salicylates and Keratosis

A sixty-year-old man, developed 2-5 mm sized, hyperemic, itchy papules, vesicles, erosions and crusts on hyperemic base on his chest, abdomen, back, gluteal region, and proximal sites of his upper and lower extremities. The direct and indirect immunoflurescence tests were negative. Histology revealed extensive acantholysis in the epidermis in the following forms: pemphigus vulgaris-like suprabasal acantholysis, Darier-like acantholytic dyskeratosis with corps ronds, Hailey-Hailey-like suprabasal clefts, and pemphigus foliaceus-like superficial acantholysis with spongiosis. Using systemic steroids, topical drying, and reepithelising therapy, the patient was cured. He was symptom-free the first, fourth, and thirteenth months after finishing steroid therapy. We review the literature and the new subdivision of the disease according to the histological and clinical features.

Topics: Acantholysis; Anti-Infective Agents, Local; Anti-Inflammatory Agents; Anti-Inflammatory Agents, Non-Steroidal; Darier Disease; Dermatologic Agents; Epidermis; Fluorescent Antibody Technique, Direct; Fluorescent Antibody Technique, Indirect; Follow-Up Studies; Glucocorticoids; Humans; Hyperemia; Keratosis; Male; Merbromin; Middle Aged; Pemphigus; Pemphigus, Benign Familial; Prednisolone; Salicylates

Trichloroacetic acid (TCA) alone or in combination with other agents is the mainstay of medium-depth chemical peels. Indications for medium-depth chemical peels include both medical conditions, such as diffuse photodamage with contiguous actinic keratoses, and cosmetic conditions, such as the aging face and solar lentiginosis. Medium-depth chemical peeling with TCA is relatively simple and is associated with a favorable risk/benefit ratio. However, proper patient selection, with attention to both medical and psychological factors, requires significant experience. The histological basis of the rejuvenating effects of TCA peels is well established, with a consistent correlation between wound depth and TCA concentration. The clinical effects of medium-depth chemical peels are generally gratifying for both patient and physician.

Topics: Administration, Cutaneous; Biopsy; Chemexfoliation; Drug Combinations; Drug Therapy, Combination; Ethanol; Female; Humans; Keratosis; Lactic Acid; Male; Photosensitivity Disorders; Resorcinols; Salicylates; Trichloroacetic Acid

The Jessner's-trichloroacetic acid (TCA) peel is a procedure developed by Monheit to produce a safe, effective medium-depth chemical peel for the treatment of photoaged skin, actinic keratoses, and superficial acne scars. The technique of pretreatment degreasing and combination chemicals allow a deeper penetration for the 35% TCA, increasing its efficacy while preserving its safety. Technique and methods are reviewed.

Topics: Acne Vulgaris; Chemexfoliation; Cicatrix; Drug Combinations; Ethanol; Face; Facial Dermatoses; Humans; Keratosis; Lactates; Lactic Acid; Resorcinols; Salicylates; Skin Aging; Trichloroacetic Acid

We compared the efficacy and safety of a medium-depth chemical peel with those of the standard regimen of topical fluorouracil in the treatment of widespread facial actinic keratoses (AK). Fifteen patients with severe facial actinic damage and similar numbers of AK on both sides of the face were treated on the left side with a single application of Jessner's solution and 35% trichloroacetic acid and on the right side with twice daily applications of 5% fluorouracil cream for 3 weeks. Evaluations were conducted before treatment and at 1, 6, and 12 months after treatment. Visible AK were counted, random skin biopsies performed, adverse effects monitored, and patients questioned about preference and perception of efficacy.. Both treatments reduced the number of visible AK by 75% and produced equivalent reductions in keratinocyte atypia, hyperkeratosis, parakeratosis, and inflammation, with no significant alteration of preexisting solar elastosis and telangiectasia. Except for erythema that lasted 3 months in one patient, no untoward side effects were observed with the chemical peel. The majority of patients preferred the peel over fluorouracil because of the single application and less morbidity.. The medium-depth peel induced by Jessner's solution and 35% trichloroacetic acid is a useful alternative therapeutic option for widespread facial AK, particularly for poorly compliant patients, because it equals fluorouracil in efficacy while being superior in terms of the convenience of a single application with little associated morbidity.

