Anti-atopic dermatitis effects of dictamni cortex: Studies on in vitro and in vivo experimental models.

BACKGROUND: Dictamni Cortex (DC), a Chinese herbal medicine with wind dispelling and itchiness relieving effects, is the most popular single herb prescribed for the treatment of atopic dermatitis (AD), as it is used in up to 12.68% of all herbal prescriptions for AD. PURPOSE: The present study aimed to evaluate the anti-AD effect of Dictamni Cortex extract (DCE) and elucidate the underlying molecular mechanisms of its action using the 1-chloro-2,4-dinitrobenzene (DNCB)-induced AD-like mouse model and a relevant in vitro experimental model. METHODS: Female Balb/c mice were sensitized with 200 µl 0.5% DNCB for three days. After sensitization, mice were challenged with 200 µl 1% DNCB on the same dorsal skin and also 20 µl 1% DNCB on each ear every 3 days, and orally administrated by gavage with DCE (0.6, 1.2 and 2.4 g/kg) daily from day 14 to day 29 for 16 consecutive days. At the end of experiment, the clinical scores for AD on the mice were calculated to evaluate the therapeutic effect of DCE; and serum, ears and dorsal skin of the mice were collected for mechanistic study. The anti-allergic activity of DCE was also evaluated using antigen-induced RBL-2H3 cell line. The release of selected cytokines, chemokines and ß-hexosaminidase was measured to determine the anti-allergic activity of DCE. In addition, intracellular Ca2+ level, MAPKs and Lyn phosphorylations were further investigated to reveal its anti-allergic molecular mechanisms. RESULTS: Our results demonstrated that DCE could markedly improve the AD-like symptoms in AD-like mice by inhibiting the mast cell infiltration, suppressing the production of Th2-associated cytokine (IL-4) and pro-inflammatory cytokines (TNF-α), and enhancing the protein expression of filaggrin through inhibition of the MAPKs and NF-κB pathways. Moreover, DCE suppressed mast cell degranulation through decreasing the intracellular Ca2+ level and inactivation of Lyn, Syk and PLCγs, suggesting DCE could regulate mast-cell-mediated allergic response. CONCLUSION: Our experimental results unambiguously indicate that DCE possesses potent anti-allergic effect, and help place the application of DC for the treatment of AD on a scientific footing.

Huang-Lian-Jie-Du extract ameliorates atopic dermatitis-like skin lesions induced by 2,4-dinitrobenzene in mice via suppression of MAPKs and NF-κB pathways.

ETHNOPHARMACOLOGICAL RELEVANCE: Huang-Lian-Jie-Du Decoction (HLJDD), is a well-known traditional Chinese herbal formula first written in the Tang dynasty. In Chinese medicine practice, HLJDD is commonly prescribed to treat various inflammatory skin diseases, such as atopic dermatitis (AD) and psoriasis. AIM OF THE STUDY: The present study aimed at investigating the therapeutic effect of HLJDD extract (HLJDE) and to elucidate the underlying molecular mechanisms of action in the 1-chloro-2,4-dinitrobenzene (DNCB)-induced AD-like mice. MATERIALS AND METHODS: Female Balb/c mice were sensitized with DNCB for three days. After sensitization, mice were challenged with DNCB every three days and orally administrated with HLJDE (150, 300 and 600 mg/kg) daily from day 14 to day 29 for consecutive 16 days. At the end of experiment, the clinical AD scores of the mice were calculated to evaluate the therapeutic effect of HLJDE, and serum, ears and dorsal skin of the mice were collected for unravelling molecular mechanisms. RESULTS: HLJDE significantly reduced the clinical symptoms in the AD-like mice by inhibiting eosinophil and mast cell infiltration, suppressing the production of Th2-associated cytokine (IL-4) and pro-inflammatory cytokines (TNF-α). In addition, HLJDE significantly suppressed the NF-κB and MAPKs pathways. Moreover, HLJDE was able to accentuate filaggrin expression in the skin lesion when compared to the sensitized mouse without treatment. CONCLUSION: HLJDE significantly improved the AD-like symptoms on the DNCB-sensitized mice through mitigating the production of inflammatory mediators via suppressing MAPKs and NF-κB pathways. Additionally, the elevated expression of filaggrin in the skin lesion by HLJDE contributes to the recovery of dysfunctional skin barrier on the DNCB-sensitized mice.

Meeting the Challenges of Acne Treatment in Asian Patients: A Review of the Role of Dermocosmetics as Adjunctive Therapy.

