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November 03, 2021
Topical Minocycline Foam (Amzeeq) Approved to Treat Acne Vulgaris: In October 2019, the U.S. Food and Drug Administration (FDA) approved minocycline (Amzeeq) 4% foam for the topical treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris in patients aged 9 years and older. Topical minocycline belongs to the tetracycline class of antibiotics and possesses antibacterial and anti-inflammatory activity with potentially lower risk of systemic side effects compared to oral administration. Three phase 3 clinical trials demonstrated its efficacy and safety compared to vehicle foam when applied once daily for 12 weeks. Long-term safety and efficacy trials and direct comparative trials are lacking. Further investigation into the potential for reduced risk of bacterial resistance development with topical administration of minocycline is warranted.
Jan. 28, 2020
Trifarotene: A New Topical Retinoid Approved for Acne Treatment: Trifarotene (Aklief) is a new topical retinoid cream approved for the treatment of acne in persons age 9 years and over. Once-daily application was superior to vehicle application alone for both facial and truncal acne; there are no direct comparative trials with other retinoids. Trifarotene possesses retinoid class side effects of skin dryness, erythema, and burning/stinging. Although a patient savings program is available for select customers, trifarotene’s high cost and lack of direct comparative trials with other retinoids seem likely to limit its use.
Feb. 19, 2019
Sarecycline (Seysara) Approved for Treatment of Acne Vulgaris: In October 2018, the FDA approved sarecycline (Seysara), a once-daily oral tablet for treatment of inflammatory lesions of non-nodular moderate to severe acne vulgaris in persons aged 9 years and older. Sarecycline is a tetracycline derivative with a narrower spectrum of activity than other tetracyclines, which may result in lower rates of bacterial resistance. Safety and efficacy of sarecycline were shown to be superior to placebo in two identical phase 3 clinical trials lasting 12 weeks. Adverse event rates were similar in nature to other tetracyclines and occurred at low rates. The high cost of the proprietary product may present a barrier to its adoption by health system formularies and widespread use by clinicians. Further research into the potential for reduced antimicrobial resistance is warranted.
Upon completion of the chapter, the reader will be able to:
Describe the pathophysiology of common skin disorders.
Assess the signs and symptoms of common skin disorders in a presenting patient.
List the goals of treatment for patients with common skin disorders.
Select appropriate nonpharmacologic and pharmacologic treatment regimens for patients presenting with common skin disorders.
Identify adverse effects that may result from pharmacologic agents used in the treatment of common skin disorders.
Develop a monitoring plan that will assess the safety and efficacy of the overall disease state management of common skin disorders.