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1.
Effect of oral isotretinoin on muscle strength in patients with acne vulgaris: a prospective controlled study.
Mülkoğlu, C, Karaosmanoğlu, N
BMC pharmacology & toxicology. 2021;(1):17
Abstract
BACKGROUND Musculoskeletal side effects related to isotretinoin are frequently reported. This study aimed to investigate the effect of oral isotretinoin treatment on muscle strength. Our second aim was to evaluate whether there was a correlation between the serum creatine phosphokinase (CPK) level, a specific marker of muscle breakdown, and muscle strength. METHODS This study included 30 patients who presented to our hospital and were started on oral isotretinoin treatment for acne vulgaris and 30 patients in the control group who were given local treatment. Age, sex, height and weight of the patients were recorded, and the body mass index (BMI) was calculated. The hamstring and quadriceps muscle strengths of the non-dominant side were evaluated in all patients using an isokinetic dynamometer, and the peak torque (PT) values were recorded. In the isotretinoin group, isokinetic measurements were performed again in those that completed six-month drug treatment and compared with the initial PT values. RESULTS The two groups were similar in terms of age, sex, and BMI (p > 0.05). There was no significant difference between the isotretinoin and control groups in terms of muscle strength at the beginning of the treatment (p > 0.05). No significant change was observed in hamstring and quadriceps PT values in the isotretinoin group after 6 months of treatment compared to baseline (p > 0.05). No statistically significant correlation was found between the serum CPK level and hamstring and quadriceps muscle strength (p > 0.05). CONCLUSION Oral isotretinoin doesn't alter muscle strength. There is no relationship between the serum CPK levels and muscle strength.
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2.
The Effect of Calcipotriene-Betamethasone Dipropionate Aerosol Foam versus Vehicle on Target Lesions in Moderate Severity Plaque Psoriasis: Focus on Elbows and Knees.
Del Rosso, JQ, Kircik, LH
Journal of drugs in dermatology : JDD. 2019;(4):358-361
Abstract
Calcipotriene 0.005%, a vitamin D analog, plus betamethasone dipropionate 0.064%, a high potency topical corticosteroid, are combined in an aerosol foam formulation proven to be effective and safe using once daily topical application for plaque psoriasis. In this investigator initiated open phase study, therapeutic response mirrored the clinical outcomes that were reported in pivotal studies. What is added to the body of medical literature on this topical combination formulation for plaque psoriasis is documentation of effective results with use on both elbows and knees as target sites. Skin tolerability was also highly favorable with this specific formulation. J Drugs Dermatol. 2019;18(4):358-361.
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3.
Dr Michaels® product family (also branded as Soratinex®) versus Methylprednisolone aceponate - a comparative study of the effectiveness for the treatment of plaque psoriasis.
Hercogovấ, J, Fioranelli, M, Gianfaldoni, S, Chokoeva, AA, Tchernev, G, Wollina, U, Tirant, M, Novotny, F, Roccia, MG, Maximov, GK, et al
Journal of biological regulators and homeostatic agents. 2016;(2 Suppl 3):77-81
Abstract
As one of the most common dermatologic chronic-recurrent disease, variable therapeutic options are available today for management of psoriasis. Although topical high potency corticosteroids, alone or in association with salicylic acid or vitamin D analogues, are still considered the best treatment, they do not seem to possess the capability for a long-term control of the disease or prevent recurrences, as their side effects are major contraindications for continuative use. The aim of this study was to investigate whether Dr. Michaels® product family is comparable to methylprednisolone aceponate (MPA) as a viable alternative treatment option for the