scholarly journals Comparing the efficacy of intense pulsed light combined with oral azithromycin versus oral azithromycin alone in the treatment of moderate to severe papulopustular acne vulgaris

2021 ◽  
Vol 42 (6) ◽  
pp. 621-626
Author(s):  
Niloofar Afshari ◽  
Mehdi Amirnia ◽  
Davod Ahmadi ◽  
Saeed Kashefi ◽  
Vahideh Aghamohammadi
Keyword(s):  
Complete Remission ◽  
Therapeutic Option ◽  
Acne Vulgaris ◽  
Intense Pulsed Light ◽  
Pulsed Light ◽  
Field Methods ◽  
Severe Acne ◽  
Group A ◽  
Group B ◽  
Oral Azithromycin

Background: Rising follicular keratin secretion, increasing sebum production, and Propionibacterium acnes are among the main etiology of acne vulgaris formation. Antibiotics are the predominant conventional treatment of acne. Antibiotic resistance is the main problem in the ordinary treatments of acne. Therefore, newer treatments are necessary. Intense pulsed light (IPL) is a novel therapeutic option with rapid application in this field. Methods: Patients referred to us were randomized into two groups: group A (cases) and group B (controls). In addition to conventional antibiotic therapy, IPL was prescribed to group A while azithromycin alone was prescribed to group B. IPL treatment was performed weekly for five weeks and the patients were followed for three months. Declining inflammatory lesions count after the intervention was considered the remission scale. Results: In group A, moderate, partial, and complete remission occurred in 4, 9, and 7 patients, respectively. In group B, moderate, partial, and complete remission occurred in 10, 7, and 3 patients, respectively. Statistically, the remission difference was meaningful between the two groups. Conclusion: IPL with conventional antibiotics is an effective treatment choice in moderate to severe acne vulgaris but also is a more accelerating agent in treatment versus antibiotics alone.

scholarly journals Comparison of efficacy and safety of oral azithromycin and oral doxycycline in acne vulgaris

2019 ◽  
Vol 8 (5) ◽  
pp. 913
Author(s):  
Marya Ahsan ◽  
Rahul Ranjan ◽  
Shalini Chandra ◽  
Kumar Mayank
Keyword(s):  
Adverse Effects ◽  
Acne Vulgaris ◽  
Optimal Dose ◽  
Chronic Inflammatory Disease ◽  
P Value ◽  
Severe Acne ◽  
Oral Doxycycline ◽  
Group A ◽  
Group B ◽  
Oral Azithromycin

Background: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit with considerable psychosocial impact. Oral azithromycin or oral doxycycline can be used for the management of moderate and severe acne vulgaris. However, there is no consensus on which antibiotic is superior and the optimal dose for management.Methods: A prospective randomized interventional study was carried out among 120 patients of moderate to severe acne vulgaris. The patients were randomized into group A and B. While group A was prescribed oral azithromycin 500 mg three times a week, group B was given oral doxycycline 100 mg daily for 12 weeks. Topical clindamycin twice daily application was also given. Global Acne Grading Scale (GAGS) score was recorded at baseline and at 2nd, 4th, 8th and 12th weeks.Results: GAGS score at baseline in azithromycin (n = 53) and doxycycline (n = 55) group was 31.98±4.49 and 30.63±3.78 respectively (p value >0.05). 83.91±6.83% (p <0.001) and 81.87±6.75% (p <0.001) improvement was seen in azithromycin group and doxycycline group after 12 weeks of treatment. However, there was no difference in the GAGS score between the groups at any follow-up (p value >0.05). 15.09% patients in azithromycin group and 20% patients in doxycycline group reported adverse effects. The most commonly reported adverse effect was diarrhoea. All adverse effects were of ‘mild’ category and causality assessment was ‘possible’.Conclusions: Oral azithromycin is equally efficacious but safer alternative to oral doxycycline for the management of acne vulgaris.

scholarly journals COMPARISON OF MONTHLY PULSE OF ORAL AZITHROMYCIN WITH DAILY DOXYCYCLINE IN THE TREATMENT OF MODERATE ACNE VULGARIS

