The efficacy of low protein acne patch containing with the extracts of Garcinia mangostana Linn and dry root of Albizia saman

Acne is a common skin disease. The alternative treatment for acne such as hydrocolloid acne patch is used for decreasing the inflammatory process. This is experimental, randomized, assessorblinded, controlled, intra-individual split face comparative study. Thirty-six volunteers with mild to moderate acne vulgaris were enrolled. The clinical outcomes were evaluated as the followings: mediantime to recovery of acne analyzed by survival analysis, lesional diameters measurement of acne, clinical erythema score, erythema index by Mexameter Mx16® (Cologne, Germany) and the patients’ s satisfaction. All the volunteers were assessed at baseline 3, 7 and 14 days. It was showed that the median time to recovery of the acne on the side that was treated with GA is 7 days, while the side that was treated with His 14 days with statistically significant difference (p=0.001). The results showed that on day 3, 7 and 14 of our visits, the group treated with GA had acne which were statistically significantly smaller in diameter size, lower clinical erythema score and lower erythema index reduction than the H group (p=1x10-6). In terms of the satisfaction, the patients were found to be more satisfied, based on satisfaction score, with thetreatment using GA than H group. This result was statistically significant difference (p=1x10-6). No adverse effects were reported from either type of patches. In conclusion, the low protein acne patch containingwith mixed extracts of Garcinia mangostana Linn and dry root of Albizia saman was effective and safe for treating acne, which was demonstrated by the more improvement than that of the hydrocolloid acne patch. As such, this can be used as an alternative inflammatory acne treatmen

Vehicles for atopic dermatitis therapies: more than just a placebo

A topical vehicle is a ‘carrier system’ for an active pharmaceutical (or cosmetic) substance, referred to hereafter as the drug, but a vehicle may also be used on its own as an emollient to ameliorate dry skin. It is well established that the vehicle plays an important role in determining the bioavailability of a given drug at its ultimate target within the skin. Yet in the treatment of atopic eczema/dermatitis (AD), wherein the structure and function of the skin's outer barrier play a pivotal role in the development and course of the condition, the interaction of the vehicle with this barrier carries a particular importance. It is now clear that the often-considered inert excipients of a vehicle bring about changes within the skin at the molecular level that promote barrier restoration and enhance innate immune defenses with therapeutic value to AD patients. Moreover, the vehicle control in randomized controlled trials (RCTs) increasingly displays significant efficacy. In light of this, we consider the implications of vehicle design in relation to AD pathophysiology and the role vehicles play as controls in RCTs of new drug treatments for this condition

