Combination therapy versus monotherapy in the treatment of recalcitrant warts: A clinical and immunological study

Summary

Background

Treatment of recalcitrant warts represents a continuing therapeutic challenge. Combination therapies can help improve treatment response, decrease adverse effects, and reduce recurrence.

Objective

To compare the efficacy, safety and immunological effects of a combined acitretin‐intralesional Candida antigen against acitretin alone and Candida antigen alone for intractable warts.

Methods

Sixty adult patients with intractable warts were included in this study. Patients were subdivided into three groups, each containing 20 patients. Acitretin alone was taken by patients of group I, Candida antigen alone was injected in patients of group II, and group III received a combination of intralesional Candida antigen and acitretin. Serum cytokine levels of IL‐10 and IFN‐γ were measured before and after therapy in the studied groups.

Results

Total resolution of warts was achieved in 8 patients (40%) of the acitretin alone group, 9 patients (45%) of the Candida antigen alone group and 15 patients (75%) of the combination therapy group. The therapeutic response was statistically higher in the combined acitretin‐Candida antigen group as compared with either agent alone. Adverse effects were non‐significant in the three groups. There were no statistically significant differences in the serum levels of IFN‐γ and IL‐10 between responders and non‐responders after therapy in the three studied groups.

Conclusion

The combination therapy of acitretin + Candida antigen is superior to either agent alone. Serum cytokine levels of IL‐10 and IFN‐γ were not associated with clearance or persistence of warts in any of the studied groups.

http://bit.ly/2EZ08wH

Sterol‐standardized phytopharmaceutical from ground cherry: Corticoid‐like properties on human keratinocytes and fibroblasts and its effects in a randomized double‐blind placebo‐controlled clinical trial

Summary

Background

Topical corticosteroids have been the most commonly prescribed drugs to treat skin inflammation, but their uses can lead to several adverse effects. Nowadays, new pharmacological strategies have been evaluated to improve dermatologic efficacy and reduce adverse effects, including natural products.

Objectives

The aim of this study was to evaluate and compare the effects of a plant sterol standardized supercritical CO₂ phytopharmaceutical of Physalis angulata L. with hydrocortisone on the immune and inflammatory mediators, and skin repair components production. Moreover, we studied effects of both products on the skin microcirculation and temperature in a double‐blind placebo‐controlled clinical trial.

Methods

Both products were evaluated on the immune (IL‐6, IL‐10, INF‐γ, TNF‐α, and IL‐1α), inflammatory (COX‐2, LOX, PLA₂, PGE₂, LTB₄, histamine, and NF‐κB), and repair components (TGF‐β, GM‐CSF, collagen, and GAG) production on human keratinocytes and fibroblast in non‐stimulated and LPS‐stimulated conditions. Indeed, in a randomized double‐blind placebo‐controlled clinical trial, we evaluated the effects of the both creams on the skin microcirculation and temperature using laser Doppler and infrared thermometer, respectively.

Results

Physalis angulata acted on the skin, modulating immune status and inflammatory response producing corticoid‐like effects, but different of hydrocortisone, increased skin repair factors. The effects of phytopharmaceutical cream in the clinical trial promoted a better reduction in skin microcirculation and temperature than hydrocortisone.

Conclusions

Taken together, the results indicate that sterol standardized CO₂ supercritical preparation of P angulata is a new and innovative phytopharmaceutical with multiple pharmacological effects potentially useful as human skin protective product, particularly against cutaneous inflammatory disorders.

http://bit.ly/2EYuHBH

1927‐nm fiber‐optic diode laser: A novel therapeutic option for facial steatocystoma multiplex

Summary

Steatocystoma multiplex (SM) is a cutaneous disorder that presents with multiple yellowish intradermal cysts originating from the pilosebaceous ducts. Although various treatments have been attempted to improve cosmetic outcomes, no optimal treatment strategy has been established to date. A 41‐year‐old man presented with a 10‐year history of multiple skin‐colored papulonodules over his entire body. He was diagnosed with SM, and we treated his facial SM with a 1927‐nm diode laser. Two treatment sessions at a 5‐week interval led to cosmetically excellent outcomes. There was no recurrence at the 8‐month follow‐up. Herein, we present a case of SM that was successfully treated with a 1927‐nm fiber‐optic diode laser.

http://bit.ly/2EYIf1c

CD30‐positive cutaneous extranodal natural killer/T‐cell lymphoma: clinicopathological features and survival outcomes

Abstract

Background

The prognostic value of CD30 expression in cutaneous extranodal natural killer/T‐cell lymphoma is controversial.

Methods

Clinicopathological features, survival outcomes, and prognostic implications of CD30 were retrospectively analyzed in 55 patients with cutaneous extranodal natural killer/T‐cell lymphoma. We classified patients into (i) primary cutaneous extranodal natural killer/T‐cell lymphoma and (ii) cutaneous extranodal natural killer/T‐cell lymphoma secondary to nasal disease depending on the primary tumor site.

Results

CD30+ cutaneous extranodal natural killer/T‐cell lymphoma was more common in patients with cutaneous extranodal natural killer/T‐cell lymphoma secondary to nasal disease than in those with primary cutaneous disease. CD30+ cases were more likely to present nodular lesions or cellulitis‐like swelling than CD30− cases. Histologically, CD30+ cutaneous extranodal natural killer/T‐cell lymphoma predominantly comprised large tumor cells compared with CD30− cases. However, the clinical morphology and tumor cell size were not associated with survival outcomes. CD30 expression was associated with better survival outcomes in patients with cutaneous extranodal natural killer/T‐cell lymphoma secondary to nasal disease.

Conclusion

CD30+ cutaneous extranodal natural killer/T‐cell lymphoma presented peculiar clinicopathological features and had more favorable disease course in patients with cutaneous dissemination from nasal disease.

http://bit.ly/2AmWrwS

Novel GNAQ mutation(R183G) of Port‐wine stains: first case in East Asia

http://bit.ly/2SqnIW8

Primary cutaneous embryonal rhabdomyosarcoma with desmoplastic growth pattern and anaplastic lymphoma kinase overexpression. Report of a case with special emphasis on the differential diagnosis

http://bit.ly/2Qe3oW0

Giant cutaneous pleomorphic fibroma: an unusual presentation

http://bit.ly/2Vgag9c