Survey of disease awareness, treatment behavior and treatment satisfaction in patients with atopic dermatitis in Korea: A multicenter study.

In Korea, there is a high dependency on oriental medicine and folk remedies (Korean J Asthma Allergy Clin Immunol, 25, 2005, 110). In addition, inaccurate information available through the Internet is increasing (Korean J Dermatol, 44, 2006, 137). So, there is always a possibility that patients may have difficulty obtaining accurate information about atopic dermatitis (AD). The aim was to determine the awareness, treatment behavior and treatment satisfaction of patients with AD and their caregivers. In October 2017, patients diagnosed with AD at nine hospitals were enrolled in this study. A questionnaire was completed by each patient. A total of 371 subjects were surveyed. In response to the question asking about knowledge of AD, the correct answer rate was 55.4%. Bathing using soap, body scrub and moisturizer showed favorable outcomes. A total of 54.9% patients responded that they were reluctant to use steroid ointment. When asked about their previous treatment, 39.6% reported using oriental medicine and 26.5% had tried folk remedies. The hospital treatment satisfaction score was 6.6. Patients usually applied their knowledge in their daily lives. However, there was a lot of inaccurate knowledge. Therefore, it is important for patients to understand the characteristics of this disease and obtain correct information.

Alternative therapies for chronic rhinosinusitis: A review.

The use of alternative medicine in chronic rhinosinusitis (CRS) continues to increase in popularity, for the most part without meeting the burden of being based on sound clinical evidence. New and emerging treatments, both natural and developed, are numerous, and it remains a challenge for otolaryngologists as well as general practitioners to keep up to date with these therapies and their efficacy. In this systematic review, we discuss a number of alternative therapies for CRS, their proposed physiologic mechanisms, and evidence supporting their use. This analysis is based on our review of the English-language literature on alternative therapies for CRS (we did not include any therapies that are already recommended by accepted professional bodies). Data collection was performed using the PubMed database (not restricted to MEDLINE due to the nature of the subject matter), the Cochrane databases, and bibliography searches. We found that while many of the alternative therapies we reviewed might have a firm basis in science, they lack any clinical evidence to support their use specifically for CRS. Some emerging therapies, such as therapeutic ultrasonography and phonophoresis, show some promise, based on a growing body of positive evidence. In addition, the use of baby shampoo, thyme honey, and bromelain additives to saline lavage in CRS are all supported by clinical evidence, as is Sinupret, an oral preparation that contains echinacea. However, higher levels of evidence gleaned from large, well-designed, prospective, randomized, controlled trials are needed before any of these therapies can be recommended.

The science behind skin care: Cleansers.

Two of the most important skin care categories with profound dermatologic implications are cleansers and moisturizers. Cleansers are composed of alkaline soaps or the less barrier-damaging synthetic detergents, known as syndets. The lower skin irritation and dryness found with syndets are related to their reduced tendency to cause protein denaturation due to the charge density of protein-bound micelle-like surfactant aggregates. Many cleansing formulations are available for purchase to meet hygiene needs varying by sex, age, ethnicity, occupation, environment, personal preferences, and the presence or absence of skin disease. This discussion covers the science of skin cleansing.

Preventive effects of topical washing with miconazole nitrate-containing soap to diaper candidiasis in hospitalized elderly patients: A prospective, double-blind, placebo-controlled study.

The objective of the present randomized, double-blind trial was to evaluate the efficacy and safety of daily washing with miconazole nitrate-containing soap for candidiasis at diaper-covered sites in elderly subjects under long-term inpatient care. To confirm the onset and disappearance of candidiasis, we microscopically evaluated the existence of the pseudohyphae and/or blastoconidia of Candida spp. We enrolled 75 elderly patients who wore diapers all day in the hospital or nursing home. Patients were randomly assigned to receive treatment with either miconazole soap or miconazole-free placebo soap, and 28 patients in the miconazole group and 27 patients in the placebo group were followed for 4 weeks. Although washing with miconazole soap did not affect the frequency of pseudohyphae/blastoconidia-positive patients, it significantly inhibited the positive conversion of pseudohyphae/blastoconidia compared with the placebo group. As a result, the frequency of patients positive for pseudohyphae/blastoconidia was significantly lower in the miconazole group than in the control group at 4 weeks (17.9% vs 44.4%). Clinically apparent diaper candidiasis did not develop in either group. Washing with miconazole soap was a significant independent factor for reducing the cases positive for pseudohyphae/blastoconidia, while diarrhea and heart failure were significant factors associated with an increase in the positive rate at the end-point. Severe adverse effects were not found in any patients. Thus, washing with miconazole soap is well-tolerated and can inhibit the positive conversion of Candida in patients wearing diapers. Therefore, maintenance of genital hygiene using this soap may prophylactically decrease the overall prevalence of patients with diaper candidiasis.

