tretinoin and Pruritus

Topics: Acanthoma; Administration, Topical; Adolescent; Biopsy, Needle; Combined Modality Therapy; Cryotherapy; Dermatologic Surgical Procedures; Diagnosis, Differential; Eczema; Female; Humans; Immunohistochemistry; Keratosis; Nipples; Pruritus; Rare Diseases; Skin Neoplasms; Treatment Outcome; Tretinoin

Acne vulgaris is the most common dermatological disorder worldwide, causing significant physical and psychological morbidity. Topical combination therapy has shown superior efficacy compared to monotherapy, especially when combined with retinoids. Few studies have directly compared combined formulations. This evaluator-blinded pilot study compared the efficacy and tolerability of two marketed topical combination acne gels, clindamycin 1%-tretinoin 0.025% (CT) and benzoyl peroxide 2.5%-adapalene 0.1% (BA) in 20 patients with mild to moderate acne vulgaris. Gels were applied daily on opposite sides of the face for 21 days. The primary outcome was difference in transepidermal water loss (TEWL) at the end of treatment. Secondary endpoints were skin moisture content measurement, Investigators' Global Assessment, subject self-assessments (SSA) of burning/stinging, itching, erythema, and dryness/scaling, and Comparative Participant Satisfaction Questionnaire (CPSQ). Efficacy was assessed by inflammatory and non- inflammatory acne efflorescences counts. TEWL increased significantly for both CT and BA (+57.74%, P=0.002; +58.77%, P<0.001); skin moisture content significantly decreased only for BA (-16.47%, P=0.02). Only BA showed a significant increase in erythema and dryness/scaling (P=0.027 and P=0.014) and in SSA burning/stinging (P=0.04). Patient satisfaction evaluation also reflected the strong BA irritation. Although CT and BA both reduced acne lesions (P<0.001) and more patients preferred to continue with CT, subject perception of acne improvement was higher for BA. These findings suggest that CT and BA have similar efficacy in the treatment of mild to moderate papulopustular acne. However, CT was better tolerated than BA by both medical and subject evaluation. CT is an effective and tolerated treatment option.J Drugs Dermatol. 2021;20(3):295-301. doi:10.36849/JDD.2021.5641.

Topics: Acne Vulgaris; Adapalene, Benzoyl Peroxide Drug Combination; Administration, Cutaneous; Adolescent; Adult; Clindamycin; Dermatologic Agents; Drug Combinations; Erythema; Female; Gels; Humans; Male; Patient Satisfaction; Pilot Projects; Pruritus; Severity of Illness Index; Skin; Treatment Outcome; Tretinoin; Water Loss, Insensible; Young Adult

The efficacy of topical retinoids is well known according to several clinical studies conducted predominantly among Caucasian patients. This study aimed to evaluate the efficacy and safety profile of adapalene and tretinoin among Mexican patients.. To compare adapalene 0.1 and 0.3% and tretinoin 0.05% in Mexican subjects with acne vulgaris.. We enrolled 171 patients in this single-center, randomized, double-blinded, placebo-controlled clinical trial. The patients applied on the face either adapalene 0.1%, adapalene 0.3%, tretinoin 0.05%, or placebo for 90 days and were evaluated for the reduction in total lesion counts and for the level of irritation.. Tretinoin 0.05% and adapalene 0.3% were more effective than adapalene 0.1% and placebo in the reduction of both inflammatory and noninflammatory lesions. Most of adverse events to adapalene and many on tretinoin group were related to skin irritation, dry skin, scaling, pruritus, burning, and postinflammatory hyperpigmentation.. Adapalene 0.3% and tretinoin 0.05% are comparable in efficacy, and adapalene 0.1% offers a better safety profile in Mexican patients.

Topics: Acne Vulgaris; Adapalene; Adolescent; Adult; Child; Dermatitis, Irritant; Dermatologic Agents; Double-Blind Method; Female; Gels; Humans; Hyperpigmentation; Keratolytic Agents; Male; Mexico; Naphthalenes; Pruritus; Tretinoin; Young Adult

