tretinoin and Alopecia

Androgenetic alopecia (AGA) is the most common form of hair loss in men, and female pattern hair loss (FPHL) is the most common form of hair loss in women. Traditional methods of treating hair loss have included minoxidil, finasteride, and surgical transplantation. Currently there is a myriad of new and experimental treatments. In addition, low-level light therapy (LLLT) has recently been approved by the United States Food and Drug Administration (FDA) for the treatment of hair loss. There are several theories and minimal clinical evidence of the safety and efficacy of LLLT, although most experts agree that it is safe. More in vitro studies are necessary to elucidate the mechanism and effectiveness at the cellular level, and more controlled studies are necessary to assess the role of this new treatment in the general population.

Topics: Alopecia; Androgens; Dermatologic Agents; Drugs, Investigational; Female; Finasteride; Humans; Male; Minoxidil; Off-Label Use; Phototherapy; Tretinoin

Male and female pattern hair loss affects a large percentage of the population, and patients frequently present for treatment of this to their dermatologist. Here we review the many treatments available for hair loss. We review the evidence for each, and outline the most effective treatment strategies for both men and women.. At the conclusion of this article, the reader should be able to describe the most effective treatments for hair loss, understand their mechanism(s) of action, and explain which treatments are the best in different settings.

Topics: Adult; Alopecia; Androgen Antagonists; Azasteroids; Drug Therapy, Combination; Dutasteride; Female; Finasteride; Hair; Humans; Hyperhidrosis; Ketoconazole; Male; Minoxidil; Phototherapy; Prostate; Sperm Count; Tretinoin

Skin changes associated with aging often manifest as cosmetic disabilities. As the population of elderly persons continues to rise, these aging skin changes and patients' dissatisfaction with them will increasingly command the attention of the primary care physician. The cosmetic aging changes and management strategies addressed here include wrinkles, hair changes, common benign neoplasms, dyspigmentation, and telangiectasias. While none of these conditions is a direct threat to the physical well being of the patient, their psychological impact, particularly with regard to self-perception, can be significant and even profound. They therefore merit a response from physicians caring for such patients.

Topics: Aged; Alopecia; Collagen; Cryosurgery; Dermabrasion; Humans; Minoxidil; Skin Aging; Skin Diseases; Tretinoin

5% topical minoxidil solution has been widely used to stimulate new hair growth and help stop hair loss in men with androgenetic alopecia (AGA). However, it is not convenient for patients to continue applying the solution twice daily on a regular basis. Tretinoin is known to increase the percutaneous absorption of minoxidil and, therefore, to enhance the response of AGA to minoxidil. For this reason, it was assumed that tretinoin would be helpful in alleviating the inconvenience associated with the recommended twice-daily application of minoxidil.. To compare the efficacy and safety of therapy using a combined solution of 5% minoxidil and 0.01% tretinoin once daily with those of the conventional 5% topical minoxidil therapy applied twice daily in the treatment of AGA.. A total of 31 male patients (aged 28-45 years, mean 39.7+/-4.5) with AGA (Hamilton-Norwood classification type III-V) were randomly assigned into two groups, one in which 5% minoxidil was applied to the scalp twice daily and the other in which the combined agent was applied once daily at night together with a vehicle placebo in the morning. The efficacy parameters were: (i) changes in total hair count, non-vellus hair count, anagen hair ratio, linear hair growth rate, and mean hair diameter assessed by macrophotographic image analysis; and (ii) the patient's and investigator's subjective assessments.. After therapy, increases in the macrophotographic variables of total hair count and non-vellus hair count were shown in both treatment groups. There were no statistically significant differences between the two treatment groups with respect to changes in macrophotographic variables or scores on subjective global assessments by patients and the investigator. The incidence of adverse effects such as pruritus or local irritation was similar in the 5% minoxidil group (4 of 14 subjects) and the combined agent group (5 of 15 subjects).. The efficacy and safety of combined 5% minoxidil and 0.01% tretinoin once-daily therapy appear to be equivalent to those of conventional 5% minoxidil twice-daily therapy for the treatment of AGA.

