Complete Histologic Response of Regionally Metastatic Melanoma Treated with Intralesional Interleukin 2, Topical Retinoid and Imiquimod

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Trifarotene for the Treatment of Facial and Truncal Acne

Objective: This article reviews clinical trials to assess the efficacy, safety, and clinical application of trifarotene 0.005% cream (Aklief). Data Sources: A systematic review of the literature was performed using the terms trifarotene OR Aklief OR CD5789 in MEDLINE (PubMed) and EMBASE databases. Articles prior to May 2020 were considered for inclusion. Bibliographies and ClinicalTrials.gov were also searched to identify further studies. Study Selection and Data Extraction: Relevant English language and human studies related to pharmacology, clinical trials, and safety were considered. Data Synthesis: In the 52-week phase III trial, treatment success rates for facial acne (Investigator Global Assessment [IGA] rating of no or almost no acne) and truncal acne (Physician’s Global Assessment [PGA] rating of no or almost no acne) were 65.1% and 66.9%, respectively. Overall success rates (IGA and PGA success in the same patient) were 57.9%; 52.8% of patients had a Dermatology Quality of Life Index score of 0 or 1, compared with 22.6% at baseline. Trifarotene was well tolerated, with pruritus, irritation, and sunburn as the most common adverse effects. Relevance to Patient Care and Clinical Practice: Trifarotene is a newly Food and Drug Administration–labeled fourth-generation topical retinoid that shows particular promise in the treatment of facial and truncal acne vulgaris. It is an effective and safe addition to currently available retinoids. Conclusion: Trifarotene is effective and safe for treatment of facial and truncal acne. Future trials should compare its efficacy and tolerability with that of the older, clinically established retinoids. Despite efficacy, cost may be a prohibitive factor.

Efficacy of Adapalene 0.1% Versus Tretinoin 0.025% Cream as Treatment of Mild Acne Vulgaris

Introduction: Acne vulgaris (AV) is a chronic inflammatory of the pilosebaceous unit. Topical retinoid is a mainstay of mild AV first-line treatment. Aim of study: To assess the efficacy of topical retinoid for the treatment of mild AV. Method: The randomized double-blind clinical trial was conducted from June to September 2019 at Dr. Mohammad Hoesin General Hospital Palembang. A total of 70 mild AV patients who fulfilled inclusion criteria were enroled consecutively. Patients randomly treated with adapalene 0.1% cream or tretinoin 0.025% cream and evaluated every 2 weeks for 8 weeks to examine the number of AV lesion (inflammation, non-inflammation and total lesion). Result: There are reduction in number of inflammatory and non-inflammatory lesions at both groups but only inflammatory lesion was statistically significant (p <0.05). Total lesions also decrease in adapalene and retinoin group (21.66 vs 5.75, 22.21 vs 7.96, respectively) and statistically significant (p <0.05). Conclusion: Adapalen 0.1% cream showed non-inferiority to tretinoin 0.025% cream in efficacy, especially in the reduction of non-inflammatory and total lesions.

Microneedle-Facilitated Intradermal Proretinal Nanoparticle Delivery

Topical retinoid treatments stimulate biological activities in the skin. The main physical barrier, which limits the efficacy of transdermal drug delivery, is the stratum corneum. Proretinal nanoparticles (PRN) have already been proven to efficiently deliver retinal into the epidermis. In the present study, two transdermal drug delivery systems, microneedles (MN) and PRN, were combined to directly target the dermis. The microchannels induced by the MN, the PRN localization in the microchannels and the skin closure kinetics were investigated by non-invasive imaging techniques, such as dermoscopy, optical coherence tomography and multiphoton tomography. Additionally, the amount of retinal in the epidermis and dermis after application in three different forms (PRN-Loaded microneedles, PRN suspension or conventional retinal solution) was compared. All imaging techniques confirmed the formation of microchannels in the skin, which were partly still detectable after 24 h. Multiphoton tomography showed the release of PRN from the MN within the microchannels. The recovered retinal concentration in the dermis was significantly higher when applied via PRN-loaded microneedles. We hypothesized that this platform of PRN-loaded microneedles can provide a rapid and efficient administration of retinal in the dermis and could be of benefit in some skin conditions such as atrophic scar or photo-aged skin.