Adapalene

The purpose of this article was to determine the safety and efficacy of adapalene gel in the treatment of actinic keratoses and solar lentigines.

A prospective two-center, randomized, controlled, investigator-masked, parallel-group study of 90 patients with actinic keratoses and solar lentigines were treated daily with either adapalene gel (0.1% or 0.3%) or its vehicle gel for 4 weeks, followed by twice-daily applications, if tolerated, for up to 9 months.

The patient population encompassed 90 Caucasian patients (69 male, 21 female; mean age 63.1 years). At the end of the study 83 patients completed the 9 month trial. The results showed that for patients treated with adapalene gel 0.1% and 0.3%, the mean number of actinic keratoses was reduced. With the vehicle gel alone, there was an increase in actinic keratoses. After 1 month of treatment, the patients who received adapalene had significant lightening of solar lentigines as compared with the patients who were treated with vehicle gel. After 9 months, 57% and 59% of the patients had lighter lesions in the adapalene 0.1% and 0.3% groups, respectively, in comparison with only 36% in the vehicle group. A retrospective evaluation of paired clinical photographs (before and after 9-month treatment) by 2 dermatologists who were treatment-blinded revealed significant improvement in wrinkles and other clinical features of photo aged skin with adapalene as compared with its vehicle. All in all, adapalene gel formulations 0.1% and 0.3% were well tolerated and improved actinic keratoses, solar lentigines, and wrinkles of photo damaged skin.

JDD ARTICLE EVALUATION

Adapalene gel has added another armament to our therapy against actinic keratoses (AKs). At the moment many topical therapies exist: 5-flurouracil (5-FU), imiquimod, retinoids, and diclofenac, to name some of the more common. Adapalene seems to be more effective than imiquimod and tretinoin for treating AKs but equally effective in treating wrinkles and solar lentigines as tretinoin. It would be interesting to compare adapalene versus tretinoin in a random, double blinded study to compare their effectiveness in treating AKs. The dosage required to treat AKs with adapalene in this study causes significant irritation, as does 5-FU, but does treitinoin?

1. Eklind J, Tattler U. Maschke J, Lidbrink P. Hengge UR. Imiquimod to treat different cancers of the epidermis. Dermatol Surg 2003 Aug; 29(8):890,6

2. Tuntrone WD, Sahai R, Caglar S. Weinberg JM, Crespo J. Topical therapy for actinic keratoses, 11: Diclofenac, colchicine, and retinoids. Cutis 2003 May; 71(5):373-9.

Kang S, Goldfarb MT, Weiss JS, Metz RD, Hamilton TA, Voorhees JJ, Griffiths CE. J Am Acad Dermatol 2003 Jul; 49(1):83-90.

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