tretinoin and Cicatrix

Scarring is a common but difficult to manage consequence of acne vulgaris. The intricate balance between the degradation of collagen and its inhibition is disturbed during the formation of acne scars. We mostly rely on invasive, non-topical modalities for the treatment of acne scars which may not be indicated in all patients. There is also a need for maintainence therapies after these procedures.. The topical agents can be utilized as individual therapy, in combination with other modalities or delivered through assisted technology like iontophoresis. Retinoids have long been tried to prevent and treat acne scars. Tacrolimus and glycolic acid are among the newer sole agents that have been explored. Ablative lasers like Er:YAG, CO2 and Microneedling are being used in combination with topical agents like silicone gel, plasma gel, lyophilized growth factors, platelet rich plasma, insulin, and mesenchymal stem cells. These procedures not only increase the permeability of the topical agents but also concomitantly improve acne scars. Iontophoresis has proven beneficial in increasing the delivery of topical estriol and tretinoin.. There is lack of evidence to support the widespread use of these topical agents, and therefore, there is need for further well designed studies.

Topics: Acne Vulgaris; Administration, Topical; Cicatrix; Combined Modality Therapy; Humans; Treatment Outcome; Tretinoin

This review is in two sections. The first section summarises 35 conditions, both common and infrequent, causing cicatrising conjunctivitis. Guidelines for making a diagnosis are given together with the use of diagnostic tests, including direct and indirect immunofluorescence, and their interpretation. The second section evaluates our knowledge of ocular mucous membrane pemphigoid, which is the commonest cause of cicatrizing conjunctivitis in most developed countries. The clinical characteristics, demographics, and clinical signs of the disease are described. This is followed by a review and re-evaluation of the pathogenesis of conjunctival inflammation in mucous membrane pemphigoid (MMP), resulting in a revised hypothesis of the autoimmune mechanisms causing inflammation in ocular MMP. The relationship between inflammation and scarring in MMP conjunctiva is described. Recent research, describing the role of aldehyde dehydrogenase (ALDH) and retinoic acid (RA) in both the initiation and perpetuation of profibrotic activity in MMP conjunctival fibroblasts is summarised and the potential for antifibrotic therapy, using ALDH inhibition, is discussed. The importance of the management of the ocular surface in MMP is briefly summarised. This is followed with the rationale for the use of systemic immunomodulatory therapy, currently the standard of care for patients with active ocular MMP. The evidence for the use of these drugs is summarised and guidelines given for their use. Finally, the areas for research and innovation in the next decade are reviewed including the need for better diagnostics, markers of disease activity, and the potential for biological and topical therapies for both inflammation and scarring.

Topics: Aldehyde Dehydrogenase 1 Family; Autoantibodies; Autoimmune Diseases; Cicatrix; Conjunctivitis; Fibroblasts; Fluorescent Antibody Technique, Indirect; Humans; Immunosuppressive Agents; Inflammation; Isoenzymes; Pemphigoid, Benign Mucous Membrane; Retinal Dehydrogenase; Tretinoin

Acne vulgaris is one of the most common inflammatory dermatoses and is seen in both the hospital setting and in general practice. Multiple factors are involved in the pathophysiology of acne, including: an alteration in the pattern of keratinization within the pilosebaceous follicles resulting in comedone formation; an increase in sebum production which is influenced by androgens; the proliferation of Propionibacterium acnes; and the production of perifollicular inflammation. Genetic and hormonal factors may also contribute to acne. Better understanding of the pathophysiology of the disease has led to the development of novel therapies which are directed at one or more of the implicated etiologic factors. Systemic antibiotics for acne have been the mainstay of treatment for many years. The main cause for concern following the use of systemic antibiotics is the emergence of antibiotic-resistant strains of P. acnes. Concomitant use of non-antibiotic therapies such as benzoyl peroxide helps to decrease the occurrence of resistance and can be effective in the treatment of resistant and nonresistant propionibacterial strains. However, no one agent is able to eradicate resistant strains completely and as resistant strains correlate to poor clinical response to therapy, prescribing strategies are required to minimize the occurrence of resistance to P. acnes. When assessing acne it is important to take an all embracing approach and to examine carefully for both the clinical and psychologic effects of the disease process. There are numerous forms of acne scarring and it is important to be aware of these as patients who are developing scarring merit early effective therapy. Some patients with acne will develop psychologic problems as a consequence of their condition. Even mild to moderate disease can be associated with significant depression and suicidal ideation and psychologic change does not necessarily correlate with disease severity. Acne scars themselves have been shown to produce significant psychopathology. When initiating treatment it is important to consider the aims of therapy. Treatment should be aimed at achieving clearance of acne, prevention of scarring and, where necessary, relief from any psychologic stress resulting from the acne. Therapy should be commenced early in the disease process in order to prevent scarring and it is important to select appropriate therapies according to the clinical signs and psychologic disability. It is also important t

