Assessing effectiveness of adding niosomal atorvastatin 1% ointment to topical calcineurin inhibitor treatment in non-segmental vitiligo.

BACKGROUND: Treatment of vitiligo is still a big challenge for dermatologists. The efficacy of statins in the treatment of vitiligo is controversial. AIM AND OBJECTIVE: We studied possible therapeutic effect of topical 1% niosomal atorvastatin ointment combined with topical 0.1% tacrolimus in treatment of non-segmental vitiligo. METHODS: This is a triple blind, pilot, randomized placebo-controlled trial (RCT) that was performed in dermatology clinic. All the patients used topical 0.1% tacrolimus cream twice daily (BD). Moreover, the intervention group participants used topical 1% niosomal atorvastatin ointment, and control group participants were prescribed placebo ointment, BD. Patients were evaluated using vitiligo area surface index (VASI) score and patients' satisfaction at baseline and after 3 months treatment. RESULTS: The mean patient satisfaction in the intervention and control groups were 5 ± 1.4 and 3.5 ± 1.9; the difference between groups was not statistically significant (p = 0.9). We found statistically significant difference in VASI score before and after treatment in both intervention and control groups (p = 0.01 and p = 0.03, respectively). However, comparison of the VASI score between groups was not statistically significant (p = 0.62). We also found no significant correlation between VASI score and other variables. CONCLUSION: The result of this study indicates that adding of niosomal atorvastatin 1% ointment to topical calcineurin inhibitor has no additional effect on non-segmental type of vitiligo. Further large studies with different combinations are recommended before any conclusive result can be concluded on efficacy of statins in vitiligo.

White patients' physical responses to healthcare treatments are influenced by provider race and gender.

The healthcare workforce in the United States is becoming increasingly diverse, gradually shifting society away from the historical overrepresentation of White men among physicians. However, given the long-standing underrepresentation of people of color and women in the medical field, patients may still associate the concept of doctors with White men and may be physiologically less responsive to treatment administered by providers from other backgrounds. To investigate this, we varied the race and gender of the provider from which White patients received identical treatment for allergic reactions and measured patients' improvement in response to this treatment, thus isolating how a provider's demographic characteristics shape physical responses to healthcare. A total of 187 White patients experiencing a laboratory-induced allergic reaction interacted with a healthcare provider who applied a treatment cream and told them it would relieve their allergic reaction. Unbeknownst to the patients, the cream was inert (an unscented lotion) and interactions were completely standardized except for the provider's race and gender. Patients were randomly assigned to interact with a provider who was a man or a woman and Asian, Black, or White. A fully blinded research assistant measured the change in the size of patients' allergic reaction after cream administration. Results indicated that White patients showed a weaker response to the standardized treatment over time when it was administered by women or Black providers. We explore several potential explanations for these varied physiological treatment responses and discuss the implications of problematic race and gender dynamics that can endure "under the skin," even for those who aim to be bias free.

Efficacy of nano-modified Runji ointment in the treatment of mild and moderate psoriasis with blood dryness syndrome: a study protocol for a double-blind randomized controlled trial.

INTRODUCTION: Psoriasis is a common, recurrent, immune skin disease, which seriously affects patients' quality of life. In clinical practice, modified Runji ointment can effectively treat mild-to-moderate psoriasis with blood dryness syndrome, but there is a lack of high-quality evidence-based medical evidence. This trial aims to evaluate the efficacy and safety of nano-modified Runji ointment in the treatment of mild-to-moderate psoriasis with blood dryness syndrome. METHODS/DESIGN: This study will be a randomized double-blind placebo-controlled trial. A total of 80 patients will be recruited and randomly divided into an intervention group (nano-modified Runji ointment group) and a placebo group at a ratio of 1:1. All included patients will receive 8 weeks of nano-modified Runji ointment or placebo ointment respectively, twice a day. The primary outcome will be the change in psoriasis area and disease severity index score at week 8 compared to baseline. The secondary outcomes will be rash area score, pruritus score, Dermatology Life Quality Index score, traditional Chinese medicine symptom score and adverse events. DISCUSSION: This study may provide high-quality evidence for the efficacy of nano-modified Runji ointment in the treatment of mild to moderate psoriasis with blood dryness syndrome. The results of this study will be published in peer-reviewed journals. TRIAL REGISTRATION: ChiCTR, ChiCTR2000034292. Registered July 1, 2020, https://www.chictr.org.cn/edit.aspx?pid=55884&htm=4.