Topics: Drug Combinations; Ethanol; Facial Dermatoses; Fluorouracil; Follow-Up Studies; Humans; Keratosis; Lactates; Lactic Acid; Male; Resorcinols; Salicylates; Sunlight; Trichloroacetic Acid

Topics: Betamethasone; Clinical Trials as Topic; Drug Combinations; Humans; Keratosis; Ointments; Salicylates

Topics: Adolescent; Adult; Aged; Betamethasone; Clinical Trials as Topic; Double-Blind Method; Drug Therapy, Combination; Female; Flumethasone; Humans; Keratosis; Male; Middle Aged; Outcome and Process Assessment, Health Care; Salicylates; Skin Diseases

In four medical centers, 40 patients with keratinizing dermatoses were treated with topical tretinoin (vitamin A acid) 0.1% cream and salicylic acid 2% cream in a short-term, double-blind study. Tretinoin was the more effective treatment for several of the keratinizing dermatoses with the exception of palmar-plantar hyperkeratosis, for which it was not effective in the concentration and method of application used. The most striking clinical responses occurred in patients with lamellar ichthyosis and ichthyosis vulgaris. Local adverse reactions-chiefly pruritus, erythema, burning, excoriation, and irritation-were not severe and could be controlled by modification of the treatment regimen.

Topics: Administration, Topical; Adolescent; Adult; Aged; Child; Child, Preschool; Double-Blind Method; Drug Evaluation; Female; Humans; Ichthyosis; Keratosis; Male; Middle Aged; Salicylates; Tretinoin; Vitamin A

Few studies have examined the long-term efficacy of fluorouracil (FU) or chemical peels for the treatment of actinic keratoses (AK). Our earlier work examined the efficacy and safety of a medium-depth chemical peel compared with the standard regimen of topical FU in the treatment of widespread facial AK through 12 months.. To determine long-term efficacy of both treatments by extending our observations through 32 months.. Fifteen patients with severe facial actinic damage were treated on the left side with a single application of Jessner's solution and 35% trichloroacetic acid and on the right side with twice daily applications of 5% FU cream for 3 weeks. Parameters evaluated at 1, 6, 12, and 32 months included counts of visible AK, random skin biopsies from both treatment areas, development of intercurrent neoplasms, and surveys assessing sun exposure.. Eight patients were available for reevaluation at 32 months. Both treatment sides showed a reduction in mean number of AK at 12 months followed by an increase in mean AK number between 12 and 32 months. Improvements in biopsies of clinically actinically damaged skin were seen in keratinocytic atypia, hyperkeratosis, parakeratosis, and inflammation at all treatment times during the study with both treatments. Three squamous cell carcinomas developed in the patients after initial treatment; one developed on the side treated with the peel, and two developed on the side treated with fluorouracil. Surveys failed to demonstrate an association between sun exposure and clinical response.. Based on these findings, patient with widespread actinic keratoses treated with medium-depth chemical peel or with 5% FU should be reevaluated yearly or every 1.5 years for reappearance of AK and retreatment.

Topics: Administration, Topical; Chemexfoliation; Drug Combinations; Ethanol; Facial Dermatoses; Fluorouracil; Follow-Up Studies; Humans; Keratosis; Lactic Acid; Male; Resorcinols; Salicylates; Sunlight; Trichloroacetic Acid

The authors report a case of a patient with pachyonychia congenita syndrome, a rare genodermatosis inherited as an autosomal dominant trait, who also had otological lesions beyond the other classic signs and symptoms of the syndrome. Many kinds of treatment have already been proposed, but all failed to show satisfactory results. A new, cheap and easy-to-use treatment was developed in this study, using keratoplastics interpolated with humectant lotion for 90 days. The results after three years of follow-up are still thoroughly satisfactory.

Topics: Adult; Drug Therapy, Combination; Ear, External; Emollients; Humans; Keratolytic Agents; Keratosis; Male; Nail Diseases; Propylene Glycol; Propylene Glycols; Salicylates; Salicylic Acid; Skin; Syndrome

The Jessner's + TCA peel is an enhanced medium-depth peel that is a combination of two acidic compounds. It has been found to be effective as a peeling procedure for moderately photoaging skin, actinic keratoses, and superficial acne scars.