Topics: Administration, Topical; Adult; Alopecia; Dermatologic Agents; Double-Blind Method; Drug Therapy, Combination; Hair; Humans; Male; Middle Aged; Minoxidil; Severity of Illness Index; Statistics, Nonparametric; Treatment Outcome; Tretinoin

Diphencyprone is a potent topical sensitizer, but is non-mutagenic in the Ames test (unlike dinitroclorobenzene) and remains relatively stable in solution (unlike squaric acid dibutyl ester). Seventeen patients with total loss of scalp hair (eight alopecia totalis, nine alopecia universalis) were treated by maintaining on one side of the scalp an allergic contact dermatitis induced by 2,3 diphenylcyclopropenone-I ('diphencyprone'), and on the other side an irritant contact dermatitis using tretinoin gel (Retin A). After 20 weeks, treatment with tretinoin was stopped and diphencyprone was applied bilaterally for a further 10 weeks. Satisfactory regrowth of terminal hair on the scalp was achieved in only one patient. Eyebrow, eyelash and beard regrowth was achieved in one individual whilst in another, moderate, but not cosmetically satisfactory, scalp regrowth took place. In no patient did regrowth take place at tretinoin treated sites until after diphencyprone was substituted.

Topics: Administration, Topical; Adolescent; Adult; Aged; Alopecia; Child; Child, Preschool; Cyclopropanes; Dermatitis, Contact; Female; Humans; Male; Middle Aged; Tretinoin

Eight patients with psoriasis (seven with plaque-type and one with palmoplantar pustular psoriasis) were treated with the synthetic retinoid etretin, the active metabolite of etretinate. An initial 8-week double-blind phase of the study with dosages of 0, 25, or 50 mg/day was followed by an open phase in which variable dosages of 25, 50, or 75 mg/day were used to achieve an optimal clinical response. All patients completed a minimum of 6 months of therapy. A good or an excellent response (at least 50% clearing) after 8 months of treatment was noted in six of the eight patients. One patient had a poor response (less than 50% clearing), and one patient continued to have worsening of psoriatic involvement during treatment. The best response occurred in those patients with the most extensive initial plaque involvement or palmoplantar pustulosis. The clinical side effects were similar to those reported with use of etretinate and seemed to be related to the dose. The laboratory abnormalities--primarily mild intermittent elevations of liver enzymes and elevations in serum lipids--were similar to those described in previous reports about etretinate. Both etretin and etretinate are potent teratogens. Because of its shorter half-life, etretin will likely be preferred, especially in female patients of childbearing potential.

Topics: Acitretin; Adult; Aged; Alopecia; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Middle Aged; Psoriasis; Random Allocation; Tretinoin

Topical all-trans-retinoic acid (tretinoin) alone and in combination with 0.5% minoxidil has been tested for the promotion of hair growth in 56 subjects with androgenetic alopecia. After 1 year, the combination of topical tretinoin with 0.5% minoxidil resulted in terminal hair regrowth in 66% of the subjects studied. Tretinoin was shown to stimulate some hair regrowth in approximately 58% of the subjects studied. One female subject with pronounced alopecia for more than 20 years had regrowth of hair using only tretinoin for a period of 18 months. Tretinoin has been shown to promote and regulate cell proliferation and differentiation in the epithelium and may promote vascular proliferation. These factors are important for hair growth promotion. These preliminary results indicate that more work should be done on the role of retinoids in hair growth. The synergistic effect of retinoids in combination with a low concentration of minoxidil should also be further investigated.

Topics: Administration, Topical; Adult; Alopecia; Drug Combinations; Female; Hair; Humans; Male; Middle Aged; Minoxidil; Stimulation, Chemical; Tretinoin

A total of 40 patients with palmoplantar pustulosis (PPP) were initially treated with oral etretinate (Tigason) in an open trail with a maximum treatment period of 16 weeks. Remission, with only slight residual changes in some cases, was achieved in 26 patients (65%) who were randomized to either a low dose of Tigason or placebo. In the Tigason group, 7 of 11 patients were still in remission afer 6 months while in the placebo group, remission persisted in 4 of the 10 patients who stayed in the study throughout the whole 6 months' period. Alopecia led to stopping the treatment in 6 patients and desquamation of the healthy skin in 2 patients. Other side-effects were only mild. As a conclusion, Tigason shows a beneficial effect in the majority of patients with PPP and is better than placebo in preventing relapse of the disease but intolerable side-effects restrict its use in many patients.

