Efficacy, Effectiveness, and Safety of Combination Cream (Clindamycin 3%, Tretinoin 0.05%, and Dexamethasone 0.05%) Over Their Monotherapy (Tretinoin 0.05%) in Acne Vulgaris Patients: Scaled-Up Retrospective Cohort Study

Sukmawati Tansil Tan, Yohanes Firmansyah, Hendsun Hendsun, Cindy Christella Chandra

Sari


ABSTRACT

 

Acne vulgaris is an inflammatory disorder that impacts pilosebaceous glands, affecting many adolescents physically and psychologically. The finest acne cream comprises retinoids, antibiotics, and corticosteroids. Accuracy of acne vulgaris therapy affects the healing and prognosis. To compare the efficacy of a single topical cream containing 0.05% Tretinoin to a combination cream containing Clindamycin 3%, Tretinoin 0.05%, and Dexamethasone 0.05%. This was a retrospective cohort study that included 1027 respondents, observing the result of using 2 types of creams for treating acne: 1) a single tretinoin 0.05% cream and 2) a combination cream therapy (Clindamycin 3%, Tretinoin 0.05%, and Dexamethasone 0.05%). The evaluated parameters were mean reduction in acne lesions quantity as the main objective and other side parameters (Spot, Pore, Wrinkle, UV moisture, UV damage, Roughness, Porphyrin, Pigmentation, and Hydration) as the secondary goals. This study shows that there was a significant difference both in primary and secondary endpoints between single tretinoin 0.05% cream and combination cream therapy (Clindamycin 3%, Tretinoin 0.05%, and Dexamethasone 0.05%) with p-value <0.05 in all parameters. As for adverse events, there was no statistically significant difference locally, and no incidence was found systemically. Combination cream (Clindamycin 3%, Dexamethasone 0.05%, and Tretinoin 0.05%) might provide superior primary and secondary efficacy parameters in acne treatment than single tretinoin cream.

 

Keywords: Acne vulgaris, Safety, Effectiveness, Tretinoin, Clindamycin, Dexamethasone


Referensi


Abraham, A., & Roga, G. (2014). Topical Steroid-Damaged Skin. Indian Journal Of Dermatology, 59(5), 456. Https://Doi.Org/10.4103/0019-5154.139872

Afriyanti, R. N. (2015). Akne Vulgaris Pada Remaja. Medical Faculty Of Lampung University.

Ahluwalia, A. (1998). Topical Glucocorticoids And The Skin-Mechanisms Of Action: An Update. Mediators Of Inflammation, 7(3), 183–193. Https://Doi.Org/10.1080/09629359891126

Akamatsu, H., Komura, J., Miyachi, Y., Asada, Y., & Niwa, Y. (1990). Suppressive Effects Of Linoleic Acid On Neutrophil Oxygen Metabolism And Phagocytosis. Journal Of Investigative Dermatology, 95(3), 271–274. Https://Doi.Org/10.1111/1523-1747.Ep12484890

Akamatsu, H., Kurokawa, I., Nishijima, S., & Asada, Y. (1992). Inhibition Of Neutrophil Chemotactic Factor Production In Comedonal Bacteria By Subminimal Inhibitory Concentrations Of Erythromycin. Dermatology, 185(1), 41–43. Https://Doi.Org/10.1159/000247401

Den Ley, J. J., Hickman, J. G., Jarratt, M. T., Stewart, D. M., & Levy, S. F. (2001). The Efficacy And Safely Of A Combination Benzoyl Peroxide/Clindamycin Topical Gel Compared With Benzoyl Peroxide Alone And A Benzoyl Peroxide/Erythromycin Combination Product. Journal Of Cutaneous Medicine And Surgery, 5(1), 37–42. Https://Doi.Org/10.1177/120347540100500109

Farrar, M. D., Ingham, E., & Holland, K. T. (2000). Heat Shock Proteins And Inflammatory Acne Vulgaris: Molecular Cloning, Overexpression And Purification Of A Propionibacterium Acnes Groel And Dnak Homologue. Fems Microbiology Letters, 191(2), 183–186. Https://Doi.Org/10.1111/J.1574-6968.2000.Tb09337.X

