Improvement of xeroderma and water content of the stratum corneum in children with a moisturizer containing oat kernel oil / 中华医学美学美容杂志

Objective:To evaluate the influence of a moisturizer containing oat kernel oil for xeroderma and water content of the stratum corneum in children.Methods:From September to December 2022, 30 children with xeroderma were treated in the Dermatology Department of Tongzhou Maternal and Child Health Hospital of Beijing; 13 were males and 17 were females, and the age was 7.33±2.63 years. This was a single-center self-controlled trial. All children applied the moisturizer on the dry skin of the bilateral limbs two time per day for 14 days, and were followed up at 7 days and 14 days. Efficacy was evaluated according to the water content of the stratum corneum, visual scale, xerosis severity scale (XSS), Specified Symptom Sum Score (SRRC), Visual Analog Scale (VAS) and so on. and side-reactions were recorded.Results:After application of the moisturizer, the median of water content in the stratum corneum was 49.00 (33.83, 87.25), 48.84 (32.58, 100.34) at 7 d and 14 d respectively, showing significant increases compared with that at baseline (median 26.51 (16.00, 47.75) ( Z=-3.075, Z=-2.911, P<0.01). The visual scale, XSS, SRRC and VAS showed that compared with the baseline at 7 d, 14 d, the skin dryness and pruritus scores improved significantly ( Z=-4.424, -4.150, -3.943, -4.400; Z=-4.744, -4.409, -4.260, -4.409, P<0.01). Conclusions:The application of this moisturizer containing oat kernel oil could effectively improve skin dryness and the water content of the stratum corneum without serious adverse reactions.

Efficacy of moisturizers in paediatric atopic dermatitis: Asystematic review and meta-analysis of randomised controlled trials

Background: Topical moisturizer is recommended for atopic dermatitis. Aims: The aim of the study was to investigate the knowledge gap regarding the efficacy of moisturizer in young patients. Methods: A systematic review and meta-analysis were conducted on randomised controlled trials comparing participant’s ≤15 years with atopic dermatitis, receiving either topical moisturizer or no moisturizer treatment. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: Six trials were included (intervention n= 436; control n= 312). Moisturizer use extended time to flare by 13.52 days (95% confidence interval 0.05–26.99, I2 88%). Greater reduction in risk of relapse was observed during the first month of latency (pooled risk ratio 0.47, 95% confidence interval 0.31–0.72, I2 28%) compared to the second and third months (pooled risk ratio 0.65, 95% confidence interval 0.47–0.91, I2 35% and pooled risk ratio 0.63, 95% confidence interval 0.47–0.83, I2 33%, respectively).Treated patients were 2.68 times more likely to experience a three–six months remission (95% confidence interval1.18–6.09, I2 56%). Moisturizer minimally improved disease severity and quality of life. Limitations: There is a dire need to conduct randomised controlled trials with more robust and standardised designs. Conclusion: Moisturizer benefits young patients with atopic dermatitis. However, more research is needed to better estimate its efficacy.

The Beneficial Effect Of 20% Sunflower Seed Oil Cream On Mild Atopic Dermatitis In Children

Objective: The objective of this study was to evaluate the beneficial effect of topical applications of 20% sunflower seed oil (SSO) in decreasing the transepidermal water loss (TEWL) and scoring of atopic dermatitis (SCORAD) index value in mild atopic dermatitis (AD) pediatric patients in Bandung, Indonesia. Methods: This was a randomized study involving 20 children with mild AD (SCORAD<25) in Bandung, Indonesia. They were divided into 2 groups: the experimental group treated with 20% SSO cream and the control group treated with a common moisturizing cream for four weeks. The TEWL score including SCORAD index was evaluated at baseline, week 1, week 2, and week 4. Results: A total of 20 participants completed the study. In the first week, the control group had TEWL score decrement by 36.62% while the experimental group by 28.89% (p=0.88). In the fourth week, the TEWL decrements of the experimental and control group were by 56.94% and 52.50%, respectively (p=0.20), and this was followed by an improvement of SCORAD index in both treatment groups. Conclusion: The 20% SSO cream has a beneficial effect in decreasing the TEWL score and improving SCORAD indices. Therefore, it can be considered as an alternative treatment for mild AD among children.

