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The Journal of Investigative Dermatology Jul 1976Twenty-five years ago many of the topical remedies for superficial mycoses were irritating, toxic, or allergenic. Total x-ray depilation of the scalp was the accepted... (Review)
Review
Twenty-five years ago many of the topical remedies for superficial mycoses were irritating, toxic, or allergenic. Total x-ray depilation of the scalp was the accepted mode of therapy for tinea capitis. The introduction of topical nystatin for candidiasis and tolnaftate for dermatophytosis were major advances, but tinea capitis, onychomycosis, and chronic tinea pedis still presented problems. Soon after its introduction in 1958, griseofulvin became the definitive form of therapy for all types of dermatophytosis and played a major role in abolishing large-scale epidemics of tinea capitis in some countries. Recently, haloprogin and the imidazole derivatives, miconazole and clotrimazole, which are topically active against dermatophytes and Candida albicans, have become available. Selective indicator media for isolating dermatophytes are useful diagnostic tools, but quicker methods of diagnosis which require little interpretation are still lacking. Epidemiologic studies in Vietnam again revealed the effects of climate and occlusion on the prevalence, incidence, and severity of superficial mycoses and led to renewed interest in host susceptibility, environment, and prevention of infections.
Topics: Administration, Topical; Adult; Animals; Antifungal Agents; Arthrodermataceae; Candidiasis; Dermatomycoses; Female; Griseofulvin; Hair Removal; Humans; Male; Nystatin
PubMed: 778288
DOI: 10.1111/1523-1747.ep12513020 -
Clinical Medicine & Research Dec 2019Timolol is a commonly-used topical antiglaucoma medication and has proven to be highly efficacious for most recipients. Among the reported adverse events, the... (Review)
Review
Timolol is a commonly-used topical antiglaucoma medication and has proven to be highly efficacious for most recipients. Among the reported adverse events, the neuropsychiatric spectrum has been cited, albeit for a small proportion of those treated. This review summarizes the cumulative published experience of such side effects and assesses the quality of evidence. As for other beta-blockers, whether orally or topically administered, various central nervous systems dysfunctions have been detailed in either case reports or larger patient series. The adverse event commonly resolves following drug termination. Rigorous and more definitive studies of causation are lacking, and to some, such paucity has reduced the belief of a cause and effect relationship. Until otherwise proven, deference should be afforded to the potential for topical timolol to cause neuropsychiatric side effects, and at-risk patients should be closely monitored when they are prescribed this pharmacological agent.
Topics: Administration, Topical; Adrenergic beta-Antagonists; Central Nervous System; Central Nervous System Diseases; Glaucoma; Global Health; Humans; Incidence; Mental Disorders; Ophthalmic Solutions; Timolol
PubMed: 31462538
DOI: 10.3121/cmr.2019.1486 -
F1000Research 2019Onychomycosis is the most common affliction of the nail. It may be caused by dermatophytes, yeasts, and non-dermatophyte molds. Traditionally, oral antifungal treatments... (Review)
Review
Onychomycosis is the most common affliction of the nail. It may be caused by dermatophytes, yeasts, and non-dermatophyte molds. Traditionally, oral antifungal treatments have been used to treat the fungus, although they can be accompanied by side effects and drug interactions. Topical treatments provide an alternative modality, bypassing the systemic effects of oral drugs; recent research has centered on topical drug improvement and development. Physical and laser treatments are being used in conjunction with topicals, which may help penetrate the thick nail plate. In this review, techniques from all categories are outlined: both novel experimental approaches and progress and effectiveness of recently developed treatments. More long-term studies are required to determine the efficacy of various treatments, but cure rates are improved when patients adhere to treatments and follow preventative measures to avoid disease recurrence.