Topics: Acne Vulgaris; Administration, Cutaneous; Administration, Oral; Androgen Antagonists; Anti-Bacterial Agents; Body Image; Cicatrix; Drug Therapy, Combination; Humans; Keratolytic Agents; Patient Satisfaction; Patient Selection; Risk Factors; Self Concept; Skin Care; Stress, Psychological; Treatment Outcome; Tretinoin

Topical treatments for the body are beneficial for photoageing as well as for specific disease processes, such as scars or striae. Every patient should topically apply photoprotectants in order to prevent photodamage to the skin. Tretinoin can improve body skin and has a documented use in striae. Alpha-hydroxy acids can restore body skin when used on a regular basis. Antioxidants may be of benefit. Scars can be improved with a variety of topically applied agents ranging from silicone gel sheeting to super-potent topical steroids. Chemical peeling for the body can improve the skin with the use of alpha- or beta-hydroxy acids. While topical therapy can improve body skin, adjunctive surgical therapy may be needed to correct body skin disorders or concerns fully.

Topics: Adipose Tissue; Administration, Topical; Antioxidants; Chemexfoliation; Cicatrix; Glycolates; Humans; Keratolytic Agents; Skin; Skin Aging; Skin Care; Skin Pigmentation; Tretinoin

Acne vulgaris is the clinical expression of inflammation of the pilosebaceous unit. Factors known to predispose to the development of acne include increased sebum, which is acted on by Propionobacterium acnes to generate inflammatory substances, and retention hyperkeratosis, which causes obstruction of the sebaceous follicle. Therapeutic modalities for acne include topical and systemic antibiotics, comedolytic agents (such as benzoyl peroxide and topical retinoids) and systemic retinoids. Acne scars may be treated surgically using procedures such as dermabrasion and dermal injections of bovine collagen or simple scar excision, scar punch elevation, or punch grafting.

Topics: Acne Vulgaris; Adolescent; Adult; Benzoyl Peroxide; Cicatrix; Female; Humans; Male; Office Visits; Surgery, Plastic; Tetracycline; Tretinoin

Common treatment of atrophic acne scars consists of invasive methods such as dermabrasion, chemopeeling, or implantation of bovine collagen. In our study a new noninvasive treatment method consisting of local iontophoresis is demonstrated. Local iontophoresis was performed with either estriol--a mainly topically active estrogen--or with tretinoin.. Eighteen women were treated with estriol iontophoresis twice weekly for a period of 3 months. In addition to photographic and clinical documentation of the skin, venous blood for determination of serum levels of prolactin and estradiol according to standard radioimmunoassay methods was obtained monthly. Tretinoin iontophoresis was performed according to the same time schedule in 28 patients (19 women and 9 men) with atrophic acne scars.. Improvement of acne scars was observed in 93% of patients treated with tretinoin iontophoresis and in 100% of the group treated with estriol iontophoresis. No hormonal changes were noted in the estrogen group. Side effects involving the skin appeared in the tretinoin group in 4 cases and consisted of increased dryness and of retinoid dermatitis.. Both treatments were shown to be clinically effective in decreasing acne scars and persistence of effects. This promising new therapeutic approach may thus replace invasive treatment methods in many patients.