Dendrobium orchid polysaccharide extract: Preparation, characterization and in vivo skin hydrating efficacy / 中草药·英文版

Objective: Dendrobium spp., the major globally commercializing tropical orchid, has been continuously used in Chinese medicine. However, preparation and standardization of this therapeutic orchid including its clinical evidence for topical application are sparely to be exploited. Methods: Maceration of the white orchid (Dendrobium cv. Khao Sanan) in water was varied on the extraction time. The extraction yields and total polysaccharide content of the extracts were compared. The best extract condition was selected, standardized, and evaluated on safety and skin hydrating efficacy in human volunteers. Results: The extraction for 3 h gave the extract with polysaccharide content that significantly (P < 0.001) greater than the other extraction times with the following specification: yield [(35.60 ± 2.51)%], moisture content [(7.65 ± 0.21)%], total polysaccharide, sugar, reducing sugar and ash content [(72.95 ± 2.37)%, (34.38 ± 0.00)%, (16.28 ± 0.00)%, and (0.12 ± 0.00)%], pH (4.42 ± 0.01), viscosity [(15.07 ± 0.12) cps] swelling and water absorption capacities [(10.00 ± 0.00)%, (1.19 ± 0.24) g/g]. This antioxidative polysaccharide caused no skin irritation with a better skin hydrating efficacy than the untreated skin and the benchmark as examined in 22 Thai volunteers. Conclusion: White Dendrobium is ready to be supplied as a specialty ingredient with a safe and efficient profile for skin dryness therapy. This innovative application of the identified traditional Chinese medicinal herb flows in the main stream of the consumers’ preferences and demand upon natural derived products.

Significance of Skin Barrier Dysfunction in Atopic Dermatitis

The epidermis contains epithelial cells, immune cells, and microbes which provides a physical and functional barrier to the protection of human skin. It plays critical roles in preventing environmental allergen penetration into the human body and responsing to microbial pathogens. Atopic dermatitis (AD) is the most common, complex chronic inflammatory skin disease. Skin barrier dysfunction is the initial step in the development of AD. Multiple factors, including immune dysregulation, filaggrin mutations, deficiency of antimicrobial peptides, and skin dysbiosis contribute to skin barrier defects. In the initial phase of AD, treatment with moisturizers improves skin barrier function and prevents the development of AD. With the progression of AD, effective topical and systemic therapies are needed to reduce immune pathway activation and general inflammation. Targeted microbiome therapy is also being developed to correct skin dysbiosis associated with AD. Improved identification and characterization of AD phenotypes and endotypes are required to optimize the precision medicine approach to AD.

A review on the role of moisturizers for atopic dermatitis

Effective management of atopic dermatitis (AD) involves the treatment of a defective skin barrier. Patients with AD are therefore advised to use moisturizers regularly. To date, there are few comparative studies involving moisturizers in patients with AD, and no classification system exists to objectively determine which types of moisturizers are best suited to specific AD phenotypes. With this in mind, a group of experts from allergy and immunology, adult and pediatric dermatology, and pediatrics centers within Southeast Asia met to review current data and practice, and to develop recommendations regarding the use of moisturizers in patients with AD within the Asia-Pacific region. Chronicity and severity of AD, along with patient age, treatment compliance, and economic background should all be taken into account when selecting an appropriate moisturizer for AD patients. Other considerations include adjuvant properties of the product, cosmetic acceptability, and availability over the counter. Well-defined clinical phenotypes of AD could optimally benefit from specific moisturizers. It is hoped that future studies may identify such differences by means of filaggrin mutation subtypes, confocal microscopic evaluation, pH, transepidermal water loss or presence of allergy specific IgE. Recommendations to improve the regular use of moisturizers among AD patients include measures that focus on treatment compliance, patient and caregiver education, appropriate treatment goals, avoidance of sensitizing agents, and collaboration with other relevant specialists.

The Effect of Powders and Moisturizers on SLS Irritated, Intertriginous Skin / 대한피부과학회지

BACKGROUND: Intertrigo is a form of contact dermatitis of skin folds of the body, for which a large variety of topical medications may be recommended. Application of a suitable barrier preparation is the cornerstone for the prevention and treatment for the intertrigo. OBJECTIVE: There is a notable absence of controlled trials to support and guide the use of barrier preparations for intertrigo. METHODS: We evaluated the effect of powders and moisturizers with non-invasive measuring methods on irritated skin reactions induced by sodium lauryl sulphate in the sintertriginous skin of 21 healthy volunteers. After skin irritation for 24 hours with patch test of 1% sodium lauryl sulphate on both axilla, we applied a powder and a moisturizer respectively. Evaluation was done at 2 weeks by transepidermal water loss, electrical capacitance. RESULTS: TEWL values of the moisturizer treated side were significantly lower than that of the powder treated side. Water holding capacity values of the moisturizer treated side were significantly higher than that of the powder treated side. CONCLUSION: These results suggest that topical application of a moisturizer might improve the disruption of permeability barrier function of intertrigo. We suggest this experimental model for further barrier preparation efficacy testing of intertrigo.