Conventional acne treatment presents several challenges such as intolerable side effects and antibiotic resistance. Dermocosmetic products may be used to reduce these unwanted effects. Dermocosmetics include skin cleansers, topical sebum-controllers, skin antimicrobial/anti-inflammatory agents, moisturizers, sunscreens, and camouflage products. Appropriate use of these products may help augment the benefit of acne treatment, minimize side effects, and reduce the need for topical antibiotics. In Asia, there is currently limited scientific data on the application and recommendations for dermocosmetic use in acne vulgaris (AV). This article reviews the evidence on dermocosmetics for AV and provides practice recommendations as discussed during the 4(th) Asia-Pacific Acne Leaders' Summit held in Bangkok, Thailand, on 7 and 8 February 2015. Through a premeeting survey, a series of plenary lectures, a stepwise program of discussion sessions, and Medline article review, the Expert Panel set forth relevant recommendations on the role of dermocosmetics as adjunct for treating AV in Asian patients.

Warts (non-genital).

INTRODUCTION: Warts are caused by the human papillomavirus (HPV), of which there are over 100 types. HPV probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to October 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 17 studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; intralesional candida antigen; contact immunotherapy; cryotherapy; duct tape occlusion; photodynamic treatment; pulsed dye laser; surgical procedures; and topical salicylic acid.

Clinical characteristics and treatment outcomes of patients undergoing nail avulsion surgery for dystrophic nails.

OBJECTIVE: To evaluate the clinical characteristics and treatment outcomes of patients undergoing surgical nail avulsion. DESIGN: Retrospective study. SETTING: Two dermatology centres in Hong Kong. PATIENTS: A total of 32 patients with nail diseases who underwent 33 nail avulsion procedures were reviewed from case records. MAIN OUTCOME MEASURES: Age, gender, co-morbidities, disease duration, clinical features, histopathology and fungal culture of nail plate, nail bed specimen for fungal culture in appropriate cases, and postoperative outcome. RESULTS: The mean age of the patients at the time of nail avulsion was 54 (range, 27-86) years. The most frequent preoperative findings were thickened nails (23 specimens, 70%) and discolouration (20 specimens, 61%). Onychomycosis was the most common pre-consultative diagnosis (20 specimens, 61%). Prior to nail avulsion, topical or systemic treatment had been tried in more than half of the cases. Histopathology of the avulsed nails confirmed onychomycosis in 24 (73%) of specimens. The clinical cure rate was 88% and the mycologic cure rate was 100%. The procedure was well tolerated without significant complications. Relapse was only noted in three (9%) of the patients having nail avulsions. The time for full re-growth ranged from 5 to 10 months. CONCLUSIONS: Total nail avulsion is an effective management option for patients whose diagnosis of onychomycosis was doubtful, and constitutes a treatment armamentarium especially for patients with single or oligo-onychomycosis.

Clinical significance of Trichomonas vaginalis detected in Papanicolaou smear: a survey in female Social Hygiene Clinic.

OBJECTIVES: To evaluate the clinical significance of Trichomonas vaginalis detected in Papanicolaou (Pap) smears in our local population. DESIGN: Retrospective study. SETTING: A sexually transmitted disease clinic in Hong Kong. PATIENTS: All patients having Pap smear, wet mount microscopy, and high vaginal swab culture performed in Tuen Mun Social Hygiene Clinic from April 2005 to December 2006 were recruited. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values of the Pap smear for the diagnosis of Trichomonas vaginalis. RESULTS: A total of 209 patients had the diagnosis of Trichomonas vaginalis in the study period. From among these, the results of 149 patients who had Pap smears, wet mount microscopy, and high vaginal swab culture performed were used in the analysis. Sixty cases were excluded because treatments were initiated before the consultation or because the Pap smear had not been done. Among the Trichomonas vaginalis cases with positive Pap smears, 58% (85/146) were symptomatic and 41% (60/146) had concomitant sexually transmitted disease. The respective sensitivity and specificity of the Pap smear in our study were: 98% (128/131; 95% confidence interval, 94-100%) and 96% (440/458; 94-98%). In total, 128 patients were defined as true positives by wet mount microscopy or culture, while 18 were defined as false positives. In our study population, the positive predictive value was 88% (128/146; 95% confidence interval, 82-93%). On comparing the clinical features of patients with true-positive and false-positive Pap smears, the odds ratio for the presence of symptoms and concomitant sexually transmitted disease was 1.9 (95% confidence interval, 0.7-5.1) and 2.0 (0.7-5.8), respectively. There were no statistically significant differences in the univariate analysis by Chi squared testing. CONCLUSION: Treatment for vaginal trichomoniasis is recommended if Trichomonas vaginalis is detected in a Pap smear.

Warts (non-genital).

INTRODUCTION: Warts are caused by the human papillomavirus (HPV), of which there are over 100 types, which probably infects the skin via areas of minimal trauma. Risk factors include use of communal showers, occupational handling of meat, and immunosuppression. In immunocompetent people, warts are harmless and resolve as a result of natural immunity within months or years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments for warts (non-genital)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 12 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic, review we present information relating to the effectiveness and safety of the following interventions: intralesional bleomycin; cimetidine; contact immunotherapy; cryotherapy; duct tape occlusion; formaldehyde, glutaraldehyde; homeopathy; photodynamic treatment; pulsed dye laser; surgical procedures; topical salicylic acid; and zinc sulphate.