Number Of Inflammatory Lesions Research Articles

Effects of Oral Antioxidants on Lesion Counts Associated with Oxidative Stress and Inflammation in Patients with Papulopustular Acne

Background: There has been an increasing focus on the extent to which oxidative stress and inflammation are involved in the pathophysiology of acne. The aim of this study is to investigate the effect of oral Silymarin, N-acetylcysteine and Selenium in the treatment of acne vulgaris. Methods: A randomized prospective clinical trial was carried out on 56 patients with acne vulgaris who were examined clinically by dermatologist and classified according to disease severity. Serum levels of Glutathione, Malondialdehyde and Interleukine-8 in the acne patients were measured pre- and eight weeks post-treatment with oral antioxidants and compared to that of 28 healthy volunteers. The clinical follow- up was done every two weeks to assess the changes in the number of inflammatory lesions. Results: Administration of antioxidants to patients with acne vulgaris significantly reduce serum Malondialdehyde level; and increased serum level of Glutathione after eight weeks compared to pre-treatment value, also significantly reduce Interleukine-8 serum levels and the number of inflammatory lesions in patients with acne compared to placebo. Conclusion: The results obtained in this study clearly showed the beneficial effect of Silymarin, N-acetylcysteine and Selenium to patients with acne vulgaris as indicated by the clinical improvement that strongly and positively correlated with improvement in biochemical data.

Discovery Of Fingolimod, The Sphingosine 1-Phosphate Receptor Modulator And Its Application For The Therapy Of Multiple Sclerosis

Fingolimod (FTY720) is a first-in-class, orally active, sphingosine 1-phosphate (S1P)-receptor modulator with a structure closely related to sphingosine. The compound was discovered by chemical modification of a natural product, myriocin. Phosphorylated form of FTY720 acts as a functional antagonist at S1P receptor type 1 (S1P(1)), inhibits lymphocyte egress from secondary lymphoid organs and shows immunomodulating effects. Phase III studies in multiple sclerosis demonstrated that oral FTY720 had superior efficacy compared with intramuscular IFN-β1a (AVONEX(®)) with regard to reducing the rate of relapse and the number of inflammatory lesions in the CNS. FTY720 has been approved as a new therapeutic drug for multiple sclerosis in more than 50 countries, including the USA, Japan and some of those in the EU.

Effects of silymarin, N-acetylcysteine and selenium in the treatment of papulopustular acne

There has been an increasing focus on the extent to which oxidative stress is involved in the pathophysiology of acne. The aim of this study is to investigate the effect of silymarin, N-acetylcysteine (NAC) and selenium in the treatment of acne vulgaris. A randomized prospective clinical trial was carried out on 56 patients of both sexes with age range of 14-35 years who attend to outpatient clinic in Al-Hussein Teaching Hospital, Karbalaa, Iraq over a period from December 2011 to May 2012, all patients examined clinically by dermatologist and classified according to disease severity. Serum levels of glutathione (GSH), malondialdehyde (MDA) and interleukine-8 (IL-8) in the acne patients were measured by using ready-for-use Elisa kits, and compared to that of 28 healthy volunteers. The clinical follow up was done every two weeks in order to assess the changes in the number of inflammatory lesions. Administration of antioxidants silymarin, NAC and selenium (but not placebo) to patients with acne vulgaris significantly reduced serum MDA and increased serum GSH levels after 8 weeks compared to pre-treatment value; also significantly reduced serum IL-8 levels and the number of inflammatory lesions in patients with acne compared to placebo. The results obtained in this study clearly showed the beneficial effect of using silymarin, NAC and selenium to patients with acne vulgaris as indicated by the clinical improvement and biochemical findings, and confirmed the role of new strategy in the targeting of pathophysiological changes accompanied with acne by using antioxidant agents.

