RESUMO
INTRODUCTION: Atopic dermatitis/eczema affects around 20% of children and is characterised by inflamed, dry, itchy skin. Guidelines recommend 'leave-on' emollients that are applied directly to the skin to add or trap moisture and used regularly, they can soothe, enhance the skin barrier and may prevent disease 'flares'. However, the suitability of the many different emollients varies between people and there is little evidence to help prescribers and parents and carers decide which type to try first. METHODS AND ANALYSIS: Design: pragmatic, multicentre, individually randomised, parallel group superiority trial of four types of emollient (lotions, creams, gel or ointments). SETTING: general practitioner surgeries in England. PARTICIPANTS: children aged over 6 months and less than 12 years with mild-to-severe eczema and no known sensitivity to study emollients. INTERVENTIONS: study-approved lotion, cream, gel or ointment as the only leave-on emollient for 16 weeks, with directions to apply twice daily and as required. Other treatments, such as topical corticosteroids, used as standard care. FOLLOW-UP: 52 weeks. PRIMARY OUTCOME: validated patient-orientated eczema measure measured weekly for 16 weeks. SECONDARY OUTCOMES: eczema signs (Eczema Area Severity Index) by masked researcher, treatment use, parent satisfaction, adverse events, child and family quality of life (Atopic Dermatitis Quality of Life, Child Health Utility 9D and Dermatitis Family Impact). SAMPLE SIZE: 520 participants (130 per group). ANALYSIS: intention-to-treat using linear mixed models for repeated measures.Nested qualitative study: audio-recording of sample of baseline appointments and up to 60 interviews with participants at 4 and 16 weeks, interviews to be transcribed and analysed thematically. ETHICS AND DISSEMINATION: Ethics approval granted by the NHS REC (South West - Central Bristol Research Ethics Committee 17/SW/0089). Findings will be presented at conferences, published in open-access peer-reviewed journals and the study website; and summaries shared with key stakeholders. TRIAL REGISTRATION NUMBER: ISRCTN84540529.
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Eczema/tratamento farmacológico , Emolientes/uso terapêutico , Criança , Análise Custo-Benefício , Emolientes/administração & dosagem , Emolientes/efeitos adversos , Inglaterra , Humanos , Estudos Multicêntricos como Assunto , Pais/psicologia , Satisfação Pessoal , Ensaios Clínicos Pragmáticos como Assunto , Pesquisa Qualitativa , Qualidade de Vida , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Introduction: Atopic dermatitis (AD) is a chronic, relapsing skin disease starting typically in atopic-prone children between 36 months of age, with most children having developed AD by the age of 5 years. Intense itching leads to sleep disturbance, especially in younger children and toddlers. This review explores early intervention in infants and young children with AD by controlling skin barrier function and inflammation at the earliest time point using a moisturizer and a proactive treatment. Methods: A working group of experienced clinicians managing pediatric populations with AD convened for a meeting. The panel reviewed the literature surrounding early intervention in infants and young children with AD and developed and discussed clinical questions aimed at optimizing clinical outcomes. Results: Complex gene/immune system/environment interactions are involved in AD development. Epidermal barrier defects play a central role in the condition, with various studies showing impairment of skin barrier function at birth may precede clinical AD. Dynamic changes take place in the amounts of skin lipids during infancy. Studies confirm that daily use of a moisturizer from birth onwards may offer benefits in improving skin barrier function and possibly prevention of AD, especially in high-risk, atopic prone newborns. Plant-based moisturizers were shown to be safe and effective when applied in pediatric patients with AD and may provide a TCS-sparing effect while improving skin condition. Conclusion: Dry skin conditions during infancy may predict the subsequent development of AD. Consequently, emollient therapy from birth represents a feasible, safe, and effective approach for AD prevention. Therefore, parental education and the application of moisturizers are recommended as an integral part of AD prevention, treatment, and maintenance. J Drugs Dermatol. 2019;18(10):1020-1027.
