Bichloroacetic acid(BCA), one of the chloroacetic acids, is an effective tissue cauterant when used in high concentration. In dermatologic surgery, BCA, in the form of 100% solution, has been used to treat xanthelasma, sebaceous hyperplasia, verrucae, hard and soft corn, seborrheic keratosis, ingrowing nail, cysts. The cauterization with BCA 100% solution can be used with a simpler technique than the surgical excision or electrical cauterization, without complicated appliance such as LASER generators, so the dermatologic surgical technique - BCA chemical cauterization, topical treatment - can be selected as a treatment of choice for many dermatologic conditions in outpatient offices. BCA destroys the barrier function of the epidermis and penetrates deeply through the papillary dermis and then creates the effect in the papillary dermis and reticular dermis. As a result, regeneration of new dermal collagens and a new epidermis occurs. This pharmacologic effect of BCA makes 100% solution of BCA to be used in the treatment of xanthelasma, pigmented nevi, acne scars with good clinical outcomes.
Acne Vulgaris ; Cautery ; Chloroacetates ; Cicatrix ; Collagen ; Dermatologic Surgical Procedures ; Dermis ; Dichloroacetic Acid ; Epidermis ; Humans ; Hyperplasia ; Keratosis, Seborrheic ; Nevus, Pigmented ; Outpatients ; Regeneration ; Skin Diseases* ; Skin* ; Warts ; Zea mays

BACKGROUND

Seborrheic keratosis is a common benign skin tumor treated with invasive methods like electrodessication, cryotherapy, or surgery. Topical therapy with trichloroacetic acid (TCA) may be a cheaper, non-invasive alternative with less complications. While TCA has been studied for other skin conditions, more research is needed on its use for seborrheic keratosis.

To compare the safety and efficacy of one time application of 80% TCA peel to 65% TCA peel in the clearance of raised seborrheic keratosis in Filipino patients.

One hundred one patients were randomized to either 80% or 65% TCA groups. Each participant underwent one session of treatment and was followed up after a month. Pre- and post-test size and thickness of lesions were compared between groups.

Based on Physician’s Lesion Assessment (PLA), both concentrations of TCA achieved high treatment success (TCA80: 66.7%, TCA65: 68%, p-value 0.89). A similar trend was observed based on Subject’s Self-Assessment (TCA80: 74%, TCA65: 74.5%, p-value 0.95). Similar reductions in lesion size and thickness were observed in both concentrations. In terms of safety, pain, pruritus, and erythema were mostly observed during and immediately after treatment, with little to no adverse events observed after 1 month in both groups.

One time application of either 80% or 65% TCA is effective in decreasing the size and thickness of seborrheic keratosis with little to no complications 1 month post- treatment. Both concentrations were safe, causing minimal and non-persistent pain, pruritus, and erythema immediately after application.

Congenital sialo-cutaneous fistula arising from the accessory parotid gland is extremely rare. Although the fistula tract can be successfully excised after making a skin incision along the skin tension line around the fistula opening, a facial scar inevitably remains. We here report a case of sialo-cutaneous fistula that was treated with chemocauterization with trichloroacetic acid (TCA). TCA cauterization is an easy and effective option for the treatment of congenital fistula from an accessory parotid gland, especially from the aesthetic point of view.
Cicatrix ; Fistula ; Parotid Gland ; Skin ; Trichloroacetic Acid

BACKGROUND: Trichloroacetic acid(TCA) chemical peel has been used for variable skin lesions. However, the effect of TCA chemical peel on acne scars has not been studied. OBJECTIVE: The object of this study is to evaluate the effect of TCA chemical peel on atrop hic acne scars. METHOD: Twenty three patients with atrophic acne scars, who were treated with TCA chemical peel were included. The patieits were interviewed for evaluation of the therapeutic efficacy of TCA chemical peel regarding the number of treatment and satisfaction rates. RESULTS: Those who received treatment for more than 6 times with good or excellent results were 13 out of 15 patients, whereas, those who received treatment for 4 times with good or excellent results were 4 out of 7 patients Thus, chemical peel on acne scars showed that the more often the treatment was carried out, the better the therapeutic effect. There was no significant complication. CONCLUSION: TCA chemical peel is safe and effective for the treatment of atrophic acne scars.
Acne Vulgaris* ; Cicatrix* ; Humans ; Skin ; Trichloroacetic Acid