Topics: Acne Vulgaris; Administration, Cutaneous; Adult; Atrophy; Cicatrix; Drug Eruptions; Estradiol; Estriol; Facial Dermatoses; Female; Follow-Up Studies; Humans; Iontophoresis; Male; Prolactin; Skin; Skin Diseases; Tretinoin

Striae distensae occur on the abdomen and/or breast in 90 percent of all pregnant women and are the result of extrinsic and intrinsic factors. This study investigated the response of pregnancy-related abdominal striae to treatment with tretinoin cream (0.025 percent) applied daily for seven months. In this study, eleven subjects were randomly assigned to tretinoin or placebo treatment groups. Before and after photographs were evaluated by a standardized system. There was no difference or improvement in the treated group compared with control subjects. Tretinoin 0.025 percent cream was ineffective in improving striae distensae in these subjects.

Topics: Abdomen; Administration, Topical; Adolescent; Adult; Analysis of Variance; Cicatrix; Double-Blind Method; Drug Administration Schedule; Elastic Tissue; Female; Humans; Pregnancy; Prospective Studies; Tretinoin

Topics: Acne Vulgaris; Administration, Cutaneous; Adult; Cicatrix; Dermatologic Agents; Face; Hair; Humans; Male; Tretinoin

Scars are problematic for thousands of patients. Scarring is a natural part of the healing process after an injury. However, the appearance of a scar and its treatment depend on multiple factors and on the experience of the therapist and the options available. Despite a plethora of rapidly evolving treatment options and technical advances, the management of atrophic and hypertrophic scars remains difficult. Innovative technologies provide an attractive alternative to conventional methods in the treatment of scars. The purpose of this trial was to determine the clinical and histological results of a method of treatment that combines radiofrequency, ultrasound, and transepidermal drug delivery. This was a prospective study conducted on 14 patients with scars of different sizes, types, and characteristics. All patients underwent six treatment sessions with the Legato device. Atrophic scars were treated with retinoic acid and hypertrophic scars with triamcinolone. Photographs and biopsies were taken before treatment and at 6 months after the last treatment session. The scars improved significantly (P < 0.0001). The mean attenuation in the severity of scars was 67% (range: 50-75%), where 100% indicates complete disappearance of the scar. Clinical and histological images of scar tissue in six patients in whom attenuation in the range of 55-75% was achieved are shown. Biopsies show regenerative changes in the scar tissue, in both the epidermis and dermis. The method makes it possible to treat extensive, heterogeneous scars on different sites with good results that are similar and predictable.

Topics: Adult; Aged; Atrophy; Biopsy, Needle; Cicatrix; Cicatrix, Hypertrophic; Cohort Studies; Combined Modality Therapy; Drug Delivery Systems; Female; Follow-Up Studies; Humans; Immunohistochemistry; Laser Therapy; Male; Middle Aged; Prospective Studies; Risk Assessment; Treatment Outcome; Tretinoin; Triamcinolone; Ultrasonic Therapy; Young Adult

Mucous membrane pemphigoid (MMP) is a systemic mucosal scarring disease, commonly causing blindness, for which there is no antifibrotic therapy. Aldehyde dehydrogenase family 1 (ALDH1) is upregulated in both ocular MMP (OMMP) conjunctiva and cultured fibroblasts. Application of the ALDH metabolite, retinoic acid (RA), to normal human conjunctival fibroblasts in vitro induced a diseased phenotype. Conversely, application of ALDH inhibitors, including disulfiram, to OMMP fibroblasts in vitro restored their functionality to that of normal controls. ALDH1 is also upregulated in the mucosa of the mouse model of scarring allergic eye disease (AED), used here as a surrogate for OMMP, in which topical application of disulfiram decreased fibrosis in vivo. These data suggest that progressive scarring in OMMP results from ALDH/RA fibroblast autoregulation, that the ALDH1 subfamily has a central role in immune-mediated ocular mucosal scarring, and that ALDH inhibition with disulfiram is a potential and readily translatable antifibrotic therapy.

