DOCSLIB.ORG

Dermatological Effects of Different Keratolytic Agents on Acne Vulgaris

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Dermatological Effects of Different Keratolytic Agents on Acne Vulgaris Clin l of ica a l T n r r i u a l o s J Alodeani, J Clin Trials 2016, 6:2 Journal of Clinical Trials DOI: 10.4172/2167-0870.1000262 ISSN: 2167-0870 Research Article Open Access Dermatological Effects of Different Keratolytic Agents on Acne Vulgaris Essa Ajmi Alodeani* College of Medicine at AD-Dwadmi, Shaqra University, Saudi Arabia *Corresponding author: Essa Ajmi Alodeani, College of Medicine at AD-Dwadmi, Shaqra University, Saudi Arabia, Tel: +966 55 075 9042; E-mail: [email protected] Received date: March 24, 2016; Accepted date: April 18, 2016; Published date: April 25, 2016 Copyright: © 2016 Alodeani EA. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Acne vulgaris is a chronic inflammatory skin disease; it's one of the most common skin disorders and affects mainly adolescents and young adults. Keratolytic agents are widely used in treatment of acne from several years. In this study we aimed to evaluate and compare the cutaneous response of different keratolytic agents in management of acne vulgaris. Ninety patients were selected among those attending the outpatient dermatology clinic in AD- Dwadmi hospital during the period from October 2015 to February 2016. The selected patients had different forms of acne vulgaris, papulo-pustular, comedonal and post acne scar. Three types of keratolytic agents were used, glycolic acid 50%, salicylic acid 20% and jessner solution. In papulopustular lesions, the three agents were effective with non-significant difference between them; however, there was more excellent results with jessner solution (70 % of patients) then glycolic acid (50%) and lastly salicylic acid (40%). According to the clinical efficacy of used keratolytic agents in comedonal lesions , all lines were found to be effective and there was non-significant difference between the 3 studied groups, however there was more excellent results with salicylic acid (80%) then glycolic acid (60%) and lastly Jessner solution (50%). According to the clinical efficacy of all keratolytic agents in acne scar lesions, there was significant difference between the 3 studied groups. Both jessner and salicylic acid were non effective, however glycolic acid was moderately effective (30% showed excellent results and 40% showed good results). Minimal complications were noticed with all the agents used. More erythema was recorded with jessner solution. However there was significant difference between all keratolytic agents as regards the incidence of visible exfoliation where glycolic acid showed least visible exfoliation (only 40% of cases) followed by jessner solution (66.7%) and lastly salicylic acid (80%). Keywords: Acne vulgaris; Salicylic acid; Glycolic acid; Jessner There are five main alpha hydroxy acids, which is a group are known solution as “fruit acids”. Glycolic acid (pKa 3.83) is the smallest molecule produced from sugar cane. So, it is the best to penetrate the epidermis Introduction and it has the greatest utility with valuable keratolytic action [7]. Lactic, malic, tartaric and citric acids are also used and comes from Acne vulgaris is chronic inflammatory skin disease; it's one of the sour milk, tomato juice, grapes, and citrus fruits respectively. Glycolic most common skin disorders. The presence of facial and shoulder acid is used to increase collagen, mucopolysaccharide, and hyaluronic lesions, pustules, pimples and sometime abscess accompanied by acid production and increase skin thickness by concentrations range disease can produce a psychological burden on the patients [1]. from 20% to 70% either in the free acid form or in the partially Combination of several factors such as hormonal changes, excessive neutralized form. Glycolic acid is effective in treatment of production of sebum and accumulation of exfoliates; allow bacterial inflammatory and non-inflammatory lesions of acne due to its growth resulting in the inflammation of the skin [2]. Acne affects antimicrobial and antioxidant action, also it can correct the mainly adolescents and young adults, with up to 90% of adolescents hyperkeratinization found in acne [8]. affected by acne at some stage. In addition, 5% of adults suffer from persistent or late onset acne [3]. Regarding to the prevalence of acne, Jessner solution is prepared by Max Jessner and composed of 14% studies show that more than 20% of adolescents with acne seek help salicylic acid, 14% lactic acid, and 14% resorcinol in 95% ethanol. The from medical professionals. Instead, individuals either do not treat solution is stable for up to 6 months, but due to salicylic acid their acne or