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S268-72
Author(s):  
Muhammad Mudassir ◽  
Ali Amar ◽  
Naeem Raza ◽  
Ayesha Khokhar ◽  
Adeel Siddiqui ◽  
...  
Keyword(s):  
Acne Vulgaris ◽  
Severity Index ◽  
Post Treatment ◽  
Military Hospital ◽  
Dermatology Department ◽  
Oral Doxycycline ◽  
Group A ◽  
Pre Treatment ◽  
Group B ◽  
Oral Azithromycin

Objective: To compare oral Azithromycin with oral Doxycycline in treatment of moderate Acne Vulgaris. Study design: Randomized control trial Place and duration of the study: Dermatology Department , Pak Emirates Military Hospital, Rawalpindi from 1st August 2017 till 31st January 2018. Materials and methods: A total of 92 patients with moderate Acne were selected from Dermatology outpatient department (OPD) Pak Emirates Military Hospital Rawalpindi, after written informed consent. Patients were randomly allocated to one of the two treatment groups: Group A and Group B by lottery method. Patients in group A were given oral Azithromycin 500 mg daily for four consecutive days each month for 03 months and patients in group B were given oral Doxycycline 100 mg daily for 03 months. Patients were reviewed monthly for 03 months and Acne Severity Index (ASI) was recorded at baseline, at one month and three months. The primary outcome measured was more than 50% decrease from baseline in ASI within 3 months of treatment, using Global Acne Grading System (GAGS). Results: Mean age of patients in group A was 21.80 + 4.64 years whereas mean age of patients in group B was 21.61 + 4.48 years. In group A mean pre-treatment ASI was 24.83 + 3.15 and mean post-treatment ASI was 10.15 + 1.7. In group B mean pre-treatment ASI was 25.30 ± 2.96 and mean post-treatment ASI was 9.86 + 1.58. Conclusion: Azithromycin is comparable to Doxycycline in terms of mean change in ASI, in the treatment of moderate Acne Vulgaris.

Efficacy of Oral Azithromycin versus Doxycycline in the Treatment of Acne Vulgaris

2021 ◽  
Vol 18 (2) ◽  
pp. 59-62
Author(s):  
Abhishek Arjel ◽  
Kumar Pokhrel ◽  
Sapana Sharma
Keyword(s):  
Acne Vulgaris ◽  
College Teaching ◽  
Medical College ◽  
Significant Difference ◽  
Common Skin ◽  
Group A ◽  
Efficacy Assessment ◽  
Grade Ii ◽  
Group B ◽  
Oral Azithromycin

Introduction: Acne vulgaris is one of the most common skin disease affecting adolescence of either sex, globally. Antibiotics like macrolides and tetracycline have been used with good results, studies comparing their efficacy are lacking. The present study compare the efficacy of Azithromycin v/s Doxycycline in acne vulgaris. Aims: To compare the efficacy of Azithromycin and Doxycycline in the treatment of acne vulgaris. Methods: This is a prospective hospital based comparative study, conducted on 80 patients attending outpatient department of Dermatology, Nepalgunj Medical College Teaching Hospital with acne vulgaris from July 2019 to April 2020. Patient were divided alternately into two groups, Group A received Azithromycin (n=40) and Group B Doxycycline (n=40) and compared the effects of treatment at 6 and 12 weeks. Efficacy assessment was done according to simple acne grading system. Results: Acne was predominant in female (62.5%) as compared to male (37.5%). Patient between 16 to 20 years age group were more prone to acne (47.5%). Most of the patients had Grade II acne before treatment in both groups (Azithromycin 52.5%, Doxycycline 55%). After the treatment most of them improve to Grade I at 6 weeks (Azithromycin 50%, Doxycycline 55%) and to Grade zero at 12 weeks (Azithromycin 42.5%, Doxycycline 67.5%).There was no statistically significant difference in treatment efficacy between the two groups at 6 weeks but at 12 weeks efficacy of Doxycycline was significantly better than Azithromycin. Conclusion:  Both oral Azithromycin and Doxycycline when given for treatment of acne vulgaris the analysis showed good improvement after 6 weeks of treatment but there was no statistically significant difference in the improvement in both groups (p 0.771). However after 12 weeks patient receiving Doxycycline showed statistically significant improvement (p 0.035) in comparison to the patients receiving Azithromycin.

