23. En una revisión sistemática de Cochrane : 30 RCT muestran que: Retinoides son las drogas que han demostrado tener un rol indesmentible en el manejo del fotoenvejecimiento Tretinoína crema>0,025% Tazaroteno crema 0,1% Dosis respuesta: efecto e irritación Brooke, Hollis S, Griffiths. Intervention for fotodamaged skin Cochrane Database of System Rev:2005 Medline:1966-2002 , EMBASE:1974 -2002 aprobados por FDA
24.
25.
26.
27. Evaluación de Adapaleno Gel 0.3% para el tratamiento de queratosis actínicas y lentigos solares Assessment of adapalene gel for the treatment of actinic keratoses and lentigines: A randomized trial Kang S ; Goldfarb MT ; Weiss J et al. J Am Acad Dermatol 2003;49:83-90
28. Resultados QUERATOSIS ACTINICAS (9 meses. 1v/d 1er mes;2v/d ) Mejoría Differin 0.3% (66%) vs vehículo (34%) Reducción media en el número de QAs P < 0.05
45. Figure 2 (a) Before treatment. (b) After treatment.
46. Cortes histopatológicos teñidos con picro-sirius rojo donde fibras colágenas se tiñen de rojo: pre y post tratamiento 20 mg mostrando incremento de fibras colágenas en la dermis superficial . Media de incremento de 37.8% a 44.4% (10 mg) p=0.029 Media de incremento de 36.6% a 41.9% (20 mg) p= 0.01
47. Tinción de resorcina-fucsina no oxidada para fibras elásticas (a) Antes de tratamiento: material elastótico se tiñe morado (b) Post tratamiento con isotretinoina 10 mg : disminución de material elastótico Media de disminución de 15.3% a 12% ; p= 0.014 (10 mg) Media de disminución de 15.5%- 14% ; p=0.125 (20 mg)
El estandar de oro y único tratamiento médico de eficacia comprobada
ADAPALENE: TARGETED DELIVERY TO THE PILOSEBACEOUS FOLLICLE A major prerequisite for an effective topical drug is that a sufficient amount of the active agent must arrive at the site of action. Adapalene gel was designed to enhance the concentration of active ingredient at the site of action, thereby diminishing local and systemic side effects. Targeted delivery to the pilosebaceous follicle was obtained by using a narrow range of adapalene particle size. The follicular penetration pathway of adapalene gel was confirmed by observing the fluorescence of adapalene microcrystals in the skin after topical application to human skin. After 5 minutes, microcrystals of adapalene were distributed in the stratum corneum and in the follicular duct with light fluorescence peripheral to the hair shaft. After 2 hours, microcrystals were even present in the follicle to a depth of 400 μ m. This significant presence in the pilosebaceous follicle directs the therapeutic agent to the microcomedones. Allec J, Chatelus A, Wagner N. Skin distribution and pharmaceutical aspects of adapalene gel. J Am Acad Dermatol. 1997;36:S119-S125.
ADAPALENE: KEY FEATURES Adapalene is a topical retinoid designed to optimize efficacy and tolerability. The attributes of the adapalene molecule are described in the following slides and include chemical stability, less irritation potential than other topical retinoids, rapid follicular penetration and allows for cosmetically appealing formulations.
THE SAFETY AND EFFICACY OF ADAPALENE GEL 0.3% AS COMPARED TO ITS VEHICLE AND ADAPALENE GEL 0.1% IN THE TREATMENT OF ACNE VULGARIS