Clinical Efficacy of Tacrolimus Ointment + 3% Boric Acid Lotion Joint Chinese Angelica Decoction in Chronic Perianal Eczema.

OBJECTIVE: To unearth the clinical efficacy of tacrolimus ointment + 3% boric acid lotion joint Chinese angelica decoction in chronic perianal eczema. METHODS: Patients with chronic perianal eczema admitted to hospital from June 2018 and June 2019 were retrospectively analyzed. Patients in the control group (n = 38) underwent basic therapy with tacrolimus ointment + 3% boric acid lotion, whereas those in the observation group (n = 38) were given oral Chinese angelica decoction on the basis of the above therapy. Patient's baseline information before therapy and clinical symptoms after therapy were observed and compared, including pruritus ani score, anus drainage and damp score, skin lesion score, skin lesion area score, life quality index score, and IL-2, IL-4, and IgE levels in serum. Overall efficacy in the two groups was also evaluated. RESULTS: No significant differences were found in the baseline information between the observation group and control group before therapy. After therapy, pruritus ani score (P = 0.023), anus drainage and damp score (P = 0.041), skin lesion score (P = 0.025), and skin lesion area score (P = 0.035) of patients in the observation group were remarkably lower than those in the control group. Significantly higher release levels of clinical symptoms of patients in the observation group were indicated. With respect to the control group, the life quality score (P = 0.020) and IgE level in serum (P = 0.003) of patients in the observation group were significantly lower, while IL-4 level in serum was significantly higher (P = 0.129). The therapy in the observation group achieved better clinical efficacy. Overall efficacy in the observation group was markedly favorable with respect to the control group. CONCLUSION: With respect to tacrolimus ointment + 3% boric acid lotion, patients with chronic perianal eczema displayed better clinical efficacy after jointly being treated by Chinese angelica decoction.

Moisturisers from birth in at-risk infants of atopic dermatitis - a pragmatic randomised controlled trial.

BACKGROUND: Atopic dermatitis (AD) is a common, chronic dermatosis, with onset of disease often manifesting in early infancy. Past studies evaluating the early use of moisturisers in the prevention of AD had mixed results. OBJECTIVES: To compare the incidence of moderate or severe AD and total incidence of AD in a cohort of 'at-risk' infants treated with moisturisers from the first 2 weeks of life, to a similar group without moisturisers. METHODS: We performed a single-centre, prospective, parallel-group, randomised study in infants with at least 2 first-degree relatives with atopy. Subjects were randomised into either a treatment group with moisturisers or a control group without moisturisers. Participants were assessed at 2, 6, and 12 months for AD and if present, the severity was assessed using SCORAD index. We also compared the overall incidence of AD, trans-epidermal water loss (TEWL), stratum corneum (SC) hydration, pH, and incidence of food and environmental sensitisation and allergies between both groups. Genotyping for loss-of-functions mutations in the FLG gene was conducted. RESULTS: A total of 200 subjects were recruited, with 100 subjects in each arm. There was no significant difference in incidence of moderate or severe AD, and total incidence of AD at 12 months between the treatment and control groups. There was a lower mean SCORAD in the treatment group than in the control group, but no significant difference in TEWL, SC hydration, and skin pH. No significant side-effects were reported. CONCLUSIONS: The early use of moisturisers in 'at-risk' infants does not reduce the incidence of moderate-to-severe AD and overall incidence of AD in infancy.

