TY - JOUR
T1 - Use of topical glycolic acid plus a lovastatin-cholesterol combination cream for the treatment of autosomal recessive congenital ichthyoses
AU - Khalil, Samar
AU - Bardawil, Tara
AU - Saade, Serena
AU - Chedraoui, Adele
AU - Ramadan, Nehmat
AU - Hasbani, Divina Justina
AU - Abbas, Ossama
AU - Nemer, Georges
AU - Rubeiz, Nelly
AU - Kurban, Mazen
N1 - Publisher Copyright:
© 2018 American Medical Association. All rights reserved.
PY - 2018/11
Y1 - 2018/11
N2 - IMPORTANCE Autosomal recessive congenital ichthyosis (ARCI) is a heterogeneous group of disorders caused by defects in signaling pathways involved in epidermal proliferation and differentiation, leading to a wide range of skin manifestations. Therapeutic options are limited and often unsatisfactory. Topical cholesterol and statin as a combined formulation has proven successful in the treatment of patients with CHILD syndrome (congenital hemidysplasia ichthyosis and limb defects). OBJECTIVE To assess change in disease severity score after a 3-month therapeutic regimen consisting of a glycolic acid, 10% to 20%, cream and a combination cream of lovastatin, 2%, with cholesterol, 2%, in the treatment of ARCI. DESIGN, SETTING, AND PARTICIPANTS This case series of 15 patients with ARCI was conducted at the American University of Beirut, a referral center in the Middle East region for genodermatoses, between May 2017 and January 2018. No age groups were excluded; all patients were from the Middle East area; and all were initially not responsive to treatment with hydrating creams in combination with urea creams, 30% to 40%, or glycolic acid, 10% to 20%. Excluded were patients who had been taking systemic retinoids within 3 months before the start of the study. INTERVENTIONS A 3-month therapeutic regimen of glycolic acid, 10% to 20%, cream and a combination of lovastatin, 2%, with cholesterol, 2%, cream. MAIN OUTCOMES AND MEASURES Percentage change in disease severity scores following 2 and 3 months of study treatment. RESULTS Of the 15 patients included in the study, 10 were male (mean age, 11.2 years; age range, 2-38 years). The average percentage reduction in the disease severity score was 33.7% at 2 months (from 60.8 to 40.2) and 57.5% at 3 months (from 60.8 to 21.9). Adverse effects were mild and consisted mainly of irritation and burning. CONCLUSIONS AND RELEVANCE These findings suggest a benefit from a treatment regimen consisting of glycolic acid, 10% to 20%, and a combination of lovastatin, 2%, with cholesterol, 2%, in the treatment of ARCI. This combination of creams might also prove to be beneficial in other types of ichthyoses and other dermatological diseases with a defective skin barrier.
AB - IMPORTANCE Autosomal recessive congenital ichthyosis (ARCI) is a heterogeneous group of disorders caused by defects in signaling pathways involved in epidermal proliferation and differentiation, leading to a wide range of skin manifestations. Therapeutic options are limited and often unsatisfactory. Topical cholesterol and statin as a combined formulation has proven successful in the treatment of patients with CHILD syndrome (congenital hemidysplasia ichthyosis and limb defects). OBJECTIVE To assess change in disease severity score after a 3-month therapeutic regimen consisting of a glycolic acid, 10% to 20%, cream and a combination cream of lovastatin, 2%, with cholesterol, 2%, in the treatment of ARCI. DESIGN, SETTING, AND PARTICIPANTS This case series of 15 patients with ARCI was conducted at the American University of Beirut, a referral center in the Middle East region for genodermatoses, between May 2017 and January 2018. No age groups were excluded; all patients were from the Middle East area; and all were initially not responsive to treatment with hydrating creams in combination with urea creams, 30% to 40%, or glycolic acid, 10% to 20%. Excluded were patients who had been taking systemic retinoids within 3 months before the start of the study. INTERVENTIONS A 3-month therapeutic regimen of glycolic acid, 10% to 20%, cream and a combination of lovastatin, 2%, with cholesterol, 2%, cream. MAIN OUTCOMES AND MEASURES Percentage change in disease severity scores following 2 and 3 months of study treatment. RESULTS Of the 15 patients included in the study, 10 were male (mean age, 11.2 years; age range, 2-38 years). The average percentage reduction in the disease severity score was 33.7% at 2 months (from 60.8 to 40.2) and 57.5% at 3 months (from 60.8 to 21.9). Adverse effects were mild and consisted mainly of irritation and burning. CONCLUSIONS AND RELEVANCE These findings suggest a benefit from a treatment regimen consisting of glycolic acid, 10% to 20%, and a combination of lovastatin, 2%, with cholesterol, 2%, in the treatment of ARCI. This combination of creams might also prove to be beneficial in other types of ichthyoses and other dermatological diseases with a defective skin barrier.
UR - http://www.scopus.com/inward/record.url?scp=85053660594&partnerID=8YFLogxK
U2 - 10.1001/jamadermatol.2018.2904
DO - 10.1001/jamadermatol.2018.2904
M3 - Article
C2 - 30208477
AN - SCOPUS:85053660594
SN - 2168-6068
VL - 154
SP - 1320
EP - 1323
JO - JAMA Dermatology
JF - JAMA Dermatology
IS - 11
ER -