7.
None of the lesions completely disappeared in any of the patients who received vehicle.Fifteen patients who responded well to treatment in the initial 10-month study were assigned to tretinoin or vehicle for an additional 6 months. Brito MFM, Pessoa IS, Galindo JCS, et al.
Changes in plasma lipids and lipoproteins during isotretinoin therapy for acne.
A standard gray card (18 percent reflectance) was included in the first picture during each session to control for any shifts in color or density due to extraneous variables.The changes in clinical and histologic measures of the hyperpigmented lesions before and during treatment in the tretinoin and vehicle groups were compared by means of the two-sample t-test.
*Examples of the Best Responses to Tretinoin Therapy in Three Patients.Overall Efficacy of 10 Months of Treatment with Tretinoin or Vehicle Cream for Hyperpigmented Lesions of the Face and Upper Extremities.Overall Change in Color in Response to Treatment with Tretinoin (Solid Lines) or Vehicle (Broken Lines).Histologic Features of Biopsy Specimens Obtained before and after 10 Months of Treatment with Tretinoin or Vehicle.
The results for the arms, forearms, and backs of the hands were averaged for each patient and are reported as results for the upper extremities.In addition to the overall assessment, four hyperpigmented lesions were identified before treatment on the basis of the likelihood of accurately locating these lesions throughout the study, thus allowing us to correlate the clinical and histologic results in the same lesions. As compared with vehicle, tretinoin caused a significant decrease in the degree of epidermal pigmentation and increases in the degree of compaction of stratum corneum, thickness of the granular cell layer, and epidermal thickness.
The comparison of changes in color of the specifically identified lesions in the two groups was based on the average of the changes in the four lesions; the clinical changes in color of the single lesion that underwent biopsy were analyzed according to histologic diagnosis (All analyses included all patients who could be evaluated; only in Fifty-eight of the 60 patients completed the 10-month study.
In all cases, the scaling and erythema were most noticeable during the first two months, after which there was a progressive decrease in their severity, frequency, and duration.The cutaneous reactions improved when emollients were applied more frequently and the amount of study medication used was decreased or treatment was stopped for one to three days. Vieira AS, Beijamini V, Melchiors AC.
Although not all of these side effects may occur, if they do occur they may need medical attention. The patients were encouraged to increase gradually the quantity of cream applied until mild erythema or scaling ensued.The patients were supplied with a mild soap and asked to wash with this or a similar agent at least 20 minutes before applying the study treatment. None of the patients who received vehicle cream had complete clearing of any of the four identified lesions during the six-month follow-up study.During the study the patients reported only cutaneous reactions,The rash occurred only in areas that came into contact with the topical medication and varied in intensity and duration among the patients and in any individual patient at different times. We investigated their …
Zane LT, Leyden WA, Marqueling AL, et al. Kızılyel, Metin, Elmas, and Aktas are from the Department of Dermatology.
At each return visit, the degree of hyperpigmentation of each of these lesions was compared with that before treatment, and color was graded by the investigator as much darker, darker, slightly darker, unchanged, slightly lighter, lighter, much lighter, or absent.The degrees of erythema, scaling, burning or stinging, and pruritus were assessed at all visits with the use of a five-point scale, in which 0 indicated the absence of such symptoms, 1 the presence of mild symptoms, 2 the presence of moderate symptoms, 3 the presence of moderately severe symptoms, and 4 the presence of severe symptoms. Asterisks denote a significant difference (P≤0.002) between groups.The two specimens are from a single hyperpigmented lesion from the patient shown in The lesions with the best clinical response tended to have the greatest decrease in epidermal pigmentation (the best linear fit is represented by the line; r = -0.53, P<0.0001).Tap into groundbreaking research and clinically relevant insights
Alcalay J, Landau M, Zucker A. Prepare to become a physician, build your knowledge, lead a health care organization, and advance your career with NEJM Group information and services.The hyperpigmented lesions commonly called liver spots distress patients, in part because such lesions are associated with aging.
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