Comparison of the clinical efficacy of NBUVB and NBUVB with benzoyl peroxide/clindamycin in progressive macular hypomelanosis

Sim, J.H.; Lee, D.J.; Lee, J.S.; Kim, Y.C.

doi:10.1111/j.1468-3083.2011.03980.x

Cited by 12 publications

(9 citation statements)

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“…[ 13 ] NBUVB phototherapy is a newer treatment modality that provides potential advantages to conventional UVB-based phototherapy. Although NBUVB is increasingly being used for the treatment of many dermatoses,[ 21 22 23 ] to the best of our knowledge, its efficacy in the treatment of inflammatory AV has not been evaluated prior to our study.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant narrow band UVB improves the efficacy of oral azithromycin for the treatment of moderate to severe inflammatory facial acne vulgaris

Rassai¹,

Rafeie²,

Ramírez-Fort³

et al. 2014

J Cutan Aesthet Surg

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Background:Acne vulgaris (AV) is a common inflammatory disease of the pilosebaceous unit. A variety of treatment modalities are available for the treatment of AV. Among the available options, oral azithromycin is popularly prescribed for its proven anti-inflammatory effects. Narrow band UVB (NBUVB) also has a potent anti-inflammatory action. Concomitant use of both modalities may result in a synergistic therapeutic response; however, the combined efficacy has not yet been evaluated for the treatment of inflammatory AV.Objective:The aim of this study was to compare the efficacy of oral azithromycin plus NBUVB (peak 311 nm) to oral azithromycin alone for the treatment of moderate to severe inflammatory AV.Materials and Methods:A randomized, open-label, clinical trial was conducted over 4 weeks. Subjects were randomized into two groups. Group 1 received 500 mg of oral azithromycin three times per week. Group 2 received 500 mg of oral azithromycin plus NBUVB three and two times per week, respectively. Concomitant topical or oral AV treatments were not permitted during the treatment period. Response to treatment was measured by photographic records at the primary endpoint (2 weeks) and at the end of treatment.Results:One hundred and four subjects were enrolled in the trial; 94 subjects completed the treatment period of the study. Group 2 demonstrated significant clinical improvement of the inflammatory papular lesions (88.55%) compared with group 1 (70.34%) at the end of treatment (P = 0.002). The clinical response of pustular (P = 0.562), nodular (P = 0.711) and cystic (P = 0.682) lesions did not significantly differ between the two treatment groups. Interestingly, response to treatment in group 2 had a significant anatomical predilection for the forehead (P = 0.023). There was no side-effect except erythema, which subsided within 1-2 days.Conclusion:NBUVB plus oral azithromycin is more effective than oral azithromycin alone for treating papular lesions of inflammatory AV. NBUVB is certainly a viable adjunct in acne therapy.

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Section: Discussionmentioning

confidence: 99%

Adjuvant narrow band UVB improves the efficacy of oral azithromycin for the treatment of moderate to severe inflammatory facial acne vulgaris

Rassai¹,

Rafeie²,

Ramírez-Fort³

et al. 2014

J Cutan Aesthet Surg

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“…A number of studies have challenged the original findings of Relyeld et al 25 in regard to the effectiveness of antimicrobial treatment and phototherapy versus phototherapy alone. In particular, Sim et al 21 and Selim et al 6 did not find any significant difference in repigmentation of PMH lesions using daily topical 5% BPO and 1% clindamycin antimicrobial treatments with NB‐UVB versus NB‐UVB monotherapy. Furthermore, in many cases recurrence of the condition occurred, although some patients retained a degree of clinical improvement.…”

Section: Challenges To the Proposal That C Acnes Is Involved In The mentioning

confidence: 93%

“…Furthermore, upon a 3‐month follow‐up, PMH patients were still found to have retained their repigmentation, although information on whether this persisted is not available. Since then, there have been many studies investigating the effectiveness of treatments for PMH using topical antibiotic lotions and BPO hydrogels (in combination or separately) alongside NB‐UVB treatment 6,9,19,21,23 . Treatment success for PMH has also been achieved using the oral tetracycline derivatives doxycycline, minocycline and lymecycline, used in the management of acne, either with or without BPO 26–29 ; this provides further circumstantial evidence that C. acnes may contribute to the development of PMH.…”

Section: Evidence Supporting a Potential Role For Cutibacterium Acnesmentioning

confidence: 99%

“…1,6,9,10,[19][20][21][22][23][24] Such UV treatments are believed to work by stimulating melanogenesis and, potentially, inhibition of C. acnes in the case of NB-UVB (see Section "Antibacterial therapy versus phototherapy"), but the results appear variable and in many cases are only temporary leading to recurrence of the condition. 6,20,21,24 In a within-patient, left-right trunk comparison study, Relyeld et al 25 demonstrated that topical treatment with 5% benzoyl peroxide (BPO) (morning) and 1% clindamycin hydrogel (night-time) in combination with UVA radiation (antibacterial therapy arm) was much superior for repigmentation versus 0.05% fluticasone propionate and UVA treatment only (anti-inflammatory therapy arm). This appeared, therefore, to exclude the possibility that treatment success was due solely to UVA treatment and provided evidence to support a bacterial role, such as C. acnes, in the pathophysiology of PMH.…”

Section: Therapeutic Success Of Antimicrobial-based Treatmentsmentioning

confidence: 99%

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Is Cutibacterium (previously Propionibacterium) acnes a potential pathogenic factor in the aetiology of the skin disease progressive macular hypomelanosis?