Topics: Adult; Aged; Aged, 80 and over; Aldehyde Dehydrogenase; Animals; Cells, Cultured; Cicatrix; Conjunctiva; Disulfiram; Female; Fibroblasts; Fibrosis; Humans; Male; Mice; Mice, Inbred C57BL; Middle Aged; Mucous Membrane; Pemphigoid, Benign Mucous Membrane; Tretinoin

Deep erythema and inflammation after re-epithelialization of superficial wounds is a sign of scar formation. Corticosteroids may prevent scarring by suppression of inflammation and fibroblast activity. Tretinoin may increase the efficacy of corticosteroids in this setting.. To evaluate the efficacy of corticosteroids plus tretinoin for prevention of scars after superficial wounds.. In a retrospective study of patients with superficial partial thickness thermal skin burn, we compared the patients who received clobetasol plus tretinoin after re-epithelialization with patients who did not receive any medication. Clobetasol propionate 0.05% ointment was used twice daily with overnight occlusive dressing in conjunction with twice weekly topical tretinoin 0.05% cream.. Among 43 patients who had light pink or no erythema after re-epithelialization and consequently did not receive clobetasol + tretinoin, no scar was developed. Among patients who had deep erythema after re-epithelialization, rate of scar formation was significantly higher in 14 patients who did not receive clobetasol + tretinoin than in 21 patients who received clobetasol + tretinoin (64% and 19%, respectively; p = 0.01).. Clobetasol + tretinoin can significantly decrease the incidence of scar formation in patients with inflammation after re-epithelialization of superficial wounds.

Topics: Adolescent; Adult; Aged; Burns; Child; Child, Preschool; Cicatrix; Clobetasol; Dermatologic Agents; Erythema; Female; Glucocorticoids; Humans; Male; Middle Aged; Occlusive Dressings; Re-Epithelialization; Retrospective Studies; Skin; Tretinoin; Ulcer; Young Adult

To observe the effect of transplantation of neural stem cells (NSCs) induced by all-trans-retinoic acid (ATRA) combined with glial cell line derived neurotrophic factor (GDNF) and chondroitinase ABC (ChABC) on the neurological functional recovery of injured spinal cord in Sprague Dawley (SD) rats.. Sixty adult SD female rats, weighing 200-250 g, were randomly divided into 5 groups (n = 12): sham operation group (group A), SCI model group (group B), NSCs+GDNF treatment group (group C), NSCs+ChABC treatment group (group D), and NSCs+GDNF+ChABC treatment group (group E). T10 segmental transversal injury model of the spinal cord was established except group A. NSCs induced by ATRA and marked with BrdU were injected into the site of injury at 8 days after operation in groups C-E. Groups C-E were treated with GDNF, ChABC, and GDNF+ChABC respectively at 8-14 days after operation; and group A and B were treated with the same amount of saline solution. Basso Beattie Bresnahan (BBB) score and somatosensory evoked potentials (SEP) test were used to study the functional improvement at 1 day before remodeling, 7 days after remodeling, and at 1, 2, 5, and 8 weeks after transplantation. Immunofluorescence staining and HE staining were performed to observe the cells survival and differentiation in the spinal cord.. Five mouse died but another rats were added. At each time point after modeling, BBB score of groups B, C, D, and E was significantly lower than that of group A, and SEP latent period was significantly longer than that of group A (P < 0.05), but no difference was found among groups B, C, D, and E at 7 days after remodeling and 1 week after transplantation (P > 0.05). BBB score of groups C, D, and E was significantly higher than that of group B, and SEP latent period was significantly shorter than that of group B at 2, 5, and 8 weeks after transplantation (P < 0.05); group E had higher BBB score and shorter SEP latent period than groups C and D at 5 and 8 weeks, showing significant difference (P < 0.05). HE staining showed that there was a clear boundary between gray and white matter of spinal cord and regular arrangement of cells in group A; there were incomplete vascular morphology, irregular arrangement of cells, scar, and cysts in group B; there were obvious cell hyperplasia and smaller cysts in groups C, D, and E. BrdU positive cells were not observed in groups A and B, but could be found in groups C, D and E. Group E had more positive cells than groups C and D, and difference was significant (P < 0.05). The number of glial fibrillary acidic protein positive cells of groups C, D, and E was significantly less than that of groups A and B, and it was significantly less in group E than groups C and D (P < 0.05). The number of microtubule-associated protein 2 positive cells of groups C, D, and E was significantly more than that of groups A and B, and it was significantly more in group E than groups C and D (P < 0.05).. The NSCs transplantation combined with GDNF and ChABC could significantly promote the functional recovery of spinal cord injury, suggesting that GDNF and ChABC have a synergistic effect in the treatment of spinal cord injury.