Medicinal and cosmetics soap production from Jatropha oil.

Soap is the most useful things which we use our everyday life in various cleansing and cosmetics purposes. Jatropha oil is nonedible oil which has more benefits to soap making. It has also cosmetics and medicinal properties. But the presence of toxic Phorbol esters in Jatropha oil is the main constrains to use it. So it is necessary to search a more suitable method for detoxifying the Jatropha oil before the use as the main ingredient of soap production. This review implies a more suitable method for removing phorbol esters from Jatropha oil. Several parameters such as the % yield of pure Jatropha oil soap, TFM value of soap, total alkali content, free caustic alkalinity content, pH, the antimicrobial activity, and CMC value of general soap should be taken into consideration for soap from detoxified Jatropha oil.

Adherence to drug treatments and adjuvant barrier repair therapies are key factors for clinical improvement in mild to moderate acne: the ACTUO observational prospective multicenter cohort trial in 643 patients.

BACKGROUND: In acne, several studies report a poor adherence to treatments. We evaluate, in a real-life setting conditions, the impact of compliance to physician's instructions, recommendations and adherence to the treatments on clinical outcome in patients with mild to moderate acne in an observational, non-interventional prospective study carried out in 72 Dermatologic Services in Spain (ACTUO Trial). METHODS: Six-hundred-forty-three subjects were enrolled and 566 patients (88 %) completed the 3 study visits. Study aimed to evaluate the impact of adherence (assessed with ECOB scale) on clinical outcome, as well as how the use of specific adjuvant treatments (facial cleansing, emollient, moisturizing and lenitive specific topical products) influences treatment's adherence and acne severity (0-5 points score). Recommendation of specific adjuvant skin barrier repair products was made in 85.2 %. RESULTS: Overall, clinical improvement was observed throughout follow-up visits with an increased proportion of patients who reported reductions of ≥50 % on the total number of lesions (2 months: 25.2 %; 3 months: 57.6 %) and reductions of severity scores (2.5, 2.0 and 1.3 at 1, 2 and 3 months after treatment, respectively). Adherence to treatment was associated with a significant reduction on severity grading, a lower number of lesions and a higher proportion of patients with ≥50 % improvement. CONCLUSIONS: Good adherence to medication plus adherence to adjuvants was significantly associated with a higher clinical improvement unlike those that despite adherence with medication had a low adherence to adjuvants. A good adherence to adjuvant treatment was associated with improved adherence and better treatment outcomes in mild to moderate acne patients. (ISRCTN Registry: ISRCTN14257026).

Analysis of the effectiveness of different hygiene procedures used in dental prostheses.

PURPOSE: To compare the effectiveness of bacterial plaque removal of six denture hygiene procedures used by patients to clean their dentures. MATERIALS AND METHODS: Fifteen students randomly divided into groups G1, G2, G3, G4, G5 and G6 used maxillary intraoral appliances for 24 h without cleaning them. Afterwards, the appliances were submitted to the following procedures: P1: washing under running water for 20 s; P2 and P3: cleaning with alkaline peroxide (Corega Tabs®) for 5 and 30 min, respectively; P4: brushing with water and liquid soap for 40 s; P5: alkaline hypochlorite for 10 minutes; P6: home use chlorine solution (Q'boa® at 0.45% for 10 min), throughout a period of 6 consecutive weeks. The procedures followed a circulating scheme, so that all the appliances were submitted to all the hygiene methods studied. After the hygiene procedures, the appliances were stained, photographed and submitted to the weighing method. RESULTS: After ANOVA and Tukey's test, differences were observed: P5 = 0.73 ± 0.3 (b), P6 = 1.27 ± 0.4(b,c), P4 = 1.92 ± 0.5 (b,c), P3 = 2.24 ± 1.0 (b,c), P2 = 7.53 ± 2.5 (c) and P1 = 26.86 ± 15. 3 (a). CONCLUSION: From the results of the study, it could be concluded that the use of alkaline hypochlorite is the best way to remove bacterial plaque, followed by the home-use chlorine solution and brushing with water and liquid soap. Corega Tabs® must be used for 30 min of immersion to have a cleaning effectiveness similar to that of alkaline hypochlorite.

