ABSTRACT
OBJECTIVE: To evaluate the efficacy and tolerance of a combined 445nm/630nm light therapy mask for the treatment of mild-to-moderate acne vulgaris with and without topical 1% salicylic acid with retinol versus 2.5% benzoyl peroxide. DESIGN: A 12-week evaluator-blinded, randomized study. Subjects were randomized to be treated with the 445nm/630nm light therapy mask alone, benzoyl peroxide, or 445nm/630nm light therapy mask with topical 1% salicylic acid with retinol. PARTICIPANTS: Healthy male and female subjects 12 to 35 years old with Fitzpatrick skin types I to VI and mild-to-moderate facial acne vulgaris. MEASUREMENTS: The primary endpoint was the change in the number of inflammatory acne lesions after 12 weeks of treatment. Secondary endpoints included the change in noninflammatory acne lesions, change in total acne lesions, change in Investigator Global Acne Assessments, and overall responder rate. RESULTS: 445nm/630nm light therapy mask-treated subjects showed a 24.4-percent improvement in inflammatory acne lesions (p<0.01) versus 17.2 percent (p<0.05) and 22.7 percent (p<0.01) in benzoyl peroxide and 445nm/630nm light therapy mask with topical 1% salicylic acid with retinol, respectively, a 19.5-percent improvement in noninflammatory lesions (p<0.001) versus 6.3 and 4.8 percent for benzoyl peroxide and 445nm/630nm light therapy mask with topical 1% salicylic acid with retinol, respectively. Subjects in the 445nm/630nm light therapy mask group also achieved a 19.0-percent improvement in the Investigator Global Acne Assessment (p<0.001) versus 4.7 percent in benzoyl peroxide and 13.9 percent in 445nm/630nm light therapy mask with topical 1% salicylic acid with retinol (p<0.01). Treatments were well-tolerated overall with trends toward less early irritation in the 445nm/630nm light therapy mask group. CONCLUSION: 445nm/630nm light therapy mask appears to be a safe and effective therapy for mild-to-moderate acne.
ABSTRACT
Neutrophilic dermatosis of the dorsal hands (NDDH) is a rare condition often misdiagnosed as a localized cutaneous infection. A type of neutrophilic dermatosis, NDDH is considered to be a subset of Sweet's syndrome and is similar to pyoderma gangrenosum. The authors report 2 cases of male patients who presented with persistent ulcerative skin lesions. In both cases, biopsy revealed neutrophilic infiltration consistent with NDDH. Patient 1 had been unsuccessfully treated with antibiotics. Lesion biopsy showed epidermal hyperplasia with spongiosis and overlying scale crust, as well as dense neutrophilic infiltration of the underlying dermis. Periodic acid-Schiff (PAS) stain was negative for fungal and yeast organisms. A biopsy of a lesion from patient 2 indicated focal parakeratosis, perivascular inflammatory cell infiltrate, and scarring. Both patients were prescribed oral and/or topical corticosteroids and the condition resolved in 1-2 months. The clinical presentation, histological features, and excellent response to corticosteroid treatment are consistent with diagnosis of NDDH. Delayed recognition of neutrophilic dermatosis and treatment of secondary infection resulted in delayed treatment. Improved recognition of neutrophilic dermatoses is important for optimal management of NDDH. .
ABSTRACT
Cytomegalovirus (CMV) is the most common cause of life-threatening opportunistic viral infection in patients with the human immunodeficiency virus (HIV) disease. The colon is a well-known target organ for CMV in these patients. CMV colitis is commonly associated with the later stages of HIV disease but rarely occurs in early HIV infection. In this study, an unusual case of CMV colitis in a 22-year-old man who had a normal CD4 count but at the same time was found to be HIV positive with a moderately high viral load is reported.