A randomized controlled open label comparative clinical study of cephalexin versus doxycycline in patients with acne vulgaris in a hospital based population of South India

Background: Oral antibiotics are frequently used for acne vulgaris. Cephalexin has documented some success against acne vulgaris in earlier studies. Here the efficacy and safety of Cephalexin have been compared against the standard therapy of Doxycyline.Methods: From September 2010 to June 2011, 100 patients of moderate Acne vulgaris were randomized into two groups to receive oral Doxycyline (100mg once daily) or Cephalexin (500mg thrice daily) in an open label manner for eight weeks. All participants were allowed to use topical 5%Benzoyl peroxide gel twice daily. Efficacy was measured in terms of reduction in the number of facial comedones and inflammatory lesions from baseline after eight weeks.Results: 44 patients from Cephalexin group and48 patients from Doxycyline group completed the study. Both drugs have significantly decreased comedone count as well as the inflammatory lesion count after eight weeks. However, Doxycycline appeared better in terms of Comedone count (14.5±3.07 versus 12.9±4.31, p=0.045) as well as inflammatory lesion count (8.64.1±2.14 versus 7.67±2.46, p=0.047) at the end. The total adverse event was slightly more with Cephalexin (6.81% versus 6.25%, p= 0.912), where Diarrhoea remained the commonest adverse effect (4.54%).Conclusions: Although for the first time oral Cephalexin has displayed efficacy against moderate acne vulgaris in a prospective clinical study, it appeared inferior to Doxycycline over eight weeks. Therefore, it becomes an option only when other oral antibiotics are contraindicated or not tolerated

Alitretinoin in dermatology-An update

Alitretinoin is a pan retinoic acid agonist. It was initially used as 0.1% gel in the management of localized Kaposi′s sarcoma. At present, the use of systemic alitretinoin has proved extremely efficacious in the management of recalcitrant chronic hand eczema. Furthermore, there have been other retinoid responsive dermatosis that have demonstrated remission post usage of systemic alitretinoin. With a better toxicity profile, compared to the other systemic retinoids, alitretinoin could be considered a valuable treatment option in the near future for the treatment of these dermatologic disorders

Apremilast: A dermatologic perspective

Apremilast is an oral phosphodiesterase 4 inhibitor, now approved by the Food and Drug Administration in the management of psoriatic arthropathy (PsA). As biologic therapy is associated with significant amounts of adverse effects, newer treatment options with an efficacious outcome, sans the toxicity, is something all clinicians would implement readily in their therapeutic regimens. Apremilast is one such drug which has shown promise in the management of psoriasis, PsA, and a few other dermatologic disorders. This review will throw light on the dermatologic perspective regarding apremilast

Vorinostat-An overview

Vorinostat is a new drug used in the management of cutaneous T cell lymphoma when the disease persists, gets worse or comes back during or after treatment with other medicines. It is an efficacious and well tolerated drug and has been considered a novel drug in the treatment of this condition. Currently apart from cutaneous T cell lymphoma the role of Vorinostat for other types of cancers is being investigated both as mono-therapy and combination therapy

Aspirin in dermatology: Revisited

Aspirin has been one of the oldest drugs in the field of medicine, with a wide range of applications. In dermatology, aspirin has shown benefit in a variety of disorders. Recently, reduction of melanoma risk with aspirin has been demonstrated. Although an analgesic to begin with, aspirin has come a long way; after cardiology, it is now found to be useful even in dermatology

Saw palmetto extract: A dermatologist's perspective

Saw palmetto extract is believed to have antiandrogenic properties and has been used widely for the treatment of androgenic alopecia. It is claimed to have much less side effects as compared to finasteride. Along with its use for androgenic alopecia, it has also been tried for other conditions associated with increased androgen levels in dermatology. This article will review a dermatologist's perspective of this traditional herb