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Use of Dermatologics during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Safe agents to treat acne during pregnancy are available and include topical agents, (such as topical erythromycin), keratolytics, and astringents. They may be safely used to treat acne during pregnancy. Topical steroids may also be safely used for the treatment of psoriasis during pregnancy. The major exception is triamcinolone, which should be avoided during pregnancy.
Disorders of Keratinization and Other Genodermatoses
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Roselyn Stanger, Nanette Silverberg
Management: Neonates require care in the neonatal intensive care unit, as they are at high risk of temperature and electrolyte dysregulation, skin and respiratory infections, sepsis, and fluid loss. Several topical agents can be used to help heal the skin, including emollients, gentle exfoliants, and topical steroids; however, topical tacrolimus should be avoided due to increased absorption leading to potentially toxic systemic levels. Topical keratolytics may be too irritating. Patients with pruritus may be given antihistamines. Nutrition is essential to help mitigate the effects of failure to thrive, and patients may benefit from the help of a professional nutritionist. Patients with anaphylaxis or other atopic tendencies can be referred to an allergist and/or pulmonologist. Biologic agents that have recently been described to improve clinical features include secukinumab and dupilumab.
Therapy For Skin, Hair and Nail Fungal Infections
Published in Raimo E Suhonen, Rodney P R Dawber, David H Ellis, Fungal Infections of the Skin, Hair and Nails, 2020
Raimo E Suhonen, Rodney P R Dawber, David H Ellis
Keratolytics may be used alone or in combination with drying or antifungal powders; oral therapy may be used if the infection is severe. The most common keratolytic is salicylic acid—e.g. 3% salicylic acid and 6% benzoic acid (Whitfield’s ointment).
The randomized trials of 10% urea cream and 0.025% tretinoin cream in the treatment of acanthosis nigricans
Published in Journal of Dermatological Treatment, 2021
Arucha Treesirichod, Suthida Chaithirayanon, Thitiwat Chaikul, Somboon Chansakulporn
The study has demonstrated that both treatments improve skin pigmentation with statistically significant difference. However, the efficacy of 0.025% tretinoin cream was greater than 10% urea in reducing hyperpigmentation associated with AN. Although, the mean M index from skin color assessment by Mexameter before treatment of the urea group was lower than the tretinoin group, the change of skin color in the reference area during the period of treatment was not statistically significant. The treatment efficacy assessed by IGE and PGE was congruent with the skin color assessment by Mexameter in a way that participants in the tretinoin treatment group had better skin improvement than the group treated with urea. The combined assessments using both Mexameter and global evaluation confirmed the result of treatment. Although the mechanisms of both treatments are not fully understood, retinoids affect epidermal turnover and improve fine and coarse wrinkling, pigmentation and roughness (5) while topical urea has been linked to proteolytic and keratolytic mechanism (6). Different concentrations of topical urea have different keratolytic effects. By using a higher concentration of topical urea, it might provide benefit to the treatment of hyperpigmentation associated with AN (7).
Emerging drugs for the treatment of hidradenitis suppurativa
Published in Expert Opinion on Emerging Drugs, 2020
Alecia S Folkes, Faris Z Hawatmeh, Alan Wong, Francisco A Kerdel
Mild to moderate HS is treated with non-biologic therapies including topical and intralesional therapies. Topical treatment includes keratolytics, which are aimed to minimize follicular plugging [10]. Antiseptics, oral, and/or topical antibiotics are used to decrease bacterial colonization and inflammation [10]. Clindamycin 1% lotion or solution is a commonly used topical antibiotic. Oral tetracyclines are the most commonly used systemic antibiotics, but a combination of oral Clindamycin with Rifampin has proven efficacious as well [10]. North American guidelines recommend isotretinoin as second- or third-line treatment for HS patients with concomitant moderate to severe acne [10]. Intralesional corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), and topical lidocaine have been used to reduce acute pain and reduce inflammation [10]. Nonpharmacologic interventions include smoking cessation, weight loss, and dietary modifications (e.g. avoidance of dairy) [10].
Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas
Published in Expert Opinion on Pharmacotherapy, 2018
Dario Kivelevitch, Jillian Frieder, Ian Watson, So Yeon Paek, M. Alan Menter
Keratolytics, such as salicylic acid (SA) 5–10%, are often used as initial therapy to reduce hyperkeratosis. After 4 weeks of SA 6% treatment, 60% of patients showed complete or nearly complete scalp clearance [24]. SA in combination with high-potency topical corticosteroids is more efficacious than either as monotherapy [25]. Side effects include local irritation (i.e. burning, dryness, peeling), as well as systemic symptoms of nausea, vomiting, tinnitus, headache, and temporary shedding of telogen hair. Systemic toxicity generally occurs with serum levels of 30–40 mg/100 ml, with risk increased after prolonged topical treatment of a large BSA (>20%), occlusion therapy, or cases of significant renal or hepatic impairment [26]. SA can reduce the efficacy of calcipotriol and should be avoided before phototherapy due to its photoprotective effects at concentrations ≥ 0.1% [27].