The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Steven R Feldman - One of the best experts on this subject based on the ideXlab platform.
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topical retinoids in Acne Vulgaris a systematic review
American Journal of Clinical Dermatology, 2019Co-Authors: Sree S Kolli, Danielle Pecone, Adrian Pona, Abigail Cline, Steven R FeldmanAbstract:Topical retinoids are a first-line treatment for Acne Vulgaris. This systematic review aims to evaluate the efficacy, safety, and tolerability of topical retinoids approved in the United States for the treatment of Acne Vulgaris. A PubMed and Embase search was conducted using the search terms ‘adapalene,’ ‘tretinoin,’ ‘tazarotene,’ and ‘Acne Vulgaris.’ Selection of articles fit the following inclusion criteria: clinical trials evaluating both efficacy and safety/tolerability of topical retinoids approved in the United States for the treatment of Acne Vulgaris and published between January 1, 2008 and September 1, 2018. Exclusion criteria included clinical trials involving 20 subjects or fewer, subjects under 12 years of age, and topical retinoid combination therapies with moisturizers or aloe vera. Of 424 search results found, a total of 54 clinical trials were chosen based on selection criteria. Topical retinoids are superior to vehicle in improving Investigator Global Assessment and Investigator’s Static Global Assessment (24.1–28.8% and 13.3–17.3%, respectively; p < 0.001). A topical retinoid combined with benzoyl peroxide led to IGA improvement compared with vehicle (26.1–34.9% vs 7–11.8%; p < 0.001) at Week 12. Topical retinoid plus an oral antibiotic was superior to vehicle in reducing lesion counts (64–78.9% vs 41–56.8%, p < 0.001). There was no significant difference in efficacy between tretinoin and tazarotene. Tretinoin 0.05% resulted in 62% of patients experiencing AEs compared with adapalene 0.1% (19%) and adapalene 0.3% (40%). More patients receiving adapalene were tolerant of the AEs compared with tazarotene (55.4% vs 24.4%; p < 0.0012). Topical retinoids are safe and efficacious for the treatment of Acne Vulgaris. They should be used in combination with benzoyl peroxide to optimize results in patients. The differences in efficacy of topical retinoids appears minor; therefore, the type of topical retinoid is not as important as choosing a particular strength of topical retinoid and combining it with an antimicrobial agent. Adapalene has a superior tolerability profile amongst topical retinoids.
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Acne Vulgaris and depression a retrospective examination
Journal of Cosmetic Dermatology, 2010Co-Authors: Elizabeth E Uhlenhake, Brad A Yentzer, Steven R FeldmanAbstract:Summary Background Acne Vulgaris is a common skin disease that affects patients both physically and mentally. Purpose To examine the prevalence of reported depression in Acne patients. Methods Patient information was obtained from a medical claims database and analyzed using the Total Resource Utilization Benchmarks™ process. Benchmarks in this study include: age, gender, co-morbid depression, antidepressant utilization, and Acne treatment modality. Depression prevalence in Acne patients was compared with general population. Results Depression was two to three times more prevalent in Acne patients than in the general population, with a reported 8.8% of Acne patients having clinical depression. The majority of cases of depression and antidepressant therapy utilization were observed in Acne patients aged 18 and over with the highest percentage in the 36–64 age group. Approximately 65.2% of the Acne patient population was female, with twice as many reported to have depression as males (10.6% females vs. 5.3% males). Limitations This analysis included only patients that sought treatment for their Acne and had also reported having clinical depression. This may underestimate the total prevalence of Acne and associated depression. Conclusions Acne is a disease that affects people of all ages both physically and psychologically. A correlation exists between clinical depression and Acne patients, particularly those older than 36. “There is no single disease which causes more psychic trauma and more maladjustment between parents and children, more general insecurity and feelings of inferiority and greater sums of psychic assessment than does Acne Vulgaris” (Sulzberger, 19481).
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benzoyl peroxide a review of its current use in the treatment of Acne Vulgaris
Expert Opinion on Pharmacotherapy, 2009Co-Authors: Matt Sagransky, B A Yentzer, Steven R FeldmanAbstract:Background: Owing to the use of topical and systemic antibiotics for Acne Vulgaris, the incidence of antibiotic-resistant Propionibacterium Acnes is increasing worldwide. Topical benzoyl peroxide (BPO) is an alternative to antibiotics in the treatment of Acne Vulgaris. Objective: This review describes and evaluates recent clinical literature regarding the efficacy and tolerability of BPO. Methods: A PubMed literature search was conducted using the keywords benzoyl peroxide, Acne, and combination therapy. Results: BPO is equally effective at concentrations of 2.5, 5.0 and 10%. However, a concentration-dependent irritant dermatitis can occur with higher concentrations. The efficacy of BPO can be enhanced when used in combination with topical retinoids, antibiotics and tertiary amines. BPO-containing combinations do not induce bacterial resistance and are important first-line treatments for mild to moderate Acne Vulgaris.
