A randomized, comparative study on the efficacy and safety of mangosteen 1% extract gel versus benzoyl peroxide 5% gel in the treatment of mild to moderate acne vulgaris

Introduction@#Acne vulgaris is a common dermatologic disorder caused by follicular epidermal hyperproliferation, excess se- bum production, inflammation, and Cutibacterium acnes (C. acnes). The mangosteen fruit rind contains large amount of xantho- nes, which has high antimicrobial activity against C. acnes.@*Objectives@#To compare the efficacy and safety of mangosteen 1% extract gel versus benzoyl peroxide (BPO) 5% gel in the treat- ment of mild to moderate acne vulgaris.@*Methods@#A total of 60 participants with mild to moderate acne or a rating of 2 or 3 in the Investigator’s Global Assessment (IGA) for acne were randomized to receive either mangosteen 1% extract gel or BPO 5% gel applied on the face twice daily over an 8-week period. Primary outcomes measured in the study were clinical remission graded as “clear” or “almost clear” (rating of 0 or 1) based on the IGA and any adverse reaction.

Pharmacological treatment options for acne

Acne vulgaris is a very common condition affecting up of about 80% to 90% of adolescents. The patients with acne have been shown to be adversely impacted by the effect of acne on their quality of life. Four factors are believed to play a key role in the development of acne lesions: excess sebum production, disturbed keratinization within the follicle, colonization of the pilosebaceous duct by Propionibacterium acnes, and the release of inflammatory mediators into the skin. Consequently, the target for acne therapy is these well-known pathogenic factors responsible for this disease state. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Fixed combination topical products with retinoids, benzoyl peroxide and antibiotics have been introduced. Use of systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the main pathogenic features of acne but is contraindicated in pregnant women and has been associated with cheilitis and dry skin. Hormonal therapy has been found to improve acne in some selective patients and should be considered for appropriate candidates. This review will present the general aspects of the pharmacological treatments for acne.

Uso do fluralaner no tratamento da demodicidose canina juvenil generalizada: relato de caso / Use of fluralaner on canine generalized juvenile demodicosis treatment: case report

O objetivo do presente trabalho foi relatar a eficácia do fluralaner no tratamento da demodicidose juvenil generalizada canina. Dois caninos, apresentando dois e três meses de idade, com diagnóstico clínico e parasitológico de demodicidose generalizada, foram tratados com administração única de fluralaner, na dose recomendada em bula pelo fabricante. Além disso, foi realizada a terapia adjuvante à base de xampu de peróxido de benzoíla e domperidona. Observou-se uma resposta terapêutica satisfatória, com repilação completa ao 30º dia após a administração do fármaco. Para cada paciente, foi realizado exame parasitológico do raspado cutâneo aos 75 e 90 dias seguintes ao início do tratamento, e todos foram negativos. Tendo em vista a elevada eficácia do tratamento proposto, sugere-se a inclusão do fluralaner nos protocolos terapêuticos destinados à demodicidose canina, particularmente nos pacientes pediátricos e com a forma generalizada da doença.(AU)

The aim of the present study was to report the efficiency of fluralaner on the treatment of two cases of canine generalized juvenile demodicosis. Two puppies, aging two and three months old, with the clinic and parasitological diagnosis of generalized demodicosis were treated with single administration of fluralaner. according to the dose recommended by the responsible laboratory. Additionally, adjuvant therapy was applied using benzoyl peroxide shampoo and domperidone. A satisfactory therapeutic response was observed, and complete repilation was present at the 30th day after drug administration. For each patient, at the 75th and 90th day after the treatment began, skin scrapings were performed in order to investigate the presence of Demodex sp; and all were negative. Considering the high efficiency of the treatment used, we suggest the inclusion of fluralaner on the therapeutic protocol for canine demodicosis, particularly in pediatric patients and with the generalized form of the disease.(AU)

