RESUMO
BACKGROUND AND AIMS: Lichen pilaris is a very common disease typically seen among young adults on their upper arms as a manifestation of hyperkeratotic lesions occurring in the pores. Only a few treatments have been reported as significantly effective, so often natural resolution over time is the only option. The present study examined the use of a 1064 nm Q-switched Nd:YAG laser (QSNY) in quasi long-pulsed mode, in an attempt to treat a case of lichen pilaris. SUBJECT AND METHODS: A 33-year-old male presented with light-brown aggregated papules observed on both sides of the upper arms. The affected areas were treated every other week (QSNY, pulse width 300 µs, pulse energy 3.0 J/cm(2), spot size 6 mm and repetition rate 10 Hz). Clinical photography was taken of the lesions at baseline and three months after the final treatment in addition to macrophotography and 3-D photography, biopsies being taken at both time points for histological comparison. RESULTS: The clinical photography and objective image evaluation demonstrated shrinkage of pores and improvement of the unevenness of the skin. Histological examination suggested that the effect of the micropulsed QSNY on the horny layer, epidermal keratinocytes and dermal collagen resulted in a peeling effect and increased dermal collagen density, which eventually led to the shrinkage of the pores and improvement of the skin condition. CONCLUSIONS: The results of this single patient case report suggest that the micropulsed QSNY could be an effective treatment option for lichen pilaris, improvement of which is often difficult. Further studies with an appropriately-sized population are merited to confirm these preliminary results.
RESUMO
Famciclovir is a guanine analog antiviral drug used commonly for herpes zoster. Efficacy of famciclovir treatment has been reported to be comparable to valacyclovir treatment. Both of these medications reduce the time to complete cessation of zoster-associated pain including post-herpetic neuralgia, as compared to acyclovir. We conducted a multicenter, randomized, open clinical trial in order to evaluate the extent of pain relief afforded by these two antiviral drugs during the acute disease phase of herpes zoster. The study group comprised 86 immunocompetent adult patients suffering from herpes zoster, who were treated with either famciclovir or valacyclovir for 7 days. Of these, 55 patients enrolled in this study within 72 h of the onset of the rash and 31 patients after 72 h of the onset. There was a significant reduction in acute herpes zoster pain with famciclovir on day 7 and at 2-3 weeks in both of these patient groups, while with valacyclovir, there was not significant reduction in pain on day 7. Of patients aged 50 years or older, there was a significantly earlier reduction in pain with famciclovir than with valacyclovir. In addition, a significant reduction in the number of patients with pain was observed as early as days 3-4 with famciclovir treatment as compared with valacyclovir treatment. We conclude that famciclovir was superior to valacyclovir in the relief of acute pain of herpes zoster. Accordingly, famciclovir is recommended for herpes zoster patients with moderate symptoms and a visual analog scale score of under 50 mm.
