Examinando por Autor "López Estebaranz, JL"

Mostrando 1 - 3 de 3

Adult female acne: a new paradigm
(Wiley, 2013) Dreno, B; Layton, A; Zouboulis, C; López Estebaranz, JL; Zalewska-Janowska, A; Bagatin, E; Zampeli, VA; Yutskowskaya, Y; Harper, JC
In the adult female, acne is a chronic condition with a substantial negative psychological, social and emotional impact. Based on time of onset, two subtypes of adult female acne are recognized: ‘persistent acne’ is a continuation of the disease from adolescence, while ‘late-onset acne’ first presents in adulthood. The morphological characteristics of adult female acne are often distinct from adolescent acne. In adults, inflammatory lesions (particularly papules, pustules and nodules) are generally more prominent on the lower chin, jawline and neck, and comedones are more often closed comedones (micro cysts). Adult acne is mainly mild-to-moderate in severity and may be refractory to treatment. A holistic approach to acne therapy should be taken in adult females, which combines standard treatments with adjunctive therapy and cosmetic use. A number of factors specific to the adult female influence choice of treatment, including the predisposition of older skin to irritation, a possible slow response to treatment, a high likelihood of good adherence, whether of child-bearing age, and the psychosocial impact of the disease. Adherence to therapy should be encouraged through further patient education and a simplified regimen that is tailored to suit the individual patient’s needs and lifestyle. This article reviews the specific characteristics of adult female acne, and provides recommendations for acne therapy in this patient group.
Detection and typing of molluscum contagiosum virus in skin lesions by using a simple lysis method and polymerase chain reaction
(Wiley, 1996) Nuñez, A; Funes, JM; Agromayor, M; Moratilla, M; Varas, AJ; López Estebaranz, JL; Esteban, M; Martín Gallardo, A
A polymerase chain reaction (PCR) assay for the rapid detection and typing of molluscum conta giosum virus (MCV) was developed. The target DNA was a 393 base pair (bp) segment, which is present in the coding region of the MCV p43K gene product. Release of MCV DNA from skin lesions was performed by using a simple proce dure that provided suitable template DNAfor am plification, and allowed detection of MCV directly in clinical material. The PCR yielded a unique 393 bp product when MCV DNA was used as template. This product was not shown with DNA from other viruses and bacterial pathogens caus ing skin diseases. The specific PCR product was obtained with individual lesions from all patients clinically diagnosed with MCV infection, whereas no products were detected with skin samples from healthy individuals. Sequencing of this PCR product allowed determination of the virus sub type on the basis of previously described nucleo tide differences between subtypes MCVI and MCVII. To avoid the sequencing process, a sec ond PCR assay was developed, in which the tar get DNA sequence included a MCVI-specific rec ognition site for the restriction endonuclease BamHI. This PCR assay yielded a unique 575 bp product with lesions from either MCVI- or MCVII infected patients. However, only the MCVI-de rived product was susceptible to BamHl diges tion, which generated two fragments of 291 and 284 bp, respectively. Amplification of specific MCV DNA sequences from single, individual le sions provides a sensitive and reliable method for laboratory diagnosis and molecular epidemi ology studies of molluscum contagiosum.
Efficacy of once-daily treatment regimens with calcipotriol/betamethasone dipropionate ointment and calcipotriol ointment in psoriasis vulgaris
(Wiley, 2004) Kragballe, K; Noerrelund, KL; Lui, H; Ortonne, JP; Wozel, G; Uuraasmaa, T; Fleming, C; Hanssen, LI; Persson, LM; López Estebaranz, JL
Background A two-compound ointment containing calcipotriol 50 lg g)1 and betamethasone dipropionate 0Æ5 mg g)1 has recently been shown to be an effective treatment for psoriasis. Objectives This study was designed to investigate efficacy and safety of different treatment regi mens with the two-compound product (Daivobet ⁄ Dovobet ; LEO Pharma, Ballerup, Denmark) and calcipotriol 50 lg g)1 ointment (Daivonex ⁄ Dovonex ; LEO Pharma). Methods In total, 972 patients with psoriasis vulgaris were randomized to one of three treatment regimens: group 1, the two-compound product once daily for 8 weeks followed by calcipotriol ointment once daily for 4 weeks; group 2, the two-compound product once daily for 4 weeks followed by 8 weeks of treatment with calcipotriol ointment once daily on weekdays and the two compound product once daily at weekends; and group 3, calcipotriol ointment twice daily for 12 weeks. The efficacy was evaluated by Psoriasis Area and Severity Index (PASI) and investiga tors’ global assessments of disease severity. The primary response criteria were percentage reduc tion in PASI and proportion of patients with absent ⁄ very mild disease according to the investigators’ global assessments after 8 weeks of treatment. Results The mean reduction in PASI from baseline to the end of 8 weeks of treatment was 73Æ3% for group 1, 68Æ2% for group 2 and 64Æ1% for group 3. The proportion of patients with absent ⁄ very mild disease at the end of 8 weeks of treatment was 55Æ3% for group 1, 47Æ7% for group 2 and 40Æ7% for group 3. For both primary response criteria, group 1 was statistically superior to group 3 (P < 0Æ001), whereas group 2 did not differ significantly from group 3. The difference between group 1 and group 2 was statistically significant with regard to PASI but not regarding the proportion of patients with absent ⁄ very mild disease. Patients receiving initial therapy with the two-compound product achieved the fastest treatment response, and the maximum treatment effect for these patients was seen after 5 weeks. This effect was maintained with continued treatment with the two-compound product for up to 8 weeks. After 12 weeks of treatment, no significant differences were seen between the three groups with regard to reduction in PASI, whereas the proportion of patients with absent ⁄ very mild disease in group 2 was superior to that in group 3. Patients receiving therapy with the two-compound product experienced fewer lesional ⁄ perilesional adverse drug reactions than the calcipotriol-treated patients (P < 0Æ001): 10Æ9% in group 1, 11Æ5% in group 2 and 22Æ3% in group 3. Conclusions Two different short-term treatment regimens employing a recently developed two compound product (calcipotriol ⁄ betamethasone dipropionate) provided rapid and marked clinical efficacy and were shown to be safe therapies for psoriasis vulgaris