Topics: Animals; Cell Differentiation; Chondroitin ABC Lyase; Cicatrix; Female; Glial Cell Line-Derived Neurotrophic Factor; Glial Fibrillary Acidic Protein; Mice; Neural Stem Cells; Random Allocation; Rats; Rats, Sprague-Dawley; Recovery of Function; Spinal Cord Injuries; Stem Cell Transplantation; Tretinoin

Laminectomy is a widely accepted treatment for lumbar disorders, and epidural fibrosis (EF) is a common complication. EF is thought to cause post-operative pain recurrence after laminectomy or discectomy. All-trans retinoic acid (ATRA) has shown anti-fibrotic, anti-inflammatory, and anti-proliferative functions. The object of this study was to investigate the effects of ATRA on the prevention of EF in post-laminectomy rats. In vitro, the anti-fibrotic effect of ATRA was demonstrated with cultured fibroblasts count, which comprised of those that were cultured with/without ATRA. In vivo, rats underwent laminectomy at the L1-L2 levels. We first demonstrated the beneficial effects using 0.05% ATRA compared to vehicle (control group). We found that a higher concentration of ATRA (0.1%) achieved dose-dependent results. Hydroxyproline content, Rydell score, vimentin-positive cell density, fibroblast density, inflammatory cell density and inflammatory factor expression levels all suggested better outcomes in the 0.1% ATRA rats compared to the other three groups. Presumably, these effects involved ATRA's ability to suppress transforming growth factor (TGF-β1) and interleukin (IL)-6 which was confirmed with reverse-transcriptase polymerase chain reaction (RT-PCR). Finally we demonstrated that ATRA down-regulated nuclear factor (NF)-κB by immunohistochemistry and western blotting for p65 and inhibition of κB (IκBα), respectively. Our findings indicate that topical application of ATRA can inhibit fibroblast proliferation, decrease TGF-β1 and IL-6 expression level, and prevent epidural scar adhesion in rats. The highest concentration employed in this study (0.1%) was the most effective. ATRA suppressed EF through down-regulating NF-κB signaling, whose specific mechanism is suppression of IκB phosphorylation and proteolytic degradation.

Topics: Animals; Cell Count; Cells, Cultured; Cicatrix; Dose-Response Relationship, Drug; Dura Mater; Epidural Space; Fibroblasts; Fibrosis; Keratolytic Agents; Laminectomy; Lumbar Vertebrae; Male; NF-kappa B; Rats; Rats, Wistar; Tretinoin

Excessive wound contraction can lead to scar formation in the conjunctiva. The effects of all-trans-retinoic acid (ATRA) on the contractility of human Tenon fibroblasts (HTFs) cultured in three-dimensional (3D) collagen gels were investigated.. Human Tenon fibroblasts were cultured in 3D gels of type I collagen and in the absence or presence of TGF-β, ATRA, or various inhibitors. Collagen gel contraction was evaluated by measurement of gel diameter. Phosphorylation of various signaling molecules was examined by immunoblot analysis. The formation of actin stress fibers and focal adhesions was detected by laser confocal microscopy.. All-trans-retinoic acid inhibited TGF-β-induced collagen gel contraction mediated by HTFs in a concentration- and time-dependent manner. The TGF-β-induced phosphorylation of focal adhesion kinase (FAK) and formation of stress fibers and focal adhesions in HTFs were attenuated by ATRA. All-trans-retinoic acid also inhibited the TGF-β-induced phosphorylation of the mitogen-activated protein kinases (MAPKs) extracellular signal-regulated kinase (ERK), p38, and c-Jun NH2-terminal kinase (JNK) as well as that of c-Jun and Smad2/3. Furthermore, TGF-β-induced collagen gel contraction was blocked by inhibitors of ERK, p38, or JNK signaling.. All-trans-retinoic acid inhibited TGF-β-induced collagen gel contraction mediated by HTFs, most likely by attenuating the formation of actin stress fibers and focal adhesions as well as signaling by MAPKs, c-Jun, and Smads. All-trans-retinoic acid may therefore prove effective for inhibition of conjunctival scarring through attenuation of the contractility of Tenon fibroblasts.

