Jørgen V. Christiansen

Topical Tretinoin, Vitamin A Acid (Airol®) in Acne vulgaris

During the winter of 1971/72, eleven dermatologists in private practice and the dermatological departments of the Finsen Institute and Marselisborg Hospital conducted a controlled clinical trial to in

The Retinoic Acid Derivative Ro 11-1430 in Acne vulgaris

In a double-blind controlled multicenter trial consisting of 257 patients with acne vulgaris an 8-week topical treatment with the retinoic acid derivative Ro 11-1430 (0.1% lotion) was compared with vitamin A acid (0.05% lotion) and the lotion alone (placebo). In reducing the number of comedones vitamin A acid was superior to Ro 11-1430, which was significantly better than placebo. The reduction in number of papules and pustules was not statistically significant on either treatment. Local side effects, i.e. erythema, desquamation, burning and pruritus occurred more frequently and were more severe on vitamin A acid than on Ro 11-1430 and placebo which did not differ. No correlation was found between incidence and severity of local reactions and therapeutic effect.

Etretinate (Tigason®) and Betamethasone Valerate (Celeston Valerate®) in the Treatment of Psoriasis

A randomized trial with 146 psoriatic patients studied the relative merits of (1) oral etretinate (daily dose approximately 1 mg/kg body weight); (2) 0,1% betamethasone valerate cream twice daily, and

Treatment of Acne vulgaris with the Retinoic Acid Derivative Ro 11-1430

In a double-blind, randomized, group-comparative clinical trial, 31 patients with acne vulgaris received topical treatment for 6-8 weeks with a lotion containing either 0.05% retinoic acid or 0.1 % of the retinoic acid derivative Ro 11-1430. The side-effects erythema, desquamation and burning were significantly less frequent with Ro 11-1430 than with retinoic acid. The treatments appeared to be approximately equally effective in reducing the number of acne elements, but due to the limited number of patients studied, the trial was admittedly not sufficient to detect differences with regard to therapeutic efficacy.

Patients’ Acceptance of Etretinate Therapy

From January 1976 to April 1982 etretinate was used to treat patients with morbus Darier (25 patients), pustulosis palmo-plantaris (72 patients), psoriasis (79 patients), and hyperkeratotic eczema of hands and feet (eczema keratoticum; 41 patients). Dosage of etretinate ranged between 0.5 and 1.0 mg/kg/day. In a retrospective survey at April 1 1982, we observed a beneficial effect of the drug in all patients with morbus Darier, in 85% of patients with pustulosis palmo-plantaris, in 69% with psoriasis, and in 93% with eczema keratoticum. Many patients experienced side effects. Within 9 months more than half of the patients had stopped treatment primarily due to side effects, except patients with morbus Darier, whose median duration of treatment was 34 months with a range from 7 to 60 months. We will recommend that etretinate is used during short-term or intermittent courses of therapy, except in patients with morbus Darier, where a low dosage of etretinate is able to give a beneficial clinical effect.

Topical Vitamin A Acid (Airol®) and Systemic Oxytetracycline in the Treatment of Acne Vulgaris

A double-blind, controlled multi-centre trial with 238 patients was employed to study the relative merits of three treatment schedules in acne vulgaris. Schedule A consisted of oral oxytetracycline an

Treatment of Dyskeratosis Follicularis Darier with the Retinoic Acid Derivative Ro 10–9359 (Tigason®)

The results of treatment of 29 patients with Dariers disease with the aromatic retinoid Ro 10-9359 are reported. Therapeutic tests for a period of more than 18 months seem to justify its use in Dariers disease. With a modest dose it is possible to keep the symptoms at an acceptable level, i. e., 50% clearing or more without too troublesome side effects. Because of the side effects the dosage must be fixed individually. It is pointed out that with the development of Ro 10-9359, an efficient remedy for Dariers disease has become available for the first time.

The Treatment of Psoriasis with 0.1% Domoprednate (a D-Homocorticosteroid) and 0.1% Betamethasone Valerate Ointment

In 85 patients with psoriasis vulgaris the efficacy and tolerance of domoprednate and betamethasone valerate were studied in a double-blind, randomized trial lasting 4 weeks. Complete or satisfactory remission was obtained in 36% in the domoprednate group and in 53% in the betamethasone group. This difference is not statistically significant (p greater than 0.10). 3 patients on each treatment experienced some local irritation. No laboratory abnormalities were found during the study.

The Retinoic Acid Derivative Ro 11-1430 (Tasmademi®) in Patients with Acne vulgaris not Tolerating Retinoic Acid

In a double-blind randomized comparative multicenter trial, consisting of 29 patients with acne vulgaris who were unable to tolerate daily applications of retinoic acid, the retinoic acid derivative Ro 11–1430 (0.1% vanishing cream) was compared in a 6–8 weeks topical treatment with vanishing cream alone (placebo). Regarding efficacy, for most criteria measured the response was always better with Ro 11–1430 than with placebo, although the differences were not always statistically significant for several reasons, one probably being the small number of patients in the trial. Regarding tolerance, both treatments were satisfactory. Ro 11–1430 and placebo did not differ significantly regarding frequency and severity of erythema, desquamation and burning. These results suggest that treatment with Ro 11–1430 should be considered in acne patients who are unable to use retinoic acid due to severe local reactions.