Use of Topical Timolol Maleate as Re-Epithelialization Agent for Treatment of Recalcitrant Wounds of Varying Etiologies

Cahn, Brian A.; Kaur, Ramanjot; Hirt, Penelope A.; Tchanque-Fossuo, Catherine N.; Dahle, Sara E.; Kirsner, Robert S.; Isseroff, Roslyn Rivkah; Lev‐Tov, Hadar

doi:10.36849/jdd.2020.5306

Cited by 11 publications

(14 citation statements)

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“…Healthy skin barriers are characterized by relatively high skin hydration levels and low water loss. An in vivo study showed that the TEWL in the lesion area of patients with rosacea was higher than that in the non‐lesion area 20,21 . It is confirmed that the skin barrier of patients with rosacea is damaged.…”

Section: Discussionmentioning

confidence: 77%

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A randomized, controlled, split‐face study of botulinum toxin and broadband light for the treatment of erythematotelangiectatic rosacea

Tong

Luo

Gao

et al. 2022

Dermatologic Therapy

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To study the efficacy and safety of botulinum toxin (BTX) combined with broadband light (BBL) in the treatment of rosacea‐related erythema and flushing. A randomized, single‐blind, split‐face controlled study including 22 patients with erythemato telangiectatic rosacea were enrolled. Both cheeks were randomly divided into experimental group and control group. They were treated three times with an interval of 1 month. In the first treatment, the experimental group received BBL treatment and intradermal injection of BTX, and the control group received BBL treatment and intradermal injection of the same amount of normal saline; in the second and third treatments were both groups received the same BBL treatment. The patients were evaluated before the first treatment and 1, 2, 3, and 6 months after the treatment. Compared with the control group, the hydration in the experimental group increased and the global flushing symptom score (GFSS), VISIA red value, erythema index, transepidermal water loss, and sebum secretion decreased. The differences were statistically significant (p < 0.05). In the experimental group, at 3 months after the first treatment, compared with before treatment, the GFSS, VISIA red value, erythema index, transepidermal water loss and sebum secretion decreased the hydration increased. The sebum secretion returned to the pretreatment level in 6 months after treatment, and the other indexes maintained the level in 3 months after treatment. One patient had a slight lifting limitation of the corners of his mouth after 10 days of BTX injection, without special treatment, and recovered after 1 month. BTX intradermal injection combined with BBL has a definite therapeutic effect on the improvement of rosacea related erythema and flushing, which is better than simple BBL, and has high safety. It is worthy of clinical promotion.

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Section: Discussionmentioning

confidence: 77%

“…An in vivo study showed that the TEWL in the lesion area of patients with rosacea was higher than that in the non-lesion area. 20,21 It is confirmed that the skin barrier of patients with rosacea is damaged. Silva et al 22 injected BTX into 6 ETR patients (2 U/0.1 ml) observe the curative effect on facial erythema and redness.…”

Section: Discussionmentioning

confidence: 93%

A randomized, controlled, split‐face study of botulinum toxin and broadband light for the treatment of erythematotelangiectatic rosacea

Tong

Luo

Gao

et al. 2022

Dermatologic Therapy

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“…Topical application of timolol is used to treat a host of dermatologic diseases [40,41], including epidermolysis bullosa [42], Kaposi sarcoma [43,44], acne and acne rosacea [45], and improving scar outcomes [46]. Timolol has also been found to be effective in treating chronic wounds [14][15][16][17]. However, this beta blockade improves healing in some, but not all, patients with chronic wounds [42,47,48].…”

Section: Discussionmentioning

confidence: 99%

“…Blocking the binding of the ligand to the beta AR by administration of beta AR antagonist, such as timolol, reverses the inhibition and improves healing in preclinical animal models [5,[11][12][13]. Indeed, beta AR blockade has been proposed as a therapeutic for non-healing wounds [14], and venous or diabetic ulcers [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Alpha and beta adrenergic receptors modulate keratinocyte migration

et al. 2021

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Keratinocyte migration into skin wounds is the step of the healing process that correlates with the wound closure rate. Keratinocyte migration, and wound epithelialization are decreased when beta 2-adrenergic receptors (B2AR) are activated by 1 μM epinephrine/adrenaline, resulting in delayed wound healing in human and mouse skin. In the present study, we found paradoxically, that in a subset of keratinocyte strains exposure to low concentrations of epinephrine (0.1 nM) increased, rather than decreased, their migratory rate. We find that both the alpha- and the beta-adrenergic receptors are expressed in human keratinocytes, and expression of alpha-2 AR subtypes demonstrated for the first time. Therefore, we tested if the alpha-AR could be modulating the increased migratory response observed in these cell strains. By using specific inhibitors to alpha-AR, we demonstrated that blocking A2B-AR could reverse the rapid cell migration induced by the 0.1 nM epinephrine. Phosphorylation of ERK was elevated after 1–10 minutes of the low epinephrine treatment and the A2B-AR inhibitor blocked the ERK phosphorylation. The results suggest that both the A2B-AR and B2AR mediate keratinocyte migration, in which with a low level of epinephrine treatment, A2B-AR could alter the B2AR signals and regulate the migration rate.

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“…Moreover, patients with rosacea often have an impaired skin barrier 8 . Recently, topical timolol has shown promising results in the treatment of recalcitrant wounds of varying etiology and to restore the skin barrier 9 . Based on these findings, we hypothesized that topical timolol may improve ETR.…”

Section: Introductionmentioning

confidence: 99%

A randomized, controlled, split‐face study of topical timolol maleate 0.5% eye drops for the treatment of erythematotelangiectatic rosacea

Wei

Hamblin

Wen

2021

J of Cosmetic Dermatology

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Rosacea is a chronic inflammatory cutaneous disease with varying prevalence. The pathophysiologic mechanisms include an interaction between genetic and environmental factors, neurovascular dysregulation, and increased immune response. These mechanisms lead to the main symptoms of inflammation, vasodilation, and angiogenesis. The classification of rosacea involves four subtypes designated as follows: subtype 1, erythematotelangiectatic; subtype 2, papulopustular; subtype 3, phymatous; subtype 4, ocular. Rosacea usually commences with a flush-like temporary dilation of capillaries and transient erythema. Once the facial vasculature becomes chronically dilated, persistent erythema can become established, known as erythematotelangiectatic rosacea (ETR) or subtype 1. [1][2][3] However, the current recommendations now suggest that patients with rosacea should be characterized by individual clinical signs and symptoms, because the focus on subtypes tended to ignore the progression from one type to another. New scientific evidence has

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Use of Topical Timolol Maleate as Re-Epithelialization Agent for Treatment of Recalcitrant Wounds of Varying Etiologies

Cited by 11 publications

References 0 publications

A randomized, controlled, split‐face study of botulinum toxin and broadband light for the treatment of erythematotelangiectatic rosacea

A randomized, controlled, split‐face study of botulinum toxin and broadband light for the treatment of erythematotelangiectatic rosacea

Alpha and beta adrenergic receptors modulate keratinocyte migration

A randomized, controlled, split‐face study of topical timolol maleate 0.5% eye drops for the treatment of erythematotelangiectatic rosacea

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