Journal of Clinical and Aesthetic Dermatology

JUN 2017

An evidence-based, peer-reviewed journal for practicing clinicians in the field of dermatology

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48 JCAD journal of clinical and aesthetic dermatology June 2017 • Volume 10 • number 6 has recently been shown to be effective for reducing nonmelanoma skin cancers and actinic keratoses in high-risk patients. 4 8 Phytonadione. topically applied phytonadione, or vitamin K1, has been shown to have beneficial effects on injured skin. Using an animal model, a topical vitamin K cream increased experimental wound healing. 49 clinically, topical vitamin K enhanced the healing of bruises caused by laser treatment. In one randomized, double-blind, placebo-controlled study (n=22), subjects applied vitamin K cream to one side of their face for two weeks before and/or two weeks after laser treatment for facial telangiectases using a 585nm pulsed dye laser. 50 there was no difference in the extent of bruising on the topical vitamin K- treated sides; however, the severity of bruising was significantly less on the vitamin K-treated sides. In a similar randomized, controlled study, the application of vitamin K gel following pulsed dye laser treatment shortened the time for resolution of facial bruising. 51 RECOMMENDATIONS FOR THE TREATMENT OF ACTINIC PURPURA My personal observation is that DerMend is very effective for the treatment of actinic purpura. My patients are exceedingly pleased with the results they have achieved as shown in Figures 1 and 2. I recommend that patients treat their hands and forearms where sun damage is more pronounced and where the skin is thinner and skin injury is more likely to occur. For some patients, this may also include the lower legs. the product should be applied to all areas twice daily to improve skin quality and prevent or minimize future lesions and three times daily on bruised areas to improve healing. sunscreens that provide both UVa and UVB protection should be applied daily, especially to affected areas. REFERENCES 1. yaar M, Gilchrest Ba. skin aging: postulated mechanisms and consequent changes in structure and function. Clin Geriatr Med. 2001;17:617–630. 2. Poljšak B, Dahmane rG, Godić a. Intrinsic skin aging: the role of oxidative stress. Acta Dermatovenerol Alp Pannonica Adriat. 2012;21:33–36. 3. Panich U, sittithumcharee G, rathviboon n, et al. Ultraviolet radiation-induced skin aging: the role of Dna damage and oxidative stress in epidermal stem cell damage-mediated skin aging. Stem Cells Int. 2016;2016:7370642. 4. al-nuaimi y, sherratt MJ, Griffiths ce. skin health in older age. Maturitas. 2014;79:256–264. 5. sahle FF, Gebre-Mariam t, Dobner B, et al. skin diseases associated with the depletion of stratum corneum lipids and stratum corneum lipid substitution therapy. Skin Pharmacol Physiol. 2015;28:42–55. 6. Kaya G, saurat Jh. Dermatoporosis: a chronic cutaneous insufficiency/fragility syndrome. clinicopathological features, mechanisms, prevention R E v I E W Fi g u r e 2 . T h e ap p e aran c e o f ac t i n i c p u r p u ra ( l e f t ) i s g re a t l y i m p ro v e d af t e r t re a t m e n t f o r 2 6 d a y s ( r i g h t ) .

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