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.

Mitochondrial Reactive Oxygen Species Elicit Acute and Chronic Itch via Transient Receptor Potential Canonical 3 Activation in Mice / 神经科学通报·英文版

Mitochondrial reactive oxygen species (mROS) that are overproduced by mitochondrial dysfunction are linked to pathological conditions including sensory abnormalities. Here, we explored whether mROS overproduction induces itch through transient receptor potential canonical 3 (TRPC3), which is sensitive to ROS. Intradermal injection of antimycin A (AA), a selective inhibitor of mitochondrial electron transport chain complex III for mROS overproduction, produced robust scratching behavior in naïve mice, which was suppressed by MitoTEMPO, a mitochondria-selective ROS scavenger, and Pyr10, a TRPC3-specific blocker, but not by blockers of TRPA1 or TRPV1. AA activated subsets of trigeminal ganglion neurons and also induced inward currents, which were blocked by MitoTEMPO and Pyr10. Besides, dry skin-induced chronic scratching was relieved by MitoTEMPO and Pyr10, and also by resveratrol, an antioxidant. Taken together, our results suggest that mROS elicit itch through TRPC3, which may underlie chronic itch, representing a potential therapeutic target for chronic itch.

Does dry skin indicate defective epidermal permeability barrier? / 中华皮肤科杂志

It has been speculated that dry skin results from dysfunction of epidermal permeability barrier. But so far, there is no sufficient evidence to support this speculation. In fact, dry skin indicates low levels of stratum corneum hydration. Stratum corneum hydration levels are primarily determined by the content of natural moisturizers in the skin, while epidermal permeability barrier is mainly regulated by intercellular lipids and structural proteins in the stratum corneum. If dry skin is due to a defective permeability barrier, stratum corneum hydration levels should be inversely correlated with transepidermal water loss (TEWL) , an indicator of epidermal permeability barrier function. But no negative correlation has been demonstrated between stratum corneum hydration levels and TEWL in either normal human skin, ichthyoses lesions of patients, or sebaceous gland-deficient mice in a number of studies. In contrast, a positive correlation between stratum corneum hydration levels and TEWL was observed in normal human skin. Taken together, a line of evidence suggests that dry skin unlikely indicates epidermal permeability barrier dysfunction.

A hospital based cross sectional study on clinical profile of patients with hypothyroidism

Background: Comorbidities and complications are more in patients with hypothyroidism compared to other people. hence early diagnosis and early treatment for hypothyroidism can prevent a lot of complications in patients with hypothyroidism and this is very true for subclinical hypothyroidism. Objective was to study the clinical profile of patients with hypothyroidism.Methods: A hospital based cross sectional study was carried out among 40 clinically diagnosed and biochemically confirmed hypothyroid cases of age group 21-60 years of age. Detailed clinical history was taken to note down the presenting symptoms. Thorough clinical examination was done to ascertain the clinical features and confirm. Data was analyzed using proportions.Results: The mean age of males was slightly more than females 36.8 years vs. 35.13 years. Total number of male patients was much lower i.e. only 10(25%) compared to 30(75%) female patients. The most common age group affected in either sexes was 31-40 years followed by 21-30 years. Among all the symptoms with which the patients presented, the most common symptom was weight gain which was seen in 29(72.5%) of the cases. The most common presenting sign was BMI >25 kg/m2 in 27 cases i.e. 67.5% of the cases followed by dry skin in 25 cases i.e. 62.5%.Conclusions: Any patient presenting with weight gain, lethargy, dry skin, hoarseness, dyspnoea, constipation, cold intolerance, depression, menstrual abnormalities, overweight, obesity, bradycardia, non-pitting edema, hypertension, pallor should be suspected of hypothyroidism and thyroid profile should be done to rule hypothyroidism.

Uremic pruritus and associated factors in hemodialysis patients: A multi-center study

BACKGROUND: Uremic pruritus is a common and disturbing problem in hemodialysis patients. Although its pathogenesis is not completely understood, it is thought to be multifactorial. The aim of this study was to identify risk factors of uremic pruritus in hemodialysis patients. METHODS: A total of 249 patients from four dialysis centers were included in this study. Data were collected using a questionnaire, the visual analogue scale, and the Hospital Anxiety and Depression Scale. We investigated whether socio-demographic and biochemical parameters were correlated to uremic pruritus. RESULTS: Pruritus was present in 53.4% of the hemodialysis patients. The mean visual analogue scale severity was 6.47 ± 1.56. Patients with white blood cell (WBC) counts > 6.7 × 103/μL had 1.73 times (95% confidence interval [CI], 1.360–2.888; P = 0.036) more pruritus than did those with WBC counts < 6.7 × 103/μL. Patients with dry skin were 0.2 times (95% CI, 0.070–0.182; P = 0.028) more likely to suffer from very severe pruritus than were those with normal skin. CONCLUSION: Uremic pruritus remains a serious problem in dialysis patients. The WBC level and presence of dry skin are thought to be among its causes. Therefore, data regarding the possible risk factors of uremic pruritus must be followed closely in patients at risk.

