Topical Tretinoin Improved Foot Ulcers in Patients With Diabetes

Topical tretinoin therapy, normally used for acne and wrinkles, significantly decreased ulcer area and depth compared with placebo treatment over the 16 weeks of the study.

To determine the efficacy and safety of short-contact administration of topical tretinoin on foot ulcers in patients with diabetes, California researchers carried out a randomized, double-blind, placebo-controlled trial at an outpatient clinic at a Veterans Affairs medical center involving 24 volunteers with diabetic foot ulcers but without evidence of peripheral arterial disease or infection. Patients were randomized to 4 weeks of daily treatment with either topical 0.05% tretinoin solution (Retin-A) or placebo saline solution. Photographs and assessment of wound size and appearance were assessed every 2 weeks for a total of 16 weeks. 22 patients, with a total of 24 foot ulcers, completed the study.

They found: “At the end of 16 weeks, 2 (18%) of 11 ulcers in the control group and 6 (46%) of 13 ulcers in the tretinoin treatment group healed completely. Topical tretinoin therapy significantly decreased ulcer area and depth compared with placebo treatment over the 16 weeks of the study (P<.01 for surface area; P = .02 for depth). Adverse effects mainly consisted of mild pain at the ulcer site.”

The researchers concluded: “Short-contact application of topical tretinoin improved the healing of foot ulcers in patients with diabetes. The tretinoin therapy was generally well tolerated, without serious local or systemic adverse effects.”

Arch Dermatol. 2005;141:1373-1377. November 2005.The Effect of Short-Contact Topical Tretinoin Therapy for Foot Ulcers in Patients With Diabetes, Wynnis L. Tom, MD; David H. Peng, MD, MPH; Atabak Allaei, BS; Daniel Hsu, DPM; Tissa R. Hata, MD

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