scholarly journals Azithromycin Pulse Therapy with Oral Doxycycline in the Treatment of Acne Vulgaris, a Randomized Group Study

2021 ◽  
pp. 1-9
Author(s):  
C. Sadhana ◽  
N. S. Muthiah
Keyword(s):  
Adverse Event ◽  
Side Effects ◽  
Acne Vulgaris ◽  
Pulse Therapy ◽  
Response To Treatment ◽  
Antibiotics Resistance ◽  
Once Daily ◽  
Severe Acne ◽  
Group I ◽  
Systemic Antibiotics

Acne vulgaris is a common dermatological problem. The choice of proper treatment is determined by the severity and extent of acne. Moderate to severe acne vulgaris cases respond well to systemic antibiotics. Antibiotics execute their anti-propionic bacterium effect by inhibiting the bacterial growth and colonization of pilosebaceous glands and thus further inflammation is prevented. The efficacy and possible side effects of various oral antibiotics has been the subject of numerous studies for at least the last twenty years in an effort to understand, which products are likely to produce better efficacy with least possible side effects. The new emerging problem is antibiotics resistance to propionic bacterium. There has been a constant increase in search of safe medications to overcome the side effects and resistance of existing formulations for the treatment of acne vulgaris. The study duration was 8 weeks. A total of 200 study participants of both sexes with complaints of acne vulgaris were included in the study and randomized into two groups. Group I (100 study subjects) – 500 mg Azithromycin once daily for three consecutive days in a week for 2 months and Group II (100 study subjects) –100 mg Doxycycline once daily for 2 months. After doing initial laboratory tests treatment was initiated. Three scheduled visits – Baseline, at the end 4th week and at the end of study were done and the response to treatment was evaluated. The efficacy of the drugs was assessed by the change in grading of acne from baseline and at follow up visits. Doxycycline was found to be better than azithromycin pulse therapy in reducing acne severity. During the visits gastrointestinal, dermatological and other side effects were also noted and recorded. Adverse event profile of both the drugs showed that there was no non- compliance incidence due to adverse event. But the number of adverse events was higher in doxycycline group.

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.

scholarly journals Oral Azithromycin Pulse Therapy and Daily Topical Adapalene in the Treatment of Acne Vulgaris: An Open Randomized Noncomparative Study

2017 ◽  
Vol 28 (2) ◽  
pp. 52-56
Author(s):  
Mohammod Abu Hena Chowdhury ◽  
Shameem Al Mamun ◽  
Mohammad Jamal Uddin ◽  
Rashed Md Khan ◽  
M Mujibul Hoque ◽  
...  
Keyword(s):  
Cystic Lesion ◽  
Acne Vulgaris ◽  
Severity Index ◽  
Pulse Therapy ◽  
Inclusion Criteria ◽  
Noncomparative Study ◽  
Percent Reduction ◽  
Once Daily ◽  
Acne Lesion ◽  
Oral Azithromycin

The safety and efficacy of oral azithromycin and topical adapalene are well documented. In this study, concomitant use of oral azithromycin pulse therapy and daily topical adapalene in the treatment of acne vulgaris is assessed. A total of 37 patients fulfilled the inclusion criteria were enrolled. Azithromycin, 500 mg orally once daily first 3 days of 10 days' cycle for 9 cycle & topical Adapalene (0.5%) at night. Patients evaluated at 4 weeks' interval by using Michaelsson acne severity index. The overall assessment was made by percent reduction of acne lesions and severity score. At the end of 12 weeks' treatment 99.8% of comedones, 98.7% papular lesion, 94.3% pustular lesion and 88.8% infiltrated lesion were cleared. Only 2.9% cystic lesion responded to the regimens. Percent reduction of Michaelsson acne severity index was 87%, which was statistically highly significant. Overall assessment revealed acne lesion cleared in 22% cases, excellent improvement observed in 65% and 13% showed good response. Adverse effect was minimal. So, azithromycin pulse therapy and topical adapalene is indeed effective and safe in the treatment of acne vulgaris.Medicine Today 2016 Vol.28(2): 52-56

scholarly journals Tretinoin 0.05% Lotion for the Once-Daily Treatment of Moderate-to-Severe Acne Vulgaris in Females: Effect of Age on Efficacy and Tolerability

2020 ◽  
Vol 4 (5) ◽  
pp. s59
Author(s):  
Linda Stein Gold ◽  
David M Pariser ◽  
Marci Levy ◽  
Eric Guenin
Keyword(s):  
Acne Vulgaris ◽  
Daily Treatment ◽  
Once Daily ◽  
Severe Acne ◽  
Effect Of Age

Abstract not available.

scholarly journals Topical Isotretinoin in Acne Vulgaris

2018 ◽  
Vol 29 (2) ◽  
pp. 1-5
Author(s):  
M Moksedur Rahman ◽  
M Abdullah ◽  
M Moazzem Hossain ◽  
MA Siddique ◽  
M Nessa ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Prospective Study ◽  
Acne Vulgaris ◽  
Topical Therapy ◽  
Outpatient Department ◽  
College Hospital ◽  
Once Daily ◽  
Medical College ◽  
Cutaneous Reactions