TeleCondutas: acne / TeleGuides: acne

Acne é a dermatose mais comum, acometendo cerca de 80% dos adolescentes e adultos jovens. É caracterizada por lesões não-inflamatórias (comedões abertos e/ou fechados) e por lesões inflamatórias (pápulas, pústulas, cistos ou nódulos) tipicamente localizados na face, pescoço, dorso, tórax e braços. A etiologia da acne vulgar resulta da associação dos seguintes fatores: hiperqueratinização e obstrução do infundíulo folicular, devido à descamação anormal do epitélio folicular; aumento da produção de sebo estimulada pelos andrógenos; colonização do folículo pelo Propionibacterium acnes, gerando inflamação. Esta guia apresenta informação que orienta a conduta para casos de acne no contexto da Atenção Primária à Saúde, incluindo: classificação da acne vulgar, Características da acne vulgar, Erupção acneiforme, Diagnóstico da acne vulgar, Tratamento - Orientações gerais, Tratamento - Medicamentos, Terapia tópica, Antibióticos sistêmicos, Terapia antiandrogênica, Acne na Gestante, Acompanhamento, Encaminhamento para serviço especializado.

A comparative study of the effectiveness of tea tree oil and benzoyl peroxide in the treatment of acne vulgaris among Filipino teenagers and adults in Metro Manila / The Health Sciences Journal

Introduction@#The researchers aimed to determine the efficacy of tea tree oil in comparison to benzoyl peroxide in treating mild acne. This study also aimed to identify the side effects of both treatment modalities.@*Methods@#Using a randomized single blinded controlled clinical trial, teenagers and young adults with mild acne vulgaris were allocated to receive tea tree oil gel or benzoyl peroxide for four weeks. The effectiveness of the agents was measured using the Investigator's Global Assessment Scale. Posttreatment scores were compared with the baseline within groups. The difference was compared between the two study arms. Adverse reactions to the two agents were also noted.@*Results @#Both tea tree oil and benzoyl peroxide groups showed a significant decrease in the posttreatment lesion counts compared to the baseline, however when the mean differences were compared between groups, the difference was not significant.@*Conclusion@#Tea tree oil is comparable to benzoyl peroxide in treating mild acne vulgaris among teenagers and young adults.

Twice-per-week Application of an Adapalene-benzoyl Peroxide Fixed-dose Combination Gel as Maintenance Treatment for Acne Vulgaris in Adults / 대한피부과학회지

BACKGROUND: The efficacy and safety of daily maintenance treatment with an adapalene-benzoyl peroxide (adapalene-BPO) fixed-dose combination gel is established in acne vulgaris in adults. OBJECTIVE: This study evaluated the efficacy and tolerability of twice-per-week maintenance therapy with an adapalene-BPO combination gel for acne vulgaris in adults. METHODS: All patients applied the adapalene-BPO combination gel once daily during the initial 8 weeks. Subsequently, the patients were randomized into two groups. The maintenance group applied the ointment twice-per-week for 12 weeks of maintenance treatment, while the control group discontinued treatment after the initial 8 weeks active treatment. The changes in the mean numbers of total, inflammatory, and non-inflammatory lesions were assessed. RESULTS: During maintenance treatment, the changes in the average numbers of total and inflammatory lesions in the maintenance group differed significantly from the control group. CONCLUSION: Twice-per-week application of an adapalene-BPO combination gel after active treatment appears to be a good option for the maintenance therapy of acne vulgaris in adults.

Effects of Adapalene-Benzoyl Peroxide Combination Gel in Treatment or Maintenance Therapy of Moderate or Severe Acne Vulgaris: A Meta-Analysis

BACKGROUND: An antibiotic-free, fixed-dose combination gel with adapalene (A) 0.1% and benzoyl peroxide (BPO) 2.5% has been developed for treatment of acne vulgaris. OBJECTIVE: To compare the clinical outcomes of A-BPO combination gel with vehicle gel for treatment or maintenance therapy of patients with acne vulgaris. METHODS: An electronic search of the database PubMed (1966 to September 2012), Embase (1984 to September 2012), and Cochrane Controlled Trials Register (CENTRAL; 3rd Quarter, 2012) was undertaken to identify relevant studies. Main clinical outcomes were success rate, treatment-related adverse events (AEs), AEs leading to discontinuation, satisfaction with the effectiveness, and overall satisfaction. RESULTS: Six studies were finally included in this meta-analysis. The A-BPO group yielded better clinical outcomes regarding the success rate (p<0.00001), satisfaction with the effectiveness of treatment (p=0.005), and overall satisfaction (p=0.005) compared to the vehicle group. The incidence of treatment-related AEs in the A-BPO group was comparable with that of vehicle group (p=0.09), while the A-BPO group was associated with a slightly increase in the incidence of AEs leading to discontinuation when compared with the vehicle group (p=0.02). CONCLUSION: A-BPO combination gel yields better clinical outcomes including success rate, satisfaction with the effectiveness, and overall satisfaction compared to vehicle gel, despite an increased incidence of AEs leading to discontinuation. The A-BPO combination agent most likely contributes to the treatment of moderate acne vulgaris rather than severe acne vulgaris, but it may be useful in maintenance therapy of patients with severe acne vulgaris.

