tetracycline and resorcinol

Exogenous ochronosis is clinically and histologically similar to its endogenous counterpart; however, it exhibits no systemic effects and is not an inherited disorder. It is characterized by an asymptomatic hyperpigmentation of the face, sides and back of the neck, back, and extensor surfaces of the extremities. The associated ochronotic discoloration most commonly results from use of products containing hydroquinone. It also occurs following use of antimalarials and products containing resorcinol, phenol, mercury or picric acid. The etiology of hydroquinone-induced hyperpigmentation in exogenous ochronosis remains speculative. The majority of patients with this condition are Black, but it has been reported to occur in Hispanics and Caucasians. Exogenous ochronosis is prevalent among South African Blacks, but is believed relatively uncommon within the US. The reasons for this phenomenon are not clear, but it could be a result of the use of skin care products containing resorcinol in combination with hydroquinone or the use of hydroquinone in a hydroalcoholic lotion. Treatment of this condition is difficult. The offending agent must be avoided, but improvement occurs only slowly. A number of topical agents have been studied as have dermabrasion and the use of lasers. Controlled studies in larger numbers of patients are require to determine the true efficacy of newer treatments.

Topics: Adrenal Cortex Hormones; Adult; Aged; Anti-Bacterial Agents; Caustics; Cosmetics; Cryotherapy; Dermabrasion; Dermatologic Agents; Female; Humans; Hydroquinones; Incidence; Keratolytic Agents; Laser Therapy; Middle Aged; Ochronosis; Resorcinols; Skin Care; South Africa; Sunscreening Agents; Tetracycline; Time Factors; Tretinoin; Trichloroacetic Acid

Hidradenitis suppurativa (HS) rarely affects pediatric patients. The literature on pediatric HS patients is scarce. This is a cross-sectional study based on case note review or interviews and clinical examination of 140 pediatric patients undergoing secondary or tertiary level care. Patients were predominantly female (75.5%, n = 105) with a median age of 16. 39% reported 1st-degree relative with HS. Median BMI percentile was 88, and 11% were smokers (n = 15). Median modified Sartorius score was 8.5. Notable comorbidities found were acne (32.8%, n = 45), hirsutism (19.3%, n = 27), and pilonidal cysts (16.4%, n = 23). Resorcinol (n = 27) and clindamycin (n = 25) were the most frequently used topical treatments. Patients were treated with tetracycline (n = 32), or oral clindamycin and rifampicin in combination (n = 29). Surgical excision was performed in 18 patients, deroofing in five and incision in seven patients. Obesity seemed to be prominent in the pediatric population and correlated to parent BMI, suggesting a potential for preventive measures for the family. Disease management appeared to be similar to that of adult HS, bearing in mind that the younger the patient, the milder the disease in majority of cases.

Topics: Acne Vulgaris; Administration, Cutaneous; Administration, Oral; Adolescent; Anti-Bacterial Agents; Body Mass Index; Child; Clindamycin; Comorbidity; Cross-Sectional Studies; Dermatologic Surgical Procedures; Drug Therapy, Combination; Female; Hidradenitis Suppurativa; Hirsutism; Humans; Male; Obesity; Pilonidal Sinus; Resorcinols; Rifampin; Risk Factors; Severity of Illness Index; Smoking; Tetracycline; Treatment Outcome; Young Adult

Topics: Acne Vulgaris; Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Androgens; Anti-Bacterial Agents; Drug Therapy; Estradiol; Estrogens; Folliculitis; Halogens; Hexachlorophene; Humans; Infant; Infant, Newborn; Minor Surgical Procedures; Neomycin; Penicillins; Resorcinols; Salicylates; Sebaceous Glands; Sulfur; Tetracycline; Toxicology; Triamcinolone