Acne Medications

J Cutan Med Surg. 2009 May-Jun; 13(3): 164-8Bleiziffer O, Dragu A, Kneser U, Horch REBACKGROUND:Acne inversa is a progressive chronic inflammatory disease associated with abscess and fistula formation and subsequent scarring. In recent years, an increasing number of reports have been published about acne inversa and concomitantly occurring Crohn disease. Extensive anogenitoperineal soft tissue defects represent an enormous challenge to therapy. Common treatment strategies of reconstructive surgery such as local flaps, free flaps, or split-thickness skin grafts are frequently problematic and associated with poor outcomes.OBJECTIVE:The aim of this case report is to demonstrate the clinical problem of extensive anogenitoperineal soft tissue defects and to present a surgical technique that can be successfully used in such difficult cases.METHODS:In both cases, extensive excision of the affected areas was carried out down to the gluteal muscles followed by intramuscular grafting of buried skin chip grafts.RESULTS:In both cases, the final postoperative results after numerous surgeries were very good, with complete wound closure resulting in complete recovery and social reintegration.CONCLUSION:The technique of buried skin chip grafting has long been ignored since split-thickness skin grafting and different techniques of flap coverage evolved, but it may constitute a highly efficient treatment strategy in challenging reconstructive situations.

Curr Opin Investig Drugs. 2009 May; 10(5): 474-81Scheinfeld NAllergen Inc has launched Aczone, a topical gel formulation of the antibacterial, anti-inflammatory agent dapsone, for the potential treatment of acne vulgaris. Oral dapsone has demonstrated efficacy in acne, but was associated with severe side effects such as anemia, which was particularly serious in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Aczone was developed to overcome this limitation, and is formulated using solvent-microparticle technology for improved absorption and action and for fewer side effects. In a phase I clinical trial, systemic exposure to dapsone was 126-fold lower following treatment with Aczone compared with oral dapsone. Aczone significantly reduced lesion counts in patients with acne in phase III trials, and was particularly effective in reducing inflammatory lesions. In a phase IV trial, Aczone was safely applied to patients with G6PD deficiency without inducing anemia. Phase IV trials in patients with acne were ongoing at the time of publication to assess safety and to compare Aczone monotherapy with combinations of Aczone and other anti-acne therapeutics. At the time of publication, Allergen was also developing Aczone for the treatment of rosacea; the drug was undergoing phase II trials for this indication. Aczone appears to be a novel promising anti-acne therapeutic option, particularly for patients with inflammatory acne.

Sirolimus (SRL) allows to minimize the use of cyclosporine (CsA), but de novo administration after transplantation is associated with various complications. We report a prospective, open-label, multicenter randomized study to evaluate conversion from a CsA-based regimen to a SRL-based regimen 3 months after transplantation.

One hundred ninety-two of a total of 237 patients were eligible at 3 months to be converted to SRL (n = 95) or to continue CsA (n = 97). All patients were also given mycophenolate mofetil (MMF) and oral steroids, planned to be discontinued at month 8.

The primary endpoint, the clearance estimated according to Cockcroft and Gault at week 52, was significantly better in the SRL group (68.9 vs. 64.4 mL/min, p = 0.017). Patient and graft survival were not statistically different.

The incidence of acute rejection episodes, mainly occurring after withdrawal of steroids, was numerically but not statistically higher in the SRL group (17% vs. 8%, p = 0.071).

Sixteen patients discontinued SRL, mainly for adverse events (n = 11), and seven patients discontinued CsA for renal failure or acute rejection. Significantly, more patients in the SRL group reported aphthous, diarrhea, acne scar medications and high triglyceride levels.

Conversion CsA to SRL 3 months after transplantation combined with MMF is associated with improvement in renal function.


"Efficacy on renal function of early conversion from cyclosporine to sirolimus 3 months after renal transplantation: concept study."
Am J Transplant. 2009 May; 9(5): 1115-23Lebranchu Y, Thierry A, Toupance O, Westeel PF, Etienne I, Thervet E, Moulin B, Frouget T, Le Meur Y, Glotz D, Heng AE, Onno C, Buchler M, Girardot-Seguin S, Hurault de Ligny B

In this study we aim to document the use of animal species in traditional medicine and healing practices in the semi-arid region of Northeastern Brazil. While widespread and of great importance to large population that has limited access to contemporary medicine, such practices are poorly understood and the potential value of medicinal animal species largely unknown.

MATERIALS AND METHODS:
Based on interviews with merchants of medicinal animals, we calculated the Informant Consensus Factor (ICF) to determine the consensus over which species are effective for particular ailments, as well as the species relative importance to determine the extent of potential utilization of each species.

RESULTS:
We describe the therapeutic effects of 36 animal species used medicinally. The zootherapeutical products sold commercially are used to treat 40 health problems that were classified into 10 broad categories. We also highlight those species valued for their effectiveness against a range of ailments. The highest ICF value (0.91) was cited for diseases of the skin and subcutaneous tissue, which include relief of symptoms such as topical acne scar medications and furuncles.

DISCUSSION AND CONCLUSION:
This study demonstrates that many animal species play an important role in healing practices. Animals provide the raw materials for remedies prescribed clinically and are also used in the form of amulets and charms in magic-religious rituals and ceremonies. The medicinal value of animal species depends on the local knowledge that exists within user communities and therefore the conservation of animal species is imperative to the preservation of local medicinal knowledge and culture.


Commercialization of animal-derived remedies as complementary medicine in the semi-arid region of northeastern Brazil.
J Ethnopharmacol. 2009 May 4; Alves RR, Neto NA, Brooks SE, Albuquerque UPAIM OF THE STUDY