Evaluation of the Efficacy, Safety, and Treatment-Related Skin Irritation of Adapalene-Benzoyl Peroxide Combination Gel and Adapalene Gel in Acne Patients: A Randomized Comparative Study / 대한피부과학회지

BACKGROUND: While adapalene and benzoyl peroxide have both been demonstrated to be effective for the treatment of acne vulgaris, they can also cause skin irritation, resulting in patient incompliance. In addition, the irritation may be severe when adapalene is co-administered with benzoyl peroxide. OBJECTIVE: The intention of this study was to evaluate the efficacy and safety of adapalene 0.1%-benzoyl peroxide 2.5% fixed-dose combination gel, and adapalene 0.1% gel monotherapy, for the treatment of mild to moderate acne. Any changes in the skin barrier function were also measured. METHODS: A total of 52 patients applied adapalene-benzoyl peroxide gel or adapalene gel once daily. The changes in lesion counts, investigator's global assessment, patient satisfaction, and adverse events were recorded for 6 weeks. The biophysical profiles of the skin, including transepidermal water loss and redness, were measured for 3 weeks. RESULTS: Both agents were effective for the treatment of acne lesions. Adapalene-benzoyl peroxide showed a faster onset of action than adapalene, especially on inflammatory lesions. However, at week 6, both agents showed a similar effect in reducing lesion counts. While most patients in both groups experienced skin irritation from week 1, this gradually reduced. Likewise, the changes in transepidermal water loss and redness showed peak rates at week 1 and 2, but decreased over time. CONCLUSION: Adapalene-benzoyl peroxide gel is effective for the treatment of acne with a safety profile comparable to adapalene gel. The skin irritation experienced may be associated with the changes in skin barrier disruption, which lasts for 1~2 weeks.

Evidence on acne therapy / Evidencias sobre o tratamento da acne

Among the current treatments available for acne vulgaris, many widely practiced options lack support from studies at the best level of scientific evidence. The aim of this narrative review was to present the very latest information on topical and systemic treatments for acne vulgaris. Information from systematic reviews and well-designed clinical trials, obtained through a systematic search of the major medical databases, is emphasized. There are important issues regarding the clinical management of acne that still lack consistent grounding in scientific evidence. Among these are the optimum dose and duration of treatment with oral antibiotics that can be given without inducing bacterial resistance, and the safety of oral isotretinoin.

Na terapêutica atual da acne vulgar, muitas opções amplamente praticadas carecem de respaldo em estudos de melhor nível de evidência científica. O objetivo desta revisão narrativa é apresentar o que há de mais recente no tratamento tópico e sistêmico da acne vulgar. São enfatizadas as informações de revisões sistemáticas e de ensaios clínicos com bom desenho metodológico, obtidas a partir de busca sistematizada nas principais bases de dados em medicina. Há importantes questões referentes à conduta clínica diante da acne que ainda requerem embasamento em evidências científicas consistentes, entre elas a dose e a duração ideais do tratamento com antibióticos orais, sem que ocorra indução de resistência bacteriana, e a segurança da isotretinoína oral.

