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A systematic review of benzoyl peroxide for acne vulgaris

Mohd Nor NH, Aziz Z

J Dermatolog Treat, 2013 Oct;24(5):377-86.
PMID: 22658322 DOI: 10.3109/09546634.2012.699179

OBJECTIVE: Comparative trials of benzoyl peroxide (BPO) have yielded contradictory results on its effectiveness for acne vulgaris. The aim of the study was to synthesise the evidence for the effectiveness of BPO-containing topical products for facial acne vulgaris.
DESIGN: Systematic review.
METHODS: The Cochrane Central Register of Controlled trials, Cochrane Library, MEDLINE and other relevant databases were searched without publication date or language restriction.
RESULTS: We identified 22 trials involving 2212 participants; 12 trials compared BPO as single agent while the other 10 trials compared BPO in combination products. All trials reported lesion count as the outcome measure but only five trials provided numerical data. However, pooling of data from these trials was inappropriate due to variations between trials in terms of acne severity, comparator used and trial duration. Overall the study quality was fair but most studies had some bias particularly in method of random generation and allocation concealment. Although the results provide some evidence that BPO reduces acne-lesion count, the available evidence is not robust enough for firm conclusions.
CONCLUSIONS: There is no high quality evidence that topical BPO improves facial acne vulgaris, and further research is needed.

Matched MeSH terms: Dermatologic Agents/administration & dosage*
Safety and efficacy of fixed-dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Yap FB

J Cosmet Dermatol, 2017 Sep;16(3):348-352.
PMID: 27539948 DOI: 10.1111/jocd.12268

INTRODUCTION: Low-dose isotretinoin is used to reduce side effects albeit higher relapse. This study aimed to determine the efficacy and safety of fixed-dose 10 mg daily isotretinoin for the treatment of acne.
METHODS: This prospective study was performed between 2011 and 2015. All 150 patients were given 10 mg daily isotretinoin until a cumulative dose of 90-110 mg/kg.
RESULTS: The mean age was 26.6 years with 64.7% moderate acne, 29.3% severe, and 6% very severe. The mean cumulative dose was 98.8 ± 6.05 mg/kg. All 150 patients had total clearance with a mean time to clearance of 24.0 weeks. Patients with severe/very severe acne had higher cumulative dosage (102.1 vs. 97.0, P

Matched MeSH terms: Dermatologic Agents/administration & dosage*
Mometasone furoate cream reduces acute radiation dermatitis in patients receiving breast radiation therapy: results of a randomized trial

Hindley A, Zain Z, Wood L, Whitehead A, Sanneh A, Barber D, et al.

Int J Radiat Oncol Biol Phys, 2014 Nov 15;90(4):748-55.
PMID: 25585779 DOI: 10.1016/j.ijrobp.2014.06.033

We wanted to confirm the benefit of mometasone furoate (MF) in preventing acute radiation reactions, as shown in a previous study (Boström et al, Radiother Oncol 2001;59:257-265).

Matched MeSH terms: Dermatologic Agents/administration & dosage*
Fulltext Topical Lyogel Containing Corticosteroid Decreases IgE Expression and Enhances the Therapeutic Efficacy Against Atopic Eczema

Ng SF, Anuwi NA, Tengku-Ahmad TN

AAPS PharmSciTech, 2015 Jun;16(3):656-63.
PMID: 25511806 DOI: 10.1208/s12249-014-0248-y

