1,721,134 research outputs found
Ciclopirox Hydroxypropyl Chitosan: Efficacy in Mild-to-Moderate Onychomycosis
No full textThe severity and percentage of nail involvement are usually considered the main prognostic factors for the treatment of onychomycosis. This study investigated the efficacy of P-3051 (ciclopirox [CPX] 8% nail lacquer in hydroxypropyl chitosan technology) in a population subset of the pivotal study, selected according to the criteria used in recent onychomycosis pivotal studies. The original study was a multicenter, randomized, three-arm, placebo-controlled, parallel groups, evaluator-blinded study comparing P-3051 with reference CPX (standard, insoluble 8% CPX nail lacquer) and placebo (P-3051 vehicle) in a 2: 2: 1 ratio, applied once daily for 48 weeks to 467 patients with onychomycosis, followed by a 12-week follow up. The primary endpoint was complete cure (negative mycology and 100% clear nail) at the end of treatment. Among the secondary endpoints, response rate (negative mycology and ≥90% clear nail) and negative culture were chosen as most representative for a clinical setting. A population subset (modified intention-to-treat population, 302 patients) was selected, excluding those with more severe disease (> 50% nail involvement), in line with recent onychomycosis pivotal trials. P-3051 was superior to placebo in all parameters but culture at week 60 and was superior to reference CPX in cure and response rates at week 60. Compared to the overall patient population, efficacy rates in the P-3051 group were higher in the subset excluding patients with nail involvement > 50%. Results increased by 33% (from 5.7 to 7.6%) at week 48 and by 19.0% (from 12.7 to 15.1%) at week 60 for cure rate, by 33% (from 24.0 to 31.9%) and 20% (from 28.7 to 34.5%) for response rate, and by 3% (from 89.1 to 91.6%) and 4.0% (from 79.0 to 82.4%) for culture conversion to negative. This post hoc analysis confirms that the severity of onychomycosis is a prognostic factor for responsiveness to antifungal treatments and that this can significantly affect reported efficacy data. The different inclusion criteria should be taken into account when reviewing the efficacy of antifungal agents from different studies
Reassurance on the safety of biotin in dermatology.
No full textReassurance on the safety of biotin in dermatology
Onychoscopy: Dermoscopy of the Nails
No full textOnychoscopy is the examination of the nail unit using a dermoscope. The dermoscopic criteria for a valid diagnosis have been developed and assessed in numerous papers. However, in all nail alterations that are suspicious or potentially malignant, a surgical intervention with subsequent histopathological evaluation should be performed. A simple visualization may not be helpful in diagnosing many nail conditions nor is a nail biopsy diagnostic in all cases. Onychoscopy is a valuable aid in enhancing visible nail features and in revealing cryptic features of diagnostic value
Rapid cosmetic improvements in nail psoriasis patients treated with K101-03
No full textBackground Nail psoriasis can cause embarrassment and stigmatization. A therapy that produces rapid cosmetic improvements could therefore make a difference to patients. Objectives Data from an 8‐week open-label multicenter study were analyzed to assess the efficacy of K101-03, a Nail psoriasis containing propylene glycol, glycerol, urea and lactic acid, in adult patients with nail psoriasis. Patients and Methods Patients (n=35) applied K101-03 to their affected nails once daily for 8 weeks. They rated the overall appearance of a selected nail (the “target” nail) versus baseline on a 4‐point scale after 1, 2, 4 and 8 weeks of treatment. At the same time points, they also assessed whether, compared to baseline, the target nail was less thickened, less discolored, less brittle and softer. Results After 8 weeks of K101‐03 treatment, the overall appearance of the target nail was improved in 94.1% of patients (95% confidence interval [CI] 86.2–100). After 1 week of treatment, 70.6% of patients (95% CI 55.3–85.9) reported an overall improvement in the target nail and 52.9% of them reported that their target nail was less discolored. Three‐quarters of patients reported softening of their target nail after 8 weeks of treatment. Conclusion In summary, K101-03 rapidly improved the appearance and other physical attributes of nails affected by psoriasis
Periungual Pyogenic Granuloma: The Importance of the Medical History.
