Topical acne treatment with acetylcysteine: clinical and experimental effects.

Among the large variety of effects of acetylcysteine, several of them relate to cutaneous function in general and to sebaceous activity in particular. Due to the latter, a study was undertaken to investigate a possible effect of this substance in grade I acne. An analysis of the data from 99 patients in a double-blind study demonstrated that 5% acetylcysteine topical gel is significantly superior to placebo (P = .04) in reducing comedo counts. Comparable results were obtained in both sexes. This study indicates that acetylcysteine is an effective therapeutic option for the treatment of mild to moderate acne.

Endometrial microstructure after long-term use of a 91-day extended-cycle oral contraceptive regimen.

OBJECTIVE: To assess the effect on the endometrial microstructure of an extended-cycle oral contraceptive (OC) regimen containing ethinyl estradiol (EE) and levonorgestrel (LNG). METHODOLOGY: Subjects received up to four cycles of a 91-day extended-cycle OC regimen (84 consecutive days of monophasic 30 microg EE/150 microg LNG followed by 7 days of placebo). Endometrial biopsies were performed prior to the initiation and at the completion of therapy. All endometrial samples were processed centrally and reviewed by three independent pathologists blinded to treatment groups. RESULTS: Endometrial biopsies were performed in 50 women. In general, samples taken after completion of therapy with no further hormonal exposure demonstrated rapid return to normal endometrial cycling. In contrast, the majority of subjects still on active extended hormonal OC therapy at the time of biopsy had inactive or atrophic endometrium. No intravascular blood clots were observed in any of the specimens. CONCLUSION: The endometrial findings observed in this cohort of women treated with a 91-day extended-cycle OC regimen for up to 1 year showed no significant pathology. Additionally, the endometrium reverted quickly to normal cyclic changes in those subjects who, after completing therapy, elected not to continue with hormonal contraception.

Value of histopathology in vitiligo.

BACKGROUND: Histopathologic studies of vitiligo have been rather limited in number, thus the microscopic features of this common disorder are not very well known. SUBJECTS AND METHODS: Skin specimens from 20 human vitiligo patients and skin specimens from five equine vitiligo patients were studied by light and transmission electron microscopy. RESULTS AND DISCUSSION: Absence of melanocytes, increased number of Langerhans' cells, epidermal vacuolization, thickening of the basement membrane, T-cell inflammatory infiltrate, and neural alterations were noted in the vitiligo lesions. These results may explain the development of depigmentation, but do not yet fully explain why and how this occurs.