1,721,288 research outputs found
Topical Therapies for Psoriasis: Improving Management Strategies and Patient Adherence
No full textPsoriasis is a chronic disease that has a substantial effect on quality of life of patients and often needs long-term treatment. Topical treatments for psoriasis include corticosteroids, vitamin D derivatives, tazarotene, anthralin, tacrolimus, pimecrolimus, and newer formulations of tar. Although many of these treatments are effective, they must be prescribed appropriately and used consistently for a period of weeks to months before clinical evidence of improvement can be seen and patients perceive that the treatment is working. As such, medication dosage/schedule, choice of vehicle, and especially patient adherence to medication are key factors for a treatment to be effective. Addressing patient preferences about treatments and concerns about treatment-related toxicities and managing their expectations represent additional aspects of patient care. Therapies such as calcipotriene and betamethasone dipropionate (Cal/BD) fixed combination foam and new drugs and vehicles continuously enhance the treatment landscape for psoriasis. Because adherence to topical treatment can be a major difficulty, keeping the treatment regimen simple and using new and sophisticated treatment vehicles that are acceptable to patients can likely improve treatment outcomes
Understanding Onychomycosis Resolving Diagnostic Dilemmas
No full textNo scientifically rigorous, large, prospective studies have been done to document the true prevalence of onychomycosis; the reported rates vary mainly by climate and by population, but the overall prevalence in the United States is estimated to be at least 10%. Advanced age and diabetes are the most commonly reported risk factors for onychomycosis. The differential diagnosis of onychomycosis is lengthy, and visual inspection alone is not sufficient for a definitive diagnosis-direct microscopic examination of a wet-mount preparation with 10% to 20% potassium hydroxide is the first-line diagnostic test
Topical Treatments in Acne Vulgaris: Guidance for the Busy Dermatologist
No full textAcne is a very common skin disease; frequently seen in adolescents and often persisting or occurring into adulthood. Topical therapy is very effective in mild to moderate disease, and is used as maintenance therapy. Fixed combination products have been studied in moderately severe disease. Combinations of benzoyl peroxide and either clindamycin or adapalene appear very effective. When utilizing a topical retinoid alone or in combination, it is essential to incorporate an appropriate skin care regimen to minimize local irritation. In the absence of direct comparative clinical trials, this review provides timely guidance for clinicians on the use of these agents, and their benefits in special populations
Acne: What\u27s New
No full textAcne vulgaris is one of the most prevalent skin conditions. Antibiotics, when considered, are most effective in combination with other therapies, and limited evidence suggests that submicrobial doses of antibiotics may improve acne without increasing the risk for antibiotic resistance. A small but significant risk for inflammatory bowel disease has also been identified in children treated with multiple courses of antibiotics. New topical agents are expanding therapeutic options for acne. Semin Cutan Med Surg 35(supp6):S114-S116
A phase 3 randomized, double-blind trial comparing the efficacy and safety of the fixed combination calcipotriene 0.005% (Cal) and betamethasone dipropionate 0.064% (BD) aerosol foam with the aerosol foam vehicle used twice weekly as long-term maintenance
No full textBackground: Psoriasis is a chronic inflammatory skin disease requiring long-term treatment for most patients. Topical maintenance treatment regimens consisting of a corticosteroid and a vitamin D analogue have shown to be effective and well tolerated. However, since these regimens require the use ofmultiple products on different days, which may be challenging for a patient in terms of adherence, a fixed combination treatment for maintenance ofresponse would provide a convenient alternative. The calcipotriene 0.005% and betamethasone dipropionate 0.064% (Cal/BD) aerosol foam was developed to improve psoriasis treatment. The clinical efficacy and safety ofthis Cal/BD foam formulation has been documented in vehicle and active-comparator trials of 4 and 12 weeks\u27 duration. Objectives and Trial Design: The present trial will evaluate the long-term efficacy and safety of a Cal/BD aerosol foam twice weekly maintenance regimen compared to vehicle in patients with mild-to-severe plaque psoriasis. During an initial 4-week, openlabel period, all patients will be treated once daily with Cal/BD aerosol foam. Patients who achieve treatment success (a Physician\u27s Global Assessment [PGA] score of ?clear\u27 or ?almost clear\u27 with at least a 2-step improvement) atWeek 4 will be randomized to either active treatment or vehicle twice weekly (3 to 4 days apart) for up to 52weeks. Relapses (PGA score of at least ?mild\u27), will be treated with Cal/BD aerosol foam once daily for up to 4 weeks until clearance is achieved; then twice weekly maintenance regimen will be resumed. If clearance is not regained within 4weeks, thepatients will leave the trial. Thus, the trial will compare two ways of using Cal/BD aerosol foam: a proactive approach with fixed twice-weekly maintenance regimen versus a conventional, reactive approach. The primary endpoint is time to first relapse. A total of 380 patients will be randomized in the trial, which is recruiting at approximately 50 sites in 5 countries. It is planned to enrol the first patient in Q4 2016. The results from this trial will add significantly to our knowledge on maintenance treatment of plaque psoriasis. Important data on long-term safety and efficacy of Cal/BD aerosol foam will be generated to show the potential of a convenient, well-tolerated fixed combination treatment for the maintenance of remission
Optimizing the use of topical agents in psoriasis
No full textThe vast majority of patients with psoriasis have localized disease that is manageable by topical therapy alone, and patients with more severe disease still require topical treatment for plaques that persist despite effective systemic treatment or phototherapy. Nevertheless, little attention today is paid to topical therapy, including new topical treatments.This article briefly addresses key issues that can adversely affect the use of and compliance with currently available topical treatments, as well as new and emerging topical agents for psoriasis
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