The Efficacy of the Moisturizer APDDR-1001 for Post-laser Wound Care / 대한피부과학회지

BACKGROUND: Because cosmetic laser treatments are getting popular, post-laser wound care becomes more important. Currently, topical moisturizers are reported to be sufficient to accelerate re-epithelialization and reduce downtime in post-laser wound care. OBJECTIVE: This study was performed to evaluate the effects of the moisturizer APDDR-1001 for post-laser wound care, after ablative fractional laser on the face. METHODS: In this double-blind, split-face study, 41 patients with photo-aged face received ablative fractional laser. They were divided into two groups, APDDR-1001 and vehicle (group 1) or control moisturizer (group 2), which were applied to the opposite sides of the face for 1 week after the laser treatment. The treatment efficacy was evaluated by the transepidermal water loss (TEWL), erythema index, investigator's assessment for recovery in erythema and overall improvement of the wound. Subjects ranked irritating symptoms and overall satisfaction ratings in the overall improvement. RESULTS: APDDR-1001 was well-tolerated and showed improvement in the erythema index and TEWL during the 7 days of treatment. In group 2, improvement in erythema graded by investigators was significantly higher for APDDR-1001 on day 3 (p<0.05). The overall improvement of wound ranked by investigators was significantly higher for APDDR-1001, compared with the controls in both groups. Subjective assessment demonstrated significantly less erythema (p=0.043), edema (p=0.041) and overall satisfaction ratings in the overall improvement (p<0.048) with APDDR-1001; however, no differences were detected in pain and edema between APDDR-1001 and vehicle (group 1). In group 2, subjects ranked 'much or very much improved' in 75 % of APDDR-1001 side and 55% of control moisturizer side. No significant differences in erythema, edema, pain and itching were reported between APDDR-1001 and control moisturizer in group 2. CONCLUSION: The moisturizer APDDR-1001 demonstrated effective improvements in wound healing and subjective symptoms after ablative fractional laser therapy.

The Steroid-sparing Effect of an Emollient APDDR-0801 in Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Defective skin barrier function is a well recognized feature in atopic dermatitis (AD) and causes symptoms such as xerosis, pruritus and erythematous lesions. Since moisturizers can strengthen a defective skin barrier and reduce the usage of corticosteroid cream, the choice of moisturizer is very significant for AD patients. OBJECTIVE: This study was done to compare the steroid-sparing effects of a ceramide-containing moisturizer, APDDR-0801, with a control moisturizer without ceramide, for relieving symptoms associated with AD. METHODS: A randomized, controlled, double-blinded 6-week study was conducted. Patients with mild to moderate AD topically applied APDDR-0801 or the control moisturizer on the whole body for 6 weeks. They also applied corticosteroid cream (Zemaderm(R)) on the lesion twice daily for 6 weeks. The amount of corticosteroid used was measured by weighing the tubes. Disease severity was evaluated by eczema severity, area index (EASI), and investigator global assessment (IGA). Transepidermal water loss (TEWL) and skin capacitance were also measured. RESULTS: Of the 40 patients enrolled, 32 completed the protocol. The mean age was (12.95+/-1.92) and the average baseline EASI score was (10.45+/-1.17). EASI score, IGA, TEWL and skin capacitance improved in both groups at 3 weeks and 6 weeks. Compared to the control group, the amount of steroid cream used at 3 weeks and 6 weeks decreased by 0.14 g (-18.78%) and 0.76 g (-7.46%), respectively, in the test group. The difference was larger in patients with moderate AD. The consumption of steroids was lower in the test group at 3 weeks [2.65 g (-34.64%)] and at 6 weeks [2.60 g (-19.38%)], respectively. CONCLUSION: The moisturizer APDDR-0801 (Atobarrier cream(R)) which contains physiologic lipid granules including ceramide, has superior steroid-sparing effects than moisturizers without ceramide.

