We searched the following databases up to February 2015: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2015, Issue 1), MEDLINE (from 1946), EMBASE (from 1974), and LILACS ((Latin American and Caribbean Health Science Information database, from 1982). To assess the effects and safety of SLNB followed by completion lymph node dissection (CLND) for the treatment of localised primary cutaneous melanoma. SLNB has become an important component of initial melanoma management providing accurate disease staging. Treatment strategies include wide excision of the primary tumour and sentinel lymph node biopsy (SLNB) to assess the status of the regional nodal basin(s). Surgery represents the mainstay of melanoma treatment. The vast majority of newly diagnosed melanomas are confined to the primary cutaneous site. Melanoma is the leading cause of skin cancer-associated mortality.
Therefore, topical retinoids have been the first-line treatment for most forms of acne vulgaris either alone or together with other agents. They prevent the formation of microcomedones and reduce their number, reduce macrocomedones, promote the normal desquamation of follicular epithelium, exert anti-inflammatory effects, enhance the penetration of other topical acne drugs, and prolong the remission periods of acne by inhibiting the formation of microcomedone formation and preventing the development of new lesions and bacterial resistance. Topical retinoids have multiple effects in the treatment of acne and act on more than one factor implicated in the etiology of acne. Increased sebum secretion from sebaceous glands, secretion of inflammatory mediators, altered keratinization and follicular plugging, and follicular colonization of Propionibacterium acnes are major four steps of acne pathogenesis. The first step in the treatment of acne is to understand the pathophysiology of disease and to act on the factors involved in the development of acne. The initial lesions of acne are the microcomedones that can be observed histologically in normal-appearing skin. Acne vulgaris is the most common skin disease in adolescents and young adults and has serious influence on quality of life of the patients.
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