This study was carried out to evaluate the efficacy, safety and adverse effects of topical isotretinoin 0.05% gel in the treatment of acne vulgaris. This prospective study was undertaken in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi. One hundred patients with mild tomoderate acne vulgaris were enrolled and were instructed to apply isotretinoin 0.05% gel once daily at night for 12 weeks. Patients were followed up at 2,4,8 and 12 weeks for efficacy and tolerability. Efficacy was measured by counting facial inflammatory and noninflammatory lesions and by grading acne severity. Cutaneous tolerance was assessed by determining erythema, scaling and burning with pruritus.Response was excellent in 80%of cases.None of the cutaneous reactions was severe, all were mild and well tolerated.Nobody had to discontinue the therapy for side effects. This study confirms that isotretinoin 0.05% gel is safe and effective topical therapy for mild to moderate acnevulgaris.TAJ 2016; 29(2): 1-5

scholarly journals Is Oral Omega-3 Effective in Reducing Mucocutaneous Side Effects of Isotretinoin in Patients with Acne Vulgaris?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mina Mirnezami ◽  
Hoda Rahimi
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Acne Vulgaris ◽  
Control Group ◽  
Case Group ◽  
Omega 3 ◽  
Double Blind ◽  
Severe Acne ◽  
Double Blind Clinical Trial ◽  
And Control

Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheilitis (at weeks 4, 8, and 12), xerosis, dryness of nose at all weeks, and dryness of eyes (at week 4) were less frequent in the group that received isotretinoin combined with oral omega-3 compared to the group that received isotretinoin alone. Conclusion. Administration of oral omega-3 in acne patients who are receiving isotretinoin decreases the mucocutaneous side effects of isotretinoin. This trial is registered with  IRCT201306238241N2.

Novel Tretinoin 0.05% lotion for the once-daily treatment of moderate-to-severe acne vulgaris: Assessment of safety and tolerability in subgroups

2018 ◽  
Vol 2 ◽  
pp. S59
Author(s):  
Joshua A Zeichner ◽  
Julie C Harper ◽  
Wendy E Roberts ◽  
Et Al.
Keyword(s):  
Acne Vulgaris ◽  
Daily Treatment ◽  
Once Daily ◽  
Severe Acne

Abstract not available. Disclosures: Study sponsored by Ortho Dermatologics. Copyright 2018 SKIN

Tazarotene 0.045% Lotion for Once-Daily Treatment of Moderate-to-Severe Acne Vulgaris: Results from Two Phase 3 Trials

2019 ◽  
Vol 19 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Emil Tanghetti ◽  
William Werschler ◽  
Terry Lain ◽  
Eric Guenin ◽  
Gina Martin ◽  
...  
Keyword(s):  
Acne Vulgaris ◽  
Daily Treatment ◽  
Phase 3 ◽  
Two Phase ◽  
Once Daily ◽  
Severe Acne

scholarly journals Assessment of Plasma Malondialdehyde in Acne Patients on Isotretinoin Therapy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M A Saleh ◽  
K M A Alzawahry ◽  
R E M Gad
Keyword(s):  
Oxidative Stress ◽  
Lipid Peroxidation ◽  
Side Effects ◽  
Serum Level ◽  
Liver Function ◽  
Lipid Profile ◽  
Acne Vulgaris ◽  
Liver Function Tests ◽  
Severe Acne ◽  
Function Tests

Abstract Background Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that affects predominantly adolescents and young adults. Oral isotretinoin is a highly effective treatment agent for patients with nodulocystic acne and moderate to severe acne resistant to conventional therapy, isotretinoin might have side effects of oxidative stress and lipid peroxidation. . Malondialdehyde is the end product of lipid peroxidation and is a good marker of free radical-mediated damage and oxidative stress. Objective The purpose of this study to estimate malondialdehyde level in patients on Isotretinoin treatment for moderate to severe acne and compare them with healthy control group. Patients and Methods The case-control study was conducted at Ain. Shams University Faculty of Medicine, Egypt, from October 2017 to April 2017, and comprised male or non-pregnant female patients more than 18 years of age. 88 participants were included in the study; 44 cases, categorized by the Global Evaluation Acne (GEA) into 22 patients with moderate acne vulgaris and 22 patients with severe acne in comparison to equal healthy matching group. Isotretinoin was started in a dosage of 0.5mg/kg/day, and1.0mg/kg/day in patients with moderate and severe acne vulgaris respectively. Malondialdehyde, liver function tests, lipid profile and CBC were tested at the baseline for all participants and after 3 months for the patients who started isotretnoin therapy. Results In the current study, the mean baseline level malondialdehyde among all cases was 141.39 µmo1/m1±88.90, (range: 34.5 -360) and in controls it was 40 [µmo1/m1 ±11.3, (range: 9.5-90.4) this difference was statistically highly significant (P = 0.001). There was highly significant difference in malondialdehyde serum level (p = 0.0001) among all cases after 3 months of isotretnoin therapy, also there was a significant increase in MDA serum level among moderate cases (p = 0.021) and highly significant increase of MDA in severe cases (p=.001).ALP, ALT, serum cholesterol and triglyceride significant increases were seen in all cases. Conclusion low dose isotretinoin seems to have less side effects on basic laboratory data such as CBC, liver function tests, lipid profile and Malondialdehyde serum levels than high dose.

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