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| RESEARCH ROUND-UP


scientific community with an enormous array of information as genetic blueprints. A landmark period, yet its potential contribution to medicine at the time was limited and unknown. However, with new technological advances, the benefits of identifying genomic profiles became apparent. This article reviews the historical accomplishments made by the human genome project, future applications of genomic expression profiles with the use of microarray gene chip technology, and the pharmacogenomic translational application of these models to dermatology. A new scientific movement in dermatology has begun with intentions of discovering individual genomic profiles responsible for dermatologic disease and drug metabolism, so that medical management can be personalized towards the genome rather than the disease. This review shows how pharmacogenomics has taken the lead in forming a basic framework of revealing specific drug metabolic pathways in the skin that can consequently be altered to maximize and minimize therapeutic efficacy and side effects, respectively. Dermatology as a model field in medicine has started to take advantage of these discoveries upon which deciphering genetic profiles can be used to enhance medical treatment.


COMBINATION EFFECTS OF COSMETIC MOISTURISERS IN THE TOPICAL TREATMENT OF ACNE VULGARIS


Munehiro A, Murakami Y, Shirahige Y et al. J Dermatolog Treat 2012; 23(3): 172–6


attributable to an inflammatory response of the pilosebaceous system, resulting from


T HE PATHOGENESIS OF ACNE IS


multiple pathological processes. Although the Differin gel (adapalene) was commercialised much later in Japan compared with Western countries, it is now the first choice treatment for acne. Adapalene is thought to inhibit hypertrophy of the follicular infundibulum in the stratum corneum, reduce the development of microcomedones, and improve skin lesions. Cutaneous symptoms such as erythema and dry skin occur, accompanied by a sensation of irritation and pruritus with the application of adapalene. In clinical practice, measures such as the concomitant use of a moisturiser are recommended to prevent skin drying. So far, few studies have assessed the usefulness of moisturisers in the topical treatment of acne. In this study, conducted on male acne patients who had not routinely practiced skin care (such as skin moisturisation), we combined cosmetic moisturisers with the standard topical treatment for acne and compared their clinical efficacy, their effects on the cutaneous physiological functions, and their relieving effects on the sensation of skin irritation and dryness caused by the topical medication.


FUTURE LONG-TERM TRIALS OF POSTMENOPAUSAL HORMONE REPLACEMENT THERAPY – WHAT IS POSSIBLE AND WHAT IS THE OPTIMAL PROTOCOL AND REGIMEN?


Purbrick B, Stranks K, Sum C, MacLennan AH. Climacteric 2012; 15(3): 288–93


HE IDEAL LONG-TERM, RANDOMIZED, placebo-controlled trial of hormone replacement therapy (HRT) from near


T prime-journal.com | June 2012 ❚ 55


menopause for up to 30 years to assess major morbidity and mortality is impractical because of high cost, participant retention, therapy compliance, and continuity of research staff and funding. Also the trial regimen may become outdated. It is nihilistic to demand such a long-term trial before endorsing HRT. However, medium-term trials using surrogate measures for long-term morbidity and mortality are possible and two are near completion. If these studies have been able to maintain reasonable participant retention, therapy compliance and minimal breach of protocol, they will set standards for trials of new HRT regimens. This paper discusses lessons learnt from past attempts at long-term trials and suggests the currently optimal protocol and cost of assessing new HRT regimens to optimize potential benefits and minimize adverse effects. A 5–7-year randomized, placebo-controlled trial of a flexible transdermal estrogen regimen ± either a selective estrogen receptor modulator, e.g. bazedoxifene, or micronized progesterone is discussed. Mild to moderately symptomatic women, 1–4 years


post


menopause, can be recruited via general practice and group meetings. Future trials should be funded by independent agencies and are high priority in womenÕs health.


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