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Management of dysfunctional tear syndrome: a Canadian consensus.

Can J Ophthalmol. 2009 Aug; 44(4): 385-94Jackson WBDry eye complaints are common, have a diverse etiology, and result from disruption of the normal tear film; hence, the term "dysfunctional tear syndrome." Recent research has shown that ocular surface disorders have an inflammatory origin, that inflammation of the ocular surface does not always manifest as "red eye," and that a patient does not have to have a systemic autoimmune disease to experience a local, ocular autoimmune event. A panel of Canadian cornea and external disease subspecialists met and developed a questionnaire and treatment algorithm to aid the comprehensive ophthalmologist. Management of ocular surface disorders begins with a review of the patient's medical history, with particular attention to medication use, and a thorough ophthalmological examination. Use of a simple questionnaire can aid in the diagnosis. A variety of treatment modalities are available, the most effective of which are th...

A comparison of metronidazole 1% cream and pimecrolimus 1% cream in the treatment of patients with papulopustular rosacea: a randomized open-label clinical trial.

Clin Exp Dermatol. 2009 Jul 6; Koca R, Altinyazar HC, Ankarali H, Muhtar S, Tekin NS, Cinar SSummary Background. There are various treatment options available for rosacea, depending on the subtype, but treatment is still generally unsatisfactory. Some reports have indicated beneficial effects of topical pimecrolimus. Aim. To compare the efficacy and safety of pimecrolimus 1% cream and metronidazole 1% cream in the treatment of patients with papulopustular rosacea (PR). Methods. A group of 49 patients with PR was investigated in this single-centre, randomized, open-label study. Patients were randomly assigned treatment with either pimecrolimus 1% cream or metronidazole 1% cream for 12 weeks. Response was evaluated by the inflammatory lesion count, the severity of facial erythema and telangiectasia, Physician's Global Assessment (PGA), and safety and tolerability at baseline and at weeks 3, 6, 9 and 12. Results. In total, 48 patients completed the study. Both treatments were very ef...

Anti-inflamatory dose doxycycline in the treatment of rosacea.

J Drugs Dermatol. 2009 Jul; 8(7): 664-8Del Rosso JQAnti-inflammatory dose doxycycline (ADD), which is the administration of doxycycline 40 mg extended-release capsule once daily, is the only oral therapy approved by the United States Food and Drug Administration (FDA) for treatment of rosacea. ADD once daily has been shown to exhibit anti-inflammatory activity while not demonstrating evidence of antibiotic effects, including with chronic administration. This article summarizes the clinical studies to date on the use of ADD once daily in papulopustular rosacea, including both monotherapy and combination therapy studies. The combination therapy approach of ADD once daily and metronidazole gel 1% once daily has been shown to exhibit a more rapid onset of therapeutic effect than topical therapy alone. ADD once daily has been demonstrated to be effective in adult subjects with moderate to severe rosacea, and exhibits a favorable safety profile coupled with absence of antibiotic selection p...

A multicenter study of topical azelaic acid 15% gel in combination with oral doxycycline as initial therapy and azelaic acid 15% gel as maintenance monotherapy.

J Drugs Dermatol. 2009 Jul; 8(7): 639-48Thiboutot DM, Fleischer AB, Del Rosso JQ, Rich PThis two-phase, multicenter study was undertaken to examine the safety and efficacy of combination therapy with oral doxycycline and topical azelaic acid (AzA) 15% gel in moderate-to-severe papulopustular rosacea and to determine the effect of subsequent maintenance monotherapy with AzA 15% gel alone. In the initial open-label, non-randomized phase of the study, subjects (n=172) received topical AzA 15% gel and oral doxycycline (100 mg), both twice daily, for or = 75% inflammatory lesion count reduction (n=136) were randomized to receive either AzA 15% gel or its vehicle twice daily for an additional 24 weeks. Assessments of efficacy were obtained at four-week intervals throughout both phases of the study and included change in inflammatory lesion count, investigator global assessment (IGA) of rosacea severity, and separate assessments of erythema and telangiectasia severity. At the last visit for...