Effect of cotton-moxibustion on chronic eczema and quality of life / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between cotton-moxibustion and compound flumetasone ointment, and observe the effect on quality of life in patients with chronic eczema.@*METHODS@#A total of 66 patients with chronic eczema were randomized into an observation group (33 cases, 2 cases dropped off) and a control group (33 cases, 2 cases dropped off). In the observation group, cotton-moxibustion was adopted on target skin lesion, once a day, 3 cones a time. In the control group, external application of compound flumetasone ointment was given twice a day. The treatment for 3 weeks was required in the both groups. Before treatment and 1,2,3 weeks into treatment, scores of visual analogue scale (VAS), eczema area and severity index (EASI) and dermatology life quality index (DLQI) were observed, and the recurrence rate was evaluated in the follow-up one month after treatment.@*RESULTS@#Compared before treatment, the VAS scores of 1,2,3 weeks into treatment, the EASI and DLQI scores of 2,3 weeks into treatment were decreased in the both groups (@*CONCLUSION@#Cotton-moxibustion can effectively improve the pruritus symptom, skin lesion and quality of life in the patients with chronic eczema, the therapeutic effect is superior to the external application of compound flumetasone ointment.

Resolution of cttaneous leishmaniasis after acue eczema due to intralesional mmeglumine antimoniate / Resolução de leishmaniose cutânea após eczema agudo devido a antimoniato de meglumina intralesional

We report a case of a 42 year-old female, who came to a leishmaniasis reference center in Rio de Janeiro, Brazil, presenting a cutaneous leishmaniasis lesion in the right forearm. Treatment with low-dose intramuscular meglumine antimoniate (MA) (5 mg Sb5+/kg/day) was initiated, with improvement after 28 days, although with the development of generalized eczema. After 87 days, the lesion worsened. Patient refused treatment with amphotericin B. MA was then infiltrated in the lesion, in two sessions, resulting in local eczema, with bullae formation; however, twenty days after, both the ulcer and eczema receded. Intralesional administration of MA should be used carefully when previous cutaneous hypersensitivity is detected.

Relatamos caso de paciente de 42 anos atendida em centro de referência em leishmanioses no Rio de Janeiro, Brasil, apresentando lesão de leishmaniose cutânea no antebraço direito. Iniciado tratamento com baixa dose de antimoniato de meglumina (AM) intramuscular (5 mg Sb5+/kg/dia), houve melhora após 28 dias, porém com desenvolvimento de eczema generalizado. Após 87 dias, notou-se piora da lesão. A paciente recusou o tratamento com anfotericina B. Infiltrou-se AM na lesão em duas sessões, resultando em eczema local com bolhas. Entretanto, 20 dias depois, tanto a úlcera quanto o eczema regrediram. A administração intralesional do AM deve ser utilizada com cautela em pacientes com hipersensibilidade cutânea a este fármaco.

Frequency of allergic contact dermatitis in hand eczema patients with European standard and corticosteroid series

To determine the frequency of allergic contact dermatitis in patients with hand eczema by patch testing with European standard and corticosteroid series. One hundred and five patients of either sex having hand eczema, aged 12 years or above were enrolled in the study from dermatology outdoor department. After taking informed consent, patch test was performed a fortnight after complete resolution of signs and symptoms of eczema and after complete withdrawal of the drugs. Patch testing was done with European standard and corticosteroid series. Readings were taken 48, 72 and 120 hours after patches removal. Patch test reactions were graded according to international contact dermatitis research group criteria. Data was analyzed according to age, sex and percentages of positive patch test results. Allergic reaction was recorded in 48.6% of patients with European standard series and 11.4% of patients with corticosteroid series. Common allergens detected with European standard series were potassium dichromate [21%], cobalt chloride [12%] and nickel sulphate [12%]. Common allergens detected with corticosteroid series were tixocortol-21-pivalate [8.6%] and hydrocortisone-17-butyrate [4.76%]. Almost half [48.6%] of the patients showed allergic reaction with European standard series and 11.4% of the cases gave positive results with corticosteroid series. Patch test needs to be performed with corticosteroid and European standard series in patients with hand eczema not responding to therapy.

Efficacy, safety and tolerability of mometasone furoate 0.1% ointment in chronic eczema

Eczema covers a wide range of skin problems, which trouble people at different stages of their lives. Mometasone furoate has been reported to be an effective vasoconstrictive agent on human skin. To evaluate the therapeutic efficacy, safety and tolerability of mometasone furoate ointment 0.1% in chronic eczema following a four-week course of therapy and to record the main events in the cascade of eczema. This quasi-experimental, multi-center study was conducted in four cities. of Pakistan [Karachi, Lahore, Islamabad, and Peshawar] from December, 2005 to February, 2006. A total 180 patients aged > 24 months of either sex with chronic eczema without secondary infection were recruited while pregnancy, known hypersensitivity to corticosteroids, presence of skin atrophy, those on systemic steroids within 28 days were excluded. Patients were instructed to apply a thin layer of ointment once daily. Tubes of mometasone furoate ointment were dispensed to the patients on days 1, 8 and 15 of the study. Patients were asked to return the used tubes at the next weekly follow-up visit. SPSS-13.0 was used for statistical analysis. Friedman test was applied to compare the significance of clinical outcome, relief in signs/symptoms and patient`s comfort at p < 0.05. On first follow up 8 days after treatment, significant majority [77%] showed improvement and in 7 [4%] patients fully resolved. After 15 days, 75% showed improvement and resolved in 19% patients. After 21 days of treatment, improvement was seen in 32% and 55% had resolved. Efficacy in terms of relief in signs and symptoms on last follow up > 21 days after treatment revealed significant resolution of signs and symptoms [p < 0.001]. The cumulative level of comfort on various follow up visits was found significant [p < 0.001]. Mometasone furoate ointment is significantly effective in relief in sign and symptoms and provides a high level of comfort after the treatment of chronic eczema