Application of chen yuangao in the treatment of soft tissue injury of football players / Aplicação de chen yuangao no tratamento da lesão dos tecidos moles de jogadores de futebol / Aplicación de chen yuangao para tratar lesiones de tejidos blandos en jugadores de fútbol

ABSTRACT The treatment of soft tissue injury in football players generally includes physical therapy, anti-inflammatory and analgesic drug treatment, surgical treatment and early rest immobilization. Western medicine treatment of soft tissue injury can quickly heal the wound and relieve pain in a short time. The treatment of traditional Chinese medicine is based on the whole and must seek the root of the disease. It is believed that the occurrence of certain diseases is related to Qi, blood, liver and kidney deficiency, so we should pay attention to the overall adjustment during treatment of symptoms. In view of this, this study analyzed the effect of Chen Yuan ointment, from traditional Chinese medicine, in the treatment of soft tissue injury. Sixty-eight football players who completed ankle ligament reconstruction were divided into four groups according to the type of operation and whether Chen Yuangao-assisted rehabilitation was used or not. The results showed that the Ankle Hindfoot Function Score and the visual analog scale (VAS) score of patients in the fibula brevis tendon reconstruction Chen Yuan ointment group were 98.3 and 0.3, respectively, at the last follow-up, which were better than those in other groups, and had lower pain scores. This result shows that Chen Yuangao has a certain effect in the treatment of soft tissue injury, which can provide a research idea for the rapid rehabilitation of football players.

RESUMO O tratamento de lesões dos tecidos moles em jogadores de futebol inclui geralmente terapia física, tratamento anti-inflamatório e analgésico, tratamento cirúrgico e imobilização de repouso precoce. O tratamento de lesões nos tecidos moles, utilizando a medicina ocidental, pode curar rapidamente as lesões e aliviar a dor em pouco tempo. A medicina tradicional chinesa se baseia no todo e deve procurar a raiz da doença. Acredita-se que a ocorrência de certas doenças está relacionada à deficiência de Qi, sangue, fígado e rim do corpo humano, por isso devemos prestar atenção ao ajuste global no tratamento dos sintomas. A partir desta perspectiva, este estudo analisou o efeito da tradicional pomada chinesa Chen Yuan no tratamento de lesões dos tecidos moles. No total, 68 jogadores de futebol que fizeram reconstrução dos ligamentos do tornozelo foram divididos em quatro grupos de acordo com o tipo de operação e se a pomada Chen Yuangao ajudou ou não na reabilitação. Os resultados mostraram que o escore da função do tornozelo retropé (Ankle Hindfoot Function Score) e o escore da Escala Analógica Visual (EVA) dos pacientes do grupo pomada Chenyuan para reconstrução do tendão fibular curto foram 98,3 e 0,3, respectivamente, no último seguimento, sendo melhores do que os de outros grupos e apresentando menores níveis de dor. Estes resultados mostra que a pomada Chen Yuangao exerce certo efeito no tratamento de lesões dos tecidos moles, pode constituir uma ideia de pesquisa para a rápida reabilitação dos jogadores de futebol.

RESUMEN El tratamiento de lesiones de los tejidos blandos en jugadores de fútbol incluye generalmente terapia física, tratamiento antinflamatorio y analgésico, tratamiento quirúrgico e inmovilización de reposo precoz. El tratamiento de lesiones en los tejidos blandos, utilizando la medicina occidental, puede curar rápidamente las lesiones y aliviar el dolor en poco tiempo. La medicina tradicional china se basa en el todo y debe procurar la raíz de la enfermedad. Se cree que la ocurrencia de ciertas enfermedades está relacionada a la deficiencia de Qi, sangre, hígado y riñón del cuerpo humano, por eso debemos prestar atención al ajuste global en el tratamiento de los síntomas. A partir de esta perspectiva, este estudio analizó el efecto de la tradicional pomada china Chen Yuan en el tratamiento de lesiones de los tejidos blandos. En total, 68 jugadores de fútbol que hicieron reconstrucción de los ligamentos del tobillo fueron divididos en cuatro grupos de acuerdo con el tipo de operación y si la pomada Chen Yuangao ayudó o no en la rehabilitación. Los resultados mostraron que el escore de la función del retropié del tobillo (Ankle Hindfoot Function Score) y el escore de la Escala Analógica Visual (EVA) de los pacientes del grupo pomada Chenyuan para reconstrucción del tendón fibular corto fueron 98,3 y 0,3, respectivamente, en el último segmento, siendo mejores que los de otros grupos y presentando menores niveles de dolor. Estos resultados muestran que la pomada Chen Yuangao ejerce cierto efecto en el tratamiento de lesiones de los tejidos blandos, puede constituir una idea de investigación para la rápida rehabilitación de los jugadores de fútbol.

