One study suggested that there is a need to evaluate patient-reported outcome measures in regard to treatment outcomes
Evaluation of the efficacy of cysteamine cream compared to hydroquinone in the treatment of melasma: a randomised, double-blinded trial
Melasma is one of the most common skin disorders that poses a challenge for clinicians. In recent studies, cysteamine cream has been a promising treatment compared to placebo.
The aim of this study was to determine the effectiveness of cysteamine cream compared to hydroquinone cream when treating melasma.
To carry out this study, a randomised, double-blinded, single-centre trial was carried out in Australia.
A total of 20 participants took part in this study, and they were given either cysteamine cream or hydroquinone cream to try for 16 weeks. The authors measured changes in the modified Melasma Area and Severity Index (mMASI), and the participants were reviewed and assessed at week 1 and 16.
By week 16, the results showed that 14 of the 20 participants completed the study, with 5 of these participants being in the cysteamine group and 9 patients in the hydroquinone group.
There was a 21.3% reduction in mMASI for the cysteamine group and a 32% reduction in the hydroquinone group. The differences were not statistically significant, but hydroquinone cream was generally more accepted than cysteamine cream.
The authors suggested that this study shows that topical cysteamine may have more comparable effectiveness to topical hydroquinone. The study shows that cysteamine may be a potential alternative to patients and clinicians who want to avoid using topical hydroquinone. Although side effects occurred more frequently for the participants using cysteamine than hydroquinone, they were mild and reversible. The authors also comment that a larger study to compare cysteamine and hydroquinone is necessary to support their study's findings.
Dermatologic adverse reactions to proton-pump inhibitors: a synthetized review
The use of prescription drug proton-pump inhibitors (PPIs) is fairly common, and the adverse reactions experienced vary in severity.
The aim of this review was to discuss all reported cutaneous side effects of PPIs and help clinicians to better understand them and also be able to provide sufficient support.
To carry out this review, the authors carried out a detailed search using PubMed, Embase and FDAAQ8. They found a total of 56 articles, including case reports, case series and articles reviewing PPI-induced cutaneous adverse reactions. The data recorded were in relation to patient age, gender, medical history, clinical manifestations, diagnostic tests, management and clinical outcomes.
The results of the review showed that PPI-induced adverse skin reactions were mostly immunological, and this included both immediate and delayed-type hypersensitivity reactions. According to the authors, these reactions can be life-threatening.
From the number of published cases of delayed-type hypersensitivity reactions found, the authors state that esomeprazole, omeprazole and lansoprazole were the most common drugs involved. It was noted that skin tests are useful in confirming PPI-induced hypersensitivity reactions.
In conclusion to this study, the authors recommended that, when considering the possible culprits for a cutaneous drug reaction, PPIs should be taken into consideration as a possible cause.
Hydroquinone: myths and reality
As a result of its capability to inhibit the enzyme tyrosinase, hydroquinone is widely used for the treatment of pigmentation.
The authors of this study reviewed the available evidence that supports the use of hydroquinone. The most effective and endurable formulations were a combination of hydroquinone, retinoid and corticosteroid.
It was found that exogenous ochronosis risk remains low if clinicians prescribe a concentration of five or less for a reduced length of time and regular monitoring. The authors advised that dermatologists should assure patients that, with controlled use, hydroquinone can be a well-endured and safe treatment for various hyperpigmentary conditions, including melasma.
Systematic review to identify and appraise patient-reported outcome measures on treatment satisfaction in acne
Acne is considered to be the second most common skin disease worldwide.
Seven core outcome domains have recently been identified, which, together, form an Acne Core Outcome Set (ACORN project). One of these outcomes was patient satisfaction with acne treatment.
The aim of this study was to carry out a review of all studies that detailed the progress of patient-reported outcome measures (PROMs), assessed one or more measurement properties of a PROM or interpreted a PROM concerning treatment satisfaction in patients with acne.
To identify PROMs on acne treatment satisfaction, the authors conducted a search on Pubmed, MEDLINE, Embase, LILACS, Web of Science, Cochrane Library, Emcare, PsychINFO and Academic Search Premier in June 2020 to find suitable studies for the review.
Two of the authors independently carried out study selection, data extraction and assessment of methodological quality according to COSMIN guidance. The authors found that they could only include one study that detailed developing a treatment satisfaction measure in acne patients.
The results from the study showed that the development that was assessed was insufficient, and that the data on measurement properties were not satisfactory. Furthermore, the authors found 188 studies reporting patient satisfaction exclusively as a result, using various methods, but none of them were standardised or validated.
In conclusion, the authors could not find a PROM on treatment satisfaction that could be recommended for a core outcome set in acne. They suggested that there is a need for a PROM assessing treatment satisfaction in acne that is developed, designed and validated.