Background: Combination therapy with antiseptics such as benzoyl peroxide (BP) and topical retinoids is widely used as first-line treatment for acne vulgaris (AV). However, these combinations could have a suboptimal s...Background: Combination therapy with antiseptics such as benzoyl peroxide (BP) and topical retinoids is widely used as first-line treatment for acne vulgaris (AV). However, these combinations could have a suboptimal skin tolerability. Recently, a new formulation of hydrogen peroxide (HP) 1%in stabilized cream (Crystacide.; Mipharm,Milan, Italy) became available. A previous clinical study has shown that HP cream monotherapy presents a better skin tolerability in comparison with BP in patients with mild AV. Objectives: To evaluate the tolerability and the efficacy of combination therapy with HP cream and adapalene 0.1%gel in comparison with the combination of BP 4%cream and adapalene 0.1%gel in the treatment of mild to moderate AV. Methods: In a randomized, investigator-blinded trial, 52 patients (mean ±SD age 25 ±6 years; 19 men and 33 women) with AV were randomly assigned to HP cream and adapalene gel (group HP +A) or to BP cream and adapalene gel (group BP +A), for eight consecutive weeks. Efficacy was assessed by total (TL), inflammatory (IL) and noninflammatory (NL) lesion counts performed at baseline and weeks 4 and 8. Tolerability was assessed by evaluating skin erythema, burning and dryness at weeks 4 and 8. Results: All patients completed the study. At baseline, the mean ±SD numbers of TL, IL and NL were 44 ±9, 25 ±7 and 19 ±6 in group HP +A and 40 ±9, 21 ±7 and 19 ±9 in group BP +A, respectively. At the end of the treatment period, TL, IL and NL were reduced by 93%, 92%and 95%, respectively, in groupHP +A and by 88%, 86%and 90%, respectively, in group BP +A. A significantly (P = 0.0025) greater reduction in NL was observed in group HP +A in comparison with group BP +A. Tolerability was significantly better in group HP +A in comparison with group BP+A (P = 0.02). Skin dryness and burning sensation were more frequent in group BP +A. Conclusions: The combination of adapalene and HP cream is an effective topical treatment regimen in mild to moderate AV. This combination has shown a better tolerability profile in comparison with the combination of BP and adapalene.展开更多
Background: Delayed pressure urticaria (DPU) is characterized by the appearance of typical painful skin lesions (weals) after pressure stimulus. Oral corticosteroids are effective treatments but long-term therapy is p...Background: Delayed pressure urticaria (DPU) is characterized by the appearance of typical painful skin lesions (weals) after pressure stimulus. Oral corticosteroids are effective treatments but long-term therapy is problematic. A new topical formulation of clobetasol propionate 0.05%in thermophobic foam (CF) (Olux) has recently become available. The foam is easy to apply, with low skin residues. Objectives: To evaluate in a double-blind placebo-controlled trial the efficacy, tolerability and safety of CF in the topical treatment of DPU. Methods: Twenty-six subjects with a positive history of DPU (13 men, mean age 44 years) were enrolled in a 4-week trial. CF or the corresponding placebo were applied twice daily. Drug application was performed in the most affected areas and in a target area where a standardized pressure challenge test was performed at baseline and at week 4. Efficacy was evaluated by scoring skin lesions regarding erythema, oedema and itching (0, no sign; 4, severe signs) and by calculating the area of the pressure challenge-induced lesion. Safety was evaluated by measuring plasma levels of adrenocorticotropic hormone (ACTH) and cortisol. Results: CF significantly (P = 0.0001) reduced lesion area by 84%in comparison with baseline values and by 97%in comparison with the placebo group values. Lesion area in the CF group was reduced from 144 cm2 to 21 cm2 at the end of the study. No significant differences in lesion area and clinical lesion scores were observed in the placebo group (lesion area 201 cm2 at baseline; 216 cm2 after 4 weeks). A significant clinical improvement was observed in all treated skin areas in the CF group. Mean ±SD erythema score was reduced by CF from 1.8 ±0.6 at baseline to 0.6 ±0.5 at the end of the treatment (P = 0.001). Similar modifications were observed also for oedema (from 1.6 ±0.6 to 0.2 ±0.5) and itching score. Nonsignificant modifications of plasma levels of ACTH, cortisol and glucose were observed in both study groups, in comparison with baseline values. No adverse events were recorded during the trial in either treatment group. Conclusions: CF is effective, safe, convenient and well tolerated in the short-term treatment of DPU.展开更多