Treatment of Acne Vulgaris with 5-Alpha Avocuta Cream 2% in Comparison with Tretinion Cream 0.025% (Single Blind Comparative Study)

Background: Acne vulgaris is a common skin disease. Its pathogenesis is multifactorial, and therapy can now be directed at many of these factors. Among these factors are androgen hormones which play an important role in the pathogenesis of acne. Accordingly,many antiandrogens have been developed to treat acne by systemic and topical ways. Five-Alpha Avocuta 2% cream is a new topical 5-alpha reductase inhibitor extracted from the tropical fruit “avocado”. Objectives: To evaluate the effectiveness and safety of 5-Alpha Avocuta cream and compare it to tretinoin 0.025% cream, in the treatment of acne vulgaris. Patients& Methods: This single blinded comparative study was done in Department of Dermatology– Baghdad Teaching Hospital - from July 2009 through October 2010. All demographic points related to the disease were obtained from each patient to evaluate severity of acne. Sixty-eight patients with acne were divided into two groups and instructed to apply the drugs for three months. Group A uses 5-Alpha avocuta 2% (Teen-derm K) cream and Group B uses tretinoin (Acretin) 0.025% cream. Severe acne was excluded from the study. The clinical improvement was evaluated by counting the number of inflammatory lesions before and after treatment and compare between them by paired t-test. Results: Fifty-eight patients completed the study, their age ranged from 12 - 30 years with a mean of 18.21 ± 4.64 years. In Group A there was a significant reduction of the mean number of papules from 29.7 before treatment to 15.5 after treatment (p < 0.0001), while the mean number of pustules decreased from 4.9 to 0.6 (p = 0.019). In Group B the mean number of papules was reduced from 28.5 to 14.9 (p < 0.0001), while the mean number of pustules dropped from 5.3 before treatment to 0.7 after treatment (p = 0.009). The mean difference of papules after 14 weeks in Group A was 15.55 ± 6.95 while in Group B, the mean difference was 14.86 ± 6.99. This result was statistically not significant (p = 0.708, t-test). The difference in the mean percentage of reduction of inflammatory lesions at week 14 between the two groups was not statistically significant (P-value = 0.999).The side effect was negligible in Group A and not required stopping the drug while in Group B treatment stopped in 2 patients. Conclusions: Five Alpha avocuta was an effective mode of therapy in treatment of acne vulgaris, and it was comparable to tretinoin, with little side effects.

Acamprosate modulates experimental autoimmune encephalomyelitis

This pilot study aimed to determine the efficacy of acamprosate (N-acetyl homotaurine) in reducing the pathological features of experimental autoimmune encephalomyelitis (EAE) which is an animal model for multiple sclerosis (MS). The amino acid taurine has multiple biological activities including immunomodulation and neuromodulation. The synthetic acetylated taurine derivative, acamprosate, which crosses the blood-brain barrier more readily compared to taurine, is currently being used for the prevention of alcohol withdrawal symptoms associated with enhanced glutamatergic receptor function and GABA receptor hypofunction. EAE was induced in C57BL/6 female mice with myelin oligodendrocyte glyocoprotein, amino acid 35-55. Mice were treated with 20, 100 and 500 mg/kg acamprosate for 21 days. Neurological scores at disease peak were reduced by 21, 64 and 9% in the 20, 100 and 500 mg/kg groups, respectively. Neurological improvement in the 100 mg/kg group correlated with a reduction in numbers of inflammatory lesions and the extent of CNS demyelination. Blood TNF-α levels were significantly reduced in the 500 mg/kg group. Acamprosate and other taurine analogs have a potential for future MS therapy.