Interventions to reduce Staphylococcus aureus in the management of eczema

© 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Background Staphylococcus aureus (S. aureus) can cause secondary infection in eczema, and may promote inflammation in eczema that does not look infected. There is no standard intervention to reduce S. aureus burden in eczema. It is unclear whether antimicrobial treatments help eczema or promote bacterial resistance. This is an update of a 2008 Cochrane Review. Objectives To assess the effects of interventions to reduce S. aureus for treating eczema. Search methods We updated our searches of the following databases to October 2018: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase and LILACS. We searched five trials registers and three sets of conference proceedings. We checked references of trials and reviews for further relevant studies. We contacted pharmaceutical companies regarding ongoing and unpublished trials. Selection criteria Randomised controlled trials of products intended to reduce S. aureus on the skin in people diagnosed with atopic eczema by a medical practitioner. Eligible comparators were a similar treatment regimen without the anti-staphylococcal agent. Data collection and analysis We used standard methodological procedures expected by Cochrane. Our key outcomes were participant-or assessor-rated global improvement in symptoms/signs, quality of life (QOL), severe adverse events requiring withdrawal, minor adverse events, and emergence of antibiotic-resistant micro-organisms. Main results We included 41 studies (1753 analysed participants) covering 10 treatment categories. Studies were conducted mainly in secondary care in Western Europe; North America; the Far East; and elsewhere. Twelve studies recruited children; four, adults; 19, both; and six, unclear. Fifty-nine per cent of the studies reported the mean age of participants (range: 1.1 to 34.6 years). Eczema severity ranged from mild to severe. Many studies did not report our primary outcomes. Treatment durations ranged from 10 minutes to 3 months; total study durations ranged from 15 weeks to 27 months. We considered 33 studies at high risk of bias in at least one domain. We present results for three key comparisons. All time point measurements were taken from baseline. We classed outcomes as short-term when treatment duration was less than four weeks, and long-term when treatment was given for more than four weeks. Fourteen studies evaluated topical steroid/antibiotic combinations compared to topical steroids alone (infective status: infected (two studies), not infected (four studies), unspecified (eight studies)). Topical steroid/antibiotic combinations may lead to slightly greater global improvement in good or excellent signs/symptoms than topical steroid alone at 6 to 28 days follow-up (risk ratio (RR) 1.10, 95% confidence interval (CI) 1.00 to 1.21; 224 participants; 3 studies, low-quality evidence). There is probably little or no difference between groups for QOL in children, at 14 days follow-up (mean difference (MD)-0.18, 95% CI-0.40 to 0.04; 42 participants; 1 study, moderate-quality evidence). The subsequent results for this comparison were based on very low-quality evidence, meaning we are uncertain of their validity: severe adverse events were rare (follow-up: between 6 to 28 days): both groups reported flare of dermatitis, worsening of the condition, and folliculitis (325 participants; 4 studies). There were fewer minor adverse events (e.g. flare, stinging, itch, folliculitis) in the combination group at 14 days follow-up (218 participants; 2 studies). One study reported antibiotic resistance in children at three months follow-up, with similar results between the groups (65 participants; 1 study). Four studies evaluated oral antibiotics compared to placebo (infective status: infected eczema (two studies), uninfected (one study), one study’s participants had colonisation but no clinical infection). Oral antibiotics may make no difference in terms of good or excellent global improvement in infants and children at 14 to 28 days follow-up compared to placebo (RR 0.80; 95% CI 0.18 to 3.50; 75 participants; 2 studies, low-quality evidence). There is probably little or no difference between groups for QOL (in infants and children) at 14 days follow-up (MD 0.11, 95% CI-0.10 to 0.32, 45 participants, 1 study, moderate-quality evidence). The subsequent results for this comparison were based on very low-quality evidence, meaning we are uncertain of their validity: adverse events requiring treatment withdrawal between 14 to 28 days follow-up were very rare, but included eczema worsening (both groups), loose stools (antibiotic group), and Henoch-Schönlein purpura (placebo group) (4 studies, 199 participants). Minor adverse events, including nausea, vomiting, diarrhoea, and stomach and joint pains, at 28 days follow-up were also rare and generally low in both groups (1 study, 68 infants and children). Antibiotic resistance at 14 days was reported as similar in both groups (2 studies, 98 infants and children). Of five studies evaluating bleach baths compared to placebo (water) or bath emollient (infective status: uninfected (two studies), unspecified (three studies)), one reported global improvement and showed that bleach baths may make no difference when compared with placebo at one month follow-up (RR 0.78, 95% CI 0.37 to 1.63; 36 participants; low-quality evidence). One study showed there is probably little or no difference in QOL at 28 days follow-up when comparing bleach baths to placebo (MD 0.90, 95% CI-1.32 to 3.12) (80 infants and children; moderate-quality evidence). We are uncertain if the groups differ in the likelihood of treatment withdrawals due to adverse events at two months follow-up (only one dropout reported due to worsening itch (placebo group)) as the quality of evidence was very low (1 study, 42 participants). One study reported that five participants in each group experienced burning/stinging or dry skin at two months follow-up, so there may be no difference in minor adverse events between groups (RR 1.00, 95% CI 0.35 to 2.87, 36 participants, low-quality evidence). Very low-quality evidence means we are also uncertain if antibiotic resistance at four weeks follow-up is different between groups (1 study, 80 participants ≤ 18 years). Authors' conclusions We found insufficient evidence on the effects of anti-staphylococcal treatments for treating people with infected or uninfected eczema. Low-quality evidence, due to risk of bias, imprecise effect estimates and heterogeneity, made pooling of results difficult. Topical steroid/ antibiotic combinations may be associated with possible small improvements in good or excellent signs/symptoms compared with topical steroid alone. High-quality trials evaluating efficacy, QOL, and antibiotic resistance are required

Serum magnesium in atopic patients with special reference to atopic dermatitis

Skin alterations related to inflammation following a state of acute or chronic hypomagnesemia are well documented. Among diverse pathogenic factors, pro-inflammatory cytokines play a crucial role in contact dermatitis (CD) and atopic dermatitis (AD). With this in mind, serum-Mg was examined in controls and in patients with CD (diagnosed by physical examination and by patch test) and AD (diagnosed by Hanifin and Rajka's criteria). There were n = 30/per group, aged 26 39 years, the ratio of females to males being similar to 4 : 1. The frequency of hypomagnesemia was 0% in controls, 10% in CD, and 16.7% in AD. Similar results were reported in the literature for allergic rhinitis and asthma. In view of the presented data, atopic patients should be routinely checked for lowered Mg levels as candidates for targeted Mg supplementation

Efficacy and Safety of Detachable Microneedle Patch Containing Triamcinolone Acetonide in the Treatment of Inflammatory Acne

Abstract Detachable microneedles (DMNs) are dissolvable microneedles that detach from the base during administration. The use of DMNs-containing steroids for acne has never been investigated. Thirty-five patients with facial inflammatory acne were evaluated for acne treatment efficacy and safety of DMNs and DMNs containing triamcinolone acetonide (TA) via a 28-day randomized, double-blind, controlled trial. Four inflammatory acne lesions were selected from each participant and randomly treated with a single application of 700 µm DMNs containing 262.02 ± 15.62 µg TA (700DMNTA), 1000 µm DMNs containing 160.00 ± 34.92 µg TA (1000DMNTA), 700 µm DMN without TA (700DMN), and a control. Efficacy was measured by assessing physical grading, diameter, volume, erythema index, and melanin index. Safety was evaluated by assessing reports of adverse effects from patients and physicians. All three treatment groups achieved resolution of inflammatory acne significantly faster than the control group, with median times for resolution of 4.6, 5.25, 6.7, and 8.1 days in the 1000DMNTA, 700DMNTA, 700DMN, and control, respectively. When compared to the control group, the diameters and post-acne erythema of inflammatory acne were significantly reduced in the treatment groups. The 1000DMNTA decreased acne size and erythema more than other treatments. DMNTA also tended to decrease acne size and erythema more than DMN with no TA, but there was no statistically significant difference. All participants preferred DMN over conventional intralesional steroid injection due to less pain and self-application. No adverse effect was observed. DMNTA is a safe, effective alternative treatment for inflammatory acne that significantly reduces post-acne erythema. Trial registration: TCTR20211215006 on December 15, 2021</jats:p