tretinoin and Pain

Striae gravidarum is a common skin condition resulting after pregnancy, caused by fibroblast dysfunction. Although not considered a disease, it may be considered cosmetically unpleasant to sufferers and remains as a therapeutic challenge to date.. To evaluate the efficacy and safety of a sublative bipolar fractional radiofrequency (FRF) system, associated with 0.1% topical tretinoin, in treating striae gravidarum.. Eighteen Chinese women with striae gravidarum on the abdomen were enrolled in the study. The target area of each patient was divided into 4 sites randomly: control, tretinoin, FRF, and tretinoin and FRF. Fractional RF was used 3 times, with 3-month intervals. Changes to striae gravidarum were evaluated through subjective scaling and objective measures, using both high-frequency ultrasound and histological study.. Both subjective assessment and skin thickness differences demonstrated significant improvement in the combination site (p < .001). Average optical density and density percentage of neocollagen and elastic fibers were also markedly increased in the combination site (p < .05). The adverse effects of FRF were limited to mild pain and transient erythema, edema, and microcrusts.. The combined therapy of FRF and topical tretinoin may be a potential method in treating striae gravidarum, with satisfactory efficacy and limited side effects.

Topics: Adult; Erythema; Female; Humans; Keratolytic Agents; Middle Aged; Pain; Pain Measurement; Patient Satisfaction; Pilot Projects; Pregnancy; Pregnancy Complications; Radiofrequency Therapy; Skin; Skin Cream; Striae Distensae; Treatment Outcome; Tretinoin; Ultrasonography

Quality-switched (QS) laser therapy is a safe and well-established treatment option for removing solar lentigines. Triple combination therapy (TCT) with the active pharmaceutical ingredients hydroquinone 5%, tretinoin 0.03%, and dexamethasone 0.03% is often used for skin-lightening.. This prospective, open-label trial compares the efficacy and safety of a QS Ruby laser (QSRL) and a TCT in the treatment of solar lentigines.. In total, 15 patients with symmetrically distributed solar lentigines on the back of both hands were included. The lesions on the back of the right hand were treated in one or 2 sessions with a QSRL, the ones on the back of the left hand with a TCT for 7 weeks accompanied by UV protection. Clinical results were evaluated 4 weeks, 8 weeks, and 20 weeks after baseline.. Treatment with QSRL provided significant lightening (p = .01) compared with TCT. Both procedures were generally well-tolerated. Comparing the side effects, the laser produced significantly more crusting and hyperpigmentation than the TCT.. Both QSRL and TCT were capable in reducing solar lentigines in Fitzpatrick skin Type I to IV with an acceptable side effect profile. The QSRL provides faster, superior, and long lasting lightening compared with TCT.

Topics: Aged; Dexamethasone; Drug Combinations; Erythema; Female; Hand Dermatoses; Humans; Hydroquinones; Lasers, Solid-State; Lentigo; Male; Middle Aged; Pain; Prospective Studies; Skin Cream; Skin Lightening Preparations; Tretinoin

Although advanced renal-cell carcinoma (RCC) responds poorly to standard therapies, phase I-II trials have shown activity for combinations of interferon-alpha2b (IFN) with a retinoid. Alitretinoin (9-cis RA) is an endogenous retinoid with high binding affinity for both RAR and RXR receptor families. This phase I-II study enrolled 38 patients with RCC in a dose-escalation study of tolerability, pharmacokinetics (PK), and efficacy of twice daily oral 9-cis RA with subcutaneous IFN. In contrast to studies with similar doses of daily 9-cis RA, PK studies found a consistent reduction in 9-cis RA concentrations of about 50% after multiple b.i.d. doses of 30 or 50 mg/m2, independent of cotreatment with IFN. In the phase I portion, toxicities included systemic symptoms typical of IFN and biochemical abnormalities previously associated with retinoids. Two patients experienced dose-limiting toxicity at 50 mg/m2 b.i.d. of 9-cis RA, thus the recommended phase II dose was 30 mg/m2 b.i.d. One of twenty-six evaluable patients achieved a durable objective partial remission, and repeated dosing with this regimen was poorly tolerated. This combination of retinoid and interferon is not recommended for further study in RCC.

