How does cryosurgery/cryotherapy work ? Cryotherapy acts by taking the heat out of tissues. To take the heat out conduction of heat is important: it is highest for metals ( for example with probes), then ice (for example freezing just after having done it once), then water (by wetting the lesion to be treated and…
DetailsRosacea is a common dermatological condition affecting 0,5 – 1 % of the population which represents over 15 million individuals in the United States It is sometimes classified in stages 1 (erythema and telangiectasia), 2 and 3 (rhinophyma). It is an important cause of distress and social withdrawal. Around 60% of individuals with stage 1…
DetailsIn 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…
DetailsRosacea 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…
DetailsAcitretin, 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…
DetailsAcne 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…
DetailsAdalimumab 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…
DetailsInfliximab 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…
DetailsCryotherapy 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…
DetailsEtanercept 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…
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