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Dermatite Atópica/tratamento farmacológico , Emolientes/administração & dosagem , Carga Global da Doença , Extratos Vegetais/administração & dosagem , Fatores Etários , Idade de Início , Pré-Escolar , Dermatite Atópica/epidemiologia , Dermatite Atópica/etiologia , Emolientes/efeitos adversos , Humanos , Incidência , Lactente , Recém-Nascido , Extratos Vegetais/efeitos adversos , Prevalência , Fatores de RiscoRESUMO
Pruritus is associated with various skin diseases, dry skin, and with it an impaired skin barrier function. The study objective was to investigate short-term and long-term effects of two emollients on symptoms and skin barrier functions in xerotic eczema. Randomized, double-blind, study enrolling females/males, with bilateral itching. Two emollients, containing lactic acid and refined almond oil with/without polidocanol were administered on left versus right body sides. Itching severity, skin moisture, lipid content, and pH were assessed on Day 1, within 30-120 min after first administration, and on Days 7 and 14, and compared with baseline assessments. Severity of itching decreased 30 min after first administration of both emollients compared with baseline (p < .0001) and reached a maximum reduction of 63% (p < .0001) and 69% (p < .0001) on Day 14. Skin moisture and lipid content increased after first application, and further ameliorated within 14 days of treatment (p < .0001). Both emollients were tolerated well, and only a few adverse events were reported. This study confirmed the clinical efficacy of the two study emollients to substantially reduce itching already after first administration, and restore skin barrier integrity and thus should be considered as therapeutic approach for xerotic eczema.
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Eczema/tratamento farmacológico , Emolientes/administração & dosagem , Ácido Láctico/administração & dosagem , Óleos de Plantas/administração & dosagem , Prurido/tratamento farmacológico , Pele/efeitos dos fármacos , Administração Cutânea , Adolescente , Adulto , Idoso , Método Duplo-Cego , Esquema de Medicação , Eczema/diagnóstico , Eczema/fisiopatologia , Emolientes/efeitos adversos , Feminino , Humanos , Ácido Láctico/efeitos adversos , Masculino , Pessoa de Meia-Idade , Óleos de Plantas/efeitos adversos , Polidocanol/administração & dosagem , Prurido/diagnóstico , Prurido/fisiopatologia , Pele/inervação , Pele/patologia , Suíça , Fatores de Tempo , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: The objective of this study was to determine the skin barrier changes during postnatal month 1 among infants receiving routine mustard oil massage in the humid conditions of rural Nepal. STUDY DESIGN: This was an observational study among 500 live-born neonates receiving mustard oil massage. Skin integrity such as erythema, rash, dryness, skin pH, stratum corneum protein concentration and transepidermal water loss was measured on days 1, 3, 7, 14 and 28. RESULTS: Erythema and rash increased (worsened) during weeks 1 and 2, then decreased over weeks 3 and 4. Skin pH (6.1±0.5 to 5.0±0.6) and stratum corneum protein (16.6±7.9 to 13.5±5.9 µg cm-2) decreased. Transepidermal water loss increased from 33.2±23.5 to 43.0±24.5 g m-2 h-1 at day 28. Skin pH and stratum corneum protein were higher for early versus late premature infants. CONCLUSION: Premature and full-term skin condition was generally poor especially during the first 2 weeks, improving thereafter. Maturational changes were evident.
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Epiderme/metabolismo , Eritema/fisiopatologia , Massagem/métodos , Mostardeira/efeitos adversos , Óleos de Plantas/efeitos adversos , Perda Insensível de Água/fisiologia , Administração Tópica , Emolientes/efeitos adversos , Feminino , Proteínas Filagrinas , Idade Gestacional , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Proteínas de Filamentos Intermediários/análise , Masculino , Nepal , Ensaios Clínicos Controlados Aleatórios como Assunto , População RuralRESUMO
Atopic dermatitis is the leading cause of pediatric dermatology visits in developed nations. Recurrent, itchy rashes in typical locations and a family/personal history of atopy helps to identify children with disease. Most cases (85%) are diagnosed by age 5 years. Some comorbidities are age-based and may affect disease course. Topical corticosteroids are the mainstay of therapy; corticosteroidphobia and side effects complicate use. Topical calcineurin inhibitors are alternatives to corticosteroids, especially in sensitive locations. Systemic therapies include antihistamines, immune suppressive agents, and phototherapy, with specific pediatric modifications. This article reviews the nuances and caveats of pediatric atopic dermatitis diagnosis and management.
