The results from four phase III, randomized, vehicle-controlled studies showed that imiquimod 5% cream (imiquimod) was safe and effective in the treatment of actinic keratosis (AK). Patients applied imiquimod or vehicle cream to AK lesions on the face or balding scalp, dosing three times per week or two times per week for 16 weeks.To obtain long-term safety follow-up data and estimate AK recurrence in patients who completely cleared their AK lesions in the treatment area at the 8-week post-treatment visit in the phase III studies.One hundred forty-six patients from 30 study centers in the United States were evaluated for clinical evidence of AK, and safety data were collected.After a median follow-up period of 16 months, 24.7% (19 of 77) of the patients administered imiquimod three times per week and 42.6% (23 of 54) of the patients administered imiquimod two times per week had a recurrence of AK (the appearance of at least one AK lesion) in the original treatment area. The median number of AK lesions present was one lesion for both patients receiving imiquimod three times and those receiving imiquimod two times per week compared with a median of six lesions at baseline in the combined three times per week and two times per week phase III studies. There were no long-term safety issues, and the skin quality seen in the imiquimod-treated patients at the end of the phase III studies was maintained.One and a half years following treatment, imiquimod continued to provide a long-term clinical benefit in a majority of patients who experienced complete clearance of their AK lesions.
Journal Article How not to get scar(r)ed: pointers to the correct diagnosis in patients with suspected primary cicatricial alopecia Get access M.J. Harries, M.J. Harries Dermatological Sciences, The University of Manchester, Salford Royal Hospital, Manchester M6 8HD, U.K.Department of Dermatology, University of Lübeck, D‐23538 Lübeck, Germany Correspondence: Matthew Harries. E‐mail: mjharries@doctors.org.uk Search for other works by this author on: Oxford Academic Google Scholar R.M. Trueb, R.M. Trueb Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland Search for other works by this author on: Oxford Academic Google Scholar A. Tosti, A. Tosti Department of Dermatology, University of Bologna, Bologna, Italy Search for other works by this author on: Oxford Academic Google Scholar A.G. Messenger, A.G. Messenger Department of Dermatology, University of Sheffield, Hallamshire Hospital, Sheffield, U.K. Search for other works by this author on: Oxford Academic Google Scholar I. Chaudhry, I. Chaudhry Department of Histopathology, Manchester Royal Infirmary, Manchester, U.K. Search for other works by this author on: Oxford Academic Google Scholar D.A. Whiting, D.A. Whiting Baylor Hair Research and Treatment Centre, Dallas, TX, U.S.A. Search for other works by this author on: Oxford Academic Google Scholar R. Sinclair, R. Sinclair Department of Dermatology, University of Melbourne, Melbourne, Australia Search for other works by this author on: Oxford Academic Google Scholar C.E.M. Griffiths, C.E.M. Griffiths Dermatological Sciences, The University of Manchester, Salford Royal Hospital, Manchester M6 8HD, U.K. Search for other works by this author on: Oxford Academic Google Scholar R. Paus R. Paus Dermatological Sciences, The University of Manchester, Salford Royal Hospital, Manchester M6 8HD, U.K.Department of Dermatology, University of Lübeck, D‐23538 Lübeck, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 160, Issue 3, 1 March 2009, Pages 482–501, https://doi.org/10.1111/j.1365-2133.2008.09008.x Published: 01 March 2009
Primary cicatricial alopecias (PCAs) are a poorly understood group of disorders that result in permanent hair loss. Clinically, they are characterized not only by permanent loss of hair shafts but also of visible follicular ostia along with other visible changes in skin surface morphology, while their histopathological hallmark usually (although not always) is the replacement of follicular structures with scar-like fibrous tissue. As hair follicle neogenesis in adult human scalp skin is not yet a readily available treatment option for patients with cicatricial alopecias, the aim of treatment, currently, remains to reduce symptoms and to slow or stop PCA progression, namely the scarring process. Early treatment is the key to minimizing the extent of permanent alopecia. However, inconsistent terminology, poorly defined clinical end-points and a lack of good quality clinical trials have long made management of these conditions very challenging. As one important step towards improving the management of this under-investigated and under-serviced group of dermatoses, the current review presents evidence-based guidance for treatment, with identification of the strength of evidence, and a brief overview of clinical features of each condition. Wherever only insufficient evidence-based advice on PCA management can be given at present, this is indicated so as to highlight important gaps in our clinical knowledge that call for concerted efforts to close these in the near future.
Fifty patients with creeping eruption were treated topically with an aqueous suspension of 15% thiabendazole. A permanent cure was obtained in 94% of patients within a fortnight and in 98% within 3 weeks. No significant side-effects were encountered and at present topical thiabendazole is the treatment of choice for this condition.
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