Mistaken jewel: A case report on bullous pemphigoid in childhood

Bullous pemphigoid (BP) is an acquired sub-epidermal immune-mediated blistering disease associated with a humoral and cellular response directed against self-antigens. Childhood BP is uncommon with only

A randomized, double-blind, placebo-controlled study on the safety and efficacy of 0.025% capsaicin (Capsicum annuum var. longum) cream against 1% hydrocortisone cream as an anti-inflammatory and anti-pruritic preparation for mosquito bites

BACKGROUND: Mosquito bite is a common dermatological complaint with various treatments but with no gold standard treatment regimen. OBJECTIVE: To compare the safety and efficacy of 0.025% capsaicin cream against 1% hydrocortisone cream and placebo as anti-inflammatory and anti-pruritic preparation for mosquito bites. METHODS: Seventy-five volunteers were enrolled in the placebo-controlled trial and randomized into three treatment groups. They were exposed to laboratory-reared mosquitoes to incur bites and to apply the designated cream. Anti-inflammatory and anti-pruritic effects were determined by mean lesion size, physician's global assessment, pruritus intensity score and 100mm visual analog scale. RESULTS: The mean lesion size and physician's global assessment, pruritus intensity score and visual analog scale showed no significant difference between 0.025% capsaicin and 1% hydrocortisone and they were both found to be superior to placebo (p-valueCONCLUSION: 0.025% capsaicin is comparable to 1% hydrocortisone as an anti-inflammatory and anti-pruritic preparation for mosquito bites.

A randomized, double-blind, placebo-controlled study on the efficacy and safety of 50% and 75% capsaicin ointment as compared to a topical local anesthetic cream (eutectic mixture of lidocaine 2.5% and prilocaine 2.5%) as a topical anesthetic agent

BACKGROUND: Capsicum frutescens or 'siling labuyo' is known for its nutritional and pharmacological properties. Its most potent and predominant chemical entity is capsaicin. A recent study on rabbits concluded that 'siling labuyo' fruit extract is comparable to a topical local anesthetic medication containing lidocaine and prilocaine as an anesthetic agent.OBJECTIVES: This study aimed to determine the efficacy and safety of capsaicin ointment as a topical anesthetic agent in comparison with a topical local anesthetic cream (eutectic mixture of lidocaine and prilocaine) and placebo ointment in healthy human volunteers.METHODS: A patch test was done prior to clinical testing. Thirty (30) healthy adult volunteers were enrolled. Irritation potential of 50% and 75% ointments were determined. On the clinical trial phase, 85 patients were included. The following test drugs were used: 50% capsaicin ointment, 75% capsaicin ointment, eutectic mixture of 2.5% lidocaine and 2.5% prilocaine, and placebo ointment. Allocation of the test drugs to the marked boxes on the patient's forearm was done through simple randomization using a computer-generated random allocation scheme. Both the subjects and the investigators were blinded on the test drugs applied. Test ointments and placebo were applied on the marked areas of the forearms and occluded with a transparent plastic film. After 60 minutes, the investigator recorded any adverse reactions. The marked areas were then tested for pain sensation using a needle lever apparatus that enabled the sharp point of the needle to thrust uniformly and perpendicularly on the marked test areas. The subjects were asked to assess the pain by a verbal response scale for pain. Adverse reactions were again noted on the 24th and 72nd hour.RESULTS: In the patch test, the primary irritation index (PII) scores of both 50% and 75% ointments (0.05 and 0.18), were classified as non-irritant and probably safe for intact human skin contact.In the clinical trial phase, the data were analyzed using Wilcoxon signed ranks test. It established that the positive control (cream containing eutectic mixture of lidocaine and prilocaine) had significantly lower pain scores than 50% and 75% capsaicin ointments and placebo. Capsaicin ointments were no better than placebo in terms of mean pain scores.CONCLUSION: In humans, 50% and 75% capsaicin ointments are not effective as a topical anesthetic agent as compared to the eutectic mixture of lidocaine and prilocaine. Capsaicin ointment is associated with mild adverse reactions which were described as stinging and itching sensations which were seen in 84.7% of patients.

A preliminary study on the mosquito repellent effect of tea tree (Melaleuca alternifolia) oil

BACKGROUND: Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF) are now considered as major health problems in the Philippines. N,N,-dietyl-3-toluamide (DEET) is recognized as the most effective against Aedes aegypti. However, the concern about its use have underscored the need to find a safer alternative repellent.OBJECTIVES: This study aims to determine and compare the repellent activity of tea tree (Melaleuca alternifolia) oil against Aedes aegypti with 7% DEET using a double-blind controlled experimental trialMETHODOLOGY: Twenty healthy subjects were allocated systematically by alternate assignment into three treatment groups (Control vs. Tea Tree oil, control vs. 7 percent DEET, Tea Tree oil vs DEET). All subjects were exposed to Aedes aegypti for 5 minutes every hour for 8 hours and the number of mosquitoes biting/landing were recorded and compared for each treatment groupRESULTS: Fifty percent tea tree oil has a repellent activity against Aedes aegypti and its efficacy is comparable to 7% DEET. Both treatments were equally effective in repelling mosquitoes for 7 hours. No cutaneous reactions to both repellents were notedCONCLUSION: The efficacy of tea tree oil is comparable to 7% DEET and is recommended as an alternative natural mosquito repellent.