Soaps and germicides as adjunct topical antimycotic agents on candida species implicated in vulvovaginal candidasis.

OBJECTIVE: The study aims at evaluating the potentials of soaps and germicides/disinfectants as adjunct topical anti-vulvovaginal candidasis agents. METHODS: In vitro inhibitory activities of the test agents, prepared according to the manufacturer's specification for toilet and midwifery purposes were determined using modified agar well-diffusion method. RESULTS: Varied susceptibility patterns were exhibited by Candida albicans (26.5%), C. glabrata (18.4%), C. pseudotropicalis (14.3%) and C. tropicalis (40.8%) implicated in vulvovaginal candidasis, indicating Crusader oil (100%), Meriko (95%), Tetmosol (84.7%) and Aloe (68.4%) as the most inhibitory soaps against the Candida strains. The in vitro inhibitory activities of the germicides and disinfectants ranged between (Dettol; 34.6% and Purit; 84.6%) for C. albicans; (Roberts; 33.3% and Purit; 83.3%) for C. glabrata; (Roberts; 21.4% and Purit; 92.9%) for C. pseudotropicalis; (Dettol; 35.0% and Purit; 87.5%) for C. tropicalis respectively. All the Candida strains were totally inhibited by the germicides and disinfectants at the second lower dilutions, except in Morigad towards C. albicans (69.2%]) C. glabrata (72.2%), C. pseudotropicalis (92.9%) and C. tropicalis (82.5%) but none of the vaginal Lactobacillus strains was inhibited by the soaps, germicides or disinfectant. About 90% of a control group indicated relief after pubic cleansing with soaps, germicides and disinfectants. CONCLUSION: Results indicatied the safety of soaps, germicides and disinfectants as potential adjunct topical cleansing-agents in cases of vaginal itching and candidasis, a common mucosal infection caused by opportunistic yeasts of the Candida genus.

An open study to evaluate topical treatment of equine chorioptic mange with shampooing and lime sulphur solution.

Chorioptic mange caused by Chorioptes bovis is a common pruritic skin condition of the horse. This surface-browsing parasite usually affects the lower legs (leg mange) but can present as a generalized skin disease. Numerous anecdotal reports exist in the literature about the benefit of lime sulphur as a treatment for surface ectoparasites in the horse. This report studies the use of lime sulphur when applied as a 5% solution, some with and some without prior shampooing and clipping, to treat confirmed cases of chorioptic mange in 22 horses. Horses included in the trial had clinical signs indicative of chorioptic mange and positive identification of chorioptic mites on skin scrapings and tape preparations. Each horse was treated with sulphurated lime dip solution four times at 7-day intervals. Most horses were clipped and/or shampooed prior to treatment. Animals were assigned a score based on a scale of 1-10 to assess the severity of their lesions and degree of behavioural signs. The horses were again scored and examined for mites after four treatments. All animals showed a reduction in scores at the end of the trial and mites were not demonstrated from any animal.

A randomized controlled trial of tea tree oil (5%) body wash versus standard body wash to prevent colonization with methicillin-resistant Staphylococcus aureus (MRSA) in critically ill adults: research protocol.

