The effect of short-contact topical tretinoin therapy for foot ulcers in patients with diabetes.
OBJECTIVE
To determine the efficacy and safety of short-contact administration of topical tretinoin on foot ulcers in patients with diabetes.


METHODS
Randomized, double-blind, placebo-controlled trial.


METHODS
Outpatient clinic at a Veterans Affairs medical center.


METHODS
Twenty-four volunteers with diabetic foot ulcers but without evidence of peripheral arterial disease or infection.


METHODS
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.


METHODS
The proportion of ulcers that healed in each group and the degree of change in ulcer size.


RESULTS
Twenty-two patients, with a total of 24 foot ulcers, completed the study. 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.


CONCLUSIONS
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.
Tom
Wynnis L
WL
Division of Dermatology, Department of Medicine, University of California, San Diego, USA.
Peng
David H
DH
Allaei
Atabak
A
Hsu
Daniel
D
Hata
Tissa R
TR
D000279:Administration, Cutaneous; D000553:Ambulatory Care; D017719:Diabetic Foot / Q000188:drug therapy* / Q000473:pathology; D004311:Double-Blind Method; D005260:Female; D006097:Granulation Tissue / Q000473:pathology; D006801:Humans; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014212:Tretinoin / Q000008:administration & dosage / Q000627:therapeutic use*; D014728:Veterans; D014945:Wound Healing
D007641:Keratolytic Agents; D014212:Tretinoin