Topical timolol: An effective treatment option for agminated pyogenic granuloma

McGinness, Anelah; Gillam, Amy; Yeh, Iwei; Mathes, Erin F.

doi:10.1111/pde.13575

Cited by 9 publications

(6 citation statements)

References 13 publications

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“… 22 , 24 , 25 , 26 , 27 , 28 , 29 Timolol maleate in 0.5% gel formulations is the most widely used topical beta‐blocker for PG. 25 A helpful case series was described by Gupta 22 in 2016, reporting 10 patients (aged 15–50 years) treated with 0.5% timolol maleate ophthalmic solution four times a day, obtaining complete resolution in 5 cases (as from 3 days and within 24 days), partial resolution in 2 patients, and no response in 2 patients. Also periocular granuloma was treated with timolol 0.5% gel twice a day in 4 children in the work by Oke et al, achieving complete resolution and no recurrence for at least 3 months.…”

Section: Beta‐blockers In Pyogenic Granuloma and Nail Paronychiamentioning

confidence: 99%

“…In the past 5 years, several case reports, case series, prospective and retrospective studies have supported the use of topical beta‐blockers such as timolol and propranolol in PG treatment 22,24–29 . Timolol maleate in 0.5% gel formulations is the most widely used topical beta‐blocker for PG 25 .…”

Section: Beta‐blockers In Pyogenic Granuloma and Nail Paronychiamentioning

confidence: 99%

“…24 In the past 5 years, several case reports, case series, prospective and retrospective studies have supported the use of topical betablockers such as timolol and propranolol in PG treatment. 22,[24][25][26][27][28][29] Timolol maleate in 0.5% gel formulations is the most widely used topical beta-blocker for PG. 25 A helpful case series was described by Gupta 22 in 2016, reporting 10 patients (aged 15-50 years) treated with 0.5% timolol maleate ophthalmic solution four times a day, obtaining complete resolution in 5 cases (as from 3 days and within 24 days), partial resolution in 2 patients, and no response in 2 patients.…”

Section: Beta-blockers In Pyogenic Granuloma and Nail Paronychiamentioning

confidence: 99%

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Topicalbeta‐blockersin dermatologic therapy

Filoni

Ambrogio

Marco

et al. 2021

Dermatologic Therapy

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An increasing use of beta-blockers in dermatology has been described over the last 10 years, despite the fact that their use in diseases other than infantile hemangiomas is off-label. This review discusses the emerging role of topical beta-blockers in the treatment of infantile hemangioma, but also pyogenic granuloma, Kaposi sarcoma, wounds and nail paronychia. Data in literature demonstrate that topical beta-blockers are a safe and valid therapeutic option in numerous cutaneous diseases. Side effects are mainly restricted to the application site. Further studies and randomized trials may contribute to reinforce the role of topical beta-blockers in the dermatological armamentarium.

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Section: Beta‐blockers In Pyogenic Granuloma and Nail Paronychiamentioning

confidence: 99%

Section: Beta‐blockers In Pyogenic Granuloma and Nail Paronychiamentioning

confidence: 99%

Section: Beta-blockers In Pyogenic Granuloma and Nail Paronychiamentioning

confidence: 99%

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Topicalbeta‐blockersin dermatologic therapy

Filoni

Ambrogio

Marco

et al. 2021

Dermatologic Therapy

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“…Topical timolol has largely been shown to be effective in the treatment of infantile hemangiomas with a 96% response rate [4,9]; in addition, evidence is emerging for its use in other conditions including pyogenic granulomas, recalcitrant wounds, chronic ulcers, and portwine stains [10]. The mechanism of action of timolol is unclear but previous studies have shown that KS lesions are dependent on β-adrenergic signaling for the reactivation of HHV-8, resulting in proliferation of KS [11].…”

Section: Cks: Classic Kaposi's Sarcomamentioning

confidence: 99%

Failed Treatment of Classic Kaposi’s Sarcoma with Topical Timolol: Case Report and Review of the Literature

Gupta¹,

DeBord²,

Dao³

2019

Cureus

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Classic Kaposi’s sarcoma (CKS) is an angioproliferative cutaneous neoplasm which currently lacks a well-defined treatment regimen. Because the disease is often localized, topical therapies offer therapeutic potential without the morbidity of systemic or surgical treatment. Timolol, a topical β-adrenergic receptor antagonist, has shown promise in the treatment of CKS in individual cases. Here we report a patient with classic Kaposi’s sarcoma who failed treatment with 0.5% topical timolol three times daily for 12 weeks. Topical timolol use has been previously reported in eight patients with CKS who all responded to treatment with no adverse effects. Our divergent experience from the literature implies that while topical timolol may be an effective and safe treatment alternative to traditional therapies for patients with CKS, further prospective studies are needed.

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“…Other β-blockers have also been shown to be beneficial in infantile hemeangioma (e.g., timolol and atenolol − ), and there is increasing interest in using topical β-blockers, and developing improved topical delivery methods, in order to avoid the significant systemic problems associated with oral propranolol. − β-Blocker treatment for retinopathy of prematurity has been shown effective (although 20% of infants had serious adverse systemic side effects , ). β-Blocker treatment for other topical vascular tumors are now being investigated and used successfully, for example, pyogenic granuloma , and Kaposi’s sarcoma, , and in reducing epistaxis in hereditary hemorrhagic telangiectasia …”

mentioning

confidence: 96%

Using Esterase Selectivity to Determine the In Vivo Duration of Systemic Availability and Abolish Systemic Side Effects of Topical β-Blockers

Baker

Fromont

Bruder

et al. 2020

ACS Pharmacol. Transl. Sci.

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For disorders of the skin, eyes, ears, and respiratory tract, topical drugs, delivered directly to the target organ, are a therapeutic option. Compared with systemic oral therapy, the benefits of topical treatments include a faster onset of action, circumventing the liver first pass drug metabolism, and reducing systemic side effects. Nevertheless, some systemic absorption still occurs for many topical agents resulting in systemic side effects. One way to prevent these would be to develop drugs that are instantly degraded upon entry into the bloodstream by serum esterases. Because topical β-blockers are used in glaucoma and infantile hemeangioma and cause systemic side effects, the β-adrenoceptor system was used to test this hypothesis. Purified liver esterase reduced the apparent affinity of esmolol, an ester-containing β-blocker used in clinical emergencies, for the human β-adrenoceptors in a concentration and time-dependent manner. However, purified serum esterase had no effect on esmolol. Novel ester-containing β-blockers were synthesized and several were sensitive to both liver and serum esterases. Despite good in vitro affinity, one such compound, methyl 2-(3-chloro-4-(3-((2-(3-(3-chlorophenyl)ureido)ethyl)amino)-2-hydroxypropoxy)phenyl)acetate, had no effect on heart rate when injected intravenously into rats, even at 10 times the equipotent dose of esmolol and betaxolol that caused short and sustained reductions in heart rate, respectively. Thus, ester-based drugs, sensitive to serum esterases, offer a mechanism for developing topical agents that are truly devoid of systemic side effects. Furthermore, differential susceptibility to liver and serum esterases degradation may also allow the duration of systemic availability for other drugs to be fine-tuned.

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Topical timolol: An effective treatment option for agminated pyogenic granuloma

Cited by 9 publications

References 13 publications

Topicalbeta‐blockersin dermatologic therapy

Topicalbeta‐blockersin dermatologic therapy

Failed Treatment of Classic Kaposi’s Sarcoma with Topical Timolol: Case Report and Review of the Literature

Using Esterase Selectivity to Determine the In Vivo Duration of Systemic Availability and Abolish Systemic Side Effects of Topical β-Blockers

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