial included 300 Japanese male patients aged 20 years or older with androgenetic alopecia who were administered either 5% topical minoxidil (n = 150) or 1% topical minoxidil (n = 150) for 24 weeks. The mean change from the baseline in non-vellus hair/cm(2), the primary efficacy variable, was 26.4 (n = 142) in the 5% topical minoxidil group and 21.2 (n = 144) in the 1% topical minoxidil group at 16 weeks, the main time point for the evaluation. The difference between the groups was significant (P = 0.020). The incidence of adverse events was 8.7% (13/150) in the 5% group and 5.3% (8/150) in the 1% group, with no significant difference between the groups (chi(2)-test: P = 0.258). Our findings confirmed the superiority of 5% topical minoxidil to 1% topical minoxidil in treating Japanese men with androgenetic alopecia.

  7. The Low Keratin Affinity of Efinaconazole Contributes to Its Nail Penetration and Fungicidal Activity in Topical Onychomycosis Treatment

    OpenAIRE

    Sugiura, Keita; Sugimoto, Noriaki; HOSAKA, Shinya; Katafuchi-Nagashima, Maria; Arakawa, Yoshio; TATSUMI, Yoshiyuki; Jo Siu, William; Pillai, Radhakrishnan

    2014-01-01

    Onychomycosis is a common fungal nail disease that is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. Keratin affinity of topical drugs is an important physicochemical property impacting therapeutic efficacy. To be effective, topical drugs must penetrate the nail bed and retain their antifungal activity within the nail matrix, both of which are adversely affected by keratin binding. We investigated these properties for efinacona...

  8. The Low Keratin Affinity of Efinaconazole Contributes to Its Nail Penetration and Fungicidal Activity in Topical Onychomycosis Treatment

    OpenAIRE

    Sugiura, Keita; Sugimoto, Noriaki; Hosaka, Shinya; Katafuchi-Nagashima, Maria; Arakawa, Yoshio; TATSUMI, Yoshiyuki; Jo Siu, William; Pillai, Radhakrishnan

    2014-01-01

    Onychomycosis is a common fungal nail disease that is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. Keratin affinity of topical drugs is an important physicochemical property impacting therapeutic efficacy. To be effective, topical drugs must penetrate the nail bed and retain their antifungal activity within the nail matrix, both of which are adversely affected by keratin binding. We investigated these properties for efinacona...

  9. Cost-effectiveness analysis of topical treatments for actinic keratosis in the perspective of the Italian health care system.

    Science.gov (United States)

    Colombo, G L; Chimenti, S; Di Matteo, S; Fargnoli, M C; Frascione, P; Silipo, V; Peris, K

    2010-10-01

    Actinic keratosis (AK) is the most common cutaneous malignant neoplasm and its prevalence continues to increase. According to the most recent findings, AK is currently considered the initial stage, in situ, of squamous cell carcinoma. Field-directed therapies for AKs are the preferred treatment since they have the advantage to clear the clinically visible lesions and also subclinical lesions within the cancerous field. We assessed the cost-effectiveness of topical treatments for AKs including 3% diclofenac in 2.5% hyaluronic acid (HA) gel, imiquimod 5% cream and photodynamic therapy with methyl aminolevulinate (MAL-PDT) in the perspective of the Italian Health Care System (SSN). We used a decision tree analytical approach and efficacy data were drawn from published clinical trials. Cost was evaluated from the SSN perspective during a time horizon of 3 months. A responder was defined as a patient with all lesions clinically cleared and showing an excellent cosmetic result. Based on the applied model, the cost per complete responder was calculated. Diclofenac 3% in HA was less expensive (Euro 256) than MAL-PDT (Euro 320) and imiquimod (Euro 342). Effectiveness was similar and better for diclofenac 3% in HA and MAL-PDT (0.813%) in comparison to 0.734% of imiquimod, respectively. The one-way and probabilistic sensitivity analyses confirmed the results of base case scenario. Based on this cost-effectiveness model, diclofenac 3% in HA can be considered the treatment of choice for AK lesions and surrounding field under a pharmacoeconomic point of view.

  10. Reducing patient copayment levels for topical and systemic treatments in plaque psoriasis as a case for evidence-based, sustainable pharmaceutical policy change in Greece.

    Science.gov (United States)

    Souliotis, Kyriakos; Golna, Christina; Kani, Chara; Litsa, Panagiota

    2016-11-01

    Psoriasis is a chronic inflammatory skin disease that requires treatment to manage co-morbidities and improve patient quality-of-life. This study estimated the budget impact to National Organization for Health Care Services Provision (EOPYY) of changing reimbursement of psoriasis treatment with topical and systemic, non-biologic, agents (75%) to bring it on par with that of biologic agents (100%) in Greece. The Business Intelligence database of EOPYY was used to identify and provide analytics on patients with plaque psoriasis. Permission for use of anonymized data was obtained by the administration of EOPYY. EOPYY is responsible for funding healthcare and pharmaceutical care services for ∼95% of the permanent population in the country. Pre-defined ICD-10 codes were applied to identify patients with plaque psoriasis and at least one reimbursed prescription between 1 June 2014 and 31 May 2015. Age, gender, medications, and cost were recorded for these patients. Of the 45,581 unique patients identified through completely anonymized data on the e-prescription system, 72% were on treatment with topicals only and accounted for 5% of EOPYY psoriasis expenditure. Another 9% of patients were on methotrexate or a per os (POS, orally administered) systemic agent and accounted for 2.35% of total expenditure. Approximately 12% of total patients were on treatment with a biologic-containing regimen and accounted for almost 90% of psoriasis expenditure. Patients on biologics were younger than patients on topical and systemic treatments. The burden to EOPYY of adjusting reimbursement levels for topical and systemic, non-biologic, treatments to 100% of their cost was estimated at €2.05 per patient per month for topical treatments (monotherapy) and an additional €9.5 per patient per month for treatment with methotrexate, POS systemic agents, and their combinations with topical agents. This additional cost is expected to be offset by averting 200 earlier than clinically

  11. Innovative bola-surfactant niosomes as topical delivery systems of 5-fluorouracil for the treatment of skin cancer.

    Science.gov (United States)

    Paolino, Donatella; Cosco, Donato; Muzzalupo, Rita; Trapasso, Elena; Picci, Nevio; Fresta, Massimo

    2008-04-02

    An innovative niosomal system made up of alpha,omega-hexadecyl-bis-(1-aza-18-crown-6) (Bola), Span 80 and cholesterol (2:5:2 molar ratio) was proposed as a topical delivery system for 5-fluorouracil (5-FU), largely used in the treatment of different forms of skin cancers. Bola-niosomes showed a mean size of approximately 400 nm, which were reduced to approximately 200 nm by a sonication procedure with a polydispersion index value of 0.1. Bola-niosomes showed a loading capacity of approximately 40% with respect to the amount of 5-FU added during the preparation. 5-FU-loaded bola-niosomes were tested on SKMEL-28 (human melanoma) and HaCaT (non-melanoma skin cancer with a specific mutations in the p53 tumor suppressor gene) to assess the cytotoxic activity with respect to the free drug. 5-FU-loaded bola-niosomes showed an improvement of the cytotoxic effect with respect to the free drug. Confocal laser scanning microscopy studies were carried out to evaluate both the extent and the time-dependent bola-niosome-cell interaction. The percutaneous permeation of 5-FU-loaded niosomes was evaluated by using human stratum corneum and epidermis membranes. Bola-niosomes provided an increase of the drug penetration of 8- and 4-folds with respect to a drug aqueous solution and to a mixture of empty bola-niosomes with a drug aqueous solution.

  12. Topical Application of Retinyl Palmitate-Loaded Nanotechnology-Based Drug Delivery Systems for the Treatment of Skin Aging

    Directory of Open Access Journals (Sweden)

    Marcela B. Oliveira

    2014-01-01

    Full Text Available The objective of this study was to perform a structural characterization and evaluate the in vitro safety profile and in vitro antioxidant activity of liquid crystalline systems (LCS with and without retinyl palmitate (RP. LCS containing polyether functional siloxane (PFS as a surfactant, silicon glycol copolymer (SGC as oil phase, and water in the ratios 30 : 25 : 45 and 40 : 50 : 10 with (OLSv = RP-loaded opaque liquid system and TLSv = RP-loaded transparent liquid system, respectively and without (OLS and TLS, respectively RP were studied. Samples were characterized using polarized light microscopy (PLM and rheology analysis. In vitro safety profile was evaluated using red cell hemolysis and in vitro cytotoxicity assays. In vitro antioxidant activity was performed by the DPPH method. PLM analysis showed the presence of lamellar LCS just to TLS. Regardless of the presence of RP, the rheological studies showed the pseudoplastic behavior of the formulations. The results showed that the incorporation of RP in LCS improved the safety profile of the drug. In vitro antioxidant activity suggests that LCS presented a higher capacity to maintain the antioxidant activity of RP. PFS-based systems may be a promising platform for RP topical application for the treatment of skin aging.

  13. New silica nanostructure for the improved delivery of topical antibiotics used in the treatment of staphylococcal cutaneous infections.

    Science.gov (United States)

    Grumezescu, Alexandru Mihai; Ghitulica, Cristina Daniela; Voicu, Georgeta; Huang, Keng-Shiang; Yang, Chih-Hui; Ficai, Anton; Vasile, Bogdan Stefan; Grumezescu, Valentina; Bleotu, Coralia; Chifiriuc, Mariana Carmen

    2014-03-25

    In this paper, we report the synthesis, characterization (FT-IR, XRD, BET, HR-TEM) and bioevaluation of a novel γ-aminobutiric acid/silica (noted GABA-SiO₂ or γ-SiO₂) hybrid nanostructure, for the improved release of topical antibiotics, used in the treatment of Staphylococcus aureus infections. GABA-SiO₂ showed IR bands which were assigned to Si-O-Si (stretch mode). The XRD pattern showed a broad peak in the range of 18-30° (2θ), indicating an amorphous structure. Based on the BET analysis, estimations about surface area (438.14 m²/g) and pore diameters (4.76 nm) were done. TEM observation reveals that the prepared structure presented homogeneity and an average size of particles not exceeding 10nm. The prepared nanostructure has significantly improved the anti-staphylococcal activity of bacitracin and kanamycin sulfate, as demonstrated by the drastic decrease of the minimal inhibitory concentration of the respective antibiotics loaded in the GABA-SiO₂ nanostructure. These results, correlated with the high biocompatibility of this porous structure, are highlighting the possibility of using this carrier for the local delivery of the antimicrobial substances in lower active doses, thus reducing their cytotoxicity and side-effects.

  14. Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients.

    Science.gov (United States)

    Hu, Ruiming; Xu, Feng; Sheng, Youyu; Qi, Sisi; Han, Yumei; Miao, Ying; Rui, Wenlong; Yang, Qinping

    2015-01-01

    Finasteride at 1 mg/day and 5% topical minoxidil are effective in male androgenetic alopecia (MAGA). However, studies describing their effects in Chinese individuals are scarce. 450 Chinese MAGA patients were randomly assigned to receive finasteride (n = 160), minoxidil (n = 130) and combined medication (n = 160) for 12 months. The patients returned to the clinic every 3 months for efficacy evaluation. And efficacy was evaluated in 428 men at treatment end, including 154, 122, and 152 in the finasteride, 5% minoxidil, and combination groups, respectively. All groups showed similar baseline characteristics, including age at enrollment, and duration and severity of alopecia (p > 0.05). At 12 months, 80.5, 59, and 94.1% men treated with finasteride, 5% minoxidil and the combination therapy showed improvement, respectively. Adverse reactions were rare (finasteride, 1.8%; minoxidil, 6.1%), and disappeared right after drug withdrawal. In conclusion, finasteride is superior to 5% minoxidil, while the combined medication showed the best efficacy. © 2015 Wiley Periodicals, Inc.

  15. Effectiveness of Topical Curcumin for Treatment of Mastitis in Breastfeeding Women: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Raha Afshariani

    2014-09-01

    Full Text Available Objective: To determine the efficacy of topical curcumin in reducing breast inflammation in women suffering from lactational mastitis. Methods: A randomized double-blind, placebo-controlled study including 63 breastfeeding women with lactational mastitis were randomly assigned to receive curcumin topical cream, one pump every 8 hours for 3 days (n=32 or topical moisturizer as placebo (n=31. Using an index for severity of breast inflammation, all of the patients had moderate breast inflammation before entering the study. The outcome of treatment was evaluated using the same index at 24, 48 and 72 hours of starting the treatment. Results: There was no significant difference between two study groups regarding the baseline characteristics such as age (p=0.361 and duration of lactation (p=0.551. After 72-hour of therapy, patients in curcumin groups had significantly lower rate of moderate (p=0.019 and mild (p=0.002 mastitis. Patients in curcumin group had significantly lower scores for tension (p<0.001, erythema (p<0.001 and pain (p<0.001, after 72-hour of treatment. Conclusion: The results of the current study indicate that topical preparation of curcumin successfully decrease the markers of lactational mastitis such as pain, breast tension and erythema within 72 hours of administration without side effects. Thus, topical preparation of curcumin could be safely administered for those suffering from lactational mastitis after excluding infectious etiologies.

  16. Topical calcitriol prior to photodynamic therapy enhances treatment efficacy in non-melanoma skin cancer mouse models

    Science.gov (United States)

    Rollakanti, Kishore; Anand, Sanjay; Maytin, Edward V.

    2015-03-01

    Non-melanoma skin cancers (NMSCs) such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the most common form of human cancer worldwide, and their incidence is increasing. Photodynamic therapy (PDT), mediated by topically applied aminolevulinic acid (ALA) and subsequent exposure to light (either a laser or a noncoherent source), is being increasingly used for the treatment of dermatological disorders, including BCC and SCC. However, therapeutic responses of NMSCs to ALA-PDT are currently not superior to standard therapies, although the latter have undesirable side effects including scarring. In this study, we report that preconditioning of skin tumors with calcitriol (active form of Vitamin D; Vit D) prior to ALA-PDT, significantly improves the treatment outcome. In BCC and UVB-induced SCC mouse models, we identified an increase in tumor-specific accumulation of ALA induced photosensitizer (protoporphyrin IX, PpIX) due to Vit D preconditioning, of up to 6- fold in vivo. In addition, increased expression of differentiation (145 fold, p < 0.02) and proliferation (42 fold, p <0.005) markers were identified in BCC tumors, all leading to increased tumor destruction (18.3 fold, p < 0.03) with the combination approach, as compared to ALA-PDT alone. Histomorphological changes identified using hematoxylin and eosin staining, and results of TUNEL staining, together documented a beneficial effect of Vit D pretreatment upon tumor cell death. We conclude that this new combination approach with Vit D and ALA-PDT has great potential to achieve complete remission of NMSC tumors, with excellent cosmetic results and an overall beneficial impact upon patient care.

  17. Effectiveness of topical skin products in the treatment and prevention of incontinence-associated dermatitis: a systematic review.

    Science.gov (United States)

    Pather, Priscilla; Hines, Sonia; Kynoch, Kate; Coyer, Fiona

    2017-05-01

    Incontinence-associated dermatitis (IAD) is inflammation of the skin resulting from repeated contact with urine and/or feces. It causes pain, redness, swelling and excoriation, and may lead to complications such as fungal skin infections and pressure injuries. It is important to prevent and treat IAD to avoid complications and improve patient outcomes. A number of products are available for protecting skin, but evidence on their effectiveness is limited. The current review aimed to establish the effectiveness of topical skin products in reducing the occurrence and/or severity of IAD. Adult patients over the age of 18 years with incontinence and/or diarrhea. Topical skin products as individual interventions or part of a skin care regimen. Both published and unpublished study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after, prospective and retrospective cohort, case-control, analytical cross-sectional, descriptive study designs including case series, individual case reports and descriptive cross-sectional studies across all care settings for inclusion. The primary outcome of interest was the absence or non-development, reduction or resolution, new development or increase in the occurrence of IAD or the increase in severity of IAD. The secondary outcome was any adverse effect caused by the skin care products used. A three-step search strategy to find both published and unpublished papers was utilized in this review. Studies were limited to those published in English from 1980 to 2016. Papers selected were assessed by two independent reviewers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Data were extracted using the standardized data extraction tool in JBI-MAStARI. The data extracted included specific details about the interventions, populations, study methods and outcomes. Studies were assessed for methodological quality and

  18. How should we treat prepubertal labial adhesions? Retrospective comparison of topical treatments: estrogen only, betamethasone only, and combination estrogen and betamethasone.

    Science.gov (United States)

    Eroğlu, Egemen; Yip, Marcus; Oktar, Tayfun; Kayiran, Sinan Mahir; Mocan, Hilal

    2011-12-01

    Labial adhesion is a common finding in prepubertal girls. Traditionally, topical estrogen cream application has been the choice of conservative treatment, however, topical betamethasone treatment has also recently been employed with some success. In this retrospective study, we analysed 131 children with labial adhesions. Eleven of 71 (15.4%) patients were treated successfully with topical estrogen cream only, and 5 of 32 (15.6%) patients were treated successfully with betamethasone cream only. We successfully treated 5 of 28 (28.5%) patients with a combination of estrogen and betamethasone creams. The mean time of treatment for each regimen of therapy was 4 weeks. There was no significance between the single-therapy estrogen and single-therapy betamethasone groups (P = 1.00), between single-therapy estrogen and the combination therapy (P = .16), and the single therapy betamethasone to combination therapy (P = .35) groups. There was also no significant difference between combination estrogen and betamethasone therapy and the combined data of the single therapies (relative risk 1.85; 95% confidence interval 0.89-3.89; P =.11). For the treatment of prepubertal labial adhesions, topical estrogen and betamethasone creams were found to have similar success rates, with limited satisfactory results. The combination therapy was mildly more efficacious than each of the single therapies but was not found to be statistically significant. Surgical separation is recommended if conservative treatment fails. Copyright © 2011 North American Society for Pediatric and Adolescent Gynecology. All rights reserved.

  19. Dapsone Topical

    Science.gov (United States)

    ... these steps: Gently wash the affected skin and pat dry with a soft towel. Ask your doctor ... back pain shortness of breath tiredness weakness dark brown urine fever yellow or pale skin Dapsone topical ...

  20. Ciclopirox Topical

    Science.gov (United States)

    ... Do not use nail polish or other nail cosmetic products on nails treated with ciclopirox topical solution. ... as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this ...

  1. Tretinoin Topical

    Science.gov (United States)

    ... lotions, astringents, and perfumes); they can sting your skin, especially when you first use tretinoin.Do not use any other topical medications, especially benzoyl peroxide, salicylic acid (wart remover), and dandruff shampoos containing sulfur or ...

  2. Imidacloprid/moxidectin topical solution for the prevention of heartworm disease and the treatment and control of flea and intestinal nematodes of cats.

    Science.gov (United States)

    Arther, R G; Charles, S; Ciszewski, D K; Davis, W L; Settje, T S

    2005-10-24

    Sixteen controlled laboratory studies, involving 420 kittens and cats, were conducted to evaluate the efficacy and safety of topically applied formulations of imidacloprid and moxidectin for the prevention of feline heartworm disease, treatment of flea infestations and treatment and control of intestinal nematodes. Unit-dose applicators and the dosing schedule used in these studies were designed to provide a minimum of 10mg imidacloprid and 1mg moxidectin/kg. Treatments were applied topically by parting the hair at the base of the skull and applying the solution on the skin. Imidacloprid treatment alone did not display activity against Dirofilaria immitis or intestinal nematodes and moxidectin treatment alone provided little or no activity against adult Ctenocephalides felis infestations. The formulation containing 10% imidacloprid and 1% moxidectin was 100% efficacious against the development of adult D. immitis infections when cats were treated 30 days after inoculation with third-stage larvae. A single treatment with this formulation also provided 88.4-100% control of adult C. felis for 35 days. Imidacloprid/moxidectin was 100% efficacious against adult Toxocara cati and 91.0-98.3% efficacious against immature adults and fourth-stage T. cati larvae. The formulation provided 98.8-100% efficacy against adult Ancylostoma and immature adults and third-stage A. tubaeforme larvae. Monthly topical application with 10% imidacloprid/1% moxidectin is convenient, efficacious and safe for the prevention of feline heartworm disease, treatment of flea infestation and for the treatment and control of intestinal nematode infections of cats.

  3. Topical Treatment of White-Tailed Deer with an Acaricide for the Control of Ixodes Scapularis (Acari: Ixodidae) in a Connecticut Lyme Borreliosis Hyperendemic Community

    Science.gov (United States)

    The 4-Poster device for the topical treatment of white-tailed deer, Odocoileus virginianus (Zimmermann), against ticks using the acaricide amitraz, was evaluated in a Lyme borreliosis endemic community in Connecticut. As part of a 5-year project from 1997 to 2002, 21–24 of the 4-Posters were distrib...

  4. A comparison study of the clinical efficacy and safety of topical adapalene gel (0.1% and tretinoin cream (0.025% in the treatment of acne vulgaris

    Directory of Open Access Journals (Sweden)

    Usha Naraindas Khemani

    2016-06-01

    Conclusions: Adapalene gel 0.1% offers comparable efficacy to tretinoin cream 0.025 % cream , but is less irritating. Adapalene gel 0.1% is a safe and effective topical agent in the treatment of mild to moderate acne vulgaris in Indian patients. [Int J Basic Clin Pharmacol 2016; 5(3.000: 628-634

  5. Non-ablative fractional resurfacing in combination with topical tretinoin cream as a field treatment modality for multiple actinic keratosis : a pilot study and a review of other field treatment modalities

    NARCIS (Netherlands)

    Prens, Sebastiaan P.; de Vries, Karin; Neumann, H. A. Martino; Prens, Errol P.

    2013-01-01

    Background: Actinic keratoses (AK) are premalignant lesions occurring mainly in sun-damaged skin. Current topical treatment options for AK and photo-damaged skin such as liquid nitrogen and electrosurgery are not suitable for field treatment. Otherwise, therapies suitable for field treatment bring a

  6. Guidelines of care for the management of psoriasis and psoriatic arthritis Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies

    Energy Technology Data Exchange (ETDEWEB)

    Menter, A.; Korman, N.J.; Elmets, C.A.; Feldman, S.R.; Gelfand, J.M.; Gordon, K.B.; Gottlieb, A.; Koo, J.Y.M.; Lebwohl, M.; Lim, H.W.; Van Voorhees, A.S.; Beutner, K.R.; Bhushan, R. [University of Texas South West Medical Center Dallas, Dallas, TX (United States)

    2009-04-15

    Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the Population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use of topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy.

  7. Guidelines of care for the management of psoriasis and psoriatic arthritis. Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies.

    Science.gov (United States)

    Menter, Alan; Korman, Neil J; Elmets, Craig A; Feldman, Steven R; Gelfand, Joel M; Gordon, Kenneth B; Gottlieb, Alice; Koo, John Y M; Lebwohl, Mark; Lim, Henry W; Van Voorhees, Abby S; Beutner, Karl R; Bhushan, Reva

    2009-04-01

    Psoriasis is a common, chronic, inflammatory, multi-system disease with predominantly skin and joint manifestations affecting approximately 2% of the population. In this third of 6 sections of the guidelines of care for psoriasis, we discuss the use of topical medications for the treatment of psoriasis. The majority of patients with psoriasis have limited disease (<5% body surface area involvement) and can be treated with topical agents, which generally provide a high efficacy-to-safety ratio. Topical agents may also be used adjunctively for patients with more extensive psoriasis undergoing therapy with either ultraviolet light, systemic or biologic medications. However, the use of topical agents as monotherapy in the setting of extensive disease or in the setting of limited, but recalcitrant, disease is not routinely recommended. Treatment should be tailored to meet individual patients' needs. We will discuss the efficacy and safety of as well as offer recommendations for the use of topical corticosteroids, vitamin D analogues, tazarotene, tacrolimus, pimecrolimus, emollients, salicylic acid, anthralin, coal tar, as well as combination therapy.

