ABSTRACT
Introduction: Periorificial dermatitis (POD) is a common, chronic, inflammatory facial skin rash that presents as tiny papules and papulopustules with underlying eczematous-like patches, typically confined to the perioral, perinasal, and periorbital areas. There is currently no Food and Drug Administration (FDA)-indicated treatment for POD; however, broad-spectrum antibiotics are efficacious as a treatment option. Broad-spectrum antibiotics negatively impact gut flora and lead to antibiotic resistance. Narrow-spectrum tetracyclines, such as sarecycline, have a low potential for promoting bacterial resistance and gastrointestinal issues. Objective: We conducted a retrospective chart review in order to evaluate the efficacy of sarecycline in a cohort of patients diagnosed with POD that were treated with sarecycline. Methods: A review of medical records was completed using an electronic medical record. Inclusion criteria included males and females aged 18 to 95 with a diagnosis of POD, treated with sarecycline with a documented follow-up. Results: Six patients met inclusion criteria, all of which had shown improvement with no reported side effects. Of the six patients, four were female and two were male and the patient ages ranged from 26 to 58 years old (mean=41 years). The course of therapy ranged from 30 to180 days (median=90 days). Conclusion: Based on the outcomes, there are many potential benefits to treatment of POD with sarecycline over the alternative tetracycline-class antibiotics. There is a need for more large-scale clinical studies evaluating treatment options for POD. Based on the efficacy and tolerability of sarecycline in large- scale acne studies, sarecycline may be an appropriate novel treatment option for POD and should be explored further.
ABSTRACT
In a recently developed murine model for the induction of mixed chimerism and tolerance, hosts are treated with T cell depleting monoclonal antibodies (TCD mAbs; days -5, -1 and +7), thymic irradiation (TI) (7 Gy), and a high dose of fully allogeneic bone marrow cells (BMC, 200 x 10(6)). To find the minimum amount of each treatment required for success with this approach, we treated groups with (1) a lower dose of TI (3.5 Gy), (2) fewer BMC (100 x 10(6)), (3) no TI, (4) no TI plus additional TCD mAbs on day +14, or (5) fewer injections of TCD mAbs (day -5 only). Chimerism was followed by flow cytometry (FCM), and tolerance was assessed by skin grafting. Without TI, no long-term chimerism or tolerance could be induced, even when an additional dose of TCD mAbs was administered on day +14. A reduction in the dose of either BMC or TI led to substantially reduced effectiveness, as demonstrated by lower levels of chimerism and poorer donor skin graft survival. However, the dose of TCD mAbs and hence the duration of recipient T cell depletion could be safely reduced and thus the potential toxicity of the conditioning regimen lowered.