James J Leyden - One of the best experts on this subject based on the ideXlab platform.
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two randomized double blind controlled trials of 2219 subjects to compare the combination clindamycin tretinoin hydrogel with each agent alone and vehicle for the treatment of Acne Vulgaris
Journal of The American Academy of Dermatology, 2006Co-Authors: James J Leyden, Lincoln Krochmal, Alex YaroshinskyAbstract:Background The development of a hydrogel to stabilize and solubilize clindamycin and tretinoin provides a single, once-daily treatment for Acne Vulgaris. Objective Our aim was to compare the efficacy and safety of the combination of clindamycin (1%) and tretinoin (0.025%) with each agent alone and vehicle. Methods Two randomized, double-blind, active drug– and vehicle-controlled 12-week studies evaluated inflammatory and noninflammatory lesion counts and the Investigator's Static Global Assessment in 2219 subjects with Acne Vulgaris. Results The combination demonstrated superior efficacy to clindamycin, tretinoin, and vehicle. Combination hydrogel was significantly more effective in reducing inflammatory ( P P ≤ .0004), and total ( P P Limitations A majority of subjects (82.6%) had grade 2-3 Acne Vulgaris at baseline; therefore these overall results may not be representative of the response in the subjects (17.4%) with grade 4-5 Acne. Conclusion The combination clindamycin/tretinoin hydrogel was well tolerated and significantly more effective than clindamycin, tretinoin, or vehicle for the treatment of Acne Vulgaris.
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therapy for Acne Vulgaris
The New England Journal of Medicine, 1997Co-Authors: James J LeydenAbstract:Acne Vulgaris, or Acne, as it is generally called, is the most common skin disease, affecting nearly 80 percent of persons at some time between the ages of 11 and 30 years.1 It can persist for years and result in disfigurement and permanent scarring, and it can have serious adverse effects on psychosocial development, resulting in emotional problems, withdrawal from society, and depression.2 The pathogenesis of Acne is multifactorial, and therapy can now be directed at many of these factors. This review summarizes current concepts of the rational treatment of Acne Vulgaris. Pathophysiology of Acne Acne Vulgaris is the result . . .
Sree S Kolli - One of the best experts on this subject based on the ideXlab platform.
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topical retinoids in Acne Vulgaris a systematic review
American Journal of Clinical Dermatology, 2019Co-Authors: Sree S Kolli, Danielle Pecone, Adrian Pona, Abigail Cline, Steven R FeldmanAbstract:Topical retinoids are a first-line treatment for Acne Vulgaris. This systematic review aims to evaluate the efficacy, safety, and tolerability of topical retinoids approved in the United States for the treatment of Acne Vulgaris. A PubMed and Embase search was conducted using the search terms ‘adapalene,’ ‘tretinoin,’ ‘tazarotene,’ and ‘Acne Vulgaris.’ Selection of articles fit the following inclusion criteria: clinical trials evaluating both efficacy and safety/tolerability of topical retinoids approved in the United States for the treatment of Acne Vulgaris and published between January 1, 2008 and September 1, 2018. Exclusion criteria included clinical trials involving 20 subjects or fewer, subjects under 12 years of age, and topical retinoid combination therapies with moisturizers or aloe vera. Of 424 search results found, a total of 54 clinical trials were chosen based on selection criteria. Topical retinoids are superior to vehicle in improving Investigator Global Assessment and Investigator’s Static Global Assessment (24.1–28.8% and 13.3–17.3%, respectively; p < 0.001). A topical retinoid combined with benzoyl peroxide led to IGA improvement compared with vehicle (26.1–34.9% vs 7–11.8%; p < 0.001) at Week 12. Topical retinoid plus an oral antibiotic was superior to vehicle in reducing lesion counts (64–78.9% vs 41–56.8%, p < 0.001). There was no significant difference in efficacy between tretinoin and tazarotene. Tretinoin 0.05% resulted in 62% of patients experiencing AEs compared with adapalene 0.1% (19%) and adapalene 0.3% (40%). More patients receiving adapalene were tolerant of the AEs compared with tazarotene (55.4% vs 24.4%; p < 0.0012). Topical retinoids are safe and efficacious for the treatment of Acne Vulgaris. They should be used in combination with benzoyl peroxide to optimize results in patients. The differences in efficacy of topical retinoids appears minor; therefore, the type of topical retinoid is not as important as choosing a particular strength of topical retinoid and combining it with an antimicrobial agent. Adapalene has a superior tolerability profile amongst topical retinoids.
Alex Yaroshinsky - One of the best experts on this subject based on the ideXlab platform.