Hydrocortisone cream intended for atopic eczema often produces unwanted side effects after long-term use. These side effects are essentially due to repeated percutaneous administration of the medication for skin dermatitis, as atopic eczema is a relapsing disorder. Hence, there is a need to develop a new hydrocortisone formulation that will deliver the drug more effectively and require a reduced dosing frequency; therefore, the side effects could be minimized. In this study, a hydroxypropyl methylcellulose (HPMC) lyogel system based on 80% organic and 20% aqueous solvents containing 1% hydrocortisone was formulated. The hydrocortisone lyogel physicochemical characteristics, rheological properties, stability profile, and in vitro Franz cell drug release properties, as well as the in vivo therapeutic efficacies and dermal irritancy in Balb/c mice were investigated. The HPMC lyogel appeared clear and soft and was easy to rub on the skin. The lyogel also showed a higher drug release profile compared with commercial hydrocortisone cream. Similar to the cream, HPMC lyogels exhibited pseudoplastic behavior. From the mouse model, the hydrocortisone lyogel showed higher inflammatory suppressive effects than the cream. However, it did not reduce the transepidermal water loss as effectively as the control did. The dermal irritancy testing revealed that the hydrocortisone lyogel caused minimal irritation. In conclusion, HPMC lyogel is a promising vehicle to deliver hydrocortisone topically, as it showed a higher drug release in vitro as well as enhanced therapeutic efficacy in resolving eczematous inflammatory reaction compared with commercial cream.

Matched MeSH terms: Dermatologic Agents/administration & dosage
Metformin as an adjunct therapy for the treatment of moderate to severe acne vulgaris: A randomized open-labeled study

Robinson S, Kwan Z, Tang MM

Dermatol Ther, 2019 07;32(4):e12953.
PMID: 31044492 DOI: 10.1111/dth.12953

Insulin, insulin-like growth factor-1 (IGF-1) and essential amino acids activate the mechanistic target of rapamycin complex 1 (mTORC1), the main nutrient-sensitive kinase. Metformin, through inhibition of mTORC1 may improve acne. A 12-week, randomized, open-labeled study evaluated the efficacy and safety of metformin as an adjunct for moderate to severe facial acne. In total, 84 patients received either oral tetracycline 250 mg bd and topical benzoyl peroxide 2.5% with or without metformin 850 mg daily. Evaluations constituted lesion counts, the Cardiff Acne Disability Index (CADI), metabolic parameters and treatment success rate (Investigators Global Assessment score of 0 or 1 or improvement of two grades). Treatment success rates were higher in the metformin group (66.7% vs. 43.2%; p = .04). The mean percentage reduction from baseline in total lesion counts at Week 12 was greater in the metformin group (71.4% vs. 65.3%; p = .278). The CADI scores showed a greater mean reduction in the metformin group (4.82 vs. 4.22; p = .451). Metformin was equally efficacious in improving acne in lean and overweight subjects. Gastrointestinal symptoms were noted in 31.7% of subjects on metformin. This study presents favorable data for metformin as an adjunct for acne treatment. Further randomized placebo-controlled studies are required.

Matched MeSH terms: Dermatologic Agents/administration & dosage*
Pruritic eruption on the chest

Chwen CC

J Fam Pract, 2014 Nov;63(11):677-9.
PMID: 25362492

The fact that this patient's rash was limited to his chest provided an important diagnostic clue.

Matched MeSH terms: Dermatologic Agents/administration & dosage
Emerging landscape in psoriasis management: From topical application to targeting biomolecules

Rapalli VK, Singhvi G, Dubey SK, Gupta G, Chellappan DK, Dua K

Biomed Pharmacother, 2018 Oct;106:707-713.
PMID: 29990862 DOI: 10.1016/j.biopha.2018.06.136

Psoriasis is a chronic autoimmune skin disorder affecting 2-3% of the world population. It has characteristic features such as increased keratinocyte proliferation and production of inflammatory mediators. The treatment involves various strategies including topical, systemic, phototherapy and biologics. Topical therapies are preferred for mild to moderate psoriasis conditions over the systemic therapies which are ideal in severe disease conditions. The systemic therapies include immunosuppressants, biological agents and recently approved phosphodiesterase-4 (PDE4) inhibitors. There are various limitations associated with the existing therapies where the new findings in the pathogenesis of psoriasis are paving a path for newer therapeutics to target at the molecular level. Various small molecules, PDE-4 inhibitors, biologics, and immunomodulator proved efficacious including the new molecules targeting Janus kinases (JAK) inhibitors that are under investigation. Furthermore, the role of genetic and miRNAs in psoriasis is still not completely explored and may further help in improving the treatment efficacy. This review provides an insight into various emerging therapies along with currently approved treatments for psoriasis.

Matched MeSH terms: Dermatologic Agents/administration & dosage*