RESUMO
BACKGROUND: Superficial chemical peels offer therapeutic results in a convenient, affordable treatment. Many clinicians use these peels in the treatment of acne and acne-prone oily skin. OBJECTIVES: This article examines the evidence base that supports the widespread use of superficial peels in this setting. METHODS: A search of the English language medical literature was performed to identify clinical trials that formally evaluated the use of chemical peeling in active acne. RESULTS: Search of the literature revealed very few clinical trials of peels in acne (N=13); a majority of these trials included small numbers of patients, were not controlled and were open label. The evidence that is available does support the use of chemical peels in acne as all trials had generally favourable results despite differences in assessments, treatment regimens and patient populations. Notably, no studies of chemical peels have used an acne medication as a comparator. As not every publication specified whether or not concomitant acne medications were allowed, it is hard to evaluate clearly how many of the studies evaluated the effect of peeling alone. This may be appropriate, however, given that few clinicians would use superficial chemical peels as the sole treatment for acne except in rare instances where a patient could not tolerate other treatment modalities. CONCLUSIONS: In the future, further study is needed to determine the best use of chemical peels in this indication.
Assuntos
Acne Vulgar/terapia , Abrasão Química , Glicolatos/uso terapêutico , Ceratolíticos/uso terapêutico , Ácido Pirúvico/uso terapêutico , Ácido Salicílico/uso terapêutico , Medicina Baseada em Evidências , HumanosRESUMO
We describe a patient with lymphocytic leukemia who developed multiple, disseminated, vesiculopustular eruptions in combination with perianal ulcer. Four years earlier, she had a herpes zoster (HZ) infection involving the ophthalmic division of her left trigeminal nerve with subsequent postherpetic neuralgia that was treated with steroids. After the studies, we concluded that the patient had a recurrent disseminated HZ infection and perianal ulcer caused by cytomegalovirus (CMV).
Assuntos
Infecções por Citomegalovirus/complicações , Fissura Anal/complicações , Herpes Zoster/complicações , Úlcera Cutânea/complicações , Idoso , Idoso de 80 Anos ou mais , Antivirais/uso terapêutico , Infecções por Citomegalovirus/tratamento farmacológico , Infecções por Citomegalovirus/virologia , Feminino , Fissura Anal/tratamento farmacológico , Fissura Anal/virologia , Ganciclovir/uso terapêutico , Herpes Zoster/tratamento farmacológico , Herpes Zoster/virologia , Humanos , Leucemia Linfoide/complicações , Recidiva , Úlcera Cutânea/tratamento farmacológico , Úlcera Cutânea/virologiaAssuntos
Oftalmopatias/etiologia , Doenças Metabólicas/complicações , Dermatopatias/etiologia , Amiloidose/complicações , Erros Inatos do Metabolismo dos Carboidratos/complicações , Complicações do Diabetes , Retinopatia Diabética , Humanos , Erros Inatos do Metabolismo Lipídico/complicações , Doenças por Armazenamento dos Lisossomos/complicações , Erros Inatos do Metabolismo/complicações , Doenças das Paratireoides/complicações , Porfirias/complicações , Doenças da Glândula Tireoide/complicaçõesRESUMO
Tissue resistance to insulin is a major feature underlying the development of acanthosis nigricans in many patients. We report two unusual cases of acanthosis nigricans with contrasting forms of insulin resistance and propose an algorithm for the evaluation of patients with acanthosis nigricans. Further, we present a schematic framework that emphasizes the role of insulin and insulin growth factors in the pathogenesis of acanthosis nigricans.