Microneedling Radiofrequency for Acne Vulgaris and Post-Acne Scarring: A Case Report

Background: There are various therapeutic modalities for acne and post acne scarring, but the best option is to have a safe, effective with affordable cost such as monotherapy or combination therapy. One of the recommended combination therapy for acne vulgaris with atrophic acne scars is microneedling radiofrequency which can improve skin structure. Case report: A 25 year old male with moderate comedonal acne vulgaris and severe scarring. The patient came with complaints of uneven skin surface on both cheeks, forehead and chin which had been felt to increase since 3 years ago. The appearance of acne on the face has been felt since 12 years ago. The patient's parents and sister also had acne complaints. On dermatological examination, on the forehead, temples, cheeks, nose and chin found blackheads, whiteheads, papules, hyperpigmented macules, multiple atrophic acne scars. The treatment choice for this patient is microneedling radiofrequency in combination with topical therapy. Discussion: The combination of microneedling with radiofrequency is one of the therapeutic modalities for acne vulgaris and also post-acne scarring with minimal side effects. In the evaluation for 2 weeks after the procedure, this patient did not complaint of any adverse events.

Topical Therapy of Skin Scabs in Psoriasis with Salicylic Acid: Case Report

The objective was to evaluate the keratolytic and anti-inflammatory action of salicylic acid in the affected area in the case reported. Methods. Clinical photography a digital camera was used Olympus SP570UZ with master software 2.0. The images obtained both in the initial phase without treatment and at the 72 hours of treatment were transferred and stored on a 4-core Sansung computer. The auto-dial adjustment option was selected. In this way, the camera selects the optimal way to take the photo shot. Analysis of the affected skin with scabs. Image J software was used to measure the area selected for the study in both cases. This measurement was made in pixels for the photographic region under study. Results. The image j software program measures the areas in pixels, to decrease in measurement error there was no calibration. That is, the measurement of the areas in pixels was maintained. The percentage ratios of the affected or non-affected areas for both left and right legs are presented in Tables. It is possible to observe the reduction of the affected area. The doubtful areas represent for the left leg 5.21% and for the right leg 30.08% after treatment. Only a clearly visible area with crusts and scabs of 1.60% was observed after treatment.

Treatment with clobetasol propionate 0.025% topical therapy in various dermatoses

Owing to their anti-inflammatory and vasoconstrictive properties. Topical corticosteroids (TCs) provide benefits in various dermatological conditions, including atopic eczema, psoriasis, chronic hand eczema, and localized vitiligo. Clobetasol propionate (CP) is the most common topical agent possessing anti-inflammatory, antimitotic, antipruritic, and immunosuppressive properties that are employed in the management of plaque psoriasis. CP 0.025% cream was approved by the United States food and drug administration for the treatment of moderate-to-severe psoriasis in adult patients. The formulation is free from known contact allergens, such as propylene glycol, short-chain alcohols, and sorbitol-based emulsifiers, and has demonstrated hypoallergenic effects. High penetration of active ingredients and a lower degree of systemic absorption make CP 0.025% an effective and safe agent. This case series discusses the clinical experience of using CP 0.025% cream in various dermatologic conditions, focusing on its efficacy and safety.

Comparative efficacy of transdermal forms for alopecia therapy

Introduction. Alopecia is a polyetiological disorder characterized by hair loss and reducing their number per unit area. Baldness causes psychological and social discomfort to patients, in connection with what an important task is to develop formulations that are more effective than the reference agents.Aim. Investigate the possibility of applying the original substance Y in several dosage forms for the treatment of alopecia in comparison with reference drugs: minoxidil and burdock oil.Materials and methods. The research subject was the original substance Y, for which several dosage forms were made: gel, alcohol and oil compositions. The study on the effectiveness and safety of the developed formulations was carried out on 9 groups of male C57BL/6 mice. Depilation with further assessment of the percentage of hair follicles in the growth and resting phases was tested as a pre-clinical model of alopecia. In the study of the mechanism of action of substance Y, chemiluminescent assay was performed compared with natural antioxidant quercetin in the system luminol – 2,2'-azo-bis(2-amidinopropane)dihydrochloride, in potassium-phosphate buffer medium (pH = 7.4). Statistical processing of the results was carried out using two-way ANOVA using GraphPad Prism 8.0.2, USA software at the level of statistical significance of differences p < 0.05 and p < 0.005.Results and discussion. Based on the results of histological analysis and visual changes, it was found that the effectiveness of the topical forms of substance Y decreases in the following order: gel, alcohol form, oil composition. The use of a combination of the gel base with the test substance Y resulted to the appearance of a larger number of hair follicles in the growth phase than when using the reference preparation – 2 % minoxidil solution (the differences are statistically significant). Chemiluminescent assessment of antioxidant activity showed the lack of antioxidant effect in substance Y.Conclusion. The study combines two pharmaceutical profiles: technological and pharmacological. In the course of the experiments, the prospects of the gel form of the original substance Y for topical therapy of alopecia were shown. In the near future, it is planned to study the mechanism of action of substance Y, as well as registration of patent protection for a new drug.