  8. Characterization of Antifungal Activity and Nail Penetration of ME1111, a New Antifungal Agent for Topical Treatment of Onychomycosis.

    Science.gov (United States)

    Tabata, Yuji; Takei-Masuda, Naomi; Kubota, Natsuki; Takahata, Sho; Ohyama, Makoto; Kaneda, Kaori; Iida, Maiko; Maebashi, Kazunori

    2016-02-01

    Fungal nail infection (onychomycosis) is a prevalent disease in many areas of the world, with a high incidence approaching 23%. Available antifungals to treat the disease suffer from a number of disadvantages, necessitating the discovery of new efficacious and safe antifungals. Here, we evaluate the in vitro antifungal activity and nail penetration ability of ME1111, a novel antifungal agent, along with comparator drugs, including ciclopirox, amorolfine, terbinafine, and itraconazole. ME1111 showed potent antifungal activity against Trichophyton rubrum and Trichophyton mentagrophytes (the major etiologic agents of onychomycosis) strains isolated in Japan and reference fungal strains with an MIC range of 0.12 to 0.5 mg/liter and an MIC50 and MIC90 of 0.5 mg/liter for both. Importantly, none of the tested isolates showed an elevated ME1111 MIC. Moreover, the antifungal activity of ME1111 was minimally affected by 5% wool keratin powder in comparison to the other antifungals tested. The ME1111 solution was able to penetrate human nails and inhibit fungal growth in a dose-dependent manner according to the TurChub assay. In contrast, 8% ciclopirox and 5% amorolfine nail lacquers showed no activity under the same conditions. ME1111 demonstrated approximately 60-fold-greater selectivity in inhibition of Trichophyton spp. than of human cell lines. Our findings demonstrate that ME1111 possesses potent antidermatophyte activity, maintains this activity in the presence of keratin, and possesses excellent human nail permeability. These results suggest that ME1111 is a promising topical medication for the treatment of onychomycosis and therefore warrants further clinical evaluation. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  9. Increased therapeutic efficacy of a newly synthesized tyrosinase inhibitor by solid lipid nanoparticles in the topical treatment of hyperpigmentation

    Directory of Open Access Journals (Sweden)

    Al-Amin M

    2016-12-01

    Full Text Available Md Al-Amin, Jiafu Cao, Muhammad Naeem, Hasanul Banna, Min-Soo Kim, Yunjin Jung, Hae Young Chung, Hyung Ryong Moon, Jin-Wook Yoo College of Pharmacy, Pusan National University, Busan, South Korea Abstract: Hyperpigmentation caused by melanin overproduction is a major skin disorder in humans. Inhibition of tyrosinase, a key regulator of melanin production, has been used as an effective strategy to treat hyperpigmentation. In this study, we investigated the use of solid lipid nanoparticles (SLNs as a highly effective and nontoxic means to deliver a newly synthesized potent tyrosinase inhibitor, MHY498, and to target melanocytes through the skin. MHY498-loaded SLNs (MHY-SLNs were prepared by an oil-in-water emulsion solvent-evaporation method, and their morphological and physicochemical properties were characterized. MHY-SLNs showed a prolonged drug-release profile and higher skin permeation than that of MHY solution. In an in vivo evaluation of antimelanogenic activity, MHY-SLNs showed a prominent inhibitory effect against ultraviolet B-induced melanogenesis, resulting in no change in the skin color of C57BL/6 mouse, compared with that observed in an MHY solution-treated group and an untreated control group. The antimelanogenic effect of MHY-SLNs was further confirmed through Fontana–Masson staining. Importantly, MHY-SLNs did not induce any toxic effects in the L929 cell line. Overall, these data indicate that MHY-SLNs show promise in the topical treatment of hyperpigmentation. Keywords: melanogenesis, hyperpigmentation, MHY498, solid lipid nanoparticles, skin delivery

  10. Biological efficacy and stability of diluted ticarcillin-clavulanic acid in the topical treatment of Pseudomonas aeruginosa infections.

    Science.gov (United States)

    Bateman, Fiona L; Moss, Susan M; Trott, Darren J; Shipstone, Michael A

    2012-04-01

    Topical compounded Timentin(®) diluted with an inactive vehicle has been reported to be effective in the treatment of otitis externa caused by Pseudomonas aeruginosa. The aims of this study were to determine the biological efficacy of Timentin(®) (ticarcillin and clavulanic acid) when diluted in the carrier vehicle Methopt(®) against P. aeruginosa and to determine the efficacy and stability of Timentin(®) aqueous stock concentrate solution. Timentin(®) stock concentrate was tested against four P. aeruginosa isolates on days 0, 7, 14, 21 and 28; then after 2, 3, 4, 5, 6, 9 and 12 months of storage at 4 or -20°C. The diluted Timentin(®)-Methopt(®) solutions were tested against all isolates after 0, 2, 4, 6, 8, 10, 12, 14, 17, 21, 24 and 28 days of storage at 24 or 4°C. Minimal inhibitory concentration (MIC) levels for all strains were determined using the broth microdilution method. The MIC of the stock solution remained relatively constant and acceptable throughout the study when stored at -20°C and was also acceptable for shorter time periods (6-9 months) when stored at 4°C. The MIC for the diluted Timentin(®)-Methopt(®) solution remained relatively constant and acceptable throughout the study for all four bacterial strains, with no difference between the solutions stored at 4 or 24°C. The results of this study indicate that storage of the Timentin(®) stock solution at -20°C does not compromise efficacy for at least 12 months and that Timentin(®) diluted in Methopt(®) was stable for 28 days when stored at either 4 or 24°C.

  11. Tolerability of NGX-4010, a capsaicin 8% patch, in conjunction with three topical anesthetic formulations for the treatment of neuropathic pain

    Directory of Open Access Journals (Sweden)

    Webster LR

    2012-01-01

    Full Text Available Lynn R Webster1, John F Peppin2, Frederick T Murphy3,4, Jeffrey K Tobias5, Geertrui F Vanhove51Lifetree Clinical Research and Pain Clinic, Lifetree Medical Inc, Salt Lake City, UT, USA; 2Clinical Research Division, The Pain Treatment Center of the Bluegrass, Lexington, KY, USA; 3Altoona Center for Clinical Research, Duncansville, PA, USA; 4University of Pennsylvania, School of Medicine, Philadelphia, PA, USA; 5NeurogesX Inc, San Mateo, CA, USABackground: The objective of this study was to assess the safety, tolerability, and preliminary efficacy of NGX-4010, a capsaicin 8% patch, following pretreatment with three different topical anesthetics in patients with peripheral neuropathic pain.Methods: This open-label, multicenter study enrolled 117 patients with post-herpetic neuralgia, HIV-associated distal sensory polyneuropathy, or painful diabetic neuropathy. Patients received pretreatment with one of three lidocaine 4%-based topical anesthetics (L.M.X.4® [Ferndale Laboratories Inc, Ferndale, MI], Topicaine® Gel [Estela Basso, Jupiter, FL], or Betacaine Enhanced Gel 4 [Tiberius Inc, Tampa, FL] for 60 minutes followed by a single 60- or 90-minute NGX-4010 application, and were followed for 12 weeks. Tolerability and safety measures included “pain now” Numeric Pain Rating Scale (NPRS scores, dermal assessments, medication use for treatment-related pain, adverse events (AEs, clinical laboratory parameters, physical examinations, and vital signs. The primary efficacy variable was the percentage change in mean NPRS scores for “average pain for the past 24 hours” from baseline to weeks 2 through 12.Results: Treatment with NGX-4010 following pretreatment with any of the three topical anesthetics was generally safe and well tolerated. Nearly all patients completed ≥90% of the planned NGX-4010 application duration. The most common treatment-related AEs, application-site burning and application-site pain, were transient, mostly mild or moderate

  12. Triple combination treatment with fractional CO2 laser plus topical betamethasone solution and narrowband ultraviolet B for refractory vitiligo: a prospective, randomized half-body, comparative study.

    Science.gov (United States)

    Li, Lu; Wu, Yan; Li, Li; Sun, Yan; Qiu, Li; Gao, Xing-Hua; Chen, Hong-Duo

    2015-01-01

    Vitiligo on extremities and/or bony prominences is very resistant to treatment. Twenty-five patients with symmetrical and stable vitiligo on extremities and/or bony prominences were enrolled. The treatment side received fractional carbon dioxide laser followed by topical compound betamethasone solution and narrowband ultraviolet B phototherapy. The control side received laser treatment plus phototherapy. The result of treatment side showed that 44% patients achieved over 50% re-pigmentation and patient satisfaction score was 5.12 ± 3.23, higher than those of control (p vitiligo.

  13. A comparison of the leaf gel extracts of Aloe ferox and Aloe vera in the topical treatment of atopic dermatitis in Balb/c mice.

    Science.gov (United States)

    Finberg, M J; Muntingh, G L; van Rensburg, C E J

    2015-12-01

    Aloe vera gel is widely used in the treatment of an array of disturbances, especially skin disorders. The wound-healing effects have been attributed to its moisturizing and anti-inflammatory effects as well as its beneficial effect on the maturation of collagen. The aim of the present study is to compare the effects of topically applied extracts of Aloe ferox with that of Aloe vera on the symptoms as well as IgE levels of a mouse model of atopic dermatitis (AD). Mice were sensitized and challenged with 2,4-dinitrochlorobenzene and treated afterwards for 10 consecutive days with the gels of either A. ferox or A. vera applied topically to the affected areas. A placebo gel was used for the control mice. Blood was collected at the beginning and end of the treatment period to measure serum IgE levels. Although the gels of both the Aloe species inhibited the cutaneous inflammatory response as well as serum IgE levels in the rats, the extracts of A. ferox were superior to that of A. vera in reducing IgE levels. The gels of A. ferox and A. vera, applied topically, may be a safe and useful alternative to antihistamines and topical corticosteroids, for the treatment of patients suffering from recurring chronic AD.

  14. Effect of topical cromoglycate solution on atopic dermatitis: combined treatment of sodium cromoglycate solution with the oral anti-allergic medication, oxatomide.

    Science.gov (United States)

    Kimata, H; Hiratsuka, S

    1994-02-01

    The effect of topically applied sodium cromoglycate solution in moderate to severe atopic dermatitis (AD) in children aged 4-14 years was studied in a double-blind, placebo-controlled, randomized group-comparative trial. One group of patients was treated with topical sodium cromoglycate solution and oral oxatomide whereas the other group was treated with topical placebo solution and oral oxatomide. After 4 weeks, AD improved significantly in the group treated with the sodium cromoglycate solution and oxatomide combination while marginal improvement was noted in the placebo. In addition, spontaneous IgE production from peripheral blood mononuclear cells decreased significantly in the sodium cromoglycate group but not in the placebo group. These results suggest that sodium cromoglycate solution may be very effective in combination with anti-allergic medication in the treatment of moderate to severe AD in children.

  15. Differential effects of topical vitamin E and C E Ferulic® treatments on ultraviolet light B-induced cutaneous tumor development in Skh-1 mice.

    Directory of Open Access Journals (Sweden)

    Erin M Burns

    Full Text Available Because of the ever-increasing incidence of ultraviolet light B (UVB-induced skin cancer, considerable attention is being paid to prevention through the use of both sunscreens and after sun treatments, many of which contain antioxidants. Vitamin E is included as an antioxidant in many sunscreens and lotions currently on the market. Studies examining the efficacy of vitamin E as a topical preventative agent for UVB-induced skin cancer have yielded conflicting results. A likely contributor to differences in study outcome is the stability of vitamin E in the particular formulation being tested. In the current study we examined the effects of topical vitamin E alone as well as vitamin E combined with vitamin C and ferulic acid in a more stable topical formula (C E Ferulic®. Mice were exposed to UVB for 10 weeks in order to induce skin damage. Then, before the appearance of any cutaneous lesions, mice were treated for 15 weeks with a topical antioxidant, without any further UVB exposure. We found that topical C E Ferulic decreased tumor number and tumor burden and prevented the development of malignant skin tumors in female mice with chronically UVB-damaged skin. In contrast, female mice chronically exposed to UVB and treated topically with vitamin E alone showed a trend towards increased tumor growth rate and exhibited increased levels of overall DNA damage, cutaneous proliferation, and angiogenesis compared to vehicle-treated mice. Thus, we have demonstrated that topical 5% alpha tocopherol may actually promote carcinogenesis when applied on chronically UVB-damaged skin while treating with a more stable antioxidant compound may offer therapeutic benefits.

  16. The low keratin affinity of efinaconazole contributes to its nail penetration and fungicidal activity in topical onychomycosis treatment.

    Science.gov (United States)

    Sugiura, Keita; Sugimoto, Noriaki; Hosaka, Shinya; Katafuchi-Nagashima, Maria; Arakawa, Yoshio; Tatsumi, Yoshiyuki; Jo Siu, William; Pillai, Radhakrishnan

    2014-07-01

    Onychomycosis is a common fungal nail disease that is difficult to treat topically due to the deep location of the infection under the densely keratinized nail plate. Keratin affinity of topical drugs is an important physicochemical property impacting therapeutic efficacy. To be effective, topical drugs must penetrate the nail bed and retain their antifungal activity within the nail matrix, both of which are adversely affected by keratin binding. We investigated these properties for efinaconazole, a new topical antifungal for onychomycosis, compared with those of the existing topical drugs ciclopirox and amorolfine. The efinaconazole free-drug concentration in keratin suspensions was 14.3%, significantly higher than the concentrations of ciclopirox and amorolfine, which were 0.7% and 1.9%, respectively (P nails into the receptor phase and also inhibited the growth of Trichophyton rubrum under the nail. In the presence of keratin, efinaconazole exhibited fungicidal activity against Trichophyton mentagrophytes comparable to that of amorolfine and superior to that of ciclopirox. In a guinea pig onychomycosis model with T. mentagrophytes infection, an efinaconazole solution significantly decreased nail fungal burden compared to that of ciclopirox and amorolfine lacquers (P nail permeability of efinaconazole and its potent fungicidal activity in the presence of keratin are related to its low keratin affinity, which may contribute to its efficacy in onychomycosis. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

  17. Monochromatic excimer light versus combination of topical steroid with vitamin D3 analogue in the treatment of nonsegmental vitiligo: a randomized blinded comparative study.

    Science.gov (United States)

    Abdel Latif, Azmy Ahmed; Ibrahim, Shady Mahmoud Attia

    2015-01-01

    Vitiligo is a difficult disease to treat, socially stigmatizing its patients. Monochromatic excimer light (MEL) was developed for use in dermatology and adapted for the treatment of vitiligo. Comparing the efficacy of MEL versus topical combination therapy of vitamin D3 analogue and steroid in the treatment of nonsegmental vitiligo. Forty-four patients with localized and stable nonsegmental vitiligo participated in the present study. In each patient, two lesions were selected and divided randomly into two groups, group A was treated with daily topical combination of calcipotriol and betamethasone and group B was treated with biweekly sessions of MEL for 3 months. Efficacy based on repigmentation percentages were blindly evaluated by two independent physicians and patient's satisfaction. There was significant improvement in both treatment modalities at the end of the study, but without significant differences in both groups. There was a significant difference between both groups regarding the onset of repigmentation (p-value vitiligo.

  18. Efficacy and tolerance of the topical application of potassium hydroxide (10% and 15% in the treatment of molluscum contagiosum: Randomized clinical trial: Research protocol

    Directory of Open Access Journals (Sweden)

    Galindo Gisela

    2011-10-01

    Full Text Available Abstract Background Molluscum contagiosum is a non-severe pediatric viral infection. Because it is highly contagious and current treatments have negative aesthetic and psychological effects, we want to test an alternative treatment in the primary care setting, consisting of two different concentrations of potassium hydroxide solution. Methods/design The study design is a double-blind, randomized clinical trial, using three types of topical treatment. The treatment consist of daily applications of potassium hydroxide (KOH in aqueous solution at 10% and 15% concentration, and a placebo administered in the control group. Four follow-up visits (at 15, 30, 45 and 60 days are planned to evaluate treatment effectiveness and patient tolerance. The main outcome measure of the trial will be the healing rate, defined as lesion disappearance in the affected zones after the topic application of the experimental treatment. Secondary measures will be the principal characteristics and evolution of the affected zone (surface area, number of lesions, size and density of lesions, treatment tolerance (hyperpigmentation, itching, burning, pain, recurrence rate and the natural evolution of lesions in the control group. Discussion KOH can potentially be an effective and safe treatment for MC in primary care, and can also reduce referrals to dermatologists and hospital pediatric departments. In addition, KOH may be a valid and less expensive alternative to current invasive treatments (surgical excision. Trial Registration ClinicalTrials.gov: NCT01348386

  19. Efficacy of the topical 5% lidocaine medicated plaster in the treatment of chronic post-thoracotomy neuropathic pain.

    Science.gov (United States)

    Sansone, Pasquale; Passavanti, Maria Beatrice; Fiorelli, Alfonso; Aurilio, Caterina; Colella, Umberto; De Nardis, Lorenzo; Donatiello, Valerio; Pota, Vincenzo; Pace, Maria Caterina

    2017-05-01

    To assess the efficacy of the topical 5% lidocaine medicated plaster (Versatis(®), Grünenthal GmbH, Aachen, Germany) in patients with post-thoracotomy neuropathic pain. Patients were randomized to receive the topical 5% lidocaine medicated plaster (n = 33) or non-medicated placebo plasters (n = 30) for 12 h every day for 8 weeks. Laser-evoked potentials (LEPs) were measured, and various questionnaires/scales completed. Numeric Rating Scale pain scores improved significantly (p plaster than in placebo recipients. The same was true for N2 and P2 LEP latency and amplitude, and other parameters. The study included neurophysiological findings and confirmed the efficacy of the topical 5% lidocaine medicated plaster in patients with chronic post-thoracotomy neuropathic pain.

  20. A Review of the Use of Topical Calendula in the Prevention and Treatment of Radiotherapy-Induced Skin Reactions.

    Science.gov (United States)

    Kodiyan, Joyson; Amber, Kyle T

    2015-04-23

    Calendula is a topical agent derived from a plant of the marigold family Calendula Officinalis. Containing numerous polyphenolic antioxidants, calendula has been studied in both the laboratory and clinical setting for the use in treating and preventing radiation induced skin toxicity. Despite strong evidence in the laboratory supporting calendula's mechanism of action in preventing radiation induced skin toxicity, clinical studies have demonstrated mixed results. In light of the controversy surrounding the efficacy of calendula in treating and preventing radiodermatitis, the topic warrants further discussion.

  1. A Review of the Use of Topical Calendula in the Prevention and Treatment of Radiotherapy-Induced Skin Reactions

    Directory of Open Access Journals (Sweden)

    Joyson Kodiyan

    2015-04-01

    Full Text Available Calendula is a topical agent derived from a plant of the marigold family Calendula Officinalis. Containing numerous polyphenolic antioxidants, calendula has been studied in both the laboratory and clinical setting for the use in treating and preventing radiation induced skin toxicity. Despite strong evidence in the laboratory supporting calendula’s mechanism of action in preventing radiation induced skin toxicity, clinical studies have demonstrated mixed results. In light of the controversy surrounding the efficacy of calendula in treating and preventing radiodermatitis, the topic warrants further discussion.

  2. Topically applied botulinum toxin type A for the treatment of primary axillary hyperhidrosis: results of a randomized, blinded, vehicle-controlled study.

    Science.gov (United States)

    Glogau, Richard G

    2007-01-01

    The objective was to demonstrate that botulinum toxin type A (BTX-A) can be delivered to targeted skin sites with topical application for the treatment of primary axillary hyperhidrosis. This randomized, blinded, vehicle-controlled study enrolled 12 patients with primary axillary hyperhidrosis with greater than 50 mg of sweat produced per 5 minutes. BTX-A (200 U), combined with a proprietary transport peptide molecule to bind the toxin in a noncovalent manner, was topically applied to one axilla; vehicle without BTX-A was applied to the other axilla. Rates of sweat production were measured and imaged at baseline and 4 weeks after application. Two patients were excluded from analyses. At 4 weeks, 10 axillae treated topically with BTX-A demonstrated a 65.3+/-21.5% mean reduction in sweating relative to the same-patient, vehicle-control axillae, which had a 25.3+/-66.2% mean reduction. The 40% difference in mean sweat reduction between groups was statistically significant (pproduction in the BTX-A-treated versus the vehicle-treated axillae. Topically applied BTX-A appears to be safe and may prove to be effective for the treatment of axillary hyperhidrosis.

  3. Comparative efficacy of topical application of tacrolimus and clotrimazole in the treatment of pityriasis versicolor: A single blind, randomised clinical trial.

    Science.gov (United States)

    Sepaskhah, Mozhdeh; Sadat, Maryam Sadat; Pakshir, Keyvan; Bagheri, Zahra

    2017-05-01

    Pityriasis versicolor (PV) is a common superficial fungal disease. Possibility of emergence of resistant strains to azoles, and difficulty in differentiation of hypopigmented PV and early vitiligo, encouraged us to evaluate the efficacy of topical tacrolimus (a calcineurin inhibitor agent with proven in vitro anti-Malassezia effect) for PV treatment generally and its effect on PV-induced hypopigmentation specifically. To evaluate the efficacy of topical tacrolimus on pityriasis versicolor. Fifty PV patients were randomly allocated into two equal groups applying either topical clotrimazol or tacrolimus twice daily for 3 weeks. They were evaluated at the beginning of study, in the third and fifth weeks clinically and mycologically (direct smear). Although both treatments resulted in global, clinical, and mycological cure of PV, there was no significant difference regarding the mentioned aspects of cure between tacrolimus and clotrimazole treated patients. (P-value: .63, .45, and .26, respectively) Tacrolimus had no significant effect on hypopigmentation in the fifth week follow-up. (P-value: .62). In spite of the lack of efficacy of tacrolimus on PV-induced hypopigmentation, the therapeutic effect on PV introduces tacrolimus as a therapeutic option for PV, especially when early vitiligo is among the differential diagnoses without concerning the aggravating effect of topical corticosteroids on PV. © 2017 Blackwell Verlag GmbH.

  4. A Comparative Evaluation of Low-Level Laser and Topical Steroid Therapies for the Treatment of Erosive-Atrophic Lichen Planus

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    Hanaa M. Elshenawy

    2015-08-01

    Full Text Available BACKGROUND: Oral lichen planus (OLP is a chronic inflammatory disease that causes bilateral white striations, papules, or plaques on the buccal mucosa, tongue, and gingivae. Erythema, erosions, and blisters may or may not be present. Several empirical therapies have been used in the treatment of (OLP. OBJECTIVE: To evaluate the effect of low level laser therapy (LLLT versus topical steroids for the treatment of erosive-atrophic lichen planus. SUBJECTS AND METHODS: Twenty-four patients with erosive-atrophic (OLP were categorized into two groups. In the first group patients were treated with 970nm diode laser irradiation, while, in the second group patients used topical corticosteroids (0.1% triamcinolone acetonide orabase. The gender, medical history and pain score were recorded. The pain score was measured before and after treatment by visual analogue scale (VAS. RESULTS: Steroid-treated group (0.1% triamcinolone acetonide orabase show reduced pain score than laser group. CONCLUSION: Topical steroids are more effective than LLLT. LLLT may be used as an alternative treatment for symptomatic OLP when steroids are contraindicated.

