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Goodbye, Larry
10 Mar2010
My first conversation with Larry Prescott took place on February 5, 2001, just four days after I took over as editor of P&T. I don’t remember much about the discussion, and the yellow sticky note summarizing our phone call was brief and matter-of-fact—probably much like the conversation itself. My chicken scratch says: “Amer Coll Cardiol, Amer Gastroenterol Assn—small mtg in Oct. Neurology—same time as Oncology.”
- In: Main
- Tags: Larry Prescott
Antibiotics
Oral antibiotics are effective in the treatment of acne, particularly when acne is related to inflammation or P. acnes infection. As previously stated, the antibiotics are useful for moderate and severe grades of inflammatory acne because of their anti-inflammatory properties.
- In: Acne
- Tags: Acne, Acne Diagnosis, Acne Treatment
Therapies for acne are varied and include proper cleaning regimens, topical agents, oral antibiotics, oral retinoids, and oral hormonal therapies. Available treatments are outlined in Table 2.
- In: Acne
- Tags: Acne, Acne Diagnosis, Acne Treatment
Follicular hyperkeratinization underlies the development of comedones, the characteristic acne lesion. Although many patients believe that acne stems from a failure to clean the face effectively and sufficiently, researchers have noted it is a failure of the skin and the pores to slough off dead skin cells. Hyperkeratinization is related to the presence of P. acnes in the follicles as it unleashes its enzymatic armamentarium and hides behind the biofilm.
- In: Acne
- Tags: Acne, Acne Diagnosis, Acne Treatment
Differential Diagnosis
The differential diagnosis of acne includes gram-negative fol-liculitis, perioral dermatitis, sebaceous hyperplasia, syringoma, tuberous sclerosis (adenoma sebaceum), trichoepithelioma, Demodex folliculitis, bacterial folliculitis, and papular sarcoido-sis. The diseases that most closely resemble acne, but are said to be distinguishable from it, include:
- gram-negative folliculitis: occurs after months of therapy with tetracycline (e.g., Sumycin, Par); responds only to sulfa antibiotics, such as sulfamethoxazole/trimethoprim (Bactrim, Women First) or isotretinoin drug; and is the type from which gram-negative pathogens can be obtained for culture
- rosacea: classically defined as a facial eruption lacking comedones
- perioral dermatitis: thought to be a variation of rosacea
- acneiform drug eruptions: most commonly associated with epidermal growth factor blockers but related, at a lower incidence, to lithium and phenytoin (Generic Dilantin, Pfizer)
- eosinophilic pustular folliculitis: most closely associated with HIV infection in the U.S. but not uncommon in the Japanese population
- In: Acne
- Tags: Acne, Acne Diagnosis, Acne Treatment
Acne: A Review of Diagnosis and Treatment
5 Mar2010
Abstract
Acne vulgaris (acne) is probably the most common derma-tological complaint in the U.S. Acne has a range of presentations and manifestations, thus apparently comprising many disease states. Although acne is not an infectious disease, specimens of bacteria such as Propionibac-terium acnes, Propionibacterium granulosus, and Staphylococcus epidermidis can be obtained for culture from the eruptions of acne. Other common associations of acne include hormonal imbalances and follicular hyperkeratinization.
- In: Acne
- Tags: Acne, Acne Diagnosis, Acne Treatment
Ramelteon is a melatonin receptor agonist. According to the manufacturer, its molecular structure is composed of a substituted tetrahydroindenofuran derivative containing a propionamide moiety with one chiral center, and the compound is produced as the (S) enantiomer. It is freely soluble in organic solvents and is considered very slightly soluble in water or aqueous buffers with a pH between 3 and 11.