16 Dermatologic Surgery S KIN & ALLERGY N EWS • June 2005 KTP Equals Pulsed Light for Photodamage
2X ONLY BY KERRI WACHTER
$%3#2)04)/. %ACH GRAM OF 2OSAC #REAM Senior Writer 7ITH 3UNSCREENS CONTAINS MG OF SODIUM .
SULFACETAMIDE AND MG OF SULFUR IN A CREAM R
CONTAINING AVOBENZONE BENZYL ALCOHOL # L AKE B UENA V ISTA, FLA. — Potas- D ALKYL BENZOATE CETOSTEARYL ALCOHOL DIMETHICONE sium titanyl phosphate laser treatment EDETATE DISODIUM EMULSIFYING WAX MONOBASIC SODIUM PHOSPHATE OCTINOXATE PROPYLENE GLYCOL can provide results comparable to and PURIl ED WATER SODIUM THIOSULFATE STEARETH perhaps even better than intense pulsed
STEARETH UNAVALLI AND
light that is now considered the preferred M 3ODIUM SULFACETAMIDE IS A SULFONAMIDE WITH ANTIBACTERIAL ACTIVITY WHILE SULFUR ACTS AS A method for treatment of photoaging, ac- KERATOLYTIC AGENT #HEMICALLY SODIUM SULFACETAMIDE cording to data presented at the annual IRISH IS . ; AMINOPHENYL SULFONYL= ACETAMIDE MONO . G R
SODIUM SALT MONOHYDRATE 4HE STRUCTURAL FORMULA IS meeting of the American Society for Laser D Medicine and Surgery. In a study designed to compare the two EISS treatments, a 532-nm potassium titanyl W phosphate (KTP) “green” laser (Gemini, OBERT HOTOS COURTESY R #,).)#!, 0(!2-!#/,/'9 4HE MOST WIDELY made by Laserscope) with a 10-mm spot P ACCEPTED MECHANISM OF ACTION OF SULFONAMIDES IS THE 7OODS &ILDES THEORY WHICH IS BASED ON THE FACT size was used to treat one side of the face, Skin shows diffuse erythema and After Gemini laser treatment, vascularity THAT SULFONAMIDES ACT AS COMPETITIVE ANTAGONISTS and intense pulsed light (Quantum SR, pigmentation from photoaging. and pigmentation are improved. TO PARA AMINOBENZOIC ACID 0!"! AN ESSENTIAL COMPONENT FOR BACTERIAL GROWTH 7HILE ABSORP made by Lumenis) was used to treat the TION THROUGH INTACT SKIN HAS NOT BEEN DETERMINED other side, said Girish Munavalli, M.D., a 6-millisecond double pulses with a 10-mil- 14 of 16 patients opted for the KTP laser for SODIUM SULFACETAMIDE IS READILY ABSORBED FROM THE GASTROINTESTINAL TRACT WHEN TAKEN ORALLY AND dermatologic surgeon at Johns Hopkins lisecond delay). A thin ice-cold gel layer subsequent treatments, preferring its effi- EXCRETED IN THE URINE LARGELY UNCHANGED 4HE University in Baltimore. A total of 16 pa- technique was used with both devices. cacy,treatment times, and comfort. KTP in- BIOLOGICAL HALF LIFE HAS VARIOUSLY BEEN REPORTED tients with diffuse redness and photoaging Dr. Munavalli has no financial interest in duced slightly more erythema and edema AS TO HOURS 4HE EXACT MODE OF ACTION OF SULFUR IN THE TREATMENT pigmentation (Fitzpatrick skin types I-IV) either of the devices used in this study. at 10 and 24 hours posttreatment. OF ACNE IS UNKNOWN BUT IT HAS BEEN REPORTED THAT IT were treated. Patients were evaluated at 1 week and at Stereotactic imaging resulted in equiv- INHIBITS THE GROWTH OF 0ROPIONIBACTERIUM ACNESS AND THE FORMATION OF FREE FATTY ACIDS The emission profile of the 532-nm 1 month using a standardized scale (1-10) by alent if not slightly better reduction of the ).$)#!4)/.3 !.$ 53!'% 2OSAC #REAM 7ITH KTP laser predicts very good absorption the treating physician. Canfield stereotactic components of photoaging (lentigines, 3UNSCREENS IS INDICATED IN THE TOPICAL CONTROL OF ACNE by hemoglobin and melanin. “In addition imaging was performed, and a physician telangiectasias) with KTP, compared with VULGARIS ACNE ROSACEA AND SEBORRHEIC DERMATITIS to the absorption spectrum, as you in- blinded to the study evaluated these images. IPL alone. #/.42!).