Effects of Chinese medical facial mask comprehensive therapy in treating acne vulgaris / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical effectiveness and safety of Chinese medical facial mask comprehensive therapy in treating acne vulgaris.</p><p><b>METHODS</b>Totally 233 acne vulgaris patients (FAS set) in I -III degree were randomly assigned to the facial mask group (113 cases) and the Western medicine group (120 cases). They were respectively treated with external application of Chinese medical facial mask (twice a week) and 5% benzoyl peroxide gel (Benzine, once in the evening). The treatment lasted for four successive weeks. The integrals of lesions and the improvement of Chinese medicine syndrome integrals were observed 1 week, 2 weeks and 4 weeks after treatment respectively. The occurrence of adverse reactions was recorded. The subjects' evaluation on using the Chinese medical facial mask comprehensive therapy was also recorded.</p><p><b>RESULTS</b>Totally 228 of the 233 patients completed the therapeutic course (7 cases of overtime, 221 cases of PPS set, 105 cases in the facial mask group and 116 cases in the Western medicine group). After 4 weeks of treatment, the lesions and the total effective rate of CM symptoms were obviously higher in the facial mask group than in the control group (46.9% vs 30.0%, 70.8% vs 55.8%, P < 0.05). The statistical results of FAS set and PPS set showed no difference. After 4 weeks of treatment, the integrals of PPS lesions and the CM syndrome integrals in the facial mask group were lower than in the Western medicine group, showing statistical difference (P < or = 0.05). After 2 weeks and 4 weeks of treatment, the integrals of lesions and the CM syndrome integrals of FAS set and PPS set were all higher in the facial mask group than in the control group (P < 0.05). The occurrence of adverse reactions was 1.8% (2/113) in the facial mask group and 2.5% (3/120) in the control group without statistical difference (P > 0.05).</p><p><b>CONCLUSIONS</b>Chinese medical facial mask comprehensive therapy is safe and effective in treating acne vulgaris of I - III degree. The occurrence of adverse reactions is very low. It is easy to operate and spread.</p>

Uso da limeciclina associada com o peróxido de benzoíla no tratamento da hipomelanose macular progressiva: um estudo prospectivo / The use of lymecycline and benzoyl peroxide for the treatment of progressive macular hypomelanosis: a prospective study

A hipomelanose macular progressiva é uma dermatose de etiopatogenia pouco conhecida. A participação do Propionibacterium acnes e a resposta ao tratamento com medicamentos com atividade para essa bactéria têm sido sugeridas. Relata-se uma série de casos de 13 pacientes com hipomelanose macular progressiva tratados com limeciclina e peróxido de benzoíla durante três meses, que apresentaram excelente resposta ao tratamento e nele se mantêm durante o período de seguimento do estudo.

Progressive macular hypomelanosis is a dermatosis of uncertain etiology. The participation of Propionibacterium acnes has been suggested in view of the response achieved following therapy with drugs that are active against this bacterium. This report describes a series of thirteen patients with progressive macular hypomelanosis who were treated with an association of lymecycline and benzoyl peroxide over a three-month period. Response to treatment was excellent and the positive results were maintained during the entire follow up period.

Eficácia da combinação tópica de peróxido de benzoíla 5 por cento e clindamicina 1 por cento para o tratamento da hipomelanose macular progressiva: um estudo randomizado, duplo-cego, placebo-controlado / Efficacy of topical combination of benzoyl peroxide 5 percent and clindamycin 1 percent for the treatment of progressive macular hypomelanosis: a randomized, doubleblind, placebo-controlled trial

FUNDAMENTOS: A hipomelanose macular progressiva é uma dermatose sem etiologia definida. Não há consenso ou medicação de primeira linha para o seu tratamento e os tratamentos utilizados são pouco eficazes. OBJETIVO: Avaliar a eficácia terapêutica da combinação tópica de peróxido de benzoíla 5 por cento e clindamicina 1 por cento associada à exposição solar para o tratamento da hipomelanose macular progressiva. MATERIAIS E MÉTODOS: Trata-se de um estudo randomizado, duplo-cego, placebo-controlado, no qual os pacientes foram divididos em dois grupos: o Grupo A utilizou a combinação tópica de peróxido de benzoíla 5 por cento e clindamicina 1 por cento e o Grupo B usou um creme gel como placebo. Os pacientes foram orientados à exposição solar diária, avaliados e fotografados sistematicamente. Os dados coletados foram inseridos e analisados pelo software Epi Info. Definiu-se a significância estatística por valor de p<0,05. RESULTADOS: Dos 23 pacientes incluídos, 13 foram do Grupo A e 10, do Grupo B. Onze pacientes do primeiro grupo (85 por cento) obtiveram melhora clínica importante e apenas dois (20 por cento) do segundo grupo obtiveram uma melhora clínica equivalente (p=0,003). Os efeitos colaterais foram mais frequentes nos pacientes do Grupo A (p=0,003). CONCLUSÃO: A combinação tópica de peróxido de benzoíla 5 por cento e clindamicina 1 por cento é eficaz no tratamento da hipomelanose macular progressiva.

