Dermatology

Conventional treatment options for hypertrichosis and hirsutism are tedious and time consuming. Laser hair removal offers an efficient way to permanently reduce excessive hair growth.

Update on: Aminolevulinic Acid Levulan Photodynamic Therapy G-3139 Genta Inc Moxifloxacin HCl Avelox Ciclopirox Loprox 8% Topical Solution 5-fluorouracil Solex Allovectin-7 Vical Inc

Localized scleroderma, or morphea, is a chronic disease that causes a thickening and induration of the skin. For plaque type morphea, the treatments include super-potent corticosteroids and calcipotriol. For the more generalized forms, as well as the linear forms, UVA is currently the best therapeutic modality.

Update on: Pyrethrins/Piperonyl butoxide Rid aerosol foam mousse Fluocinolone acetonide 0.01% Derma-Smoothe/FS Quinupristin/ Dalfopristin Synercid IV Rid Lice Egg Loosener Gel Tacrolimus Protopic Ointment Docosanol

Topical acne treatment can positively benefit patients with acne. This review summarizes clinical and prescribing information on currently available topical agents. The efficacy of the medications included in this report is supported by properly designed randomized clinical trials.

Scabies and lice have afflicted man since ancient times. Permethrin is generally the treatment of choice for head lice and scabies, because of its residual effect. Toxicity and absorption are minimal. Ivermectin should be reserved for cases where permethrin fails.

Update on: Alendronate Fosamax Alitretinoin Panretin Gel 0.1% Malathion Ovide 0.5% Lotion Abacavir Sulfate Ziagen Interferon alpha-2a Roferon-A Lidocaine Patch 5% Lidoderm Pexiganan acetate Locilex cream 1% Aminolevulinic acid Levulan Photodynamic Therapy Ketoconazol Teva Antiviral Agents Antirejection Therapy

There are three electrolysis modalities. In galvanic electrolysis, a direct electric current is passed down a needle inserted into the hair follicle, destroying the follicle. In thermolysis a high frequency alternating current is passed down the needle and produces destructive heat.

Corticosteroids have dominated the class of anti-inflammatory agents for the past 50 years. In the last ten years, new corticosteroids have been developed for topical use. Characteristics common to these several chemically different corticosteroids are their class III, or high potency designation and their improved safety profile.

Update on: Mupirocin Bactroban® Roxithromycin Rulid® Temoporfin Foscan®Fluticasone propionate Cutivate® Cream 17-Beta-Estradiol Vagifem® Itraconazole injection Sporanox® IV injection Becaplermin Regranex® Gel 0.1% Lidocaine/prilocaine EMLA® cream

Adatosil® is a viscous silicone oil which was granted FDA approval in 1994. This designation removes the legal obstacles to usage for soft tissue augmentation. However, physicians are advised to exercise discretion when using this product.

Cyanoacrylates are surgical adhesives that provide another option for wound closure. There are a number of surgical adhesives either currently available or under development. The presently available butylcyanoacrylates and octylcyanoacrylates are reviewed.

Botulinum toxin type-A (BTX-A) is a neurotoxin which blocks presynaptic release of acetylcholine. It interferes with neuromuscular transmission, temporarily paralyzing the affected muscle. Of special interest for dermatologists is the unlabelled cosmetic applications, for conditions such as wrinkles and hyperhidrosis.

Update on: Methoxsalen Uvadex Becaplermin 0.01% Regranex®Aldesleukin Proleukin®Post-herpetic neuralgia Lidoderm® patch Betamethasone valerate foam Luxiq® 0.12% Paclitaxel Taxop®Dietary supplements, Temozolomide Temodal®Terbinafine HCl cream 1% Lamisil®

A review of this list of agents that are presently undergoing clinical trial. Although only a few of the drugs on this list will gain regulatory approval, what is exciting is the likelihood that some new agents will be approved and will radically alter the way we treat psoriasis.

Diane-35®, known as Dianette® in some countries, is a combination of cyproterone acetate 2 mg and ethinyl estradiol 0.035 mg. It has recently received regulatory clearance in Canada, but has not yet been approved by the US FDA.

Update on: Imiquimod Aldara® Cream Abacavir Ziagen® Finasteride 1 mg tablets Propecia® Lyme disease vaccine LYMErix®Aldesleukin Proleukin®Varicella Vaccine Varivax®Minoxidil Taisho

Drug Treatments Introduced in 1998

This review concentrates on those drugs which have been clearly shown, or are widely reputed, to make psoriasis worse. There is insufficient clinical evidence to justify the inclusion of many drugs which have been included in published lists of drugs said to exacerbate psoriasis.

Update on: Lidocaine 2.5%, prilocaine 2.5% Emla® patch Cyclosporin SangCya®Metronidazole lotion 0.75% Metrolotion® Imiquimod Aldara® 2-octylcyanoacrylate Dermabond Topical Skin Adhesive®Alitretinoin gel 0.1% Panretin®Loratidine Claritin®Cetirizine Zyrtec®Penciclovir Denavir®Lyme disease vaccine LYMErix®

Onychomycosis has a significant impact on the patient. With three new, orally effective, antifungal agents, we have for the first time effective treatment that can provide benefit for a high percentage of patients. This review examines some of the areas of uncertainty and controversy.

