A quick look at the noteworthy articles in dermatology research

| January 23, 2009

Journal Watch
January 2009

by Laura G. Alexander

Section Editors: Dr. Brian Berman, MD, PhD, is Professor of Dermatology and Internal Medicine at the University of Miami Miller School of Medicine, Miami, Florida. Dr. Paolo Romanelli, MD, is Associate Professor, Department of Dermatology and Cutaneous Surgery at the University of Miami Miller School of Medicine, Miami, Florida. Contributor: Ms. Alexander is a freelance writer and
editor who lives in New Orleans, Louisiana.


Azelaic acid 15% gel in the treatment of rosacea.
Gollnick H, Layton A. Expert Opin Pharmacother. 2008;9(15):2699–2706.
Synopsis: Authors describe treatment of rosacea using azelaic acid 15% gel, including its apparent main pharmacological action (anti-inflammatory effect via reduction of reactive oxygen species), results of clinical studies, clinical manifestations of improvement, and adverse effects.
PMID: 18803456

Comparative study of some treatment modalities of rosacea.
Mostafa F, El Harras M, Gomaa S, et al. J Eur Acad Dermatol Venereol. 2008 Aug 13. [Epub ahead of print]
Synopsis: Over 15 weeks, researchers compared three topical rosacea treatments—azelaic acid 20% cream, metronidazole 0.75% cream, and permethrin 5% cream—in 24 patients (23 female) that were divided into three treatment groups of eight patients/16 face sides each. They found significant improvement in lesions with all three treatments and no significant difference in side effects. The azelaic acid treatment was significantly more effective on inflammatory lesions but not erythema compared to the other two treatments.
PMID: 18705632

Cumulative irritation potential among metronidazole gel 1%, metronidazole gel 0.75%, and azelaic acid gel 15%.
Colón LE, Johnson LA, Gottschalk RW. Cutis. 2007;79(4):317–321.
Synopsis: Over 21 days, researchers evaluated the cumulative irritation potential of three topical rosacea treatments—metronidazole 0.75% gel, metronidazole 1% gel and azelaic acid gel 15%—in 36 patients. They found that the azelaic acid treatment had significantly greater potential for irritation than the metronidazole 0.75% treatment, which in turn had significantly greater potential for irritation than the metronidazole 1% treatment.
PMID: 17500380

Scavenging properties of metronidazole on free oxygen radicals in a skin lipid model system.
Narayanan S, Hünerbein A, Getie M, et al. J Pharm Pharmacol. 2007;59(8):1125–1130.
Synopsis: To examine the hypothesis that metronidazole’s mechanism of action as a topical treatment of rosacea is to reduce reactive oxygen species by acting as an antioxidant scavenger, researchers used skin lipid models and quantitative assays to determine the antioxidative properties of metronidazole after ultraviolet irradiation. Based on the results, they conclude that metronidazole exhibits antioxidative effects by decreasing the production of reactive oxygen species through modulation of neutrophil activity as well as decreasing the concentration of reactive oxygen species via scavenging properties.
PMID: 17725855


Botanical extracts used in the treatment of cellulite.
Hexsel D, Orlandi C, Zechmeister DO, Prado D. Dermatol Surg. 2005;31(7 Pt 2):866–872; discussion 872. Review.
Synopsis: In this article, authors review the literature on botanical extracts used as active ingredients in the treatment of cellulite and discuss acquisition of botanicals as raw materials, standardization, and quality control.
PMID: 16029680


Choi CM, Berson DS. Semin Cutan Med Surg. 2006;25(3):163–168. Review.
Synopsis: Authors discuss categories of cosmeceuticals, including antioxidants, growth factors, peptides, anti-inflammatories/botanicals, polysaccharides, and pigment-lightening agents.
PMID: 17055397

Chemoprevention of photocarcinogenesis by selected dietary botanicals.

Baliga MS, Katiyar SK. Photochem Photobiol Sci. 2006;5(2):243–253. Epub 2005 Aug 12. Review.
Synopsis: In this review, authors summarize the antiphotocarcinogenesis effects of dietary botanicals, including apigenin, curcumin, grape seed proanthocyanidins, resveratrol, silymarin, and green tea polyphenols, and also discuss the mechanism of chemopreventive action of these agents.
PMID: 16465310


The use and safety of doxycycline hyclate and other second-generation tetracyclines.
Sloan B, Scheinfeld N. Expert Opin Drug Saf. 2008;7(5):571–577. Review.
Synopsis: Authors discuss the pharmacological development of the tetracyclines in the treatment of dermatological conditions with a focus on doxycycline hyclate, including adverse effects, delayed release versus powder forms, antimicrobial dosing for acne, periodontic use, and anti-inflammatory use for rosacea.
PMID: 18759709

Recently approved systemic therapies for acne vulgaris and rosacea.
Del Rosso JQ. Cutis. 2007;80(2):113–120. Review. Erratum in: Cutis. 2007;80(4):334.
Synopsis: Published studies and clinical applications related to the use of systemic therapy for acne vulgaris and rosacea, primarily tetracycline derivatives such as anti-inflammatory dose doxycycline and extended-release minocycline, are discussed in this article.
PMID: 17944168

Safety and efficacy of a new extended-release formulation of minocycline.
Fleischer AB Jr, Dinehart S, Stough D, et al. Cutis. 2006;78(4 Suppl):21–31.
Synopsis: Authors report the results of a Phase 2, dose-finding study and two Phase 3, safety and efficacy studies on extended-release minocycline. The studies were prospective, multicenter, randomized, double-blinded, and placebo-controlled, and results from 1,038 subjects with moderate-to-severe acne were pooled for analysis. They found that treatment with extended-release minocycline significantly reduced the number of inflammatory lesions and improved severity assessment scores, with adverse events reporting comparable to placebo.
PMID: 17436826


Regulation of angiogenesis: Wound healing as a model.
Eming SA, Brachvogel B, Odorisio T, Koch M. Prog Histochem Cytochem. 2007;42(3):115–170. Epub 2007 Aug 20. Review.
Synopsis: In this article, authors discuss cellular and molecular mechanisms controlling angiogenesis in cutaneous tissue repair, including the contribution of growth factors, basement membrane molecules, and mural cells in wound angiogenesis. Authors support modulating the outcome of the healing response by targeting the angiogenic response.
PMID: 17980716

The science of wound bed preparation.