  5. Topical photodynamic therapy with methylaminolevulinate for the treatment of actinic keratosis and reduction of photodamage in organ transplant recipients: A case-series of 16 patients

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    Ariel Hasson

    2012-01-01

    Full Text Available Background: Organ transplant recipients (OTR are at high risk of developing cutaneous neoplasms. Topical photodynamic therapy (PDT has been used for the treatment of actinic keratosis (AK in OTR. Aims: The objective was to evaluate the efficacy of PDT with methylaminolevulinate (MAL in the treatment of facial AK in OTR. As a secondary objective, we wanted to evaluate the usefulness of topical PDT in the reduction of photodamage in OTR. Methods: A prospective, single center, single arm study was made. 16 OTR were included. Topical PDT was applied for 1 or 2 cycles depending on the patient′s characteristics. An evaluation of AK was made at visits pre-treatment, at 12 weeks and at 24 weeks. Photodamage was measured with multispectral image technique (SkinCare®. Results: A complete response rate of 100% was achieved for AK in all patients; it persisted without change at 12 and 24 weeks of follow-up. 62.5% of patients improved their photodamage as measured by SkinCare®, but this result was not statistically significant (P = 0.12. All patients had high level of satisfaction at the end of the therapy. Conclusions: MAL-PDT is an effective therapy for the treatment of AK in OTRs. It can reduce photodamage in this group of patients, but these results were not statistically significant.

  6. A mucoadhesive polymer extracted from tamarind seed improves the intraocular penetration and efficacy of rufloxacin in topical treatment of experimental bacterial keratitis.

    Science.gov (United States)

    Ghelardi, Emilia; Tavanti, Arianna; Davini, Paola; Celandroni, Francesco; Salvetti, Sara; Parisio, Eva; Boldrini, Enrico; Senesi, Sonia; Campa, Mario

    2004-09-01

    Bacterial keratitis is a serious infectious ocular disease requiring prompt treatment to prevent frequent and severe visual disabilities. Standard treatment of bacterial keratitis includes topical administration of concentrated antibiotic solutions repeated at frequent intervals in order to reach sufficiently high drug levels in the corneal tissue to inhibit bacterial growth. However, this regimen has been associated with toxicity to the corneal epithelium and requires patient hospitalization. In the present study, a mucoadhesive polymer extracted from tamarind seeds was used for ocular delivery of 0.3% rufloxacin in the treatment of experimental Pseudomonas aeruginosa and Staphylococcus aureus keratitis in rabbits. The polysaccharide significantly increased the intra-aqueous penetration of rufloxacin in both infected and uninfected eyes. Rufloxacin delivered by the polysaccharide reduced P. aeruginosa and S. aureus in the cornea at a higher rate than that obtained by rufloxacin alone. In particular, use of the polysaccharide allowed a substantial reduction of S. aureus in the cornea to be achieved even when the time interval between drug administrations was extended. These results suggest that the tamarind seed polysaccharide prolongs the precorneal residence times of antibiotics and enhances drug accumulation in the cornea, probably by reducing the washout of topically administered drugs. The tamarind seed polysaccharide appears to be a promising candidate as a vehicle for the topical treatment of bacterial keratitis.

  7. Topical anesthesia

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    Mritunjay Kumar

    2015-01-01

    Full Text Available Topical anesthetics are being widely used in numerous medical and surgical sub-specialties such as anesthesia, ophthalmology, otorhinolaryngology, dentistry, urology, and aesthetic surgery. They cause superficial loss of pain sensation after direct application. Their delivery and effectiveness can be enhanced by using free bases; by increasing the drug concentration, lowering the melting point; by using physical and chemical permeation enhancers and lipid delivery vesicles. Various topical anesthetic agents available for use are eutectic mixture of local anesthetics, ELA-max, lidocaine, epinephrine, tetracaine, bupivanor, 4% tetracaine, benzocaine, proparacaine, Betacaine-LA, topicaine, lidoderm, S-caine patch™ and local anesthetic peel. While using them, careful attention must be paid to their pharmacology, area and duration of application, age and weight of the patients and possible side-effects.

  8. Topical application of trichloroacetic acid is efficacious for the treatment of internal anal high-grade squamous intraepithelial lesions in HIV-positive men.

    Science.gov (United States)

    Cranston, Ross D; Baker, Jonathan R; Liu, Yimeng; Wang, Lu; Elishaev, Esther; Ho, Ken S

    2014-07-01

    To assess the efficacy of topical 80% trichloroacetic acid (TCA) to treat internal anal high-grade squamous intraepithelial lesions (HSILs) in HIV-positive individuals. All patients who attended the University of Pittsburgh Anal Dysplasia Clinic for treatment of biopsy-proven internal anal HSIL with topical TCA between July 1, 2009, and June 30, 2012, and who had 1 or more follow-up visits to assess treatment efficacy were included in the analysis. Recurrence of HSIL was assessed in July 1, 2013. A total of 98 HSILs from 72 patients were treated, and 77 (78.6%) resolved to normal epithelium or low-grade SIL during follow-up. Forty-eight (49.0%) and 27 (27.6%) of lesions resolved with 1 and 2 TCA treatments, respectively, whereas 1 lesion (1%) each resolved with 3 and 4 TCA treatments. Twenty-one (21.4%) lesions in 20 patients remained without resolution after TCA treatments. These patients were offered an alternative treatment. During follow-up, 8 (15.1%) of 53 patients had a lesion that recurred at the index site (11/53 [20.8%], inclusive of adjacent lesions) and 17 patients had new lesions diagnosed. Topical TCA is an efficacious treatment of internal anal HSIL in an anal dysplasia clinic setting with high-resolution anoscopy capacity. Advantages of TCA for this recurrent disease process include the following: low cost, no requirement for special equipment beyond that for high-resolution anoscopy, and painless application procedure. A larger prospective comparative study would better define efficacy and patient acceptability between treatment methods.

  9. Tolerability of NGX-4010, a capsaicin 8% patch, in conjunction with three topical anesthetic formulations for the treatment of neuropathic pain

    Science.gov (United States)

    Webster, Lynn R; Peppin, John F; Murphy, Frederick T; Tobias, Jeffrey K; Vanhove, Geertrui F

    2012-01-01

    Background The objective of this study was to assess the safety, tolerability, and preliminary efficacy of NGX-4010, a capsaicin 8% patch, following pretreatment with three different topical anesthetics in patients with peripheral neuropathic pain. Methods This open-label, multicenter study enrolled 117 patients with post-herpetic neuralgia, HIV-associated distal sensory polyneuropathy, or painful diabetic neuropathy. Patients received pretreatment with one of three lidocaine 4%-based topical anesthetics (L.M.X.4® [Ferndale Laboratories Inc, Ferndale, MI], Topicaine® Gel [Estela Basso, Jupiter, FL], or Betacaine Enhanced Gel 4 [Tiberius Inc, Tampa, FL]) for 60 minutes followed by a single 60- or 90-minute NGX-4010 application, and were followed for 12 weeks. Tolerability and safety measures included “pain now” Numeric Pain Rating Scale (NPRS) scores, dermal assessments, medication use for treatment-related pain, adverse events (AEs), clinical laboratory parameters, physical examinations, and vital signs. The primary efficacy variable was the percentage change in mean NPRS scores for “average pain for the past 24 hours” from baseline to weeks 2 through 12. Results Treatment with NGX-4010 following pretreatment with any of the three topical anesthetics was generally safe and well tolerated. Nearly all patients completed ≥90% of the planned NGX-4010 application duration. The most common treatment-related AEs, application-site burning and application-site pain, were transient, mostly mild or moderate, and could be adequately managed by local cooling or short-acting oral opioid analgesics. Although slightly more patients used medication for treatment-related discomfort following pretreatment with Topicaine compared with L.M.X.4 or Betacaine, there were no statistical differences between the topical anesthetics. Neuropathic pain reduction from baseline to weeks 2 through 12 was approximately 30% and was similar among the topical anesthetics; the proportion of

  10. Comparison of the efficacy and tolerability of topical levocabastine and sodium cromoglycate in the treatment of seasonal allergic rhinoconjunctivitis in children.

    Science.gov (United States)

    Vermeulen, J; Mercer, M

    1994-11-01

    Children (n = 110) with seasonal allergic rhinoconjunctivitis were randomized to receive either twice daily 0.05% levocabastine eye drops and nasal spray plus twice daily topical placebos or 2% sodium cromoglycate eye drops and nasal spray four times daily for a period of 4 weeks. Patients were required to use the nasal sprays as directed and the eye drops only when required. The results obtained suggest that topical levocabastine is at least as effective as sodium cromoglycate for the treatment of this condition. After 2 weeks treatment the effect of therapy on nasal symptoms was considered to be excellent or good in 72% of levocabastine-treated patients and 54% of patients on sodium cromoglycate (p = 0.009), with corresponding values for ocular symptoms of 81% and 57% in the two groups, respectively (p sodium cromoglycate with intergroup differences attaining statistical significance in favor of the topical antihistamine for nasal congestion (p < 0.05). Both agents were well-tolerated with no significant differences in the incidence or type of adverse reactions in the two treatment groups.

  11. Topical administration of isoflavones for treatment of vaginal symptoms in postmenopausal women: A systematic review of randomised controlled trials.

    Science.gov (United States)

    Ghazanfarpour, M; Latifnejad Roudsari, R; Treglia, G; Sadeghi, R

    2015-01-01

    Current systematic review evaluated the efficacy of topical isoflavones to relieve vaginal symptoms in menopausal women. MEDLINE (1966 to January 2014), Scopus (1990 to January 2014), and the Cochrane Central Register of Controlled Trials (The Cochrane Library issue 1, 2013) were searched using keywords 'isoflavone and vagina'. Relevant studies were reviewed by two independent reviewers. Only randomised controlled trials (RCTs) were included in the systematic review. Out of 115 potentially relevant publications, four studies met the inclusion criteria. Topical isoflavones showed beneficial effects on dyspareunia, vaginal dryness and maturation value. Based on only one trial, the result of conjugated equine oestrogen cream (0.3 mg/day) was similar to use of isoflavone vaginal gel and superior to that of placebo gel. However, drawing any definite conclusion was difficult because of the limited number of RCTs, the small sample sizes, weak methodology and considerable heterogeneity of the included studies.

  12. Comparison of Emla cream and topical lidocaine tape for pain relief of V-beam laser treatment.

    Science.gov (United States)

    Horikiri, Masaru; Ueda, Kazuki; Sakaba, Takao

    2017-06-23

    The authors compared the analgesic effects of two topical applications; Emla(®) cream (Sato Pharmaceutical Co. Ltd., Tokyo, Japan) and 60% lidocaine tape (Penles(®) tape; Maruho, Osaka, Japan). The authors examined 20 outpatients with capillary malformations. Emla(®) cream or Penles(®) tape was applied 1 h before laser irradiation using V-Beam. After V-Beam irradiation, pain intensity was measured using Pain Vision(®) (NIPRO, Osaka, Japan), while subjective pain was converted into numerical values using the VAS system. In the assessment using Pain Vision(®), pain was significantly lower in patients who received Emla(®) cream (Welch test), whereas no difference was observed in VAS ratings between the two applications (student's t test). The objective system showed that Emla(®) cream had a significantly greater analgesic effect. We plan to evaluate the analgesic effects of these topical anesthetics by applying them to other anatomical areas.

  13. Long-pulsed Nd:YAG laser in the treatment of facial hypertrichosis during topical minoxidil therapy.

    Science.gov (United States)

    Benmously Mlika, Rym; Ben Hamida, Myriam; Hammami, Houda; Dorbani Ben Thabet, Imen; Rouatbi, Mondher; Mokhtar, Inçaf

    2013-08-01

    Hypertrichosis is a well-recognized adverse effect of therapy with either oral or topical minoxidil. We report a case of fronto-temporal hypertrichosis occurring in an 8-year-old girl treated for patchy alopecia areata of the frontal area of the scalp with 2% minoxidil solution. After failure of 5-months minoxidil-discontinuation, hair removal with Nd:YAG laser (1064 nm line) (Smartepil II, Deka) was tested leading to complete resolution within 2 sessions.

  14. The topical treatment of anthroponotic cutaneous leishmaniasis with the tincture of thioxolone plus benzoxonium chloride (Thio-Ben) along with cryotherapy: a single-blind randomized clinical trial.

    Science.gov (United States)

    Daie Parizi, Mohammad Hossein; Karvar, Mehran; Sharifi, Iraj; Bahrampour, Abbas; Heshmat Khah, Amireh; Rahnama, Zahra; Baziar, Zahra; Amiri, Rezvan

    2015-01-01

    A simple efficacious topical treatment for cutaneous leishmaniasis (CL) is still an unresolved challenge. This study aimed to evaluate the efficacy of the topical use of thioxolone plus benzoxonium chloride (Thio-Ben) tincture in combination with cryotherapy in comparison with intralesional meglumine antimoniate (Glucantime) along with cryotherapy in treating anthroponotic CL (ACL). The study was conducted in Leishmaniasis Center in Dadbin Health Care Clinic, Kerman, Iran. Sixty-four CL lesions were randomly assigned to receive Thio-Ben plus cryotherapy (TC) (n = 32) or Glucantime plus cryotherapy (GC) (n = 32). Thio-Ben was used topically every other day and Glucantime was used intralesionally once a week for a maximum of 3 months. In both study groups, cryotherapy was administered using liquid nitrogen once every 2 weeks. Of 64 recruited lesions, 47 lesions completed the study protocol. Twenty lesions (91%) in TC group and 23 lesions (92%) in GC group showed complete cure. TC group showed faster clinical response. Pain, hypersensitivity reaction, dizziness, and nausea were only seen in GC group. This study showed that the topical use of Thio-Ben combined with cryotherapy has a good efficacy in treating ACL with the benefit that Thio-Ben has more patient compliance and less side effects than intralesional Glucantime.

  15. Topology, divergence dates, and macroevolutionary inferences vary between different tip-dating approaches applied to fossil theropods (Dinosauria).

    Science.gov (United States)

    Bapst, D W; Wright, A M; Matzke, N J; Lloyd, G T

    2016-07-01

    Dated phylogenies of fossil taxa allow palaeobiologists to estimate the timing of major divergences and placement of extinct lineages, and to test macroevolutionary hypotheses. Recently developed Bayesian 'tip-dating' methods simultaneously infer and date the branching relationships among fossil taxa, and infer putative ancestral relationships. Using a previously published dataset for extinct theropod dinosaurs, we contrast the dated relationships inferred by several tip-dating approaches and evaluate potential downstream effects on phylogenetic comparative methods. We also compare tip-dating analyses to maximum-parsimony trees time-scaled via alternative a posteriori approaches including via the probabilistic cal3 method. Among tip-dating analyses, we find opposing but strongly supported relationships, despite similarity in inferred ancestors. Overall, tip-dating methods infer divergence dates often millions (or tens of millions) of years older than the earliest stratigraphic appearance of that clade. Model-comparison analyses of the pattern of body-size evolution found that the support for evolutionary mode can vary across and between tree samples from cal3 and tip-dating approaches. These differences suggest that model and software choice in dating analyses can have a substantial impact on the dated phylogenies obtained and broader evolutionary inferences.

  16. Macroevolutionary assembly of ant/plant symbioses: Pseudomyrmex ants and their ant-housing plants in the Neotropics.

    Science.gov (United States)

    Chomicki, Guillaume; Ward, Philip S; Renner, Susanne S

    2015-11-22

    Symbioses include some of the clearest cases of coevolution, but their origin, loss or reassembly with different partners can rarely be inferred. Here we use ant/plant symbioses involving three plant clades to investigate the evolution of symbioses. We generated phylogenies for the big-eyed arboreal ants (Pseudomyrmecinae), including 72% of their 286 species, as well as for five of their plant host groups, in each case sampling more than 61% of the species. We show that the ant-housing Vachellia (Mimosoideae) clade and its ants co-diversified for the past 5 Ma, with some species additionally colonized by younger plant-nesting ant species, some parasitic. An apparent co-radiation of ants and Tachigali (Caesalpinioideae) was followed by waves of colonization by the same ant clade, and subsequent occupation by a younger ant group. Wide crown and stem age differences between the ant-housing genus Triplaris (Polygonaceae) and its obligate ant inhabitants, and stochastic trait mapping, indicate that its domatium evolved earlier than the ants now occupying it, suggesting previous symbioses that dissolved. Parasitic ant species evolved from generalists, not from mutualists, and are younger than the mutualistic systems they parasitize. Our study illuminates the macroevolutionary assembly of ant/plant symbioses, which has been highly dynamic, even in very specialized systems. © 2015 The Author(s).

  17. Assessment of β-lapachone loaded in lecithin-chitosan nanoparticles for the topical treatment of cutaneous leishmaniasis in L. major infected BALB/c mice.

    Science.gov (United States)

    Moreno, Esther; Schwartz, Juana; Larrea, Esther; Conde, Iosune; Font, Maria; Sanmartín, Carmen; Irache, Juan Manuel; Espuelas, Socorro

    2015-11-01

    Patients affected by cutaneous leishmaniasis need a topical treatment which cures lesions without leaving scars. Lesions are produced not only by the parasite but also by an uncontrolled and persistent inflammatory immune response. In this study, we proposed the loading of β-lapachone (β-LP) in lecithin-chitosan nanoparticles (NP) for targeting the drug to the dermis, where infected macrophages reside, and promote wound healing. Although the loading of β-LP in NP did not influence the drug antileishmanial activity it was critical to achieve important drug accumulation in the dermis and permeation through the skin. When topically applied in Leishmania major infected BALB/c mice, β-LP NP achieved no parasite reduction but they stopped the lesion progression. Immuno-histopathological assays in CL lesions and quantitative mRNA studies in draining lymph nodes confirmed that β-LP exhibited anti-inflammatory activity leading to the down-regulation of IL-1β and COX-2 expression and a decrease of neutrophils infiltrate. Cutaneous leishmaniasis often leaves patients with unsightly scars due to the body's inflammatory response to the infection. The authors in this paper described topical treatment using β-lapachone (β- LP) loaded in lecithin-chitosan nanoparticles (NP) in an animal model. Results confirmed the reduction of inflammatory response without affecting the parasite killing efficacy. These findings would pave way for further clinical testing in the near future. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Topical rapamycin as a treatment for fibrofolliculomas in Birt-Hogg-Dube syndrome: a double-blind placebo-controlled randomized split-face trial.

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    Lieke M C Gijezen

    Full Text Available BACKGROUND: Birt-Hogg-Dubé syndrome (BHD is a rare autosomal dominant disorder characterised by the occurrence of benign, mostly facial, skin tumours called fibrofolliculomas, multiple lung cysts, spontaneous pneumothorax and an increased renal cancer risk. Current treatments for fibrofolliculomas have high rates of recurrence and carry a risk of complications. It would be desirable to have a treatment that could prevent fibrofolliculomas from growing. Animal models of BHD have previously shown deregulation of mammalian target of rapamycin (mTOR. Topical use of the mTOR inhibitor rapamycin is an effective treatment for the skin tumours (angiofibromas in tuberous sclerosis complex, which is also characterised by mTOR deregulation. In this study we aimed to determine if topical rapamycin is also an effective treatment for fibrofolliculomas in BHD. METHODS: We performed a double blinded, randomised, facial left-right controlled trial of topical rapamycin 0.1% versus placebo in 19 BHD patients. Trial duration was 6 months. The primary outcome was cosmetic improvement as measured by doctors and patients. Changes in fibrofolliculoma number and size were also measured, as was occurrence of side effects. RESULTS: No change in cosmetic status of fibrofolliculomas was reported in the majority of cases for the rapamycin treated (79% by doctors, 53% by patients as well as the placebo treated facial sides (both 74%. No significant differences between rapamycin and placebo treated facial halves were observed (p = 1.000 for doctors opinion, p = 0.344 for patients opinion. No significant difference in fibrofolliculoma number or change in size of the fibrofolliculomas was seen after 6 months. Side effects occurred more often after rapamycin treatment (68% of patients than after placebo (58% of patients; p = 0.625. A burning sensation, erythema, itching and dryness were most frequently reported. CONCLUSIONS: This study provides no evidence that

  19. A Clinical Study of Melasma and a Comparison of the Therapeutic Effect of Certain Currently Available Topical Modalities for its Treatment

    Science.gov (United States)

    Sardesai, Vidyadhar R; Kolte, Jennifer N; Srinivas, Babu N

    2013-01-01

    Background: Melasma is a common acquired facial hypermelanosis. Conventional treatment of melasma includes a sunscreen and hypopigmenting agents. The treatment of this recalcitrant disorder is often difficult and unsatisfactory. Aims: The objective is to carry out a detailed clinical study of melasma and to assess the therapeutic effect and side effects of certain currently available topical modalities for the treatment of melasma. Materials and Methods: 160 patients of all age groups and both sexes were treated sequentially with five different combination regimes for 3 months. Assessment of the response was done subjectively as well as by melasma area and severity index (MASI). Results: Out of the five modalities studied, the modified Kligman's formula was the most effective. However, it had comparatively higher incidence of side effects. Conclusions: Among the currently available topical modalities for the treatment of melasma, the most effective combination is the modified Kligman's formula. However, in view of the side effects it causes, it must be used with caution and proper counseling. PMID:23723484

  20. A clinical study of melasma and a comparison of the therapeutic effect of certain currently available topical modalities for its treatment

    Directory of Open Access Journals (Sweden)

    Vidyadhar R Sardesai

    2013-01-01

    Full Text Available Background: Melasma is a common acquired facial hypermelanosis. Conventional treatment of melasma includes a sunscreen and hypopigmenting agents. The treatment of this recalcitrant disorder is often difficult and unsatisfactory. Aims: The objective is to carry out a detailed clinical study of melasma and to assess the therapeutic effect and side effects of certain currently available topical modalities for the treatment of melasma. Materials and Methods: 160 patients of all age groups and both sexes were treated sequentially with five different combination regimes for 3 months. Assessment of the response was done subjectively as well as by melasma area and severity index (MASI. Results: Out of the five modalities studied, the modified Kligman′s formula was the most effective. However, it had comparatively higher incidence of side effects. Conclusions: Among the currently available topical modalities for the treatment of melasma, the most effective combination is the modified Kligman′s formula. However, in view of the side effects it causes, it must be used with caution and proper counseling.

  1. Topical Steroids and CO2 Laser in the Treatment of Refractory Oral Lichenoid Drug Reaction and Lichenoid Contact Lesion: a Case Report.

    Science.gov (United States)

    Thongprasom, Kobkan; Sessririsombat, Somchai; Singkharotai, Kanjana; Vathanasanti, Achara; Subbalek, Keskanya

    2014-09-01

    A 54-year-old female presented with severe pain on the gingiva and buccal mucosa. Oral findings revealed generalized fiery red gingiva, ulcerative with white striae covered by pseudo-membranes on both buccal mucosae. She had hypertension, dyslipidemia, subclinical hypothyroidism and arthritis. She was treated with atorvastatin, hydrochlorothiazide, valsartan, levothyroxine and non-steroidal anti-inflammatory drug (NSAIDs). Her oral lesions were a slight improvement from a previous treatment with pimecrolimus cream, triamcinolone acetonide 0.1% orabase and injection. After diclofenac was replaced with tenoxicam and oral lesions were treated with various topical steroids, the lesions showed marked improvement. The biopsy from the buccal mucosa revealed oral lichen planus. Patch test showed positivity to mercury, gold sodium thiosulfate and palladium. One year later the left buccal mucosa showed red, round papillomatous-like lesions. The histopathological report showed a non-specific ulcer with chronic inflammation. The lesions flared up after replacing amalgam with crowns. After CO2 laser treatment, the lesions showed some improvement. Direct and indirect immunofluorescence of the lesions proved to be negative. This first case report showed that the palliative treatment of refractory oral lichenoid lesions with potent topical steroids for 7 years had no side-effects. CO2 laser can be an alternative treatment of refractory lesion in this case.