Topics: Cells, Cultured; Cicatrix; Collagen; Conjunctiva; Eye Injuries; Fibroblasts; Humans; Imaging, Three-Dimensional; Immunoblotting; Microscopy, Fluorescence; Tenon Capsule; Transforming Growth Factor beta; Tretinoin; Wound Healing

Hypopigmented scarring is a challenging condition to treat, with current treatments showing limited efficacy and temporary results. Nonablative fractional resurfacing has been demonstrated to be an effective and safe modality in the treatment of hypopigmented scars.. To demonstrate the efficacy and safety of combining fractional resurfacing with topical bimatoprost and topical tretinoin or pimecrolimus for the treatment of hypopigmented scars.. Fourteen patients with hypopigmented scars were treated with a mean of 4.5 sessions of a fractionated 1,550-nm erbium-doped laser at 4- to 8-week intervals and subsequently started topical bimatoprost and tretinoin or pimecrolimus. An independent physician evaluated digital photographs taken before and 4 weeks after the last laser treatment using a quartile grading scale (grade 1, ≤25% improvement; grade 2, 26-50% improvement; grade 3, 51-75% improvement; grade 4, >75% improvement).. Five patients had >75% improvement in hypopigmentation, and 12 had >50% improvement. After a mean follow-up of 20.1 months, all patients demonstrated prolonged results. Side effects were limited to transitory post-treatment edema and erythema.. The combination of fractional resurfacing, topical bimatoprost, and tretinoin or pimecrolimus is a potential effective resource for the treatment of hypopigmented scars, with long-lasting results.

Topics: Administration, Cutaneous; Adult; Aged; Amides; Bimatoprost; Cicatrix; Cloprostenol; Combined Modality Therapy; Female; Humans; Hypopigmentation; Keratolytic Agents; Lasers, Solid-State; Male; Middle Aged; Retrospective Studies; Tretinoin; Young Adult

The results suggest that vitamin A can prevent scar formation in the vocal fold after surgery.. This study aimed to evaluate the effects of topically applied vitamin A on healing after vocal fold trauma.. Vocal folds of 20 adult rabbits were traumatized unilaterally. Ten of them were treated with topical application of vitamin A and the others served as controls. All animals were sacrificed after 10 days. Vocal folds were resected for analysis by light microscopy.. The untreated vocal folds showed extensive deposition of collagen and fibroblast on light microscopy and vocal folds treated with vitamin A showed less deposition. There was a significant difference between the two groups according to the percentage of collagen and fibroblasts in the lamina propria (p<0.01).

Topics: Administration, Topical; Animals; Cell Division; Cicatrix; Collagen; Fibroblasts; Laryngeal Mucosa; Laryngoscopy; Rabbits; Tretinoin; Vocal Cords; Wound Healing

Atrophic scars are a frequent consequence of acne, with a negative esthetic and psychological influence. Treatment of atrophic acne scars includes different invasive methods. In our study, we used a noninvasive method with local application of 0.05% tretinoin gel by iontophoresis. In patients with a tendency towards exacerbation, we performed mild peeling with 5% trichloroacetic acid (TCA) solution 3-4 times during the treatment. Twenty-minute treatments were applied on 38 patients, 29 women and 9 men, during 3.5 months on average. Median age of patients was 21 years (range, 16-29). Clinical assessment included an assessment of scars, pore size, skin moisture, vascularization, and skin firmness and elasticity. As confirmed by photographs taken before and after therapy, the treatment proved to be clinically effective in decreasing acne scars and persistence of effects. Flattening of acne scars was observed in 79% of the patients. The results depended on duration of scars persistence as well as on a the type of scars. The best results were achieved with younger scars as well as with superficial and ice pick scars. Side effects involved a very mild retinoid dermatitis and more often acne exacerbation. The therapy was clinically effective and the patients accepted the treatment very easily. Local therapy of acne scars with tretinoin by iontophoresis can in some cases successfully replace invasive techniques, and could also be combined with those techniques.