Comparative Evaluation of Efficacy and Safety of Tacrolimus and Dinoprostone Following Dermabrasion in Stable Vitiligo.

BACKGROUND: Dinoprostone (DNP), a prostaglandin E2 (PGE2) analogue, has been found to cause repigmenation in vitiliginous lesions. Combined medical and surgical therapy might be more useful for successful treatment of vitiligo. OBJECTIVES: In this study, we aimed to evaluate the efficacy and safety of dermabrasion followed by dinoprostone gel and to compare it with tacrolimus ointment following the same procedure in the treatment of localized stable vitiligo. METHODS: 40 patients of stable vitiligo were enrolled which were divided in two groups of 20 patients each. In group 1, dermabrasion followed by tacrolimus 0.1% ointment was done and in group 2, dermabrasion followed by dinoprostone gel was done. RESULTS: Group 1 patients showed slightly better response (P=0.039), whereas the side effect profile was better for group 2. CONCLUSION: DNP and tacrolimus have immunomodulatory and melanocyte stimulating effect and are well tolerated when combined with dermabrasion. Their effect on skin pigmentation could be enhanced by dermabrasion. J Drugs Dermatol. 2021;20(5):519-522. doi:10.36849/JDD.5751.

Carboxytherapy Mask as Post Nanofractional Radiofrequency Treatment for Improvement of Facial Skin Quality and Photoaging.

BACKGROUND: Skin rejuvenation can be achieved with minimally invasive treatments using energy-based devices that feature reduced side effects and downtime. Post-treatment care is key to minimize any potential side effects and skin reactions such as erythema, dryness, or dyschromia. OBJECTIVE: The objective of this study was to evaluate the efficacy and patient satisfaction of a novel carboxytherapy gel mask compared with petroleum-based lanolin-containing ointment to accelerate wound healing facial post-nanofractional radiofrequency treatment. METHODS AND MATERIALS: Ten subjects were enrolled in this pilot, prospective, randomized, single-blind study and randomized into two arms. One arm received one nanofractional radiofrequency treatment with ointment right after and four consecutive days of ointment applications twice a day, while the second arm followed this regimen with a carboxytherapy gel mask application right after and four consecutive days after treatment. Investigator, safety, and patient assessments were conducted at 24 hours and one-week post treatment. Safety was monitored throughout. The primary endpoint was defined as the degree of investigator global assessment (IGA) in photodamage, pigmentation, and wrinkles using standardized photographs. Secondary endpoints included investigator-rated degree of erythema, edema, crusting, exudation, percentage healing, improvement of skin quality, and patient satisfaction. RESULTS: Nine patients completed the study. There was improvement of one degree in IGA for photodamage, pigmentation and wrinkles in all patients using the carboxytherapy gel mask at the one-week follow up. Blinded investigator ratings showed significant improvement of dryness, erythema, edema, crusting, and percentage healing at the 24-hour follow up, with all patients remaining the same a week post treatment. All patients in the carboxytherapy group were satisfied with the treatment and had no adverse effects. Three patients in the petroleum-based lanolin-containing group experienced mild edema and acne breakout that resolved two weeks after treatment. CONCLUSION: Carboxytherapy delivered via a gel mask after skin rejuvenation procedures is a safe and effective strategy to improve clinical outcomes and reduce post-treatment side effects. J Drugs Dermatol. 20(4):461-465. doi:10.36849/JDD.5856.