Topics: Adult; Aged; Alitretinoin; Antineoplastic Agents; Carcinoma, Renal Cell; Chemical and Drug Induced Liver Injury; Combined Modality Therapy; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Synergism; Fatigue; Female; Fever; Humans; Immunologic Factors; Interferon alpha-2; Interferon-alpha; Kidney Neoplasms; Male; Middle Aged; Nephrectomy; Pain; Recombinant Proteins; Remission Induction; Treatment Failure; Tretinoin

Differentiation therapy with all-trans retinoic acid (ATRA) has marked a major advance and become the first choice drug in the treatment of acute promyelocytic leukemia (APL). However, patients who relapse from ATRA-induced complete remission (CR) have difficulty in obtaining a second CR with a second course of ATRA therapy alone. We tested the efficacy of a new synthetic retinoid, Am80, in APL that had relapsed from CR induced by ATRA in a prospective multicenter study. Am80 is approximately 10 times more potent than ATRA as an in vitro differentiation inducer, is more stable to light, heat, and oxidation than ATRA, has a low affinity for cellular retinoic acid binding protein, and does not bind to retinoic acid receptor-gamma. Patients received Am80, 6 mg/m2, orally alone daily until CR. Of 24 evaluable patients, 14 (58%) achieved CR. The interval from the last ATRA therapy was not different between CR and failure cases. The clinical response was well correlated with the in vitro response to Am80 in patients examined. Adverse events included 1 retinoic acid syndrome, 1 hyperleukocytosis, 9 xerosis, 8 cheilitis, 16 hypertriglyceridemia, and 15 hypercholesterolemia, but generally milder than those of ATRA, which all patients had received previously. Am80 is effective in APL relapsed from ATRA-induced CR and deserves further trials, especially in combination with chemotherapy.

Topics: Adult; Aged; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Benzoates; Cell Differentiation; Chemical and Drug Induced Liver Injury; Combined Modality Therapy; Cytarabine; Daunorubicin; Drug Resistance, Neoplasm; Female; Gastrointestinal Diseases; Humans; Leukemia, Promyelocytic, Acute; Leukocytosis; Male; Middle Aged; Pain; Prospective Studies; Receptors, Retinoic Acid; Recurrence; Remission Induction; Retinoic Acid Receptor gamma; Retinoids; Salvage Therapy; Tetrahydronaphthalenes; Treatment Outcome; Tretinoin

Topics: Adult; Antineoplastic Agents; Bone Diseases; Humans; Leukemia, Promyelocytic, Acute; Male; Pain; Pain Management; Treatment Outcome; Tretinoin

Hematological malignancies such as leukemia or lymphoma are mainly treated by hospitalization or in outpatient clinics. Therefore, home care and home nursing are not so intensively done in the treatment of these malignancies. However, G-CSF administration against neutropenia after chemotherapy and administration of narcotics or opioids against severe pain have been performed sometimes during home care, and have been contributing to better QOL of the patients.

Topics: Analgesics, Opioid; Granulocyte Colony-Stimulating Factor; Home Care Services, Hospital-Based; Humans; Leukemia; Lymphoma; Multiple Myeloma; Myelodysplastic Syndromes; Neutropenia; Pain; Quality of Life; Tretinoin