Chemokine Receptor CXCR3 in the Spinal Cord Contributes to Chronic Itch in Mice / 神经科学通报·英文版

Recent studies have shown that the chemokine receptor CXCR3 and its ligand CXCL10 in the dorsal root ganglion mediate itch in experimental allergic contact dermatitis (ACD). CXCR3 in the spinal cord also contributes to the maintenance of neuropathic pain. However, whether spinal CXCR3 is involved in acute or chronic itch remains unclear. Here, we report that Cxcr3 mice showed normal scratching in acute itch models but reduced scratching in chronic itch models of dry skin and ACD. In contrast, both formalin-induced acute pain and complete Freund's adjuvant-induced chronic inflammatory pain were reduced in Cxcr3 mice. In addition, the expression of CXCR3 and CXCL10 was increased in the spinal cord in the dry skin model induced by acetone and diethyl ether followed by water (AEW). Intrathecal injection of a CXCR3 antagonist alleviated AEW-induced itch. Furthermore, touch-elicited itch (alloknesis) after compound 48/80 or AEW treatment was suppressed in Cxcr3 mice. Finally, AEW-induced astrocyte activation was inhibited in Cxcr3 mice. Taken together, these data suggest that spinal CXCR3 mediates chronic itch and alloknesis, and targeting CXCR3 may provide effective treatment for chronic pruritus.

<b>Three Cases of Dermatitis Successfully Treated with Shichimotsukokato</b> / 日本東洋医学雑誌

Shichimotsukokato is composed of shimotsuto with chotoko, ogi, obaku, and this formula has been frequently used for the treatment of hypertension, eye-fundal hemorrhage and headaches. Here we describe three cases of chronic dermatitis with hypertension and dry skin of legs, which were successfully treated with shichimotsukokato. Case 1 was a 67-year-old man whose chief complaint was pruritus and skin eruption on his chest. He also had dry skin accompanied with pruritus on his legs, and hypertension. Case 2 was a 59-year-old man who had skin eruption accompanied with pruritus on his trunk and extremities. He also showed diastolic hypertension and renal insufficiency due to the side effect of an immunosuppressant. Case 3 was a 64-year-old man who had dry skin with eruption on the upper trunk. Furthermore, his blood pressure fluctuated within the high normal range. After medication with shichimotsukokato, both the hypertension and dermatitis improved in all three cases. <br>According to these observations, shichimotsukokato may alleviate dermatitis along with dry skin of legs and hypertension, and it may be worth noting that shichimotsukokato is an option for the treatment of skin lesion.

<b>Three Cases of Trigger Finger which were Successfully Treated with U</b><b>nkeito</b> / 日本東洋医学雑誌

Trigger finger develops because of stenosis around the A1 annular ligament, which causes inhibition of smooth expansion and contraction of the finger. It is effectively treated by an anti-inflammatory analgesic and/or steroid infusion, and by Western style medical surgery. Here, we report 3 cases of trigger finger effectively treated with unkeito. The first case was a 71-year-old female who had been treated with Kampo medicine for an enlarged feeling in the abdomen. She complained of trigger finger, in the knuckle of her right third finger, dry lips, and hot flashes in her hands and feet. The second case was a 56-year-old female who had been treated with Kampo medicine for polyarticular pain in her fingers. She complained of trigger finger of the left fourth finger and hot flashes in her hands. The third case was a 71-year-old female who had been treated for chronic renal failure. She complained of trigger finger in the left first finger and dry skin but had neither hot flashes in the hands nor dry lips. One of the target symptoms of unkeito is hot flashes in the hands and dry lips. Unkeito is composed of herbs which improve <i>ketsu </i>deficiency, <i>oketsu</i>, inflammation, and dry skin. It is possible that these actions of unkeito are effective in trigger finger as well.

