The Journal of dermatological treatment
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Review Meta Analysis
Different doses of gabapentin formulations for postherpetic neuralgia: A systematical review and meta-analysis of randomized controlled trials.
Gabapentin, extended-release gabapentin (gabapentin ER), and gabapentin enacarbil (GEn), play an important role in relieving pain associated with postherpetic neuralgia (PHN). Although previous systematic reviews have assessed the efficacy and safety of gabapentin formulations for PHN, they have failed to take formulation differences and dose differences into account. Aiming at assessing the efficacy and safety of different doses of gabapentin formulations for PHN, this study performed a systematical review and meta-analysis of randomized controlled trials (RCTs). ⋯ An increasing gabapentin dose may not provide a good pharmacological therapy, whereas it can increase the risk of adverse events. Gabapentin ER, 1800 mg/day once daily treatment is significantly effective in pain relief, following high incidence of adverse events, but twice daily treatment shows no significant differences in both efficacy and safety compared with placebo. GEn 1200 mg/day and 2400 mg/day doses are more effective and safe in treating PHN. The long-term efficacy and safety of different doses of gabapentin formulations remain to be determined.
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Atopic dermatitis (AD), a chronic inflammatory skin disease affecting children and adults, presents as mild-to-moderate disease in the majority of patients. Pruritus, one of the key diagnostic criteria for AD, is associated with reduced quality of life and disease aggravation. Current treatments include emollients and topical pharmaceutical agents. ⋯ The development of a more specific anti-inflammatory treatment which is easy to use and targets pruritus could provide clinically meaningful improvements for patients with AD. The majority of emerging therapies for AD are focused on inhibiting phosphodiesterase 4 (PDE4), an enzyme which is increased in inflammatory disorders such as AD. This review will update readers on the recent advances in topical therapies, including PDE4 inhibitors, for the treatment of AD.
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Randomized Controlled Trial
Gabapentin: A promising therapy for uremic pruritus in hemodialysis patients: A randomized-controlled trial and review of literature.
Treatment of uremic pruritus (UP) is a big challenge. ⋯ Gabapentin is a promising and a well-tolerated treatment option for patients with UP. We recommend it as a first line therapy with a maintenance post-HD dose of 100-300 mg. We also recommend the 5-D scale in the assessment of the severity of pruritus.
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Vitamin D plays a key role in the immune responses generated by lymphocytes and antigen-presenting cells. Decreased vitamin 25-hydroxyvitamin D (25(OH)D) levels have been implicated in several allergic disorders and association between 25(OH)D levels and chronic urticaria (CU) symptom scores has been evaluated in a few studies. This study was performed to assess the effects of vitamin D supplementation on the symptoms and quality of life scores in chronic spontaneous urticaria (CSU) and to vitamin D levels in CSU patients in comparison with controls. ⋯ This study support the contributing and beneficial effects of vitamin D in the treatment of CU. Replacement of vitamin D may provide improvement in both the severity of symptoms and the quality of life scores in these patients.
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Deep erythema and inflammation after re-epithelialization of superficial wounds is a sign of scar formation. Corticosteroids may prevent scarring by suppression of inflammation and fibroblast activity. Tretinoin may increase the efficacy of corticosteroids in this setting. ⋯ Clobetasol + tretinoin can significantly decrease the incidence of scar formation in patients with inflammation after re-epithelialization of superficial wounds.