To study the involvement of all-trans retinoic acid (ATRA) in the development and maintenance of inflammatory pain.. Adult male Wistar rats and murine neuro2a and human SH-SY5Y neuroblastoma cells.. Soft-tissue inflammation was induced by the intraplantar administration of 100 microl of carrageenan lambda. The oral treatment with either ATRA or vehicle lasted for seven days and consisted in a dose of 15 mg/kg the first two days and a dose of 10 mg/kg the following five days. Neuroblastoma cells were incubated for 16 h with ATRA.. Rats were tested twice daily for intensity and evolution of withdrawal reflexes evoked by mechanical and thermal stimulation. The expression of COX enzymes was studied in spinal cords and neuroblastoma cells by western blot.. The animals treated with ATRA showed a significantly more intense development of mechanical allodynia (p < 0.01), mechanical hyperalgesia (p < 0.01), thermal hyperalgesia (p < 0.001) and reduction of threshold for mechanical (29 +/- 4 vs. 60 +/- 6 mN, p < 0.001) and thermal stimulation (12 +/- 0.3 vs. 8.4 +/- 0.3 s, p < 0.001) than control animals. Recovery to mechanical baseline data was slower in animals treated with ATRA, the main difference was observed in the test carried out on day 2, p.m. In neuroblastoma cells incubated with ATRA, a concentration-dependent increase in the expression of COX-2 protein was observed. Changes in the expression of COX-1 enzyme were not clear. An increase in COX-2 expression in the lumbar spinal cord was also observed in animals treated with ATRA.. A clear relationship between the oral administration of ATRA and an enhancement of the nociceptive withdrawal reflexes was observed in rats. This relationship was associated with an increment of the expression of the COX-2 enzyme.

Topics: Administration, Oral; Animals; Behavior, Animal; Blotting, Western; Carrageenan; Cell Line, Tumor; Cyclooxygenase 1; Cyclooxygenase 2; Dose-Response Relationship, Drug; Hot Temperature; Humans; Inflammation; Isoenzymes; Male; Membrane Proteins; Mice; Pain; Pain Measurement; Pressure; Prostaglandin-Endoperoxide Synthases; Rats; Rats, Wistar; Reflex; Spinal Cord; Time Factors; Tretinoin

Arsenic trioxide has recently been introduced as a promising new agent to treat refractory acute promyelocytic leukemia (APL). In the present study, arsenic trioxide was given intravenously for 42 days to a 56-year-old female patient suffering from chemotherapy/ATRA-resistant APL, with 43% APL blasts in the bone marrow and elevated D-dimers. During the first days of arsenic trioxide treatment a rapid decrease in the D-dimers was seen (normal values reached until day 7), together with a slight decrease in peripheral blood leukocytes. This initial coagulation response was followed by a second phase of hematological response (starting on days 15-20) characterized by leukocytosis, occurrence of myeloid progenitor cells in the peripheral blood, and a decrease in bone marrow blasts (<1% on days 28 and 36). Finally, the patient entered complete hematological and cytogenetic remission, although the PML-RAR alpha fusion product was still detectable by PCR. These data confirm the therapeutic value of arsenic trioxide in relapsed/resistant APL.

Topics: Antineoplastic Agents; Arsenic Trioxide; Arsenicals; Bone Marrow; Chromosome Banding; Colony-Forming Units Assay; Drug Resistance, Neoplasm; Feeding and Eating Disorders; Female; Humans; Leukemia, Promyelocytic, Acute; Leukocyte Count; Metaphase; Middle Aged; Musculoskeletal Diseases; Oxides; Pain; Polymerase Chain Reaction; Recurrence; Tretinoin

Acute promyelocytic leukaemia (APL) (FAB-M3) is associated with fatal haemorrhagic complications in 10 to 20% of patients. Recently ALL-Trans Retinoic acid (ALL-Trans RA) therapy has been used with rapid correction of the coagulopathy. Although minimal haematologic toxicity has been reported, a number of potentially serious side-effect have been described. We report a case of bone marrow necrosis occurring in a patient with APL treated with ALL-Trans RA. The possible relationship of this complication to retinoid therapy is discussed. This patient subsequently recovered and not only achieved complete remission but tolerated two cycles of chemotherapy without problems.

Topics: Bone Marrow; Female; Humans; Immunologic Factors; Leukemia, Promyelocytic, Acute; Leukocyte Count; Leukocytosis; Middle Aged; Mitoxantrone; Necrosis; Pain; Prednisone; Remission Induction; Tretinoin

Topics: Adult; Drug Administration Schedule; Female; Headache; Humans; Isotretinoin; Male; Menstruation Disturbances; Middle Aged; Neoplasms; Pain; Risk; Tretinoin

Topics: Acne Vulgaris; Adolescent; Humans; Isotretinoin; Male; Muscle Spasticity; Muscles; Pain; Recurrence; Tretinoin