$)#!4)/.3 2OSAC #REAM 7ITH 3UNSCREENS IS CONTRAINDICATED FOR USE BY PATIENTS crease the spot size to 10 mm you get At 1 week, physician evaluation rated the The Gemini laser can also be set for spot HAVING KNOWN HYPERSENSITIVITY TO SULFONAMIDES deeper penetration of this wavelength,” KTP treatment as producing an overall im- sizes between 1 and 5 mm, in 0.1-mm in- SULFUR OR ANY OTHER COMPONENT OF THIS PREPARATION 4HIS DRUG IS NOT TO BE USED BY PATIENTS WITH KIDNEY Dr. Munavalli explained. provement in vascularity and pigmentation crements. In addition the KTP laser can be DISEASE Treatment with the KTP laser lasted for of 64%, compared with a 50% improve- switched out with a 1,064-nm Nd:YAG 7!2.).'3 !LTHOUGH RARE SENSITIVITY TO SODIUM 2 SULFACETAMIDE MAY OCCUR 4HEREFORE CAUTION AND 90-120 seconds at 7-9 J/cm (20-millisec- ment for IPL. Patients rated the two treat- laser. CAREFUL SUPERVISION SHOULD BE OBSERVED WHEN ond pulses). Contact cooling is used with ments as producing overall improvements The system has received Food and Drug PRESCRIBING THIS DRUG FOR PATIENTS WHO MAY BE PRONE TO HYPERSENSITIVITY TO TOPICAL SULFONAMIDES this device. Intense pulsed-light (IPL) treat- of 56% and 40%, respectively. Administration clearance for the treat- 2 3YSTEMIC TOXIC REACTIONS SUCH AS AGRANULOCYTOSIS ment lasted 3-5 minutes at 26 J/cm using At 1 month, both sides were rated as pro- ment of acne, wrinkles, vascular and pig- ACUTE HEMOLYTIC ANEMIA PURPURA HEMORRHAGICA a 560-nm filter (2.5-millisecond pulses, ducing an improvement of 50%. However, mented lesions, and hair removal. ■ DRUG FEVER JAUNDICE AND CONTACT DERMATITIS INDICATE HYPERSENSITIVITY TO SULFONAMIDES 0ARTICULAR CAUTION SHOULD BE EMPLOYED IF AREAS OF DENUDED OR ABRADED SKIN ARE INVOLVED 02%#!54)/.3 'ENERAL )F IRRITATION DEVELOPS USE OF THE PRODUCT SHOULD BE DISCONTINUED AND Radiesse Efficacious as Soft Tissue Filler APPROPRIATE THERAPY INSTITUTED &OR EXTERNAL USE ONLY +EEP AWAY FROM EYES 0ATIENTS SHOULD BE CAREFULLY OBSERVED FOR POSSIBLE LOCAL IRRITATION OR BY DAMIAN McNAMARA swelling for about 24-48 hours and some A small volume is needed for correc- SENSITIZATION DURING LONG TERM THERAPY 4HE OBJECT Miami Bureau OF THIS THERAPY IS TO ACHIEVE DESQUAMATION WITHOUT bruising are possible). tion. For example, only 1-2 cc is required IRRITATION BUT SODIUM SULFACETAMIDE AND SULFUR CAN Dr. Goldberg surveyed 155 of his pa- for nasolabial folds or the corners of the CAUSE REDDENING AND SCALING OF EPIDERMIS 4HESE M IAMI B EACH — Calcium hydroxyla- tients 6 months after soft tissue augmen- mouth. A total of about 1 cc is required SIDE EFFECTS ARE NOT UNUSUAL IN THE TREATMENT OF ACNE VULGARIS BUT PATIENTS SHOULD BE CAUTIONED ABOUT THE patite can effectively fill wrinkles, correct tation with the filler, and 90% indicated for upper and lower lip augmentation, un- POSSIBILITY +EEP OUT OF REACH OF CHILDREN acne and other scars, and augment lips, al- they would use it again. less a very large increase in volume is de- #ARCINOGENESIS -UTAGENESIS AND )MPAIRMENT OF &ERTILITY ,ONG TERM STUDIES IN ANIMALS HAVE NOT though there is a learning curve with lips, Calcium hydroxylapatite is packaged as sired. BEEN PERFORMED TO EVALUATE CARCINOGENIC POTENTIAL David J. Goldberg, M.D., said at a sym- cellulose-based gel with a glycerin-water Dr. Goldberg recommended a threading 0REGNANCY #ATEGORY # !NIMAL REPRODUCTION posium sponsored by the Florida Society base. No reconstitution is required. Its technique. Inject a thin thread of the ma- STUDIES HAVE NOT BEEN CONDUCTED WITH 2OSAC #REAM WITH 3UNSCREENS )T IS ALSO NOT KNOWN WHETHER THIS of Dermatology and Dermatologic consistent viscosity makes it easy to inject. terial as the needle is withdrawn. The typ- DRUG CAN CAUSE FETAL HARM WHEN ADMINISTERED TO A Surgery. Other potential advan- ical injection is 0.05 cc. A PREGNANT WOMAN OR CAN AFFECT REPRODUCTION CAPACITY )T SHOULD BE GIVEN TO A PREGNANT WOMAN ONLY IF Calcium hydroxylapatite (Radiesse, tages for physicians in- Advantages include 25- to 27-gauge, 1.25- CLEARLY NEEDED BioForm Medical Inc.) is identical to a clude its stability, a shelf stability, a shelf inch needle is recom- .URSING -OTHERS )T IS NOT KNOWN WHETHER SODIUM natural compound in human bone and life of 2 years without re- mended for nasolabial SULFACETAMIDE IS EXCRETED IN HUMAN MILK FOLLOWING TOPICAL USE OF 2OSAC #REAM 7ITH 3UNSCREENS teeth. Oncologists, orthopedists, dentists, frigeration, and its com- life of 2 years folds. A smaller 0.5-inch, (OWEVER SMALL AMOUNTS OF ORALLY ADMINISTERED and other health care professionals have patibility with other cos- 25- to 27-gauge needle is SULFONAMIDES HAVE BEEN REPORTED TO BE ELIMINATED without refrigeration, IN HUMAN MILK )N VIEW OF THIS AND BECAUSE MANY used the material for years in implants metic procedures, said recommended for inject- DRUGS ARE EXCRETED IN HUMAN MILK CAUTION SHOULD and drug delivery systems. The Food and Dr. Goldberg, who is and compatibility ing the corners of the BE EXERCISED WHEN THIS DRUG IS ADMINISTERED TO A NURSING WOMAN Drug Administration approved the bio- also director of laser re- with other cosmetic mouth. 0EDIATRIC 5SE 3AFETY AND EFFECTIVENESS IN material for vocal cord injections, as a tis- search and Mohs Local anesthesia with CHILDREN UNDER THE AGE OF HAVE NOT sue marker, and for periodontal use for surgery at Mount Sinai procedures. epinephrine is recom- BEEN ESTABLISHED !$6%23% 2%!#4)/.3 !LTHOUGH RARE SODIUM onlay of bone. Nasolabial folds and HIV School of Medicine, mended. Also consider SULFACETAMIDE MAY CAUSE LOCAL IRRITATION facial lipoatrophy studies are currently New York. doing a nerve block prior to lip augmen- $/3!'% !.$ !$-).)342!4)/. !PPLY A THIN l LM pending. The filler stays soft in tissue. It is long tation. A small amount of local anesthet- OF 2OSAC #REAM 7ITH 3UNSCREENS TO AFFECTED AREAS TO TIMES DAILY Soft tissue filler uses are off label, but it lasting but not permanent, and eventual- ic in the lips promotes vasoconstriction, (/7 3500,)%$ G TUBES .$# is a legal use of the product, according to ly resorbs. A disadvantage is predicting Dr. Goldberg said.
3TORE AT CONTROLLED ROOM TEMPERATURE ª ª# Dr. Goldberg, who is in private practice in exactly how long the correction will last. The calcium hydroxylapatite implant ª ª& Westwood, N.J. For example, 12-22 months after injec- does not calcify or ossify. The particles act There is no need for sensitization test- tion, 30%-100% of initial results remain, as scaffold for tissue infiltration, he ex- ing because calcium hydroxylapatite is according to Dr. Goldberg. Another po- plained. There is a self-limited fibroblas- nonallergic. Other advantages from a pa- tential disadvantage is formation of lip tic response. The particles are not os- 3TIEFEL ,ABORATORIES )NC #ORAL 'ABLES &, tient’s perspective include the product’s nodules. Use of the filler in lips is best left teoinductive: They do not cause long-term effectiveness, its lack of migra- to experienced operators, he emphasized fibroblasts to differentiate to become os- 0ATENT 0ENDING ■ 2EV tion, and minimal downtime (soft tissue at the meeting. teoblasts.