Topics: Adult; Alopecia; Clinical Trials as Topic; Double-Blind Method; Etretinate; Female; Humans; Male; Middle Aged; Random Allocation; Skin; Skin Diseases; Suppuration; Tretinoin

Topics: Administration, Topical; Alopecia; Animals; Biological Transport; Drug Therapy, Combination; Hydrogels; Keratolytic Agents; Liposomes; Male; Minoxidil; Rats; Rats, Sprague-Dawley; Skin; Skin Diseases; Tretinoin; Vasodilator Agents

Topics: Alopecia; Antirheumatic Agents; Biopsy; Diagnosis, Differential; Drug Administration Routes; Humans; Hydroxychloroquine; Keratolytic Agents; Lupus Erythematosus, Discoid; Male; Middle Aged; Scalp Dermatoses; Skin; Treatment Outcome; Tretinoin

Minoxidil sulfate is the active metabolite required to exert the vasodilatory and hair growing effects of minoxidil. For hair growth, sulfotransferase enzymes expressed in outer root sheath of the hair follicle sulfonate minoxidil. The large intra-subject variability in follicular sulfotransferase was found to predict minoxidil response and thus explain the low response rate to topical minoxidil in the treatment of androgenetic alopecia. A method to increase minoxidil response would be of significant clinical utility. Retinoids have been reported to increase minoxidil response. The purported mechanism of action was retinoid modulation of skin permeation to minoxidil; however, evidence to the contrary supports retinoids increase dermal thickness. In order to elucidate the effect of topical retinoids on minoxidil response, we studied the effect of topical tretinoin on follicular sulfotransferase. In this study, we demonstrate that topical tretinoin application influences the expression of follicular sulfotransferase. Of clinical significance, in our cohort, 43% of subjects initially predicted to be nonresponders to minoxidil were converted to responders following 5 days of topical tretinoin application. To the best of our knowledge, this is the first study to elucidate the interaction mechanism between topical minoxidil and retinoids and thus provides a pathway for the development of future androgenetic alopecia treatments.

Topics: Administration, Topical; Adult; Alopecia; Female; Gene Expression Regulation, Enzymologic; Humans; Male; Minoxidil; Sulfotransferases; Tretinoin; Up-Regulation

Biological evaluation of hair growth/differentiation activity in vitro has been a formidable challenge, primarily due to the lack of relevant model cell systems. To solve this problem, we generated a stable model cell line in which successive differentiation via epidermal progenitors to hair components is easily inducible and traceable. Mouse induced pluripotent stem (iPS) cell-derived cells were selected to stably express a tetracycline (Tet)-inducible bone morphogenic protein-4 (BMP4) expression cassette and a luciferase reporter driven by a hair-specific keratin 31 gene (krt31) promoter (Tet-BMP4-KRT31-Luc iPS). While Tet- BMP4-KRT31-Luc iPS cells could be maintained as stable iPS cells, the cells differentiated to produce luciferase luminescence in the presence of all-trans retinoic acid (RA) and doxycycline (Dox), and addition of a hair differentiation factor significantly increased luciferase fluorescence. Thus, this cell line may provide a reliable cell-based screening system to evaluate drug candidates for hair differentiation activity.

Topics: Alopecia; Animals; Bone Morphogenetic Protein 4; Cell Differentiation; Cell Engineering; Cell Line; Doxycycline; Drug Evaluation, Preclinical; Hair; Induced Pluripotent Stem Cells; Keratins, Hair-Specific; Keratins, Type I; Luciferases; Luminescent Agents; Mice; Promoter Regions, Genetic; Tetracycline; Tretinoin

We report the case of a 24-year-old man who presented with pustules, atrophic scars, and alopecia on the scalp, along with follicular keratotic papules on the cheeks, chest, abdomen, back, lateral upper arms, thighs, and axillae, of 6 years' duration. A diagnosis of folliculitis spinulosa decalvans (FSD) was made based on the clinical manifestation and histopathological findings. Dental examination also revealed dental anomalies and a fissured tongue, which are not known to be related to FSD. We provide an overview of the characteristic findings of FSD as well as a review of previously reported cases.