Efficacy and safety of Hemoheal cream in patients with hemorrhoids: a randomized double-blind placebo controlled clinical trial.

OBJECTIVE: To evaluate the efficacy and safety of Hemoheal cream, an anti-hemorrhoid herbal preparation, (inspired by Persian medicine literatures in a double-blind, randomized placebo-controlled trial. METHODS: Hemoheal cream consists of aqueous extract of Allium ampeloprasum L., Commiphora mukul (Hook. Ex Stocks) Engl and the oil of Sesamum indicum L. Fifty-two patients with symptomatic hemorrhoids were randomized to receive hemoheal cream or placebo for 3 weeks. The patients were evaluated before and after the intervention in terms of the severity of anal irritation, bleeding, anal itching, pain, defecation discomfort and swelling sense, and overall subjective improvement (%), as well as any reported adverse events. RESULTS: The results showed that after 3 weeks of treatment, distribution of anal irritation, bleeding, pain as well as swelling sense were significantly different (P < 0.05), while the analysis showed no significant differences between two groups for anal itching and defecation discomfort (P > 0.05). Furthermore, a significant difference was observed between the overall subjective improvement of Hemoheal cream and placebo groups (P = 0.012). One patient in the treatment group complained of rashes on the application site. CONCLUSION: The present study showed a positive effect of Hemoheal cream in improving clinical signs and symptoms in patients with hemorrhoids.

Efficacy and safety of Soshiho-tang in atopic dermatitis patients with gastrointestinal disorders: A double-blinded, randomized, and placebo-controlled clinical trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Because of the growing incidence of AD, psychosocial and economic burden of AD patients are often considerable. Steroid treatments are widely used, but long term use of this treatment can cause side effects. To reduce the burden of AD patients and find new efficient treatment, this study chose Soshiho-tang, a traditional medicine used in eastern Asia. AIM OF THE STUDY: Soshiho-tang (SSHT) is a traditional herbal medicine that has anti-inflammatory effects and improves immune function. This clinical trial evaluated the efficacy and safety of SSHT in atopic dermatitis (AD) patients with gastrointestinal disorders in comparison with placebo. MATERIALS AND METHODS: This study was a single-center, randomized, double-blinded, placebo-controlled, and investigator-initiated clinical trial. A total of 60 patients aged 3-18 years with gastrointestinal disorders and diagnosed with AD by Hanifin & Rajka criteria with a Scoring Atopic Dermatitis (SCORAD) index between 15 and 49 were enrolled. Participants were randomly assigned to the SSHT or placebo groups in a ratio of 1:1 and efficacy evaluation was conducted at week 4 and 8. The participants orally administered SSHT or placebo three times a day for 4 weeks. The primary outcome was measured based on a change of SCORAD index. The secondary outcome measurements included the following: survey questionnaires of gastrointestinal disorder, amount and frequency of ointment application for AD, dermatology quality of life index, and safety evaluation (diagnostic test, adverse reaction, and vital sign monitoring). RESULTS: During efficacy evaluation, the SCORAD score and digestive symptoms in the experimental and placebo groups were not statistically significant. However, the amount and frequency of ointment application in the experimental group were reduced compared to those in the placebo group at week 8. Also, In the Children's Dermatology Life Quality Index (CDLQI), statistically significant Quality of Life (QOL) improvement was observed in the SSHT experimental group compared to the placebo group. In safety evaluation, all participants were within the normal range during the study period. Blood sample testing indicated that the lymphocytes ratio decreased, and neutrophils ratio increased in the experimental group, whereas the placebo group showed the opposite immune response pattern. CONCLUSION: We concluded that SSHT administration can reduce steroid ointment dependence and improve the QOL in AD patients by regulating neutrophil-lymphocyte ratio.

A Retrospective Study of Corneal Endothelial Dystrophy in Dogs (1991-2014).