Although reliable prevalence data are not available, adult acne is thought to be somewhat common, and it is not unusual for patients to have acne as well as early signs of skin aging. A novel anti-acne/anti-aging formulation (Treatment A) has been developed for daily use by patients to address both signs of skin aging and facial acne vulgaris. The novel, non-prescription formulation includes several ingredients shown to target factors underlying the pathogenesis of acne vulgaris while also addressing multiple components in the pathophysiology of skin aging.. A blinded, randomized, split-face study was conducted to evaluate and compare the tolerability and efficacy of the novel anti-acne/ anti-aging product in subjects with photodamaged skin and acne vulgaris relative to tretinoin cream 0.025% (Treatment B). All subjects also were given supportive skincare, consisting of a cleanser, moisturizer, and sunscreen. Each treatment was assessed for its effects on subjects' appearance, lesion count reductions, and tolerability.. Treatment A produced statistically significantly greater improvements in skin tone evenness, skin tone clarity, and blemishes and blotchiness. There were also statistically greater reductions in total lesion count for acne patients on the side of the face treated with Treatment A compared to Treatment B; Treatment A was also associated with early (day 2) improvement in skin tone evenness and clarity, tactile skin smoothness, and blemishes and blotchiness. Both treatments demonstrated favorable tolerability.. The novel topical anti-aging/anti-acne therapy (Treatment A) within a comprehensive skin care regimen of cleanser, moisturizer, and sunscreen may maximize efficacy and tolerability and contribute to our armamentarium for treating both photodamage and acne at the same time.

Topics: Acne Vulgaris; Administration, Topical; Adult; Dermatologic Agents; Female; Humans; Male; Middle Aged; Pruritus; Single-Blind Method; Skin Aging; Sunscreening Agents; Treatment Outcome; Tretinoin

The use of topical medications for acne vulgaris is often limited by their irritant properties. Newer combination preparations are available and offer convenience, but irritant potential may still be a hindrance, perhaps more so with the combination of 2 agents. Few studies have compared these formulations directly for tolerability.. We sought to compare the tolerability of 2 combination topical acne products, clindamycin 1.2%-tretinoin 0.025% (CLIN/RA) gel and benzoyl peroxide 2.5%-adapalene 0.1% (BPO/ADA) gel.. CLIN/RA and BPO/ADA were applied daily to opposite sides of a subject's face for 21 days in a double-blinded fashion. Investigators' Global Assessments and study subject self-assessments of burning/stinging, itching, erythema, and dryness/scaling were collected. Transepidermal water loss (TEWL) was also measured as an objective measure of skin irritation. A mixed model analysis and repeated-measures analysis of variance were used to compare outcomes for both acne formulations.. CLIN/RA produced significantly less burning/stinging than BPO/ADA (P<.001) as well as significantly less pruritus than BPO/ ADA (P<.001). BPO/ADA caused significantly more TEWL than CLIN/RA (P=.005). There was no significant difference in the amount of erythema or the amount of dryness/scaling caused by either formulation.. CLIN/RA produced significantly less skin irritancy and TEWL than BPO/ADA.

Topics: Acne Vulgaris; Adapalene; Adult; Anti-Bacterial Agents; Benzoyl Peroxide; Clindamycin; Dermatologic Agents; Diagnostic Self Evaluation; Double-Blind Method; Drug Combinations; Erythema; Female; Humans; Irritants; Keratolytic Agents; Linear Models; Male; Naphthalenes; Pruritus; Skin; Tretinoin; Water Loss, Insensible; Young Adult

Despite the many beneficial effects of dermatologic applications, most of the current treatments for acne cause local irritation. The objective of this study was to compare the ability of the epidermis to tolerate adapalene 0.1% cream and gel and tretinoin microsphere in concentrations of 0.04% and 0.1%. A total of 31 subjects were enrolled in the study. The test products were applied under occlusive dressings on the upper back for approximately 24 hours, 4 times a week, and for 72 hours, once a week, for a period of 3 weeks. Skin reactions (erythema score plus other local reactions) at the product application sites were assessed 5 to 30 minutes after dressing removal. Twenty-six subjects completed the study. A total of 10 subjects discontinued use of 1 or more of the test products because of irritation scores reaching severe or greater, all of these discontinuations were at sites treated with the tretinoin products. The mean 21-day cumulative irritancy indices for adapalene 0. 1% cream and gel were significantly lower (P<.01) than those for tretirnoin microsphere 0.04% and 0. 1% and not higher than that of the negative control product.