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Corticosteroides/uso terapêutico , Dermatite Atópica/epidemiologia , Dermatite Atópica/terapia , Emolientes/uso terapêutico , Administração Cutânea , Adolescente , Corticosteroides/administração & dosagem , Criança , Pré-Escolar , Comorbidade , Ciclosporina/uso terapêutico , Dermatite Atópica/diagnóstico , Fármacos Dermatológicos/uso terapêutico , Emolientes/efeitos adversos , Humanos , LactenteRESUMO
Topical oils on baby skin may contribute to development of childhood atopic eczema. A pilot, assessor-blinded, randomized controlled trial assessed feasibility of a definitive trial investigating their impact in neonates. One-hundred and fifteen healthy, full-term neonates were randomly assigned to olive oil, sunflower oil or no oil, twice daily for 4 weeks, stratified by family history of atopic eczema. We measured spectral profile of lipid lamellae, trans-epidermal water loss (TEWL), stratum corneum hydration and pH and recorded clinical observations, at baseline, and 4 weeks post-birth. Recruitment was challenging (recruitment 11.1%; retention 80%), protocol adherence reasonable (79-100%). Both oil groups had significantly improved hydration but significantly less improvement in lipid lamellae structure compared to the no oil group. There were no significant differences in TEWL, pH or erythema/skin scores. The study was not powered for clinical significance, but until further research is conducted, caution should be exercised when recommending oils for neonatal skin.
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Emolientes/administração & dosagem , Eritema/tratamento farmacológico , Massagem , Azeite de Oliva/administração & dosagem , Óleos de Plantas/administração & dosagem , Pele/efeitos dos fármacos , Administração Cutânea , Emolientes/efeitos adversos , Inglaterra , Eritema/diagnóstico , Eritema/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Recém-Nascido , Adesão à Medicação , Azeite de Oliva/efeitos adversos , Projetos Piloto , Óleos de Plantas/efeitos adversos , Pele/metabolismo , Pele/patologia , Óleo de Girassol , Fatores de Tempo , Resultado do Tratamento , Perda Insensível de ÁguaRESUMO
BACKGROUND: In this study we tried to assess the efficacy of topical emollients in the treatment of patients with PUVA-induced pruritus. MATERIAL AND METHODS: 41 patients over 18 years of age, who received PUVA treatment in the phototherapy unit, were included in the study. Patients were randomly divided into two groups; Group I was administered with a 4% urea lotion and Group II was administered with liquid petrolatum. The follow-up period was minimum 4 weeks. During the first 2 weeks, patients were administered topical emollients and received PUVA treatment together. The next 2 weeks, they continued PUVA treatment without any medication. RESULTS: When time-dependent changes in the visual analogue scale scores for pruritus of both groups were considered, both treatment methods were found to be remarkably successful (p < 0.0001). In addition, an insignificant group-time interaction was identified (p = 0.753). CONCLUSIONS: Topical emollients were found to be effective in the treatment of PUVA-induced pruritus. Both forms of medication can be successfully administered and increase the patient's compliance with medication.
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Emolientes/uso terapêutico , Óleo Mineral/uso terapêutico , Terapia PUVA/efeitos adversos , Prurido/tratamento farmacológico , Ureia/uso terapêutico , Adulto , Emolientes/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prurido/etiologiaRESUMO
BACKGROUND: This study evaluates the efficacy and safety of a pollen blocker cream in treatment of perennial allergic rhinitis (PAR) in a Chinese population. METHODS: A randomized double-blind placebo-controlled, crossover trial was conducted in the Outpatient Department of the Eye, Ear, Nose, and Throat Hospital, Fudan University, Shanghai, China. Patients diagnosed with PAR were randomly assigned to receive pollen blocker cream or placebo, which was applied and evenly distributed to the lower internal nose region three times daily for a total of 30 days. The primary outcome measures for efficacy were nasal symptom scores (NSSs) and quality of life scores (QoLSs). Medication scores and adverse events were also monitored. RESULTS: After application of pollen blocker, the mean NSS fell from 23.1 to 12.4 points, and the QoLSs fell from 83.9 to 53.2 points (p < 0.001). The decrease in NSSs of pollen blocker (10.7) was highly significant compared with the placebo (3.6; p < 0.001). The decrease in QoLSs of pollen blocker was 30.7 compared with 7.1 in the placebo group, and the difference was also significant (p < 0.05). Interestingly, the mean NSS of the placebo group also decreased from 23.7 to 20.1 (p < 0.05). Additionally, the efficacy of pollen blocker was superior to the placebo both in adults and in children. However, there was no significant difference for individual symptoms of rhinorrhea, nasal itching, sneezing, and nasal congestion between the pollen blocker group and placebo group (p > 0.05). Only one mild epistaxis was reported. CONCLUSION: The pollen blocker was significantly more effective than the placebo in relieving allergy symptoms and improving life quality of PAR in 30 Chinese people.
