Lincoln Krochmal

Ultraviolet A sunscreen evaluations in normal subjects

We have used a specially modified xenon arc solar simulator to examine ultraviolet A (UVA) protection of a research sunscreen formulation. UVA doses were given to sunscreen-protected and unprotected skin with the use of irradiance values of 50 mW/cm2 and 100 mW/cm2. Erythemal responses were evaluated 5.2 +/- 0.9 hours later and again 24.4 +/- 1.8 hours later. The overall mean unprotected UVA minimal erythema dose (MED) was 23.6 joules/cm2 (SD = 4.8) and the mean UVA protection factor (APF) was 3.2 (SD = 0.78). Neither irradiance nor evaluation time significantly affected MED or APF. These preliminary findings indicate that the modified solar simulator permits convenient determination of sunscreen APF. The APF of a sunscreen is analogous to SPF: APF refers to UVA protection, while SPF refers to protection from the entire solar spectrum, predominantly from the effects of UVB.

Topical corticosteroid compounding: Effects on physicochemical stability and skin penetration rate

Compounding compatibility studies of four corticosteroid cream products and four commonly added chemicals are presented. Physical alteration, chemical stability, micropreservative challenge status, and in vitro skin penetration were evaluated at ambient conditions for 2 months. The study was designed to generate useful, previously unavailable information to aid dispensing pharmacists and dermatologists.

Therapeutic activity of lactate 12% lotion in the treatment of ichthyosis: Active versus vehicle and active versus a petrolatum cream

Lactate 12% lotion was significantly more effective than both its vehicle and a petrolatum-based cream in the treatment of ichthyosis. The treatment regimen was twice-daily application for 4 weeks with evaluations weekly during the treatment period and for 2 weeks after treatment was stopped. Vulgaris, lamellar, sex-linked, Nethertons, and epidermolytic hyperkeratotic forms of ichthyosis were significantly improved by treatment with lactate 12% lotion. This new therapeutic modality expands the scope and extent of ichthyotic conditions that may now be successfully treated.

Comparative efficacy of 12% ammonium lactate lotion and 5% lactic acid lotion in the treatment of moderate to severe xerosis

This double-blind study was designed to evaluate treatment results and time effects of 12% ammonium lactate and 5% lactic acid lotion for moderate to severe xerosis. Results showed 12% ammonium lactate lotion was significantly more effective than 5% lactic acid lotion in reducing the severity of xerosis in both the 3-week, twice-a-day treatment period and the following 3-week, no-treatment (regression) period.

A controlled comparative efficacy study of 5% ammonium lactate lotion versus an emollient control lotion in the treatment of moderate xerosis

percutaneous biliary catheterization may disseminate malignant tumor cellsalong the catheter tract.2-5In these cases the cutaneous metastases were found as a solitary tumor at the current or previous entry site of percutaneous transhepatic drainage in the abdomen. In our case, multiple papules first appeared at the site of previous drainage 5 months after tube removal. The cutaneous metastasis in our patient was also ascribed to postoperative migration of the carcinomatous cells through the percutaneous drainage catheter.

Impact of seasonality on conducting clinical studies in dermatology

It is generally accepted among dermatologists that certain skin diseases are subject to seasonal influence. This belief, however, is based primarily on anecdotal observation rather than fact-based evidence. To address this controversy, we performed a retrospective analysis of a total of 3931 subjects enrolled in 7 phase 3 clinical trials across the diseases acne, atopic dermatitis, and seborrheic dermatitis and found a seasonal effect to exist in the treatment response of the 3 very common dermatologic diseases studied. To be truly representative of a drugs benefit when the disease is known to be impacted by seasonality, efficacy figures in the package insert should therefore be based on data collected from patients enrolled across all seasons.

The safety of halobetasol 0.05% ointment in the treatment of psoriasis.

The effects on the hypothalamic‐pituitary‐adrenal axis of the ultra‐high potency corticosteroid halobetasol in the treatment of psoriasis were evaluated in seven patients with extensive, long‐standing plaque psoriasis. Each patient applied 3.5 g halobetasol 0.05% ointment in the morning and evening for 7 days. Morning plasma Cortisol levels and 24‐hour urinary excretion of 17‐hydroxycorticosteroid were determined before and on the last 2 days of treatment; plasma Cortisol levels were also determined 4 and 5 days after completion of therapy. Morning plasma Cortisol concentrations did not decrease significantly during treatment, and no values were below the normal range. Mean 24‐hour urinary 17‐hydroxycorticosteroid excretion fell from 6.6 ± 1.4 mg to 5.1 ± 1.4 mg. Two patients had mild, localized pruritus and stinging with the initial ointment application. No other adverse cutaneous effects were observed. Halobetasol was also clinically efficacious over the 7 days of treatment, based on evaluation of pruritus, erythema, scaling, and plaque elevation. These results demonstrate no adverse effects of the drug on the hypothalamic‐pituitary‐adrenal axis at doses that are clinically effective in the management of plaque psoriasis.

Evaluation of ammonium lactate in the treatment of seborrheic keratoses

A double-blind, paired comparison study was used to evaluate treatment effects of 12% ammonium lactate lotion (Lac-Hydrin) against its vehicle on seborrheic keratoses. Fifty-eight volunteer patients, 37 to 82 years of age, were studied for 16 weeks. The patients had a minimum of two seborrheic keratoses at least 10 cm apart. They applied the medication twice daily. The lesions were evaluated for height, surface characteristics, color, and length with the use of 7X calibrated loupe, a template, skin replicas, and scanning electron microscopy. Lac-Hydrin 12% lotion significantly reduced the height (elevation) of seborrheic keratoses, and two seborrheic keratoses cleared completely; however, there was no statistically significant difference in the length, color, and surface characteristics between the study group and the control group. Skin replicas and scanning electron microscopy can be used to evaluate lesion surface characteristics, dimensions, and therapeutic effects.