Randomized trial comparing a chemical peel containing a lipophilic hydroxy acid derivative of salicylic acid with a salicylic acid peel in subjects with comedonal acne

Lipohydroxyacid is a lipophilic derivative of salicylic acid with comedolytic properties. To compare lipohydroxyacid and salicylic acid peels in subjects with comedonal acne. In this split face, randomized study, 20 subjects with comedonal acne received lipohydroxyacid peels on one side of the face, while the other side was treated with salicylic acid peels. A total of six peels at 2-week intervals were performed. Efficacy was evaluated by counting noninflammatory and inflammatory lesions and by performing a global change in acne assessment. Safety was assessed by evaluating adverse events, global tolerance, and the presence of erythema, scaling, and dryness. There was a statistically significant decrease of 55.6% and 48.5% from baseline to Day 98 in the mean number of noninflammatory lesions for the sides treated with lipohydroxyacid and salicylic acid peels, respectively (P < 0.001). There was no significant difference in the degree of reduction in noninflammatory lesions between the two peels. There was no significant reduction in the number of inflammatory lesions. Both peels were generally very well tolerated. This study suggests that lipohydroxyacid peels can be beneficial to subjects with comedonal acne.

Indole‐3‐acetic acid: A potential new photosensitizer for photodynamic therapy of acne vulgaris

ALA (5-aminolevulinic acid) photodynamic therapy (PDT) is a new treatment option for acne. However, it needs a relatively long incubation period and adverse effects are common. Indole-3-acetic acid (IAA) is not toxic by itself but produces free radicals with ultraviolet B. In this study we examined the potential of IAA as a photosensitizer for acne treatment. Free radical formation was measured after visible light irradiation of IAA. Antimicrobial effect was evaluated by assessing growth suppression of Propionibacterium acnes and Staphylococcus aureus after IAA PDT. To evaluate the histological changes, skin biopsies were performed on nude mice skin after IAA PDT. To evaluate the clinical efficacy of IAA PDT, 14 acne patients were treated with the following IAA PDT regimen: three times each with a 15 minutes incubation period and a 2-week interval. The number of inflammatory lesions and the amount of sebum secretion were then assessed. IAA produced free radicals with green light irradiation. Importantly, IAA lost its photosensitizing ability after exposure to certain amount of light. This implies IAA PDT would not require post-procedure photo-protection. The growth of P. acnes and S. aureus were significantly suppressed with IAA PDT. In addition, IAA PDT treated skin showed destruction of follicular ostia epithelium. Interestingly, there was no significant difference between a 4 hours and a 30 minutes incubation, which means that longer absorption time is not necessary for IAA PDT. In the clinical study, inflammatory lesions and sebum secretion were significantly reduced. The procedure was painless and no adverse effect was observed. Photo-protection was not performed and there were no further phototoxic responses. IAA PDT has therapeutic effects on acne via its antimicrobial activities, its sebum-reducing effect and through relieving follicular occlusion. It is a very simple and safe treatment option for acne.

Azelaic acid 15% gel in the treatment of rosacea

Rosacea represents a chronic inflammatory dermatosis of uncertain pathophysiology. There are several associated risk factors and the need for long-term treatment is well recognized. This diverse disease is frequently difficult to manage and has a significant impact on quality of life. There are several topical and oral treatments available, of which azelaic acid 15% gel (Finacea®) is the first new treatment for rosacea in more than a decade. Azelaic acid per se has multiple modes of action in rosacea, but an anti-inflammatory effect achieved by reducing reactive oxygen species appears to be the main pharmacological action. Clinical studies have shown that azelaic acid 15% gel is an effective and safe first-line topical therapeutic option in patients with mild-to-moderate papulopustular rosacea. Significant continuous improvement in the number of inflammatory lesions and in erythema has been shown over a period of 15 weeks. Adverse effects associated with azelaic acid 15% gel are mostly mild or transient and do not usually necessitate discontinuation of therapy.

Combined 0.1% Retinaldehyde/ 6% Glycolic Acid Cream in Prophylaxis and Treatment of Acne Scarring

Background: Acne often results in permanent, badly tolerated, difficult to treat scars. Objective: To evaluate the efficacy and safety of a 0.1% retinaldehyde/6% glycolic acid (RALGA) cream at preventing and treating acne scarring in patients previously treated for moderate acne. Methods: A double-blind vehicle-controlled study was conducted in 145 patients randomized to apply RALGAor vehicle cream every evening for 3 months. Global scarring score and patient’s assessment of global efficacy, then residual acne lesions, quality of life and tolerance were evaluated at inclusion and each month until study completion. Results: Global scarring score, number of inflammatory lesions and comedones significantly improved in each group from day 28 (p < 0.0001). Number of inflammatory lesions were significantly decreased only in the RALGA group. RALGA cream was more efficient than vehicle on scarring after 3 months in compliant patients (p = 0.007) due to erythema and hyperpigmentation improvement. Conclusion: RALGA cream is efficient at preventing and treating acne scarring in patients with moderate acne.