Never before have so many people sought our assistance to help get get rid of their wrinkles. Until recently, most biological materials presented shortcomings – resorption within months, allergic reaction, and on occasion, foreign body or granuloma formation at the site of injection.

Update on: Efavirenz Sustiva® Nevirapine Viramune®Famciclovir Famvir®Cetirizine Zyrtec® Rifapentine Priftin® Denileukin diftitox Ontak® Doxorubicin Caelyx® Graftskin Apligraf® Dangers of alternative medicine, Protease inhibitors during pregnancy

Some of the most striking advances in dermatology have followed the off-label use of drugs. This review examines some of the issues surrounding off-label use of drugs by dermatologists, illustrates the need for such use and looks at possible changes in the regulatory system.

Update on: Famciclovir Famvir® Acyclovir sodium Zovirax® Calcipotriol Dovonex® Thalidomide 50 mg Thalomid® Finasteride 1mg tablets Propecia® Aids vaccine Aidsvax® phase III, Indinavir Crixivan® Calcipotriene 0.005% Dovonex®ointment

We review the various controversies surrounding sunscreen use.

Approximately 50% of patients with psoriasis have nail psoriasis but the life time chance of nail changes must be much higher. Nail changes in psoriasis include pitting, thickening, onycholysis, discoloration, oily spots, splinter hemorrhages and paronychia. Treatment of choice depends on the form the psoriasis takes.

Estimates of the percentage of patients with cutaneous lichen planus (LP) who also have oral LP vary from somewhere between a third and a half 1-3, to as high as 70% and even higher when the cutaneous lesions are of long duration.

Update on: Diclofenac sodium Solarase Gel 3% Trovafloxacin (oral) Alatrovafloxacin (IV) Trovan Zidovudine 300 mg/ lamivudine 150 mg Combivir Hydroquinone 4%, glycolic acid & an antioxidant complex. Lustra 10% Docosanol Cream Bleomycin ANDA Leprosy vaccine Minocycline Minocin Protease inhibitor side-effects

On the 26th of February 1998, Hoffmann-LaRoche, on the instructions of the FDA, sent out more than 210,000 Dear Dr. warning letters to health care providers communicating new safety information about the prescribing of isotretinoin for acne, and citing isolated reports of drug-induced depression, psychosis and rarely, suicidal thoughts and action.

Alpha-hydroxy acids (AHAs) are naturally occurring organic carboxylic acids such as glycolic acid, a natural constituent of sugar cane juice and lactic acid, found in sour milk and tomato juice. Topical formulations incorporating these acids are now frequently used or prescribed by dermatologists.

Update on: Norgestimate / Ethinylestradiol Tri-Cyclen® Lidocaine/Prilocaine Cream Emla®Tretinoin gel 0.025% Avita® Adapalene solution 0.1% Differin®Topical tissue adhesive Dermabond® Atorvastin calcium Lipitor® Isotretinoin Accutane®

Tinea capitis, the most contagious of all the tineas caused by dermatophytes, has been described as a scourge of young children. Children are most susceptible before puberty, and the infection develops less commonly in older age groups.

Finasteride 1 mg (Propecia®, Merck) was approved by the US FDA December, 1997 for the treatment of male pattern hair loss (androgenetic alopecia, AGA) in men only. Safety and efficacy were demonstrated in men between 18 and 41 years of age with mild to moderate hair loss of the vertex and anterior mid-scalp area.

Update on: Mupirocin calcium cream 2% Bactroban Cream® Butenafine cream Mentax®Becaplermin gel 0.01% Regranex®Finasteride 1mg tablets Propecia®Minoxidil 5% Rogaine Extra Strength for Men® Dermagraft® Graftskin® (apligraf) UV light as carcinogen

Clinical rosacea is not a single disease but rather a combination of cutaneous stigmata which include flushing, erythema, telangiectasia, facial edema, papules, pustules, ocular lesions, and rhinophyma. A review of rosacea, treatment, and management.

For Erythema Nodosum Leprosum there are no good alternative treatments to thalidomide. ENL is a severe and painful complication for approximately half of all leprosy patients, affecting about two million people worldwide. A review of thalidomide.

Update on: Amphotericin B Lipid Complex Injection Abelcet® Butenafine HCl Cream 1% Mentax® Itraconazole Sporanox® Acitretin Soriatane® Penciclovir cream 1% Denavir® Valacyclovir  Valtrex® Laser device Sharplan Silktouch laser®Permethrin lotion Nix®Ivermectin Mectizan® (6 mg tablet) 

Antibiotic prophylaxis aims to prevent wound infections and provide adequate antibiotic cover for patients with prostheses or at risk for endocarditis. Most recommendations are based spread of risk factors may not accurately predict the risks for patients. A case for prophylaxis is made.

Imiquimod is an immune response modifier. Studies have shown that it has potent immunomodulatory effects and stimulates human peripheral mononuclear cells to release interferon alpha, sub-types α1,α2, α5, α6, and α8.