BACKGROUND: Over the past ten years MRSA has become endemic in hospitals and is associated with increased healthcare costs. Critically ill patients are most at risk, in part because of the number of invasive therapies that they require in the intensive care unit (ICU). Washing with 5% tea tree oil (TTO) has been shown to be effective in removing MRSA on the skin. However, to date, no trials have evaluated the potential of TTO body wash to prevent MRSA colonization or infection. In addition, detecting MRSA by usual culture methods is slow. A faster method using a PCR assay has been developed in the laboratory, but requires evaluation in a large number of patients. METHODS/DESIGN: This study protocol describes the design of a multicentre, phase II/III prospective open-label randomized controlled clinical trial to evaluate whether a concentration of 5% TTO is effective in preventing MRSA colonization in comparison with a standard body wash (Johnsons Baby Softwash) in the ICU. In addition we will evaluate the cost-effectiveness of TTO body wash and assess the effectiveness of the PCR assay in detecting MRSA in critically ill patients. On admission to intensive care, swabs from the nose and groin will be taken to screen for MRSA as per current practice. Patients will be randomly assigned to be washed with the standard body wash or TTO body wash. On discharge from the unit, swabs will be taken again to identify whether there is a difference in MRSA colonization between the two groups. DISCUSSION: If TTO body wash is found to be effective, widespread implementation of such a simple colonization prevention tool has the potential to impact on patient outcomes, healthcare resource use and patient confidence both nationally and internationally.

Efectividad de la asepsia con cloruro de benzalconio vs. el uso de agua y jabón en la prevención de la onfalitis neonatal. Hospital de Apoyo José Alfredo Mendoza Olavarría. Tumbes 2006 / Effectiveness of aseptic benzalkonium chloride vs. using soap and water in preventing neonatal omphalitis. Hospital de Apoyo Jose Alfredo Mendoza Olavarria. Tumbes 2006

Objetivo: demostrar que la asepsia con cloruro de benzalconio es más efectiva que el uso de agua y jabón en la prevención de la onfalitis neonatal en el Hospital de Apoyo JAMO de Tumbes durante el período enero a abril del 2006. Métodos: estudio descriptivo, prospectivo, longitudinal y comparativo. Se incluyeron neonatos de ambos sexos, a término, de parto eutócico y cesárea, y se utilizó el muestreo no probabilístico de tipo accidental. El diseño fue de dos grupos, con sujetos aleatorizado y sólo con posprueba. Para la comparación de la efectividad del cloruro de benzalconio vs. El uso de agua y jabón se utilizaron las pruebas paramétricas Chi Cuadrado y t de Student. Resultados: ingresaron al estudio 84 neonatos; la mitad recibió asepsia con cloruro de benzalconio y el resto, con agua y jabón. Del total de la muestra, 82 neonatos no presentaron signos de onfalitis y sólo se evidenciaron dos casos, uno con cada tipo de antiséptico (2.4%). Sin embargo, no se encontró una relación significativa (p>0.05) entre la presencia de signos inflamatorios y el producto empleado para la asepsia. Asimismo, del total de la muestra (84 neonatos), cuatro presentaron la caída del cordón umbilical entre 3er y 5to día (uno con cloruro de benzalconio y tres con agua y jabón) mientras que a 78 neonatos se les desprendió el cordón umbilical entre el 6° y el 9° día y a dos neonatos pasados los diez días (un caso para cada antiséptico usado). Las pruebas estadísticas no mostraron relación significativa (p>0.05) entre el tiempo de caída del cordón umbilical y el tipo de antiséptico usado. Encontramos que al tasa de prevalencia de onfalitis fue de 2.38% y el tiempo promedio de aparición de los signos de onfalitis fue de cuatro días luego de utilizar ambos antisépticos.

Treatment of eczema.

Eczema is a chronic inflammatory skin disease that has reached nearly epidemic proportions in childhood. Moreover, it is a difficult disease to control and, with its onset in childhood, is often the first manifestation of atopy. The clinical features of eczema include itchy red skin accompanied by dryness and lichenification. In the past, treatment options consisted primarily of avoidance of soap and water. These options have considerably improved with both nonpharmacologic and pharmacologic approaches. However, eczema is still a treatment challenge. Part of the problem in developing new treatment options has been the relative failure in translating basic science information into clinical application. It is hoped that the newer biologics will help bridge this gap and lead to greater success rates.

Efficacy of triclosan soap against superficial dermatomycoses: a double-blind clinical trial in 224 primary school-children in Kilombero District, Morogoro Region, Tanzania.