Topics: Adult; Alopecia; Anti-Infective Agents; Clarithromycin; Dermatologic Agents; Diagnosis, Differential; Folliculitis; Fusidic Acid; Humans; Keratosis; Male; Metronidazole; Scalp; Scalp Dermatoses; Skin; Treatment Outcome; Tretinoin

Retinoic acid (RA) is a potent signaling molecule that is essential for many biological processes, and its levels are tightly regulated by mechanisms that are only partially understood. The synthesis of RA from its precursor retinol (vitamin A) is an important regulatory mechanism. Therefore, the esterification of retinol with fatty acyl moieties to generate retinyl esters, the main storage form of retinol, may also regulate RA levels. Here we show that the neutral lipid synthesis enzyme acyl-CoA:diacylglycerol acyltransferase 1 (DGAT1) functions as the major acyl-CoA:retinol acyltransferase (ARAT) in murine skin. When dietary retinol is abundant, DGAT1 deficiency results in elevated levels of RA in skin and cyclical hair loss; both are prevented by dietary retinol deprivation. Further, DGAT1-deficient skin exhibits enhanced sensitivity to topically administered retinol. Deletion of the enzyme specifically in the epidermis causes alopecia, indicating that the regulation of RA homeostasis by DGAT1 is autonomous in the epidermis. These findings show that DGAT1 functions as an ARAT in the skin, where it acts to maintain retinoid homeostasis and prevent retinoid toxicity. Our findings may have implications for human skin or hair disorders treated with agents that modulate RA signaling.

Topics: Alopecia; Animals; Diacylglycerol O-Acyltransferase; Epidermis; Female; Homeostasis; Male; Mice; Mice, Knockout; Retinoids; Retinol O-Fatty-Acyltransferase; Signal Transduction; Tretinoin

Clouston's syndrome is an ectodermal dysplasia characterized by dystrophic nails, alopecia, and palmoplantar hyperkeratosis. Alopecia is due to decrease in number and degree of maturation of the hair follicles. Tretinoin is a mitogen by itself and also enhances the absorption of minoxidil which acts by enlarging the miniaturized hair follicles. We report a case of alopecia in Clouston's syndrome who responded to treatment with topical minoxidil and tretinoin.

Topics: Administration, Topical; Alopecia; Child; Dermatologic Agents; Drug Therapy, Combination; Ectodermal Dysplasia; Hair; Humans; Male; Minoxidil; Tretinoin

Novel potent C-4 azolyl retinoic acid metabolism blocking agents (RAMBAs)-VN/14-1, VN/50-1, VN/66-1, VN/67-1, and VN/69-1, have been synthesized and investigated for their in vitro and in vivo effects against breast and prostate cancers. These RAMBAs, in addition to being potent inhibitors of all-trans-retinoic acid (ATRA) metabolism have potent anti-cancer properties and in vivo anti-tumor efficacies as characterized in breast and prostate cancer models. Here we determined the toxicity and pharmacokinetics (PK) of these various RAMBAs.. Preliminary acute toxicity studies of these RAMBAs were carried out using Swiss NIH mice. The toxicity profile of the RAMBAs was evaluated relative to ATRA. Three different doses (8.3, 33, and 100 micromol/kg/day) of ATRA and RAMBAs were administered on a daily basis subcutaneously for 14 days to the mice. Clinical signs of toxicity alopecia, scaly skin, and loss of body weight in the mice were observed during the study and the maximum tolerated dose was determined. PK of selected agents (VN/14-1, VN/50-1, and VN/66-1) was studied in Balb/C mice after a single dose subcutaneous administration. Plasma concentrations of the agents were quantitatively determined using a high-performance liquid chromatographic method with ultraviolet detection. Plasma concentration versus time profiles were fit to various PK structural models and relevant PK parameters were estimated.. VN/66-1 and VN/69-1 were found to be the least toxic even at the highest doses when compared to the other RAMBAs and ATRA. VN/66-1 had the longest half-life, the slowest clearance, and the greatest exposure.. Based on PK characteristics and toxicity studies, VN/66-1 appeared to be the most favorable agent. However, both VN/14-1 and VN/66-1 are our leads based on the fact that VN/14-1 has been found to be highly effective in endocrine-sensitive and -resistant breast cancer cells and tumors with little toxicity. Our findings provide valuable information that will be used to select RAMBAs and establish therapeutic regimens that provide optimal efficacy with minimal toxicity.

