In deciding which therapy to use, many factors must be taken into consideration, including safety, efficacy, availability, and cost. Long-term side effects will, of course, become better known as experience with each therapy grows. In particular, biologic medications are already in their second decade of use in rheumatology, but there is much less experience than…
Rosacea is still a mystery with regards to etiology but it has been suggested that the Demodex mite might be associated with its presence and/or severity. Canthelicidines are antimicrobial peptides that protect the skin through: direct antimicrobial activity by initiating a hosp response resulting in cytokine release, inflammation, angiogenesis and reepitheliazation. In rosacea the…
Acitretin, like all retinoids, promote the differentiation of keratinocytes. It is useful in combination with other therapies, particularly with phototherapy, or as a maintenance therapy after control with a faster reacting agent. Dosing of acitretin is usually started at 10-25 mg per day, with a slow titration up in dose. Recent studies have shown that…
Acne scarring is a common complaint in acne patients. This is a visible sequlae of active acne and persists for a lifetime. Treatments can be costly and include chemical peels and fractionated CO2 laser therapy. This study measures the effect of adapalene in the treatment of acne scars Methods prospective study single-center, open-label, pilot study…
Adalimumab is a monoclonal antibody against TNF. It is currently approved for the treatment of psoriatic and rheumatoid arthritis and ankylosing spondylitis. Dosing is 40 mg subcutaneously every other week. Phase III trial results showed excellent results in the treatment of psoriasis. There has also been a recent placebo controlled trial presented comparing methotrexate to…
Infliximab is a chimeric monoclonal antibody against TNF, with human constant regions and murine variable regions. Studies have shown that it is the most effective biologic agent for the treatment of psoriasis at the usually prescribed doses. Since dosing is weight-based (start 0.5 mg/kg on weeks 0, 2, and 6, then 0.5 mg/kg every 8…
Cryotherapy is a mostly destructive method and therefore biopsies tend to be less reliable but it does act through other mechanisms: direct injury: location: center of the lesion when: acts when the lesion is frozen vascular injury: location: periphery of the lesion when: acts upon thawing (reheating) of the lesion apoptosis: location: periphery of the…
Etanercept is a fusion protein consisting of two tumor necrosis factor (TNF) receptors linked to the Fc protein of human immunoglobulin (IgG). It works by inhibiting the pro- inflammatory action of TNF in psoriasis. Patients inject the medication subcutaneously, with dosing either at 50 mg weekly (either as a single dose or divided into two…
Systematic review of oral treatments for seborrheic dermatitis. Gupta AK, Richardson M, Paquet M. J Eur Acad Dermatol Venereol. 2014 Jan;28(1):16-26. doi: 10.1111/jdv.12197. Epub 2013 Jun 26. Seborrheic dermatitis (SD) is a common inflammatory disorder which affects: the scalp where it creates flaking of the skin or what is known as common dandruff (Pityriasis capitis).…
Outline: Acne Vulgaris – New Insights From The Bench To The Clinic + overstimation of the risks of oral isotretinoin Recent advances in acne research have allowed a better understanding of the pathogenesis and etiological factors associated with acne: sebum overproduction by sebaceous glands is influenced by: dihydrotestosterone (DHT) Insulin-like Growth Factor (IGF)-1 PPAR ligands…