self-treat with over the counter products [4]. photosensitivity it must kept in amber glass containers. The presence of salicylic acid and resorcinol gives the solution keratolytic and anti- Salicylic acid belongs to β-hydroxy acids Pka3 which is most widely microbial activity also, lactic acid provide epidermolysis action so, the used in common skin disease like acne, psoriasis, warts, corn and solution suitable for comedonal acne, post-inflammatory calluses. It used mainly for its keratolytic, bacteriostatic, fungicidal, hyperpigmentation, mild melasma, and photoaging [9]. and photoprotective properties by different concentrations vary from 0.5% to 60% in topical preparation [5]. It exerts its function by reduce The aim of this study was to evaluate and compare the cutaneous the rate of keratinocyte proliferation and inhibits cholesterol response of different keratolytic agents in management of acne sulfotransferase enzyme which is responsible for cholesterol sulfate vulgaris. formation within keratinocytes, also salicylic acid directly solubilizes the stratum corneum by dissolving the intercellular cement [6]. J Clin Trials Volume 6 • Issue 2 • 1000262 ISSN:2167-0870 JCTR, an open access journal Citation: Alodeani EA (2016) Dermatological Effects of Different Keratolytic Agents on Acne Vulgaris. J Clin Trials 6: 262. doi: 10.4172/2167-0870.1000262 Page 2 of 8 Patients and Methods Salicylic acid 20%: 20 gram of salicylic acid crystals were dissolved in 95% alcohol to form 100cc of 20% solution (wt./vol.) and saved in Patients dark amber containers. Application: The skin was degreased as mentioned above and Ninety patients with acne vulgaris were selected among those salicylic acid was applied using square cotton gauze starting with attending the outpatient dermatology clinic in AD-Dwadmi hospital forehead and cheeks then chin, nose and lower eyelids within 30 during the period from October 2015 to February 2016. The selected seconds. At that time, patient was suffering from a stinging and patients had different forms of acne vulgaris include papulo-pustular, burning sensation which increased during the next 2 minutes, reached comedonal and post acne scar. patients who had history of maximum at 3 min and then rapidly decreased to baseline over the photosensitivity, keloid formation, poor wound healing, immuno- next minute; this is considered the end point. After application of suppression, kidney or liver disease, recurrent herpes simplex, , salicylic acid it leaves white precipitate on the surface of the face which dermabrasion or isotretinoin therapy in the past year were excluded called salicylic acid frost due to evaporation of hydroethanolic vehicle from this study. The selected 90 patients were divided into 3 groups so, penetration of the active agent is diminished. At this point, the according to the used keratolytic agents, each group contains 30 agent causes a superficial anesthesia to light touch and the patient is patients as follows: instructed to wash the face with water. • Group I: This group include 30 patients treated with glycolic acid Jessner solution: 14 gram of resorcinol, 14 gram of salicylic acid, and 50%. 14 ml of 85% lactic acid mixed in enough 95% ethanol to bring the • Group II: This group include 30 patients treated with salicylic acid quantity to 100 cc and saved in dark amber containers. 20%. • Group III: This group include 30 patients treated with jessner Application: The skin was degreased as mentioned above and the solution. solution was applied rapidly covering the entire face starting with forehead then cheeks followed by the nose then upper lip and chin According to the predominant acne lesion, each group was within 30 seconds with a cotton applicator. If no frost appears a second subdivided into 3 subgroups as follows: coat of the solution was applied until frost appeared. • Ten patients with predominate papulo-pustular lesions. Post application instructions: The patient was instructed to avoid • Ten patients with predominate comedonal lesions. extensive sun exposure, prevent the use of any topical preparations • Ten patients with acne scar lesions. except the sunscreens or moisturizers, wash the treated area very carefully two times daily with non-irritating soap and male patients Methods could shave after 3 days from the session. Medical history was taken from each patient to complete the The results were evaluated by clinical investigator during the eight exclusion criteria mentioned above. sessions and based on evaluation of efficacy of treatment and beginning of improvement were encountered through doctor opinion, Clinical examination was done for each patient and the numbers of where the mean value of two different physicians opinions in percent lesions were evaluated after
Load more

