Use of Dexpanthenol for Atopic Dermatitis-Benefits and Recommendations Based on Current Evidence.

BACKGROUND: Atopic dermatitis (AD) is an inflammatory skin disease of multiple phenotypes and endotypes, and is highly prevalent in children. Many people of all ages, including active adolescents, pregnant women, and the elderly, suffer from AD, experiencing chronicity, flares, and unexpected relapse. Dexpanthenol has multiple pharmacological effects and has been employed to treat various skin disorders such as AD. We aimed to summarize the up-to-date evidence relating to dexpanthenol and to provide a consensus on how to use dexpanthenol effectively for the treatment of AD. METHODS: The evidence to date on the application and efficacy of dexpanthenol in AD was reviewed. The literature search focused on dexpanthenol use and the improvement of skin barrier function, the prevention of acute flares, and its topical corticosteroid (TCS) sparing effects. Evidence and recommendations for special groups such as pregnant women, and the effects of dexpanthenol and emollient plus in maintenance therapy, were also summarized. RESULTS: Dexpanthenol is effective and well-tolerated for the treatment of AD. Dexpanthenol improves skin barrier function, reduces acute and frequent flares, has a significant TCS sparing effect, and enhances wound healing for skin lesions. CONCLUSION: This review article provides helpful advice for clinicians and patients on the proper maintenance treatment of AD. Dexpanthenol, as an active ingredient in ointments or emollients, is suitable for the treatment and maintenance of AD. This paper will guide dermatologists and clinicians to consider dexpanthenol as a treatment option for mild to moderate AD.

Recovery from tanning induced by narrow-band UVB phototherapy in brown-skinned individuals with psoriasis: twelve-month follow-up.

BACKGROUND: Pigmentation induced by narrow-band UVB (NBUVB) phototherapy can cause complaints by psoriasis patients, especially those with brown skin. Nevertheless, the recovery process from tanning after the completion of NBUVB treatment is not known. OBJECTIVE: The purpose of this study was to evaluate the extent of tanning recovery after the end of NBUVB treatment and determine the time required to recover from the fully tanned state. METHOD: Sixteen psoriasis patients with brown skin were observed. The skin color changes on the lower back were measured before beginning phototherapy, upon completion of NBUVB treatment, and subsequently every month for the first one-half year, then bimonthly for the second one-half year, using two different reflectance spectrophotometers. The results are presented as the erythema index (EI) and melanin index (MI), L*a*b* values as recommended by the Commission Internationale de l'Eclairge, and the individual typology angle (ITA degrees). RESULTS: The mean L* value reached 64.4 by the 10th month after the end of NBUVB treatment, with no significant difference from the value before beginning phototherapy. The mean ITA degrees approximated the initial angle at the 8th month after completing NBUVB treatment with no significant difference, thus representing recovery to the original intermediate skin color. The MI recovered to the initial values earlier than the L* value and ITA degrees. The EI appeared the earliest recovery value. CONCLUSION: Understanding the recovery process from tanning induced by NBUVB treatment will improve the patient's compliance for treatment and bring higher efficacy and safety to the retrial of phototherapy in brown-skinned individuals with psoriasis.

A retrospective review of 20% vs. 10% incremental narrowband UVB regimens to treat psoriasis in skin phototypes III-V Koreans.

BACKGROUND: The optimal incremental dose regimen of narrowband UVB (NBUVB) phototherapy that will provide maximal efficacy and safety has not been determined for patients with brown skin and psoriasis. OBJECTIVE: To compare 20% and 10% incremental dose regimens of NBUVB phototherapy with respect to efficacy and safety in Korean patients with brown skin and psoriasis whose Fitzpatrick skin phototypes (SPT) are III-V. METHOD: A retrospective study was designed to compare the 20% and 10% incremental dose groups with respect to the number of sessions, duration of treatment, maximum dose, cumulative dose until response, and adverse effects. RESULTS: The mean number of sessions was significantly lower, the duration of treatment was significantly shorter, and the maximum dose was significantly higher in the 20% incremental dose group. The cumulative dose was not significantly different between the two groups, and there was no statistically significant difference between the groups with respect to the percentage of total adverse effects. CONCLUSION: Use of a 20% incremental dose regimen could be advantageous over a 10% incremental dose regimen in patients with brown skin and psoriasis because of a faster treatment response and higher efficacy without a significant increase in the risk of adverse effects.

Pilot study on photodynamic therapy for acne using indocyanine green and diode laser.