Topics: Administration, Oral; Administration, Topical; Antifungal Agents; Humans; Nails; Onychomycosis
PubMed: 31297182
DOI: 10.12688/f1000research.18646.1 -
Neural Regeneration Research Sep 2021Neurotrophins are a family of proteins that support neuronal proliferation, survival, and differentiation in the central and peripheral nervous systems, and are... (Review)
Review
Neurotrophins are a family of proteins that support neuronal proliferation, survival, and differentiation in the central and peripheral nervous systems, and are regulators of neuronal plasticity. Nerve growth factor is one of the best-described neurotrophins and has advanced to clinical trials for treatment of ocular and brain diseases due to its trophic and regenerative properties. Prior trials over the past few decades have produced conflicting results, which have principally been ascribed to adverse effects of systemic nerve growth factor administration, together with poor penetrance of the blood-brain barrier that impairs drug delivery. Contrastingly, recent studies have revealed that topical ocular and intranasal nerve growth factor administration are safe and effective, suggesting that topical nerve growth factor delivery is a potential alternative to both systemic and invasive intracerebral delivery. The therapeutic effects of local nerve growth factor delivery have been extensively investigated for different ophthalmic diseases, including neurotrophic keratitis, glaucoma, retinitis pigmentosa, and dry eye disease. Further, promising pharmacologic effects were reported in an optic glioma model, which indicated that topically administered nerve growth factor diffused far beyond where it was topically applied. These findings support the therapeutic potential of delivering topical nerve growth factor preparations intranasally for acquired and degenerative brain disorders. Preliminary clinical findings in both traumatic and non-traumatic acquired brain injuries are encouraging, especially in pediatric patients, and clinical trials are ongoing. The present review will focus on the therapeutic effects of both ocular and intranasal nerve growth factor delivery for diseases of the brain and eye.
PubMed: 33510063
DOI: 10.4103/1673-5374.306062 -
Dermatology Practical & Conceptual Feb 2022Atopic dermatitis is a Th2 disease, due to relapse of IL-4 and IL-13 by Th2 cells. Despite the approval by FDA of dupilumab, the first monoclonal antibody for the severe... (Review)
Review
Atopic dermatitis is a Th2 disease, due to relapse of IL-4 and IL-13 by Th2 cells. Despite the approval by FDA of dupilumab, the first monoclonal antibody for the severe forms, traditional drugs remain a milestone for the treatment of this dermatosis. Dermatologists need a good knowledge of all therapies for an integrated and personalized management of patients.
PubMed: 35223191
DOI: 10.5826/dpc.1201a155 -
Medicine Jul 2021Tranexamic acid (TXA) is an antifibrinolytic agent used to reduce bleeding in major surgical procedures. This study evaluates the efficacy and safety of the systemic and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Tranexamic acid (TXA) is an antifibrinolytic agent used to reduce bleeding in major surgical procedures. This study evaluates the efficacy and safety of the systemic and topical intra-articular administration of TXA in total hip arthroplasty (THA).
METHODS
Patients (N = 123) scheduled for primary unilateral THA were divided into 3 treatment groups: control group; TXA, systemic, repeated 1 g bolus; TXA, topically intra-articularly, 2 g in 50 mL saline. Primary readouts used were intra- and postoperative bleeding, transfusion requirement, postoperative hemoglobin levels and complications.
RESULTS
Both systemic and topical intra-articular TXA administrations decreased bleeding and transfusion requirements. Topical intra-articular use of TXA led to the reduction in intraoperative and postoperative bleeding and affected hemoglobin levels compared with control. Systemic administration of TXA led to a significant reduction of postoperative bleeding and transfusion rate compared with control and was not different in efficacy and complication incidence when compared to topical administration of TXA.
CONCLUSIONS
The use of TXA to reduce blood loss and transfusion requirements in THA is an effective and safe concept in practice. The dose of 2 g TXA topically intra-articularly and a repeated bolus of 1 g TXA systematic led to lower intra- and postoperative bleeding and a significantly lower transfusion rate than the control group. Topical intra-articular TXA administration could be a reasonable alternative in high-risk patients.
Topics: Administration, Intravenous; Aged; Antifibrinolytic Agents; Arthroplasty, Replacement, Hip; Blood Transfusion; Drug Monitoring; Female; Hemoglobins; Humans; Injections, Intra-Articular; Male; Postoperative Hemorrhage; Risk Adjustment; Slovakia; Tranexamic Acid; Treatment Outcome
PubMed: 34190197
DOI: 10.1097/MD.0000000000026565 -
The Journal of Clinical and Aesthetic... Aug 2021Laser resurfacing produces a controlled skin injury, resulting in a wound healing response. This wound healing response allows for collagen remodeling, which improves... (Review)
Review
BACKGROUND
Laser resurfacing produces a controlled skin injury, resulting in a wound healing response. This wound healing response allows for collagen remodeling, which improves skin texture and tone. Topical agents are often employed following laser treatments to facilitate recovery. The introduction of newer small-molecule technologies allow for improved recovery and cosmesis.
OBJECTIVE
We sought to perform a critical review of the safety and efficacy of newer small-molecule technologies employed following laser resurfacing.