Graham, G. M., Farrar, M. D., Cruse-Sawyer, J. E., Holland, K. T., & Ingham, E. (2004). Proinflammatory Cytokine Production By Human Keratinocytes Stimulated With Propionibacterium Acnes And P. Acnes Groel. British Journal Of Dermatology, 150(3), 421–428. Https://Doi.Org/10.1046/J.1365-2133.2004.05762.X

Gratton, D., Raymond, G., Guertin-Larochelle, S., Maddin, S., Leneck, C., Warner, J., Collins, J., Gaudreau, P., & Bendl, B. (1982). Topical Clindamycin Versus Systemic Tetracycline In The Treatment Of Acne. Journal Of The American Academy Of Dermatology, 7(1), 50–53. Https://Doi.Org/10.1016/S0190-9622(82)80009-1

Griffiths, C. E. M., Finkel, L. J., Ditre, C. M., Hamilton, T. A., Ellis, C. N., & Voorhees, J. J. (1993). Topical Tretinoin (Retinoic Acid) Improves Melasma. A Vehicle-Controlled, Clinical Trial. British Journal Of Dermatology, 129(4), 415–421. Https://Doi.Org/10.1111/J.1365-2133.1993.Tb03169.X

Griffiths, C. E. M., Finkel, L. J., Tkanfaglia, M. G., Hamilton, T. A., & Voorhees, J. J. (1993). An In Vivo Experimental Model For Effects Of Topical Retinoic Acid In Human Skin. British Journal Of Dermatology, 129(4), 389–394. Https://Doi.Org/10.1111/J.1365-2133.1993.Tb03163.X

Grimes, P., & Callender, V. (2006). Tazarotene Cream For Postinflammatory Hyperpigmentation And Acne Vulgaris In Darker Skin: A Double-Blind, Randomized, Vehicle-Controlled Study. Cutis, 77(1), 45–50.

Kraft, J., & Freiman, A. (2011). Management Of Acne. In Cmaj. Canadian Medical Association Journal (Vol. 183, Issue 7). Canadian Medical Association. Https://Doi.Org/10.1503/Cmaj.090374

Kuhlman, D. S., & Callen, J. P. (1986). A Comparison Of Clindamycin Phosphate 1 Percent Topical Lotion And Placebo In The Treatment Of Acne Vulgaris. Cutis, 38(3), 203–206.

Leibowitz, H. M., & Kupferman, A. (1979). Optimal Frequency Of Topical Prednisolone Administration. Archives Of Ophthalmology, 97(11), 2154–2156. Https://Doi.Org/10.1001/Archopht.1979.01020020472014

Leyden, J. J., Berger, R. S., Dunlap, F. E., Ellis, C. N., Connolly, M. A., & Levy, S. F. (2001). Comparison Of The Efficacy And Safety Of A Combination Topical Gel Formulation Of Benzoyl Peroxide And Clindamycin With Benzoyl Peroxide, Clindamycin And Vehicle Gel In The Treatments Of Acne Vulgaris. American Journal Of Clinical Dermatology, 2(1), 33–39. Https://Doi.Org/10.2165/00128071-200102010-00006

Leyden, J. J., Krochmal, L., & Yaroshinsky, A. (2006). Two Randomized, Double-Blind, Controlled Trials Of 2219 Subjects To Compare The Combination Clindamycin/Tretinoin Hydrogel With Each Agent Alone And Vehicle For The Treatment Of Acne Vulgaris. Journal Of The American Academy Of Dermatology, 54(1), 73–81. Https://Doi.Org/10.1016/J.Jaad.2005.04.046

Leyden, J. J., Shalita, A., Thiboutot, D., Washenik, K., & Webster, G. (2005). Topical Retinoids In Inflammatory Acne: A Retrospective, Investigator-Blinded, Vehicle-Controlled, Photographic Assessment. Clinical Therapeutics, 27(2), 216–224. Https://Doi.Org/10.1016/J.Clinthera.2005.02.009

Puhvel, S. M., & Reisner, R. M. (1972). The Production Of Hyaluronidase (Hyaluronate Lyase) By Corynebacterium Acnes. Journal Of Investigative Dermatology, 58(2), 66–70. Https://Doi.Org/10.1111/1523-1747.Ep12551495

Purwaningdyah, R. A. K. (2013). Profil Penderita Akne Vulgaris Pada Siswa-Siswi Di Sma Shafiyyatul Amaliyyah Medan. E-Jurnal Fakultas Kedokteran Usu, 1(1).

