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RF – Topical Timolol in Dermatology
FR – Usos de timolol tópico en Dermatología
Servicio de Dermatología, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain
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"apellidos" => "Aranegui" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102200792X?idApp=UINPBA000044" "url" => "/00017310/0000011400000004/v1_202304111712/S000173102200792X/v1_202304111712/es/main.assets" ] "asociados" => array:1 [ 0 => array:18 [ "pii" => "S000173102200792X" "issn" => "00017310" "doi" => "10.1016/j.ad.2021.09.014" "estado" => "S300" "fechaPublicacion" => "2023-04-01" "aid" => "3202" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2023;114:334-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">FORO DE RESIDENTES</span>" "titulo" => "FR - Usos de timolol tópico en Dermatología" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "334" "paginaFinal" => "335" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "RF - FTopical Timolol in Dermatology" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Lopez-Bernal, B. Aranegui" "autores" => array:2 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Lopez-Bernal" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Aranegui" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173102200792X?idApp=UINPBA000044" "url" => "/00017310/0000011400000004/v1_202304111712/S000173102200792X/v1_202304111712/es/main.assets" ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => " RF – Topical Timolol in Dermatology" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "T334" "paginaFinal" => "T335" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "T. Lopez-Bernal, B. Aranegui" "autores" => array:2 [ 0 => array:4 [ "nombre" => "T." "apellidos" => "Lopez-Bernal" "email" => array:1 [ 0 => "telobe95@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Aranegui" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR – Usos de timolol tópico en Dermatología" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Topical β-adrenergic antagonists such as timolol maleate have been used off-label for some years now in the treatment of small, superficial infantile hemangioma. However, a recent phase 2a randomized controlled trial found that timolol maleate was not superior to placebo with respect to the number of infantile hemangiomas cured during the early proliferative phase. According to the authors, these results could be due to an insufficient sample size and a greater number of losses than initially calculated. Therefore, larger-scale clinical trials are necessary to show the superiority of timolol maleate in this indication.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Possible dermatologic indications have recently been proposed for timolol maleate, with a low-quality grade of evidence.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Pawar<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> reported using timolol maleate 0.5% to treat recalcitrant fissures and erosions in chronic hand eczema and proposed applying 2–3 drops on each lesion before bedtime and observing healing after 1 week of therapy. The author postulated that the mechanism by which the β<span class="elsevierStyleInf">2</span> antagonists accelerated recovery of the skin barrier could be associated with migration of keratinocytes and re-epithelization of the affected area.</p><p id="par0020" class="elsevierStylePara elsevierViewall">This pathway has also shown the usefulness of timolol maleate in the healing of venous ulcerated chronic lesions, and even in patients with junctional epidermolysis bullosa, when applied at the abovementioned dose, albeit for a longer period (8 weeks).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Patients with inflammatory acne may have residual hyperpigmentation and erythema as sequelae. Afra et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> report the case of a patient in whom these sequelae were treated effectively with timolol maleate 0.5% for 12 weeks. The clinical and dermoscopic improvement observed seems to be due to the drug's vasoconstrictive and angiogenesis-inhibiting properties.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Pyogenic granulomas are rapidly growing benign vascular tumors. Timolol maleate can help to reduce the size of and bleeding in these lesions before surgery, as well as the size of the postsurgical scar.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The adverse effects of topical β-adrenergic antagonists are very uncommon. Timolol maleate should be used with caution in low-birth-weight infants and infantile hemangioma thicker than 3<span class="elsevierStyleHsp" style=""></span>mm in the diaper area or close to the mucosal membranes, since there have been reports of bradycardia, hypotension, apnea, and hypothermia in preterm infants.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The dose should not exceed 0.2<span class="elsevierStyleHsp" style=""></span>mg/kg/d (1 drop [0.05<span class="elsevierStyleHsp" style=""></span>mL] of timolol 0.5% solution contains 0.25<span class="elsevierStyleHsp" style=""></span>mg of timolol).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Owing to the drug's mechanism of action, it should be used with caution in patients with underlying cardiopulmonary diseases<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> and over small areas of skin.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no funding was received for the present study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "xpalclavsec1631425" "titulo" => "Keywords" ] 1 => array:2 [ "identificador" => "xpalclavsec1631426" "titulo" => "Palabras clave" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1631425" "palabras" => array:6 [ 0 => "Timolol maleate" 1 => "Capillary hemangioma" 2 => "Eczema" 3 => "Wound healing" 4 => "Acne vulgaris" 5 => "Pyogenic granuloma" ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of topical timolol for the treatment of infantile hemangioma in the early proliferative stage: a randomized clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.Z. Muñoz-Garza" 1 => "M. Ríos" 2 => "E. Roé-Crespo" 3 => "J. Bernabeu-Wittel" 4 => "M.T. Montserrat-García" 5 => "L. Puig" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2021.0596" "Revista" => array:7 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2021" "volumen" => "157" "paginaInicial" => "583" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33825828" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0016508515005995" "estado" => "S300" "issn" => "00165085" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical timolol in chronic, recalcitrant fissures and erosions of hand eczema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Pawar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2020.04.070" "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2021" "volumen" => "84" "paginaInicial" => "e125" "paginaFinal" => "e126" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical timolol for chronic wounds in patients with junctional epidermolysis bullosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Chiaverini" 1 => "T. Passeron" 2 => "J.P. Lacour" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2016.08.005" "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2016" "volumen" => "75" "paginaInicial" => "e223" "paginaFinal" => "e224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27846969" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S2468125320300777" "estado" => "S300" "issn" => "24681253" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical timolol for postacne erythema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.P. Afra" 1 => "T.M. Razmi" 2 => "D. De" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2020.04.144" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2021" "volumen" => "84" "paginaInicial" => "e255" "paginaFinal" => "e256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32376427" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Timolol for the treatment of pyogenic granuloma (PG) in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Knöpfel" 1 => "M.D.M. Escudero-Góngora" 2 => "A. Bauzà" 3 => "A. Martín-Santiago" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2016.03.036" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2016" "volumen" => "75" "paginaInicial" => "e105" "paginaFinal" => "e106" "itemHostRev" => array:3 [ "pii" => "S0168827813002663" "estado" => "S300" "issn" => "01688278" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011400000004/v1_202304111712/S0001731023001631/v1_202304111712/en/main.assets" "Apartado" => array:4 [ "identificador" => "83195" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Foro de Residentes" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000004/v1_202304111712/S0001731023001631/v1_202304111712/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023001631?idApp=UINPBA000044" ]
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