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Emolientes/administração & dosagem , Vaselina/administração & dosagem , Rinite Alérgica Sazonal/tratamento farmacológico , Administração Cutânea , Adolescente , Adulto , China , Estudos Cross-Over , Método Duplo-Cego , Emolientes/efeitos adversos , Feminino , Humanos , Masculino , Pacientes Ambulatoriais , Vaselina/efeitos adversos , Pólen/efeitos adversos , Qualidade de Vida , Rinite Alérgica Sazonal/imunologia , Resultado do TratamentoAssuntos
Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia , Emolientes/efeitos adversos , Helichrysum/efeitos adversos , Fitoterapia/efeitos adversos , Preparações de Plantas/efeitos adversos , Administração Cutânea , Idoso , Emolientes/administração & dosagem , Feminino , Dermatoses da Mão/induzido quimicamente , Humanos , Dermatoses da Perna/induzido quimicamente , Testes do EmplastroRESUMO
INTRODUCTION: Almost half of breast cancer survivors experience chronic sexual problems. Despite the negative effects of dyspareunia on physical and overall quality of life, sexual dysfunction remains underreported and undertreated in clinical practice. This is likely due to the paucity of evidence-based interventions to improve sexual functioning. AIM: The study aims to prospectively evaluate the acceptability, feasibility, and efficacy of a novel intervention (Olive Oil, Vaginal Exercise, and MoisturizeR [OVERcome]) to improve sexual problems following breast cancer treatment. MAIN OUTCOME MEASURES: Dyspareunia, sexual functioning, quality of life, distress, and pelvic floor muscles (PFMs) functioning were evaluated. METHODS: Twenty-five women with dyspareunia were instructed to perform pelvic floor muscle (PFM) relaxation exercises twice/day to prevent/manage PFM overactivity, apply a polycarbophil-based vaginal moisturizer three times/week to alleviate vaginal dryness, use olive oil as a lubricant during intercourse, and complete a weekly compliance diary. PFM relaxation training was administered by a physiotherapist at weeks 0 and 4, with follow-up at weeks 12 and 26. At each visit, women completed validated self-report questionnaires and the physiotherapist recorded objective measures of PFM functioning. RESULTS: OVERcome resulted in significant improvements in dyspareunia, sexual function, and quality of life over time (all P<0.001). PFM relaxation training was reported to be effective (P≤0.001). Maximum benefits were observed at week 12. Most women rated PFM relaxation exercises (92%), vaginal moisturizer (88%), and olive oil (73%) as helpful, indicating that the intervention was acceptable. Unexpectedly, six cases (11%) of vaginal stenosis were noted during initial screening. CONCLUSIONS: This novel intervention is acceptable to patients with demonstrated efficacy in improving dyspareunia and sexual function following breast cancer. Delivery of the OVERcome intervention appears feasible in a clinical setting, providing a potential treatment for this important clinical issue. The unexpected number of observed cases of stenosis further highlights the underreporting of sexual problems in this population, deserving further exploration.
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Neoplasias da Mama/terapia , Dispareunia/terapia , Emolientes/uso terapêutico , Terapia por Exercício , Lubrificantes/uso terapêutico , Diafragma da Pelve/fisiopatologia , Óleos de Plantas/uso terapêutico , Comportamento Sexual/efeitos dos fármacos , Vagina/efeitos dos fármacos , Adulto , Idoso , Biorretroalimentação Psicológica , Terapia Combinada , Dispareunia/diagnóstico , Dispareunia/etiologia , Dispareunia/fisiopatologia , Dispareunia/psicologia , Emolientes/efeitos adversos , Terapia por Exercício/efeitos adversos , Estudos de Viabilidade , Feminino , Humanos , Lipídeos/efeitos adversos , Lipídeos/uso terapêutico , Lubrificantes/efeitos adversos , Pessoa de Meia-Idade , Relaxamento Muscular , Azeite de Oliva , Satisfação do Paciente , Óleos de Plantas/efeitos adversos , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Vagina/fisiopatologia , Cremes, Espumas e Géis VaginaisRESUMO
When treating psoriasis, various topical emollients exist that can affect the penetration of ultraviolet radiation in phototherapy. Compared with normal-appearing skin with a reflectance of 4% to 5%, psoriatic skin has higher reflectance as a result of its increased air-to-corneocyte interfaces. Studies have tested the effect of emollients on light penetration by assessing psoriatic plaque clearance, differences in minimal erythema dose, and physical properties of the emollient (eg, monochromatic protection factor and absorbance). Psoriatic plaque clearance was found to improve with serous (thin liquid)-based emollients (eg, Vaseline oil [Unilever, Blackfriars, London, UK], mineral oil, and glycerol), whereas clearance decreased with salicylic acid and viscous-based emollients (eg, petrolatum). Emollients with high ultraviolet absorbance properties increased minimal erythema dose, and those with low absorbance properties decreased minimal erythema dose. Interestingly, when a liquid emollient with a refractive index close to that of normal-appearing skin was applied, there was a net increase in light absorption, or a reduction in reflection that exceeded the emollient's innate ability to absorb light.