scholarly journals Comparative Efficacy and Safety of Low Dose versus High Dose Isotretinoin in Severe Acne Vulgaris Patients

2019 ◽  
Vol 8 (1) ◽  
pp. 18-22
Author(s):  
Maria Syed ◽  
Syed Afaq Ahmed
Keyword(s):  
Side Effects ◽  
Low Dose ◽  
Acne Vulgaris ◽  
High Dose ◽  
High Dose Regimen ◽  
Severe Acne ◽  
Dose Oral ◽  
Group A ◽  
Oral Isotretinoin ◽  
Group B

Background: Oral isotretinoin is the recommended treatment for acne vulgaris, a skin disease especially common in teenagers and adolescents. This study was designed to compare the efficacy and safety of low dose with high dose isotretinoin in severe acne vulgaris patients.Material and Methods: This randomized controlled trial included 110 patients with a clinical diagnosis of acne vulgaris. They were divided into two groups. Both groups were matched for age (mean 18.2±3.7 vs 17.6±3.2 years), weight (mean 58±10.2 vs 60.7±9.3 Kg), gender and disease duration (3±1.1 vs 3±1.0 years). Group A received low dose oral isotretinoin (20 mg/day) while group B received standard high dose regimen (1mg/kg/day). All patients were followed up for 16 weeks to assess efficacy (assessment of complete remission) and safety (mucocutaneous side effects). All calculations were performed using SPSS v. 16 with p value <0.05 considered as statistically significant.Results: There was no statistically significant difference in efficacy. However, significantly fewer mucocutaneous side effects were reported in group A (80%) as compared to group B (100%). This safety profile spectrum was observed across all pre-defined subsets i.e chielitis (78.1% vs 98.2%), dry skin (69.1% vs 92.7%), dry mouth (47.2% vs 72.7%) and facial rash (12.7% vs 30.9%).Conclusion: In patients with severe acne vulgaris, efficacy (complete remission) of low dose oral isotretinoin is almost equal to conventional high dose regimen but it is statistically superior in terms of safety (mucocutaneous side effects).

scholarly journals A randomized open label comparative study to determine the various side effects and patient satisfaction of low dose continuous versus low dose intermittent oral isotretinoin therapy in moderate to severe acne vulgaris

2018 ◽  
Vol 7 (6) ◽  
pp. 1169
Author(s):  
Santhosh A. Shetti ◽  
Nagesh H. N. ◽  
Nagabushan Hanumanthaiah
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Low Dose ◽  
Acne Vulgaris ◽  
Once Daily ◽  
Severe Acne ◽  
Treatment Regimens ◽  
Group A ◽  
Oral Isotretinoin ◽  
Group B

Background: Acne Vulgaris is chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for moderate to severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low dose treatment protocols. However, long term daily use of this drug results in frequent side effects such mucocutaneous and systemic side effects. Our aim was to assess and compare the various side effects and patient satisfaction of oral isotretinoin in low dose continuous and intermittent treatment of moderate to severe acne vulgaris.Methods: This was a prospective randomized open labeled comparative study carried out at outpatient department in the Department of Dermatology in Mandya Institute of Medical sciences, Mandya. Patients with moderate to severe acne were assigned equally (50 subjects each) to one of the two treatment regimens by using block randomization technique, Group A was given low dose continuous regimen-20 mg oral isotretinoin once daily for 4 months and Group B was given low dose intermittent regimen-20 mg oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4th week during the treatment period. The patients were examined and side effects were noted in each visit. A six month follow-up evaluation was done to analyze patient satisfaction.Results: Muco-cutaneous dryness was most common adverse effect noted in both the groups A and B. Itching (42%), Alopecia (44%), Myalgia (36%) were seen most commonly in group A and Acne flaring (47%) was most common with group B. With regard to patient satisfaction, in group A 42% were satisfied and 20% were very satisfied, in group B 36% were satisfied and 14% were very satisfied.Conclusions: Study suggests that, Muco-cutaneous dryness was most common side effect in both treatment regimens. Side effects were more frequent with low dose continuous than low dose intermittent isotretinoin regimen. Patient satisfaction was better in continuous regimen.