Clobetasol propionate solid lipid nanoparticles cream for effective treatment of eczema: formulation and clinical implications.

In the present study clobetasol propionate (Cp) was loaded as solid lipid nanoparticles (SLN), incorporated it in suitable cream base and evaluated in vitro and its performance clinically against equivalent marketed formulation. Cp was incorporated into SLN by high-pressure homogenization technique and characterized for mean particle size, surface morphology and per cent drug entrapment. Drug permeation and skin uptake studies from Cp creams were carried out in a validated Franz static diffusion cell across human cadaver skin (HCS). Sixteen chronic eczema patients were enrolled in a controlled double blind clinical trial. Optimized Cp-SLN was smooth and spherical under scanning electron microscopy; with average particle size of 177 nm and per cent drug entrapment of 92.05%. In vitro permeation studies revealed lower mean flux value and higher skin uptake of Cp from Cp-SLN cream compared to marketed drug cream. Both formulations were found to be responsive to manifestations of chronic eczema, while Cp-SLN cream prepared in this investigation registered significant improvement in therapeutic response (1.9 fold; inflammation, 1.2 fold; itching) in terms of per cent reduction in degree of inflammation and itching against marketed cream. Further clinical trials are required to ascertain the efficiency of the present formulation.

Role of bacterial flora in the pathogenesis & management of atopic dermatitis.

The carriage state of Staphylococcus aureus and its role in the pathogenesis and management of atopic dermatitis were evaluated in 50 patients, aged 3 months to 12 yr. An equal number of age and sex matched controls were also studied. The positivity of Staph.aureus in patients with atopic dermatitis was 50 per cent from eczematous skin, 34 per cent from anterior nares and 26 per cent from normal skin. In controls, the comparative figures were 14 per cent from anterior nares and 10 per cent from normal skin. After institution of oral erythromycin or cloxacillin therapy (according to sensitivity), the colony counts dropped to 18 per cent from eczematous skin, 14 per cent from anterior nares and 8 per cent from normal skin after one week and to zero after 3 wk. This was associated with significant clinical improvement. The results of this study suggest that Staph. aureus aggravates the eczematous process in patients with atopic dermatitis and antibiotics decrease the severity and are useful in long term prognosis of the disease.

Estudio randomizado doble ciego, comparando pirrolidona carboxilato de sodio con hidrocortisona al 1 por ciento, contra pirrolidona carboxilato de sodio / A randomized doble blind study comparing sodium salt of pyrrolidone carboxilic acid with hydrocortisone 1 per cent against sodium salt of pyrrolidone carboxylic acid

En un estudio efectuado en eccemas de diferente naturaleza, comparamos la eficacia de pirrolidona carbo xilato de sodio con hidrocortisona al 1 por ciento contra pirrolidona carboxilato de sodio simple en 100 pacientes observados a lo largo de dos semanas. Se evaluaron tanto la eficacia clínica, como la aceptación cosmética y los posibles efectos colaterales, al fin del tratamiento y una semana después. Con pirrolidona carboxilato de sodio con hidrocortisona al 1 por ciento los resultados se consideraron como muy buenos en 94 porciento, y moderados en 6 porciento. Con pirrolidona carboxilato de sodio los resultados fueron muy buenos en 40 porciento y moderados en 60 porciento. La aceptación cosmética fue excelente. No se encontraron efectos colaterales.

Avaliaçäo da eficácia de um glicocorticoide (deflazacort) no tratamento de afecçöes dermatológicas / Evaluation of the effectiveness of a glucocorticoid (deflazacort) in the treatment of skin disorders

Vinte pacientes com formas agudas e crônicas de eczema, dos quais cinco eram portadores de diabetes mellitus, foram tratados com deflazacort, um glicocorticóide de síntese que apresenta dissociaçäo enre o efeito antiinflamatório e alteraçöes no metabolismo mineral e dos carboidratos. No período de observaçäo de quatro semanas, a análise da evoluçäo clínica mostrou uma resposta moderada a excelente. Em relaçäo aos sintomas, houve melhora em 100% dos pacientes com edema, em 80% daqueles com pápulas, vesículas e eritema, em 75% dos que apresentavam escamas e em 50% dos pacientes com liquenificaçäo. Nos pacientes diabéticos näo houve modificaçäo dos parâmetros bioquímicos do sangue