treatment and management of stable chronic plaque psoriasis. Thirty adults (13 male, 17 female, mean age 40 years) with mild to severe stable chronic plaque psoriasis, were included in the study. Patients were advised to treat the lesions of the two sides of their body (left and right) with two different unknown modalities for 8 weeks; the pack of Dr. Michaels® products on the left side (consisting of a cleansing gel, an ointment and a skin conditioner) and a placebo pack on the right side, consisting of a cleansing gel, methylprednisolone ointment and a placebo conditioner. Assessment was done using the Psoriasis Activity Severity Index (PASI) scores before treatment and after 2, 4, 6 and 8 weeks. The results achieved with the Dr. Michaels® (Soratinex®) product family for the treatment of chronic plaque psoriasis were better than the results achieved with methylprednisolone aceponate (MPA), even though quicker resolution was achieved with the steroid with 45% of patients achieving resolution within 8-10 days in comparison to 5-6 weeks in the Dr. Michaels® (Soratinex®) group. Before therapy, the mean PASI score of the LHS in Dr. Michaels® (Soratinex®) group was 13.8±4.1 SD and 14.2±4.2 SD in the RHS methylprednisolone aceponate (MPA) group. After 8 weeks of treatment 62% of the Dr. Michaels® (Soratinex®) group had achieved resolution whilst in the methylprednisolone aceponate (MPA) group, the figure remained at 45%. The mean PASI score after 8 weeks of treatment was calculated and in the LHS Dr. Michaels® (Soratinex®) group it was 2.8±1.6 SD and 6.8±2.4 SD in the RHS methylprednisolone aceponate group. In the RHS -methylprednisolone aceponate (MPA) group, 22% of patients failed to respond to the treatment in comparison to 6% in the LHS Dr. Michaels® (Soratinex®) group. Based on the results of this study, Dr. Michaels® products are a more effective treatment option, with insignificant side effects, compared to local treatment with methylprednisolone aceponate (MPA).
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4.
Effect of different doses of isotretinoin treatment on the levels of serum homocysteine, vitamin B 12 and folic acid in patients with acne vulgaris: A prospective controlled study.
Kamal, M, Polat, M
JPMA. The Journal of the Pakistan Medical Association. 2015;(9):950-3
Abstract
OBJECTIVE To investigate the effects of different doses of isotretinoin on serum homocysteine, vitamin B12 and folic acid in patients with acne vulgaris. METHODS The case-control study was conducted at Gazi University School of Medicine, Ankara, Turkey, from November 2012 to March 2013, and comprised male or non-pregnant female patients more than 18 years of age. The cases had moderate to severe nodulocystic acne, while an equal and matching control group had healthy individuals. Isotretinoin was started in a dosage of 0.5 mg/kg/day, and 1.0 mg/kg/day in patients with medium and severe acne vulgaris respectively. Homocysteine, vitamin B12, folic acid, liver function tests, serum cholesterol and triglyceride levels were tested at the baseline and on day 45. SPSS 11 was used for statistical analysis. RESULTS The two groups had 62 subjects each. The cases had 47(76%) women and 15(25%) men with a group mean age of 21.0±2.7 years. The controls had 45(72.6%) women and 17(27.4%) men with a group mean age of 21.6±3.0 years. Homocysteine levels were significantly increased in both groups taking 0.5 mg/kg/day and 1.0 mg/kg/day isotretinoin (p<0.05). There were no statistically significant differences in the levels of vitamin B12, folate and liver function tests (p>0.05 each). Total cholesterol level increased significantly in the group using 1.0 mg/kg/day (p<0.05). In the triglyceride levels, significant increases were seen in both groups (p<0.05). CONCLUSIONS Evaluation of homocysteine, vitamin B12 and folic acid beside the routine tests were beneficial for the patients before they started isotretinoin treatment.
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5.
[Angioprotectors in the treatment of rosacea].