PURPOSE: To retrospectively evaluate the clinical data, diagnostic tests, treatments, and outcomes for dogs with corneal endothelial dystrophy (CED) and determine risk factors for CED when compared with a canine reference population. METHODS: Medical records of 99 dogs (1991-2014) diagnosed with CED at the University of California Davis Veterinary Medical Teaching Hospital were reviewed and compared with 458,680 dogs comprising the general hospital population during the study period. Retrieved data included signalment, examination findings, diagnoses, treatments, and outcomes associated with CED. The exact Pearson χ2 test or exact Kruskal-Wallis test was used to compare parameters between the groups. Progression of corneal edema was assessed using 3 independent Kaplan-Meier curves, identifying clinically significant changes in corneal opacity. RESULTS: Boston terriers, German wirehaired pointers, and Dachshunds were overrepresented in the CED-affected group, whereas Labradors were underrepresented. Dogs older than 11 years were overrepresented in the CED-affected group, whereas intact dogs were underrepresented. Surgical intervention was performed (n = 11) based on the severity of disease and secondary complications from CED. Median time to progression of corneal edema was 1) 368 days when an at-risk eye initially without edema developed edema at a subsequent visit, 2) 701 days when there was progression from mild to marked corneal edema, and 3) 340 days when there was progression from focal to diffuse corneal edema. CONCLUSIONS: Many CED-affected dogs progress over months to years without surgical intervention, making dogs with CED a useful model for studying genetic predispositions and development of novel therapeutics for Fuchs endothelial corneal dystrophy.

Sinecatechins ointment as a potential novel treatment for usual type vulval intraepithelial neoplasia: a single-centre double-blind randomised control study.

OBJECTIVE: To compare the safety and efficacy of 10% sinecatechins (Veregen® ) ointment against placebo in the treatment of usual type vulvar intraepithelial neoplasia (uVIN). DESIGN: A Phase II double-blind randomised control trial. SETTING: A tertiary gynaecological oncology referral centre. POPULATION: All women diagnosed with primary and recurrent uVIN. METHODS: Eligible patients were randomised 1:1 to receive either sinecatechins or placebo ointment (applied three times daily for 16 weeks) and were followed up at 2, 4, 8, 16, 32 and 52 weeks. MAIN OUTCOME MEASURES: The primary outcome measure, recorded at 16 and 32 weeks, was histological response (HR). Secondary outcome measures included clinical (CR) response, toxicity, quality of life and pain scores. RESULTS: There was no observed difference in HR between the two arms. However, of the 26 patients who were randomised, all 13 patients who received sinecatechins showed either complete (n = 5) or partial (n = 8) CR, when best CR was evaluated. In placebo group, three patients had complete CR, two had partial CR, six had stable disease and two were lost to follow up. Patients in the sinecatechins group showed a statistically significant improvement in best observed CR as compared with the placebo group (P = 0.002). There was no difference in toxicity reported in either group. CONCLUSION: Although we did not observe a difference in HR between the two treatment arms, we found that 10% sinecatechins application is safe and shows promise in inducing clinical resolution of uVIN lesions and symptom improvement, thus warranting further investigation in a larger multicentre study. TWEETABLE ABSTRACT: A randomised control study indicating that sinecatechins ointment may be a novel treatment for uVIN.

In Vitro Release Testing of Acyclovir Topical Formulations Using Immersion Cells.

The objective of the study was to reinforce the applicability of the immersion cells for the in vitro release testing (IVRT) of topical formulations by using marketed acyclovir 5% cream formulation (Cream 1) as a model. The method employing the immersion cells was optimized by studying the effect of variables, such as membrane type, media temperature and volume, agitation speed, and cell size, on acyclovir release from the formulation. The in-house formulation similar to the qualitative and quantitative composition of Cream 1 and the other trial formulations with variable compositions were prepared and studied by using the immersion cells. Various other brands of acyclovir topical formulations available in the Indian market were also subjected to IVRT by using the optimized method. An increase in the media temperature from 32°C to 37°C and the stirring speed from 50 to 100 to 150 rpm led to an increase in the drug release. As the immersion cell size increased (0.5, 2 and 4 cm2 surface area), the release rate also increased. Nitrocellulose membrane showed the highest drug release and Fluoropore™the least. The optimized IVRT method could establish the differences in the drug release rates among the formulations with the altered compositions. The method could also prove its discriminatory potential for various marketed formulations. The immersion cell method could serve as a simpler, facile, and reliable aid during product development and also as a quality control tool in assessing stability, aging, and batch-to-batch uniformity of semisolid formulations.