  2. Enhancement of physicochemical properties of nanocolloidal carrier loaded with cyclosporine for topical treatment of psoriasis: in vitro diffusion and in vivo hydrating action

    Science.gov (United States)

    Musa, Siti Hajar; Basri, Mahiran; Fard Masoumi, Hamid Reza; Shamsudin, Norashikin; Salim, Norazlinaliza

    2017-01-01

    Psoriasis is a chronic autoimmune disease that cannot be cured. It can however be controlled by various forms of treatment, including topical, systemic agents, and phototherapy. Topical treatment is the first-line treatment and favored by most physicians, as this form of therapy has more patient compliance. Introducing a nanoemulsion for transporting cyclosporine as an anti-inflammatory drug to an itchy site of skin disease would enhance the effectiveness of topical treatment for psoriasis. The addition of nutmeg and virgin coconut-oil mixture, with their unique properties, could improve cyclosporine loading and solubility. A high-shear homogenizer was used in formulating a cyclosporine-loaded nanoemulsion. A D-optimal mixture experimental design was used in the optimization of nanoemulsion compositions, in order to understand the relationships behind the effect of independent variables (oil, surfactant, xanthan gum, and water content) on physicochemical response (particle size and polydispersity index) and rheological response (viscosity and k-value). Investigation of these variables suggests two optimized formulations with specific oil (15% and 20%), surfactant (15%), xanthan gum (0.75%), and water content (67.55% and 62.55%), which possessed intended responses and good stability against separation over 3 months’ storage at different temperatures. Optimized nanoemulsions of pH 4.5 were further studied with all types of stability analysis: physical stability, coalescence-rate analysis, Ostwald ripening, and freeze–thaw cycles. In vitro release proved the efficacy of nanosize emulsions in carrying cyclosporine across rat skin and a synthetic membrane that best fit the Korsmeyer–Peppas kinetic model. In vivo skin analysis towards healthy volunteers showed a significant improvement in the stratum corneum in skin hydration. PMID:28405165

  3. Enhancement of physicochemical properties of nanocolloidal carrier loaded with cyclosporine for topical treatment of psoriasis: in vitro diffusion and in vivo hydrating action.

    Science.gov (United States)

    Musa, Siti Hajar; Basri, Mahiran; Fard Masoumi, Hamid Reza; Shamsudin, Norashikin; Salim, Norazlinaliza

    2017-01-01

    Psoriasis is a chronic autoimmune disease that cannot be cured. It can however be controlled by various forms of treatment, including topical, systemic agents, and phototherapy. Topical treatment is the first-line treatment and favored by most physicians, as this form of therapy has more patient compliance. Introducing a nanoemulsion for transporting cyclosporine as an anti-inflammatory drug to an itchy site of skin disease would enhance the effectiveness of topical treatment for psoriasis. The addition of nutmeg and virgin coconut-oil mixture, with their unique properties, could improve cyclosporine loading and solubility. A high-shear homogenizer was used in formulating a cyclosporine-loaded nanoemulsion. A D-optimal mixture experimental design was used in the optimization of nanoemulsion compositions, in order to understand the relationships behind the effect of independent variables (oil, surfactant, xanthan gum, and water content) on physicochemical response (particle size and polydispersity index) and rheological response (viscosity and k-value). Investigation of these variables suggests two optimized formulations with specific oil (15% and 20%), surfactant (15%), xanthan gum (0.75%), and water content (67.55% and 62.55%), which possessed intended responses and good stability against separation over 3 months' storage at different temperatures. Optimized nanoemulsions of pH 4.5 were further studied with all types of stability analysis: physical stability, coalescence-rate analysis, Ostwald ripening, and freeze-thaw cycles. In vitro release proved the efficacy of nanosize emulsions in carrying cyclosporine across rat skin and a synthetic membrane that best fit the Korsmeyer-Peppas kinetic model. In vivo skin analysis towards healthy volunteers showed a significant improvement in the stratum corneum in skin hydration.

  4. Clinical, Microbiological and Radiologic evaluation of topical use of Co-Amoxiclav 25% dental gel in the treatment of adult periodontitis

    Directory of Open Access Journals (Sweden)

    Samaneh Masoumi

    2016-06-01

    Full Text Available The aim of this study was to compare the effect of the topical application of co-amoxiclav gel with placebo in the treatment of adult periodontitis by conducting clinical, microbiological and radiologic measurements. A randomized double-blind placebo-controlled clinical trial design was employed. Subjects were12 patients with adult periodontitis divided into two control and experimental groups both initially received subgingivalscaling and root planning therapy.Clinical, microbiological andradiologic examinations were carried out before treatment and on days 15, 45, and 90 after gel treatment in the experimental group. Radiographic analysis was performed using Trophy radiovisiography (RVG system determining bone density and bone loss in the study sites. Paired-t test, Wilcoxon matched-pairs test, and binominal test were used for statistical analysis. The statistical analyses showed that both treatments were effective in reducing PPD and BOP over the 3-month period.At the end of follow-up period, the mean reduction in PPD and BOP were1.71 mm and 54.83%, respectively.The increase in mean of alveolar bone crest density (38.16mm was statistically significant in gel treatment (p<0.03 but it was not significant in placebo group. There was a significant difference between the two treatments with respect to the reduction inproportions of anaerobic gram-negative bacilli during 0-15 and 0-90 day periods. It was concluded that the useof a topically appliedco-amoxciclav 25% gel seems to be effective as aconventionalmechanical therapy in the treatment of adult periodontitis

  5. Comparative efficacy on dogs of a single topical treatment with the pioneer fipronil/(S-methoprene and an oral treatment with spinosad against Ctenocephalides felis

    Directory of Open Access Journals (Sweden)

    Beugnet F.

    2011-11-01

    Full Text Available In the study reported here, the pioneer fipronil/(S-methoprene topical product (FRONTLINE® PLUS, Merial Limited, Duluth, GA was compared to the oral spinosad product (COMFORTIS® Elanco, Greenfield, IN for efficacy against adult fleas and preventing egg production. The product presentations, doses and labelling were the one applicable in the USA. Using a standard protocol, 200 cat fleas of mixed sex were applied to dogs on Days 1, 7, 14, 21, 28, 35, and 42. Dogs were combed to remove fleas 24 hours post-infestation, the fleas were counted, collected, and then reapplied to each dog following completion of their respective count. At 48 hours post-infestation, comb counts were performed and fleas were removed. No fleas were collected from any dog in the fipronil/(S-methoprene group at any 24 or 48 hours post-infestation assessment throughout the six weeks study, yielding a preventive efficacy of 100%. For the spinosad treatment, efficacy was 100% at 24 hours and 48 hours through Day 16, and thereafter declined. The results observed in the spinosad-treated dogs were highly variable between animals. At the 24 and 48 hours counts following the Day 21 infestation, only five of eight spinosad-treated dogs (62.5% were flea-free. Following the Day 28 infestation, spinosad efficacy fell to 85% and 89%, for the 24 hours and 48 hours counts, and only two dogs (25% were flea free, compared to 100% flea-free dogs in the fipronil/(S-methoprene group. No fleas were collected from the fipronil/(S- methoprene treated dogs throughout the entire study, therefore, no eggs were collected at any time from any dog in the group. However, in the spinosad group adult fleas were found on dogs starting on Day 21 and by Day 30, 42 eggs were collected from one dog that had 107 adult fleas counted at 48 hours. At Day 37 and Day 49, more than 100 eggs were collected from each dog in the spinosad-treated and control groups.

  6. Becaplermin Topical

    Science.gov (United States)

    ... the use of special shoes, walkers, crutches, or wheelchairs to keep weight off the ulcer; and treatment ... to the ulcer. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist ...

  7. Efinaconazole Topical

    Science.gov (United States)

    ... a pedicure or apply nail polish or other cosmetic nail products to your toenails during your treatment ... as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this ...

  8. topics revised

    African Journals Online (AJOL)

    Chantel

    Efficient management and treat- ment of episodes .... Note: Over-treatment with atropine may induce atropine poisoning. Biperiden ... dminister appropriate quantities of calcium gluconate. To ... -hour allergy tablets are not recommended.

  9. Influence of the treatment protocol upon the in vivo efficacy of cidofovir (HPMPC) and of acyclovir (ACV) formulations in topical treatment of cutaneous HSV-1 infection in hairless mice.

    Science.gov (United States)

    Afouna, M I; Mehta, S C; Ghanem, A H; Higuchi, W I; Kern, E R; DeClercq, E; El-Shattawy, H H

    1999-05-01

    In recent studies we found that the topical effectiveness of acyclovir (ACV) formulations was a single-valued function of C-the target site free drug concentration. The topical efficacy was the same when the therapy was initiated 0, 1, or 2 days after intracutaneous herpes simplex virus type-1 (HSV-1) inoculation in hairless mice. The purpose of the present study was to examine the hypothesis that the topical effectiveness of cidofovir (HPMPC) would not be a single valued function of C and that it would be dependent upon when the therapy was initiated relative to the time of viral infection. Formulations of HPMPC and ACV in 95% DMSO as a vehicle were used. Hairless mice intracutaneously infected with HSV-1 were used, and 20 microL of the test formulation was topically applied twice a day. In protocol A, the treatment was continued until the fourth day after virus inoculation, whereas in protocol B the treatment was terminated on the day of virus inoculation. Treatment was initiated on various days ranging from day -6 to day 4, and the lesions were scored on day 5. Treatment of ACV according to protocol A proved efficacious whether started as early as 6 days before virus inoculation or later, whereas the efficacy of ACV was annihilated if applied following protocol B. For HPMPC, on the other hand, the in vivo efficacies were found to be strongly dependent on how early the therapy was initiated, and significant efficacy was observed even when the treatment was terminated on the day of virus inoculation. This difference was attributed to the virus-independent intracellular phosphorylation of HPMPC and slow clearance of its metabolites from the cell. It was also noted that, similar to ACV, for HPMPC the topical efficacy is likely to be a function of C for a fixed protocol. However, unlike for ACV, for HPMPC the efficacy was not a single-valued function of C.

  10. Isolated and combined effects of photobiomodulation therapy, topical nonsteroidal anti-inflammatory drugs, and physical activity in the treatment of osteoarthritis induced by papain

    Science.gov (United States)

    Tomazoni, Shaiane Silva; Leal-Junior, Ernesto Cesar Pinto; Frigo, Lúcio; Pallotta, Rodney Capp; Teixeira, Simone; de Almeida, Patricia; Bjordal, Jan Magnus; Lopes-Martins, Rodrigo Álvaro Brandão

    2016-10-01

    Osteoarthritis (OA) is a chronic inflammatory disease and is characterized as a degenerative process. This study aimed to evaluate and compare the effects of a topical nonsteroidal anti-inflammatory drug (NSAID), physical activity, and photobiomodulation therapy (PBMT) applied alone and/or in combination between them in an experimental model of knee OA. OA was induced by injection of papain in the knees of rats. After 21 days, the animals started to be treated with the above treatment. Histological analysis shows that the experimental model of OA induction causes morphological changes consistent with the disease, and among treatments, the PBMT is the most effective for reducing these changes. Moreover, the results demonstrate that PBMT and NSAID reduce the total number of cells in the inflammatory infiltrate (peffective for reducing the activity of myeloperoxidase (peffective for reducing the gene expression of MMP-3 (peffective treatment (peffective therapy in stopping disease progression, and improving inflammatory conditions observed in OA.

  11. The Evaluation of Efficacy and Safety of Topical Saw Palmetto and Trichogen Veg Complex for the Treatment of Androgenetic Alopecia in Men

    Directory of Open Access Journals (Sweden)

    Ercan Arca

    2014-12-01

    Full Text Available Objective: Androgenetic alopecia (AGA is a special type, characterized with the follicular miniaturization of the frontal and parietal areas of scalp. In this study, we intended to evaluate the efficacy and safety of a hair lotion including saw palmetto and 10% trichogen veg complex (TVC within male patients with AGA. Methods: Male patients, who treated with topical saw palmetto and TVC for four months between 2011-2012 were included to our study. Among the patient files, records of 25 patient were accepted available and taken into consideration according to the vertex photographs and tricoscan evaluations. Derived data were analyzed with SPSS program. Results: Total hair count was increased 11.9% compared with the pretreatment period. The final ratio of anagen/telogen hair was compared with the initials and the increase in ratio was 38%. According to the evaluation of vertex photographs, the observers declared that enhancement was noted in 48% of the patients and no difference was not noted in 36% of the patients. Conclusion: At the end of the study, topical saw palmetto and TVC were evaluated efficient and safe for the treatment of AGA. Randomized controlled trials among patient groups will reveal more conclusive data associated with topical saw palmetto and TVC.

  12. A randomized controlled clinical trial of topical insulin-like growth factor-1 therapy for sudden deafness refractory to systemic corticosteroid treatment.

    Science.gov (United States)

    Nakagawa, Takayuki; Kumakawa, Kozo; Usami, Shin-ichi; Hato, Naohito; Tabuchi, Keiji; Takahashi, Mariko; Fujiwara, Keizo; Sasaki, Akira; Komune, Shizuo; Sakamoto, Tatsunori; Hiraumi, Harukazu; Yamamoto, Norio; Tanaka, Shiro; Tada, Harue; Yamamoto, Michio; Yonezawa, Atsushi; Ito-Ihara, Toshiko; Ikeda, Takafumi; Shimizu, Akira; Tabata, Yasuhiko; Ito, Juichi

    2014-11-19

    To date, no therapeutic option has been established for sudden deafness refractory to systemic corticosteroids. This study aimed to examine the efficacy and safety of topical insulin-like growth factor-1 (IGF-1) therapy in comparison to intratympanic corticosteroid therapy. We randomly assigned patients with sudden deafness refractory to systemic corticosteroids to receive either gelatin hydrogels impregnated with IGF-1 in the middle ear (62 patients) or four intratympanic injections with dexamethasone (Dex; 58 patients). The primary outcome was the proportion of patients showing hearing improvement (10 decibels or greater in pure-tone average hearing thresholds) 8 weeks after treatment. The secondary outcomes included the change in pure-tone average hearing thresholds over time and the incidence of adverse events. In the IGF-1 group, 66.7% (95% confidence interval [CI], 52.9-78.6%) of the patients showed hearing improvement compared to 53.6% (95% CI, 39.7-67.0%) of the patients in the Dex group (P = 0.109). The difference in changes in pure-tone average hearing thresholds over time between the two treatments was statistically significant (P = 0.003). No serious adverse events were observed in either treatment group. Tympanic membrane perforation did not persist in any patient in the IGF-1 group, but did persist in 15.5% (95% CI, 7.3-27.4%) of the patients in the Dex group (P = 0.001). The positive effect of topical IGF-1 application on hearing levels and its favorable safety profile suggest utility for topical IGF-1 therapy in patients with sudden deafness. UMIN Clinical Trials Registry Number UMIN000004366, October 30th, 2010.

  13. Efficacy of Surgical Excision in Combination with Mitomycin C and Postoperative Topical 0.002% Mitomycin C Administration for Treatment of Conjunctival Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Özlen Rodop Özgür

    2011-08-01

    Full Text Available Purpose: To evaluate the efficacy of surgical excision in combination with mitomycin C (mit-C and postoperative topical mit-C 0.002% administration for the treatment of conjunctival intraepithelial neoplasia (CIN. Material and Method: Twelve eyes of twelve patients who were histopathologically diagnosed as CIN between March 2004 and July 2008 were evaluated retrospectively for their treatment modalities and results. All lesions were excised with wide margins in combination with mit-C 0.02% application for 2 minutes. Five of 12 eyes were treated with topical mit-C 0.002% eye drops four times a day for 14 days after histopathological confirmation. Large conjunctival defects in 5 eyes were reconstructed with amniotic membrane (3 eyes and autologous conjunctiva (2 eyes. Results: Seven patients were women and 5 were men, with a mean age of 68.37 (range: 30-94 years. The right eye was involved in 6 patients and the left one - in 6 patients. The conjunctival lesion was located on the nasal conjunctiva in 5 eyes and on the temporal one - in 7 eyes. Histopathological diagnosis was CIN in all cases. After a mean follow-up period of 41.75 months (between 10 and 62 months, one recurrence (8.3% was noted. This case with recurrent lesion has been previously treated with surgical excision in combination with mit-C 0.02% application and the large conjunctival defect has been reconstructed with amniotic membrane. Discussion: Surgical excision in combination with mit-C and use of additional postoperative topical mit-C 0.002% in selected cases for conjunctival intraepithelial treatment provides a safe and effective cure. (Turk J Ophthalmol 2011; 41: 138-42

  14. The utility of onion extract gel containing topical allantoin and heparin after surgical treatment of upper extremity burn scars

    Directory of Open Access Journals (Sweden)

    Mehmet Ihsan Okur

    2014-12-01

    Conclusion: Although no significant difference was obtained with Contractubex gel treatment in this study, cosmetic and functional success can be achieved through excision of the scar and use of medium thickness skin graft in patients with upper extremity hypertrophic burn scarring that is resistant to conservative treatments. [Hand Microsurg 2014; 3(3.000: 74-79

  15. A case report of combination treatment with potassium-titanyl phosphate laser and brimonidine topical gel in erythematotelangiectatic rosacea.

    Science.gov (United States)

    Hofmann, Maja A; Kokolakis, G

    2017-01-31

    Laser therapies have been shown to provide symptom improvement in patients with erythema and telangiectasia of rosacea; however, they are associated with side effects such as erythema. Combinatorial treatment with pharmacological agents and laser have demonstrated better efficacy, fewer side effects and continued long-term remission compared with monotherapies. A case of moderate facial erythema that responded well to combination treatment with brimonidine 3 mg/g gel and a treatment course of potassium-titanyl phosphate (KTP) laser therapy is presented, showing a reduction from baseline, maintained after final laser session, by applying brimonidine 3 mg/g gel daily. Using brimonidine 3 mg/g gel to target post-laser treatment erythema is highly effective in minimising refractory erythema. Continued use of brimonidine 3 mg/g gel provides a sustained reduction of erythema, increasing the visibility of other signs and symptoms of rosacea that may be present. This can facilitate the treatment of these additional signs and symptoms.

  16. A randomized trial comparing combination electron-beam radiation and chemotherapy with topical therapy in the initial treatment of mycosis fungoides

    Energy Technology Data Exchange (ETDEWEB)

    Kaye, F.J.; Bunn, P.A. Jr.; Steinberg, S.M.; Stocker, J.L.; Ihde, D.C.; Fischmann, A.B.; Glatstein, E.J.; Schechter, G.P.; Phelps, R.M.; Foss, F.M.; (National Cancer Institute-Navy Medical Oncology Branch, Bethesda, MD (USA))

    1989-12-28

    Mycosis fungoides is a T-cell lymphoma that arises in the skin and progresses at highly variable rates. Nonradomized studies have suggested that early aggressive therapy may improve the prognosis in this usually fatal disease. We studied 103 patients with mycosis fungoides, who, after complete staging, were randomly assigned to receive either combination therapy, consisting of 3000 cGy of electron-beam radiation to the skin combined with parenteral chemotherapy with cyclophosphamide, doxorubicin, etoposide, and vincristine (n = 52) or sequential topical treatment (n = 51). The prognostic factors were well balanced in the two groups. Combined therapy produced considerable toxicity: 12 patients required hospitalization for fever and transient neutropenia, 5 had congestive heart failure, and 2 were later found to have acute nonlymphocytic leukemia. Patients receiving combined therapy had a significantly higher rate of complete response, documented by biopsy, than patients receiving conservative therapy (38 percent vs. 18 percent; P = 0.032). After a median follow-up of 75 months, however, there was no significant difference between the treatment groups in disease-free or overall survival. We conclude that early aggressive therapy with radiation and chemotherapy does not improve the prognosis for patients with mycosis fungoides as compared with conservative treatment beginning with sequential topical therapies.

  17. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

    Science.gov (United States)

    Bakhtiari, Sedigheh; Mojahedi, Seyyed Masoud; Azari-Marhabi, Saranaz; Namdari, Mahshid; Rankohi, Zahra Elmi

    2017-06-29

    Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. The present study compared the clinical effects of the photodynamic therapy and dexamethasone mouthwash in the treatment of oral lichen planus lesions. In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30seconds (630nm wavelength and 7.2-14.4J/CM2 dose) for 4 sessions in the days 1,4,7,14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15,30,60,90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. No significant difference existed between two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects. Copyright © 2017. Published by Elsevier B.V.

  18. Topical ketoprofen patch.

    Science.gov (United States)

    Mazières, Bernard

    2005-01-01

    Although oral nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in the treatment of a variety of acute and chronic pain conditions, their use may be associated with serious systemic adverse effects, particularly gastrointestinal disorders. In order to minimise the incidence of systemic events related to such agents, topical NSAIDs have been developed. Topical NSAIDs, applied as gels, creams or sprays, penetrate the skin, subcutaneous fatty tissue and muscle in amounts that are sufficient to exert a therapeutic effect on peripheral and central mechanisms in the absence of high plasma concentrations. Data indicate that topical NSAIDs are effective at relieving pain in a number of acute and chronic pain indications. This review article discusses the pharmacokinetics, efficacy and tolerability of a new formulation of ketoprofen available as a topical patch. The topical patch containing ketoprofen 100mg as the active principle has been developed using a novel delivery system that dispenses therapeutic doses of the drug directly to the site of injury. Pharmacokinetic data indicate that although plasma levels of ketoprofen are higher when the drug is administered as a patch versus a gel, the total systemic bioavailability of ketoprofen 100 mg administered via a patch is no more than 10% of that reported for ketoprofen 100 mg administered orally. Because the patch facilitates ketoprofen delivery over a 24-hour period, the drug remains continually present in the tissue subjacent to the site of application. High tissue but low plasma ketoprofen concentrations mean that while tissue concentrations are high enough to exert a therapeutic effect, plasma concentrations remain low enough to not result in systemic adverse events caused by elevated serum NSAID levels. Phase III clinical trials in patients with non-articular rheumatism and traumatic painful soft tissue injuries showed that the topical ketoprofen patch was significantly more effective than placebo at

  19. Development of an integrated, in-situ remediation technology: Task 1 -- Evaluation of treatment zone formation options. Topical report, September 26, 1994--May 25, 1996

    Energy Technology Data Exchange (ETDEWEB)

    Shoemaker, S.H.; Landis, R.C.; Griffith, R.J.; Schultz, D.S. [Monsanto Co., St. Louis, MO (United States); Quinton, G.E. [E.I. duPont de Nemours and Co., Inc., Wilmington, DE (United States)

    1997-05-01

    Contamination in low permeability soils poses a significant technical challenge to in-situ remediation efforts. Poor accessibility to the contaminants and difficulty in delivery of treatment reagents have rendered existing in-situ treatments such as bioremediation, vapor extraction, pump and treat rather ineffective when applied to low permeability soils present at many contaminated sites. The technology is an integrated in-situ treatment in which established geotechnical methods are used to install degradation zones directly in the contaminated soil and electro-osmosis is utilized to move the contaminants back and forth through those zones until the treatment is completed. This topical report presents the results of evaluations by E.I. duPont de Nemours and Co., Inc. of treatment zone and electrode emplacement alternatives for use in the integrated treatment process. Specifically, the scope of this study was limited to vertical configuration emplacements. Several promising alternatives were identified ranging from approaches involving standard excavation techniques to relatively specialized geotechnical construction methods which could be modified for the treatment zone emplacement purpose. Information developed in this report is designed to help the user select the most promising emplacement method(s) for a given site on the basis of (1) depth of emplacement, and (2) restrictions on handling excavated soils. Advantages, disadvantages, and estimated costs are identified for each alternative, and possible bases for improvement and cost reduction through further development are described.