Recommended publications
  • Scabies in Healthcare Facilities
    Scabies in Healthcare Facilities Tammra L. Morrison, RN BSN Healthcare Associated Infections Coordinator Communicable Disease Branch, Epidemiology Section December 9, 2016 Symptoms • In a person who has never had scabies: • May take 4-6 weeks for symptom onset • In a person who has had scabies in the past: • Symptoms may start in 1-4 days • May be spread PRIOR to symptom onset What to Look for • Intense itching • Especially at night • Pimple-like itchy rash • May affect entire body OR Dermatologie.md common sites: • Wrist, elbow, armpit, webbing between the fingers, nipple, penis, waist, belt-line, and buttocks • Burrows (tunnels) may be seen on the skin • Tiny raised and crooked grayish-white or skin- colored lines Transmission • Direct, prolonged, skin-to-skin contact with an infested person • Sexual partners • Household members • Quick handshake/hug will usually not spread scabies How Long Do Mites Live? • 1-2 months on a person • 48-72 hours off a person • Scabies mites will die at 122 degrees for 10 minutes Webmd.com 5 Diagnosis • Customary appearance and distribution of the rash and presence of burrows. • Confirm diagnosis: • Obtain a skin scraping to examine under a microscope for mites, eggs, or mite fecal matter • Person can still be infested even if mites, eggs, or fecal matter cannot be found • Typically fewer than 10-15 mites present on the entire body • **Crusted scabies may be thousands of mites and should be considered highly contagious** How Do You Treat Scabies? 7 Treatment • Available only by prescription • No "over-the-counter“
    [Show full text]
  • AHFS Pharmacologic-Therapeutic Classification System
    AHFS Pharmacologic-Therapeutic Classification System Abacavir 48:24 - Mucolytic Agents - 382638 8:18.08.20 - HIV Nucleoside and Nucleotide Reverse Acitretin 84:92 - Skin and Mucous Membrane Agents, Abaloparatide 68:24.08 - Parathyroid Agents - 317036 Aclidinium Abatacept 12:08.08 - Antimuscarinics/Antispasmodics - 313022 92:36 - Disease-modifying Antirheumatic Drugs - Acrivastine 92:20 - Immunomodulatory Agents - 306003 4:08 - Second Generation Antihistamines - 394040 Abciximab 48:04.08 - Second Generation Antihistamines - 394040 20:12.18 - Platelet-aggregation Inhibitors - 395014 Acyclovir Abemaciclib 8:18.32 - Nucleosides and Nucleotides - 381045 10:00 - Antineoplastic Agents - 317058 84:04.06 - Antivirals - 381036 Abiraterone Adalimumab; -adaz 10:00 - Antineoplastic Agents - 311027 92:36 - Disease-modifying Antirheumatic Drugs - AbobotulinumtoxinA 56:92 - GI Drugs, Miscellaneous - 302046 92:20 - Immunomodulatory Agents - 302046 92:92 - Other Miscellaneous Therapeutic Agents - 12:20.92 - Skeletal Muscle Relaxants, Miscellaneous - Adapalene 84:92 - Skin and Mucous Membrane Agents, Acalabrutinib 10:00 - Antineoplastic Agents - 317059 Adefovir Acamprosate 8:18.32 - Nucleosides and Nucleotides - 302036 28:92 - Central Nervous System Agents, Adenosine 24:04.04.24 - Class IV Antiarrhythmics - 304010 Acarbose Adenovirus Vaccine Live Oral 68:20.02 - alpha-Glucosidase Inhibitors - 396015 80:12 - Vaccines - 315016 Acebutolol Ado-Trastuzumab 24:24 - beta-Adrenergic Blocking Agents - 387003 10:00 - Antineoplastic Agents - 313041 12:16.08.08 - Selective
    [Show full text]
  • CCA Senior Care Options Formulary
    Commonwealth Care Alliance Senior Care Option HMO SNP 2021 List of Covered Drugs Formulary 30 Winter Street • Boston, MA 02108 PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/01/2021. For more recent information or other questions, please contact Senior Care Options Program (HMO SNP) Member Services, at 1-866-610-2273 or, for TTY users, 711, 8 a.m. – 8 p.m., 7 days a week, or visit www.commonwealthcaresco.org. HPMS Approved Formulary File Submission ID 00021589, Version Number 13 Senior Care Options Program (HMO SNP) 2021 Formulary (List of Covered Drugs) PLEASE READ: THIS DO CUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN HPMS Approved Formulary File Submission ID 00021589, Version Number 13 Note to existing members: This formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take. When this drug list (formulary) refers to “we,” “us”, or “our,” it means Commonwealth Care Alliance. When it refers to “plan” or “our plan,” it means 2021 Senior Care Options Program. This document includes list of the drugs (formulary) for our plan which is current as of 08/01/2021. This formulary document applies to all SCO members. For an updated formulary, please contact us. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. You must generally use network pharmacies to use your prescription drug benefit. Benefits, formulary, pharmacy n etwork, and/or copayments/coinsurance may change on January 1, 2022, and from time to time during the year.