Topics: Adapalene; Adult; Dermatologic Agents; Dose-Response Relationship, Drug; Double-Blind Method; Drug Eruptions; Erythema; Female; Gels; Humans; Male; Microspheres; Middle Aged; Naphthalenes; Ointments; Pruritus; Skin; Tretinoin

Adapalene is a new synthetic retinoid analogue developed for the topical treatment of acne vulgaris.. The study was designed to compare the efficacy and safety and adapalene gel 0.1% with tretinoin gel 0.025% in the treatment of grade II to II facial acne vulgaris.. Three hundred twenty-three patients were enrolled in this investigator-masked, randomized, parallel group, multicenter trial. Patients applied the test materials to the entire facial area daily, for a period of 12 weeks. Efficacy and cutaneous tolerance were assessed at baseline and weeks 2,4,8, and 12. Efficacy was determined by investigator counts of noninflammatory open and closed comedones, and inflammatory papules and pustules, as well as global improvement. Cutaneous tolerance was evaluated by erythema, scaling, and dryness, along with burning and pruritus.. Staring at weeks 2 and 4, adapalene gel produced numerically greater lesion reductions than did tretinoin gel for all lesion types. At week 12, the mean percent reduction in the different lesion counts was as follow: 49% versus 37% for total lesions (p<0.01); 46% versus 33% for noninflammatory lesions (p=0.02); 48% versus 38% for inflammatory lesions (p=0.06) in adapalene and tretinoin gel treatment groups, respectively. Cutaneous side effects were limited to a mild "retinoid dermatitis" occurring in both treatment groups; however, patients treated with adapalene gel tolerated this therapy significantly better than those treated with tretinoin gel. Laboratory test evaluations (hematology, blood chemistries, urinalysis) were performed in 54 patients before and after 3 months of treatment. No clinically significant changes were observed.. Adapalene gel 0.1% applied once daily was significantly more effective in reducing acne lesions and was better tolerated than tretinoin gel 0.025% in the treatment of acne vulgaris.

Topics: Acne Vulgaris; Adapalene; Adolescent; Adult; Anti-Inflammatory Agents, Non-Steroidal; Child; Drug Eruptions; Drug Tolerance; Erythema; Facial Dermatoses; Female; Gels; Humans; Keratolytic Agents; Male; Naphthalenes; Pruritus; Single-Blind Method; Skin Diseases; Tretinoin

Fenretinide, N-(4-hydroxyphenyl)retinamide (HPR), is a synthetic retinoid which has been proven effective in inducing cell differentiation and in inhibiting carcinogen induced mammary tumors in rodents. Because of its efficacy and low toxicity in animals, HPR has been proposed for chemopreventive evaluation in humans. Thus, a randomized trial has been conducted to select a dose which can be administered over a lengthy period of time and with acceptable toxicity. The retinoid was administered orally to patients already operated on for breast cancer in daily doses of 100, 200 and 300 mg for 6 months and subsequently at 200 mg for another 6 months. No acute toxicity was found. Dermatological toxicity was minimal and no liver function abnormalities were observed. Nausea and headaches were infrequent and always mild. Menstrual irregularities were recorded with similar frequency in the treatment and placebo groups and appeared to be more age related than drug dependent. After 6 months of treatment one of 25 patients taking 300 mg HPR daily experienced impaired night vision, confirmed by the electroretinogram, and resolved by interruption of treatment. Because the 300 mg daily dose is possibly associated with impaired dark adaptation, the recommended dose for chemoprevention trials of HPR is 200 mg per day.

Topics: Adult; Aged; Breast Neoplasms; Drug Eruptions; Drug Evaluation; Drug Tolerance; Female; Fenretinide; Humans; Middle Aged; Pruritus; Random Allocation; Tretinoin

In a double-blind controlled multicenter trial consisting of 257 patients with acne vulgaris an 8-week topical treatment with the retinoic acid derivative Ro 11-1430 (0.1% lotion) was compared with vitamin A acid (0.05% lotion) and the lotion alone (placebo). In reducing the number of comedones vitamin A acid was superior to Ro 11-1430, which was significantly better than placebo. The reduction in number of papules and pustules was not statistically significant on either treatment. Local side effects, i.e. erythema, desquamation, burning and pruritus occurred more frequently and were more severe on vitamin A acid than on Ro 11-1430 and placebo which did not differ. No correlation was found between incidence and severity of local reactions and therapeutic effect.

