Modern approaches to the prevention and correction of complications caused by systemic treatment of severe acne forms

Abstract

Background. According to European and RF clinical guidelines, only the systemic use of isotretinoin in severe acne has a high level of evidence. However, this therapy is frequently associated with the development of retinoid dermatitis, the prevention and correction of which requires the application of emollients. Aim. To evaluate the efficacy and tolerability of the Perfectoin cream during treatment and prevention of retinoid dermatitis in patients with severe acne receiving systemic treatment with isotretinoin.Materials and methods. Two groups of patients each comprising 38 people with moderate, severe and resistant to standard therapy forms of acne were observed. Each group included 22 patients with retinoic dermatitis manifestations and 16 without such symptoms. The patients in the main and comparison groups were prescribed the Perfectoin cream and the dexpanthenol cream, respectively. Control of the skin condition was performed prior to the study and following 1, 3 and 6 months of therapy. Assessment parameters were the main symptoms of retinoid dermatitis (erythema, lichenification, excoriation, itching, feeling of dryness/tightness of the skin), indicators of the hydration of the horny layer of the epidermis and the transepidermal loss of moisture, as well as the dermatology life quality index.Results. The study has shown that the Perfectoin cream in patients with acne receiving isotretinoin therapy helps to restore skin hydration and leads to a rapid regression of the main dermatological symptoms of retinoid dermatitis, thus improving the overall quality of patients’ life.

Topical Ectoine Application in Children and Adults to Treat Inflammatory Diseases Associated with an Impaired Skin Barrier: A Systematic Review

“…Six studies were assessed, of which three were designed as prospective, open label studies [48][49][50], one as a prospective, open label study with control pairs [51], one as a randomized, nonblinded study [52], and one as randomized, intraindividual double-blinded study [35]. Certainty of evidence was graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and ranged from very low (one study) to moderate certainty (three studies) (Table 1).…”

“…Certainty of evidence was graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework and ranged from very low (one study) to moderate certainty (three studies) (Table 1). The studies predominately included patients with atopic dermatitis [35,[48][49][50][51], while one study evaluated the prevention and management of retinoid dermatitis after pharmacological acne treatment [52]. The study duration (including follow-up) varied from 2 to 4 weeks for atopic dermatitis and 6 months for retinoid dermatitis.…”

“…Sample sizes ranged from 30 [49] to 242 [48], resulting in 525 recruited patients. Studies were performed on various continents and in several countries including Asia (Hong Kong) [49] and Europe (Germany, Poland, Russia) [35,48,[50][51][52].…”

“…The applied formulations contained between 5.5% [48] and 7% ectoine [35,[49][50][51][52]. Creams or emollients were used in all studies including the brand products Dermaveel, Perfectoin, and EHK02-01 creams (all by bitop AG, Witten, Germany).…”

“…The application in four studies was combined with other treatment regimens [48][49][50][51] including histamine antagonists [48,49], topical corticosteroids [48][49][50][51], and calcineurin inhibitor [48,51]. For the prevention and management of retinoid dermatitis, the ectoine-containing formulation was combined with standard isotretinoin therapy [52].…”