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| |  Combination Anti-inflammatory Agents Better Than a Retinoid for Comedonal Acne: Presented at AAD By Alex Morrisson NEW ORLEANS -- February 7, 2011 -- So-called “noninflammatory” acne appears to respond to agents that reduce inflammation better than treatment with retinoids alone, researchers said here at the 69th Annual Meeting of the American Academy of Dermatology (AAD). A growing body of histological and biochemical evidence suggests that inflammation occurs within normal-appearing acne skin, as well as open and closed comedones, and that the classification of comedonal lesions as noninflammatory may be a misnomer, reported Emil Tanghetti, MD, Center for Dermatology and Laser Surgery, Sacramento, California, in his poster presentation today. His findings suggest that inflammation appears to be present at all stages of acne, including early comedonal acne. “These data suggest that the term noninflammatory is inaccurate as a descriptor of these acne lesions,” he reported. “It would be more accurate to refer to this type of acne as comedonal, to include microcomedones and open and closed comedones.” He added that the “combination of an anti-inflammatory agent, such as dapsone, or an antibacterial agent, such as clindamycin, with a retinoid, is effective, and potentially more effective than a retinoid alone, for the treatment of comedonal acne.” Dr. Tanghetti demonstrated in his study that the combination of a retinoid with an anti-inflammatory or antibacterial agent could effectively treat comedonal acne. The 60 patients treated with clindamycin 1%/benzoyl peroxide 5% gel in combination with tazarotene cream 0.1% achieved about a 67.8% reduction in comedonal lesions at week 12 compared with a 47.8% reduction in comedonal lesions achieved among patients treated with tazarotene cream 0.1% (P =.0124), Dr. Tanghetti and colleagues reported. In a second study, in which a combination of dapsone gel 5% plus tazarotene cream 0.1% was compared with tazarotene monotherapy, 83 patients with the combination therapy achieved a 59.7% reduction in comedonal lesions compared with a 46.5% reduction in the lesions among the 77 patients on tazarotene monotherapy who finished the 12-week study. Again, that difference achieved statistical significance (P =.0097). He said those studies as well as earlier work “challenge existing treatment guidelines, which stipulate the use of a retinoid alone to treat comedonal acne.” Funding for this study was provided by Allergan, Inc. [Presentation title: Unexpected Benefits of Topical Dapsone or Clindamycin/Benzoyl Peroxide in Combination With Tazarotene in Treatment of Comedonal Acne. Abstract P703]
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