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Objective:To analyze clinical characteristics of cosmetics-related adverse reactions and main allergenic components of cosmetics, to provide guidance for cosmetics-related adverse reaction monitoring, and to provide an objective basis for risk assessment.Methods:A total of 512 patients with suspected cosmetic adverse reactions were collected from the outpatient clinic of Chongqing Traditional Chinese Medicine Hospital from March 2018 to October 2019, including 14 males and 498 females. A uniform cosmetic adverse reaction report card was filled in, and medical history of patients and related information about the used cosmetics were recorded; 103 patients (3 males and 100 females) were subjected to patch test with their own cosmetics or cosmetic ingredients, and 48- and 72-hour patch test results were combined for comprehensive determination and analysis.Results:Among the 512 cases of suspected cosmetic adverse reactions, contact dermatitis (495 cases, 96.7%) was the most common manifestation. Cosmetic adverse reactions mainly manifested as erythema (501 cases, 97.9%), papules (313, 61.1%), edema (249, 48.6%), and scaling (166, 32.4%) ; main symptoms included itching (480, 93.8%), burning sensation (359, 70.1%), and tense sensation (297, 58.0%). Patch test with cosmetic ingredients showed positive reactions in 71 of 103 cases, and thimerosal was the allergen mostly liable to cause adverse reactions (31 cases, 30.1%), followed by sodium dodecyl sulfate (29 cases, 28.2%), Peru balsam (17 cases, 16.5%), bronopol (12 cases, 11.7%) and triethanoamine (10 cases, 9.7%). The cosmetic allergens were divided into 14 categories, and the top 4 categories with high positive patch test rates were emulsifiers (54 cases, 45.8%), preservatives (47 cases, 39.8%), fragrances (17 cases, 14.4%) and surfactants (10 cases, 8.5%). Positive patch test reactions were observed in 2 males and 69 females, and there was no significant difference in the positive rate between males and females (2/3 vs. 69/100, χ2 = 0.01, P > 0.05) ; there was also no significant difference in the positive rate among the groups aged 18 - 29 years (34%), 30 - 49 years (34%) and 50 - 70 years (32.4%; χ2 = 0.693, P > 0.05) . Conclusions:Contact dermatitis is the most common adverse reaction to cosmetics. Among the diverse allergenic components of cosmetics, thimerosal is the allergen that is mostly liable to cause adverse reactions, followed by sodium dodecyl sulfate, Peru balsam, bronopol and triethanoamine.
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Objective:To screen and evaluate sunscreen cosmetics for sensitive facial skin.Methods:From June to August in 2019, 40 subjects with positive lactic acid sting test were recruited from the staff of Chongqing Traditional Chinese Medicine Hospital, and subjected to human skin closed patch testing with 4 kinds of sunscreen cosmetics for sensitive skin (marked as products Ⅰ, Ⅱ, Ⅲ, Ⅳ respectively) separately. Then, the 40 subjects were equally divided into 2 groups to apply 2 sunscreen products with relatively higher safety (according to the above closed patch testing results) on the face respectively. Erythema, edema and desquamation were evaluated at baseline, 2 and 4 weeks after application of the 2 products, and non-invasive measurement methods were used to detect transepidermal water loss (TEWL) , stratum corneum hydration, skin melanin content and skin sebum content. In additon, the 2 products were applied on the back of the subjects separately, and an ultraviolet solar simulator was used to determine the sun protection factor (SPF, n = 12) and protection factor of UVA (PFA, n = 11) . Measurement data were compared using paired t test and one-way analysis of variance, and nonparametric data were compared using Wilcoxon signed rank test. Results:Patch testing showed that only 1 subject developed a grade 1 reaction to the sunscreen product Ⅲ, no subjects showed positive reactions to the product Ⅳ, and the safety of products Ⅲ and Ⅳ was higher than that of the other 2 products. Subjective safety evaluation revealed that the degree of erythema after 4-week application of products Ⅲ and Ⅳ was significantly lower than that before application (Wilcoxon signed rank test, Z = 4.73, 4.82 respectively, both P < 0.05) . Objective efficacy evaluation revealed that the TEWL, stratum corneum hydration and skin melanin content significantly differed among different time points (baseline, after 2- and 4-week application of products Ⅲ and Ⅳ, all P < 0.05); after 4-week application of products Ⅲ and Ⅳ, the TEWL (30.05 ± 1.47, 30.37 ± 1.28 respectively) and skin melanin content (112.58 ± 7.34, 103.47 ± 5.48 respectively) were significantly lower than those before application (all P < 0.05) , and the stratum corneum hydration (62.35 ± 2.67, 63.72 ± 2.54 respectively) was significantly higher than that before application (both P < 0.05) . At week 4, the skin melanin content was significantly lower in the product Ⅳ group (103.47 ± 5.48) than in the product Ⅲ group (112.58 ± 7.34, t = 8.45, P < 0.05) . The SPF and PFA values of the product Ⅳ (51.8 ± 2.9, 10.1 ± 1.2 respectively) were both significantly higher than those of the product Ⅲ (31.5 ± 2.6, 7.4 ± 0.7, t = 15.34, 24.66, respectively, both P < 0.05) . Conclusion:Comprehensive application of closed patch testing, long-term application test and sun protection index determination can be used to screen and evaluate the safety and efficacy of sunscreen cosmetics for sensitive facial skin.