Topics: Alopecia; Animals; Antineoplastic Agents; Area Under Curve; Body Weight; Chromatography, High Pressure Liquid; Dose-Response Relationship, Drug; Female; Half-Life; Imidazoles; Injections, Subcutaneous; Mice; Mice, Inbred BALB C; Skin Diseases; Tissue Distribution; Tretinoin

Perifolliculitis capitis abscedens et suffodiens (PCAS) is rare chronic, suppurative and inflammatory scalp disease. Its aetiology and pathogenesis is not completely understood. The treatment is usually difficult and often disappointing. We report a case of 29-year-old male who presented with tender, fluctuant nodules and abscesses, with draining pus and patchy alopecia on his scalp for 3 years. A skin biopsy from scalp lesions revealed features that are characteristic of perifolliculitis. Initially, the patient was treated with periodic incision and drainage of the scalp abscesses. The answer was very poor. When admitted to our department, isotretinoin was started at daily dose of 30 mg, because initially his cholesterol and triglyceride levels were mildly increased. When dose was reduced to 10 mg the levels of cholesterol and triglyceride remained normal. A response to treatment was excellent and rapid. The treatment of PCAS represents usually difficulties and frustration for both the patient and the physician. A long course of isotretinoin can be considered as one of the most effective treatment for PCAS.

Topics: Administration, Topical; Adult; Alopecia; Folliculitis; Humans; Keratolytic Agents; Male; Scalp Dermatoses; Tretinoin

The active metabolite of vitamin A (retinoic acid, RA) acts through the nuclear receptors RARalpha, beta and gamma and RXRalpha, beta and gamma. These receptors form RAR/RXR heterodimers, which bind to genetic regulatory DNA sequences and activate transcription of RA target genes. As RXR form heterodimers with a number of other nuclear receptors, such as the vitamin D3 receptor (VDR) and are involved in several signaling pathways. In the skin, RARgamma and RXRalpha predominate, but RARalpha and RXRbeta are also expressed. To elucidate the role of RA in skin physiology, we produced mutant mouse lines null for RAR or RXR. On the one hand, null mutations for RARa or RXRbeta have no effect on the skin, whereas a RARgamma-null mutation induces alterations in the granular cell layer. On the other, genetic inactivation of RXRa leads to embryonic lethality before epidermal development. Consequently, to determine the role of RXRa in adult mice, studies were performed using conditional somatic mutagenesis (permitting inactivation of a given gene in a specific tissue and in a time-dependent manner). Using this novel genetic approach, mutant mice were obtained in which RXRalpha was not expressed in the skin. These mice developed hair follicle degeneration, then alopecia, similar to that observed in VDR-null mutants, suggesting that hair follicle homeostasis depends on RXRalpha/VDR heterodimers. A similar genetic approach applied to the RARgamma locus demonstrated that topical administration of RA on the skin activates RARgamma/RXR heterodimers in suprabasal cells, and induces expression of a paracrine growth factor (HB-EGF) in these cells which, in turn, stimulates the proliferation of basal cells.

Topics: Alopecia; Animals; DNA; Gene Expression Regulation; Hair Follicle; Keratolytic Agents; Mice; Point Mutation; Receptors, Retinoic Acid; Signal Transduction; Skin Physiological Phenomena; Tretinoin

Topics: Alopecia; Animals; Drug Therapy, Combination; Enzyme Inhibitors; Female; Finasteride; Hair; Humans; Keratolytic Agents; Male; Minoxidil; Retinoids; Tretinoin; Vasodilator Agents

Topics: Alopecia; Finasteride; Hair; Humans; Minoxidil; Tretinoin

Topics: Administration, Cutaneous; Administration, Oral; Adult; Alopecia; Cholestenone 5 alpha-Reductase; Enzyme Inhibitors; Finasteride; Humans; Keratolytic Agents; Male; Minoxidil; Oxidoreductases; Pharmaceutical Vehicles; Tretinoin; Vasodilator Agents