BACKGROUND: Progressive macular hypomelanosis is a dermatosis without definite etiology. There is no consensus or first-line therapy in the treatment of progressive macular hypomelanosis, and the treatment options used are very little effective. OBJECTIVE: To evaluate the therapeutic efficacy of the topical combination of benzoyl peroxide 5 percent and clindamycin 1 percent associated with sun exposure for the treatment of progressive macular hypomelanosis. MATERIALS AND METHODS: This is a randomized, double-blind, placebo-controlled study in which patients were divided into two groups. Group A used the topical combination of benzoyl peroxide 5 percent and clindamycin 1 percent and Group B used gel cream as a placebo. Patients were advised to expose themselves to the sun on a daily basis and were systematically evaluated and photographed. The collected data were entered and analyzed using Epi Info. A p value < 0.05 was considered statistically significant. RESULTS: Out of the 23 patients included in the study, 13 were in group A and 10 in group B. Eleven patients (85 percent) in group A had significant clinical improvement and only two patients (20 percent) in group B showed an equivalent clinical improvement (p = 0.003). Side effects were more frequent in group A (p = 0.003). CONCLUSION: The topical combination of benzoyl peroxide 5 percent and clindamycin 1 percent is effective in the treatment of progressive macular hypomelanosis.

Cutaneous Adverse Reactions Associated with Epidermal Growth Factor Receptor Inhibitors / 대한피부과학회지

BACKGROUND: Cutaneous adverse reactions are often observed during chemotherapy with epidermal growth factor receptor (EGFR) inhibitors including papulopustular eruptions, xerosis and paronychia. OBJECTIVE: To investigate and compare the cutaneous adverse reactions induced by EGFR inhibitors including erlotinib, gefitinib and cetuximab which have commonly been used as chemotherapeutic agents in Korea. METHODS: We reviewed cutaneous adverse effects through the medical records and clinical photographs of 43 Korean patients who had been treated with erlotinib, gefitinib or cetuximab at Pusan Paik Hospital between June 2003 and January 2010. RESULTS: Papulopustular eruptions occurred in 28 patients (65.1%); they were easily controlled by topical benzoyl peroxide, clindamycin and a retinoid, or by oral minocycline and tetracycline. There were no significant differences in incidence, duration and severity grades of papulopustular eruptions among EGFR inhibitors. In contrast to previous studies, the frequency and severity of papulopustular eruptions were not significantly correlated with treatment responses to EGFR inhibitors. Xerosis appeared in 14 patients (41%), and was easily controlled by topical emollients and steroids, and by systemic steroids and antihistamines. Paronychia occurred in 8 patients (18.6%) and were controlled by conservative treatments. CONCLUSION: Papulopustular eruptions, xerosis and paronychia are common cutaneous adverse reactions associated with EGFR inhibitors and there are no significant differences in adverse cutaneous reactions among EGFR inhibitors. As these cutaneous adverse reactions are relatively easily controlled with treatment, it will be helpful to detect and treat these adverse reactions early, including reassuring the patients, which should increase compliance of patients during treatment with EGFR inhibitors.

Peróxido de benzoilo asociado con eritromicina en el manejo de la hipomelanosis macular progresiva del tronco / Benzoyl peroxide associated with erythromycin in the management of progressive macular hypomelanosis of the trunk

Se presenta una paciente de sexo femenino, mestiza, de 23 años de edad, con historia de 10 años de aparición de máculas hipopigmentadas en el dorso del tronco, asintomática, que había recibido múltiples tratamientos sin mejoría. Los hallazgos en el examen físico, sumados a los estudios de hongos e histopatológico, permitieron hacer el diagnóstico de hipomelanosis macular progresiva del tronco. Recibió tratamiento tópico con una combinación de peróxido de benzoilo y eritromicina, y presentó resolución de las lesiones. Se presenta el caso como ejemplo de una alternativa terapéutica en el manejo de esta entidad.