Correlação entre o efeito hidratante da ureia em diferentes concentrações de aplicação: estudo clínico e corneométrico / The skin moisturizing effects of different concentrations of urea: a clinical and corneometry study

Objetivo: Avaliar a correlação entre as diferentes concentrações e o efeito hidratante da ureia. Material e Método: Cada indivíduo recebeu aplicações de emulsões com 3%, 5% e 10% de ureia e uma emulsão controle. Realizaram-se avaliações clínicas, subjetivas e corneométricas em 1, 4 e 6 horas. Resultados: Todas as emulsões, incluindo a do controle, obtiveram efeito hidratante na primeira avaliação (p < 0,05). A ureia a 10% foi signifi cativamente superior às outras concentrações ­ na avaliação de 4 horas comparada à ureia a 3% e na avaliação de 6 horas, às concentrações de 3 e 5%. Formigamento e ardência foram mencionados para a ureia a 10% na avaliação de 1 hora. Conclusão: A duração das propriedades higroscópicas da ureia está positivamente relacionada com a concentração. Sintomas adversos, como ardência, foram observados apenas em maiores concentrações.

Objective: To evaluate the correlation from different concentrations and hydration effect of urea. Material and Method: A double blind, randomized, placebo-controlled clinical trial, with dry skin individuals submitted to one application of three different urea emulsion concentrations: 3%, 5% and 10%, and a control emulsion. Corneometry measures, clinical evaluation and a questionnaire at 1, 4, and 6 hours were developed. Results: All the emulsions, including the control, had a signifi cant moisturizing effect in the fi rst evaluation (p < 0,05); 10% urea is superior to other concentrations, which was observed at 4 hour evaluation against 3% urea, and at 6 hour evaluation against 5% and 3%. Itching and stinging were mentioned for 10% urea at 1 hour evaluation. Conclusion: The duration of urea hygroscopic properties is positively related with the concentration; adverse symptoms like stinging are observed only in higher concentrations.

Investigation of Clinical Indications of Choyoto based on 9 Effective Cases / 日本東洋医学雑誌

Choyo-to, which has long been used for acute and chronic intestinal disease, dermatological disorders and pulmonary abscess, is attributed to the writings of 7th Century physician Sun Simiao, known as the “Qian-jinyao-fang”. We have also successfully treated nine different patients suffering from various diseases, using Choyo-to. In most of these cases, patients complained of constipation. Thus far, our modern experience suggests that Choyo-to may be indicated for not only right-side pain upon naval palpitation, pressure sensation at the ileocecum and excessive strain of abdominal muscles, but also for cases of dry skin, edematous skin and tendency of normal tongue color.

Analysis of the Cutaneous Manifestations of Patients in the Intensive Care Unit / 대한피부과학회지

BACKGROUND: Although primary dermatological conditions requiring intensive care unit (ICU) admission is rare, skin lesions due to manifestations of systemic diseases or complications in the critically ill patients are relatively common. During the process of critical care for the significant illness, the skin lesions are often ignored in daily clinical examination. OBJECTIVE: We have analyzed the skin manifestations of patients in the ICU and to correlate them with ventilator care, nutrition and the period of admission. METHODS: Among 113 patients in the ICU, 83 with ventilator care and 30 without ventilator care were examined for their skin lesions. The dermatologic conditions were classified into 5 groups: (1) primary skin diseases requiring intensive care; (2) dermatologic disorders due to multi-system disorders; (3) skin diseases as complications of intensive care; (4) previously acquired coincidental dermatologic diseases; and (5) nonspecific cutaneous manifestations. Dermatologic conditions in each category between the ventilator group and the non-ventilator group were compared. RESULTS: The study results are summarized as follows: 1. The incidence of cutaneous manifestations was 80.5% (91/113) in total, 80.7% (67/83) in the ventilator group and 80.0% (24/30) in the non-ventilator group. 2. The skin manifestations of ICU patients were classified into primary dermatological conditions, multi-system disorders with cutaneous signs, skin conditions developing as the complications of intensive care, previous dermatologic disorders, and nonspecific cutaneous symptoms which were 0 cases (0%), 25 cases (22.1%), 32 cases (28.3%), 37 cases (32.7%) and 45 cases (39.8%) respectively. Twenty-two patients had no skin lesions. These manifestations were not significantly different between the ventilator group and the non-ventilator group. 3. The incidence of xerosis was elevated in proportion to the period of admission. 4. Nonspecific cutaneous manifestations such as edema on the extremities and xerotic skin were not correlated with the nutritional status of the patients. CONCLUSION: The most common dermatologic manifestation in ICU patients is nonspecific skin lesion such as peripheral edema and xerotic skin. The incidence of xerosis was related with the periods of admission, it is considered that the longer the duration of hospitalization was, the dryness of the ICU environment and the exposed skin of patients were increased. Therefore the dryness should be corrected and the exposure of the skin should be avoided.