BACKGROUND: Superficial dermatomycoses are a common problem in tropical regions. Due to limited resources, specific antimycotic therapy is often not available. The present study was performed to assess the clinical efficacy of the antimicrobial agent Triclosan in bar soap in comparison with regular soap against selected superficial dermatomycoses in Tanzanian schoolchildren. METHODS: 820 primary school children were examined for skin disorders and 224 of these were included in the soap trial. The clinical presentation of dermatomycoses was recorded using a symptom score. Samples were taken for microscopic examination and mycological culture. The study participants received either bar soap containing Triclosan or a placebo for 2 months. They were re-examined at the end of this period. RESULTS: The benefit achieved by the addition of Triclosan was not statistically significant. Overall cure rates for Triclosan and placebo groups taken together were 21.8% for tinea versicolor, 58.3% for tinea capitis, 55.5% for tinea corporis and 68.8% for tinea pedis. This was confirmed microscopically. For the majority of the children the dermatomycoses improved significantly. CONCLUSIONS: The results strongly argue for regular soap use against common dermatomycoses as a low-cost and effective treatment. This promising finding should be considered in settings where dermatophyte infections represent a public health problem and where access to appropriate treatment and financial resources are limited.

Control of Biomphalaria pfeifferi population and schistosomiasis transmission in Ethiopia using the soap berry endod (Phytolacca dodecandra), with special emphasis on application methods.

The endod (Phytolacca dodecandra)-based schistosomiasis mansoni control project was implemented in Ethiopia between 1994 and 1999. The aim was to develop an effective, cheap and sustainable method of controlling schistosomiasis. First, different formulations of the Ethiopian endod strain 44 (E-44) were compared for potency in the laboratory. Secondly, spray and drip-feeding methods were compared for simplicity and effectiveness in the field. Lastly, the efficacy of endod powder soap was compared with the endod spray method. In Bati stream, endod powder soap was distributed to the residents every weekend at laundry sites. In Worke stream, endod was sprayed along a 1-km stretch of the stream at 3-month intervals. No endod was applied in Harbu stream. The immediate and long-term effects of endod application on the snail population and schistosomal infection were determined. Using the spray method, 100% snail mortality could be obtained, and it was simpler and more effective than the drip-feeding method. Snail mortality ranged from 20 to 100% using endod soap. There was a progressive decline in the snail population and infection in Bati stream compared with Worke stream, mainly due to sustained use of endod soap. The advantages and disadvantages of the different endod delivery systems are discussed.

Safety and effectiveness of large-volume enema solutions.

The effectiveness and side effects of three types of enema solutions were compared in healthy subjects. Using a repeated-measures, double-blind design, the three different enemas (soapsuds, tap water, and polyethylene glycol-electrolyte solution) were given at 1-week intervals to 24 healthy volunteers. Soapsuds and tap water enemas produced significantly greater returns than polyethylene glycol electrolyte solution (PEG-ES) and were also more uncomfortable. Rectal biopsies showed surface epithelium loss after soapsuds and tap water but not after PEG-ES enemas. Before recommending changes in nursing practice, further research is needed to determine the mechanism for the surface epithelium damage and to determine if this damage produces a stronger defecation stimulus and discomfort.

Preference and compliance of waterless hand-hygiene products versus soap and water.

PURPOSE: To compare handwashing using traditional antimicrobial soap and water with two antimicrobial waterless hand-hygiene products for personal preference and compliance. METHODS: Fifty dental and dental hygiene students were randomly chosen to participate in the study. All subjects were anonymously observed prior to the introduction of the waterless products for handwashing compliance using soap and water for 1 week. All subjects were then instructed on the use of a waterless gel and foam for handwashing. Both waterless products were used for a period of 1 week and students again were anonymously observed. A questionnaire was distributed at the conclusion of the study to determine product preference. RESULTS: During handwashing with soap and water, the average time the soap was in contact with the hands was 7.0 seconds. The average contact time with the gel and foam was 15.3 seconds and 20.0 seconds, respectfully. Questionnaire results indicated that the foam was significantly preferred over the gel and soap and water (54%, 28% and 16%, respectively). The foam was also significantly preferred when evaluating fragrance (52%), kindness to the skin (66%), convenience (64%) and fastest drying time (54%). Results from this study indicate that the waterless foam product was significantly preferred over the waterless gel and traditional soap and water for handwashing procedures. Since handwashing guidelines, regardless of which product used, recommend a minimum of 15 seconds to minimize the number of transient microorganisms on the hands, compliance was found only with the foam and the gel.