BACKGROUND: Most laboratories in Korea have been used kinetic Jaffe method for creatinine measurement. However, kinetic Jaffe method is interfered by hyperbilirubinemia, which causes creatinine decrement. In this study, we evaluated the usefulness of deproteinization by trichloroacetic acid (TCA) in eliminating negative interference of bilirubin for accurate creatinine measurement. METHODS: We evaluated the correction effect of serum creatinine levels by deproteinization using 0.55 mol/L TCA in 43 samples with various total bilirubin levels. For 26 samples of them we measured creatinine using the enzymatic method for evaluating accuracy of TCA correction. Creatinine was measured by using the Toshiba 200-FR automated analyzer and the HiSense CREA reagents. RESULTS: After TCA treatment, 22 to the total 43 samples with more than 10 mg/dL of total bilirubin, revealed statistically higher creatinine concentration (P=0.0002) and the difference of creatinine results is mean 0.53 mg/dL (0.15-1.92 mg/dL). Also, 19 of them (86.4%) revealed 20% or more difference of creatinine results before and after TCA treatment and the negative interference of bilirubin increased in proportion to the rise in total bilirubin concentration (r=0.870). There was no significant difference of creatinine results between kinetic Jaffe method with 0.55 mol/L TCA treatment and enzymatic method (P=0.216). CONCLUSIONS: TCA deproteinization is simple and very efficient method for estimating accurate creatinine level by using kinetic Jaffe method in a patient with hyperbilirubinemia.
Bilirubin ; Creatinine ; Humans ; Hyperbilirubinemia ; Korea ; Trichloroacetic Acid

BACKGROUND: Most laboratories in Korea have been used kinetic Jaffe method for creatinine measurement. However, kinetic Jaffe method is interfered by hyperbilirubinemia, which causes creatinine decrement. In this study, we evaluated the usefulness of deproteinization by trichloroacetic acid (TCA) in eliminating negative interference of bilirubin for accurate creatinine measurement. METHODS: We evaluated the correction effect of serum creatinine levels by deproteinization using 0.55 mol/L TCA in 43 samples with various total bilirubin levels. For 26 samples of them we measured creatinine using the enzymatic method for evaluating accuracy of TCA correction. Creatinine was measured by using the Toshiba 200-FR automated analyzer and the HiSense CREA reagents. RESULTS: After TCA treatment, 22 to the total 43 samples with more than 10 mg/dL of total bilirubin, revealed statistically higher creatinine concentration (P=0.0002) and the difference of creatinine results is mean 0.53 mg/dL (0.15-1.92 mg/dL). Also, 19 of them (86.4%) revealed 20% or more difference of creatinine results before and after TCA treatment and the negative interference of bilirubin increased in proportion to the rise in total bilirubin concentration (r=0.870). There was no significant difference of creatinine results between kinetic Jaffe method with 0.55 mol/L TCA treatment and enzymatic method (P=0.216). CONCLUSIONS: TCA deproteinization is simple and very efficient method for estimating accurate creatinine level by using kinetic Jaffe method in a patient with hyperbilirubinemia.
Bilirubin ; Creatinine ; Humans ; Hyperbilirubinemia ; Korea ; Trichloroacetic Acid

Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Trichloroacetic Acid ; urine