The Influence of Physiologic Lipid Containing Moisturizer on the Normal Skin Barrier / 대한피부과학회지

BACKGROUND: Moisturizers are commonly used for the management of many skin problems and sometimes they are used to maintain healthy skin. Previous studies on the short-term treatment with moisturizers have shown that moisturizers can weaken or strengthen the skin barrier function. OBJECTIVE: We evaluated the effect of long-term treatment with a physiologic lipid-containing moisturizer on the barrier function of normal skin. METHODS: 39 healthy volunteers applied the moisturizer on one forearm 3 times daily for 8 weeks and then they were followed-up for the next 2 weeks (the regression period). No moisturizer was used on the other forearm as a control. The TEWL, skin capacitance and skin lipid content were evaluated weekly during the 8 weeks treatment period and then daily during 2 weeks of the regression period. RESULTS: During the treatment period, the skin capacitance and lipid content values of the treated side were significantly higher than that of the control side, and the TEWL values of the treated side were significantly lower than that of the control side. During the regression period, all the values of the treated side steadily became closer to those of the control side. These results suggest that long term treatment with moisturizer does not deteriorate the skin barrier function. CONCLUSION: Long-term treatment with moisturizer containing physiologic lipid not only enhances the normal skin barrier, it does not suppress the endogenous lipid synthesis of the skin.

The Influence of Physiologic Lipid Containing Moisturizer on the Normal Skin Barrier / 대한피부과학회지

BACKGROUND: Moisturizers are commonly used for the management of many skin problems and sometimes they are used to maintain healthy skin. Previous studies on the short-term treatment with moisturizers have shown that moisturizers can weaken or strengthen the skin barrier function. OBJECTIVE: We evaluated the effect of long-term treatment with a physiologic lipid-containing moisturizer on the barrier function of normal skin. METHODS: 39 healthy volunteers applied the moisturizer on one forearm 3 times daily for 8 weeks and then they were followed-up for the next 2 weeks (the regression period). No moisturizer was used on the other forearm as a control. The TEWL, skin capacitance and skin lipid content were evaluated weekly during the 8 weeks treatment period and then daily during 2 weeks of the regression period. RESULTS: During the treatment period, the skin capacitance and lipid content values of the treated side were significantly higher than that of the control side, and the TEWL values of the treated side were significantly lower than that of the control side. During the regression period, all the values of the treated side steadily became closer to those of the control side. These results suggest that long term treatment with moisturizer does not deteriorate the skin barrier function. CONCLUSION: Long-term treatment with moisturizer containing physiologic lipid not only enhances the normal skin barrier, it does not suppress the endogenous lipid synthesis of the skin.

Clinical evaluation of glycerin and sesame oil praeparatum in treatment of xerosis / 中华医学美学美容杂志

Objective To evaluate the clinical efficacy and safety of praeparatum containing glycerin and sesame oil in treating dry skin patients. Methods one of patient's limbs was randomly selected to use praeparatum containing 23. 8 % glycerin twice a day, and the other side to use praeparatum containing 43. 7% sesame oil twice a day. During 14 days, the effects were observed and recorded when following-up at the days 0,3,7 and 14. Extent of drying was measured by evaluating each of the clinical symptoms (rough, drying and scale) and the following parameters were also evaluated: stratum corneum hydration (SCH) and trans-epidermal water loss (TEWL). Results The clinical trial was completed in 24 xerosis patients, including 10 males and 14 females. The clinical scores for rough, drying and scale, were assessed by the patients and doctors, and both experimental and control groups were improved. Stratum corneum hydration was improved, trans-epidermal water loss was reduced, and both values had statistically significant difference (P<0. 01). There were no adverse reactions in all the patients during this experiment. Conclusions Both praeparatum containing glycerin and sesame oil could improve the condition of skin safely and effectively in xerosis patients, and the efficacy of glycerin praeparatum is better than sesame oil praeparatum.

