Literature reviews

Literature review -1

Aim

To systematically review and critically appraise the evidence for effectiveness of Aloe vera gel
for radiation-induced skin reactions.

Materials and methods

Major biomedical databases and specialist complementary and alternative medicine databases
were searched. Additionally, efforts were made to identify unpublished and ongoing research.
Relevant research was systematically categorized by study type and appraised according to study
design. Clinical commentaries were obtained for each study included in the review.

Results

One earlier systematic review on Aloe Vera for a variety of conditions was located. Five
published randomized-controlled trials (RCTs) were found, along with two additional RCTs that
are not published. No non-RCTs, uncontrolled studies or qualitative studies were found.

Conclusions

There is no evidence from clinical trials to suggest that topical Aloe Vera is effective in
preventing or minimizing radiation-induced skin reactions in cancer patients. Further
methodologically rigorous, sufficiently powered research studies should be conducted to
evaluate the effectiveness of currently used and novel therapies for the prevention, minimization
and management of radiation-induced skin reactions.

Literature Review -2

Aims

During pelvic radiotherapy, many patients develop radiation-induced gastrointestinal symptoms,

which may interfere with treatment. Prophylaxis during radiotherapy should ideally prevent
acute reaction and the development of delayed injury. Sucralfate, an aluminium sucrose
octasulphate, has been used for acute and delayed radiation side-effects. However, conflicting
results have been published. We report here a prospective, randomised, placebo-controlled
study of prophylactic sucralfate during pelvic radiotherapy. In addition, a meta-analysis of
available data from the literature has been carried out.
Materials and methods

Fifty-one patients with localized pelvic tambours scheduled for curative conformal pelvic

radiotherapy (total dose 64–70 Gy over 6.5–7 weeks in 2 Gy daily fractions) were included.
Peroral sucralfate 2 g three times daily, or identically appearing placebo tablets, was given
during the course of radiotherapy. Symptom registration, endoscopy and biopsies were carried
out immediately before radiotherapy, 2 weeks and 6 weeks into the treatment course, and 2
weeks after completing radiotherapy. Mucosal cup forceps biopsies were obtained through a
rigid proctoscope. Graded endoscopic appearance and quantitative histology were registered.

Results

On the basis of previously published negative reports, an unplanned interim analysis of 44

evaluable patients showed significantly increased diarrhoea in the sucralfate group and the trial
was stopped. No difference was seen in other symptoms, endoscopic appearance or histology. A
meta-analysis comprising five published studies showed no statistically significant beneficial
effect of sucralfate on acute symptoms.

Conclusion

Sucralfate cannot be recommended for prophylaxis of acute radiation proctopathy and may even
worsen the symptoms.

Literature review- 3

Aim

Many OTC products advertise dramatic results, but there have been relatively little scientific data
to support these claims. We reviewed the literature on ingredients commonly found in OTC anti-
aging creams. We conclude that although many different compounds are marketed as anti-aging
products, studies proving their efficacy are limited. Vitamin C and alpha-hydroxy acids have
been the most extensively researched products, and their anti-aging capabilities have been
demonstrated in the literature. There have also been some promising studies on vitamin A and
vitamin B derivatives

Materials and methods

A few experimental studies have investigated OTC vitamin A derivatives as anti-aging

alternatives. The studies on vitamin A derivatives are promising, but there have been few large-
scale double-blinded placebo-controlled trials investigating the clinical benefits of any of the
OTC vitamin A products. A new vitamin B chorine analog, called 2-dimethylaminoethanol
(DMAE) , has recently been investigated.  Vitamin C is one of the well-studied vitamins in anti-
aging and has been proven effective in multiple studies.
Conclusion

Although many different compounds are marketed as anti-aging products, there are few studies
proving their efficacy. Vitamin C, alpha-hydroxyl acids, and pentapeptides have been the most
extensively researched compounds, and their anti-aging capabilities have been replicated in the
literature. There have also been some promising studies on vitamin A and vitamin B derivatives.
Other newer botanicals require more research to formulate conclusions that can be extended to
their topical application. Moisturizers have been shown to increase skin hydration and improve
the overall appearance of skin.Despite the limited body of evidence, patients continue to use a
variety of OTC products. However, for many patients, OTC remedies alone may not be sufficient
to produce the desired effects, and prescription-strength medications or surgical procedures may
be necessary.

Literature review-4

Aim

the intention of this article to review the most important anti-aging strategies that dermatologists
have nowadays in hand, including including preventive measurements, cosmetological strategies,
topical and systemic therapeutic agents and invasive procedures.

Materials and methods

Chemical peels are methods to cause a chemical ablation of defined skin layers to induce an even
and tight skin as a result of the regeneration and repair mechanisms after the inflammation of the
epidermis and dermis. Chemical peels are classified into three categories. It is possible that the
potential of GF, cytokines and telomerase will eventually be harnessed via technological
advancement and innovation in the burgeoning fields of tissue engineering and gene therapy in
the nearest future. DNA photodamage and UV-generated reactive oxygen species (ROS) are the
initial molecular events that lead to most of the typical histological and clinical manifestations of
chronic photodamage of the skin. Wrinkling and pigmentary changes are directly associated with
premature photo-aging and are considered its most important cutaneous manifestations.

Conclusion

While natural aging is genetically determined, extrinsic aging can be prevented. Aesthetic
dermatology should contribute to “healthy aging” not only in cosmetic means by trying to erase
time vestiges in skin but by also playing a significant part in prevention, regeneration, and
delaying of skin aging combining knowledge of possible local and systemic therapy,
instrumental devices and invasive procedures, filling the lack of scientific investigations and
becoming one of the important focuses of the aging research.
Literature review -5

Aim

The literature currently lacks definitive recommendations for the use of tretinoin-containing
products prior to undergoing facial procedures. Tretinoin pretreatment regimens vary greatly in
terms of the strength of retinoid used, the length of the pre-procedure treatment, and the ideal
time to stop treatment before the procedure. Based on the current literature and personal
experience, the authors set forth a set of guidelines for the use of tretinoin prior to various facial
procedures.

Materials and methods

Despite the literature being devoid of studies directly comparing tretinoin to retinol, it is
presumed that retinol anti-wrinkle products are not as clinically efficacious as prescription
strength tretinoin therapies. Retinoids' primary action is on the upper papillary dermis where
collagen content is increased by collagen degradation inhibition. Topical tretinoin increases Type
I collagen production by 80% in photoaged skin and increases wrinkle effacement through
epidermal hyperplasia with compaction of the stratum corneum and thickening of the granular
layer. Retinol-containing products have been in use, cosmetically, since 1984. The use of retinol
was widely accepted after published a study showing that retinol induces epidermal thickening in
a similar manner as retinoic acid, but with minimal side effects, unlike tretinoin. Retinol causes
less transepidermal water loss, irritancy, erythema and scaling compared to tretinoin. Likewise,
clinical studies proved retinol's relative capacity in monotherapy to produce fine wrinkle
effacement.

Conclusion

Based on the available literature exploring the mechanism of action of tretinoin, as described
above, as well as published observational studies and personal experience, we propose the
following algorithm for the pre-operative use of tretinoin in facial resurfacing . For ablative
lasers, the authors recommend using 0.1% tretinoin cream applied nightly for 3 months prior to,
and discontinuing 24 h before, the planned procedure.