McDowell

McLaughlin

Layton

2020

Acad Dermatol Venereol

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Progressive macular hypomelanosis (PMH) is a skin condition that normally causes symmetrically distributed hypopigmented macules on the front and back of the trunk, but rarely the face. To date, the pathophysiology of the condition is not well understood, but a role for the anaerobic skin bacterium Cutibacterium (previously Propionibacterium) acnes in the development of the disease has been proposed due to its sole presence within lesional, but not normal peri‐lesional, skin. The success of antimicrobials in the treatment of PMH also provides circumstantial evidence that this association may be causal, although this is still to be proven. More recent culture and metagenomic typing studies indicate that strains of C. acnes subsp. elongatum (type III) may be important in the aetiology of the condition, which would help to explain why PMH does not normally affect the face since such strains are rarely present there, and why no association between this condition and acne vulgaris is found; acne appears to primarily involve type IA1 strains from C. acnes subsp. acnes (type I). In this review, we summarize current knowledge on the relationship between C. acnes and PMH, and re‐examine previous challenges to the view that the bacterium plays a role in the condition against the backdrop of newly emerged data.

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“…Wu ve arkadafllar› darbant UVB + benzoil peroksit kombinasyonunu bir PMH hastas›nda uygulam›fllar ve etkili bulmufllard›r 16 . Sim ve arkadafllar› darbant UVB ile darbant UVB + topikal antibakteriyel ajan (benzoil peroksit/klindamisin) kombinasyonunu karfl›laflt›rm›fl-lar ve kombine terapinin darbant UVB'nin tek bafl›na kullan›-m›na üstün olmad›¤›n› saptam›fllard›r 17 . Kwah ve arkadafllar› ortalama 27 seans darbant UVB tedavisi verdikleri 6 hastay› tedavi etmifller ancak tedavi sonland›r›ld›ktan sonra 3 hastada nüks görmüfllerdir.…”

Section: Tedaviunclassified

Progresif Maküler Hipomelanozis

Mevlitoğlu¹,

Aykol²

2011

Turkderm

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Progresif maküler hipomelanozis (PMH) ilk olarak 1988 y›l›nda Guillet taraf›ndan tan›mlanm›flt›r. PMH s›kl›kla gövdeyi tutan, asemptomatik, zor fark edilen, numuler, skuams›z, hipopigmente maküllerle karakterizedir. PMH ço¤unlukla adölesan ve genç kad›nlarda görülür. Etyopatogenezi hala bilinmemektedir. Wood lambas› alt›nda hipopigmente maküllerde k›rm›z› foliküler florasan görünürken komflu normal deride florasan gözlenmez. PMH'nin histopatolojik bulgular› genellikle non-spesifiktir, ancak hipopigmente maküllerin melanin içeri¤inin normal deriye göre azalm›fl olmas› s›k görülen bir bulgudur. Etkili bir tedavi halen bilinmemektedir. Ancak fototerapi PMH'yi kontrol alt›na almada etkili bulunmufl olmas›na karfl›n hastal›¤›n rekürrensini önlememektedir. Biz bu makalede PMH'nin etyopatogenezi, klinik bulgular›, histopatolojisi, ay›r›c› tan›s› ve tedavi seçeneklerini derlemeyi amaçlad›k. (Türkderm 2011; 45: 62-5) Anahtar Kelimeler: Progresif maküler hipomelanozis, pigmentasyon bozukluklar› SummaryProgressive macular hypomelanosis (PMH) was initially described and named by Guillet in 1988. PMH is characterized by asymptomatic, ill-defined, nummular, non-scaly, hypopigmented macules, localized predominantly on the trunk. PMH is mostly seen in adolescents and young females. The etiopathogenesis of PMH is still unknown. The red follicular fluorescence becomes visible in the hypopigmented macules under Wood's lamp but is absent in normal adjacent skin. The histopathologic findings in PMH are usually non-specific, but a common feature is the decreased melanin content in the hypopigmented macules compared to the normal skin. No effective therapy is currently known. Phototherapy was found to be effective for the control of PMH; however, it does not prevent recurrence of the disease. In this paper, we aimed to review the etiopathogenesis, clinical findings, histopathology, differential diagnosis and treatment options of PMH. (Turkderm 2011; 45: 62-5

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Comparison of the clinical efficacy of NBUVB and NBUVB with benzoyl peroxide/clindamycin in progressive macular hypomelanosis

Abstract: Background Progressive macular hypomelanosis (PMH) is a skin disorder characterized by multiple

Cited by 12 publications

References 14 publications

Adjuvant narrow band UVB improves the efficacy of oral azithromycin for the treatment of moderate to severe inflammatory facial acne vulgaris

Adjuvant narrow band UVB improves the efficacy of oral azithromycin for the treatment of moderate to severe inflammatory facial acne vulgaris

Is Cutibacterium (previously Propionibacterium) acnes a potential pathogenic factor in the aetiology of the skin disease progressive macular hypomelanosis?

Progresif Maküler Hipomelanozis

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