Articulos varios... Protecció solar en niños e ivermectina vs metronidazol gel..

Effective Sun Safety in Children: A Randomized Controlled Trial of a Multicomponent Program

Improving sun-protective behaviors in children may minimize sun damage and reduce skin cancer risks later in life. Investigators performed a randomized, controlled clinical trial that included 300 pediatric patients (ages 2–6) and their caregiver; 51% were randomized to receive a read-along book, a swim shirt, and weekly text-messaged questions about sun protection that elicited a yes/no response from caregivers: ("During the past week, did your child wear a hat?"). The control group (49%) received information typically given at a well-child visit.

Caregivers were surveyed about sun exposures and sun irritation/burn at baseline and at 4-week follow-up. Spectrophotometric melanin measurements of the outer upper arm (under the shirt sleeve) were performed at baseline and at 4 weeks. Caregivers received a $20 gift card at baseline and $50 gift card at study completion. The intervention group had significantly higher scores related to sun-protective behaviors and did not have increased melanin levels on the upper arm. The control group had significantly increased melanin levels on the arm. The authors conclude that this multicomponent intervention program led to increased sun-protective behaviors.

Editor Disclosures at Time of Publication

• Disclosures for Mary Wu Chang, MD at time of publication Consultant / Advisory board Pierre Fabre; Valeant Speaker's bureau Pierre Fabre

Metronidazole vs. Ivermectin

Topical metronidazole 0.75% cream (MET) twice daily and ivermectin 1% cream daily (IVER) both effectively treat the papulopustular component of rosacea. Is one better at producing remissions? Investigators conducted a 36-week, randomized, parallel group phase III study to find out.

They enrolled 399 patients who had been judged clear or almost clear (Investigators Global Assessment [IGA] score, 0 or 1) after 16 weeks of treatment in an earlier, phase III, investigator-blinded, randomized, parallel group study showing superiority of IVER for reducing papule and pustule counts (P<0.001). These patients now stopped treatment. If recurring papules and pustules warranted an IGA score of ≤2, patients resumed their original topical treatment until remission was again obtained. Primary endpoints were relapse rate and days to first relapse.

The median number of days to first relapse was higher in IVER recipients (median, 115 days; 95% confidence interval, 113–165 days) than in MET recipients (median, 85 days; 95% CI, 85–113 days). The relapse rate by study end at 36 weeks was lower for IVER recipients (62.7%) than MET recipients (68.4%). No serious adverse treatment-related events were recorded.

Editor Disclosures at Time of Publication

• Disclosures for Mark V. Dahl, MD at time of publication Consultant / Advisory board Ulthera, Inc.; AuBio LifeSciences, LLC; Paris Therapeutics EquityElorac, Inc.; Makucell, Inc.; Paris Therapeutics Editorial boards UpToDateLeadership positions in professional societies National Rosacea Society (Chairman, Medical Board)