The Therapeutic Efficacy of the Moisturizer APDDR-0801 for Patients with Atopic Dermatitis / 대한피부과학회지

BACKGROUND: The patients with atopic dermatitis (AD) show a defective barrier function of the skin and symptoms such as xerosis, pruritus and erythematous lesions with increased transepidermal water loss (TEWL). The choice of topical moisturizer is very significant for AD patients because these symptoms could be relieved by a local moisturizing agent that strengthens the epidermal barrier function. OBJECTIVE: This study was performed to evaluate the effects of the moisturizer APDDR-0801, which contains physiologic lipid granules (DermaON(R)), for relieving the symptoms associated with AD. METHODS: 128 patients (17.8+/-12.1 years) who were suffering from mild to moderate AD topically applied the test moisturizer twice daily for up to 4 weeks. The treatment efficacy was evaluated by the investigator global assessment (IGA) score, the eczema area and severity index (EASI) score, the transepidermal water loss (TEWL), the visual analogue scale (VAS) for pruritus and sleep disturbance, and the level of inflammatory cytokines in the horny layer of the flexural areas. RESULTS: The test moisturizer was well-tolerated and 58.6% of the patients achieved clinical improvements (over moderate) after the application of the test moisturizer for 4 weeks. The significant relief of AD symptoms was observed from 2 week to 4 week in a time-dependent manner. Significant improvements in the signs and symptoms of AD were observed at 4 week, such as the EASI score (37.8% improvement), the TEWL (20.3% improvement in the antecubital fossa lesion), the VAS score for pruritus (26.2% improvement), and VAS score for insomnia (39.7% improvement). CONCLUSION: The moisturizer APDDR-0801 (Atobarrier Cream(R), which contains physiologic lipid granules, effectively relieved the symptoms associated with AD.

Comparação entre duas loções hidratantes de diferentes pHs na melhora da hidratação da pele e na redução do prurido / Comparison between two moisturizing lotions with diff erent pHs in skin moisture improvement and pruritus reduction

Introdução: A dermatite atópica (DA) afeta aproximadamente 15% da população e é uma das doenças infl amatórias crônicas mais comuns da infância. O prurido e a xerose intensa da pele são os seus sintomas mais importantes. A restauração dos elementos da barreira de proteção epidérmica através do uso de emolientes é essencial para o tratamento da doença. Objetivo: Avaliar a melhora do prurido, a hidratação cutânea e xerose em dois grupos de pacientes utilizando hidratantes idênticos (aveia coloidal, Glicerol e petrolato), mas com diferentes pHs em pacientes com DA. Materiais e Métodos: Vinte e um pacientes, com idades entre 7 a 54 anos, com DA moderada a grave e prurido, foram divididos aleatoriamente em dois grupos. Os grupos foram trocados após 30 dias. Resultados: Os resultados foram avaliados após 60 dias. A melhora no prurido, na xerose e na hidratação foram avaliadas pelo médico, pelo paciente e por corniometria. Não houve diferença estatística em ambos os grupos, sendo então os dados avaliados como de um único grupo ao fi nal. A redução do prurido foi observada por 59% dos pacientes e por 52% dos clínicos, e da xerose por 52% dos pacientes e 43% dos clínicos. O nível de hidratação da pele nas áreas com eczema aumentou em 79%, em comparação com o início do tratamento. Conclusão: Hidratantes contendo aveia coloidal, glicerol e petrolato com pH próximo ao da pele normal mostraram-se apropriados na melhora do prurido em pacientes com DA.

Introduction: Atopic dermatitis (AD) affects approximately 15% of the population and is one of chronic infl ammatory diseases more common in childhood. Intense pruritus and skin xerosis are the most important symptoms of the disease. Restoration of epidermal barrier protection elements through the use of emollients is essential for disease treatment. Objective: To evaluate the improvement in pruritus, skin hydration, and xerosis in two groups of patients using the same moisturizer (colloidal oatmeal, glycerol and petrolatum), but with different pH values in patients with AD. Materials and Methods: Twenty-one patients aged 7 to 54 years with AD moderate to severe and pruritus were randomly divided in two groups. The groups were switched after 30 days. Results: The results were assessed after 60 days. Improvement in pruritus, xerosis, and hydration were evaluated by the physician, the patient, and by corneometry. There was no statistical difference in the two groups; therefore, data were evaluated as belonging to a single group at the end. Decrease in pruritus was observed by 59% of patients and 52% of physicians; xerosis reduction was observed by 52% of patients and 43% of physicians. The level of skin hydration in areas with eczema has increased by 79% compared with baseline period. Conclusion: Moisturizers containing colloidal oatmeal, glycerin, and petrolatum with pH close to the one in normal skin showed to be appropriate to improve pruritus in patients with AD.