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two randomized double blind controlled trials of 2219 subjects to compare the combination clindamycin tretinoin hydrogel with each agent alone and vehicle for the treatment of Acne Vulgaris
Journal of The American Academy of Dermatology, 2006Co-Authors: James J Leyden, Lincoln Krochmal, Alex YaroshinskyAbstract:Background The development of a hydrogel to stabilize and solubilize clindamycin and tretinoin provides a single, once-daily treatment for Acne Vulgaris. Objective Our aim was to compare the efficacy and safety of the combination of clindamycin (1%) and tretinoin (0.025%) with each agent alone and vehicle. Methods Two randomized, double-blind, active drug– and vehicle-controlled 12-week studies evaluated inflammatory and noninflammatory lesion counts and the Investigator's Static Global Assessment in 2219 subjects with Acne Vulgaris. Results The combination demonstrated superior efficacy to clindamycin, tretinoin, and vehicle. Combination hydrogel was significantly more effective in reducing inflammatory ( P P ≤ .0004), and total ( P P Limitations A majority of subjects (82.6%) had grade 2-3 Acne Vulgaris at baseline; therefore these overall results may not be representative of the response in the subjects (17.4%) with grade 4-5 Acne. Conclusion The combination clindamycin/tretinoin hydrogel was well tolerated and significantly more effective than clindamycin, tretinoin, or vehicle for the treatment of Acne Vulgaris.
Rox R Anderson - One of the best experts on this subject based on the ideXlab platform.
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photodynamic therapy for Acne Vulgaris a critical review from basics to clinical practice part i Acne Vulgaris when and why consider photodynamic therapy
Journal of The American Academy of Dermatology, 2010Co-Authors: Fernanda H Sakamoto, Jose Daniel Lopes, Rox R AndersonAbstract:The first-line treatments for Acne Vulgaris are conventional topical and/or oral medications. However, many patients have contraindications, only partial response, significant adverse effects, or recurrence. Light-based treatments and photodynamic therapy (PDT) using topical precursors of porphyrins are off-label alternative treatments for Acne Vulgaris, with their own advantages and disadvantages. To date, there is no consensus on PDT methodology and parameters. An understanding of pathophysiology of Acne, light-tissue interactions, and PDT mechanisms of action is helpful whenever PDT is considered as an alternative treatment. In general, blue light alone improves Acne because of its antiinflammatory effects. PDT using 5-aminolevulenic acid (ALA) or ALA derivatives induces transient antimicrobial and antiinflammatory effects. At high doses, red light PDT may induce inhibition or destruction of sebaceous glands, resulting in clinical improvement. Learning objectives After completing this learning activity, participants should be able to compare different treatments of Acne, recognize when photodynamic therapy may be a useful off-label treatment for Acne Vulgaris, and identify variables that may affect the efficacy of photodynamic therapy.
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topical ala photodynamic therapy for the treatment of Acne Vulgaris
Journal of Investigative Dermatology, 2000Co-Authors: Wichai Hongcharu, Charles R Taylor, Yuchiao Chang, David Aghassi, Kittisak Suthamjariya, Rox R AndersonAbstract:Topical aminolevulinic acid is converted into a potent photosensitizer, protoporphyrin, in human hair follicles and sebaceous glands. Photodynamic therapy with topical aminolevulinic acid was tested for the treatment of Acne Vulgaris, in an open-label prospective human study. Each of 22 subjects with Acne on the back was treated in four sites with aminolevulinic acid plus red light, aminolevulinic acid alone, light alone, and untreated control. Half of the subjects were treated once; half were treated four times. Twenty percent topical aminolevulinic acid was applied with 3 h occlusion, and 150 J per cm2 broad-band light (550–700 nm) was given. Sebum excretion rate and auto-fluorescence from follicular bacteria were measured before, and 2, 3, 10, and 20 wk after, treatment. Histologic changes and protoporphyrin synthesis in pilosebaceous units were observed from skin biopsies. Aminolevulinic acid plus red light caused a transient Acne-like folliculitis. Sebum excretion was eliminated for several weeks, and decreased for 20 wk after photodynamic therapy; multiple treatments caused greater suppression of sebum. Bacterial porphyrin fluorescence was also suppressed by photodynamic therapy. On histology, sebaceous glands showed acute damage and were smaller 20 wk after photodynamic therapy. There was clinical and statistically significant clearance of inflammatory Acne by aminolevulinic acid plus red light, for at least 20 wk after multiple treatments and 10 wk after a single treatment. Transient hyperpigmentation, superficial exfoliation, and crusting were observed, which cleared without scarring. Topical aminolevulinic acid plus red light is an effective treatment of Acne Vulgaris, associated with significant side-effects. Aminolevulinic acid plus red light causes phototoxicity to sebaceous follicles, prolonged suppression of sebaceous gland function, and apparent decrease in follicular bacteria after photodynamic therapy. Potentially, aminolevulinic acid plus red light may be useful for some patients with Acne.