  20. Development, Characterization, and In Vitro Biological Performance of Fluconazole-Loaded Microemulsions for the Topical Treatment of Cutaneous Leishmaniasis

    Directory of Open Access Journals (Sweden)

    Marcela Brito Oliveira

    2015-01-01

    Full Text Available Cutaneous leishmaniasis (CL is a resistant form of leishmaniasis that is caused by a parasite belonging to the genus Leishmania. FLU-loaded microemulsions (MEs were developed by phase diagram for topical administration of fluconazole (FLU as prominent alternative to combat CL. Three MEs called F1, F2, and F3 (F1—60% 50 M phosphate buffer at pH 7.4 (PB as aqueous phase, 10% cholesterol (CHO as oil phase, and 30% soy phosphatidylcholine/oil polyoxyl-60 hydrogenated castor oil/sodium oleate (3/8/6 (S as surfactant; F2—50% PB, 10% CHO, and 40% S; F3—40% PB, 10% CHO, and 50 % S were characterized by droplet size analysis, zeta potential analysis, X-ray diffraction, continuous flow, texture profile analysis, and in vitro bioadhesion. MEs presented pseudoplastic flow and thixotropy was dependent on surfactant concentration. Droplet size was not affected by FLU. FLU-loaded MEs improved the FLU safety profile that was evaluated using red cell haemolysis and in vitro cytotoxicity assays with J-774 mouse macrophages. FLU-unloaded MEs did not exhibit leishmanicidal activity that was performed using MTT colourimetric assays; however, FLU-loaded MEs exhibited activity. Therefore, these MEs have potential to modulate FLU action, being a promising platform for drug delivery systems to treat CL.

  1. Preoperative subconjunctival injection of mitomycin C versus intraoperative topical application as an adjunctive treatment for surgical removal of primary pterygium

    Directory of Open Access Journals (Sweden)

    Ehab M Ghoneim

    2011-01-01

    Materials and Methods : Seventy eyes of 70 patients with primary pterygia were randomly allocated to two groups. The first group (Group A, 35 eyes received 0.1 ml of 0.15 mg/ml of subconjunctival MMC injected into the head of the pterygium 24 h before surgical excision with the bare sclera technique. The second group (Group B 35 eyes underwent surgical removal with the bare sclera technique with intraoperative application of MMC (0.15 mg/ml over bare sclera for 3 min. The study was performed between March 2007 and December 2008, and follow up was performed for 1 year postoperatively. Differences between frequencies in both groups were compared by the Chi-square test or Fisher exact test. Differences between means in both groups were compared by Student′s t-test. P 0.05. Postoperatively, scleral thinning occurred in one eye in each group that resolved by 5 months postoperatively. No serious postoperative complications occurred in either group. Conclusion : Preoperative local injection of 0.15 mg/ml MMC is as effective as intraoperative topical application of 0.15 mg/ml MMC for preventing pterygium recurrence after surgical removal.

  2. Comparison of topical dry eye medications for the treatment of keratoconjunctivitis sicca in a botulinum toxin B-induced mouse model.

    Science.gov (United States)

    Lekhanont, Kaevalin; Leyngold, Ilya M; Suwan-Apichon, Olan; Rangsin, Ram; Chuck, Roy S

    2007-01-01

    To compare the effects of topical dry eye medications including anti-inflammatory agents and lubricant eyedrops for the treatment of keratoconjunctivitis sicca (KCS) in a botulinum toxin B (BTX-B)-induced mouse model. CBA mice were randomized into 10 groups. The first 5 groups received a transconjunctival injection of saline into the lacrimal gland, and the remaining groups were injected with 0.05 mL of 20 mU BTX-B. Each group received treatment with 0.1% fluorometholone (FML), 0.05% cyclosporine A (CsA), a 50:50 combination of FML and CsA, artificial tears, or saline 3 days after injections. Tear production, corneal staining, and blink rate were compared in each of the 10 groups. Tear production in BTX-B-injected CsA-treated, FML-treated, and combined-treated groups started to return to baseline level within 2 weeks of treatment, whereas those treated with saline or artificial tears still exhibited reduction of lacrimation up to 4 weeks after injection. Topical FML significantly reversed the staining score within 1 week of treatment. The improvement of corneal staining in BTX-B-challenged combined-treated and CsA-treated groups occurred later within 2 weeks after treatment. No significant improvement in corneal staining was observed for the BTX-B-injected mice treated with artificial tears or saline. No significant changes were noted in blink frequency between the control and study groups undergoing the various dry eye therapies. The therapeutic effects of dry eye medications in a BTX-B-induced mouse model of KCS are similar to the human response.

  3. Topical insulin-like growth factor 1 treatment using gelatin hydrogels for glucocorticoid-resistant sudden sensorineural hearing loss: a prospective clinical trial

    Directory of Open Access Journals (Sweden)

    Teramukai Satoshi

    2010-11-01

    Full Text Available Abstract Background Sudden sensorineural hearing loss (SSHL is a common condition in which patients lose the hearing in one ear within 3 days. Systemic glucocorticoid treatments have been used as standard therapy for SSHL; however, about 20% of patients do not respond. We tested the safety and efficacy of topical insulin-like growth factor 1 (IGF1 application using gelatin hydrogels as a treatment for SSHL. Methods Patients with SSHL that showed no recovery to systemic glucocorticoid administration were recruited. We applied gelatin hydrogels, impregnated with recombinant human IGF1, into the middle ear. The primary outcome measure was the proportion of patients showing hearing improvement 12 weeks after the test treatment. The secondary outcome measures were the proportion of patients showing improvement at 24 weeks and the incidence of adverse events. The null hypothesis was that 33% of patients would show hearing improvement, as was reported for a historical control after hyperbaric oxygen therapy. Results In total, 25 patients received the test treatment at a median of 23 days (range 15-32 after the onset of SSHL, between 2007 and 2009. At 12 weeks after the test treatment, 48% (95% CI 28% to 69%; P = 0.086 of patients showed hearing improvement, and the proportion increased to 56% (95% CI 35% to 76%; P = 0.015 at 24 weeks. No serious adverse events were observed. Conclusions Topical IGF1 application using gelatin hydrogels is well tolerated and may be efficacious for hearing recovery in patients with SSHL that is resistant to systemic glucocorticoids.

  4. The clinical trials supporting benzyl alcohol lotion 5% (Ulesfia): a safe and effective topical treatment for head lice (pediculosis humanus capitis).

    Science.gov (United States)

    Meinking, Terri L; Villar, Maria E; Vicaria, Maureen; Eyerdam, Debbie H; Paquet, Diane; Mertz-Rivera, Kamara; Rivera, Hector F; Hiriart, Javier; Reyna, Susan

    2010-01-01

    Benzyl alcohol lotion 5% (BAL 5%) is a non-neurotoxic topical head lice treatment that is safe and effective in children as young as 6 months of age. The safety and efficacy of this pediculicide has been studied in 695 (confirm number) subjects in all phases of clinical development. Scanning electron micrographs (SEM) demonstrated that the active agent appears to stun the breathing spiracles open, enabling the vehicle to penetrate the respiratory mechanism (spiracles), therefore asphyxiating the lice. Initial phase II trials compared this novel product to RID using identical volumes of treatment (4 oz/application) and yielding, almost, identical efficacy. This outcome pointed to the significant importance of completely saturating the hair with the product in order to achieve maximum treatment success. A second phase II trial, which allowed the use of sufficient product to saturate the hair, resulted in 100% efficacy after both 10 and 30 minute treatments. A third phase II trial verified an effective dose. Phase III trials compared BAL 5% to vehicle placebo for two 10-minute applications. It proved to be safe and effective (p < 0.001) for treatment of head lice and is the first FDA-approved non-neurotoxic lice treatment, now available in the United States as Ulesfia lotion.

  5. Ajoene in the topical short-term treatment of tinea cruris and tinea corporis in humans. Randomized comparative study with terbinafine.

    Science.gov (United States)

    Ledezma, E; López, J C; Marin, P; Romero, H; Ferrara, G; De Sousa, L; Jorquera, A; Apitz Castro, R

    1999-06-01

    Ajoene (CAS 92284-99-6), an organic trisulphur originally isolated from garlic, has an antimycotic activity which has been widely demonstrated both in vitro and in vivo. The objective of this work was to compare the safety and effectiveness of ajoene (0.6%, gel) with terbinafine (CAS 91161-71-6) (1%, cream) for the treatment of tinea corporis and tinea cruris. The patients selected were 60 soldiers with clinical and mycological diagnosis of either dermatophytosis. They were distributed at random in two treatment groups, one treated with ajoene at 0.6% and the other with terbinafine at 1%. All patients were evaluated clinically and mycologically 30 and 60 days after completion of the treatment, which was considered effective when clinical signs and symptoms had disappeared and the mycological cultures were negative. Thirty days after treatment, the percent healing rate was 77 and 75 for the groups treated with ajoene and terbinafine, respectively. Sixty days after treatment, the healing rate 73% and 71% for the groups treated with ajoene and terbinafine, respectively. These results and those obtained in previous studies confirm that ajoene is a new agent for the topic treatment of superficial mycoses, and for the first time show the therapeutic usefulness of an inhibitor of phospholipids biosynthesis in eukaryotes.

  6. Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel on transcutaneous PO2 in venous insufficiency.

    Science.gov (United States)

    Cesarone, M R; Belcaro, G; Ippolito, E; Ricci, A; Ruffini, M; Dugall, M

    2004-01-01

    A gel including aescin, essential phospholipids (EPL), and heparin (EG) has been used for many years for local treatment of venous, microcirculatory alterations (varicose veins, chronic venous insufficiency). Bruises, swelling, thrombophlebitis, and contusions are effectively treated with this compound. The aim of this study was the evaluation of the efficacy of the effects of an AEPL (aescin+EPL) gel on the microcirculation in subjects with chronic venous insufficiency, venous hypertension (CVH), and venous microangiopathy. Transcutaneous PO(2) was measured at the perimalleolar region. After 2 weeks of treatment, all individual values (100%) were significantly increased (p < 0.05). In all patients, PO(2) increased, indicating a decrease in level of venous microangiopathy. Considering transcutaneous skin PO(2), treatment with AEPL in areas of venous microangiopathy is beneficial in the prevention of ulceration and improves skin healing.

  7. Efficacy of Topical Compound Danxiong Granules for Treatment of Dermatologic Toxicities Induced by Targeted Anticancer Therapy: A Randomized, Double-Blind, Placebo-Controlled Trial.

    Science.gov (United States)

    Tian, Aiping; Zhou, Aiping; Bi, Xinyu; Hu, Shangying; Jiang, Zhichao; Zhang, Wen; Huang, Zhen; Shi, Hongzhe; Yang, Boyan; Chen, Wei

    2017-01-01

    Dermatologic toxicities resulting in dose reduction or discontinuation of treatment pose challenges for targeted anticancer therapies. We conducted this randomized, double-blind, placebo-controlled trial to investigate the efficacy of topical application of Compound Danxiong Granules (CDG) for treatment of dermatologic toxicities associated with targeted anticancer therapies. One hundred and ten patients with dermatologic toxicities induced by targeted anticancer therapies were randomly assigned to CDG or placebo group. Each crude herb (Rhizoma Chuanxiong, Paeonia suffruticosa Andr., Cortex Phellodendri, Geranium sibiricum L., and Flos Carthami) was prepared as an instant herbal powder. Application of the CDG via topical washes lasted 20 minutes, twice daily, for 10 days. The primary outcome was the total effective rate, defined as reduction in at least one grade of skin toxicity. The total effective rate was 77.61% (52/67) in the CDG group and 27.27% (9/33) in the placebo group (P dermatologic toxicities induced by targeted anticancer therapies. The effect of CDG was more pronounced in hand-foot skin reaction.

  8. Ethosomes® and transfersomes® containing linoleic acid: physicochemical and technological features of topical drug delivery carriers for the potential treatment of melasma disorders.

    Science.gov (United States)

    Celia, Christian; Cilurzo, Felisa; Trapasso, Elena; Cosco, Donato; Fresta, Massimo; Paolino, Donatella

    2012-02-01

    Two vesicular colloidal carriers, ethosomes® and transfersomes® were proposed for the topical delivery of linoleic acid, an active compound used in the therapeutic treatment of hyperpigmentation disorders, i.e. melasma, which is characterized by an increase of the melanin production in the epidermis. Dynamic light scattering was used for the physicochemical characterization of vesicles and mean size, size distribution and zeta potential were evaluated. The stability of formulations was also evaluated using the Turbiscan Lab® Expert based on the analysis of sample transmittance and photon backscattering. Ethosomes® and transfersomes® were prepared using Phospholipon 100 G®, as the lecithin component, and ethanol and sodium cholate, as edge activator agents, respectively. Linoleic acid at 0.05% and 0.1% (w/v) was used as the active ingredient and entrapped in colloidal vesicles. Technological parameters, i.e. entrapment efficacy, drug release and permeation profiles, were also investigated. Experimental findings showed that physicochemical and technological features of ethosomes® and transfersomes® were influenced by the lipid composition of the carriers. The percutaneous permeation experiments of linoleic acid-loaded ethosomes® and transfersomes® through human stratum corneum-epidermidis membranes showed that both carriers are accumulated in the skin membrane model as a function of their lipid compositions. The findings reported in this investigation showed that both vesicular carriers could represent a potential system for the topical treatment of hyperpigmentation disorders.

  9. The eye drop chart: a pilot study for improving administration of and compliance with topical treatments in glaucoma patients

    Directory of Open Access Journals (Sweden)

    McVeigh KA

    2015-05-01

    Full Text Available Katherine Anne McVeigh,1 Georgios Vakros21Department of Ophthalmology, Royal United Hospital, Combe Park, Bath, UK; 2Department of Ophthalmology, Queen’s Hospital, Romford, Essex, UKAim: In order to improve patient education, compliance, and administration of eye drops prescribed for patients suffering with glaucoma within a UK ophthalmology department, an eye drop chart (EDC was designed, developed, and piloted with patients attending the glaucoma clinic over 1 month.Methods: A cross-sectional prospective pilot study of 25 patients using an administration aid and a self-reported questionnaire. Chi-square tests were used to compare responses pre- and postintervention.Results: Results demonstrated an impressive improvement in nine of eleven categories assessed regarding drop administration and compliance. Patients stating that they always wash their hands increased significantly from 64% (13 participants to 92% (23 participants (P=0.029, and those who always shake the bottle improved from 40% (10 to 84% (21 (P=0.001. Punctal occlusion techniques improved from 44% (11 to 72% (18 (P=0.015. Finally, patients who always discarded the bottle after 28 days of use rose from 68% to 92%, though the difference was not significant (P=0.09. Only the number of drops being administered to the eye and the length of time left between the application of drops remained relatively unchanged. Sixty-four percent reported finding EDC helpful or useful, 52% had positive responses when asked if they would continue using EDC, and 88% would recommend it to a friend.Conclusion: Although there are limitations to the data as they are subjective, descriptive, and limited to sample size of 25, the results of this pilot study have shown promise. The EDC appears to be a cost-effective way at improving patients’ use of topical ocular medications.Keywords: glaucoma, administration, compliance, aid, drop chart

  10. Successful Treatment of Chronic Staphylococcus aureus-Related Dermatoses with the Topical Endolysin Staphefekt SA.100: A Report of 3 Cases

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    Joan E.E. Totté

    2017-05-01

    Full Text Available Staphylococcus aureus plays an important role in skin and soft tissue infections and contributes to the pathophysiology of complex skin disorders such as atopic dermatitis. Bacterial resistance against commonly used antibiotics has increased considerably in the last decades demanding alternative treatment approaches. We present 3 cases where patients with chronic and recurrent S. aureus-related dermatoses were successfully treated with Staphefekt SA.100. Staphefekt SA.100 is a recombinant phage endolysin for topical skin application that specifically targets both methicillin-sensitive and methicillin-resistant S. aureus. As a consequence of its specific mechanism of action, bacterial resistance is unlikely to develop. In our 3 cases, resistance induction was not observed. Our results indicate that targeted treatment with Staphefekt might be an attractive alternative for (long-term classical antibiotic therapy, and confirmatory randomized controlled trials are warranted to evaluate its clinical efficacy and safety.

  11. Comparison of efficacy and safety of topical Ketotifen (Zaditen with Cromolyn sodium in the treatment of Vernal keratoconjunctivitis

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    MR Shoja

    2005-03-01

    Full Text Available Background: This study compared the efficacy of Ketotifen fumarate .025% (Zaditen with Cromolyn sodium 4% (Opticrom eye drops in prevention of itching, tearing, and redness in Vernal Keratoconjunctivitis (VKC. Methods: This double blind randomized single center clinical trial conducted between April and August 2004 in Yazd. One hundred eligible patients with clinical diagnosis of moderate VKC were randomly prescribed Zaditen (group A: n=50 and Cromolyn sodium (group B: n=50 eye drops for a 4 weeks period. Itching, lacrimation, redness, and photophobia were scored on a 4-points severity scale. Results: After 7 days of treatment, the response rates based on subjects assessment of global efficacy was significantly greater in Ketotifen group (61.5% than in Cromolyn group(53%.A clear response to treatment occurred in 94.4 of Zaditen and 81.2% of Sodium Cromoglycate treated patients. The investigator,s assessment of response rates also showed that Ketotifen was superior to Cromolyn sodium (P=0.001. Ketotifen produced a significantly better outcome than Cromolyn for relief of signs and symptoms of VKC (P<0.05. Ketotifen fumarate treatment significantly reduced the total signs and symptoms score for each patients, in compare with day 0. Conclusion: Ketotifen had a faster onset of action and provided better symptom relief than Cromolyn. The rapid onset of action and symptom control, make Zaditen a valuable treatment for VKC. Keywords : VKC , allergic conjuctivitis , zaditen

  12. Clinical application of oral form of ANGIPARSTM and in combination with topical form as a new treatment for diabetic foot ulcers: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Bahrami A

    2008-04-01

    Full Text Available ANGIPARSTM is a new herbal extract which has been produced in oral, topical, and intravenous forms. The present article contains preliminary results of the study which was planned to evaluate the efficacy and safety of orally applied ANGIPARSTM and to compare it with the combination of oral and topical forms and also with conventional therapy in patients with diabetic ulcers of the lower extremities."nTwenty one patients with diabetic foot ulcers were divided into 3 groups. The first group received 100 mg of oral ANGIPARSTM twice a day for 6 weeks in addition to conventional therapies. In the second group, ANGIPARSTM gel 3% was added to the oral form of the same product besides the conventional therapies for the same period of time. Finally, in the third group which was considered as control, only conventional therapies were performed. The patients were followed for 6 weeks. Parameters such as granulation tissue formation, skin epithelization, and wound surface areas changes were analyzed to determine the effectiveness of the compound in wounds healing. Furthermore, drug safety was assessed by monitoring adverse events and by clinical and laboratory evaluations."nThe study data showed significant differences between the intervention and control groups with respect to efficacy and tolerability. In each intervention group, primary wound healings occurred following 2 weeks. Complete wound healing which was greater than 70% improvement in wounds surface areas was achieved in 83% and 100% of group 1 and group 2 participants, respectively after 6 weeks. On the other hand, at the same period of time, only 22.2% of patients in control group revealed complete healing. Therefore, ANGIPARSTM had significant positive effect in increasing the incidence of complete wound closure compared with control group (p = 0.042. However, our evaluations indicated that adding topical treatment with 3% gel once a day to the oral therapy with the same product did not make

  13. Preliminary investigation of the effects of topical mixture of Lawsonia inermis L. and Ricinus communis L. leaves extract in treatment of osteoarthritis using MIA model in rats.

    Science.gov (United States)

    Ziaei, Atousa; Sahranavard, Shamim; Gharagozlou, Mohammad Javad; Faizi, Mehrdad

    2016-05-03

    Many plants have been introduced in Iranian traditional medicine for treatment of different joint problems including knee pain. Topical application of the mixture of Lawsonia inermis L. leaves (Henna) with aqueous extract of Ricinus communis L. leaves have been mentioned to have significant effects on reducing knee pain. The present study was designed to evaluate the analgesic and anti-inflammatory effects of the mixture of these two herbs in male rats. We induced knee osteoarthritis as a model of chronic pain by intra-articular injection of mono sodium iodoacetate (MIA). Mechanical allodynia, hotplate latency test, spontaneous movements and gait analysis were used for the evaluation of analgesic activity. Anti-inflammatory activity was evaluated by measuring the diameter and the volume of the injected paw compared to contralateral paw. These tests were monitored at days 1, 3, 7, 14 and 21 of MIA administration. Histopathological evaluations were also used to assess the efficacy of the treatment on inflammation and lesions in knee tissue. In all tests, diclofenac topical gel was used as a positive control. The herbal extracts, their mixture, and vehicle or diclofenac gel were administered daily for 14 days by topical route. The mixture of these two extracts significantly reduced the knee joint width and volume of the injected paws and also improved foot prints in gait analysis after 3 days of MIA injection. Analysis of mechanical allodynia (after 21 days), hotplate latency test (after 10 days), spontaneous movements (after 7 days) and in positive control group (after 3 days in all tests and in mechanical allodynia after 14 days) compared to the vehicle group, showed significant effects. Topical usage of the selected formulation made significant histopathological changes on the knee of the rats. Compared to the vehicle group, the tests and diclofenac groups showed less reactions characterized by negligible edema and a few scattered inflammatory lymphoid

  14. Comparative study of topical 80% trichloroacetic acid with 35% trichloroacetic acid in the treatment of the common wart.

    Science.gov (United States)

    Pezeshkpoor, Fakhrozaman; Banihashemi, Mahnaz; Yazdanpanah, Mohammad Javad; Yousefzadeh, Hadis; Sharghi, Mohammad; Hoseinzadeh, Hossein

    2012-11-01

    Common warts caused by the human papillomavirus (HPV) are considered to be the most common infectious skin disease. No individual treatment for common warts is effective as monotherapy in eradicating the lesions. The aim of this study is to evaluate the clinical efficacy of a 35% and an 80% trichloroacetic acid (TCA) solution in the treatment of the common wart. In this single-blinded clinical trial, 62 eligible patients with common warts referred to the dermatology clinic of Ghaem Hospital in Mashhad, Iran. Patients were randomly divided into two groups, each treated with a TCA solution (group A, TCA 80%; group B, TCA 35%) once per week until complete clearance of the lesions or for a maximum duration of six weeks. Seven patients were excluded from the final analysis (one patient in group A and six patients in group B) for various reasons, including irregular follow-up, using physical tools such as razor blades to remove the lesion, and failure to complete treatment; and 55 patients were included in the final analysis. Improvement to treatment responses was classified as: no change (no changes in the number of warts), mild (clearing of less than 25% of warts), moderate (clearing of 25% to 75% of warts), and good (clearing of more than 75% of warts). At the end of follow-up, the clinical improvement of group A (n=30) was: 10 patients (33.3%) with a mild response, 6 patients (20%) with a moderate response, and 14 patients (46.7%) with a good response. In group B (n=25), 16 patients (64%) showed a mild response, 6 patients (24%) a moderate response, and 3 patients (12%) a good response. There was a statistically significant difference in improvement between the two treatment groups (P=.017). Improvement was greater with a higher concentration of TCA solution. This study showed that a different concentration of TCA solution was an effective form of treatment for common warts. Trichloroacetic acid 80% is more effective, but this solution must be used only with careful

  15. Assessment of the efficacy and safety of a combination of 2 topical retinoids (RetinSphere) in maintaining post-treatment response of acne to oral isotretinoin.