A Study of the Effectiveness in the Treatment of Mild to Moderate Severity Acne with Adapalene-benzoyl Peroxide Fixed-dose Combination Gel (Epiduo(R)) / 대한피부과학회지

BACKGROUND: A fixed-dose combination gel with adapalene 0.1% and benzoyl peroxide (BPO) 2.5% has been developed for once-daily treatment of acne. It is known to be effective to reduce inflammatory and non-inflammatory lesions, but there have been no study in Korean yet. OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of adapalene 0.1%-BPO 2.5% fixed-dose combination gel (adapalene-BPO) for the treatment of mild to moderate severity acne in Korean. METHODS: In total, 64 patients with mild to moderate severity acne were enrolled. Adapalene-BPO was applied to face once daily at night. The efficacy assessment was performed at baseline and monthly for 3 months: inflammatory lesions (IL), non-inflammatory lesions (NIL), total lesions (TL) were counted and median percentage changes of each lesion were measured for 3 months with patient satisfaction and adverse events questionnaire. RESULTS: Of the 64 patients enrolled, 58 have completed 3-month treatments. Adapalene-BPO showed early onset of action with significant reduction in inflammatory, non-inflammatory, and total lesion counts. The median percentage reduction of mild group from baseline to 3rd month was greater than moderate group in IL, NIL, and TL counts (71.1% vs 65%/61.4% vs 56.4%/67.7% vs 62% reduction). Also, patient satisfaction score improved and significant reduction of Korea Acne Grading System (KAGS) was noted in both groups. All the reported adverse events were mild. CONCLUSION: This study shows that adapalene-BPO is an effective and safe treatment regimen for both mild and moderate acne. It has a better effect for treating mild severity acne than moderate acne with reduction of the IL, NIL, and TL counts and greater patient satisfaction.

Pharmacologic Treatment of Acne

Acne is one of the most common skin diseases. It usually occurs during adolescence, but can persist into middle age. The most deleterious form can result in permanent scarring on the face, chest, and back. The pathogenesis of acne is thought to be multifactorial. There are four most significant pathogenic factors of acne: Androgen-stimulated production of sebum, hyperkeratinization and obstruction of sebaceous follicles, proliferation of Propionibacterium acnes and inflammation. Therefore, pharmacologic treatment of acne should be focused on at least one of these main causative factors. The ultimate goal of treatment is to address as many of the pathogenic factors of acne as possible while minimizing side effects. Topical retinoids correct abnormal keratinization, but it should be applied cautiously because of irritation. Benzoyl peroxide is an effective bactericidal agent against P. acnes. Main topical antibiotics are erythromycin and clindamycin. Recently, fixed combination topical products have been highlighted. Use of Systemic antibiotics, including tetracyclines and macrolides rapidly improves inflammatory acne lesions. Oral isotretinoin is effective against all of the pathogenic features of acne but is contraindicated in pregnant women and has been associated with elevations in triglyceride levels, cheilitis and dry skin. Hormonal therapy has been found to improve acne in some women and should be considered for appropriate candidates. Because acne is a complex multifactorial disorder, combination treatment may be required to target its various pathogenic factors. Combination treatments also offer the most improvement over the shortest time. This review provides a general overview of pharmacologic treatment of acne.