    [Show full text]
  • Salicylic Acid
    Treatment Guide to Common Skin Conditions Prepared by Loren Regier, BSP, BA, Sharon Downey -www.RxFiles.ca Revised: Jan 2004 Dermatitis, Atopic Dry Skin Psoriasis Step 1 - General Treatment Measures Step 1 - General Treatment Measures Step 1 • Avoid contact with irritants or trigger factors • Use cool air humidifiers • Non-pharmacologic measures (general health issues) • Avoid wool or nylon clothing. • Lower house temperature (minimize perspiration) • Moisturizers (will not clear skin, but will ↓ itching) • Wash clothing in soap vs detergent; double rinse/vinegar • Limit use of soap to axillae, feet, and groin • Avoid frequent or prolonged bathing; twice weekly • Topical Steroids Step 2 recommended but daily bathing permitted with • Coal Tar • Colloidal oatmeal bath products adequate skin hydration therapy (apply moisturizer • Anthralin • Lanolin-free water miscible bath oil immediately afterwards) • Vitamin D3 • Intensive skin hydration therapy • Limit use of soap to axillae, feet, and groin • Topical Retinoid Therapy • “Soapless” cleansers for sensitive skin • Apply lubricating emollients such as petrolatum to • Sunshine Step 3 damp skin (e.g. after bathing) • Oral antihistamines (1st generation)for sedation & relief of • Salicylic acid itching give at bedtime +/- a daytime regimen as required Step 2 • Bath additives (tar solns, oils, oatmeal, Epsom salts) • Topical hydrocortisone (0.5%) for inflammation • Colloidal oatmeal bath products Step 2 apply od-tid; ointments more effective than creams • Water miscible bath oil • Phototherapy (UVB) may use cream during day & ointment at night • Humectants: urea, lactic acid, phospholipid • Photochemotherapy (Psoralen + UVA) Step 4 Step 3 • Combination Therapies (from Step 1 & 2 treatments) • Prescription topical corticosteroids: use lowest potency • Oral antihistamines for sedation & relief of itching steroid that is effective and wean to twice weekly.
    [Show full text]
  • Oral Alitretinoin in Congenital Ichthyosis: a Pilot Study Shows Variable Effects and a Risk of Central Hypothyroidism
    Included in the theme issue: 256 Letters to the Editor ACNE, RETINOIDS AND LYMPHOMAS Acta Derm Venereol 2012; 92: 256–257 Oral Alitretinoin in Congenital Ichthyosis: A Pilot Study Shows Variable Effects and a Risk of Central Hypothyroidism Agneta Gånemo1, Mette Sommerlund2 and Anders Vahlquist3* 1Department of Dermatology, Institute of Clinical Research in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden, 2Department of Dermatology and Venereology, Aarhus University Hospital, Aarhus, Denmark, and 3Department of Medical Sciences (Dermatology), Uppsala University, Uppsala, Sweden. E-mail: [email protected] Accepted October 20, 2011. Congenital ichthyosis is a large group of hereditary skin planned treatment period of 3 months. Clinical and laboratory disorders with different aetiologies, all of which are pre- evaluations were performed before the start of therapy and at monthly intervals, and consisted of physical examination, pho- sent at birth (1). The patients have dry, widespread scaling tography, interviewing the patients about effects and side-effects and thickened skin (2). At present there is no cure for of therapy, and blood sampling for analysis of haematological ichthyosis and therapy is mostly symptomatic. Life-long parameters, liver enzymes, creatinine, cholesterol, triglycerides, treatment with emollients is essential, and some patients thyroxin (T4) and tyroid-stimulating hormone (TSH) levels. also use systemic therapy with retinoids, especially aci- tretin (3). The most serious adverse effect of retinoids is RESULTS teratogenicity, which is a special concern for acitretin as it is excreted from the body slowly (3). All 4 patients completed the 3-month long trial, and two Alitretinoin (9-cis retinoic acid) is a fairly new oral of them (nos 1 and 3) wished to continue alitretinoin retinoid with more rapid clearance than acitretin.