Topics: Acne Vulgaris; Adult; Cicatrix; Female; Humans; Iontophoresis; Male; Time Factors; Tretinoin

Atrophic acne scars are a frequent problem after acne. Hitherto, mainly invasive treatment measures were possible. In a recent paper, we demonstrated the positive effects of iontophoresis with 0.025% tretinoin gel vs. estriol 0.03%.. In this further study, the recording of the clinical effects of iontophoresis with 0.025% tretinoin gel in atrophic acne scars was supplemented by immunohistochemistry investigations of collagen I and III, proliferation markers, and the estimation of epidermal thickness.. The treatment was performed twice weekly in 32 volunteer patients for a period of 3 months by application of the substance under a constant direct current of 3 mA for 20 min. Skin biopsies prior to and at the end of treatment were performed in 32 voluntary patients in order to investigate collagen I/III and proliferation markers by immunohistochemistry methods.. Clinically, at the end of treatment, in 94% of patients a significant decrease in the scar depth was observed. Neither epidermal thickness nor proliferation markers revealed a significant increase at the end of treatment. Furthermore, collagen I and collagen III showed no common trend, as expressed statistically by a lack of significance. In some cases, increases in collagen III became evident at the end of treatment.. Tretinoin-iontophoresis is an effective, noninvasive treatment of atrophic acne scars without causing disturbing side-effects.

Topics: Acne Vulgaris; Administration, Cutaneous; Adolescent; Adult; Atrophy; Cicatrix; Collagen; Female; Humans; Immunohistochemistry; Iontophoresis; Keratolytic Agents; Ki-67 Antigen; Male; Middle Aged; Skin; Treatment Outcome; Tretinoin

Eleven female patients are reported who underwent full-face resurfacing. Three patients were treated for cosmetic rhytids, five for residual acne scarring, and three for photoaging. There were no complications or side effects in this group of patients. Reepithelialization was achieved in an average of 9.3 days, and erythema disappeared in an average of 8.9 weeks. The UltraPulse carbon dioxide laser with computerized pattern generator (CPG) scanner allows a rapid, uniform laserbrasion. The sequence of the procedure involves close application of adjacent squares at 60 W, 200 to 300 ml, at moderate density. Skin preparation with Retin-A and bleaching agents is important for best wound healing. Postoperative wound care includes maintenance of a moist environment and Zovirax for herpes prophylaxis.

Topics: Acne Vulgaris; Acyclovir; Adult; Aged; Aged, 80 and over; Anti-Inflammatory Agents; Antiviral Agents; Carbon Dioxide; Cicatrix; Dexamethasone; Epithelium; Erythema; Facial Dermatoses; Female; Follow-Up Studies; Glycolates; Herpesviridae Infections; Humans; Hydroquinones; Keratolytic Agents; Laser Therapy; Middle Aged; Radiation-Protective Agents; Rhytidoplasty; Skin Aging; Skin Care; Therapy, Computer-Assisted; Tretinoin; Wound Healing

We present a patient with atrophodermia vermiculata. A family tree study revealed an autosomal mode of inheritance with good penetrance. A slight improvement of the atrophic scars of the disease was noticed after local treatment with tretinoin cream, 0.05 percent, and cryotherapy.

Topics: Administration, Cutaneous; Atrophy; Child; Cicatrix; Cryotherapy; Epidermis; Erythema; Facial Dermatoses; Humans; Male; Pedigree; Tretinoin

Topics: Acne Vulgaris; Burns; Cicatrix; Female; Humans; Self-Injurious Behavior; Tretinoin

Topics: Acne Vulgaris; Adult; Cicatrix; Female; Humans; Skin; Tretinoin

Since the introduction in the 1940s of an effective method for facial dermabrasion using the wire brush, there have been many ancillary procedures developed. Preoperative aids include scar elevation and punch grafting of deep scars prior to dermabrasion. Retinoic acid can prime the skin for more rapid healing. Gas sterilization of electrical equipment eliminates cross-contamination between patients. Intraoperative improvements include regional block anesthesia of the face, staged narcotic administration and newer methods of facial prechilling, and criteria for the ambient air in the operatory. Gentian Violet staining of the face and use of microfoam tape to delineate the mandibular boundary of a dermabrasion are helpful. The use of a custom handle for the spray refrigerant, the safety of Turkish towels used for retraction, and the application of a sharp Buck's curette make the procedure simpler and more effective. Postoperative aids include the use of systemic steroids and the new biological dressings which simplify the postoperative recovery period.