In order to investigate some of the relationships between age concealment and gender, 269 adults completed on anonymous questionnaire dealing with signs of aging and the use of techniques to conceal them. Although most of the signs of aging were considered unattractive for both males and females, aging women were seen as particularly unappealing. More women than men were expected to use age concealment techniques and female subjects were indeed more likely to use them. Both men and women who concealed their age were likely to be judged harshly by others, although individuals indicated a willingness to use age concealment techniques themselves. The results are consistent with the hypothesis that there are two different double standards of aging, one indicating that aging is judged differently depending on the gender of the person doing the judging and the target, and one indicating that people may judge the use of age concealment techniques more harshly in others than in themselves.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aging; Alopecia; Attitude; Body Constitution; Body Image; Chemexfoliation; Cosmetics; Esthetics; Female; Hair; Hair Color; Hair Dyes; Humans; Male; Middle Aged; Self Concept; Sex; Skin Aging; Tretinoin

Topics: Alopecia; Cosmetics; Dermatologic Agents; Humans; Minoxidil; Nonprescription Drugs; Photosensitivity Disorders; Skin Diseases; Tretinoin

Topics: Alopecia; Humans; Male; Minoxidil; Tretinoin

Topics: Alopecia; Dermatology; Female; Humans; Male; Minoxidil; Skin; Syphilis; Tretinoin

A 55-year-old patient was treated with a combination of minoxidil and retinoic acid. After 1 month an explosive eruption of pyogenic granuloma appeared on the scalp. Despite redness and itchy reaction, caused only by the test containing both chemicals, histology did not give evidence of contact allergy.

Topics: Alopecia; Drug Combinations; Hemangioma; Humans; Male; Middle Aged; Minoxidil; Scalp; Skin Neoplasms; Tretinoin

Topics: Alopecia; Cosmetics; Drug Prescriptions; Humans; Minoxidil; Physicians, Family; Self Concept; Tretinoin

Topics: Aging; Alopecia; Humans; Minoxidil; Skin; Tretinoin

Forty patients suffering of different forms of acne (papulo-pustular, nodulo-cystic, conglobata, rosacea), all in severe conditions and non-responding to other treatments, have been administered 13-cis-retinoic acid p.o. The treatment resulted in a complete and ultimate healing in 31 pts (77.5%) and a marked amelioration in the remaining 9 cases. The initial drug dosage was 40 mg/die (an average of 0.66 mg/kg/die) but it was reduced along the treatment to 2.5 mg/die, a still effective dose. The average treatment duration was 24 weeks (range: 12 to 40). The tolerance was generally excellent, but some adverse effect have been recorded, mainly localized in the skin and mucosa. Increases of total serum cholesterol (66% of the cases) and of triglyceride (72%) level have been observed. This effect was reversible at the end of the treatment. As a conclusion we can confirm that the 13-cis-retinoic acid is the most effective drug for the pharmacotherapy of severe acne.

Topics: Acne Vulgaris; Adult; Alkaline Phosphatase; Alopecia; Cholesterol; Drug Tolerance; Epistaxis; Female; Humans; Isotretinoin; Male; Pruritus; Rosacea; Transaminases; Tretinoin; Triglycerides

Etretinate 0.5 mg/kg body weight combined with 0.1% triamcinolone acetonide and 5% salicylic acid in an O/W cream gave more than 70% improvement in 62% of 75 patients. Of this satisfactorily improved group, at least 41% were still in the same condition after 3 years on a maintenance dose of, on average, 0.3 mg/kg body weight etretinate daily and 20 g weekly of a relatively strong corticosteroid cream. The side effects were acceptable and the convenience for the patients is great as compared with other treatment.

Topics: Administration, Oral; Administration, Topical; Alopecia; Atrophy; Etretinate; Follow-Up Studies; Humans; Psoriasis; Skin; Tretinoin

One female patient 18 years old who suffers from Congenital Uaquioniquis since infancy, with serious alterations of nails, was treated with oral retinoid (Ro 10-9359-Tigason) during 20 months, with clinical improvement of her lesions. Clinical and laboratory controls were carried out periodically and they did not show any alterations. The only side-effects were itching, discrete hair loss headache, chelitis, all which were moderate in degree and transient.