This study was designed to prospect the 'In-labelled paclitaxel as tumor imaging agent. In order to provide a taxol molecule with a functional group which is able to chelate In-lll, taxol-DTPA conjugate and 2-hemisuccinyltaxol were synthesized by esterification of taxol at C-2 on C-13 carbon with DTPA anhydride and succinic anhydride, respectively. Synthesis yield of the taxol derivatives was 34% for taxol- DTPA and 80% for 2'-hemisuccinyltaxol. Cytotoxicity of the taxol derivatives were measured by MTT method toward cell lines HT29, B16, P388, and CT26. The cytotoxic activities of the taxol derivatives were maintained, although less active than taxol. Radiolabelling of the taxol derivatives were proceeded directly with 111InCh or indirectly with 111In-citrate(ligand-exchange method). The ligand-exchane methocl was not suitable because some precipitat:es appeared during the reaction. On the contrary, by direct radiolabelling methnd, we were able to obtain taxol DTPA-111In in 100% radiochemical yield. However, 2'-hemisuccinyltaxol was not labellecl by both methods. Yield and radiochemiral purity of the radiolabelled com- pound were determined by HPI.C, paper chromatography and instant thin layer chromatography. Taxol-DTPA-111In was characterized to be hydrophilic by lipophi- licity test, and nearly non-adhesive to HT29, E316, P388, and CT26 by cell hinding affinity test. Binding affinity of the taxol-DTPA-111In complex to serum proteins was also examined by protein precipitation with 30% trichloroacetic acid. The results showed that 309o of the taxol-DTPA-111In complex binds with serum proteins.
Blood Proteins ; Carbon ; Cell Line ; Chromatography, Paper ; Chromatography, Thin Layer ; Esterification ; Paclitaxel* ; Pentetic Acid ; Trichloroacetic Acid

This study was done to characterize the structural changes in the tretinoin pretreatment on trichloroacetic acid(TCA) chemical peel. In guinea pigs, the right halves pretreated with tretinoin and the left halves treated nothing were compared in their structural changes after TCA chemical peel. Epidermal thickness in the tretinoin pretreated group was almost the same in the first and second week. But epidermis of the TCA group increased continuously. In the first week, mitotic figures in the epidermis were more increased in the TCA group, but those in hair follicles were more increased in the tretinoin pretreated group. In the second week, mitotic figures in the epidermis were almost same in both group, but in hair follicles of the tretinoin pretreated group, mitotic figures were much more increased. In alcian blue staining, glycosaminoglycan was stained much more strongly in dermis of the TCA group in first week, but was more strongly stained in the tretinoin pretreated group in second week. On electron microscopic findings, the fibroblasts in upper dermis were larger and had plentier cytoplasm with more organelles in the tretinoin pretreated group. Conclusively, tretinoin pretreatment on TCA chemical peel sustained the effects of TCA longer and showed synergistic effects of TCA and induced enhanced wound healing.
Animal ; Epidermis/drug effects/pathology ; Guinea Pigs ; Skin/*drug effects/pathology ; Tretinoin/*pharmacology ; Trichloroacetic Acid/*pharmacology

BACKGROUND: Various methods have been employed for treatment of onychomycosis. These methods can be categorized as topical, oral, or device-related. Among them, oral therapies have been regarded as the gold standard for treatment. However, the efficacy of oral therapies on onychomycosis remains limited and safety may be an issue, leaving many patients in need of alternative treatments. As an alternative treatment for onychomycosis, topical therapies are under investigation with great interest. OBJECTIVE: We conducted an investigation on the efficacy of trichloroacetic acid (TCA) as a new therapeutic option in treatment of onychomycosis. METHODS: Fourteen patients with onychomycosis in both great toenails, which was confirmed by fungal examination, were enrolled. About 0.1 ml of 100% TCA solution was applied on one great toenail of the patients eight times at an interval of one week. The other great toenail of the patients was treated with vehicle. RESULTS: At the end of the treatment period, clinical improvement of TCA-treated great toenails with onychomycosis was observed in eleven out of 14 patients. By contrast, no clinical improvement was observed in vehicle-treated great toenails with onychomycosis. Irritant contact dermatitis of the periungual nail folds occurred in 29% as an adverse effect. CONCLUSIONS: Topical solution of TCA may become a new therapeutic option for treatment of patients with onychomycosis who desire alternatives to oral antifungal agents.
Antifungal Agents ; Dermatitis, Contact ; Humans ; Nails* ; Onychomycosis* ; Pilot Projects* ; Trichloroacetic Acid*