Tsiskarishvili, NV, Katsitadze, A, Tsiskarishvili, Ts, Tchitanava, L, Tsiskarishvili, NI
Georgian medical news. 2014;(228):51-4
Abstract
Rosacea - a common chronic inflammatory dermatosis (3-10% of all dermatoses) primarily affecting the skin of face. Numerous methods for the treatment of rosacea are defined by the diversity of etiologic and pathogenic factors of dermatosis, its stage and clinical form. But a significant role in its development, most researchers relate to vascular disturbances. It is suggested that vascular changes in this disease are the product of two interrelated pathological processes: the disturbances in integrity and tone of the vascular wall and disorganization of perivascular connective tissue. The results of these processes are formation of a stable dilatation of skin blood vessels clinically manifested by erythema and telangiectasia. Based on foregoing, The aim of this study was evaluation of therapeutic efficacy of Rutin Forte in complex treatment and prevention of rosacea. 30 patients with an erythematous stage of rosacea were under observation (20 women and 10 men) aged 25 to 50 years. The first group (15 patients) was treated by the standard procedure (Antibiotics, systemic metronidazole, antihistamines, traditional external therapy). Patients of the second group (15 people) additionally received a Rutin Forte containing long-acting vitamin C, zinc and selenium. The drug was administered at a dose of 2 capsule per day. Duration of treatment - 2 to 3 months. Observation period after treatment were 12 months. During this period we revealed a significant reduction of erythema, recurrence of disease in the second group of patients was not observed, but in the group of comparison recurrences were detected on 3rd month of follow up and the degree of erythema reduction was significantly less. Thus, the study revealed that Rutin Forte is an effective means for the treatment and prevention of the torpid relapsing forms of rosacea on erythematous stage of dermatosis.
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6.
The in vitro and in vivo genotoxicity of isotretinoin assessed by cytokinesis blocked micronucleus assay and comet assay.
Silva, FS, Oliveira, H, Moreiras, A, Fernandes, JC, Bronze-da-Rocha, E, Figueiredo, A, Custódio, JB, Rocha-Pereira, P, Santos-Silva, A
Toxicology in vitro : an international journal published in association with BIBRA. 2013;(2):900-7
Abstract
Isotretinoin is a retinoic acid frequently used in monotherapy or combined with narrow-band ultraviolet B (NBUVB) irradiation to treat patients with acne and psoriasis vulgaris. As both diseases need frequent and/or prolonged therapeutic interventions, the study of the genotoxicity of retinoids becomes important. Our aim was to study the genotoxic effects of isotretinoin alone or combined with NBUVB. In vitro studies were performed in the absence of S9 metabolic activation using blood from five healthy volunteers, incubated 72 h with isotretinoin (1.2-20 μM) (i.e., at concentrations usually achieved in blood with therapeutic doses as well as at higher concentrations). In vivo studies were also performed using blood from two patients with acne and three patients with psoriasis vulgaris treated with isotretinoin in monotherapy (8 or 20mg/day) or combined with NBUVB (20mg isotretinoin/day+NBUVB). The genotoxic effect was evaluated by the cytokinesis-blocked micronucleus and the comet assays. Our studies showed that isotretinoin alone was not genotoxic when tested in human lymphocytes in vitro and in vivo. There was no clear genotoxic effect in psoriatic patients treated with isotretinoin and NBUVB. The in vitro studies showed that isotretinoin induced apoptosis and necrosis in human lymphocytes at higher doses.
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7.
Evaluating the efficacy and safety of calcipotriene/betamethasone ointment occluded with a hydrogel patch: a 6-week bilaterally controlled, investigator-blinded trial.
Patel, T, Bhutani, T, Busse, KL, Koo, J
Cutis. 2011;(3):149-54
Abstract
Occlusive therapy with or without topical agents is effective in the treatment of psoriasis. This study assessed the efficacy and safety of an occlusive hydrogel dressing. Participants were treated with calcipotriene 0.005%-betamethasone dipropionate 0.064% ointment with and without a hydrogel patch. Thirty participants completed the 6-week, bilaterally controlled, investigator-blinded, single-center study. Substantial reductions in total modified psoriasis area and severity index (PASI) scores of occluded lesions versus nonoccluded lesions were seen as early as the first week of treatment and sustained through 4 weeks of the study. No adverse effects related to the study, including skin irritation, were observed or reported. Hydrogel dressings provide an effective and safe occlusive option to enhance topical therapy for psoriasis.
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8.