Efficacy and safety of oral dapsone in acne vulgaris – experience of a tertiary care teaching hospital in central Lahore

2020 ◽  
Vol 14 (2) ◽  
pp. 87-90
Author(s):  
Sadaf Amin Chaudhry ◽  
Nadia Ali Zafar ◽  
Rabia Hayat ◽  
Ayesha Noreen ◽  
Gulnaz Ali ◽  
...  
Keyword(s):  
Side Effects ◽  
Therapeutic Option ◽  
Acne Vulgaris ◽  
Treatment Options ◽  
Tertiary Care ◽  
Poor Response ◽  
Global Assessment Scale ◽  
Severe Acne ◽  
Hematologic Profile

Background: Acne is the eighth most prevalent disease affecting 9.4% of the population worldwide and its prevalence in our country is estimated to be around 5%. Severe inflammatory acne is most likely to leave scars and in order to prevent facial disfigurement due to acne scarring, early treatment is desirable. Various treatment options have been formulated for acne, and are tailored according to the severity of the disease. Numerous clinical trials have been conducted till now, to determine the usefulness and side effect profile of such therapies, making acne treatment a highly studied area in dermatology. Objective of this study is to highlight the fact that oral Dapsone could be used as a cheaper alternate to isotretinoin in recalcitrant severe acne, especially in females where retinoids are sometimes contraindicated. Patients and methods: 51 patients, suffering from severe nodulocystic acne, fulfilling the criteria, were enrolled from the Department of Dermatology, Sir Ganga Ram Hospital, Lahore. All the study patients were given oral Dapsone 50mg for initial two weeks and then 100mg daily for the next 10 weeks along with oral cimetidine and topical clindamycin application twice daily. Investigator Global Assessment Scale (IGAS) was employed to measure effectiveness. The treatment was considered ʽeffectiveʹ if the patient achieves 2 or more than 2-grade improvement or almost clear or clear skin at the end of 12 weeks according to IGAS scale. The lesion counts were also done before the start of therapy (day 1) and at every two weeks follow up for 12 weeks. The change in lesion count observed between the baseline number and that seen at follow up visits was also used to evaluate the effectiveness of oral Dapsone. Safety was analyzed by fortnightly visits of the patients to look for any undesirable side effects and monitoring of the hematologic profile of the patients. Final follow up was done at the end of 16 weeks. Results: The study was conducted on 51 patients, with a ratio of 1:3 for males and females and a mean age of 25.2 years (SD ±5.81). At 12th week, patients had significant reduction in their acne lesions; with 7 patients (13.7%) showing completely clear skin, 17 patients (33.3%) had almost clear skin, 5 patients (9.8%) had 3-grade improvement. Twelve patients (23.5%) had 2-grade improvement from baseline score and only 2 patients (3.9%) had 1-grade improvement from baseline. Based on percentage reduction of lesions, excellent response was seen in 32 patients (62.7%), good response in 9 patients (17.6%), moderate response in 2 patients (3.9%), while no patient showed poor response. Dapsone was discontinued in 8 patients due to derangement of hematologic profile. Conclusion: Oral Dapsone, when given carefully, is a very effective therapeutic option in severe recalcitrant acne, with limited side effects.