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OBJECTIVE:To provide reference for ensuring safe and effective drug use in obstetrics and gynecology outpatient department.METHODS:Medication education intervention was conducted among some patients in obstetrics and gynecology outpatient department from 4 third grade class A hospitals of our province through making Wechat pushing messages,videos and leaflets.The difference of rational drug use knowledge awareness and compliance was compared before and after intervention by questionnaire survey.RESULTS:A total of 60 questionnaires were distributed,and 60 valid questionnaires were collected with effective recovery rate of 100％.Compared to before intervention,correct rate of 20 questions about the knowledge of rational drug use were improved after intervention in respects of awareness and compliance.The awareness and compliance scores about the knowledge of rational drug use after intervention were higher than before intervention;there was statistical significance in Wechat pushing message group [(53.18 ± 11.51) vs.(88.48 ± 7.12),(55.15 ± 11.82)vs.(86.81 ± 7.69)],in video group [(49.50 ± 17.23) vs.(85.00 ± 11.55),(52.00 ± 17.70)vs.(86.00 ± 6.99)],in leaflets group[(41.47 ± 9.14)vs.(77.05 ± 9.36),(43.23 ± 10.89)vs.(78.82 ± 9.11)] be-fore and after intervention (P＜0.05).There was no statistical significance in the improvement of awareness or compliance score among those groups (P=0.992 and P=0.397).CONCLUSIONS:Three intervention methods can effectively improve the awareness and compliance of patients about rational drug use knowledge in obstetrics and gynecology outpatient department.Pharmacists can choose the appropriate medication education intervention based on the patient's different educational levels,preferences and acceptability.
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OBJECTIVE:To provide reference for ensuring safe and effective drug use in obstetrics and gynecology outpatient department.METHODS:Medication education intervention was conducted among some patients in obstetrics and gynecology outpatient department from 4 third grade class A hospitals of our province through making Wechat pushing messages,videos and leaflets.The difference of rational drug use knowledge awareness and compliance was compared before and after intervention by questionnaire survey.RESULTS:A total of 60 questionnaires were distributed,and 60 valid questionnaires were collected with effective recovery rate of 100％.Compared to before intervention,correct rate of 20 questions about the knowledge of rational drug use were improved after intervention in respects of awareness and compliance.The awareness and compliance scores about the knowledge of rational drug use after intervention were higher than before intervention;there was statistical significance in Wechat pushing message group [(53.18 ± 11.51) vs.(88.48 ± 7.12),(55.15 ± 11.82)vs.(86.81 ± 7.69)],in video group [(49.50 ± 17.23) vs.(85.00 ± 11.55),(52.00 ± 17.70)vs.(86.00 ± 6.99)],in leaflets group[(41.47 ± 9.14)vs.(77.05 ± 9.36),(43.23 ± 10.89)vs.(78.82 ± 9.11)] be-fore and after intervention (P＜0.05).There was no statistical significance in the improvement of awareness or compliance score among those groups (P=0.992 and P=0.397).CONCLUSIONS:Three intervention methods can effectively improve the awareness and compliance of patients about rational drug use knowledge in obstetrics and gynecology outpatient department.Pharmacists can choose the appropriate medication education intervention based on the patient's different educational levels,preferences and acceptability.