    Science.gov (United States)

    Truchuelo, M T; Jiménez, N; Mavura, D; Jaén, P

    2015-03-01

    The high rate of relapse of acne lesions following oral isotretinoin treatment is a common problem which remains unsolved. To avoid or minimize relapses, topical retinoids have been used for many years as maintenance treatment. However, adverse effects frequently occur. To determine the efficacy and safety of a new retinoid combination (Retinsphere technology) in maintaining post-treatment response to oral isotretinoin. Prospective, randomized, double-blind and vehicle-controlled study of 30 patients with acne previously treated with isotretinoin. Treatment with the retinoid combination was applied to one side of the face and vehicle was applied to the other, once daily, for 3 months. Standardized photographs were taken using RBX technology at baseline, 1.5 months and 3 months. The primary efficacy endpoint was the appearance of relapse on the treated side compared to the vehicle-treated side. Other endpoints included lesion count, investigator-reported improvement, patient-reported improvement, impact on quality-of-life, and side effects. Although the majority of patients did not reach the total target dose of oral isotretinoin, the relapse rate was significantly lower on the retinoid-treated side compared to the vehicle-treated side. Likewise, improved lesion count and excellent tolerance were observed. This new retinoid combination (Retinsphere technology) were effective and safe as maintenance therapy after post-treatment response to oral isotretinoin in patients with acne. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  16. Clinical Observation of Medicines and Associated with Topical Treatment of Eczema%中药治疗湿疹临床观察

    Institute of Scientific and Technical Information of China (English)

    姚春

    2014-01-01

    目的:观察中药内服与外用联合治疗湿疹的临床疗效。方法:选取228例湿疹患者,予以中药汤剂口服及外用治疗,随症加减,12 d为1个疗程,平均2个疗程后观察疗效。结果:所有患者中治愈145例,占63.6%;显效83例,占36.4%,未发现无效者。结论:中药治疗湿疹临床疗效显著,不良反应小。%Objective:Observe the clinical efficacy of herbal internal and external use combined treatment of eczema. Methods:choose 228 cases of eczema patients,oral and topical treatment of traditional Chinese medicine medicinal broth,along with the add and sub-tract,12 d for a period of treatment,the average after 2 courses of treatment. Results:all patients cured 145 cases,accounting for 63. 6%;83 cases had marked effect,36. 4%,found no is invalid. Conclusion:Chinese medicine treatment of eczema clinical curative effect,less adverse reaction.

  17. The Effectiveness of Diclofenac Sodium in the Treatment of Mondor's Disease of the Breast: The Topical Patch Compared to the Oral Capsules.

    Science.gov (United States)

    Shirah, Bader Hamza; Shirah, Hamza Assad; Alonazie, Wedad Salem

    2017-07-01

    Mondor's disease of the breast is a rare, benign sclerosing superficial thrombophlebitis of the subcutaneous veins of the anterior or lateral chest wall, which is treated conservatively. We aim in this study to evaluate the outcome and effectiveness of our treatment protocol using oral diclofenac sodium and topical diclofenac sodium patch in 172 patients. A retrospective database analysis of 172 female patients between January 2001 and December 2010 was done. The treatment protocol consisted of group 1: treatment by oral diclofenac sodium 100 mg once daily for 3 weeks. Group 2: treatment by diclofenac sodium patches for 8 hours twice daily (morning and evening) for 1 week. The patients were instructed to document the time as soon as pain relief is achieved following the patch application and the intake of the oral dose. The incidence rate was 2.49%. Diclofenac sodium patch was statistically found to be significantly better in subsiding the inflammatory process of the veins, relieving the pain, and enhancing faster healing rate. We conclude that diclofenac sodium patch showed a promising role in the treatment of Mondor's disease of the breast by significantly decreasing the inflammatory process due to its transdermal migration action within a short period and the ability to reach a high local concentration. It achieved the best results for rapid relief of pain and disease regression compared to the oral capsules. Therefore, our protocol was changed to implement diclofenac sodium patch as the first choice in treating Mondor's disease of the breast. © 2017 Wiley Periodicals, Inc.

  18. Study on vasoactive intestinal polypeptide receptor 1 gene translation in psoriatic epidermis with the topical treatment of capsaicin ointment

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Objective To investigate the mechanism of capsaicin in treating active psoriasis vulgaris.Methods A total of 42 patients with active psoriasis vulgaris diagnosed by histology and clinical features were given either placebo or 0.025% capsaicin ointment four times daily for 30 days randomly by double-blind method.Vasoactive intestinal polypeptide receptor 1(VIPR1)gene translation in active psoriatic lesions before and after treatment with capsaicin ointment was detected by in situ hybridization.Results There ...

  19. The effect of different formulations of equivalent active ingredients on the performance of two topical wound treatment products.

    Science.gov (United States)

    Gray, Mikel; Jones, David P

    2004-03-01

    Product selection for the management of pressure ulcers or perineal dermatitis is typically based on consideration of active ingredients, but a growing body of evidence suggests that delivery vehicles also may influence product safety and efficacy. A 10-day, randomized, controlled experimental study was conducted to compare the safety and efficacy of two prescription products used for the treatment of pressure ulcers and perineal dermatitis. Both products contain equivalent active ingredients (balsam of Peru, castor oil, and trypsin), but one product delivers these ingredients in an ointment base while the other uses an aerosol spray. Sixty healthy volunteers (> 65 years of age) underwent intentional creation of two equivalent skin wounds (approximately 6 mm in diameter) using an Erbium-YAG laser. Volunteers served as their own control. Wounds were randomized to treatment with one of the balsam of Peru products or saline. Wounds were evaluated every other day. Significant differences between treatments were observed for most outcome variables (edema, scabbing, erythema, epithelialization). Wounds managed with the ointment-based product had lower edema, scabbing, and erythema scores and higher epithelialization scores than the spray or saline managed wounds. The results of this study confirm that formulation of the vehicle base can have a significant effect on product safety and effectiveness.

  20. Recent advances in topical anesthesia

    Science.gov (United States)

    2016-01-01

    Topical anesthetics act on the peripheral nerves and reduce the sensation of pain at the site of application. In dentistry, they are used to control local pain caused by needling, placement of orthodontic bands, the vomiting reflex, oral mucositis, and rubber-dam clamp placement. Traditional topical anesthetics contain lidocaine or benzocaine as active ingredients and are used in the form of solutions, creams, gels, and sprays. Eutectic mixtures of local anesthesia cream, a mixture of various topical anesthetics, has been reported to be more potent than other anesthetics. Recently, new products with modified ingredients and application methods have been introduced into the market. These products may be used for mild pain during periodontal treatment, such as scaling. Dentists should be aware that topical anesthetics, although rare, might induce allergic reactions or side effects as a result of an overdose. Topical anesthetics are useful aids during dental treatment, as they reduce dental phobia, especially in children, by mitigating discomfort and pain. PMID:28879311

  1. Minoxidil topical treatment may be more efficient if applied on damp scalp in comparison with dry scalp.

    Science.gov (United States)

    Angelo, T; Barbalho, G N; Gelfuso, G M; Gratieri, T

    2016-09-01

    There is yet no consensus among prescribers whether minoxidil (MXD) formulations should be applied on wet/damp or dry scalp and no clear FDA guidelines on the matter. We hypothesized that the use of MXD on damp scalp may lead to higher drug penetration. First, because the drug diffusion and consequent deposition into the hair follicle may be favored when follicle cast is humid. Second, because humidity may also prevent drug crystallization and, therefore, maintain a higher thermodynamic activity for longer periods, which leads to increased penetration. Following in vitro experiments on rat and porcine skin we confirmed the hypothesis, which could markedly improve treatment effectiveness. © 2016 Wiley Periodicals, Inc.

  2. Evaluation of topical 0.1% tazarotene cream in the treatment of palmoplantar psoriasis: An observer-blinded randomized controlled study

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    Bijal H Mehta

    2011-01-01

    Full Text Available Background : Palmoplantar psoriasis is a frequently encountered variant of psoriasis. It is difficult to treat and even more difficult to maintain remission as it is exacerbated by friction and trauma of the patient′s daily activities. Existing topical modalities of treatment are often inadequate and show unpredictable response. Aim : To study the efficacy and safety of a newer retinoid, tazarotene, as 0.1% cream in the treatment of palmoplantar psoriasis. Materials and Methods : Thirty adult patients with palmo-plantar psoriasis were randomized to therapy with once daily application of topical tazarotene cream (0.1% or once daily application of clobetasol propionate cream (0.05% for 12 weeks. The patients were assessed every 2 weeks for improvement in Erythema, Scaling, Fissures and Induration (ESFI score and Physicians Global Assessment Scale. Results : At 12 weeks, the tazarotene group showed mean ESFI reduction to 1.12 (83.2% from 6.65 at baseline. Complete clearance was noted in 52.9% of the patients. Clobetasol propionate group showed mean ESFI reduction to 0.62 (89.1% from 5.69 at baseline, with complete clearance in 61.5% of the patients. Differences between the two groups were statistically insignificant. Side effects observed were initial irritation (41% in the tazarotene group and hypopigmentation (53.8% in the steroid-treated patients. Conclusion : Tazarotene is as effective as clobetasol propionate and provides a good alternative for the treatment of palmo-plantar psoriasis where hypopigmentation limits the use of clobetasol propionate cream.

  3. Effect of topical calcineurin inhibitors as monotherapy or combined with phototherapy for vitiligo treatment: a meta-analysis.

    Science.gov (United States)

    Dang, Yu-Ping; Li, Qiang; Shi, Fei; Yuan, Xiao-Ying; Liu, Wei

    2016-01-01

    Vitiligo is a common skin disease for which immunomodulating calcineurin inhibitors have been considered reasonable treatment. We searched the MEDLINE, Embase, and Cochrane central register of controlled trials databases for articles published prior to September 2014. Thirteen studies were included in the meta-analysis. After pooling the trials, we concluded that calcineurin inhibitors showed a better therapeutic effect on vitiligo than placebo, according to lesion report (RR = 2.62, 95%CI, 1.39-4.93, p = 0.003) and patient report (RR = 1.42, 95%, 0.87-2.31, p = 0.157). Subgroup analysis was performed to determine whether the combination with phototherapy was a source of heterogeneity. The trial sequence analysis indicated that the results of combined therapy by lesion report were reliable and conclusive. However, in the patient report trials, the frequency of lesions on the hand and foot was higher, and the effect of combined therapy was still not significant. Calcineurin inhibitors showed a better therapeutic effect than placebo in the treatment of vitiligo with phototherapy. However, the typical UV-resistant sites (i.e., hand and foot) were still difficult to cure even with combined therapy. Because of concerns about photocarcinogenesis, the clinical application of combined therapy should be explored with caution.

  4. What defines an adaptive radiation? Macroevolutionary diversification dynamics of an exceptionally species-rich continental lizard radiation.

    Science.gov (United States)

    Pincheira-Donoso, Daniel; Harvey, Lilly P; Ruta, Marcello

    2015-08-07

    Adaptive radiation theory posits that ecological opportunity promotes rapid proliferation of phylogenetic and ecological diversity. Given that adaptive radiation proceeds via occupation of available niche space in newly accessed ecological zones, theory predicts that: (i) evolutionary diversification follows an 'early-burst' process, i.e., it accelerates early in the history of a clade (when available niche space facilitates speciation), and subsequently slows down as niche space becomes saturated by new species; and (ii) phylogenetic branching is accompanied by diversification of ecologically relevant phenotypic traits among newly evolving species. Here, we employ macroevolutionary phylogenetic model-selection analyses to address these two predictions about evolutionary diversification using one of the most exceptionally species-rich and ecologically diverse lineages of living vertebrates, the South American lizard genus Liolaemus. Our phylogenetic analyses lend support to a density-dependent lineage diversification model. However, the lineage through-time diversification curve does not provide strong support for an early burst. In contrast, the evolution of phenotypic (body size) relative disparity is high, significantly different from a Brownian model during approximately the last 5 million years of Liolaemus evolution. Model-fitting analyses also reject the 'early-burst' model of phenotypic evolution, and instead favour stabilizing selection (Ornstein-Uhlenbeck, with three peaks identified) as the best model for body size diversification. Finally, diversification rates tend to increase with smaller body size. Liolaemus have diversified under a density-dependent process with slightly pronounced apparent episodic pulses of lineage accumulation, which are compatible with the expected episodic ecological opportunity created by gradual uplifts of the Andes over the last ~25My. We argue that ecological opportunity can be strong and a crucial driver of adaptive

  5. Topical stabilized retinol treatment induces the expression of HAS genes and HA production in human skin in vitro and in vivo.

    Science.gov (United States)

    Li, Wen-Hwa; Wong, Heng-Kuan; Serrano, José; Randhawa, Manpreet; Kaur, Simarna; Southall, Michael D; Parsa, Ramine

    2017-05-01

    Skin Aging manifests primarily with wrinkles, dyspigmentations, texture changes, and loss of elasticity. During the skin aging process, there is a loss of moisture and elasticity in skin resulting in loss of firmness finally leading to skin sagging. The key molecule involved in skin moisture is hyaluronic acid (HA), which has a significant water-binding capacity. HA levels in skin decline with age resulting in decrease in skin moisture, which may contribute to loss of firmness. Clinical trials have shown that topically applied ROL effectively reduces wrinkles and helps retain youthful appearance. In the current study, ROL was shown to induce HA production and stimulates the gene expression of all three forms of hyaluronic acid synthases (HAS) in normal human epidermal keratinocytes monolayer cultures. Moreover, in human skin equivalent tissues and in human skin explants, topical treatment of tissues with a stabilized-ROL formulation significantly induced the gene expression of HAS mRNA concomitant with an increased HA production. Finally, in a vehicle-controlled human clinical study, histochemical analysis confirmed increased HA accumulation in the epidermis in ROL-treated human skin as compared to vehicle. These results show that ROL increases skin expression of HA, a significant contributing factor responsible for wrinkle formation and skin moisture, which decrease during aging. Taken together with the activity to increase collagen, elastin, and cell proliferation, these studies establish that retinol provides multi-functional activity for photodamaged skin.

  6. Effect of a topical treatment in organotypic culture of human breast skin after exposure to gamma-rays

    Directory of Open Access Journals (Sweden)

    N Gagliano

    2009-08-01

    Full Text Available The early radiation of epidermal reactions can lead to healing of the lesion or radiation necrosis. There is no general agreement for either the prevention and/or treatment of radiation skin response, also as little is known about the immediate phases of this phenomenon. We investigated the early effects exerted by Healing and Wound Emulsion (HWE on human skin response after ionizing radiation. Epidermal morphology, Heat Shock Protein (HSP 70, and Transforming Growth Factor-b1 (TGF-b1 gene expression were investigated in organotypic human skin cultures undergoing a double dose of gamma-rays (2 Gy. HSP70 gene expression tended to be induced in the HWE group 6 hours after cream administration and was significantly up-regulated after 48 hours, when epidermal morphological alterations were evident. TGF- b1 seems not affected in cream treated samples. HWE may stimulate skin to mount an early defensive response against damage induced by gamma rays.

  7. Effect of pre-seasonal seasonal treatment with budesonide topical nasal powder in patients with seasonal allergic rhinitis

    Directory of Open Access Journals (Sweden)

    Maria C Morelli

    1996-01-01

    Full Text Available The efficacy and safety of budesonide nasal powder (Rhinocort Turbuhaler® in seasonal allergic rhinitis when given only at the onset of symptoms during the pollen season or when also given before the pollen season, were compared. The study was carried out in 364 patients from 14 centres in Italy as a randomized, double-blind, parallel-group, placebo- controlled comparison of five alternative treatment regimens given for 4 weeks during the pre-pollen and early pollen season (PPS and for 6 weeks during the pollen season (PS. It was concluded that either 200μg or 400μg of budesonide given once daily PPS provides significant control of symptoms experienced during PPS. The 400μg dose, however, also provides additional prophylactic protection against symptoms during early PS. When the pollen season is established, the dose of budesonide may be reduced to 200μg.

  8. Preparation and characterization of novel carbopol based bigels for topical delivery of metronidazole for the treatment of bacterial vaginosis.

    Science.gov (United States)

    Singh, Vinay K; Anis, Arfat; Banerjee, Indranil; Pramanik, Krishna; Bhattacharya, Mrinal K; Pal, Kunal

    2014-11-01

    The current study reports the development of bigels using sorbitan monostearate-sesame oil organogel and carbopol 934 hydrogel. The microstructures and physicochemical properties were investigated by microscopy, viscosity measurement, mechanical analysis and differential scanning calorimetry analysis. Fluorescence microscopy confirmed the formation of oil-in-water type of emulsion gel. There was an increase in the strength of the bigels as the proportion of the organogel was increased in the bigels. The developed bigels showed shear-thinning flow behavior. The stress relaxation study suggested viscoelastic nature of the bigels. The developed bigels were biocompatible. Metronidazole, drug of choice for the treatment of bacterial vaginosis, loaded bigels showed diffusion-mediated drug release. The drug loaded gels showed good antimicrobial efficiency against Escherichia coli. In gist, the developed bigels may be used as delivery vehicles for the vaginal delivery of the drugs. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Therapeutic paint of cidofovir/sucralfate gel combination topically administered by spraying for treatment of orf virus infections.

    Science.gov (United States)

    Sonvico, Fabio; Colombo, Gaia; Gallina, Laura; Bortolotti, Fabrizio; Rossi, Alessandra; McInnes, Colin J; Massimo, Gina; Colombo, Paolo; Scagliarini, Alessandra

    2009-06-01

    The aim of the research was to study a new cidofovir/sucralfate drug product to be used as a spray for treating the mucosal and/or skin lesions. The product, i.e., a water suspension of sucralfate (15% w/w) and cidofovir (1% w/w), combines the potent antiviral activity of the acyclic nucleoside phosphonate cidofovir ((S)-1-[3-hydroxy-2-(phosphonomethoxy)propyl]cytosine) and the wound healing properties of sucralfate gel (sucrose octasulphate basic aluminum salt). The product was characterized in vitro with respect to compatibility between drug and carrier, spray particle size, spray deposition, drying kinetics, and drug content and release. An interaction between the two active substances was found. The interaction between sucralfate and cidofovir was counteracted by introducing sodium dihydrogen phosphate (16% w/w) in the preparation. The spray formulation containing cidofovir/sucralfate gel painted the skin and dried quickly to a scab, remaining firmly adhered to the lesions. The therapeutic paint was tested in vivo on lambs infected with orf virus by treating the animals with different cidofovir/sucralfate formulations (0.5% or 1% cidofovir + sucralfate 15% + NaH(2)PO(4) 16% w/w) and with sucralfate gel suspension alone as control. The treatment with formulations containing cidofovir and phosphate salt for four consecutive days resulted in a rapid resolution of the lesions, with scabs containing significantly lower amounts of viable virus when compared with untreated lesions and lesions treated with sucralfate suspension alone.

  10. A novel topical agent in the treatment of seborrheic keratoses: A proof of concept study by clinical and dermoscopic evaluation.

    Science.gov (United States)

    Lacarrubba, Francesco; Nasca, Maria Rita; Verzì, Anna Elisa; Micali, Giuseppe

    2017-08-10

    In this proof of concept study, 50 lesions from 15 patients with multiple seborrheic keratoses (SKs) were treated with a novel aqueous solution containing nitric acid, zinc and copper salts, and organic acids (acetic, lactic, and oxalic acid). Treatment consisted in the application of an amount of the solution sufficient to obtain a whitening/yellowish reaction. Application of the nitric-zinc solution was performed every other week until clinical and dermoscopic clearance or crust formation, for a maximum of 4 applications. Efficacy evaluation was performed at 8 weeks (T1) and 6 months (T2). All subjects, who reported no or minimal discomfort during and after the application of the solution, completed the study. At T1, a complete clinical and dermoscopic resolution was observed in 37 lesions after an average of 3 applications/lesion (range 2-4). A partial response, with minimal persistent residual spots, was detected in the remaining 13 lesions. All patients with complete clearance showed no relapses at a 6-month follow-up (T2). The positive preliminary results indicate that this novel solution may represent a promising alternative option for SKs especially in patients not keen or eligible to undergo invasive tissue-destructive procedures. © 2017 Wiley Periodicals, Inc.

  11. Polymeric Films Loaded with Vitamin E and Aloe vera for Topical Application in the Treatment of Burn Wounds

    Directory of Open Access Journals (Sweden)

    Gabriela Garrastazu Pereira

    2014-01-01

    Full Text Available Burns are serious traumas related to skin damage, causing extreme pain and possibly death. Natural drugs such as Aloe vera and vitamin E have been demonstrated to be beneficial in formulations for wound healing. The aim of this work is to develop and evaluate polymeric films containing Aloe vera and vitamin E to treat wounds caused by burns. Polymeric films containing different quantities of sodium alginate and polyvinyl alcohol (PVA were characterized for their mechanical properties and drug release. The polymeric films, which were produced, were thin, flexible, resistant, and suitable for application on damaged skin, such as in burn wounds. Around 30% of vitamin E acetate was released from the polymeric films within 12 hours. The in vivo experiments with tape stripping indicated an effective accumulation in the stratum corneum when compared to a commercial cream containing the same quantity of vitamin E acetate. Vitamin E acetate was found in higher quantities in the deep layers of the stratum corneum when the film formulation was applied. The results obtained show that the bioadhesive films containing vitamin E acetate and Aloe vera could be an innovative therapeutic system for the treatment of burns.

  12. TWO TOPICAL CALCINEURIN INHIBITORS FOR THE TREATMENT OF ATOPIC DERMATITIS IN PEDIATRIC PATIENTS: A META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS (VARIANT OF THE ARTICLE IN RUSSIAN

    Directory of Open Access Journals (Sweden)

    S.L. Chen

    2011-01-01

    Full Text Available Two new topical immunomodulators, pimecrolimus cream and tacrolimus ointment for atopic dermatitis (AD in pediatric patients, have provided alternatives to topical corticosteroids without the associated adverse events. Objective: To evaluate the efficacy and safety of tacrolimus ointment and pimecrolimus cream for the treatment of AD in pediatric patients. MEDLINE, Embase, the CNKI and Cochrane Library databases were searched up to December 2008. Additional data sources were manual searches of abstract proceedings and personal contact with investigators and pharmaceutical companies. Two investigators assessed the quality of trials with unified tables independently. Disagreements on validity assessment were resolved through discussion or consultation with the third author. Quality analysis of methodology was evaluated according to the Jadad scale, including randomization, blinding and patients’ discontinuation. Twenty trials involving 6288 infants and children with AD met the inclusion criteria. More patients using tacrolimus had a good response than those in control groups including vehicle, 1% hydrocortisone acetate and 1% pimecrolimus, the corresponding OR were (4.56; 95%CI: 2.80 to 7.44, (3.92; 95% CI: 2.96 to 5.20 and (1.58; 95% CI: 1.18 to 2.12. The effect difference between 0.03% tacrolimus and 0.1% tacrolimus ointments was not statistically significant (OR = 0.90; 95% CI: 0.55 to 1.48. The incidence of adverse events of tacrolimus ointment or pimecrolimus cream was similar to the vehicle. The major adverse events were burning and pruritus. Both tacrolimus ointment and pimecrolimus cream are safe and effective in the treatment of AD in pediatric patients. Tacrolimus ointments were superior to pimecrolimus cream.Key words: atopic dermatitis, children, meta-analysis, pimecrolimus, tacrolimus.