Rajka, G. (1985). On Therapeutic Approaches To Some Special Types Of Acne. Acta Dermato-Venereologica. Supplementum, 120, 39–42.

Schachner, L., Pestana, A., & Kittles, C. (1990). A Clinical Trial Comparing The Safety And Efficacy Of A Topical Erythromycin-Zinc Formulation With A Topical Clindamycin Formulation. Journal Of The American Academy Of Dermatology, 22(3), 489–495. Https://Doi.Org/10.1016/0190-9622(90)70069-T

Shaikh, A. H., Petersen, M. R., Sisk, R. A., Foster, R. E., Riemann, C. D., & Miller, D. M. (2013). Comparative Effectiveness Of The Dexamethasone Intravitreal Implant In Vitrectomized And Non-Vitrectomized Eyes With Macular Edema Secondary To Central Retinal Vein Occlusion. Ophthalmic Surgery, Lasers And Imaging Retina, 44(1), 28–33. Https://Doi.Org/10.3928/23258160-20121221-09

Shroot, B., & Michel, S. (1997). Pharmacology And Chemistry Of Adapalene. Journal Of The American Academy Of Dermatology, 36(6), S96–S103. Https://Doi.Org/10.1016/S0190-9622(97)70050-1

Siegle, R. J., Fekety, R., Sarbone, P. D., Finch, R. N., Deery, H. G., & Voorhees, J. J. (1986). Effects Of Topical Clindamycin On Intestinal Microflora In Patients With Acne. Journal Of The American Academy Of Dermatology, 15(2), 180–185. Https://Doi.Org/10.1016/S0190-9622(86)70153-9

Tschen, E. H., Katz, H. I., Jones, T. M., Monroe, E. W., Kraus, S. J., Connolly, M. A., & Levy, S. F. (2001). A Combination Benzoyl Peroxide And Clindamycin Topical Gel Compared With Benzoyl Peroxide, Clindamycin Phosphate, And Vehicle In The Treatment Of Acne Vulgaris. Cutis, 67(2), 165–169.

Tucker, S. B., Tausend, R., Cochran, R., & Flannigan, S. A. (1984). Comparison Of Topical Clindamycin Phosphate, Benzoyl Peroxide, And A Combination Of The Two For The Treatment Of Acne Vulgaris. British Journal Of Dermatology, 110(4), 487–492. Https://Doi.Org/10.1111/J.1365-2133.1984.Tb04664.X

Uva, L., Miguel, D., Pinheiro, C., Antunes, J., Cruz, D., Ferreira, J., & Filipe, P. (2012). Mechanisms Of Action Of Topical Corticosteroids In Psoriasis. International Journal Of Endocrinology, 2012, 1–16. Https://Doi.Org/10.1155/2012/561018

Van Vlem, B., Vanholder, R., De Paepe, P., Ringoir, S., & Vogelaers, D. (1996). Immunomodulating Effects Of Antibiotics: Literature Review. Infection, 24(4), 275–291. Https://Doi.Org/10.1007/Bf01743360

Webster, G. F., Berson, D., Stein, L. F., Fivenson, D. P., Tanghetti, E. A., & Ling, M. (2001). Efficacy And Tolerability Of Once-Daily Tazarotene 0.1% Gel Versus Once-Daily Tretinoin 0.025% Gel In The Treatment Of Facial Acne Vulgaris: A Randomized Trial. Cutis, 67(6 Suppl), 4–9.




DOI: https://doi.org/10.33024/mahesa.v4i9.15463

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