Skin Care for Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Interplay of numerous constitutional and precipitating factors are involved in the development of atopic dermatitis (AD). Most of these etiologic factors are not controllable, but barrier dysfunction can be managed. Correction of barrier abnormalities has been accepted as a first-line therapy with effective anti-inflammatory therapy. OBJECTIVE: We wished to establish standardized skin care guidelines for Korean patients who suffer from atopic dermatitis. METHODS: The skin care guidelines were proposed by the Korean Atopic Dermatitis Association (KADA), with a particular emphasis for barrier dysfunction in AD from a review of more than 100 published studies and related documents in the clinical literature by a task force team (TFT) of the KADA. The TFT also evaluated the reliability of the studies based on scientific evidence and the size of the study populations. The TFT disregarded controversial findings and summarized all of the collected studies. RESULTS: Skin care guidelines were proposed by the KADA, particularly for barrier dysfunction in AD. A warm bath for approximately 20 minutes was recommended once daily. Soap can be used two or three times per week and aggressive skin scrubbing should be avoided. A topical moisturizer should be applied at least twice a day. Immediate application of emollient is required after bathing. The donning of clothing made of cotton is recommended. Nails should be cut short to reduce skin damage caused by a skin scratch. CONCLUSION: Application of moisturizer immediately after appropriate bathing may be the most important treatment for skin care. A topical steroid should be used whenever AD develops. Nail care and proper clothing are also be helpful for the prevention of dermatitis aggravation. Proper ways to bathe, use of moisturizer and topical steroids and nail care and appropriate clothing were considered.

The Effect of Oral Isotretinoin on the Barrier Function of the Lipsof Acne Patients and the Protective Role of Moisturizer / 대한피부과학회지

BACKGROUND: Oral isotretinoin is an effective treatment for acne patients, and this agent may cause variable side effects. Among them, cheilitis is the most common symptom that occurs in virtually all these patients. OBJECTIVE: We wanted to assess the functional changes of the lips of acne patients who were treated with oral isotretinoin by measuring the transepidermal water loss (TEWL), and we evaluated the benefit of using a moisturizing cream as an adjunctive treatment to oral isotretinoin. METHODS: We measured the TEWL of the lips and cheeks in 17 acne patients who were treated with oral isotretinoin for 6 weeks. Then we compared the changes of the patients and the differences of the TEWL of the lip according to the dose of isotretinoin. In addition, we compared the TEWL change of the lips between 10 patients who were treated with oral isotretinoin and moisturizer cream (PHYSIOGEL(R) A.I. Cream) with that of 10 patients who received only isotretinoin. RESULTS: The TEWL of the lip increased significantly during isotretinoin treatment while the TEWL of the cheek showed no noticeable increase. The increase of the TEWL of the lip was more definite in the 20 mg isotretinoin group than that of the 10 mg isotretinoin group. However, the TEWL of the lip remained stable in the patients treated with oral isotretinoin and moisturizer cream. CONCLUSION: The lips are vulnerable to the mechanism of isotretinoin due to the poor barrier function of the parakeratotic mucosal epithelium with incomplete corneocyte formation. Therefore, regular use of moisturizer on the lips is recommended as an adjunctive treatment along with oral isotretinoin.

The Effect of Oral Isotretinoin on the Barrier Function of the Lipsof Acne Patients and the Protective Role of Moisturizer / 대한피부과학회지

BACKGROUND: Oral isotretinoin is an effective treatment for acne patients, and this agent may cause variable side effects. Among them, cheilitis is the most common symptom that occurs in virtually all these patients. OBJECTIVE: We wanted to assess the functional changes of the lips of acne patients who were treated with oral isotretinoin by measuring the transepidermal water loss (TEWL), and we evaluated the benefit of using a moisturizing cream as an adjunctive treatment to oral isotretinoin. METHODS: We measured the TEWL of the lips and cheeks in 17 acne patients who were treated with oral isotretinoin for 6 weeks. Then we compared the changes of the patients and the differences of the TEWL of the lip according to the dose of isotretinoin. In addition, we compared the TEWL change of the lips between 10 patients who were treated with oral isotretinoin and moisturizer cream (PHYSIOGEL(R) A.I. Cream) with that of 10 patients who received only isotretinoin. RESULTS: The TEWL of the lip increased significantly during isotretinoin treatment while the TEWL of the cheek showed no noticeable increase. The increase of the TEWL of the lip was more definite in the 20 mg isotretinoin group than that of the 10 mg isotretinoin group. However, the TEWL of the lip remained stable in the patients treated with oral isotretinoin and moisturizer cream. CONCLUSION: The lips are vulnerable to the mechanism of isotretinoin due to the poor barrier function of the parakeratotic mucosal epithelium with incomplete corneocyte formation. Therefore, regular use of moisturizer on the lips is recommended as an adjunctive treatment along with oral isotretinoin.