  13. Study of Topical Human Umbilical Cord Blood Serum in the Treatment of Alkaline Corneal Epithelial Wounds in Rabbit Model

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    B Sharifi

    2011-04-01

    Full Text Available Introduction & Objective: One of the important functions of the cornea is to maintain normal vision by refracting light onto the lens and retina. This property is dependent in part on the ability of the corneal epithelium to undergo continuous renewal. Ocular surface failure which follows a variety of endogenous and exogenous precipitating factors, the most common being: chemical trauma, infection, alkaline burn, inflammation and hereditary conditions, lid or lash abnormalities, tear deficiency or reduced sensation. The core principal underpinning management strategy for ocular surface failure is establishing or promoting new growth of healthy conjunctiva and corneal epithelium. This process is mediated by many proteins that are inducers of corneal cell migration, proliferation, and differentiation. The current study was performed to investigate the efficacy of umbilical cord serum on alkaline corneal epithelial wound healing in the rabbit model. Materials & Methods: In this study conducted at Yasuj University of Medical Sciences in 2010, thirty two rabbits were randomly assigned into two equal groups. Central corneal alkali wound was formed in one eye of the rabbits by applying a 6-mm round filter paper, soaked in 1 N NaOH, for 60 seconds. Group one of animals received umbilical cord blood serum and group two received Sno*Tear in the eyes. The treatment was dosed 4 times a day with the eye drops, and epithelial wound closure was recorded using slit lamp. The data were analyzed to determine the rate of wound closure. Results: The mean wound radius closure rate was 0.77 mm/day (SD=0.013 for umbilical cord blood serum-treated eyes, 0.73 mm/day (SD=0.018 for artificial tear-treated eyes. Conclusion: This study shows that alkali-injured corneal epithelial wound heal faster when treated with umbilical cord blood serum than with artificial tear in rabbit model.

  14. Lipid nanoparticles for topical and transdermal application for alopecia treatment: development, physicochemical characterization, and in vitro release and penetration studies

    Science.gov (United States)

    Gomes, Maria João; Martins, Susana; Ferreira, Domingos; Segundo, Marcela A; Reis, Salette

    2014-01-01

    Alopecia is a dermatological disorder, commonly known as hair loss, which affects up to half of the Caucasian male population by middle age, and almost all (95%) Caucasian men by old age. Considering that alopecia affects so many people and that there is currently no scientifically proven treatment with few side effects, new drug-delivery systems able to improve alopecia therapy are urgently required. With this purpose in mind, the present study aimed to develop lipid nanoparticles (nanostructured lipid carriers) with the ability to incorporate and deliver anti-alopecia active compounds (minoxidil and finasteride) into the dermis and hair follicles. Lipid nanoparticles, prepared by ultrasonication method, showed mean particle sizes around 200 nm, which is sufficient for reaching the dermis and hair follicles, and zeta potential values around −30 mV, which indicates good physical stability. Over 28 days of storage, no significant variations in these parameters were observed, which indicates that all nanoformulations are stable in storage over that period. Cryo-scanning electron microscope measurements showed that all the lipid nanoparticles exhibited a spherical shape and a smooth surface regardless of their composition. Differential scanning calorimetry studies allowed the determination of phase transition temperatures and confirmed the recrystallization of the lipid nanoparticles (recrystallization index between 11% and 86%). A high loading efficiency was achieved for finasteride (between 70% and 90%), while less than 30% was achieved for minoxidil nanoparticles, over 28 days. Controlled release assays in physiological conditions demonstrated that nanoparticles loaded with minoxidil yielded a prolonged release, as desired. Penetration assays through pig ear skin demonstrated that nanoparticles loaded with minoxidil and finasteride had low levels of penetration. These results suggest that the proposed novel formulation presents several good characteristics

  15. Single-session intense pulsed light combined with stable fixed-dose triple combination topical therapy for the treatment of refractory melasma.

    Science.gov (United States)

    Figueiredo Souza, Linton; Trancoso Souza, Simone

    2012-01-01

    The effectiveness of intense pulsed light (IPL) has been reported in adults with melasma, but there is little information about IPL with triple combination topical therapy (TC) and refractory melasma. Sixty-two patients with totally or partially refractory melasma were enrolled in this randomized open-label study. Thirty-one patients were treated with IPL in a single session, bleaching agents and broad-spectrum sunscreens. Thirty-one patients were in the control group, receiving only bleaching agents and broad-spectrum sunscreens. The Melasma Area and Severity Index (MASI) and the investigator's global assessment using a seven-point scale were used to determine the impact and effectiveness of the treatment. The IPL group results based on MASI showed a 49.4% reduction (from 17.6 to 8.9; p group and control group was significant (p = 0.002), with a better response in the IPL group. Single session IPL combined with stable fixed-dose triple combination treatment is a safe and effective treatment for refractory mixed and dermal melasma.

  16. MRI evaluation of topical heat and static stretching as therapeutic modalities for the treatment of eccentric exercise-induced muscle damage.

    Science.gov (United States)

    Jayaraman, R C; Reid, R W; Foley, J M; Prior, B M; Dudley, G A; Weingand, K W; Meyer, R A

    2004-10-01

    The aim of this study was to monitor the effects of topical heat and/or static stretch treatments on the recovery of muscle damage by eccentric exercise. For this purpose, 32 untrained male subjects performed intense eccentric knee extension exercise, followed by 2 weeks of treatment (heat, stretch, heat plus stretch) or no treatment (control, n=8/group). Isometric strength testing, pain ratings, and multi-echo magnetic resonance imaging of the thigh were performed before and at 2, 3, 4, 8, and 15 days following the exercise. Increased T2 relaxation time, muscle swelling, pain ratings, and strength loss confirmed significant muscle damage during the post-exercise period. Pain ratings and muscle volume recovered to baseline by 15 days, although muscle strength remained lower [77 (4) vs. 95 (3) kg pre-exercise, mean (SE)] and T2 values higher [32.2 (0.8) vs. 28.6 (0.2) ms pre-exercise]. Our results indicate that heat and/or static stretching does not consistently reduce soreness, swelling or muscle damage. The practical implication of our findings is that clinicians should be aware that prescribing heat and/or static stretching following intense eccentric or unaccustomed exercise will not enhance the recovery of damaged muscles.

  17. Comparison of the efficacy and safety of topical clindamycin and 5% benzoyl peroxide with nadifloxacin cream and 5% benzoyl peroxide gel in the treatment of acne vulgaris and assessment of the effects of these treatments on quality of life

    Directory of Open Access Journals (Sweden)

    Aslıhan Kırkağaç

    2015-03-01

    Full Text Available Background and Design: Acne vulgaris is a multifactorial chronic inflammatory disase of the pilosebaceous unit. Topical antibiotics and anti-inflammatory treatment are used for mild and moderate acne. Clindamycin is frequently used for acne treatment, altough nadifloxacin is a relatively new agent. There are few studies evaluating nadifloxacin efficacy. It's impact on quality of life has not been determined previously. In this study, it is aimed to compare the effect of these two agents, and to evaluate the effect of these treatments on quality of life. Materials and Methods: Eighty patients with mild-moderate acne vulgaris were divided in two groups of 40 people that had no difference in terms of age, gender and acne severity. The combination of topical clindamycin and 5% benzoyl peroxide gel twice a day was given to group 1 for 12 weeks. The combination of nadifloxacin cream and 5% benzoyl peroxide gel twice a day was given to group 2 for 12 weeks. The number of the inflammatory and non-inflammatory lesions were recorded at baseline and on weeks 2, 4, 8, 12 and side effects were recorded and evaluated. Global improvement was evaluated separately by patients and doctor after the treatment. Before and after the treatment, the quality of life of the patients were evaluated with Skindex-29. Results: Both treatment group regimens were significantly effective on inflammatory and non-inflammatory lesions and were well tolerated by patients in terms of side effects. It was also observed that there was statistically significant recovery after treatment in terms of clinical severity and quality of life. There was not any statistically significant difference between two treatment methods in terms of effectiveness, side effect and quality of life. Conclusion: Nadifloxacin and 5% benzoyl peroxide combination is effective in the treatment and improvement of quality of life in acne patients.

  18. Lipid nanoparticles for topical and transdermal application for alopecia treatment: development, physicochemical characterization, and in vitro release and penetration studies

    Directory of Open Access Journals (Sweden)

    Gomes MJ

    2014-03-01

    Full Text Available Maria João Gomes,1 Susana Martins,2,3 Domingos Ferreira,2 Marcela A Segundo,1 Salette Reis1 1REQUIMTE, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, 2Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal; 3Department of Physics, Chemistry and Pharmacy, University of Southern Denmark, Odense, Denmark Abstract: Alopecia is a dermatological disorder, commonly known as hair loss, which affects up to half of the Caucasian male population by middle age, and almost all (95% Caucasian men by old age. Considering that alopecia affects so many people and that there is currently no scientifically proven treatment with few side effects, new drug-delivery systems able to improve alopecia therapy are urgently required. With this purpose in mind, the present study aimed to develop lipid nanoparticles (nanostructured lipid carriers with the ability to incorporate and deliver anti-alopecia active compounds (minoxidil and finasteride into the dermis and hair follicles. Lipid nanoparticles, prepared by ultrasonication method, showed mean particle sizes around 200 nm, which is sufficient for reaching the dermis and hair follicles, and zeta potential values around -30 mV, which indicates good physical stability. Over 28 days of storage, no significant variations in these parameters were observed, which indicates that all nanoformulations are stable in storage over that period. Cryo-scanning electron microscope measurements showed that all the lipid nanoparticles exhibited a spherical shape and a smooth surface regardless of their composition. Differential scanning calorimetry studies allowed the determination of phase transition temperatures and confirmed the recrystallization of the lipid nanoparticles (recrystallization index between 11% and 86%. A high loading efficiency was achieved for finasteride (between 70% and 90%, while less than 30% was

  19. Acute treatment with kerosene damages the dermal barrier and alters the distribution of topically applied benzo(a)pyrene in mice.

    Science.gov (United States)

    LaDow, Kathy; Schumann, Brenda L; Luse, Nicole; Warshawsky, Dave; Pickens, William L; Hoath, Steven B; Talaska, Glenn

    2011-12-01

    The dermal route is important in many occupational exposures. Some materials may reduce the barrier function of the skin to enhance absorption and effect on internal organs. We have reported previously that kerosene cleaning following treatment with used engine oil increased DNA adduct levels in the lungs of mice compared with animals treated with used oil alone. To investigate what other physiological parameters might be affected by kerosene, we conducted in vitro and in vivo measurements of skin barrier function. We also topically applied (3)H-BAP(100 nM in 25 μL acetone) and washed half the mice with 25 μL kerosene 1 hr after carcinogen application. Groups of four mice were euthanized from 1 to 72 hr after treatment. Skin, lungs, and livers were harvested from each animal and stored separately. Kerosene application reduced the barrier function of the skin in vitro beyond the effect of the acetone vehicle and the vehicle plus BAP. In vivo studies indicated that kerosene treatment reduced the barrier function at 4 and 8 hr post application and that the barrier function recovered at 24 hr after a single treatment. The fraction of the radiolabel remaining in the skin of animals treated with (3)H-BAP and washed with kerosene was significantly less than those not washed, beginning at 24 hr (pKerosene treatment compromises dermal barrier function and the ability of the skin to retain water, enhances carcinogen absorption, and alters organ distribution. This appears to contribute to the increase in BAP DNA adducts we reported earlier.

  20. Pooled safety analysis of diclofenac sodium topical solution 1.5% (w/w in the treatment of osteoarthritis in patients aged 75 years or older

    Directory of Open Access Journals (Sweden)

    Roth SH

    2012-06-01

    Full Text Available Sanford H Roth1, Philip Fuller21Arizona Research and Education, Phoenix, AZ, 2Medical Affairs, Mallinckrodt Inc, Hazelwood, MOBackground: This study aimed to determine the safety of diclofenac sodium topical solution 1.5% (w/w in 45.5% dimethyl sulfoxide (TDiclo for the treatment of knee or hand osteoarthritis in persons aged 75 years or older.Methods: A pooled analysis of safety data from seven multicenter, randomized, blinded, Phase III clinical trials (4–12 weeks' duration of TDiclo was conducted. The analysis focused on a subset of patients (n = 280 aged 75 years or older with a primary diagnosis of osteoarthritis of the knee (six trials or hand (one trial. Patients received one of three topical treatments: TDiclo (n = 138; placebo (2.33% or 4.55% dimethyl sulfoxide, n = 39; or control (45.5% dimethyl sulfoxide, n = 103. Treatment groups were compared using Chi-square analysis, Fisher's Exact test, or analysis of variance.Results: The most common adverse events involved the skin or subcutaneous tissue, primarily at the application site. The incidence of dry skin was higher in the TDiclo (36.2%; P < 0.0001 and dimethyl sulfoxide control (18.4%; P = 0.0142 groups than in the placebo group (2.6%; the incidence of other skin or subcutaneous tissue adverse events was similar between the groups. Relatively few patients (<18% experienced gastrointestinal adverse events, and group differences were not detected. In the TDiclo group, constipation (3.6%, diarrhea (3.6%, and nausea (3.6% were the most common gastrointestinal adverse events. Cardiovascular and renal/urinary adverse events were rare, and group differences were not detected. There was one case (0.7% each of hypertension, spider veins, and vasodilation in the TDiclo group. Changes from baseline to the final visit in blood pressure and hepatic/renal enzyme levels were also similar between the groups.Conclusion: TDiclo appears to be well tolerated for the treatment of osteoarthritis in

  1. Brief Review on Differentiating Factors for Topical Drug Selections in Skin Disease Treatment%掌握多种差异性合理使用皮肤外用药

    Institute of Scientific and Technical Information of China (English)

    申国庆

    2015-01-01

    依据皮肤病分个体、分部位、分病程的治疗特性及皮肤外用药物与剂型的相关特点,浅述皮肤病外用药治疗选择的差异因素,归纳外用药使用的一般原则,提高用药的治疗效果。%Treatment of skin diseases is personalized. Treatment options also depend on location and course of diseases, as well as characteristics and dosage forms of topical drugs. Based on these observations, this review discusses on differentiating factors for topical drug selections in skin disease treatment, which helps to understand general principles of topical drug usages, and to improve drug treatment outcomes.

  2. Systematic review on the rapidity of the onset of action of topical treatments in the therapy of mild-to-moderate acne vulgaris.

    Science.gov (United States)

    Jacobs, A; Starke, G; Rosumeck, S; Nast, A

    2014-03-01

    The time until a patient achieves a relevant improvement during the treatment of a skin disease is important for selecting a therapy, but has been largely neglected in reviews and guidelines. The aim of this systematic review was to determine the time until the onset of action (TOA) of topical acne treatments. The primary outcome was the TOA defined as the time until a 25% reduction in the mean number of inflammatory lesions had been achieved. A systematic literature search in Medline and Embase was carried out. Clinical trials that evaluated head-to-head comparisons of treatments in patients suffering from mild-to-moderate papulopustular acne were included. Abstract and full-text screening and data extraction were done independently by two investigators. With respect to inflammatory lesions, different concentrations of benzoyl peroxide (BPO) or adapalene did not seem to influence the TOA. BPO seemed to act more quickly than isotretinoin and tretinoin. Adapalene showed a shorter TOA than isotretinoin. Conflicting results were seen when comparing adapalene with tretinoin, with a tendency for adapalene to be faster. Clindamycin/BPO seemed to act more quickly than adapalene. Inconsistent results were seen for the comparison of clindamycin/BPO and BPO alone with a slight indication of a shorter TOA for clindamycin/BPO. Adapalene/BPO and clindamycin/BPO showed comparable TOA. When interpreting the data, the different study designs and the limited study quality need to be taken into account. Further research is needed to identify treatments that offer an early onset of action and possibly help to optimize patients' adherence. TOA should be considered as an additional outcome in acne trials.

  3. Patient-reported outcomes after discontinuation of long-term topical corticosteroid treatment for atopic dermatitis: a targeted cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Takahashi-Ando N

    2015-04-01

    Full Text Available Naoko Takahashi-Ando,1 Mark A Jones,2 Shigeki Fujisawa,3 Rokuro Hama4 1Department of Applied Chemistry, Faculty of Science and Engineering, Toyo University, Saitama, Japan; 2School of Population Health, The University of Queensland, Herston, Queensland, Australia; 3Fujisawa Dermatology Clinic, Tokyo, Japan; 4Japan Institute of Pharmacovigilance, Osaka, Japan Background: Topical corticosteroid (TCS treatment is widely prescribed for atopic dermatitis (AD. However, TCS treatment is associated with tachyphylaxis, and discontinuation after long-term use may cause exacerbation of symptoms. Some AD patients are reluctant to use TCS. Objective: To evaluate patient-reported short- and long-term outcomes after discontinuation of TCS treatment for AD. Methods: Questionnaires were distributed to adult AD patients (n=1,812 of doctors who did not recommend TCS as first-line therapy for patients who preferred to avoid TCS. Data collected included current TCS use, duration of TCS use, past discontinuation of TCS use, exacerbation of symptoms after discontinuation of TCS use, and limitations to daily activities because of AD. Results: Of 918 respondents, 97.7% had used TCS, of whom 92.3% had experienced discontinuation of TCS use. After discontinuation, 63.9% experienced their most severe AD symptoms ever. The severity of exacerbation of symptoms was significantly correlated with the length of TCS use (P<0.001. Although most respondents who experienced severe exacerbation after TCS discontinuation were not current TCS users, they generally had fewer current limitations to activities than when AD symptoms were at their worst. Conclusion: Adult Japanese AD patients who experience severe exacerbation of symptoms immediately after discontinuation of TCS use generally improve over time. We suggest caution regarding long-term TCS treatment in AD patients.Keywords: adverse effects of corticosteroids, symptom exacerbation, rosacea-like dermatitis 

  4. Topical treatment with the opioid antagonist naltrexone accelerates the remodeling phase of full-thickness wound healing in type 1 diabetic rats.

    Science.gov (United States)

    Immonen, Jessica A; Zagon, Ian S; Lewis, Gregory S; McLaughlin, Patricia J

    2013-10-01

    Wound repair involves a series of overlapping phases that include inflammation, proliferation, and tissue remodeling, with the latter phase requiring months for proper healing. Delays in any of these processes can result in infection, chronic ulceration, and possible amputation. Diabetes is a major risk factor for improper wound repair, and impaired wound healing is a major complication for more than 26 million people in the US diagnosed with diabetes. Previous studies have demonstrated that the opioid antagonist naltrexone (NTX) dissolved in moisturizing cream reverses delays in wound closure in streptozotocin-induced type 1 diabetic (T1D) rats. NTX accelerated DNA synthesis and increased the number of epithelial and mast cells, as well as new blood vessel formation. In this study, remodeling was evaluated in T1D rats up to eight weeks after initial wounding. Twenty days following wounding, diabetic rats treated with vehicle had elevated numbers of MMP-2+ fibroblasts, suggesting delayed healing processes; birefringence of granulation tissue stained with Sirius red revealed diminished collagen formation and maturation. Wound tissue from NTX-treated T1D rats had comparable numbers of MMP-2+ fibroblasts to control specimens, as well as accelerated maturation of granulation tissue. The integrity of wounded skin was evaluated by tensile strength measurements. T1D resulted in delayed wound healing, and wounded skin that displayed reduced tensile strength relative to normal rats. Topical NTX applied to wounds in T1D rats resulted in enhanced collagen formation and maturation over a 60-day period of time. Moreover, the force required to tear skin of NTX-treated T1D rats was elevated relative to the force necessary to tear the skin of vehicle-treated T1D rats, and comparable to that for normal rats. These data reveal that complications in wound healing associated with T1D involve the novel OGF-OGFr pathway, and that topical NTX is an effective treatment to enhance wound

  5. Topical treatment with fresh human milk versus emollient on atopic eczema spots in young children: a small, randomized, split body, controlled, blinded pilot study.

    Science.gov (United States)

    Berents, Teresa Løvold; Rønnevig, Jørgen; Søyland, Elisabeth; Gaustad, Peter; Nylander, Gro; Løland, Beate Fossum

    2015-05-04

    Public health nurses report on effects of fresh human milk as treatment for conjunctivitis, rhinitis and atopic eczema (AE), the latter being highly prevalent in early childhood. Emollients and topical corticosteroids are first line treatment of AE. As many caregivers have steroid phobia, alternative treatment options for mild AE are of interest. The aim of this small pilot study was to assess the potential effects and risks of applying fresh human milk locally on eczema spots in children with AE. This was a split body, controlled, randomized and physician blinded pilot study, of children with AE with two similar contralateral eczema spots having a mother breastfeeding the child or a sibling. Fresh expressed milk and emollient was applied on the intervention spot and emollient alone on the control area, three times a day for four weeks. The severity and area of the eczema spots was evaluated weekly, and samples from milk and the spots were analysed weekly with respect to bacterial colonisation. Of nine patients included, six completed the study. Mean age at inclusion was 18.5 months. The spots examined were localized on the arms, legs or cheeks. The spots were similar in severity, but differed in area. In one patient the eczema ceased after inclusion. In four patients both control and intervention areas increased during the intervention. The relative change in eczema area compared to baseline showed less increase in the intervention spots in two patients, whereas the opposite was observed in three. In four children Staphylococcus aureus was found in their eczema once or more. In three of the 28 human milk samples, Staphylococcus aureus, alfa haemolytic streptococci or coagulase negative staphylococci were detected. Staphylococcus aureus was found once both in human milk and in the eczema spots, no clinical signs of infection were however observed. No secondary infection due to milk application was detected. In this small pilot study, no effect was found on eczema

  6. Effect of Topical Application of the Cream Containing Magnesium 2% on Treatment of Diaper Dermatitis and Diaper Rash in Children A Clinical Trial Study

    Science.gov (United States)

    Nourbakhsh, Seyyed Mohammad-Kazem; Rouhi-Boroujeni, Hojjatollah; Kheiri, Maryam; Mobasheri, Mahmoud; Shirani, Majid; Ahrani, Saeedeh; Karami, Javad

    2016-01-01

    Introduction Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and usually itchy, which could cause bacterial or candida infection, and predispose the infants to penis or vaginal and urinary infection and lead to discomfort, irritability, and restlessness. The drugs which have been so far administered for this disease (topical steroids) cause special complications for the sensitive skin in this area. Magnesium (Mg) is known for its anti-inflammatory and wound-healing properties. Aim The aim of the present study was to study the effect of the cream containing Mg 2% on treatment of diaper dermatitis and diaper rash in children. Materials and Methods In this clinical trial study, 64 children aged less than two years old with diaper dermatitis referring Paediatric Ward of Hajar Hospital were randomly assigned to two groups of 32. Group one was treated with the combined cream Mg 2% and Calendula and group two with Calendula cream alone. The duration of recovery was compared between the two groups. Results The duration of recovery was significantly lower in the intervention group than the control group (p-value<0.001), but there was no significant difference in the lesions size and diapers’ number between the two groups. Conclusion Based on the finding of this study, Mg is effective on treatment of diaper dermatitis and could be used for treating diaper dermatitis and other types of dermatitis. PMID:26894161

  7. Treatment of distal subungual onychomycosis with a topical preparation of urea, propylene glycol and lactic acid: results of a 24-week, double-blind, placebo-controlled study.

