Journal of the American Academy of Dermatology 08/2012; 67(2):318-20. DOI:10.1016/j.jaad.2012.02.045 · 4.45 Impact Factor
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ABSTRACT: BACKGROUND: Acne is a common skin condition often requiring complex therapeutic regimens. Patient nonadherence to prescribed medication regimens is a factor in treatment failure. OBJECTIVE: The goal of this study was to determine if daily automated text messages would result in increased adherence to recommended use of topical acne medication and consequently greater improvement in acne. METHODS: Forty patients with mild to moderate acne were prescribed clindamycin/benzoyl peroxide 1%/5% gel in the mornings and adapalene 0.3% gel in the evenings for 12 weeks. Each medication tube was fitted with an electronic Medication Event Monitoring System cap (MEMS, Aardex Group, Sion, Switzerland) (to record the date and time of every opening/closing of the tube). Twenty patients were randomly assigned to receive customized twice-daily text messages instructing them to apply their morning and evening medication. The remainder of patients (N = 20), who did not receive text messages, served as control subjects. RESULTS: Mean adherence rates for the correct application of both medications on a daily basis over 12 weeks was 33.9% for patients in the reminder group and 36.5% for patients in the control group (P = .75). Patients in both groups had similar clinical improvement of their acne. LIMITATIONS: The small sample size may limit the ability to detect differences between the study groups. CONCLUSIONS: Electronic reminders in the form of daily, customized text messages were not associated with significant differences in adherence to topical medications in patients with mild to moderate acne and had no significant effect on therapeutic response.
Journal of the American Academy of Dermatology 04/2012; 67(6). DOI:10.1016/j.jaad.2012.02.031 · 4.45 Impact Factor
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ABSTRACT: Punch grafting is a well-established treatment for vitiligo, but predictive factors for outcomes are not well established.
To determine the characteristics of responses to punch grafting performed in patients with vitiligo.
Retrospective, single-center chart review. Response rates were assessed using photographs taken before and after grafting using a 1.5-mm punch instrument. Effectiveness of repigmentation was assessed using the following scale: worse, no improvement, 0% to 25% improvement, 25% to 50% improvement, 50% to 75% improvement, and 75% to 100% improvement. Repigmentation rates were correlated with patient demographics.
Thirty-seven charts were reviewed, from which data were available from 30 patients. The total number grafts was 606 in 44 transplanted areas; 87% (530/606) of the transplants survived, and 26 of the 30 (87%) patients achieved some degree of repigmentation. Patients younger than 20 achieved the greatest average improvement in repigmentation (mean 61%), whereas those aged 60 and older showed the least improvement (mean 38%). Punch grafting of the neck and trunk achieved the greatest repigmentation, with 65% and 63% average improvement, respectively. Acral sites and skin overlying joints improved the least.
Punch grafting is successful in most patients with vitiligo, with an 87% graft survival rate, but the rates of repigmentation vary depending on clinical characteristics.
Dermatologic Surgery 09/2011; 38(1):14-9. DOI:10.1111/j.1524-4725.2011.02171.x · 2.11 Impact Factor