Search

Tretinoin, or retinoic acid, is a compound related to vitamin A which has improved skin that has been aged by sun exposure. Of 30 patients who participated in a four-month study, 21 continued tretinoin treatment for 10 months, and 16 continued for 22 months. Patients who did not continue treatment cited inconvenience or objection to further biopsies, but not lack of effectiveness, as the reason. Evaluation of patients receiving the more prolonged treatment showed that improvement of skin appearance and structure continued in spite of reductions in the dosage or frequency of treatment. Most improvements occurred during the first 6 to 10 months of therapy. Besides continued improvement of skin wrinkling and texture, 71 percent of liver spots disappeared. Other notable changes associated with treatment were increased skin pinkness, which was not adverse, and skin dryness with a red, flaking dermatitis, which diminished with continued treatment. There was no difference in adverse effects at different doses of tretinoin. Anatomic changes and the persistence of improvement for two months after therapy was discontinued indicate that tretinoin alters basic skin structure rather than causing a transient, superficially beneficial, swelling of the skin. The study suggests that tretinoin is likely to benefit sun-aged skin. (Consumer Summary produced by Reliance Medical Information, Inc.)

Alopecia areata is the loss of hair in sharply defined patches, usually involving the scalp or beard, and accounts for two percent of dermatologic outpatient visits. The disease may also occur in severe forms such as the total loss of scalp hair, alopecia totalis, or the total loss of body hair, alopecia universalis. Alopecia areata has been treated with various forms of therapy including corticosteroids, ultraviolet light, minoxidil, and topical cyclosporine. Cyclosporine prevents the activation of a type of immune cell, the T helper cells, which may be involved in the pathogenesis of alopecia areata. The effectiveness of cyclosporine given orally, or by mouth, was evaluated for 12 weeks in six patients with alopecia areata. Three patients had alopecia universalis, one had alopecia totalis, and two had patchy alopecia areata of the scalp. Hair regrowth occurred within the second and fourth weeks of treatment initially on the scalp and later on the face, chest, pubic area, extremities, and axilla or armpit region. Hair regrowth on the scalp, that was considered cosmetically acceptable, occurred in three patients. There was significant hair loss in all patients within three months of stopping drug treatment. Hair regrowth was associated with changes in the hair follicles and in the immune cells, such as the T helper cells; these changes are described. The results indicate that cyclosporine is effective for the short-term treatment of alopecia areata; successful treatment is associated with changes in the immune cells within the hair follicle. (Consumer Summary produced by Reliance Medical Information, Inc.)

Systemic use of the immunosuppressive agent cyclosporin has been shown to be effective in the treatment of psoriasis, a common skin disorder characterized by circumscribed red patches covered by thick dry scales. Oral administration of cyclosporine has been associated with side effects that are related to the size of the dose given. Topical application of cyclosporine has not proved effective. To determine whether cyclosporine produces its effect on psoriasis by working systemically or locally on the lesion, six patients were studied. Each patient had one psoriasis lesion injected with cyclosporine, one with a pharmacologically neutral solution or vehicle, and one with saline solution. These injections were done three times a week for four weeks. All six psoriatic lesions injected with cyclosporine showed either complete or significant clearing when compared with the other lesions injected with vehicle or saline. When treatment was administered once a week, the effect was only minimal. It appears that cyclosporine does not have to be taken systemically to be effective. Failure of cyclosporine to work topically may be the result of inadequate penetration into the skin. (Consumer Summary produced by Reliance Medical Information, Inc.)