Prevention and treatment of acute and chronic radiodermatitis

Sophie Seité,1 René-Jean Bensadoun,2 Jean-Michel Mazer3 1La Roche-Posay Laboratoire Dermatologique, Levallois-Perret, 2Centre de Haute Energie (CHE), Nice, 3Centre Laser International de la Peau, Paris, France Abstract: More than half the number of patients with cancer, who are treated with radiotherapy, will have radiodermatitis at some point during their treatment. Radiodermatitis either occurs early on in the treatment period or appears months or up to several years later. Acute radiodermatitis is a burn injury that varies in severity according to both treatment and inherent patient factors. Most acute radiodermatitis reactions resolve after several weeks but some reactions persist and can cause complications. Late-onset radiodermatitis is characterized by telangiectasia that forms on atrophic and fragile skin. These radiodermatitis reactions can have a significant negative impact on concomitant and subsequent therapeutic protocols and most particularly on the patient’s quality of life. Today, treatment of radiodermatitis reactions is in its infancy. Although there is insufficient evidence available to form recommendations that would prevent or reduce radiodermatitis, some advances have been made using low level light therapy (LLLT) or vascular lasers to control the symptoms. Some recent preclinical and clinical research suggests that LLLT has biostimulating properties which allow the tissues to regenerate and heal faster, reduce inflammation, and prevent fibrosis. Also, in late-onset radiodermatitis pulsed dye laser treatment has been shown to be beneficial in clearing radiation-induced telangiectasia. In the absence of evidence-based recommendations, the objective of this paper is to review how to prevent or manage the symptoms of radiodermatitis reactions. Keywords: acute radiodermatitis, chronic radiodermatitis, low level light therapy, laser, pulsed dye, prevention, management, skin car

Clinical efficacy of emollients in atopic dermatitis patients – relationship with the skin microbiota modification

Sophie Seité,1 Hana Zelenkova,2 Richard Martin3 1La Roche-Posay Dermatological Laboratories, Asnières, France; 2DOST, Private Clinic of Dermatovenereology, Svidnik, Slovakia; 3L’Oréal Research and Innovation, Tours, France Background: We speculated that an emollient supplemented with a biomass of nonpathogenic bacteria such as Vitreoscilla filiformis (Vf), grown in a medium containing thermal spring water (LRP-TSW); (LRP-Vitreoscilla filiformis biomass [LRP-VFB]), could have a beneficial effect for patients with atopic dermatitis (AD). Patients and methods: This double-blind, randomized, comparative study was conducted with 60 patients with moderate AD. Before starting the study, participants were pretreated for 15 days with drug therapy to improve their SCORing Atopic Dermatitis (SCORAD) by at least 25%. On Day 1, the eligible patients were randomized to either the emollient containing LRP-VFB associated with mannose (Product A) or another emollient (product B) and were treated twice daily for 1 month. Recurrence of flare-ups and microbial communities were characterized from swabs taken at Day 1 and Day 28, under axenic conditions, from affected (AF) and proximal unaffected (UAF) skin areas. Results: At Day 1, the average SCORAD of each group and the microbial communities of AF and UAF areas for each participant were similar. One month after the end of the therapeutic treatment (Day 28), the average evolution of SCORAD at Day 28 compared to Day 1 of patients treated with product A was significantly lower than that of the patients treated with product B. A significantly increased level of Xanthomonas genus was noticed in the group treated with product A (versus product B). On the other hand, the level of Staphylococcus genus increased between Day 1 and Day 28 in the group treated with product B, but not in the group treated with product A. Interestingly, these differences were more pronounced for patients in relapse, and the associated SCORAD worsening was less in the group treated with product A versus the group treated with product B. Conclusion: This study demonstrated that a specific emollient containing a biomass of non-pathogenic bacteria Vf grown in a medium containing TSW and associated with a selected carbon source is able to normalize skin microbiota and significantly reduce the number and severity of flare-ups compared with another emollient. Keywords: skin microbiota, atopic dermatitis, emollient, Vitreoscilla filiformis, thermal spring water, Xanthomonas genu