Effectiveness of flesh-moistening paste in psoriasis vulgaris patients with symptom pattern of blood stasis: a randomized and parallel-controlled trial.

OBJECTIVE: To evaluate the efficacy and safety of flesh-moistening paste for treating psoriasis vulgaris in patients with blood stasis pattern in terms of Traditional Chinese Medicine (TCM). METHODS: Eudipleural rashes on both the left and right side of the same patients with psoriasis vulgaris, diagnosed via TCM as blood stasis pattern, were selected as the targeted skin lesions. A randomized, double-blind, parallel-controlled, multicenter controlled trial was conducted. The targeted skin lesions were categorized into either the treatment or control group. The treatment group used the flesh-moistening paste; the control group used a placebo. Both the paste and the placebo were topically applied twice daily for eight weeks. The patients were examined biweekly to evaluate the effects. The two groups were compared in terms of the psoriasis area and severity index (PASI) of the targeted skin lesions, which is scored according to erythema, desquamation, infiltration, area, pruritus, and improvement of skin barrier function. Adverse events were recorded during the study period. SPSS 21.0 was used to analyze the data. RESULTS: Fifty-six patients were enrolled between February 2016 and October 2017. Two were complicated by cardio-cerebrovascular disease and were excluded; thus, 54 outpatients were finally enrolled in the study. Four dropped out during the study period: three failed to complete their follow-up visits for unknown reasons, and one exited due to an adverse event. The final trial comprised 50 of the 56 originally selected patients, with a 92.6% completion rate. After 8 weeks of treatment, the targeted skin lesion scores differed significantly (P < 0.05). The PASI scores of the targeted skin lesions differed significantly beginning at week 6 (P < 0.05). The treatment group presented better results than those of the control group. Only one patient had an adverse reaction associated with the treatment. Improvements in skin barrier function differed significantly (P < 0.05). CONCLUSION: The flesh-moistening paste demonstrated a reliable curative effect and safety for treating psoriasis vulgaris in patients with blood stasis patterns. The topical paste improved the barrier function of the skin lesions.

Effects and Characterization of Some Topical Ointments Based on Vegetal Extracts on Incision, Excision, and Thermal Wound Models.

The present paper aims to formulate and characterize four phytotherapeutic ointments based on Hippophae fructus, Calendulae flos, Bardanae folium, and Millefolii herba, which are included in a novel ointment base. In order to investigate the healing properties of the ointments, in vivo experimental wound models of linear incision, circular excision, and thermal burn were performed on Wistar rats. Topical treatment was performed daily for 21 days. Determination of the wound contraction rate (WCR), the period of reepithelization, and histopathological examination were achieved. Additionally, for the tested ointments, oscillatory and rotational rheological tests were carried out, and for the extracts, HPLC analysis was performed. The results demonstrate that the tested novel ointments are safe for use and the most effective ointment proved to be the one based on Arctium lappa, followed by that of Calendulae flos.

Surgical Sphincter Saving Approach and Topical Nifedipine for Chronic Anal Fissure with Hypertonic Internal Anal Sphincter.