No full textPyogenic granuloma (PG) is a common, benign vascular proliferation that can arise on the skin or subcutaneous tissue. It is more frequent in the early decades of life, and the most common locations are the digits of both hands and feet. The most common cause of periungual PG is drug intake, but many other trigger factors have been described in the literature. Treatment should be chosen according to the cause. We describe 2 particular cases of periungual PG in which the clinical history has been fundamental. In the first case, there was an underlying hand eczema, and in the second case, a foreign body was present
Treatment of nail psoriasis with topical application of clobetasol propionate 0.05% solution: a pilot study.
No full textAbstracts: BACKGROUND: Nail psoriasis affects 50% of patients with skin disease and may occur in the absence of skin lesions. The course is typically chronic, with fingernails affected more commonly than toenails. For this reasons, impairment of cosmetic appearance and of fingernail function are typical complains. Treatment of psoriasis limited to the nails is not standardized, as it depends on severity of nail changes and number of nail affected. Topical therapies include drugs vehicled in creams and ointments that are often scarcely liked by patients, resulting in poor compliance and low efficacy. OBJECTIVE: The aim of our study was to evaluate the efficacy, tolerability and patient’s compliance of topical therapy with clobetasol propionate 0,05% vehicled in a solution in nail psoriasis. METHODS: 15 patients (8 females and 7 males aged 18-50 years), affected by isolated nail psoriasis of 1 to 3 digits, were prescribed topical therapy with clobetasol propionate lotion to be applied on the affected nail once a day for 4-6 months. 8 patients presented nail bed psoriasis with onycholysis and subungual hyperkeratosis, while 7 patients had also signs of matrix disease. Periodic evaluation (every 2 months) of treatment efficacy was performed by iconography. At the end of the treatment period, efficacy was evaluated also by the experimenter and by the patient, who also gave his/her opinion about tolerability and easiness of application. RESUTS: All patients concluded the study, with marked improvement of the nail signs seen in 10 patients and complete resolution in 5. Nail bed disease responded better than matrix diseases, as expected. No side effects were recorded. All patients judged the treatment easy to apply and effective. CONCLUSIONS: The lotion composed by clobetasol propionate 0,05% is an effective and safe option for topical therapy of nail psoriasis
Poliosis and Neurofibromatosis Type 1: Two Familiar Cases and Review of the Literature.
Full text linkTwo brothers were referred to our clinic for reevaluation of neurofibromatosis type 1 (NF1). Both brothers presented a peculiarity that is not so common in NF1: poliosis overlying plexiform neurofibromas on the scalp. Poliosis overlying plexiform neurofibromas is rarely reported in the literature. The peculiarity of our cases is the familiarity and the presence of poliosis in the same locatio
Management of mycoses in daily practice.
No full textThe guideline recommendations, albeit founded on thorough reviews of clinically relevant literature data, are often not immediately adaptable to everyday life. Considering the marked heterogeneity of superficial mycoses, each of them requires specific management in a real life context; in all cases diagnostic confirmation is required with microscopic and culture examination. In tinea capitis oral therapy is necessary (minimum six weeks) and should be continued until clinical and, above all, mycological healing. In cases of tinea corporis, cruris or pedis, it may be necessary to associate oral therapy to topical treatment. The main oral antifungals are fluconazole, itraconazole and terbinafine. Fluconazole has favorable pharmacokinetic and pharmacodynamic characteristics, and is effective in most superficial mycoses, for example in cases of diffuse or recurrent pityriasis versicolor in which oral therapy with an azole derivative is useful. Topical treatment, lasting 6-12 months, is indicated in onychomycosis that is confined to one nail. In frequent cases of onychomycosis involving multiple nails or recurrence, oral therapy is necessary. Pharmacological history is important, given the possible interactions of some systemic drugs. In chronic or recurrent relapsing vulvovaginitis, first-choice therapy is oral fluconazole with a therapeutic regimen that respects the mycotic biorhythm (200 mg on days 1, 4, 11, 26, and subsequently 200 mg/week for 3 months)
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