Safety and Efficacy of Tretin‐X Compared With Retin‐A in Patients With Mild‐to‐Severe Acne Vulgaris

The therapeutic efficacy of the tretinoin products Tretin-X (Triax Pharmaceuticals, Cranford, NJ) and Retin-A (Johnson & Johnson, New Brunswick, NJ) in the treatment of acne vulgaris was compared in four bioequivalence studies. Four double-blind, three-treatment, parallel-group studies randomly assigned 1642 adolescents and adults, 12-40 years of age, with mild-to-severe acne vulgaris to receive topical tretinoin therapy with Tretin-X, Retin-A, or placebo (drug vehicle) as 0.1% cream (study 1), 0.025% cream (study 2), 0.025% gel (study 3), and 0.01% gel (study 4) once daily for 84 days. The primary efficacy measures were overall acne severity and the number of inflammatory lesions. The secondary efficacy measure was the total number of lesions. In each trial, Tretin-X and Retin-A were clinically equivalent according to all primary and secondary end points at Weeks 2, 4, 8, and 12, a finding also demonstrated by the averaged scores from Weeks 2 through 12. Moreover, each active treatment was significantly more efficacious than placebo at the conclusion of the study (p<or=0.05). Both of the Tretin-X and Retin-A formulations compared in each study were well tolerated. The severity of erythema and peeling did not differ significantly among the three groups studied. The four bioequivalence studies demonstrated that Tretin-X and Retin-A tretinoin products behaved similarly in patients with mild-to-severe acne vulgaris and were thus clinically bioequivalent. Both treatments were well tolerated, and their associated adverse events were similar to those with placebo.

The effect of aloe vera gel on the anti-acne properties of the essential oil of Ocimum gratissimum Linn leaf – a preliminary clinical investigation

Aim: This study was designed to investigate possible synergistic effect of aloe vera gel on the anti-acne properties of Ocimum gratissimum oil and to compare the activities of both agents singly and in combinations with the anti-acne agent Dalacin™ – a 1% Clindamycin phosphate solution. Methods: 84 subjects presenting with clinically significant Acne vulgaris (mainly undergraduates of a University) were randomly assigned into seven groups and treated with different test preparations (2% v/v Ocimum oil lotion containing graded concentrations (0–≈100%) of aloe gel, placebo or control preparations). Samples tested were applied to the face after washing morning and evening. The numbers of inflammatory lesions (papules and pustules) were counted prior to application and daily for 4 weeks. The efficacy of the preparations was rated in terms of product activity (1/ D), which is the reciprocal value of the number of days taken to achieve 50% reduction in lesion count. Results: The efficacy of the Ocimum oil lotion products increased with increasing aloe gel contents. Products formulated with the undiluted or 50% aloe gels were most active and resolved inflammatory lesions faster than the standard product. The aloe gel alone showed minimal activity. Adverse effect was mild and tolerable. Conclusion: Aloe vera gel enhanced the anti-acne properties of Ocimum oil; the oil or its combination with aloe vera gel is more effective than 1% Clindamycin in the treatment of Acne vulgaris.