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.

Zentai(Cicadae Periostracum) may exacerbate Itchiness in Atopic Dermatitis / 日本東洋医学雑誌

Zentai (Cicadae Periostracum) is classified by traditional Chinese medicine as one of the “pungent cool-natured” drugs, but its pharmacological action is not well known yet.<br>Zentai is used in Shofu-san as an expelling pathogenic wind component for relieving itchiness for patients with eczema, dermatitis, urticaria, etc.<br>We examined a number of patients with atopic dermatitis whose condition worsened after they were treated with Zentai to relieve itchiness.<br>In the current study, five male and ten female adolescent/adult patients were randomly selected to receive 2.5g of Zentai. These patients had been treated with Kagen-ichiin-sen-ka-kiban-kyo and their skin conditions had been stable so far.<br>In a follow-up two weeks later, the water content of the horny layer of skin at the forehead and the anterior side of the forearm decreased significantly (p<0.05). In terms of the level of itchiness, two patients (13.3%) improved, nine patients (60%) worsened, and the other four (26.7%) remained unchanged.<br>The current study indicates that Zentai worsens dry skin and exacerbates itchiness. Care will be required in the use of Zentai for the treatment of atopic dermatitis because of its drying pharmacological character.

Kampo Therapy of Atopic Dermatitis in Adolescents and Adults. Oral Administration of Kagen-ichiin-sen-ka-kiban-kyo-sekko / 日本東洋医学雑誌

Atopic dermatitis in adolescents and adults has severe erythema and desquamation, particularly on the face and the neck, and is often resistant for various treatments. We previously reported the case of intractable erythematous dry-type atopic dermatitis where Kagen-ichiin-sen-ka-kiban-kyo was effect. Kagenichiin-sen-ka-kiban-kyo has an effect for nourishing <i>Yin and Blood</i>. Although its antiinflammatory effect is weak, we expected it would improve the deteriorated barrier function of the skin by moistening dry skin, and treat the atopic dermatitis more fundamentally. This time aiming broad application for the lesion of exudative eczema, we treated atopic dermatitis by using sekko-added Kagen-ichiin-sen-ka-kiban-kyo (Kagen-ichiin-sen-ka-kiban-kyo-sekko). The moisture content of the forehead and the extensor surface of forearm sequentially increased. And IgE-KIST and LDH, the markers of the state of a disease, were significantlly reduced. Good results were given; 68.8% of efficacy in men and 77.8% in women.<br>This Kampo formulation is assumed one of the effective formulations for the treatment of atopic dermatitis.

Consideration of Kampo treatment in atopic dermatitis / 日本東洋医学雑誌

In Oriental medicine, atopic dermatitis is referred to as Fu-shitsu-netsu (wind-wetness heat), Ketsu-netsu (blood heat), Ketsu-kyo (blood deficiency) and Oketsu (blood stagnation). Though formulations such as Unsei-in (Wen-qing-yin), Ji-zuso-ippo (Zhi-tou-chuang-yi-fang), Shofu-san (Xiao-feng-san), Jumihaidoku-to (Shi-wei-bai-du-tang), Eppi-ka-jutsu-to (Yue-bi-jia-shu-tang), Byakko-ka-ninjin-to (Bai-hu jia-ren-shen-tang), and ku-Oketsu-zai (drugs for overcoming blood stagnation) are widely used, actually the treatment of adult atopic dermatitis is not an easy matter. The failure to improve dry skin in conventional treatments of atopic dermatitis has been the subject of many clinical trials.<br>In this study when changing to a modified formulation of Kagen-ichiinsen-ka-kiban-kyo in five cases of dry erythema, which we had been having difficulties in treating, a therapeutic effect was achieved. As Kagenichiinsen-ka-kiban-kyo has the effects of moisturizing dryness by nourishing blood, nourishing Yin to promote the production of body fluid, and clearing away heat-evil by nourishing Yin, dry skin was improved as well as skin inflammation, and it was relatively easy to withdraw external steroids.<br>Because of dry skin, the barrier function of the epidermis of patients with atopic dermatitis is hindered, and it becomes sensitive to mechanical stimulation from such things as sweat, clothing, and abrasion, or to allergens in the environment like mites. Therefore, as well as anti-inflammation, dry skin must be improved in treatment of atopic dermatitis. The cause of dry skin is loss of moisture in the corneal layer of epidermis, and this is an important point which must be considered in treatment.

D-Squame(R) Disc with Image Analysis in Measuring Skin Dryness Induced by Sodium Lauryl Sulfate / 대한피부과학회지

No abstract available.