Estudo clínico, prospectivo, aberto, randomizado e comparativo para avaliar a segurança e a eficácia da luz azul versus peróxido de benzoíla 5 por cento no tratamento da acne inflamatória graus II e III / A prospective, randomized, open and comparative study to evaluate the safety and efficacy of blue light treatment versus a topical benzoyl peroxide 5 percent formulation in patients with acne grade II and III

FUNDAMENTOS: Muitos pacientes relatam melhora da acne com a exposição à luz solar, e vários estudos demonstram que a luz azul é efetiva no tratamento da acne. OBJETIVOS: Verificar a segurança e a eficácia da luz azul (espectro eletromagnético de 407 a 420 nm) no tratamento da acne inflamatória graus II e III, comparada à terapêutica tópica com peróxido de benzoíla a 5 por cento. MÉTODOS: O estudo avaliou 60 pacientes em cinco visitas: uma de seleção, uma com 7, 14 e 28 dias de tratamento e uma última de seguimento, 14 dias após o término do tratamento. Trinta foram randomizados para luz azul (oito sessões, duas vezes por semana), e outros 30, para peróxido de benzoíla a 5 por cento, duas vezes ao dia, diariamente. A avaliação foi por meio da contagem das lesões e fotografias. RESULTADOS: A redução no número médio de lesões foi semelhante com os dois tratamentos, independente do tipo de lesão (p 0,05), porém o tratamento com a luz azul apresentou menos efeitos colaterais. CONCLUSÕES: A luz azul foi um tratamento tão eficaz quanto o peróxido de benzoíla a 5 por cento para o tratamento da acne graus II e III, mas com menos efeitos adversos.

BACKGROUND: Many acne patients improve after exposure to sunlight and there are many reports about the efficacy of blue light phototherapy on acne lesions. OBJECTIVES - The purpose of this study was to evaluate efficacy and safety of blue light treatment versus topical benzoyl peroxide 5 percent formulation in patients with acne grades II and III. METHODS - Sixty volunteers with facial acne were included and evaluated in 5 visits: the first one for screening, another 3 held on days 7, 14 and 28 of treatment, and the last one after 14 days of the end of treatment. Thirty of them were irradiated with Blue Light (8 times, twice a week) and the other thirty were treated with topical Benzoyl Peroxide 5 percent formulation, auto-applied twice a day, every day. We assessed the severity of acne by counting the lesions and analyzing the photographs. RESULTS - The improvement achieved by the blue light was the same as the one with benzoyl peroxide, regardless of the type of lesion (p 0.05). Otherwise, the side effects were less frequent in the group treated with blue light. CONCLUSIONS - Blue light irradiation was as effective as Benzoyl Peroxide in acne treatment grades II and III but there were fewer side effects.

Clinical Features of the Cutaneous Adverse Events Induced by Combination Chemotherapy that Includes Cetuximab (Erbitux(R)) / 대한피부과학회지

BACKGROUND: Epidermal growth factor receptor (EGFR) inhibitors are associated with cutaneous adverse events, including papulopustular eruption, xerosis, paronychia, hair abnormality and mucositis. In particular, acneiform eruptions might serve as the visible markers of anti-tumor activity and the therapeutic efficacy of EGFR inhibitors. OBJECTIVE: Our aims are to investigate the common cutaneous adverse events induced by cetuximab, which is one of the EGFR inhibitors approved by the US Food and Drug Administration, and to analyze whether the presence and severity of papulopustular eruptions have a correlation with the tumor response. METHODS: We retrospectively reviewed the medical records and clinical photographs of 114 Korean patients who had been treated with cetuximab at Asan Medical Center from September 2004 to March 2007. Results: Papulopustular eruptions occurred in 100 patients (87.7%) and this usually happened 10 days after starting chemotherapy. There was a tendency that the better the tumor responded to the chemotherapeutic agents including cetuximab, the more severe were the papulopustular eruptions. The papulopustular eruptions prominently improved after the treatment with topical agents such as benzoyl peroxide, metronidazole, clindamycin and retinoid, and with systemic agents such as minocycline and tetracycline, and there was no adverse event induced by this treatment for papulopustular eruptions. Xerosis appeared in 67 patients (58.8%), and there was a tendency that the more severe papulopustular eruptions were, the more frequently xerosis occurred. Paronychia occurred in 8 patients (7.0%). CONCLUSION: Although the cutaneous adverse events are burdensome to the patients, they might serve as visible markers of the anti-tumor activity and therapeutic efficacy of cetuximab and they can be easily and safely controlled with many topical and systemic agents. Therefore, it is important for dermatologists to properly treat these cutaneous adverse events and to reassure the patient to continue with the cetuximab treatment.