Prolonged exposure to natural or artificial sun light (UV rays) is not recommended because the gel may cause photosensitivity. Irritation due to benzoyl peroxide can be reduced by avoiding harsh facial cleansers and wearing sunscreen prior to sun exposure.Clinical studies have shown systemic absorption of clindamycin through topical application, in some cases leading to diarrhea, bloody diarrhea, and colitis. Reports of anaphylaxis were also seen. However, the sources of these reports were personal accounts without controls and of an unknown population, thus it is difficult to attribute their cause to the clindamycin/benzoyl peroxide gel. Interactions
No formal interaction studies have been done. Combination with topical products containing alcohol or astringents, as well as skin peelings, may increase the irritant effect of clindamycin/benzoyl peroxide. Topical erythromycin may antagonise the effect of clindamycin, although this has only be demonstrated in in vitro studies. Topical tretinoin and other retinoids may be inactivated by benzoyl peroxide or increase its irritant effect. Pharmacology
Mechanism of action
Clindamycin phosphate is a water-soluble ester of the semi-synthetic antibiotic clindamycin, which is synthesized from lincomycin. Like the macrolide antibiotics, it acts as a bacteriostatic agent by interfering with the 50S subunit of the ribosome of Cutibacterium acnes, inhibiting bacterial protein synthesis and preventing bacteria from replicating. C. acnes plays a role in the development of acne.Benzoyl peroxide also kills C. acnes, but by releasing free radical oxygen species, thus oxidizing bacterial proteins. Also, it dries out the area by reducing sebum production, prevents clogged pores, and is a keratolytic agent.
It originates in the substitution of one Nordic capital (Stockholm, Sweden) for another (Helsinki, Finland). It entered popular culture when used in the Bruce Willis film Die Hard, by a doctor appearing on a television show and describing the phenomenon. The bumbling host says this refers to "Helsinki, Sweden", and the doctor corrects him, saying "Finland". History
Stockholm bank robbery
In 1973, Jan-Erik Olsson, a convict on parole, took four employees (three women and one man) of Kreditbanken, one of the largest banks in Stockholm, Sweden, hostage during a failed bank robbery. He negotiated the release from prison of his friend Clark Olofsson to assist him. They held the hostages captive for six days (23–28 August) in one of the banks vaults. When the hostages were released, none of them would testify against either captor in court; instead, they began raising money for their defense.Nils Bejerot, a Swedish criminologist and psychiatrist coined the term after the Stockholm police asked him for assistance with analyzing the victims reactions to the 1973 bank robbery and their status as hostages. As the idea of brainwashing was not a new concept, Bejerot, speaking on "a news cast after the captives release" described the hostages reactions as a result of being brainwashed by their captors. He called it Norrmalmstorgssyndromet (after Norrmalmstorg Square where the attempted robbery took place), meaning "the Norrmalmstorg syndrome"; it later became known outside Sweden as Stockholm syndrome.