Large-scale survey to describe acne management in Brazilian clinical practice

Sophie Seité,1 Clarice Caixeta,2 Loan Towersey3 1La Roche-Posay Dermatological Laboratories, Asnières, France; 2La Roche-Posay Dermatological Laboratories, Rio de Janeiro, RJ, Brazil; 3AIDS Division, Hospital Municipal Carlos Tortelly, Niterói, RJ, Brazil Background: Acne is a chronic disease of the pilosebaceous unit that mainly affects adolescents. It is the most common dermatological problem, affecting approximately 80% of teenagers between 12 and 18 years of age. Diagnosis is clinical and is based on the patient's age at the time the lesions first appear, and on its polymorphism, type of lesions, and their anatomical location. The right treatment for the right patient is key to treating acne safely. The aim of this investigational survey was to evaluate how Brazilian dermatologists in private practice currently manage acne.Materials and methods: Dermatologists practicing in 12 states of Brazil were asked how they manage patients with grades I, II, III, and IV acne. Each dermatologist completed a written questionnaire about patient characteristics, acne severity, and the therapy they usually prescribe for each situation.Results: In total, 596 dermatologists were interviewed. Adolescents presented as the most common acneic population received by dermatologists, and the most common acne grade was grade II. The doctors could choose more than one type of treatment for each patient, and treatment choices varied according to acne severity. A great majority of dermatologists considered treatment with drugs as the first alternative for all acne grades, choosing either topical or oral presentation depending on the pathology severity. Dermocosmetics were chosen mostly as adjunctive therapy, and their inclusion in the treatment regimen decreased as acne grades increased.Conclusion: This survey illustrates that Brazilian dermatologists employ complex treatment regimens to manage acne, choosing systemic drugs, particularly isotretinoin, even in some cases of grade I acne, and heavily prescribe antibiotics. Because complex regimens are harder for patients to comply with, this result notably raises the question of adherence, which is a key factor in successful treatment. Keywords: acne, management, severity of acne, Brazi

Survey of Hand Issues Encountered by Hairdressers and Hairdresser Related Professionals: From Epidemiological Data to Clinical Observational Survey Results

Sophie Seité, Guénaëlle Le Dantec, Ann’Laure Demessant-Flavigny, Delphine Kerob Medical Department, La Roche-Posay International, Levallois-Perret, FranceCorrespondence: Delphine Kerob, Cosmétique Active International, La Roche-Posay International, 62 quai Charles Pasqua, Levallois-Perret, 92300, France, Tel +33 6 62 40 22 52, Email [email protected]: Hand eczema is frequent among hairdressers. The aim of this open survey was (i) to assess the prevalence and identify causing factors of hand issues encountered by hairdressers and (ii) to assess the benefit of a cosmetic skin care in clinical signs and symptoms through a clinical observational survey.Methods: The survey was conducted among 391 hairdressers and hairdresser-related professionals, collecting information on frequency of daily procedures, frequency/type/severity of hand issues, and glove usage. The satisfaction provided by a dermocosmetic containing niacinamide, glycerin, shea butter and thermal spring water was examined in an evaluation visit one month after survey initiation.Results: Investigated subjects were mostly hairdressers (73%). In their daily procedures, a majority (≥ 76%) always or often used shampoos, hair dyes, oxidants, bleachers, straighteners and perms. Overall, a majority (> 60%) of subjects always or often had hand irritation due to this use (except for straighteners). Most subjects (≥ 60%) reported using gloves in their procedures except with shampoos and straighteners. Among hand problems reported at survey initiation, the most intense was skin dryness, followed by redness, irritation, cracks, and fissures. Hand problems induced annoyance in their activities for most subjects (> 65%), leading to discontinuation of their professional activities for 28% subjects. The test dermocosmetic was applied for 1 week up to 1 month. At evaluation visit (1 month), the intensity of all hand signs and symptoms was decreased compared to initiation visit. In addition, 58.3% subjects reported return to professional activities instantly at evaluation visit versus 31.3% at initial visit. Most subjects (≥ 73%) were satisfied or very satisfied with the test cream properties.Conclusion: Our survey confirms the impact of hand issues experienced by hairdresser professionals and highlights the need for gloves and for efficient hand care products.Keywords: hand eczema, daily procedures, activity discontinuation, protective measure

Expression of intercellular adhesion molecule-1 in UVA-irradiated human skin cells in vitro and in vivo.

Ultraviolet A (UVA) radiation represents an important oxidative stress to human skin and certain forms of oxidative stress have been shown to modulate intercellular adhesion molecule-1 (ICAM-1) expression. ICAM-1 has been shown to play an important part in many immune reactions and the perturbations of this molecule by ultraviolet radiation could have implications in many inflammatory responses. An enhancement immunohistochemical method with avidin/biotin was used for analysing the early effects of UVA radiation on human cell cultures and human skin (340-400 nm). Both in vitro and in vivo data show that ICAM-1 staining in epidermal keratinocytes, which was expressed constitutively, decreased in a UVA dose-dependent manner. The decrease was most noted at 3-6 h following UVA radiation with some ICAM-1 staining returning by 48 h post-UVA. ICAM-1 positive staining in the dermis was specific for vascular structures and was increased 24 h after UVA radiation. Cultured dermal fibroblasts exhibited ICAM-1 staining which increased slightly within 6-48 h post-UVA radiation. As epidermal ICAM-1 expression is depleted following UVA radiation and dermal expression increases due to an increase in the vascular structures, ICAM-1 provides a valuable marker following UVA radiation in human skin that can be readily measured in situ