文摘Background: Combination therapy with antiseptics such as benzoyl peroxide (BP) and topical retinoids is widely used as first-line treatment for acne vulgaris (AV). However, these combinations could have a suboptimal skin tolerability. Recently, a new formulation of hydrogen peroxide (HP) 1%in stabilized cream (Crystacide.; Mipharm,Milan, Italy) became available. A previous clinical study has shown that HP cream monotherapy presents a better skin tolerability in comparison with BP in patients with mild AV. Objectives: To evaluate the tolerability and the efficacy of combination therapy with HP cream and adapalene 0.1%gel in comparison with the combination of BP 4%cream and adapalene 0.1%gel in the treatment of mild to moderate AV. Methods: In a randomized, investigator-blinded trial, 52 patients (mean ±SD age 25 ±6 years; 19 men and 33 women) with AV were randomly assigned to HP cream and adapalene gel (group HP +A) or to BP cream and adapalene gel (group BP +A), for eight consecutive weeks. Efficacy was assessed by total (TL), inflammatory (IL) and noninflammatory (NL) lesion counts performed at baseline and weeks 4 and 8. Tolerability was assessed by evaluating skin erythema, burning and dryness at weeks 4 and 8. Results: All patients completed the study. At baseline, the mean ±SD numbers of TL, IL and NL were 44 ±9, 25 ±7 and 19 ±6 in group HP +A and 40 ±9, 21 ±7 and 19 ±9 in group BP +A, respectively. At the end of the treatment period, TL, IL and NL were reduced by 93%, 92%and 95%, respectively, in groupHP +A and by 88%, 86%and 90%, respectively, in group BP +A. A significantly (P = 0.0025) greater reduction in NL was observed in group HP +A in comparison with group BP +A. Tolerability was significantly better in group HP +A in comparison with group BP+A (P = 0.02). Skin dryness and burning sensation were more frequent in group BP +A. Conclusions: The combination of adapalene and HP cream is an effective topical treatment regimen in mild to moderate AV. This combination has shown a better tolerability profile in comparison with the combination of BP and adapalene.
文摘Background: Delayed pressure urticaria (DPU) is characterized by the appearance of typical painful skin lesions (weals) after pressure stimulus. Oral corticosteroids are effective treatments but long-term therapy is problematic. A new topical formulation of clobetasol propionate 0.05%in thermophobic foam (CF) (Olux) has recently become available. The foam is easy to apply, with low skin residues. Objectives: To evaluate in a double-blind placebo-controlled trial the efficacy, tolerability and safety of CF in the topical treatment of DPU. Methods: Twenty-six subjects with a positive history of DPU (13 men, mean age 44 years) were enrolled in a 4-week trial. CF or the corresponding placebo were applied twice daily. Drug application was performed in the most affected areas and in a target area where a standardized pressure challenge test was performed at baseline and at week 4. Efficacy was evaluated by scoring skin lesions regarding erythema, oedema and itching (0, no sign; 4, severe signs) and by calculating the area of the pressure challenge-induced lesion. Safety was evaluated by measuring plasma levels of adrenocorticotropic hormone (ACTH) and cortisol. Results: CF significantly (P = 0.0001) reduced lesion area by 84%in comparison with baseline values and by 97%in comparison with the placebo group values. Lesion area in the CF group was reduced from 144 cm2 to 21 cm2 at the end of the study. No significant differences in lesion area and clinical lesion scores were observed in the placebo group (lesion area 201 cm2 at baseline; 216 cm2 after 4 weeks). A significant clinical improvement was observed in all treated skin areas in the CF group. Mean ±SD erythema score was reduced by CF from 1.8 ±0.6 at baseline to 0.6 ±0.5 at the end of the treatment (P = 0.001). Similar modifications were observed also for oedema (from 1.6 ±0.6 to 0.2 ±0.5) and itching score. Nonsignificant modifications of plasma levels of ACTH, cortisol and glucose were observed in both study groups, in comparison with baseline values. No adverse events were recorded during the trial in either treatment group. Conclusions: CF is effective, safe, convenient and well tolerated in the short-term treatment of DPU.
