evaluation of topical erythromycin and topical lactate with or without systemic ketoconazole in acne vulgaris

Four groups of 16 patients each, having acne vulgaris, were treated with (1) 5% lactate lotion, applied all over the face twice a day, (2) 5% lactate lotion topically along with 200 mg ketoconazole orally per day, (3) 2% erythromycin lotion topically all over the face twice a day, and (4) 2% topical erythromycin lotion with oral ketoconazole, respectively. The efficacy of these regimes was evaluated by counting the number of comedones, inflammatory lesions, and cysts separately, before starting the treatment and at 4, 8, and 12 weeks of treatment. Percent reduction in the number of inflammatory and comedonic lesions respectively at the end of 3 months of treatment was 61 .1 % and 44.0% with lactate lotion, 62.6% and 32.8% with lactate lotion combined with oral ketoconazole, 66.4% and 62.2% with erythromycin lotion alone, and 78.1% and 48.8% with erythromycin lotion and oral ketoconazole. The overall improvement was graded into 3 categories i.e.,. excellent response, moderate response, and poor response. Lactate lotion produced excellent, moderate, and poor responses in 3,10, and 3 patients respectively; lactate lotion with ketoconazole in 1,12, and 3 patients; erythromycin lotion alone in 4,8, and 4 patients; and erythromycin lotion with ketoconazole in 1, 15, and nil patients respectively with respect to the inflammatory lesions. The results with respect to the comedonic lesions were 3, 7, and 6 patients; 1, 6, and 9 patients; 4, 6, and 6 patients; and 1, 8, and 7 patients in the respective categories. All the agents were well tolerated.