PURPOSE: The role of augmented internal anal sphincter (IAS) tone in the genesis of posterior chronic anal fissure (CAPF) is still unknown. Lateral internal sphincterotomy is the most employed surgical procedure, nevertheless it is burdened by high risk post-operative anal incontinence. The aim of our study is to evaluate results of sphincter saving procedure with post-operative pharmacological sphincterotomy for patients affected by CAPF with IAS hypertonia. Methods: We enrolled 30 patients, undergone fissurectomy and anoplasty with V-Y cutaneous flap advancement; all patients received topical administration of nifedipine 0.3% and lidocaine 1.5% ointment-based therapy before and for 15 days after surgery. The primary goal was patient's complete healing and the evaluation of incontinence and recurrence rate; the secondary goal included the evaluation of manometry parameters, symptom relief and complications related to nifedipine and lidocaine administration. Results: All wounds healed within 40 days after surgery. We didn't observe any de novo postoperative anal incontinence case. We reported 2 cases of recurrences, healed after conservative therapy. We didn't report any local complications related to the administration of the ointment therapy; with whom all patients reported a good compliance. Conclusions: Fissurectomy and anoplasty with V-Y cutaneous advancement flap and topical administration of nifedipine and lidocaine, is an effective treatment for CAPF with IAS hypertonia.

Sulfated polysaccharide ascophyllan from Padina tetrastromatica enhances healing of burn wounds by ameliorating inflammatory responses and oxidative damage.

Sulfated polysaccharide ascophyllan from marine brown algae has been identified to have burn wound healing properties. Thus, we examined the effects of ascophyllan fraction (AF3) on the inflammatory response and oxidative damage in burn wounds. Full-thickness burn wounds in rats were then treated twice per day with topical AF3 ointment (5%), while control groups were treated with 10% povidone-iodine (positive control) and petroleum jelly-based ointment (negative control). The activity of cyclooxygenase-2 and myeloperoxidase and levels of C-reactive protein, nitric oxide, and proinflammatory cytokines (tumor necrosis factor-α, interleukin-6, and interleukin-1ß) were observed to have significantly decreased in peripheral blood mononuclear cells, serum, and wound tissue of the group treated with AF3 ointment on day 8 after wounding. The expression of inducible nitric oxide synthase, endothelial nitric oxide synthase, and vascular endothelial growth factor at the mRNA level was determined to be upregulated in the wound tissue of the AF3 ointment-treated group. After treatment with AF3 ointment, the antioxidant enzyme activity and level of reduced glutathione were upregulated, whereas the content of thiobarbituric acid reactive substances decreased. Treatment of burn wounds using 5% AF3 ointment decreases oxidative damage associated with inflammation deceptively via inhibition of inflammatory enzymes, regulation of proinflammatory cytokines, upregulation of angiogenesis, and activity of antioxidant enzymes.

The use of moist exposed burn ointment (MEBO) for the treatment of burn wounds: a systematic review.

Moist exposed burn ointment (MEBO) is an oil-based herbal paste, purported to be efficacious in managing burn wounds and more commonly used in Asia and the Middle East. A PRISMA-compliant systematic review was performed to analyse the evidence for the use of MEBO on burn wounds. Wound healing rate was the primary outcome of interest. PubMed-listed randomised controlled trials (RCTs) comparing the efficacy of MEBO with placebo, standard care or other therapies in the treatment of partial thickness burns in adults and children were eligible for inclusion (November 2019). Six RCTs were eligible. The majority of trials comparing wound healing between MEBO and SSD favoured MEBO (two of three). There may be improved healing in MEBO-treated wounds vs. those treated with povidone-iodine + bepanthenol cream. There was no difference between MEBO and Acquacel Ag, but Helix Aspersa had faster healing rates than MEBO. However, all evidence was from moderately to poorly reported trials with a high risk of bias, thereby limiting the strength of this evidence. In conclusion, the evidence for MEBO in English-language literature was poor and inconsistent with respect to wound healing rate and analgesis compared to 1% SSD, Acquacel Ag, Helix aspersa cream and povidone-iodine + bepanthenol cream. Blinded RCTs comparing MEBO to both placebo and other common topical treatments may further improve the confidence in concluding their analysis. There is some evidence that MEBO is as safe as its comparators as shown by the low complication rate.