Topics: Administration, Oral; Adolescent; Alopecia; Cheilitis; Etretinate; Female; Humans; Nail Diseases; Tretinoin

The anti-inflammatory effect of the new topical corticosteroid fluocortin butyl ester is approximately equal to that of hydrocortisone acetate but it has the advantage that systemic side-effects are lacking. Vitamin A acid and benzoyl peroxide have brought significant advances in the topical treatment of acne. For the treatment of chloasma and other hyperpigmentations the combination of vitamin A acid and hydroquinone with a corticoid is considerably more effective than any of the single components alone. Povidone-iodine with its extraordinarily low sensitization rate has proved useful for external antimicrobial treatment. Extensive or multiple precancerous lesions are effectively treated with 5-fluorouracil. New hair growth can be induced in alopecia areata by the local application of DNCB.

Topics: Acne Vulgaris; Administration, Topical; Alopecia; Benzoyl Peroxide; Dinitrochlorobenzene; Fluocortolone; Fluorouracil; Humans; Hydroquinones; Pigmentation Disorders; Precancerous Conditions; Skin Diseases; Tretinoin

In a multicentre, cooperative study into the treatment of extensive psoriasis with a new aromatic retinoid (Ro 10--9359) trichogram, liver function tests and the light erythema threshold were investigated. In some of the patients hair loss occurred, usually in the fifth to eighth week after a total dose of 1.9 g retinoid. In all cases this improved an average of six weeks after dose reduction or cessation of treatment. The trichogram in 27 patients showed a diffuse toxic hair loss. In 70% the effluvium was telogenic, in 22% telogen-dystrophic. GPT, GOT, alkaline phosphatase and prothrombin index showed no significant alterations during retinoid treatment. However, in individual cases there was a rise in GOT and GPT up to 80 U/l. Furthermore there was a statistical tendency in rising bilirubin levels. Finally there was no evidence for an increase in light sensitivity after three weeks of retinoid treatment. Measurement of the erythema threshold showed rather more a reduction in light sensitivity under treatment.

Topics: Alanine Transaminase; Alkaline Phosphatase; Alopecia; Aspartate Aminotransferases; Erythema; Humans; Liver; Prothrombin; Psoriasis; Time Factors; Tretinoin; Vitamin A

The aromatic retinoic acid derivative Ro 10-9359 was administered orally to 25 severe psoriatic patients (14 with generalized plaques, 7 erythrodermic, 4 pustular). The initial dose was 25 mg/20 kg body weight daily for 4 weeks; afterwards the same posology was given every other day during several months (Max : 18 months). Excellent results were obtained in 16 patients (64 p. 100) particularly in severe erythrodermic and pustular psoriasis. However, under follow-up therapy relapses sometimes occurred leading to temporary resumption of initial posology. The most important side effects are cheilitis, palmoplantar scaling with thinning of the skin, hyperhidrosis and diffuse hair loss. A slight increase of transaminases and of alkaline phosphatases was found in a few patients. The Ro 10-9359 compound is a very useful new therapy of severe psoriasis.

Topics: Administration, Oral; Adult; Alkaline Phosphatase; Alopecia; Cheilitis; Female; Humans; Hyperhidrosis; Male; Psoriasis; Transaminases; Tretinoin; Vitamin A

The administration of anti-androgens brings favourable results especially in such skin diseases showing unsatisfactory therapeutic results, i.e. all severe forms of acne, seborrhoea, androgenic alopecia and hirsutism. Exact knowledge of the oestrogen and gestagen effect is essential. Also of fundamental importance is the observation and consideration of side effects besides the contraceptive efficacy and therapeutic results in dermatology.

Topics: Acne Vulgaris; Alopecia; Androgen Antagonists; Contraceptives, Oral; Contraceptives, Oral, Hormonal; Dermatitis, Seborrheic; Female; Hirsutism; Humans; Hypertrichosis; Skin Diseases; Tetracycline; Tretinoin

Topics: Administration, Topical; Adult; Aged; Alopecia; Animals; Diarrhea; Female; Humans; Male; Middle Aged; Rats; Skin Diseases; Tretinoin; Vitamin A