    Science.gov (United States)

    Emtestam, L; Kaaman, T; Rensfeldt, K

    2012-11-01

    Onychomycosis is difficult to cure as this requires eradication of the primary infection and protection of new areas of growth from reinfection. A new topical treatment (K101) has been developed. The aim of this study was to assess the efficacy, safety and tolerability of K101 treatment of distal subungual onychomycosis. This was a 24-week (plus 2-week washout), multicentre, randomised, double-blind, placebo-controlled study in 493 patients with distal subungual onychomycosis (K101, n = 346; placebo, n = 147), stratified according to degree of nail involvement. More patients with ≤50% nail involvement achieved the primary endpoint (mycological cure after 26 weeks) in the K101 group (27.2%) than placebo (10.4%; P = 0.0012). Proportions for patients with 51-75% involvement were 19.1% for K101 and 7.0% for placebo (not significant). More patients applying K101 than placebo judged that their condition had improved from week 2 (P = 0.0148) to week 24 (P = 0.0004). No safety issues were identified. K101 provides early visible improvements in nail appearance and a clinically meaningful antifungal activity.

  8. Effect of Topical Application of the Cream Containing Magnesium 2% on Treatment of Diaper Dermatitis and Diaper Rash in Children A Clinical Trial Study.

    Science.gov (United States)

    Nourbakhsh, Seyyed Mohammad-Kazem; Rouhi-Boroujeni, Hojjatollah; Kheiri, Maryam; Mobasheri, Mahmoud; Shirani, Majid; Ahrani, Saeedeh; Karami, Javad; Hafshejani, Zahra Keivani

    2016-01-01

    Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and usually itchy, which could cause bacterial or candida infection, and predispose the infants to penis or vaginal and urinary infection and lead to discomfort, irritability, and restlessness. The drugs which have been so far administered for this disease (topical steroids) cause special complications for the sensitive skin in this area. Magnesium (Mg) is known for its anti-inflammatory and wound-healing properties. The aim of the present study was to study the effect of the cream containing Mg 2% on treatment of diaper dermatitis and diaper rash in children. In this clinical trial study, 64 children aged less than two years old with diaper dermatitis referring Paediatric Ward of Hajar Hospital were randomly assigned to two groups of 32. Group one was treated with the combined cream Mg 2% and Calendula and group two with Calendula cream alone. The duration of recovery was compared between the two groups. The duration of recovery was significantly lower in the intervention group than the control group (p-valueeffective on treatment of diaper dermatitis and could be used for treating diaper dermatitis and other types of dermatitis.

  9. Topical Acne Treatments and Pregnancy

    Science.gov (United States)

    ... may be concern when a pregnant woman takes acetylsalicylic acid (aspirin), a related medication which is taken by mouth. At doses used for pain relief, aspirin has been shown to interfere with the development ...

  10. Pooled analysis of clinical trial data evaluating the safety and effectiveness of diclofenac epolamine topical patch 1.3% for the treatment of acute ankle sprain

    Directory of Open Access Journals (Sweden)

    Lionberger DR

    2011-07-01

    Full Text Available David R Lionberger1, Eric Joussellin2, Jillmarie Yanchick3, Merrell Magelli3,4, Arturo Lanzarotti51Southwest Orthopedic Group, LLP, Houston, TX, USA; 2Institut National du Sport, Paris, France; 3Formerly Alpharma Pharmaceuticals LLC, Piscataway, NJ, USA; 4GTx, Inc., Memphis, TN, USA; 5Institut Biochimique SA, SwitzerlandAbstract: This pooled analysis assessed the efficacy and safety of the diclofenac epolamine topical patch 1.3% (DETP for the treatment of acute mild-to-moderate ankle sprain. Data from 2 randomized, double-blind, placebo-controlled studies enrolling 274 male and female patients aged 18 to 65 years with acute ankle sprain were pooled and evaluated. The primary end point was pain reduction on movement assessed using a 100 mm visual analog scale (VAS. Safety and tolerability were also assessed. Beginning approximately 3 hours after initial treatment, DETP-treated patients experienced statistically significant and sustained lower mean VAS scores in pain intensity on movement (mean ± SD, 54.1 ± 20.0 mm versus 60.3 ± 16.8 mm compared with placebo-treated patients, representing a 20% versus 13% reduction in VAS pain scores from baseline (P = 0.012. This statistically significant difference in mean VAS score was maintained through day 7 (9.4 ± 14.4 mm versus 18.4 ± 18.2 mm, P < 0.0001. The DETP and placebo patches were well tolerated. These results further confirm the efficacy and safety of DETP for the treatment of acute pain from ankle sprains.Keywords: soft tissue injury, acute pain, visual analog scale, clinical trial, double-blind, safety

  11. 仙人掌外敷治疗产后乳房胀痛效果观察%The cactus topical treatment of postpartum breast tenderness effect observation

    Institute of Scientific and Technical Information of China (English)

    韦美丽

    2015-01-01

    Objective To explore the cactus external treatment effect for the treatment of postpartum breast tenderness.Methods 50 cases of maternal postpartum breast tenderness, wash clean, apply adequate amount of fresh cactus thorn take skin pound becomes slimy state, after baking hot (not very hot as appropriate) ring cover on the breast, thickness determined according to the degree of breast tenderness and induration, areola and nipple part is not covered, topical 20 min - 30 min, and then remove the cactus, with hot towel to clean the breast, then massage and breast milk, 3 to 4 times daily.Results After the intervention of maternal breast tenderness degree and induration was significantly reduced.Conclusion The cactus external treatment can obviously relieve maternal breast tenderness, reduce breast hardness, to breast milk.%目的:探讨仙人掌外敷治疗产后乳房胀痛的效果。方法对产后乳房胀痛的产妇50例,取适量新鲜仙人掌洗干净,去刺带皮捣烂成泥状,焙热(以不烫为宜)后环型覆盖于乳房上,厚度根据乳房胀痛及硬结程度决定,乳晕及乳头部分不覆盖,外敷20min-30min,然后除去仙人掌,用热毛巾清洁乳房,再按摩乳房及挤奶,每日3-4次。结果干预后产妇乳房胀痛程度及硬结得到明显缓解。结论仙人掌外敷可明显缓解产妇乳房胀痛,减轻乳房硬度,利于乳汁排出。

  12. Topics in atomic physics

    CERN Document Server

    Burkhardt, Charles E

    2006-01-01

    The study of atomic physics propelled us into the quantum age in the early twentieth century and carried us into the twenty-first century with a wealth of new and, in some cases, unexplained phenomena. Topics in Atomic Physics provides a foundation for students to begin research in modern atomic physics. It can also serve as a reference because it contains material that is not easily located in other sources. A distinguishing feature is the thorough exposition of the quantum mechanical hydrogen atom using both the traditional formulation and an alternative treatment not usually found in textbooks. The alternative treatment exploits the preeminent nature of the pure Coulomb potential and places the Lenz vector operator on an equal footing with other operators corresponding to classically conserved quantities. A number of difficult to find proofs and derivations are included as is development of operator formalism that permits facile solution of the Stark effect in hydrogen. Discussion of the classical hydrogen...

  13. A comparative study of toluidine blue-mediated photodynamic therapy versus topical corticosteroids in the treatment of erosive-atrophic oral lichen planus: a randomized clinical controlled trial.

    Science.gov (United States)

    Jajarm, Hasan Hoseinpour; Falaki, Farnaz; Sanatkhani, Majid; Ahmadzadeh, Meysam; Ahrari, Farzaneh; Shafaee, Hooman

    2015-07-01

    Recently, photodynamic therapy (PDT) has been suggested as a new treatment option that is free from side effects for erosive-atrophic oral lichen planus (OLP). The purpose of this study was to compare the effect of toluidine blue-mediated photodynamic therapy (TB-PDT) with local corticosteroids on treatment of erosive-atrophic OLP. In this randomized clinical trial, 25 patients with keratotic-atrophic-erosive oral lichen planus were allocated randomly into two groups. Group 1 (experimental): topical application of toluidine blue with micropipette was applied, and after 10 min, the patients were treated with a 630-nm GaAlAs laser (power density: 10 mW/cm(2)) during two visits. Group 2 (control) used mouthwash diluted with dexamethasone (tab 0/5 in 5 ml water) for 5 min, and then, it was spat out, and after 30 min, the mouth was rinsed with 30 drops of nystatin 100,000 units for 5 min and again spat out. Demographic data, type, and severity of the lesions and pain were recorded before and after treatment and then at the 1-month follow-up visit. Response rate was defined based on changes in intensity of the lesions and pain. In the experimental and control groups, sign scores of changes significantly reduced after treatment respectively (p = 0.021) and (p = 0.002), but between the two groups, no significant difference was observed (p = 0.72). In the experimental (p = 0.005) and control groups (p = 0.001), the intensity of lesions significantly reduced after treatment and there was a significant difference between the two groups (p = 0.001). The mean amount of improvement in pain was significantly greater in the control group compared with the experimental group (p < 0.001) (α = 0.05). Our study showed that TB-PDT with laser was effective in the management of OLP.

  14. Combined treatment with low-dose methotrexate and initial short-term superpotent topical steroids in bullous pemphigoid: an open, multicentre, retrospective study.

    Science.gov (United States)

    Du-Thanh, A; Merlet, S; Maillard, H; Bernard, P; Joly, P; Estève, E; Richard, M A; Pauwels, C; Ingen-Housz-Oro, S; Guillot, B; Dereure, O

    2011-12-01

    The interest of long-term superpotent topical steroids (STS) in bullous pemphigoid (BP) has been supported by randomized controlled trials. However, inadequate compliance, poor cutaneous tolerance and nursing difficulties are potential drawbacks. Open-label studies on limited series of patients suggested that low-dose methotrexate (MTX) may be useful, permitting long-term maintenance of a clinical remission obtained by initial, short-term STS. Open, clinical records-based retrospective analysis of a multicentre series of patients receiving a combined regimen of initial, short-term STS and MTX followed by long-term MTX alone. The primary objective was evaluation of the clinical efficiency of this strategy based on initial clinical remission and subsequent clinical maintenance. The secondary objective was evaluation of the tolerance (type and rating of adverse events) of this combined regimen. Seventy patients with BP (mean age 82·7 years) were included. Treatment consisted of an initial combination of STS and MTX for a mean duration of 12·3 weeks followed by long-term MTX alone for a mean duration of 8·48 months with a mean and median MTX dosage of 10 mg per week. One hundred per cent of the patients showed an initial, complete clinical remission after a mean time interval of 21·9 days. The overall rate of long-term disease control was 76%, whereas 24% of patients experienced at least one relapse during subsequent treatment with MTX alone. Drug-related adverse effects were mainly haematological and gastrointestinal and resulted in treatment discontinuation in 11 patients (16%). Six patients (9%) died during the follow-up period with one death (1%) most likely to be related to treatment. Long-term low-dose MTX combined with short-term STS may result in protracted control of BP in carefully selected patients. These results should prompt randomized controlled trials comparing this treatment with the more usual regimen of long-term STS alone. © 2011 The Authors

  15. Topical report review status

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-08-01

    This report provides industry with procedures for submitting topical reports, guidance on how the U.S. Nuclear Regulatory Commission (NRC) processes and responds to topical report submittals, and an accounting, with review schedules, of all topical reports currently accepted for review schedules, of all topical reports currently accepted for review by the NRC. This report will be published annually. Each sponsoring organization with one or more topical reports accepted for review copies.

  16. Reduction in facial hyperpigmentation after treatment with a combination of topical niacinamide and tranexamic acid: a randomized, double-blind, vehicle-controlled trial.

    Science.gov (United States)

    Lee, Do Hyun; Oh, In Young; Koo, Kyo Tan; Suk, Jang Mi; Jung, Sang Wook; Park, Jin Oh; Kim, Beom Joon; Choi, Yoo Mi

    2014-05-01

    Facial hyperpigmentation occurs in multiple conditions. In addition, many Asian women desire a lighter skin color. Thus, there is a need for the development of skin lightening agents, and niacinamide and tranexamic acid (TXA) are promising candidates. To assess the effectiveness of a combination of niacinamide and TXA as a topical moisturizing formulation for treatment of irregular facial pigmentation. A total of 42 Korean women (age range: 30-60 years) who were not pregnant, nursing, or undergoing any concurrent therapy were enrolled in this study for 8 weeks. Subjects used a twice-daily regimen of either a moisturizing cream containing 2% niacinamide + 2% TXA (test formulation; n = 21) or cream vehicles (vehicle control; n = 21) in addition to an assigned sunscreen each morning. Pigmentation was measured objectively using a mexameter and chromameter, in addition to physicians' assessment using clinical photographs. The niacinamide + TXA formulation regimen was significantly (P niacinamide + TXA reduced the appearance of irregular pigmentation, providing an effect beyond that achieved with sunscreen. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Topical glyceryl trinitrate in the treatment of anal fissure Utilidad del gliceril trinitrato en el tratamiento tópico de la fisura anal

    Directory of Open Access Journals (Sweden)

    F. Novell

    2004-04-01

    Full Text Available Aim: the aim of this study was to assess the effectiveness of topical glyceryl trinitrate (GTN in the treatment of anal fissure. Patients: eighty consecutive patients were randomized to receive 0.2% GTN gel twice a day during a minimum of 6 weeks. Of these 80 patients 34 were males and 46 female, with ages be-tween 20 and 78 years. All patients underwent a work-up that included gender, age, symptom duration, site, previous treatment attempts, pain score, associated diseases, and maximum anal resting pressure. These patients were followed at regular intervals of 4, 8, and 12 weeks to assess symptom outcome, rate of healing, adverse effects, and recurrence rate. Results: pain scores were significantly reduced during the treatment period in 65% of cases. After 4 weeks, 55% of patients had healed, and 78% after 9 weeks. In 18 patients (22%, anal fissures did not heal even with 6 additional weeks of treatment, and 12 of them (15% underwent lateral sphincterotomy. Sixty one percent of patients had flushing and 15% severe headaches. Conclusion: the results of this study have demonstrated the significant benefit of topical GTN when administered to patients suffering from anal fissures.Objetivo: el objetivo de este estudio era la valoración de la aplicación tópica de gliceril trinitrato en el tratamiento de las fisuras anales. Pacientes: un total de 80 consecutivos pacientes eran randomizados recibiendo gliceril trinitrato al 0,2% gel dos veces al día, durante un mínimo de 6 semanas. De los 80 pacientes, 34 eran varones y 46 mujeres, con edad comprendida entre 20 y 78 años. En los pacientes se controlaba sexo, edad, duración de síntomas, duración de tratamiento, localización, patología previa asociada, y valoración del dolor. Seguimiento a 4, 8 y 12 semanas, para controlar la sintomatología, el grado de curación, los efectos adversos y la relación de recidiva. Resultados: la disminución del dolor fue significativa en el 65% de los casos y

  18. Topical treatment with Xiaozheng Zhitong Paste alleviates bone cancer pain by inhibiting proteinase-activated receptor 2 signaling pathway.

    Science.gov (United States)

    Bao, Yanju; Wang, Gaimei; Gao, Yebo; Du, Maobo; Yang, Liping; Kong, Xiangying; Zheng, Honggang; Hou, Wei; Hua, Baojin

    2015-09-01

    Herbal analgesic Xiaozheng Zhitong Paste (XZP) and related modifications are often used in traditional Chinese medicine to manage cancer pain. However, its underlying mechanism remains unknown. To investigate the effects and mechanism of XZP on bone cancer pain in a rat model of breast cancer-induced bone pain, a bone cancer pain model was established by inoculating Walker 256 cells into Wistar rats. Bone cancer-bearing rats were topically treated with different doses of XZP or injected with 5 mg/kg of osteoprotegerin (OPG) as positive control. Bone destruction, bone mineral content (BMC) and bone mineral density (BMD) were analyzed by radiology. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were examined to determine pain levels. Trypsin, TNF-α and IL-1β serum levels were determined using enzyme-linked immunosorbent assay (ELISA). Central sensitization markers such as c-Fos, GFAP, IBA1 and CGRP, as well as proteinase-activated receptor 2 (PAR2) signaling pathway mediators such as PAR2, PKC-γ, PKA and TRPV1, were determined by quantitative RT-PCR and western blotting assay. XZP treatment significantly mitigated bone cancer-related nociceptive behavior, bone damage, BMC and BMD; and decreased radiological scores in rats. XZP treatment significantly inhibited IBA1, GFAP, c-Fos and CGRP expressions in the spinal cord; and significantly mitigated trypsin, TNF-α and IL-1β serum levels. Furthermore, PAR2, PKC-γ, PKA and TRPV1 relative mRNA levels and protein expression in bone lesions were significantly reduced in rats treated with XZP. XZP significantly alleviates breast cancer-induced bone pain by inhibiting the PAR2 signaling pathway.

  19. Comparison of the Therapeutic Effect of 2% Topical Minoxidil with Rosemary Solution in the Treatment of Alopecia Areata on the Scalp

    Directory of Open Access Journals (Sweden)

    R Yaghmaei

    2014-09-01

    Full Text Available Background & aim: Alopecia Areata is a chronic inflammatory disease which affects the hair roots. Different drugs and methods are used to treat this disease, nevertheless there is still no cure. The aim of this study was to compare the therapeutic effect of topical Minoxidil 2% solution in the treatment of alopecia areata on the scalp with rosemary solution. Methods: The present clinical-trial study was conducted on 78 patients with Alopecia Areata. Block randomization was designed in two groups of four Minoxidil 2% (n=39 and Rosemary (n=39. During the initial evaluation, patients were assessed in terms of location, number and extent of lesions by a dermatologist, and then the data were recorded. Patients in the intervention group were administered rosemary, as well as those in the control group were given Minoxidil 2%. The patients were instructed to apply the medication to the lesion twice a day. The lesion was re-evaluated two months later. Data were analyzed using SPSS version 18 as well as T-test and Chi-square test and descriptive statistics. Results: There were no significant differences in terms of mean age, mean duration of disease, and alopecia conflict in the patients of two groups (p>0.05. There was no significant difference in cure rates between the two groups (05/0 p>0.05. Conclusions: The findings of this study revealed that both Rosemary and Minoxidil had the same effects on alopecia areata. Due to the fact that the treatment of alopecia areata by rosemary plant is effective and affordable, it can be recommended.

  20. Comparison of the Therapeutic Effect of 2% Topical Minoxidil with Rosemary Solution in the Treatment of Alopecia Areata on the Scalp

    Directory of Open Access Journals (Sweden)

    R Yaghmaei

    2014-12-01

    Full Text Available Background & aim: Alopecia Areata is a chronic inflammatory disease which affects the hair roots. Different drugs and methods are used to treat this disease, nevertheless there is still no cure. The aim of this study was to compare the therapeutic effect of topical Minoxidil 2% solution in the treatment of alopecia areata on the scalp with rosemary solution. Methods: The present clinical-trial study was conducted on 78 patients with Alopecia Areata. Block randomization was designed in two groups of four Minoxidil 2% (n=39 and Rosemary (n=39. During the initial evaluation, patients were assessed in terms of location, number and extent of lesions by a dermatologist, and then the data were recorded. Patients in the intervention group were administered rosemary, as well as those in the control group were given Minoxidil 2%. The patients were instructed to apply the medication to the lesion twice a day. The lesion was re-evaluated two months later. Data were analyzed using SPSS version 18 as well as T-test and Chi-square test and descriptive statistics. Results: There were no significant differences in terms of mean age, mean duration of disease, and alopecia conflict in the patients of two groups (p>0.05. There was no significant difference in cure rates between the two groups (05/0 p>0.05. Conclusions: The findings of this study revealed that both Rosemary and Minoxidil had the same effects on alopecia areata. Due to the fact that the treatment of alopecia areata by rosemary plant is effective and affordable, it can be recommended.

  1. Efficacy and tolerability of fitostimoline (vaginal cream, ovules, and vaginal washing) and of benzydamine hydrochloride (tantum rosa vaginal cream and vaginal washing) in the topical treatment of symptoms of bacterial vaginosis.

    Science.gov (United States)

    Boselli, F; Petrella, E; Campedelli, A; Muzi, M; Rullo, V; Ascione, L; Papa, R; Saponati, G

    2012-01-01

    Two hundred and 91 patients showing signs and symptoms of bacterial vaginosis (BV) were randomized to receive topical treatment with Fitostimoline (vaginal cream and vaginal ovules + vaginal washing) or benzydamine hydrochloride (vaginal cream + vaginal washing) for 7 days. Signs (leucorrhoea, erythema, oedema, and erosion) and symptoms (burning, pain, itching, vaginal dryness, dyspareunia, and dysuria) (scored 0-3) were evaluated at baseline and at the end of treatment; the total symptoms score (TSS) was also calculated. In 125 patients, a bacterial vaginosis was confirmed by vaginal swab test. The primary efficacy variable analysis, that is, the percentage of patients with therapeutic success (almost complete disappearance of signs and symptoms), demonstrated that Fitostimoline ovules and vaginal cream were therapeutically equivalent and that pooled Fitostimoline treatment was not inferior to benzydamine hydrochloride. All the treatments were well tolerated, with only minor local adverse events infrequently reported. The results of this study confirmed that gynaecological Fitostimoline is a safe and effective topical treatment for BV.

  2. A Prospective, Descriptive Study to Assess the Clinical Benefits of Using Calendula officinalis Hydroglycolic Extract for the Topical Treatment of Diabetic Foot Ulcers.

    Science.gov (United States)

    Buzzi, Marcelo; de Freitas, Franciele; Winter, Marcos

    2016-03-01

    /dL (range 82-395 mg/dL), most (34) with Wagner type 1 ulcers--completed the study. The proportions of patients who achieved complete wound closure after 11, 20, and 30 weeks of treatment was 54%, 68%, and 78%, respectively; mean healing time was 15.5 ± 6.7 weeks. When individual weekly healing rates (the percentage reduction in wound area per week) were corrected for variability in initial DFU area, the values were nearly 6-fold higher for complete wound closure (7.8% ± 3.6%) than for incomplete wound closure (1.4% ± 0.7%) (Student t-test; P = 0.001). After 30 weeks of treatment, the number of colonized wounds decreased from 29 at baseline to 5, and the number of odorous wounds decreased from 19 to 1. Ulcer bed planimetry data showed a significant reduction in the amount of exudate, fibrin slough, and necrotic tissue after the treatment with C. officinalis hydroglycolic extract (χ(2) test; P = 0.001). No adverse events were observed during treatment. The study findings suggest C. officinalis extract is safe and has a beneficial effect on DFU healing. Randomized, controlled studies using C. officinalis hydroglycolic extract are warranted to confirm its safety and establish its clinical efficacy and effectiveness for the topical treatment of DFUs.

  3. Topical 5% lidocaine (lignocaine) medicated plaster treatment for post-herpetic neuralgia: results of a double-blind, placebo-controlled, multinational efficacy and safety trial.

    Science.gov (United States)

    Binder, Andreas; Bruxelle, Jean; Rogers, Peter; Hans, Guy; Bösl, Irmgard; Baron, Ralf

    2009-01-01

    Post-herpetic neuralgia (PHN) is a distressing neuropathic pain condition mainly affecting elderly patients. Neuropathic pain symptoms can be of a burning, shooting and stabbing nature, and may continue for prolonged periods and are often poorly controlled by polymedication. The aim of this study was to evaluate the analgesic efficacy and safety of topical analgesic treatment (5% lidocaine [lignocaine] medicated plaster) compared with placebo plaster in patients with PHN. This was a double-blind, placebo plaster-controlled, parallel-group, multicentre study employing enriched enrolment with randomized withdrawal methodology. After an initial 8-week open-label, active run-in phase, respo