A randomized, double-blind comparison of a clindamycin phosphate/benzoyl peroxide gel formulation and a matching clindamycin gel with respect to microbiologic activity and clinical efficacy in the topical treatment of acne vulgaris

Background: One approach to suppressing the overgrowth of antibiotic-resistant bacteria is to develop combination products composed of active constituents with complementary but distinct mechanisms of antibacterial action.Objective: The purpose of this study was to compare the antimicrobial and clinical efficacy and tolerability of clindamycin phosphate 1%/benzoyl peroxide 5% gel formulation with matching clindamycin 1% gel in the treatment of acne vulgaris.Methods: This 16-week, single-center, double-blind, randomized, parallel-group study compared the combination gel with clindamycin monotherapy applied BID in patients 13 to 30 years of age with mild to moderate acne and facial Propionibacterium acnes counts ≥104 colony-forming units per square centimeter of skin.Results: Seventy-nine patients were enrolled and randomly assigned to receive the combination gel (n = 40) or clindamycin monotherapy (n = 39). Seventy patients (50 males, 20 females; mean age, 18.2 years) were included in the intent-to-treat group. The combination gel treatment produced significantly greater reductions (P ≤ 0.046) from baseline in total lesion counts and in numbers of inflammatory lesions and comedones compared with clindamycin monotherapy. Greater reductions in the severity of acne also were observed in the physician's and patient's Clinical Global Improvement scale scores and in other secondary efficacy measurements. Reductions in clindamycin-resistant Pacnes counts were observed relative to baseline in the combination gel group; in contrast, P acnes counts increased by > 1600% in the clindamycin monotherapy group at week 16 (P = 0.018 vs combination gel). Reductions in inflammatory (r2 = 0.31; P = 0.016) and total (r2 = 0.28; P = 0.027) lesions were correlated with decreases in clindamycin-resistant bacteria. Also, significant correlations were observed between the percent change from baseline in total lesion counts (r2 = 0.44; P < 0.001) and comedo counts (r2 = 0.50; P < 0.001) and the log10 change from baseline in total P acnes counts.Conclusions: The total P acnes count (P = 0.002) and the clindamycin-resistant P acnes count (P = 0.018) were significantly reduced after 16 weeks of treatment with combination gel compared with clindamycin monotheraphy. These reductions in total P acnes and clindamycin-resistant P acnes counts correlated with reductions in total acne lesions.

A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea

Background: Although it is important for physicians to have sufficient clinical data on which to base treatment decisions, little comparative data exist regarding newer treatment modalities for rosacea. Objective: The goal of the study was to compare the efficacy and safety of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. Parameters of patient satisfaction to treatment were also assessed. Methods: Forty patients with the clinical manifestation of symmetric facial rosacea were investigated in this single-center, double-blind, randomized, contralateral split-face comparison clinical trial. Results: After 15 weeks of treatment, both azelaic acid and metronidazole induced significant, albeit equal reductions in the number of inflammatory lesions (pustules and papules). A significantly higher physician rating of global improvement was achieved with azelaic acid. Changes in the rosacea signs and symptoms of dryness, burning, telangiectasia, and itching were equal between treatments. A reduction in erythema tended toward significance with azelaic acid at week 15. A trace amount of stinging on application was noted with azelaic acid; however, such discomfort did not appear to concern patients because their overall impression of azelaic acid was superior to that of metronidazole. Conclusion: Azelaic acid 20% cream provides an effective and safe alternative to metro-nidazole 0.75% cream with the added benefit of increased patient satisfaction. (J Am Acad Dermatol 1999;40:961-5.)

Efficacy and safety of azelaic acid and glycolic acid combination therapy compared with tretinoin therapy for acne

We conducted a 12-week, multicenter, randomized, double-masked, parallel-group study of the efficacy, safety, and tolerability of azelaic acid 20% cream and glycolic acid lotion compared with tretinoin 0.025% cream and a vehicle lotion to treat mild-to-moderate facial acne vulgaris. Patients treated with azelaic/glycolic acid experienced a significantly greater reduction in the number of papules, as well as a greater reduction in the number of inflammatory lesions, than those treated with tretinoin. Overall global improvement was approximately 25% in both groups. In the physician evaluations, treatment with azelaic/glycolic acid was found to cause significantly less dryness, scaling, and erythema than tretinoin. Patients also reported significantly less dryness, redness, and peeling with azelaic/glycolic acid. Significantly more patients in the azelaic/glycolic acid group than the tretinoin group reported that they felt attractive. The combination of azelaic acid and glycolic acid is a useful alternative to tretinoin, being at least as efficacious as the latter, while offering a superior tolerability and patient approval profile.