Panuncialman J, Falanga V. Clin Plast Surg. 2007;34(4):621–632.
Synopsis: Authors discuss the concept of wound bed preparation and how it changes current thoughts on acute versus chronic wounds, the division of the normal healing process into phases, and the presence of necrotic tissue, hypoxia, high bacterial burden, corrupt matrix, and senescent cells within the wound bed. The major advance of wound bed preparation approach is to address the problems of wound healing individually, thus, organizing the therapeutic regimens.
PMID: 17967618

Wound complications following diagnostic skin biopsies in dermatology inpatients.
Wahie S, Lawrence CM. Arch Dermatol. 2007;143(10):1267–1271.
Synopsis: To study risk factors and wound complication rate for dermatology patients undergoing diagnostic skin biopsies, authors prospectively assessed 100 postdiagnostic skin biopsy wounds. They found, among other things, that of the 29 biopsies that developed wound complications, elliptical incisional biopsies developed complications more frequently when subcutaneous sutures were not used. Authors conclude that dermatology inpatients exhibit a high rate of wound complications after diagnostic dermatologic surgery, with significant host and procedural risk factors.
PMID: 17938340

Wound re-epithelialization: Modulating keratinocyte migration in wound healing.
Raja, Sivamani K, Garcia MS, Isseroff RR. Front Biosci. 2007;12:2849–2868. Review.
Synopsis: In this review, authors focus on mechanisms that regulate keratinocyte migration in the re-epithelialization process and discuss cell attachments via desmosomes, hemidesmosomes, and integrins, the expression of keratins, the role of growth factors, cytokines and chemokines, eicosanoids, oxygen tension, antimicrobial peptides, and matrix metalloproteinases. They also review novel mediators of keratinocyte motility including the role of electric fields as well as signaling via the acetylcholine and beta-adrenergic receptors.
PMID: 17485264

Adverse cutaneous reactions to soft tissue fillers—a review of the histological features.

Dadzie OE, Mahalingam M, Parada M. J Cutan Pathol. 2008;35(6):536–548. Epub 2008 Jan 14. Review.
Synopsis: Authors discuss the histological features of adverse reactions to soft tissue fillers currently available in the United States and elsewhere in an attempt to enhance awareness of the diversity of these reactions.
PMID: 18201242


Treatment of melanoma and nonmelanoma skin cancer.
Rass K, Tilgen W. Adv Exp Med Biol. 2008;624:296-318. Review.
Synopsis: Authors discuss treatment approaches for both melanoma and nonmelanoma skin cancer, including removal of localized metastases; chemoimmunotherapy; photodynamic therapy; local immune modifiers; and antiproliferative, antiangiogenic, and proapoptotic agents as well as combination strategies using chemo-, targeted, and vaccination therapy approaches.
PMID: 18348465
See also in the same issue:
Molecular biology of basal and squamous cell carcinomas.
Xie J. Adv Exp Med Biol. 2008;624:241–251. Review.
PMID: 18348461

Idiopathic basal cell carcinoma in children.
Alcalay J, Ben-Amitai D, Alkalay R. J Drugs Dermatol. 2008;7(5):479–481.
Synopsis: Basal cell carcinoma in children is rare and is usually associated with genetic disorders, such as basal cell nevus syndrome, Bazex syndrome, albinism, and xeroderma pigmentosum. Idiopathic childhood onset is rare. In this case study, authors report on a child with idiopathic onset of basal cell carcinoma who was treated with Mohs micrographic surgery. They include a discussion of 108 children, including this patient, who reported with idiopathic de novo basal cell carcinoma.
PMID: 18505143

Basal cell carcinoma of the prostate: Report of a case and review of the published reports.
Segawa N, Tsuji M, Nishida T, et al. Int J Urol. 2008;15(6):557–559.
Synopsis: In this case study, authors discuss the histological and immunohistochemical findings of a 67-year-old patient with pure basaloid basal cell carcinoma (serum prostate specific antigen and prostatic acid phosphatase were within normal range), showing an extraprostatic extension and lymph node metastases.
PMID: 18489650

Clinical investigation of the novel iron-chelating agent, CP94, to enhance topical photodynamic therapy of nodular basal cell carcinoma.
Campbell SM, Morton CA, Alyahya R, et al. Br J Dermatol. 2008 Jun 7. [Epub ahead of print].
Synopsis: To assess the safety and efficacy of adding a novel iron-chelating agent, CP94 (1,2-diethyl-3-hydroxypyridin-4-one hydrochloride), to topical aminolevulinic acid (ALA) to temporarily increase the accumulation of the photosensitizer in the tumor during photodynamic therapy, researchers used a mixed topical formula of ALA with increasing concentrations of CP94 to conduct photodynamic therapy on a previously biopsied nodular basal cell carcinoma with no prior lesion preparation using standard light delivery. They found that photodynamic therapy using 40 percent CP94 resulted in significantly greater clearance rates. No adverse reactions were noted.
PMID: 18544077

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