Topics: Administration, Topical; Chemexfoliation; Clinical Protocols; Dermatologic Surgical Procedures; Drug Combinations; Ethanol; Face; Female; Humans; Keratolytic Agents; Keratosis; Lactic Acid; Male; Pigmentation Disorders; Resorcinols; Salicylates; Skin; Skin Aging; Trichloroacetic Acid

A methyl salicylate-buffered, croton oil-containing 50% salicylic acid ointment peel, following pretreatment with topical tretinoin and localized 20% trichloroacetic acid, is extremely effective for removal of lentigines, pigmented keratoses, and actinically damaged skin from the dorsum of the hands and forearms. The ease of application, uniform results, decreased risk of scarring, and one-time application of this peel, in comparison with other methods used for treatment of these aging-skin changes, warrants consideration by the dermatologic surgeon.

Topics: Aged; Bandages; Chemexfoliation; Dermatitis, Seborrheic; Female; Forearm; Hand Dermatoses; Humans; Keratosis; Lentigo; Ointments; Pigmentation Disorders; Salicylates; Salicylic Acid; Tretinoin; Trichloroacetic Acid

Lichen spinulosus is a rare, idiopathic dermatosis characterized by follicular keratotic papules that are grouped into large patches. In this report the clinical and histologic data of 35 patients with lichen spinulosus are presented. The patients consisted of 14 males and 21 females, and their average age was 17.8 +/- 9.5 years. The average age at onset of disease was 16.2 +/- 10.1 years. Affected areas were symmetrically distributed and involved the extensor surfaces of the arms and legs, back, chest, face, and neck. Lesions were characterized by round or oval, 2 to 6 cm plaques composed of grouped punctate, "thorny," 1 to 3 mm, follicular keratotic papules. Microscopic examination revealed keratotic plugging of the follicular infundibulum and a perivascular and perifollicular mononuclear infiltrate. Although the cause is not yet known, lichen spinulosus probably represents a follicular reaction pattern of more than one origin.

Topics: Adolescent; Adult; Child; Female; Humans; Keratosis; Male; Salicylates; Skin Diseases, Vesiculobullous; Triamcinolone

Water content of the epidermis was measured before and after a 3-h , 4-day, and 10-day treatment using 10% salicylic acid or 10% carbamide ointment. The measurement was performed using the Corneometer CM 420 from the firm "Schwarzhaupt Medizintechnik GmbH". Salicylic acid ointment was applied on one and carbamide ointment on the other back of the hand. Neither salicylic acid nor carbamide seem to influence significantly the water content of the healthy epidermis. In two patients with more severe hyperkeratosis carbamide increased the water content more than salicylic acid did.

Topics: Administration, Topical; Adult; Body Water; Dermatologic Agents; Female; Hand Dermatoses; Humans; Ichthyosis; Keratolytic Agents; Keratosis; Male; Psoriasis; Salicylates; Salicylic Acid; Skin; Urea

Topics: Animals; Aspirin; Cell Division; Dermatologic Agents; Dose-Response Relationship, Drug; Guinea Pigs; Hydrocortisone; Keratosis; Mitosis; Salicylates; Skin

In an attempt to avoid the side-effects of treating solar keratoses with 5% 5-fluorouracil (5-FU) ointment, a new pharmacological varnish containing 5% 5-FU and 5-10% salicylic acid to collodium was tried. Twenty patients with such lesions were treated. A drop of the varnish was applied on each lesion every 3 weeks. Only one to five applications on facial lesions were necessary to obtain apparent cure in all patients. Lesions reappeared in four patients, but were cured after a second and similar treatment. The keratoses of the hands were more resistant and needed seven applications in one patient and nine in the other.

Topics: Administration, Topical; Adult; Aged; Collodion; Drug Combinations; Female; Fluorouracil; Hand; Humans; Keratosis; Male; Middle Aged; Paint; Recurrence; Salicylates; Sunlight

Topics: Dermatologic Agents; Drug Compounding; Gels; Ichthyosis; Keratosis; Propylene Glycols; Salicylates; Solutions; Time Factors

Topics: Disinfectants; Foot; Humans; Keratosis; Microscopy, Electron; Nitrogen; Papillomaviridae; Recurrence; Salicylates; Warts