METHODS
We performed a PubMed search of the generic name of the following topicals and included literature relevant to laser procedures, with an emphasis on laser resurfacing: thermal spring water, conjugated linolenic acid, vitamin C/vitamin E/ferulic acid serum, tripeptide/hexapeptide technology-containing products, growth factor serum and gel, recombinant human epidermal growth factor ointment and gel, red deer umbilical cord lining mesenchymal stem cell extract cream and serum, silicone-based gel, and microparticulate (1-3, 1-6 beta-glucan) gel.
RESULTS
Our search of the PubMed database yielded 62 results, out of which 17 clinical studies were included in this publication. The majority of aforementioned topicals show promise in terms of improving post-resurfacing recovery or cosmesis.
CONCLUSION
Clinical data regarding these agents is limited by the number and quality of studies. It is therefore challenging to propose a recommendation supporting any particular topical. We provide our own provider-specific post-laser resurfacing protocols to offer insight regarding new small-molecule technologies.
PubMed: 34840654
DOI: No ID Found -
Asian Journal of Pharmaceutical Sciences May 2020Dermatological disorders have a huge psychosocial impact, causing significant impairment of patient's life. Topical therapy plays a pivotal role in management of such... (Review)
Review
Dermatological disorders have a huge psychosocial impact, causing significant impairment of patient's life. Topical therapy plays a pivotal role in management of such disorders. Conventional topical delivery systems result in overmedication/undermedication, leading to adverse effects and reduction in therapeutic efficacy. Consequently, researchers have been striving towards the development of alternative delivery systems for dermatological applications. In the last decade, microsponges emerged as an attractive option for topical delivery. Their characteristic particle size offers enhanced benefits, making them superior to the contemporary microcarriers. The present review furnishes a comprehensive account of state of the art, important factors affecting the performance and mechanism of drug release from topically applied microsponges, along with characterization techniques. Further, a list of marketed products and their applications for common dermatological disorders has been presented. All in all, this paper is an attempt to lay a bibliographic foundation for researchers working in this field and foster further investigations in this arena.
PubMed: 32636947
DOI: 10.1016/j.ajps.2019.05.004 -
International Wound Journal Oct 2019Peristomal pyoderma gangrenosum (PPG) is an under-recognised and difficult condition to treat. We describe a case series using a novel topical combination therapy that... (Review)
Review
Peristomal pyoderma gangrenosum (PPG) is an under-recognised and difficult condition to treat. We describe a case series using a novel topical combination therapy that promotes wound healing and allows for adhesion of the stoma appliance. A crushed oral prednisolone tablet mixed with Stomahesive Protective Powder (ConvaTec) was applied topically to seven patients with PPG and resulted in pain relief and wound healing in six of seven patients. Only one patient experienced recurrence. The novel topical therapy we describe is cost-effective, readily available, and easily applied in any inpatient or outpatient setting.
Topics: Administration, Topical; Aged; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prednisolone; Pyoderma Gangrenosum; Retrospective Studies; Risk Assessment; Sampling Studies; Surgical Stomas; Talc; Wound Healing
PubMed: 31298491
DOI: 10.1111/iwj.13164 -
Current HIV/AIDS Reports Aug 2019Pre-exposure prophylaxis (PrEP) is a potent HIV prevention strategy, but uptake of daily oral PrEP remains low. This review covers PrEP agents currently available and... (Review)
Review
PURPOSE OF REVIEW
Pre-exposure prophylaxis (PrEP) is a potent HIV prevention strategy, but uptake of daily oral PrEP remains low. This review covers PrEP agents currently available and agents and modalities under investigation.
RECENT FINDINGS
Injectable ARV preparations have high acceptability among users but are likely to require adherence to 8-week interval injections. Topical microbicide gels and vaginal rings have underperformed by intention-to-treat analyses in efficacy studies, at least in large part due to challenges with adherence and/or sustained use. However, daily oral TDF-FTC also underperformed in randomized, placebo-controlled trials compared to expectations and subsequent real-world pragmatic use. On-demand (2-1-1 dosing strategy for MSM) and injectable PrEP appear to be acceptable among participants in clinical trials. These modalities are particularly compelling alternatives for individuals who either do not want to take a daily medication (both on-demand and injectable) and/or want to take PrEP without a long commitment (on-demand). Emerging modalities such as vaginal films, microneedles, and subdermal implants have numerous advantages but are still in early stages of development.
Topics: Administration, Topical; Adult; Anti-HIV Agents; Anti-Infective Agents; Contraceptive Devices, Female; Emtricitabine; Female; HIV Infections; Homosexuality, Male; Humans; Injections; Male; Pre-Exposure Prophylaxis; Sexual and Gender Minorities; Tenofovir
PubMed: 31222499
DOI: 10.1007/s11904-019-00450-9