Avocado and soybean extracts as active principles in the treatment of mild-to-moderate vulvar lichen sclerosus: results of efficacy and tolerability.

OBJECTIVE: Limited evidence is available on the effectiveness of treatments alternative to corticosteroids for vulvar lichen sclerosus (VLS). The present study aimed to assess the efficacy and tolerability of avocado and soybean extracts (ASE) as active principles of both a topical product and a nutritional supplement in the treatment of active mild-to-moderate VLS. MATERIALS AND METHODS: Twenty-three patients were enrolled. Treatment consisted of a topical product containing ASE and other lenitive and anti-oxidant principles administered twice daily for 24 weeks, in association with a dietary supplement containing ASE, vitamin E and para-aminobenzoic acid for the first 12 weeks. The primary efficacy endpoint was the rate of patients achieving an improvement from baseline in global subjective score (GSS) and global objective score (GOS) of ≥ 75%. Secondary efficacy endpoint was the rate of patients achieving GSS50 and GOS50. Tertiary efficacy endpoint was the mean reduction in subjective and objective scores throughout the treatment. RESULTS: By the end of the 24-week treatment, 12 (70.5% of symptomatic patients) and 13 patients (72.2%) achieved an improvement of at least 75% in subjective and objective global scores, respectively; 100% and 88.9% reached GSS50 and GOS50, respectively. Mean symptom and sign scores decreased significantly after treatment. The treatment was well tolerated. CONCLUSIONS: Our results provide evidence that the topical and dietary supplements used in the study, which contain active principles exerting anti-inflammatory, anti-fibrotic, emollient and lenitive actions, are effective alternatives in the treatment of symptoms and signs of mild-to-moderate VLS.

Avaliação preliminar da atividade antimicrobiana do extrato de erva-mate (Ilex paraguariensis A. St. - Hil.) obtido por extração com CO2 supercrítico / Preliminary evaluation of the antimicrobial activity of "erva mate" (Ilex paraguariensis A. St. - Hil.) extract obtained by using supercritical CO2

Ilex paraguariensis A. St. - Hil. (erva-mate) é uma árvore pertencente à família Aquifoleaceae, nativa da região sul da América do Sul e de grande importância cultural e econômica para os três estados da região sul do Brasil. O presente trabalho determinou o potencial antimicrobiano do extrato de erva-mate obtido por fluido supercrítico, frente a alguns microrganismos. As folhas de Ilex paraguariensis foram coletadas na região norte do RS. O extrato bruto da planta desidratada foi obtido pelo método de extração com fluido supercrítico, utilizando dióxido de carbono (CO2) como solvente. Foi obtida a solução mãe desse extrato (100 mg mL-1) que a seguir foi diluído (50; 25; 12,5; 6,25 mg mL-1) para avaliação da atividade antimicrobiana por meio da técnica de difusão do disco em ágar Müeller Hinton, sobre cepas de Acinetobacter baumannii (ATCC 19606), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 25923) e Enterococcus faecalis (ATCC 29212). As análises foram efetuadas em triplicata, utilizando como controle negativo disco estéril sem impregnação e como controle positivo discos de antibióticos comerciais variáveis de acordo com a espécie bacteriana. Após 16 a 24h de incubação a 35ºC os halos com significância foram medidos. Observou-se atividade antimicrobiana frente a S. aureus (halos de inibição variaram entre 7 e 18 mm) e para P. aeruginosa (halos entre 6 e 11 mm), ambos nas concentrações de 100 até 25 mg mL-1. O extrato obtido por extração em fluido supercrítico de Ilex paraguariensis apresentou atividade antimicrobiana frente a S. aureus e P. aeruginosa.

Ilex paraguariensis A. St. - Hil. ("erva mate") is a tree of the Aquifoliaceae family, native to the south region of South America and of great cultural and economic importance for the three states of the south region of Brazil. The present study aimed to determine the antimicrobial potential of "erva mate" extract obtained by supercritical fluid against some microorganism strains. The leaves of Ilex paraguariensis were collected in the north region of Rio Grande do Sul State. The crude extract of dehydrated plant was obtained by supercritical fluid extraction, using carbon dioxide (CO2) as solvent. The extract mother solution (100 mg mL-1) was diluted (50; 25; 12, 5; 6.25 mg mL-1) for antimicrobial activity evaluation, by means of disk diffusion method on Müeller-Hinton agar, against strains of Acinetobacter baumannii (ATCC 19606), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 25923) and Enterococcus faecalis (ATCC 29212). The analyses were done in triplicate, using as negative control sterile disk without impregnation and as positive control, commercial antibiotic disks according to the bacterial species. After 16-24h incubation at 35ºC, the diameters of inhibition zones were measured. Antimicrobial activity was observed against S. aureus (inhibition zones between 7 and 18 mm) and P. aeruginosa (inhibition zones between 6 and 11 mm), both at the concentrations of 100 mg mL-1 to 25 mg mL-1. The extract of Ilex paraguariensis obtained by supercritical fluid presented antimicrobial activity against S. aureus and P. aeruginosa.

Use of topical herbal remedies and cosmetics: a questionnaire-based investigation in dermatology out-patients.

BACKGROUND: Although topical remedies and cosmetics based on herbal ingredients are becoming increasingly popular with the public due to the perception that botanical compounds are safer and healthier than their synthetic counterparts, a large number of adverse cutaneous effects of plant extracts, notably contact sensitization, have been reported in medical literature. OBJECTIVE: To evaluate the prevalence of herbal compound usage in a dermatological out-patient population and to estimate the incidence of consequent cutaneous side-effects. METHODS: Four hundred patients were subjected to a self-administered 15-item questionnaire to assess both prevalence and type of topical botanical preparations used and occurrence of skin adverse reactions. RESULTS: Two hundred forty-one patients (60.25%) reported use of natural topical products, predominantly aloe, marigold, chamomile, propolis and arnica. Females used herbal products, for both medicinal and cosmetic purposes, more frequently than males. Fifteen patients (6.22%) referred one or more adverse cutaneous reactions. CONCLUSION: Herbal preparations were widely used in the examined population, but, despite the common belief in the innocuous nature of botanical extracts, the incidence of side-effects referred by the patients confirms that they should be regarded as a potential source of adverse skin events. The lack of adequate patch testing in case of suspected contact allergic dermatitis, incomplete or misleading product labelling, and the risk of chemical adulteration may represent further concerns as regards application of botanical products.