    [Show full text]
  • History of Formulary Changes Contents
    History of Formulary Changes Pre-Single PDL Changes (before October 1, 2020) Revised for 11/1/2020 Contents Medicaid Health Plan Common Formulary Changes Effective October 1, 2020 ................................................................................................................................... 2 Medicaid Health Plan Common Formulary Changes Effective July 1, 2020 .......................................................................................................................................... 4 Medicaid Health Plan Common Formulary Changes Effective April 1, 2020 ........................................................................................................................................ 6 Medicaid Health Plan Common Formulary Changes Effective January 1, 2020 .................................................................................................................................... 8 Medicaid Health Plan Common Formulary Changes Effective October 1, 2019 ................................................................................................................................. 10 Medicaid Health Plan Common Formulary Changes Effective July 1, 2019 ........................................................................................................................................ 12 Medicaid Health Plan Common Formulary Changes Effective April 1, 2019 ...................................................................................................................................... 14
    [Show full text]
  • ED227273.Pdf
    DOCUMENT RESUft ED 227 273 y CE 035 300 ' TITLE APharmacy Spicialist, Militkry Curriculum Materials for Vocation47 andileChlaical Education. INSTITuTION Air Force Training Command, Sheppa* AFB, Tex.; Ohio State Univ., Columbus. Natfonal Center for Research in Vocational Education. SPONS AGENCY Office of Education (DHEW)x Washington, D.C. PUB DATE 18 Jul 75 NOTE 774p.; Some pages are marginally legible. ,PUB TYPE Guides - Classroom Use Guides (For Teachers) (052), , EDRS ?RICE 14P05/PC31 Plus Postage. ` DESCRIPTORS Behavioral Objectives; Course Descriptions; A Curriculum Guides; Drug Abuse; Drug,Therapy; 4Drug Use; Learning Activities; Lesson Plans; *Pharmaceutical Education; Pharmacists; *Pharmacology; *Pharmacy; Postsecondary Education; Programed Instructional Materials; Textbooks; Workbooks IDENTIFIERS. Military CuFr.iculum Project liBSTRACT These teacher and studdnt,materials for a . postsecondary-level course in pharmacy comprise one of a numberof military-developed curriculum packages selected for adaptation to voCational instruction 'and curriculum dei7elopment in acivilian setting. The purpose stated for the 256-hour course iS totrain students in the basic technical phases of pharmacy and theminimum essential knowledge and skills necessaryior.the compounding and - dispensing of drugs, the economical operation of a pharmacy,and the proper use of drugs, chemicals, andbiological products. The course consists of three blocks of instruction. Block I contains four, lessons: pharmaceutical calculations I and laboratory,inorganic chemistry, and organic chemistry. The five lessons in Block II cover anatomy ,and physiology, introduction topharmacoloe, toxicology, drug abuse, and pharmaceutical and medicinal agents. Block III provides five lessons: phdrmaceutical calculations\I and II, techniques"of pharmaceutical compounding, pharmaceutiCal dosage for s, and compounding laboratbry. Instructormaterials include a cb se chart, lesson plans, and aplan of instruction detailing instructional,bnits, criterion objectives, lesson duration,and support materials needed.
    [Show full text]
  • Anthony J. Mancini, MD Human Skin Has the Important Function Of
    Skin Anthony J. Mancini, MD ABSTRACT. Human skin provides a barrier between hazardous or infectious agents and a vulnerable tar- the host and the physical, chemical, and biological envi- get of environmental toxins. During the past several ronment. It is also a potential portal of entry for hazard- decades, we have witnessed important strides in our ous or infectious agents and a potential target of envi- understanding of skin vulnerability, the cutaneous ronmental toxins. Cutaneous vulnerability may take on susceptibility to potentially noxious stimuli. Al- many forms in the embryo, infant, child, and adolescent. though the differing vulnerabilities of the skin of the Teratogenic agents may occasionally target skin, as ap- preciated in the proposed association of the antithyroid embryo, infant, child, and adolescent still are not medication methimazole, with the congenital malforma- completely understood, much has been learned tion known as aplasia cutis congenita. Percutaneous based on current knowledge of cutaneous embryo- absorption of topically applied substances and the po- genesis, epidermal barrier formation and function, tential for resultant drug toxicities are important consid- and the cumulative effects of ultraviolet (UV) radia- erations in the child. Many topical agents have been tion on photocarcinogenesis. These cutaneous vul- associated with systemic toxicity, including alcohol, nerabilities are the focus of this section. hexachlorophene, iodine-containing compounds, eutectic mixture of local anesthetics, and lindane. Percutaneous toxicity is of greatest concern in the premature infant, SKIN DEVELOPMENT in whom immaturity of the epidermal permeability bar- Skin is a complex tissue derived from both embry- rier results in disproportionately increased absorption. onic mesoderm and ectoderm.