To demonstrate the efficacy of photodynamic therapy using indocyanine green (ICG) dye with a diode laser for acne treatment of Asian subjects, an analysis was performed of 16 randomly chosen Korean patients with acne vulgaris treated by photodynamic therapy for a mean follow up of 2 months. Volunteers were divided into two groups, a single- and multiple-treatment group, in which photodynamic therapy was repeated three times with 1-week intervals. Photodynamic therapy using ICG dye with a diode laser was effective for acne treatment of Korean subjects. However, multiple treatments were not superior to single treatments in controlling acne lesions. Photodynamic therapy combined with ICG dye and diode laser might be an alternative treatment modality for acne in Asian subjects.

Classification of facial psoriasis based on the distributions of facial lesions.

BACKGROUND: Psoriasis is a common chronic inflammatory skin disease that may involve any skin site. In particular, psoriasis on the face gives rise to considerable concern because of associated cosmetic problems and psychosocial distress. Some authors have reported that a significant proportion of patients with psoriasis have facial involvement, and several reports have suggested that facial involvement is a marker of severe psoriasis. However, patients with facial psoriasis seem to have clinical characteristics that depend on the distributions of their facial lesions. OBJECTIVE: We sought to classify facial psoriasis and evaluate clinical characteristics according to the distribution of facial psoriatic lesions, and to compare the severities of body and scalp psoriasis in patients with central or peripheral facial lesions. METHODS: A total of 194 patients with psoriasis with facial involvement who presented at our psoriasis clinic were enrolled in this study. Onset of psoriasis, family history, history of phototherapy or systemic therapy, and admission history were recorded. Severity of psoriasis on whole body, face, and scalp were rated using Psoriasis Area and Severity Index (PASI) scores. Patients were categorized into 3 types according to facial lesion distribution: peripherofacial type (PF) (upper forehead and/or periauricular lesions), centrofacial type, and mixed type. RESULTS: The PF and mixed type were more common than the centrofacial type. Peripherofacial involvement was related to a high scalp PASI score, whereas centrofacial involvement was associated with a high whole body PASI score. Disease duration before facial lesion development was less for the PF. Early onset of disease and extensive treatment were more frequent for centrofacial type than PF. The relationship between facial and body psoriasis progression was less strong for PF. LIMITATIONS: This was a retrospective study conducted at a single location, and the severity and extent of psoriasis were evaluated only once, at first visits. CONCLUSION: Facial psoriasis can be categorized into 3 different types. Peripherofacial involvement might be a consequence of severe scalp psoriasis, whereas centrofacial involvement might be a marker of severe body psoriasis. Thus, it would help during the treatment of patients with psoriasis to consider that different lesion distributions may reflect different clinical characteristics.

An efficient method of preparing dressing materials for laser procedures.

Cutting numerous dressing materials for every laser-treated site is tedious and time-consuming. Here, we describe an efficient method of rapidly mass producing dressing materials. We found that a one-hole punch - commonly used in daily office work - can be used as a powerful tool for this laborious task.

Time course of tanning induced by narrow-band UVB phototherapy in Korean psoriasis patients.

BACKGROUND: Narrow-band (TL-01) UVB lamps are being increasingly used for phototherapy in cases of psoriasis and other dermatoses due to the excellent results obtained. However, in Korea many patients receiving phototherapy have complained about the tanning effect of ultraviolet radiation. OBJECTIVE: The aim of this study was to determine the time-course of pigmentation induced by phototherapy during and after narrow-band UVB treatment. METHODS: Changes in skin color were recorded during phototherapy in 40 patients and after treatment in 20 patients. All patients were Korean and were evaluated during 10 weeks of phototherapy (three sessions per week), and then weekly post-phototherapy using two different reflectance spectrophotometers for 10 weeks. Results are presented as erythema (E)- and melanin (M)-indexes and as L*a*b* values as recommended by the Commission Internationale de l'Eclairge and individual typology angle (ITA). RESULTS: L* values, which indicate luminance, decreased continuously over the 5 weeks of phototherapy and showed a plateau after 5 weeks of treatment, and then slowly recovered over 10 weeks of post-treatment observation. Patterns of a* and b* values were comparable with L* values both during and after therapy. Mean ITA values also showed a pattern similar to L* values. E and M indexes changed slowly both during and post-phototherapy. In addition, when data were analyzed by skin type, the different skin types showed temporal patterns similar to the overall skin values, but the L* values and ITA and M indexes of skin type III recovered faster than those of skin types IV or V. CONCLUSION: This study shows that pigmentation induced by narrow-band UVB phototherapy increases continuously during the therapy and that recovery requires 10 weeks or more.