The Journal of dermatological treatment
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Efalizumab is a recombinant, humanized IgG1 monoclonal antibody used in the treatment of plaque psoriasis. Efalizumab specifically targets T cells, leading to the subsequent inhibition of T-cell activation. The recent cases (three confirmed and one unconfirmed but suspected case) of the demyelinating disease progressive multifocal leukoencephalopathy (PML) have resulted in efalizumab being pulled from the market by European and Canadian regulatory agencies. ⋯ In light of these events, this report is a practical guide to transitioning patients from efalizumab to alternative psoriasis therapies. The major consideration is the possibility for efalizumab-associated rebound of psoriasis. According to limited available literature and in the experience of the authors, the most effective agent for minimizing or preventing rebound is cyclosporine at the maximum dermatologic dose of 5 mg/kg per day.
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Solid and hollow microneedles hold potential for painless vaccinations and drug injections. Hollow microneedles offer the potential for short-term bolus injections and long-term continuous injections. However, efficient injection requires complete penetration through the lipophilic stratum corneum. Furthermore, human skin is elastic, making microneedle penetration challenging. Here, we investigate whether hollow microneedles can penetrate and inject past the stratum corneum in human volunteers. ⋯ Our results demonstrate that hollow microneedle arrays deliver past the stratum corneum and not into the stratum corneum. Therefore, microneedles improve delivery in humans by penetrating past the stratum corneum and would be especially useful in the delivery of lipophilic drugs that partition slowly from the stratum corneum into the epidermis.
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Snail extracts have been increasingly used in numerous dermatologic conditions and recent literature attributes healing, soothing and anti-aging properties to them. This study evaluates the efficacy of Helix aspersa extract in an open wound management protocol for deep partial thickness (PT) facial burns and compares it to moist exposure burn ointment(MEBO). A total of 27 adult patients with deep partial thickness facial burns (group A) were treated by application of a snail extract cream twice daily for a maximum period of 14 days or until full epithelialization. ⋯ Mean times for eschar detachment were 9 +/- 2 days (group A) and 11 +/- 2 days (group B) (p = 0.003) and for burn surface epithelialization were 11 +/- 2 days and 15 +/- 3 days respectively (p < 0.001). VAS pain scores after application in group A were significantly lower compared to group B (p < 0.001). Helix aspersa extract is a natural, safe and effective alternative treatment in open wound management of partial thickness burns in adults.
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Randomized Controlled Trial Comparative Study
The efficacy of pimecrolimus 1% cream plus narrow-band ultraviolet B in the treatment of vitiligo: a double-blind, placebo-controlled clinical trial.
Recently, narrow-band ultraviolet B (NB-UVB) and topical immunomodulators have been successfully used in the treatment of vitiligo. ⋯ On the face, NB-UVB works better if combined with pimecrolimus 1% cream rather than used alone.
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Randomized Controlled Trial Comparative Study
A pramoxine-based anti-itch lotion is more effective than a control lotion for the treatment of uremic pruritus in adult hemodialysis patients.
The objective of this study was to evaluate the efficacy of a commercially available anti-itch lotion containing 1% pramoxine hydrochloride versus control lotion in the treatment of uremic pruritus in adult hemodialysis patients. ⋯ Our study shows that individuals using pramoxine 1% lotion experienced a reduction in pruritus to a greater degree than those using the control lotion. This safe, convenient and effective topical lotion may potentially benefit the large number of patients affected by pruritus associated with end-stage renal disease.