The Effects of Physiogel(R) Cream on the Allergic Contact Dermatitis / 대한피부과학회지

BACKGROUND: A allergic contact dermatitis has been increasing in the world. The first choice of treatment for the allergic contact dermatitis is topical steroids, but application of topical steroids may lead to many side effects. Physiogel(R) cream, made of ceramide, triglyceride, squalene and others is a moisturizer without any fragnance or preservatives which has effects of normalizing the damaged skin barrier and soothing troubled skin. OBJECTIVES: We carried out this study to evaluate the effects of the Physiogel(R) cream in the treamemt of the allergic contact dermatitis. METHODS: Among the patients clinically suspected to have allergic contact dermatitis due to fragnance or perservatives, patients already diagnosed with allergic contact dermatitis were included. On the skin lesions of the right side of individual patients the Physiogel(R) cream was applied twice a day. No topical agents were applied to the lesions of the left side. Two weeks later the clinical improvement of skin lesions was compared. RESULTS: In fourteen (61%) out of 23 patients the Physiogel(R) cream-applied lesions showed significant clinical improvement compared with the control lesions. In cases of atopic dermatitis or seborrheic dermatitis, the ratio of patients in whom the Physiogel(R) cream was efficacious, was 80% or 70% respectively. The skin lesions of all patients of 2nd and 3rd decades were significantly improved by the Physiogel(R) cream. In patients whose skin lesions were not responsive to the Physiogel(R) cream, patch test results showed the highest positive response rate against nickel (20%) and formaldehyde (20%). CONCLUSION: Physiogel(R) cream could be used as well as topical steroids in the treatment of allergic contact dermatitis reducing the risk of side effects due to long-term use of topical steroids.

Evaluation of the Anti-inflammatory Effect of a Moisturizer Containing Green-Tea Extracts / 대한피부과학회지

BACKGROUND: For the long-term management of chronic dermatitis such as atopic dermatitis or xerotic eczema, it is important for a clinician to choose a medication that has the least side effects. OBJECTIVE: We planned to evaluate the anti-inflammatory effect of a moisturizer containing green-tea extracts compared with 1% hydrocortisone lotion. METHODS: The anti-inflammatory effects of 1% hydrocortisone lotion and a moisturizer containing green-tea extracts were evaluated in the inflammation of skin induced by ultraviolet B(UVB) irradiation and sodium lauryl sulfate(SLS) irritation. Twice a day application of topical agents for reducing artificially induced local inflammation was done. Mexameter and chromameter were used for the evaluation of erythema. RESULTS: UVB induced erythema continued to increase regardless of applying topical agents. In contrast, SLS-induced erythema slowly decreased with time duration. Furthermore, increasing pattern of erythema was irregular after UVB irradiation. These results suggest that SLS-induced erythema was more reliable for evaluation of anti-inflammatory effects of topical agent. In addition, we found that a moisturizer containing green tea extracts showed nearly the same effect as or even more effective than 1% hydrocortisone lotion. CONCLUSION: A moisturizer containing green tea extracts would be effective for improving dry skin and also for the treatment of atopic dermatitis or xerotic eczema.

Dry Skin

Though there is ambiguity in its medical definition, dry skin is a frequent skin problem of increasing importance these days. Generally "dry skin" denotes the status of skin showing erythema, roughness, scales, and itching resulted from low water content in the skin. Abnormalities in epidermal lipids, natural moisturizing factors, or corneocyte desquamation are regarded as important factors in its pathophysiology. It is not only accompanied with skin aging, but with various kinds of skin and systemic diseases(such as atopic dermatitis, ichthyosis, chronic renal failure, and diabetes mellitus). Important principles in the management or treatment of dry skin are preventing excessive washing and keeping moisture in the epidermis. For gentle cleansing, mild surfactants are better than the soap. Moisturizers are applied to the surface of skin to increase epidermal water content. Two different kinds of moisturizers are used as a mixture for the best result. Humectants are the material that draw water from the air or dermis. And emollients are the material that protects membrane by preventing water from evaporating from the epidermis. Though moisturizers are very helpful in management of dry skin, harmful result may happen by inadequate selection and wrong use.