Azelaic acid: An update

Azelaic acid: An update

P114 P116 AN ASSESSMENT OF CUTANEOUS TOLERABILITY WITH TOPICAL METRONIDAZOLE James Del Rosso, DO, University of Nevada School of Medicine, Las Vegas...

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P114

P116

AN ASSESSMENT OF CUTANEOUS TOLERABILITY WITH TOPICAL METRONIDAZOLE James Del Rosso, DO, University of Nevada School of Medicine, Las Vegas, NV, United States

ASSESSMENT OF ADAPALENE CREAM AS MAINTENANCE THERAPY IN COSMETIC AND DERMATOLOGIC CONDITIONS Michael Gold, MD, Gold Skin Care Center, Nashville, TN, United States

Topical metronidazole has been available for clinical use in the United States for more than 15 years. Controlled clinical trials are inclusive of more than 550 actively treated patients. Although patients with rosacea often exhibit an increased propensity for signs and symptoms of irritation, such as erythema, stinging and burning, all currently available topical metronidazole vehicle formulations have demonstrated excellent tolerability profiles. This poster reviews available data related to the skin tolerability of topical metronidazole and reports on results from a clinical study examining the frequency and severity related to topical metronidazole use as monotherapy or in combination with other topical agents. Galderma, Stiefel, Dermik, Medicis, Berlex, Healthpoint 100% sponsored by Galderma Laboratories, L. P.

The earliest generation of lasers in dermatology consisted of ablative lasers, such as the carbon dioxide and erbium lasers, that are capable of resurfacing the skin and causing dermal remodeling through controlled ablation of the epidermis and upper dermis. A new epidermis forms within about 4 days after laser ablation, but erythema may persist for weeks or months. The demand for aesthetic treatments by skin ablation or resurfacing, and more subtle nonablative treatments has increased. Laser skin resurfacing, the controlled ablation of the epidermis and upper dermis with the use of lasers, has revolutionized the treatment of many cutaneous conditions, including vascular and pigmented lesions, tattoos, scars, and unwanted hair. A maintenance regimen is required after both ablative and nonablative laser resurfacing to prevent continuing damage to the newly resurfaced skin as well as to maintain the improvement in skin tone and texture. The use of adapalene 0.01% cream has been proven to aid in the maintenance of skin texture and tone for many patients. Of paramount importance as well is sun avoidance and the use of high sun protection factor (SPF) sunblock and protective clothing. This poster will present several cases of and the rationale for utilizing adapalene cream to maintain the cosmetic benefits in the treatment of various conditions, including photoaging and specifically fine lines, wrinkles, sagging, sallowness, telangiectasia, and areas of dyspigmentation. 100% supported by Galderma

P117 P115 AN OPEN STUDY AND IN VITRO INVESTIGATION OF ACNE PHOTOTHERAPY WITH A HIGH-INTENSITY, ENHANCED, NARROWBAND, BLUE LIGHT SOURCE Makiko Fukao, MD, Akira Kawada, MD, PhD, Yoshinori Aragane, MD, PhD, Hideki Endo, MD, PhD, Department of Dermatology, Kinki University School of Medicine, Osaka-Sayama City, Osaka, Japan

AZELAIC ACID: AN UPDATE Aditya Gupta, MD, PhD, Division of Dermatology, Department of Medicine, Sunnybrook and Women’s College Health Sciences Center (Sunnybrook site) and the University of Toronto, ON, Canada, and Mediprobe Research Inc., London, ON, Canada

The purpose of this investigation was to confirm the efficacy of phototherapy with a newly developed, high-intensity, enhanced, narrowband, blue light source in patients with mild to moderate acne. An open study was performed in 42 acne patients who were treated twice a week up to 5 weeks. Acne lesions were reduced by 60%. No patient discontinued treatment because of adverse effects. In vitro investigation revealed that irradiation from this light source reduced the number of Propionibacterium acnes, but not Staphylococcus epidermidis that were isolated from the acne patients. Phototherapy using this blue light source was effective and well tolerated in acne patients and had an ability to decrease numbers of P acnes in vitro, suggesting that this phototherapy may be a new modality for acne.

Azelaic acid (1,7-heptanedicarboxylic acid) is a naturally occurring saturated dicarboxylic acid. Azelaic acid has many beneficial properties including antiinflammatory, antibacterial, and antikeratinizing effects. It is a known inhibitor of tyrosinase, a vital constituent in the production of melanin, and it also has the ability to inhibit 5a-reductase, which is involved in androgenetic alopecia. It has been used in various formulations to treat rosacea, acne, and melasma. Recently, the Food and Drug Administration approved azelaic acid 15% gel for the topical treatment of inflammatory papules and pustules of mild to moderate rosacea. The 15% gel has a high efficacy and is generally well tolerated, with local irritation (burning, stinging, itching, scaling) being typically mild and transient. The gel has many advantages, including a higher azelaic acid dose fraction and greater stability, allowing for an increased drug release and bioavailabilty at a lower concentration. Azelaic acid 15% gel is considered an effective and safe first-line treatment for inflammatory papulopustular rosacea.

Nothing to disclose.

Dr. Gupta has received educational grants from Berlex.

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J AM ACAD DERMATOL

MARCH 2005