Topics: Air Conditioning; Analgesics, Opioid; Anesthesia, Conduction; Cicatrix; Dermabrasion; Freezing; Gentian Violet; Humans; Operating Rooms; Postoperative Care; Preoperative Care; Skin Transplantation; Sterilization; Transplantation, Autologous; Tretinoin

Topics: Acne Vulgaris; Adult; Cicatrix; Drug Administration Schedule; Female; Humans; Tretinoin

There are relatively few studies of the effect of retinoids on dermal tissue. A selective review of the literature reveals that when retinoids, especially all-trans-retinoic acid (tretinoin), are exposed to cultured human fibroblasts, they produce a marked reduction of fibroblast proliferation and collagen synthesis. Our clinical study of keloids and hypertrophic scars demonstrates in vivo effects of retinoids that are consistent with the in vitro data. Retinoids have significant clinical activity on dermal tissue, and further in vitro and in vivo development and testing of retinoids may lead to significant therapeutic advances in the treatment of fibrotic diseases.

Topics: Cell Division; Cells, Cultured; Cicatrix; Collagen; Fibroblasts; Humans; In Vitro Techniques; Keloid; Retinoids; Skin; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Adrenal Cortex Hormones; Benzoyl Peroxide; Cicatrix; Contraceptives, Oral, Hormonal; Humans; Isotretinoin; Minocycline; Propionibacterium acnes; Tetracycline; Tretinoin

Topics: Acne Vulgaris; Anti-Bacterial Agents; Benzoyl Peroxide; Cicatrix; Female; Hormones; Humans; Isotretinoin; Tretinoin

Topics: Acne Vulgaris; Administration, Topical; Adolescent; Anti-Bacterial Agents; Benzoyl Peroxide; Child; Cicatrix; Dermatologic Agents; Erythromycin; Estrogens; Humans; Sebum; Tetracycline; Tretinoin

Disorders of epidermal pigmentation not amenable to surgical intervention were treated with topical agents in 15 patients. In cases of hypopigmentation, methoxsalen 1% solution was applied prior to photosensitizing ultraviolet light exposures on alternate days for 2 to 6 months. In cases of hyperpigmentation, hydroquinone 4%, retinoic acid 0.05%, and triamcinolone acetonide 0.25% were applied twice daily for 6 weeks. Of three patients with surgically induced depigmentation, all had moderate repigmentation. Of 12 patients with hyperpigmentation, 4 had significant resolution, 5 had partial resolution, and 3 failed to complete the study. Overall, 6 of the 15 patients reported marked satisfaction with their therapy. Mild localized phototoxicity or irritant reactions were the only complications. Topical chemotherapy produced subjective and objective improvement in all patients who completed a therapeutic trial for either hyperpigmentation or hypopigmentation, and in several patients the results were excellent. The safety of these medications and the lack of acceptable alternatives justify their further use in appropriate clinical settings.

Topics: Administration, Topical; Adolescent; Adult; Child; Cicatrix; Drug Therapy, Combination; Female; Humans; Hydroquinones; Male; Methoxsalen; Middle Aged; Photochemotherapy; Pigmentation Disorders; PUVA Therapy; Tretinoin; Triamcinolone Acetonide

In a clinical trial twenty-eight intractable cases with scars were treated with daily applications of a 0.05% solution of retinoic acid. The results were evaluated objectively and subjectively. Slight to marked reduction of the size of these scars and decrease of such complaints as itching were noted in the majority of the cases. A favourable result was obtained according to the patients in 79%, and according to the opinion of the medical examiner in 77% of the patients.

Topics: Administration, Topical; Adolescent; Adult; Aged; Child; Child, Preschool; Cicatrix; Female; Humans; Hypertrophy; Keloid; Male; Middle Aged; Tretinoin

Topics: Cicatrix; Female; Humans; Hypertrophy; Time Factors; Tretinoin