Evaluation of comparative efficacy of Guda Sunthi and Manjistha Guggulu Avapeedana Nasya in Manyastambha (Cervical Spondylitis)

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Manjunath Akki ◽  
Suresh Hakkandi ◽  
Arti Panwar
Keyword(s):  
Complete Remission ◽  
Routine Activities ◽  
Household Work ◽  
Comparative Efficacy ◽  
Exclusion Criteria ◽  
Patient Complaints ◽  
The People ◽  
Comparative Clinical Study ◽  
Group A ◽  
Group B

Manyastambha is described under Nanatmaja Vatavyadhi. It is a condition where, the aggravated Vata get localized in the Manya Pradesha causing symptoms like Stambha and Shoola. Manyastambha can be compared with earliest symptoms of cervical spondylitis. In this condition, patient complaints of neck pain. The neck is held rigidly and neck movements may exacerbate pain. Now a day, Cervical spondylitis is very common in the people who do routine activities like travelling, household work, desk job etc. It can be seen in people as early as 25 years of age. In Manyastambha, Nasya is the main line of treatment. (i.e. Vatakaphahara Nasya). Objectives: To evaluate the comparative efficacy of Guda Sunthi Avapeedana Nasya and Manjistha Guggulu Avpeedana Nasya in Manyastambha (Cervical Spondylitis). Materials and Methods: This is a comparative clinical study conducted to assess the efficacy in Manyastambha. As per the inclusion and exclusion criteria, the patients who fulfill the criteria were randomly selected and equally divided into two groups. Group A - 15 Patients received Guda-Sunthi Avapeedana Nasya. Group B - 15 Patients received Manjistha-Guggulu Avapeedana Nasya. Results and Conclusion: In Group A, 9 patients (60%) showed complete remission and 6 patients (30%) showed marked response. In Group B, 3 patients (20%) showed complete remission, 1 patient (7%) showed marked response. 6 patients (30%) showed moderate response, 4 patients (26%) showed mild response and 1 patient (7%) showed unchanged response.

scholarly journals AB0393 EFFICACY OF HYDROXYCHLOROQUINE FOR LUPUS NEPHRITIS IN MAINTENANCE PHASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1496.2-1496
Author(s):  
M. Watanabe ◽  
Y. Haji ◽  
M. Kato ◽  
T. Ito ◽  
Y. Banno ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Therapeutic Option ◽  
Maintenance Phase ◽  
Base Line ◽  
Prednisolone Dose ◽  
Daily Urine ◽  
Group A ◽  
The Mean ◽  
Group B

Background:Hydroxychloroquine (HCQ) is an essential drug for systemic lupus erythematosus. But in Japan, chloroquine and HCQ remain unavailable until mid 2015 because of a series of lawsuits about its retinal toxicity in the 1970s. There is insufficient knowledge regarding renal protective effect of HCQ.Objectives:We aimed to investigate its efficacy of adding HCQ for Lupus nephritis (LN) as a maintenance-phase therapy.Methods:We conducted an observational retrospective cohort study included patients with LN (n=42) in maintenance-phase in Japan. We reviewed medical records of LN patients aged > 18 years who were initiated HCQ from May 2015 to May 2018. Maintenance phase was defined as stabilization in serum creatinine and urinary segment after induction therapy and who achieved complete or partial remission. The annual change of proteinuria was compared between patients on HCQ who have proteinuria (>0.5g/gCr) or not. Other outcome measures were disease flare, dose of steroids, renal and immunologic features.Results:A total of 42 patients were analyzed and allocated to two groups based on their amount of daily urine protein level: HCQ with proteinuria as group A (>0.5g/gCr, n=14) and HCQ without proteinuria as group B(≦0.5g/gCr, n=28). Both groups were comparable, with mean (SD) age of 36.1 (12.9) years and 37.5 (13.8), female 78.6% and 92.9% in each group, mean (SD) disease duration until HCQ of 3.5 (3.25) and 3.3 (2.9) years in group A and group B, with prednisolone dose at base line of 10.3 (7.1) mg and 7.9 (4.4) mg, respectively. The mean (SD) proteinuria at base line was 1.38 (1.11) g/gCr in group A and 0.20 (0.09) g/gCr in group B and after 12 months, proteinuria decreased in group A (-1.34 g/gCr in group A vs +0.03 g/gCr in group B; p<.001;95% CI,0.305-0.736). No relapse was experienced in group A during the study period.Conclusion:In patients with clinically stable LN but with proteinuria, hydroxychloroquine is a good therapeutic option for achievement of complete remission.Disclosure of Interests:None declared

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