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Clotrimazole for hidradenitis suppurativa ) is not an approved agent for treatment of severe acne. The results our studies using TCS are conflicting with inconsistent outcomes for several studies. Some studies showed favorable effects on inflammatory lesions and some have not. The safety of TCS was evaluated in 1 clinical trial, which had significant limitations including the use of TCS that is not available by prescription. Because of these limitations, we felt that this approach was not acceptable given the current data available for this drug. The adverse-event reporting guidelines for new drugs are generally followed in the United States (28). Although our study has limitations associated with our design, we considered the most relevant adverse-event data that had been published. Our findings suggest that topical tretinoin in combination with an alpha hydroxy acid may improve inflammatory lesion appearance and activity in severe acne. Further studies with the use of combination therapy in acne vulgaris are needed. Although the data on a new topical tretinoin and AHA should acetazolamide generic cost be interpreted with caution given the inconsistent outcomes and lack of efficacy data available, they further support the concept of using combination therapy in severe acne and suggest that topical tretinoin may offer greater efficacy than one or the other agent. The authors' responsibilities were as follows—YJ: designed the study; HMB: obtained data on the composition of aqueous and petrolatum-based solutions; MSS: collected the data and assisted with interpretation of the data; HBS: had primary responsibility for the final content and writing of the manuscript; FH, JH: provided valuable reviews and edited the manuscript. None of authors reported a conflict interest in connection with the manuscript. REFERENCES 1. Hjortdal JE, Thomsen KE, Brem JL, et al. The European Society of Dermatology, Norwegian the European Association of Dermatologists and Pharmacists, the Norwegian Society of Cosmetic Science and the International European Association of Dermatology (EIDEM): a group professional societies with members and corresponding committees from around 190 different countries. A proposal to amend the EIDEM recommendations for treatment of acne vulgaris and psoriasis. Eur J Dermatol 2007;15:11–19. doi: 10.1007/s00495-008-0493-0 PubMed Abstract | CrossRef Full Text Google Scholar 4. Klimov N, Hjortdal JE, Thomsen K, Røska JF, KB, Føllesdal M, et al. Skin surface area distribution of tretinoin/alpha hydroxy acid in different geographical areas Europe. J Cosmet Dermatol 2006;1:21–23. doi: 10.1007/s10433-006-0206-3 PubMed Abstract | CrossRef Full Text Google Scholar 8. Vassorg buy acetazolamide 250 mg online P, Søderlind M. Acne and vulgaris in Oslo: diagnosis treatment. Acta Derm Venereol 1993;59:834–841. Google Scholar 10. Vassorg P, Søderlind M. Acne and vulgaris in Oslo Årheim: a comparison of the treatment options. Dermatoendocrinol 1999;19:9–12. doi: 10.1016/S0011-8601(99)00041-4 PubMed Abstract | CrossRef Full Text Google Scholar 17. Van Zile K, Zyl HW, M. Acne vulgaris: prevalence and the impact of treatment. J Am Acad Dermatol 1987;13:1131–1139. Google Scholar 19. van Zyl HW, M. Prevalence of acne in children and women: epidemiological study in The Netherlands. Acta Derm Venereol 1992;62:867–872. Google Scholar 20. Bensussen VL, de Weker R. best cheap drugstore lip liner Risk of adverse effects associated with the oral and topical buy acetazolamide online uk use of retinoids. Drugs 2009;74:1759–1767. doi: 10.1016/j.dcs.2008.01.004 PubMed Abstract | CrossRef Full Text Google Scholar 23. Hjortdal JE, Buy buspirone australia Thomsen K, Mørland L, KB, Sæbø A, Tjønneland FK, et al. Purity and pharmacokinetic analysis of 4-(hydroxyphenyl)-2-picrylhydrazyl-(3-pyridin-1-yl)-1,2,3-triazole: a new hydroxy acid from the benzophenone-free retinyl acetate. J Am Acad Dermatol 2000;38:1203–1213. doi: 10.

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