    [Show full text]
  • Eczema (Chronic)
    NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SINGLE TECHNOLOGY APPRAISAL (STA) SPECIFICATION FOR MANUFACTURER/SPONSOR SUBMISSION OF EVIDENCE Update to reflect the new Guide to the Methods of Technology Appraisals Update July 2008 Page 1 of 151 Contents 3 Executive summary 7 4 Context 10 5 Equity and equality 15 6 Clinical evidence 15 7 Cost effectiveness 81 8 Assessment of factors relevant to the NHS and other parties 119 9 References 127 10 Appendices 127 Update July 2008 Page 2 of 151 Section A 1 Description of technology under assessment 1.1 Give the brand name, approved name and, where appropriate, therapeutic class. Toctino®, oral alitretinoin (9-cis retinoic acid) 1.2 Does the technology have a UK marketing authorisation/CE marking for the indications detailed in this submission? Oral alitretinoin was granted a Marketing Authorisation for the UK on 5th September 2008 following recommendation for approval under the EMEA decentralised procedure and became commercially available on the 22nd September 2008. 1.3 What are the (anticipated) indication(s) in the UK? Oral alitretinoin (9-cis retinoic acid) is indicated for use in adults who have severe chronic hand eczema that is unresponsive to treatment with potent topical corticosteroids. 1.4 To what extent is the technology currently being used in the NHS for the proposed indication? Toctino (oral alitretinoin) was launched on 8th September 2008 and became commercially available on the 22nd September 2008. 1.5 Does the technology have regulatory approval outside the UK? Oral alitretinoin has regulatory approval in Germany, France, Denmark, and Finland. 1.6 Is the technology subject to any other form of health technology assessment in the UK? A new product assessment form for alitretinoin was submitted to the Scottish Medicines Consortium (SMC) on Monday 22nd September 2008.
    [Show full text]
  • Topical Therapeutic Dermatology
    Over the Counter Dermatology Bonnie T. Mackool, MD, MSPH Assistant Professor of Dermatology, Harvard Medical School Massachusetts General Hospital Disclosures Neither I nor my spouse/partner has a relevant financial relationship with a commercial interest to disclose. Seinfeld: • “Saving Lives? She’s one step above working at the Clinique Counter.” • George: Quote from The Slicer (S09E07) Dermatology Related Aisles (all): Acne, Cosmetics (Beauty), Personal Care, Diet and Nutrition, baby and Child, Vitamins, Sexual wellness Steroid Acne HC ointment 1 % x 7 days Side Effects of Topical Glucocorticoids Topical Side Effects Systemic Side Effects • Atrophy (sheen) • Sodium Retention • Telangiectases • Hyperglycemia • Striae • CHF • Acne (perioral dermatitis) • Femoral Head Necrosis • Worsening cutaneous fungal • Cataracts infection • Glaucoma • Tachyphylaxis • Hypokalemia(digoxin toxicity) • Adrenal suppression • Growth retardation Acne Treatment with OTC Products • Benzoyl Peroxides (creams, gels, washes) • Topical Vitamin A (adapalene) • Salicylic acid (washes, creams, pads) • Antibiotic: sulphur Acne Inflammatory Papules Open Comedones Closed Comedones Post Inflammatory Hyperpigmentation Benzoyl Peroxides Properties Side Effects • Anti-bacterial • Dryness • Lotions, gels • Irritation • Decrease bacterial • Bleach clothing with contact resistance with topical antibiotic (compared to topical antibiotic alone) Topical Retinoids: Adapalene OTC Other Retinoids Requiring Prescription: Tretinoin and Tazarotene Properties Side Effects • Comedolytic
    [Show full text]
  • Mal-A-Kettm Shampoo and Wipes • Shampoo Formulated for Use in Dogs, Cats and Horses, Wipes Formulated for Use in Dogs and Cats