Topics: Acne Vulgaris; Administration, Topical; Clinical Trials as Topic; Drug Eruptions; Drug Evaluation; Erythema; Humans; Pruritus; Tretinoin; Vitamin A

There is a major clinical need for new therapies for the treatment of chronic itch. Many of the molecular components involved in itch neurotransmission are known, including the neuropeptide NPPB, a transmitter required for normal itch responses to multiple pruritogens in mice. Here, we investigated the potential for a novel strategy for the treatment of itch that involves the inhibition of the NPPB receptor NPR1 (natriuretic peptide receptor 1). Because there are no available effective human NPR1 (hNPR1) antagonists, we performed a high-throughput cell-based screen and identified 15 small-molecule hNPR1 inhibitors. Using in vitro assays, we demonstrated that these compounds specifically inhibit hNPR1 and murine NPR1 (mNPR1). In vivo, NPR1 antagonism attenuated behavioral responses to both acute itch- and chronic itch-challenged mice. Together, our results suggest that inhibiting NPR1 might be an effective strategy for treating acute and chronic itch.

Topics: Animals; Behavior, Animal; Cell-Free System; Dermatitis, Contact; Disease Models, Animal; Ganglia, Spinal; Humans; Mice, Inbred C57BL; Mice, Knockout; Neurons; Pruritus; Receptors, Atrial Natriuretic Factor; Reproducibility of Results; Signal Transduction; Small Molecule Libraries

Chronic itch with secondary scratch lesions such as prurigo has a major impact on quality of life. Due to its relapsing nature and often unknown origin, its treatment is challenging.. We sought to demonstrate that alitretinoin can be an efficacious and well-tolerated treatment in a patient suffering from chronic itch with concomitant prurigo and psoriatic lesions.. Case report.. After 1 month of alitretinoin treatment (30 mg daily), itch as well as prurigo and psoriasis lesions decreased markedly. Three cycles of alitretinoin were administered, as each cessation of treatment led to relapse of the symptoms after 6-8 weeks. Tapering of the alitretinoin dose (30 mg every second day) after the third cycle allowed to maintain the effects for over 18 months.. Treatment of refractory prurigo with alitretinoin might be an efficacious alternative to standard therapies. In case of relapse, retreatment with alitretinoin reinduces a further long-lasting response.

Topics: Alitretinoin; Antineoplastic Agents; Female; Humans; Middle Aged; Prurigo; Pruritus; Psoriasis; Retreatment; Tretinoin

The aim of the CARPE registry is to investigate characteristics and medical care in patients affected by chronic hand eczema. Patients are assessed by dermatological examination and patient questionnaire. Socio-economic and clinical data are collected, and quality of life is measured using the Dermatology Life Quality Index (DLQI). A total of 1,163 patients with chronic hand eczema were eligible for analysis (mean age 47.0 years; 54.6% female; mean disease duration 7.6 years). At inclusion, chronic hand eczema was very severe in 23.4%, severe in 47.0%, moderate in 20.1%, and clear or almost clear in 9.6% of patients. Median DLQI was 8.0. In all, 93.8% of patients reported use of topical corticosteroids, 25.6% systemic antihistamines, 28.3% topical calcineurin-inhibitors, 38.0% ultraviolet phototherapy, and 35.3% systemic treatment (19.7% alitretinoin) prior to inclusion in the registry. A significant proportion of patients may not receive adequate treatment according to the guideline on management of hand eczema.

Topics: Administration, Topical; Adolescent; Adult; Aged; Aged, 80 and over; Alitretinoin; Calcineurin Inhibitors; Chronic Disease; Eczema; Female; Germany; Glucocorticoids; Hand Dermatoses; Histamine Antagonists; Humans; Male; Middle Aged; Occupations; Pruritus; Quality of Life; Registries; Severity of Illness Index; Tretinoin; Ultraviolet Therapy; Young Adult

A 28-year-old woman presented with a 12-year history of red to brown papules in a linear distribution on the left lateral chest associated with recent flares of pruritus. She had previously been clinically diagnosed with lichen planus. A punch biopsy was performed, and histopathologic exam revealed Darier-like acantholysis. The patient was diagnosed with type 1 segmental Darier disease and her symptoms improved with topical tretinoin.

Topics: Adult; Darier Disease; Female; Humans; Keratolytic Agents; Pruritus; Thorax; Tretinoin

Patients with reactions to topical products may be eliciting a physical urticaria, dermographism, by rubbing. These reactions may be misinterpreted as allergic, and three cases demonstrating this phenomenon were reviewed. All patients with reactions to topical products due to dermographism improved with counseling and antihistamine therapy. Repeat open application testing confirmed the safety of previously suspect medications in two of the three cases, preventing unnecessary changes in the medication regimens and inaccurate diagnoses of medication allergy. We observe that intolerance to topical medications due to dermographism can usually be managed without extensive testing or treatment.

