Category Archives: JAMA Dermatol

Evaluation of the Efficacy, Safety, and Tolerability of 3 Dose Regimens of Topical Sodium Nitrite With Citric Acid in Patients With Anogenital Warts: A Randomized Clinical Trial.


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Evaluation of the Efficacy, Safety, and Tolerability of 3 Dose Regimens of Topical Sodium Nitrite With Citric Acid in Patients With Anogenital Warts: A Randomized Clinical Trial.

JAMA Dermatol. 2015 Aug;151(8):854-61

Authors: Ormerod AD, van Voorst Vader PC, Majewski S, Vanscheidt W, Benjamin N, van der Meijden W

Abstract
IMPORTANCE: Anogenital warts are a common disorder associated with significant physical and mental distress and a substantial cause of health care costs.
OBJECTIVE: To assess the efficacy of the topical application of nitric oxide delivered using acidified nitrite.
DESIGN, SETTING, AND PARTICIPANTS: A multicenter, randomized, controlled, dose-ranging clinical trial was conducted in European genitourinary medicine clinics between December 20, 2001, and January 14, 2003. Analysis was by intent to treat for all individuals initiating therapy. Participants included male and female volunteers older than 18 years with between 2 and 50 external anogenital warts. A total of 299 individuals from 40 centers were randomized to a control arm and a treatment arm that received 3 doses of acidified nitrite applied topically for 12 weeks with an additional 12 weeks of follow-up, with the final follow-up visit on January 14, 2003.
INTERVENTIONS: Placebo nitrite cream and placebo citric acid cream were applied twice daily. Active treatment was divided as low dose (sodium nitrite, 3%, with citric acid, 4.5%, creams applied twice daily), middle dose (sodium nitrite, 6%, with citric acid, 9%, creams applied once daily at night, with placebo applied in the morning), and high dose (sodium nitrite, 6%, with citric acid, 9%, creams applied twice daily).
MAIN OUTCOMES AND MEASURES: The primary outcome was proportion of patients with complete clinical clearance of target warts; secondary outcomes were reduction in target wart area and safety.
RESULTS: Complete clinical clearance at 12 weeks occurred in 10 of 74 patients (14%; 95% CI, 6%-21%) with placebo; 11 of 72 (15%; 95% CI, 7%-24%) with low-dose treatment; 17 of 74 (23%; 95% CI, 13%-33%) with middle-dose treatment; and 22 of 70 (31%; 95% CI, 21%-42%) with high-dose treatment (P = .01). Reduction in target wart area, time to clearance, and patient and investigator assessments supported the superiority of the high-dose therapy vs placebo. There were no systemic or serious adverse events associated with treatment. However, there was a dose-related increase in itching, pain, edema, and staining of the anogenital skin associated with the active treatment. Overall, 21 patients withdrew from active treatment because of adverse events compared with none using placebo.
CONCLUSIONS AND RELEVANCE: Use of sodium nitrite, 6%, with citric acid, 9%, twice daily is more effective than placebo in the treatment of anogenital warts. Treatment was associated with local irritant adverse effects.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT02015260.

PMID: 25922903 [PubMed – indexed for MEDLINE]

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Toward a practical renaming of bullous pemphigoid and all its variants-reply.

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Toward a practical renaming of bullous pemphigoid and all its variants-reply.
JAMA Dermatol. 2014 Apr;150(4):459-60
Authors: Bakker CV, Terra JB, Jonkman MF
PMID: 24718432 [PubMed – indexed f… Continue reading






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Prevalence of self-reported skin complaints and avoidance of common daily life consumer products in selected European Regions.


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Prevalence of self-reported skin complaints and avoidance of common daily life consumer products in selected European Regions.

JAMA Dermatol. 2014 Feb;150(2):154-63

Authors: Naldi L, Cazzaniga S, Gonçalo M, Diepgen T, Bruze M, Elsner P, Coenraads PJ, Svensson Å, Bertuccio P, Ofenloch R, EDEN Fragrance Study Group

Abstract
IMPORTANCE Skin disorders are common in the general population, and they may be associated with significant disability. The use of daily skin products may affect the appearance and severity of skin conditions. OBJECTIVES To assess the prevalence of reported itchy rash lasting longer than 3 days among the general population and to evaluate lifetime avoidance of different types of consumer products because of skin problems. DESIGN, SETTING, AND PARTICIPANTS The European Dermato-Epidemiology Network (EDEN) Fragrance Study comprised a large descriptive epidemiological survey of the general population conducted in 6 European regions from August 20, 2008, to October 10, 2011. Participants were a random sample of individuals aged 18 to 74 years, based on electoral precincts. The participants were interviewed using a standardized questionnaire. EXPOSURES Lifetime exposure to products of common use was considered, including toiletry items that remained on the skin or were rinsed off and household and functional items. MAIN OUTCOMES AND MEASURES The 1-month, 1-year, and lifetime age-standardized prevalence rates of itchy rash that lasted longer than 3 days. RESULTS In total, 12 377 individuals (53.9% female; median age, 43 years) were interviewed. The overall prevalences of itchy rash were 19.3% (95% CI, 18.6%-20.0%) during the month preceding the interview, 31.8% (95% CI, 31.0%-32.6%) during the preceding year, and 51.7% (95% CI, 50.8%-52.6%) over a lifetime. In addition, the percentage of individuals who reported avoidance of any product varied from 37.0% for products intended to be left on the skin to 17.7% for household or functional products. CONCLUSIONS AND RELEVANCE Our findings confirmed the magnitude of skin problems among the general population reported in other surveys. Although itchy rash is a nonspecific manifestation, it may be considered in epidemiological surveys to reflect a constellation of skin conditions and to summarize the burden of these conditions on general health.

PMID: 24369385 [PubMed – indexed for MEDLINE]

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Bullous pemphigoid as pruritus in the elderly: a common presentation.

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Bullous pemphigoid as pruritus in the elderly: a common presentation.
JAMA Dermatol. 2013 Aug;149(8):950-3
Authors: Bakker CV, Terra JB, Pas HH, Jonkman MF
Abstract
IMPORTANCE: In the literatur… Continue reading






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