    Mal-A-KetTM Shampoo and Wipes • Shampoo formulated for use in dogs, cats and horses, wipes formulated for use in dogs and cats • Antibacterial/Antifungal – for moderate to severe bacterial/ fungal infections Indications For support of healthy skin for animals with conditions responsive to ketoconazole and/or chlorhexidine. Active Ingredients Chlorhexidine Gluconate: • Generally used as adjunctive therapy for bacterial skin infections caused by Gram-positive and Gram-negative bacteria. • Typically considered to be less drying and less irritating than benzoyl peroxide (see DermaBenSs), it is sometimes used in patients that cannot tolerate benzoyl peroxide, however chlorhexidine does not have keratolytic, comedolytic, or 1 degreasing properties. Product No. Size • Considered to have residual effects and can remain active on skin after rinsing. MKW 8 oz shampoo • Bacteria and fungi do not tend to develop resistance towards GMKW 1 gallon shampoo chlorhexidine gluconate. WMKW 50 ct wipes Ketoconazole: • A synthetic antifungal drug used to prevent and treat skin and fungal infections Reference 1 Koch, S.N. (2012). Canine and Feline Dermatology Drug Handbook. Ames: Wiley-Blackwell For Technical Support or information, contact: Dechra Veterinary Products at 866-933-2472 or www.dechra-us.com 02PB-MAL50012-0213 Mal-A-KetTM Plus TrizEDTATM Flush and Spray Conditioner • Formulated for use in dogs and cats • Antibacterial/Antifungal – for moderate to severe bacterial/fungal infections • Unique combination of chlorhexidene, ketoconazole and USP TrizEDTA which aids in breaking down bacterial cell walls increasing the efficacy of the active ingredients. Indications For support of healthy skin for animals with conditions responsive to ketoconazole and/or chlorhexidene. Active Ingredients Chlorhexidene gluconate: • Generally used as adjunctive therapy for bacterial skin infections caused by Gram-positive and Gram-negative bacteria.
    [Show full text]
  • 49Th Annual ESDR Meeting September 18–21, 2019 Bordeaux, France
    Volume 139, Number 9S, Supplement 2, September 2019 www.jidonline.org Supplement to the Journal of Investigative Dermatology 49th Annual ESDR Meeting September 18–21, 2019 Bordeaux, France JJID_v139_i9_sS_COVER.inddID_v139_i9_sS_COVER.indd 1 331-07-20191-07-2019 20:33:1120:33:11 JOURNAL OF INVESTIGATIVE DERMATOLOGY The official journal of The Society for Investigative Dermatology and European Society for Dermatological Research Volume 139 Number 9S, Supplement 2, September 2019 Editor Mark C. Udey, St. Louis, MO Principal Deputy Editor Medical Writer Thomas Krieg, Cologne, Germany Heather Yarnall Schultz, Huntington, WV Deputy Editors JID Connector Editor Leena Bruckner-Tuderman, Freiburg, Germany Lynn A. Cornelius, St. Louis, MO Kilian Eyerich, Munich, Germany David E. Fisher, Boston, MA Cells to Surgery Quiz Contributors Joel M. Gelfand, Philadelphia, PA Jeremy Etzkorn, Philadelphia, PA Valerie Horsley, New Haven, CT Eva Hurst, St. Louis, MO Sarah E. Millar, Philadelphia, PA Rajiv Nijhawan, Dallas, TX Tony Oro, Stanford, CA Keyvan Nouri, Miami, FL Vincent Piguet, Toronto, Canada Meet the Investigator Editor Section Editors Ayman Grada, Boston, MA Martine Bagot, Paris, France Meeting Reports Section Editor Isaac Brownell, Bethesda, MD Jouni Uitto, Philadelphia, PA An-Wen Chan, Toronto, Canada Keith A. Choate, New Haven, CT Podcast Editor Andrzej Dlugosz, Ann Arbor, MI Robert Dellavalle, Denver, CO James T. Elder, Ann Arbor, MI Research Techniques Made Simple Janet Fairley, Iowa City, IA Jodi Lynn Johnson, Chicago, IL, Coordinating Editor John E. Harris, Worcester, MA Sara J. Brown, Dundee, UK, Contributing Editor Daniel H. Kaplan, Pittsburgh, PA Lu Q. Le, Dallas, TX, Contributing Editor Ethan A. Lerner, Boston, MA Carien M.
    [Show full text]