Topics: Administration, Cutaneous; Adult; Dermatitis, Allergic Contact; Diagnosis, Differential; Female; Humans; Middle Aged; Patch Tests; Pruritus; Tretinoin; Urticaria

Eight men with severe recessive x-linked ichthyosis were treated with acitretin, the main metabolite of etretinate, during four months. All of the patients showed marked clinical improvement of scaling during therapy. Hypervitaminosis A-type adverse reactions were observed in all patients. Although the overall tolerance was good, therapy was interrupted in one atopic patient because of pruritus. There were no undesirable laboratory changes in values. Thirty-five milligrams of acitretin daily provided the best efficacy, with minimal side effects. The beneficial effect of this retinoid lasted between four and six weeks after therapy was stopped. These results suggest that acitretin is a useful agent in the symptomatic therapy of severe recessive x-linked ichthyosis resistant to topical therapeutic modalities. Good results with this agent can be achieved with interval therapy adjusted to seasonal variations of the skin symptoms.

Topics: Acitretin; Adult; Follow-Up Studies; Genetic Linkage; Humans; Ichthyosis; Male; Middle Aged; Pruritus; Tretinoin; X Chromosome

The efficacy and safety of isotretinoin in the treatment of idiopathic seborrhea in dogs were examined. Isotretinoin was judged effective in only 1 of 8 dogs. Side effects included mild conjunctivitis, transient erythematous rash, and increased serum cholesterol and triglyceride concentrations.

Topics: Animals; Conjunctivitis; Dermatitis, Seborrheic; Dog Diseases; Dogs; Female; Isotretinoin; Male; Pruritus; 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

The ichthyosis of seven patients with the Sjögren-Larsson syndrome was treated with an aromatic retinoid, etretinate, during six months. Very good results were registered in six of the patients measured both as clinical improvement and as reduction in quantity of emollients needed. No unexpected side effects were noted.

Topics: Adolescent; Adult; Aged; Etretinate; Humans; Ichthyosis; Middle Aged; Pruritus; Sjogren's Syndrome; Time Factors; Tretinoin

The effect of the aromatic retinoid, etretinate, has been evaluated in 17 patients suffering from moderate to severe Darier's disease (DD). The erythema, hyperkeratosis and number of papules as well as the extension of the lesions were scored before and at regular intervals during treatment. In the first treatment period a daily dose of 50 mg was given until healing but no longer than 10 weeks. In the majority of patients the effect was very good with almost complete clearing in 6 patients. In patients with severe DD a reduction of the initial score by more than 50% was seen in 7 out of 8 patients. Isomorphic reactions developed in 6 of 17 patients and was the most important side effect. In patients with moderate disease the remission periods without treatment exceeded 4 weeks. 8 patients were treated intermittently with a lower dose up to 4 treatment periods. Equally good results were obtained. The treatment of choice in DD seems to be etretinate at an intermittent regime with low doses (less than or equal to 0.5 mg/kg).

Topics: Adolescent; Adult; Aged; Darier Disease; Dose-Response Relationship, Drug; Erythema; Etretinate; Female; Humans; Lipoproteins; Male; Middle Aged; Pruritus; Tretinoin

Topics: Adult; Anti-Bacterial Agents; Aspirin; Child; Cimetidine; Cyclophosphamide; Dipyridamole; Female; Humans; Infant; Isotretinoin; Pruritus; Skin Diseases; Tretinoin; Ultraviolet Therapy

Topics: Administration, Oral; Etretinate; Female; Humans; Keratosis; Middle Aged; Pruritus; Tretinoin

Diffuse lichen planus, a rare disorder in children, was observed in an 8-year-old boy. Effective therapy in this disease remains a problem and currently relies predominantly on the use of the corticosteroids. The complications attendant with corticosteroid administration in children are discussed and a review of alternate modes of therapy for lichen planus is presented.

Topics: Adrenal Cortex Hormones; Adrenal Insufficiency; Child; Griseofulvin; Growth Disorders; Humans; Lichen Planus; Male; Pruritus; PUVA Therapy; Tretinoin; Vitamin A