Efficacy of a Tyrothricin-Containing Wound Gel in an Abrasive Wound Model for Superficial Wounds

Background: Topical preparations are a common treatment for superficialacute wounds, which at the least do not interfere with healing andideally result in enhanced wound healing irrespective of microbialcolonization. Objective: To examine the effects of a topicalantimicrobial gel and its vehicle on the wound healing of standardized,superficial abrasions. Methods: Thirty-three healthy volunteers wereenrolled in a double-blinded, randomized, intraindividual comparisonstudy. Three standardized, superficial abrasions were induced on theirforearms. A tyrothricin 0.1% gel (Tyrosur (R) gel; EngelhardArzneimittel GmbH & Co. KG, Niederdorfelden, Germany) and its vehiclewere randomly applied to two of the test areas, and one lesion remaineduntreated. Results: A significant improvement of wound healing was seenwith both tyrothricin 0.1% gel and its corresponding vehicle in theclinical assessment. The mean area under the curve (AUC) of woundhealing scores was the same for both preparations and the meanreepithelization scores were comparable at all test points over theentire 12 days. A lower mean AUC representing less reepithelization wasfound for the untreated test fields. Conclusion: The use of tyrothricin0.1% gel and its corresponding vehicle resulted in statisticallysignificant improved wound healing with an earlier onset of healing inparticular. Based on these results obtained using an abrasive woundmodel, it can be concluded that the addition of tyrothricin 0.1% to thegel vehicle did not interfere with the improved wound healing seen withthe vehicle alone

Bioavailability, Antipsoriatic Efficacy and Tolerability of a New Light Cream with Mometasone Furoate 0.1%

Mometasone furoate, a potent glucocorticoid (class III) with a favorable benefit/risk ratio, has emerged as a standard medication for the treatment of inflammatory skin disorders. The purpose of the investigation presented here was to determine the noninferiority of a topical mometasone formulation, a light cream (O/W 60/40 emulsion) with mometasone furoate 0.1% (water content of 33%) versus marketed comparators. Using the vasoconstrictor assay, a strong blanching effect of the new cream (called Mometasone cream) comparable to that of a mometasone comparator, a fatty cream with mometasone furoate 0.1%, could be demonstrated. Thus, the topical bioavailability of the active ingredient mometasone furoate (0.1%) was regarded to be similar for Mometasone cream and the mometasone comparator. Using the psoriasis plaque test, a strong antipsoriatic effect comparable to that of the mometasone comparator was found for Mometasone cream after 12 days of occlusive treatment. A nearly identical reduction in the mean infiltrate thickness and similar mean AUC values were noted with both formulations confirmed by clinical assessment data. The noninferiority of Mometasone cream to its active comparator with re-spect to the AUC of change to baseline in infiltrate thickness was demonstrated. Both medications were well tolerated. Overall, Mometasone cream and the mometasone comparator showed similar efficacy and tolerability. Mometasone cream, in addition to its high potency and good tolerability, provides the properties of a light cream, which might make this new medication particularly suitable for application on acutely inflamed and sensitive skin. Copyright (C) 2012 S. Karger AG, Base

Evidence-Based Management of Hand Eczema

Hand eczema is a common skin disease with a wide variation in morphology and a complex etiology based on endogenous and exogenous factors.The diagnosis of hand eczema is based on patient history, exposure assessment, physical examination, and the results of patch testing. Management of hand eczema starts with education of the patient on the etiology of the disease, and the needed changes in behavior regarding skin care and preventive measures, and avoidance of relevant exposure factors. In many cases, medical treatment is needed for successful management of the disease; use of medication can only be successful with proper education and avoidance of relevant exposure

Tandem repeated irritation in aged skin induces distinct barrier perturbation and cytokine profile in vivo

The barrier perturbation pattern and molecular markers of inflammation upon tandem repeated irritation in chronologically aged skin have not been previously studied. We aimed to investigate the barrier impairment kinetic and in vivo cytokine profile following sequential irritation with sodium lauryl sulfate (SLS) and undiluted toluene (Tol) in aged compared with young skin. Four fields on the volar forearm of healthy aged and young volunteers (median age, respectively, 63.9 and 32.6 years) were sequentially exposed to 0.5% SLS and undiluted toluene in a controlled tandem repeated irritation test; an adjacent nontreated field served as control. The permeability barrier function was monitored by repeated measurements of transepidermal water loss (TEWL), capacitance and erythema every 24 h up to 96 h. The stratum corneum cytokines were harvested by sequential tape stripping and quantified by multiplex bead array and enzyme-linked immunosorbent assay. Compared with young skin, aged skin was characterized by delayed and/or less pronounced alterations in the visual irritation score, TEWL, chromametry a*-value and capacitance, assessed by the respective Δ-values for each parameter and monitoring time point. In both groups, exposure to SLS/SLS, SLS/Tol and Tol/SLS resulted in decreased interleukin (IL)-1α levels, whereas the application of Tol/Tol induced an increase in IL-1α. Furthermore, decreased IL-1 receptor antagonist (IL-1RA) levels and a lower IL-1RA/IL-1α ratio were found following repeated exposure to the irritants. Our results provide evidence for selective alterations in the cytokine profile and distinct barrier impairment kinetic following tandem repeated irritation with SLS and Tol in aged compared with young skin in viv