title: The effect of short-contact topical tretinoin therapy for foot ulcers in patients with diabetes.
abstract: 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.
authors.affiliation: Division of Dermatology, Department of Medicine, University of California, San Diego, USA.
authors.forename: Wynnis L
authors.initials: WL
authors.lastname: Tom
authors.forename: David H
authors.initials: DH
authors.lastname: Peng
authors.forename: Atabak
authors.initials: A
authors.lastname: Allaei
authors.forename: Daniel
authors.initials: D
authors.lastname: Hsu
authors.forename: Tissa R
authors.initials: TR
authors.lastname: Hata
mesh_terms: 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
chemical_list: D007641:Keratolytic Agents; D014212:Tretinoin