Astrocytic hypertrophy: An important pathological feature of chronic experimental autoimmune encephalitis in aged rats

Experimental autoimmune encephalomyelitis (EAE) was induced in young (2–3 month old), middle-aged (12–13 month old) and geriatric (24–26 month old) Lewis (JC) rats by active immunisation with myelin basic protein (MBP) in complete Freund's adjuvant (CFA). It was found that aged Lewis (JC) rats developed a more chronic form of EAE than younger rats of the same strain, a phenomenon observed in both male and female rats despite males developing more severe disease than females at all ages. Middle-aged recipients also developed more severe disease than young recipients when EAE was induced by the adoptive transfer of lymphocytes from actively immunised young donors, suggesting that disease chronicity in middle-aged animals is a property of the central nervous system (CNS) milieu. Histological studies demonstrated that disease chronicity did not correlate with the number of inflammatory lesions in the CNS, young animals containing substantial numbers of CNS lesions following recovery and lesions being largely absent from middle-aged animals which still exhibited signs of disease. No significant differences were found in the degree of fibrin deposition or demyelination between young and middle-aged or symptomatic and asymptomatic animals. However, astrocytic hypertrophy was found to correlate with manifestation of disease in both young and middle-aged animals and in particular with disease chronicity in middle-aged animals. In parallel studies, no significant differences were found in the levels of the inflammatory mediators tumor necrosis factor (TNF)-α, prostaglandin E (PGE) 2, reactive nitrogen intermediates (RNI) and corticosterone in young and middle-aged animals. However, markedly elevated corticosterone levels were found in both young and middle-aged animals with the development of clinical signs which returned to baseline levels with the resolution of clinical signs. Elevated levels of RNI were evident in animals immediately prior to and during the early stages of symptomatic EAE. Although these results suggest that nitric oxide may play a role in the pathogenesis of disease, whereas corticosterone may play a role in the immunoregulation of the disease, these factors cannot explain differences in disease chronicity evident in middle-aged animals. Based on the results presented in this paper, it is proposed that the neurological deficit of chronic EAE in middle-aged animals may be caused by astrocytic hypertrophy with the resolution of this CNS response being a major factor contributing to recovery from the disease in animals of all ages.

Efficacy and safety of CD 271 alcoholic gels in the topical treatment of acne vulgaris

CD 271, a naphthoic acid, is a powerful modulator of epidermal differentiation. This double-blind, randomized study compared the efficacy and safety of two concentrations (0.03% w/w and 0.1% w/w) of CD 271 alcoholic gel, with 0.025% w/w tretinoin gel in 72 male patients with acne vulgaris over a period of 12 weeks. Efficacy was measured by counting facial inflammatory and non-inflammatory lesions and by grading the severity of the acne at each visit. Skin tolerance was assessed with subjective symptoms, such as burning and pruritus, as well as clinical assessment of erythema, dryness and scaling on the treated areas. The alcoholic 0.1% CD 271 gel was as effective as 0.025% tretinoin gel in reducing total comedone counts (83% reduction for both products after 12 weeks' treatment). The reduction in the number of inflammatory lesions and the total number of acne lesions were significantly greater with 0.1% CD 271 gel than with tretinoin gel (69% and 79% for 0.1% CD 271, 50% and 73% for tretinoin gel, respectively, P less than 0.05). All three treatments were well tolerated and there were no changes in any major blood parameters. No CD 271 could be detected in blood plasma at the end of the study (detection limit = 1 ng/ml).