Expert consensus statement on diagnosis and management of sensitive skin in current clinical practice

<p class="abstract">Sensitive skin is a very commonly seen entity in current dermatological practice that has a significant impact on quality of life. The pathophysiology, classification, diagnosis, and treatment of sensitive skin have evolved over the years, with new studies trying to bring about new robust evidence about the same. The current consensus aims at providing a comprehensive overview on evidence and experience-based approaches for sensitive skin. A total of 35 experts in the field of clinical dermatology participated in expert group meetings organized via teleconference webinar. Current evidence elaborating various aspects like classification, diagnosis, and management of sensitive skin along with clinical experience of experts were discussed in detail. The prerequisites for selecting suitable products, importance of cosmeceuticals as adjunctive therapy and the need for avoiding triggering factors in individuals with sensitive skin as well as associated dermatological disorders were also described. In addition to medical history, physical examination and routine investigations, a draft checklist and its clinical relevance in accurately diagnosing sensitive skin were emphasized upon by the experts. The overall management encompasses avoidance of individual trigger factors, thorough topical therapy using mild, non-irritating ingredients along with adjunctive therapies like moisturizers, sunscreens, and cleansers. The “two-week” strategy was described to be a useful approach for treating sensitive skin. This review article provides a consensus clinical viewpoint of expert dermatologists for effective evaluation, differential diagnosis and appropriate pharmacological as well as non-pharmacological management of sensitive skin in Indian subjects.</p>

Physician-reported Clinical Unmet Needs, Burden and Treatment Patterns of Paediatric Psoriasis Patients: a US and EU Real-world Evidence Study

This study is a retrospective analysis using data collected from the Adelphi Paediatric Psoriasis Disease-Specific Programme cross-sectional survey. Despite being treated for their psoriasis, a substantial proportion of paediatric patients presented with moderate (18.3%) or severe (1.3%) disease at sampling; 42.9% and 92.0% had a body surface area (BSA) of >10%, and 38.8% and 100.0% had a Psoriasis Area Severity Index (PASI) score >10, respectively. Overall, 69.9% of patients had only ever been treated with a topical therapy for their psoriasis. For patients with moderate or severe disease at sampling, 16.3% and 14.4% were currently receiving conventional systemics or biologic therapy, respectively. There is a clinical unmet need in this paediatric population; a considerable percentage of patients still experienced moderate or severe disease and persistent psoriasis symptoms, with numerous body areas affected. A significant proportion of patients were undertreated, which may explain the high burden of disease observed.

Antibiotics in prevention of skin toxic reactions of epidermal growth factor receptor inhibitors (literature review)

The article is an overview and contains up-to-date information on the use of tetracycline antibiotics in the prevention of acne-like rash in patients receiving therapy with epidermal growth factor receptor inhibitors. According to studies, prevention of skin toxicity is necessary to maintain the effectiveness of the antitumor effect of EGFR inhibitors and to minimize the negative effect of adverse effects from the skin on the quality of life of patients. The use of tetracycline antibiotics in combination with topical therapy and photoprotection for the prevention of acne-like rash against the background of the use of EGFR inhibitors is a fairly safe method for long-term use. Of the antibacterial drugs for the prevention of acne-like rash, the most advisable is the appointment of doxycycline at a dose of 100 mg per day from the first day of taking EGFR inhibitors.

Cryotherapy with liquid nitrogen for chronic and recalcitrant intertrigo of toe webspaces

<p><strong>Background:</strong> The inflammation of the toe web spaces is known as foot intertrigo. Most commonly caused by candida. Important predisposing factors such as diabetes mellitus, obesity and immunosuppression lead to persistence and recurrence. Cryotherapy is a promising, safe, cost-effective, easily available therapeutic approach to treat recalcitrant intertrigo compared to available topical medications. Aim of the study was to observe the clinical improvement and therapeutic response of recalcitrant intertrigo and to observe treatment response based on photographs.</p><p><strong>Methods:</strong> A total of 30 patients who were clinically diagnosed with chronic candida intertrigo (CI) who fulfilled the inclusion and exclusion criteria were enrolled. Cryotherapy was administered with 3 cycles of freeze and thaw of 30 seconds each, every 2 weeks for a maximum of 3 treatment sessions. Follow-up of patients were done for 4 months.</p><p><strong>Results:</strong> Among 30 patients treated, 21 patients showed excellent clinical response, 6 patients showed good response. Only 2 patients showed poor response. Minimal side effects were observed, of which transient pain at the cryotherapy site is the most common. Diabetes was the most common comorbidity with poor response to treatment and recurrence.</p><p><strong>Conclusions:</strong> Cryotherapy can be used as a safe modality of treatment for recalcitrant CI cases unresponsive to topical therapy by providing faster therapeutic response and improving the quality of life in these patients. </p>

New Formulations Loading Caspofungin for Topical Therapy of Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC) poses a significant problem worldwide affecting women from all strata of society. It is manifested as changes in vaginal discharge, irritation, itching and stinging sensation. Although most patients respond to topical treatment, there is still a need for increase the therapeutic arsenal due to resistances to anti-infective agents. The present study was designed to develop and characterize three hydrogels of chitosan (CTS), Poloxamer 407 (P407) and a combination of both containing 2% caspofungin (CSP) for the vaginal treatment of VVC. CTS was used by its mucoadhesive properties and P407 was used to exploit potential advantages related to increasing drug concentration in order to provide a local effect. The formulations were physically, mechanically and morphologically characterized. Drug release profile and ex vivo vaginal permeation studies were performed. Antifungal efficacy against different strains of Candida spp. was also evaluated. In addition, tolerance of formulations was studied by histological analysis. Results confirmed that CSP hydrogels could be proposed as promising candidates for the treatment of VVC.