Dermatology : international journal for clinical and investigative dermatology
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Dermatology (Basel) · Jan 1997
Multicenter Study Clinical TrialRoaccutane treatment guidelines: results of an international survey.
Oral isotretinoin (Roaccutane) revolutionized the treatment of acne when it was introduced in 1982. ⋯ Our recommendation is that oral isotretinoin should be prescribed not only to patients with severe disease but also to patients with less severe acne, especially if there is scarring and significant psychological stress associated with their disease. Acne patients should, where appropriate, be prescribed isotretinoin sooner rather than later.
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In recent years, liposomes have been increasingly explored as novel drug delivery systems, and several liposome-based drug products have been approved in Europe, the USA and Japan. Depending on size, composition and surface characteristics, liposomes interact specifically with biological structures. Liposomal drug products provide a topical activity at the desired locus of action and are deemed more effective and less toxic than conventional drug formulations. ⋯ The other aim is a well-tolerated liposomal PVP-I hydrogel for improved antiseptic wound treatment with moisturizer. It has been reported that liposomes are enriched at the wound bottom for direct action against infection and support of wound healing. An animal study on the efficacy and tolerability of different formulations of a hydrogel with PVP-I liposomes in deep dermal burn wounds has indicated an outstanding quality of wound healing with smooth granulation tissue, less inflammation, less wound contraction and no hyperkeratotic reactivity, especially with the 3% PVP-I liposome formulation.
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Dermatology (Basel) · Jan 1997
Profile of patients treated with Betadine cream and ointment in a major burn centre over a period of ten years (1986-1995).
The management of burns has shown substantial progress over the years. The application of an effective topical agent improves the healing rate of burns. Betadine cream and ointment have been used in all the burn admissions since 1986. ⋯ The major cause of injury was accidental scalding in 34.2% patients, and the majority (65.4%) stayed between 1 and 4 weeks in hospital. There were 452 deaths. This audit reviewing 6,056 sequential burn cases represents a 10-year experience of burn management, using Betadine cream and ointment as topical agent.
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The introduction of oral 13-cis-retinoic acid (isotretinoin, Roaccutane/Accutane) has been a key step in he history of dermatological treatments; it was and still is more than 15 years later the only compound which cures acne while oral antibiotics and other therapies, at best, have less dramatic effects. That oral isotretinoin works so well is probably entirely linked to its effect of the sebaceous glands that dedifferentiate and stop producing sebum. Amongst oral retinoids, both natural (such an all-trans-retinoic acid and 9-cis-retinoic acid) and synthetic (such as etretinate, acitretin, arotinoids), only 13-cis-retinoic acid exerts such an effect on sebum production and therefore on acne. ⋯ Considering the broad experience gained with this drug until now, guidelines for adequate use are evolving. Accordingly, it appears appropriate to: (1) redefine the indications for treatment with oral isotretinoin; (2) reconsider cost-benefit; (3) update labeling recommendations regarding daily doses since a cumulative treatment dose appears to be accepted as a means of preventing relapse, and (4) continue to control the teratogenic risk. These questions were the 'raison d'être' of this symposium.
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Dermatology (Basel) · Jan 1997
Psoriatic erythroderma: a histopathologic study of forty-five patients.
There are conflicting opinions about the diagnostic value of skin biopsy in erythrodermic psoriasis. ⋯ When features of early lesions of psoriasis are found during the evaluation of a biopsy specimen from a patient with a clinically nonspecific erythroderma, the dermatopathologist should be aware that this patient could have psoriasis and a renewed anamnesis and a close follow-up should be made.