A neutralization-resistant Theiler's virus variant produces an altered disease pattern in the mouse central nervous system

Theiler's murine encephalomyelitis virus infection of mice is an animal model for human demyelinating diseases. To further define the role of this virus in the disease process, we selected a virus variant resistant to neutralization by a monoclonal antibody to VP-1. This virus variant was then injected into SJL/J mice. Central nervous system tissue was compared between variant virus- and wild-type virus-infected mice. Within the brain, no large differences were observed between the two groups as to the distribution of inflammatory infiltrates around the injection site and the number of viral antigen-positive cells during the first weeks of the observation period. In contrast, in the spinal cord major differences were found between variant virus- and wild-type virus-infected mice regarding the number of inflammatory lesions, infected cells, and the size of the areas involved with time. By immunohistochemistry, equivalent numbers of infected cells could be found in the spinal cord 1 week postinfection (p.i.): however, after that time, the number of infected cells in the wild-type virus-infected mice continued to increase, whereas the virus-positive cells from the variant virus-infected mice gradually decreased. Thus, the number of viral antigen-containing cells peaked by 1 week p.i. in the variant virus-infected animals. Conversely, the number of infected cells in the spinal cords from mice inoculated with wild-type virus steadily increased until 8 weeks p.i. At this time (8 weeks p.i.), no more variant virus antigen-positive cells could be observed within the spinal cord. Plaque assay of central nervous system tissue confirmed these differences between the two groups observed by immunohistochemistry. No infectious variant virus could be isolated after 2 weeks p.i. from the brain and 4 weeks p.i. from the spinal cord, whereas infectious wild-type virus could be detected up to the end of the observation period (12 weeks p.i.). Virus which was isolated from variant virus-infected mice still retained the neutralization-resistant phenotype. These studies emphasize the important biological in vivo activity of Theiler's virus VP-1 in determining neurovirulence.

Topical erythromycin v clindamycin therapy for acne. A multicenter, double-blind comparison

The efficacy and safety of topical 1.5% erythromycin solution and 1% clindamycin phosphate solution were compared in the treatment of acne. The number of inflammatory lesions was significantly reduced at 12 weeks by 62% and 59% and the number of noninflammatory lesions by 43% and 39% in the erythromycin and clindamycin groups, respectively. The reduction in lesions was also reflected in the clinical evaluation of the overall facial condition; 73% of the 74 patients treated with erythromycin solution and 62% of the 80 patients treated with clindamycin solution had excellent or good responses at 12 weeks. The results of this study show that topically applied 1.5% erythromycin and 1.0% clindamycin solutions are both effective and comparable in reducing the clinical manifestation of acne in patients with moderate disease.

Topical Erythromycin v Clindamycin Therapy for Acne

The efficacy and safety of topical 1.5% erythromycin solution and 1% clindamycin phosphate solution were compared in the treatment of acne. The number of inflammatory lesions was significantly reduced at 12 weeks by 62% and 59% and the number of noninflammatory lesions by 43% and 39% in the erythromycin and clindamycin groups, respectively. The reduction in lesions was also reflected in the clinical evaluation of the overall facial condition; 73% of the 74 patients treated with erythromycin solution and 62% of the 80 patients treated with clindamycin solution had excellent or good responses at 12 weeks. The results of this study show that topically applied 1.5% erythromycin and 1.0% clindamycin solutions are both effective and comparable in reducing the clinical manifestation of acne in patients with moderate disease.

Contribution to the interpretation of the occurrence of unsuccessful therapeutical results in acne vulgaris with topical erythromycin (Propionibact. acnes)

Investigations are reported which attempt to contribute towards an understanding of those cases in which topical treatment with erythromycin is unsuccessful. In 13 acne patients no resistance of P. acnes was observed after seven weeks of topical treatment with erythromycin. This demonstrates that the 20% frequency of resistance induction reported in the literature is too high. In the 13 treated patients there was no essential reduction in the number of inflammatory lesions although a decrease in the number of Propionibacteria in the pilosebaceous ducts occurred. This result is perhaps connected with a concurrent increase in Micrococcaceae, which could suggest that not only Propionibacteria, but also Micrococcaceae play a role in the pathogenesis of acne.