Enhanced healing of surgical wounds of the lower leg using weekly zinc oxide compression dressings.
Stebbins, WG, Hanke, CW, Petersen, J
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]. 2011;(2):158-65
Abstract
BACKGROUND Management of lower extremity wounds after Mohs micrographic surgery can pose a challenge to the surgeon. Postoperative reactive edema and inflammation can lead to a painful and protracted healing course. Unna boots deliver zinc oxide to the wound bed and surrounding skin while providing compression and occlusion of the wound. OBJECTIVE To evaluate the utility of weekly Unna boot therapy in decreasing postoperative edema, inflammation, and morbidity; minimizing postoperative wound care; and improving the rate of wound healing in patients with lower leg surgical defects. METHODS Ten patients (6 men, 4 women) aged 72 to 91 with postoperative defects on the distal lower extremity were treated with weekly Unna boots until wounds had sufficiently granulated or re-epithelialized. RESULTS In all 10 patients, weekly Unna boot therapy was well tolerated, with high satisfaction levels relating to minimal postoperative wound care, rapid granulation, minimal pain, and excellent esthetic outcome of postoperative wounds. No infections or other complications were noted during the healing process. LIMITATIONS This was not a randomized, controlled trial. CONCLUSIONS In patients with postoperative wounds of the lower leg, weekly Unna boots significantly improve the healing process, decrease postoperative pain, and minimize wound care.
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9.
Practical applications of genomics research for treatment of aging skin.
Kaczvinsky, JR, Grimes, PE
Journal of drugs in dermatology : JDD. 2009;(7 Suppl):s15-8
Abstract
Skin aging integrates the impact of extrinsic skin insults (e.g., ultraviolet [UV] light, etc.) with chronological, genetically programmed decreases in cellular function. A genomic study of aged skin highlighted the mechanistic importance of skin barrier function, exfoliation, control of reactive oxygen species and maintenance of extracellular matrix to the aging process. A set of topical products designed to address these mechanistic themes was developed and clinically tested. The individual products improved skin barrier function, hydration and skin turnover, as well as the smoothness and depth of periorbital wrinkles. Treatment with a regimen of these products improved the appearance of facial wrinkles after eight weeks. Changes in treated subjects' stratum corneum protein biomarker levels were consistent with the mechanistic pathways identified in the genomic work. Thus, leveraging a genomic understanding of skin aging led to the development of a clinically efficacious, aesthetically pleasing cosmetic regimen that improved the appearance of aged skin.
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10.
Plasma homocysteine level is elevated in patients on isotretinoin therapy for cystic acne: a prospective controlled study.
Polat, M, Lenk, N, Bingöl, S, Oztaş, P, Ilhan, MN, Artüz, F, Alli, N
The Journal of dermatological treatment. 2008;(4):229-32
Abstract
PURPOSE Isotretinoin (Iso) has marked side effects. Homocysteine (Hcy) metabolizes in the liver, requiring folate and vitamin B12. Elevated blood levels of Hcy have been linked to an increased risk of premature coronary artery disease (CAD). In this study, we evaluated Hcy levels, vitamin B12, and folate in patients on Iso treatment for cystic acne (CA). METHODS Seventy-four patients with CA were included to the study group. Blood levels of Hcy, vitamin B12, and folate were assessed before and after 45 days of Iso therapy. The control group consisting of 80 individuals were tested once. RESULTS Hcy levels were statistically significantly increased in patients on Iso treatment. Vitamins were unaltered, while lipids and liver enzymes increased statistically significantly. CONCLUSION Hcy levels are elevated in patients on Iso treatment for CA. It may be due to either the inhibition of cystathionine-beta-synthase, an enzyme required in the metabolism of Hcy, by the drug and/or the liver dysfunction. Daily supplementation with vitamin B12 and folate, which are the cofactors of the enzymatic reactions involved in Hcy metabolism, can lower plasma levels of Hcy, so it is recommended to take these vitamins in case of deficiency along with Iso to prevent premature occlusive vascular disease.