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Emolientes/efeitos adversos , Fototerapia/métodos , Psoríase/terapia , Terapia Ultravioleta/métodos , Humanos , Fototerapia/normas , Refratometria , Terapia Ultravioleta/normasRESUMO
An excess of 70 million cutaneous surgical procedures are conducted annually in the United States that may result in scarring. Skin scars are a normal outcome of the tissue repair process. However, individuals with abnormal scarring may have aesthetic, psychological, and social consequences. As a result, there is a high patient demand for products that will reduce the scarring. The principles underlying scar formation are now better understood. Products are being developed to address those critical components of the wound-healing process, namely inflammation, hydration, and collagen maturation. A multicomponent scar product was previously shown effective in preventing exaggerated scarring in patients undergoing various surgical procedures. The present outpatient study was conducted in patients undergoing shave biopsies. Following reepithelialization, this investigator-blinded, randomized, 8-week trial compared twice-daily application of either the scar product or the standard of care, white petrolatum. Evaluation visits were conducted at baseline and at weeks, 1, 2, 4 and 8. Subjects were evaluated by the blinded investigator for clinical efficacy and tolerability using grading scales. Standardized digital photographs were taken at each visit, and subjects completed a self-assessment questionnaire regarding treatment effectiveness and satisfaction. Twenty-eight subjects completed the 8-week study. The scar product provided earlier improvements than the white petrolatum. At week 1, 70% of subjects receiving the scar product demonstrated at least 50% global improvement in scar appearance vs only 42% of the subjects receiving white petrolatum. The more rapid improvement was accompanied by greater reductions in stinging/burning and itching with the scar product at all visits. Importantly, there was also greater subject satisfaction with the scar product at all visits. This scar product may be useful in hastening the healing of cutaneous shave biopsies and reducing the stinging/burning and itching associated with the normal healing process.
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Cicatriz/tratamento farmacológico , Cicatriz/patologia , Emolientes/uso terapêutico , Vaselina/uso terapêutico , Adulto , Idoso , Biópsia , Centella/química , Autoavaliação Diagnóstica , Método Duplo-Cego , Emolientes/efeitos adversos , Feminino , Géis , Humanos , Glucosídeos Iridoides , Iridoides , Masculino , Pessoa de Meia-Idade , Vaselina/efeitos adversos , Extratos Vegetais/uso terapêutico , Prurido/etiologia , Piranos/uso terapêutico , Fluxo Sanguíneo Regional , Sensação , Pele/irrigação sanguínea , Pele/patologia , Pigmentação da Pele , Vasodilatadores/uso terapêutico , Adulto JovemRESUMO
Infections and complications from prematurity cause a majority of global neonatal deaths. Recent evidence has demonstrated the life-saving ability of topical emollient therapy in resource-poor settings. With the potential to reduce infection and neonatal mortality by 41 and 26%, respectively, emollient therapy is a promising option for improving newborn care. While application of oil to the newborn is nearly universal in South Asia, little is known about this behavior in Africa. This article draws on literature regarding neonatal skin care in Africa to describe behaviors, motivations and potential for introducing topical emollients. Oil massage does not appear to be universal. When oil massage occurs, substances of unknown toxicity and possibly damaging massage practices are used; thus, there is scope for introduction of improved therapeutic practices. Overall, more research is needed to develop the evidence base of current neonatal skin care behaviors in Africa, and to determine emollient therapy effectiveness there.
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Emolientes/uso terapêutico , Doenças do Prematuro/prevenção & controle , Higiene da Pele/métodos , Administração Tópica , África , Emolientes/efeitos adversos , Humanos , Recém-Nascido , Massagem/métodos , Óleos/administração & dosagem , Qualidade da Assistência à SaúdeAssuntos
Dermatite Alérgica de Contato/etiologia , Emolientes/efeitos adversos , Formaldeído/efeitos adversos , Lonicera/efeitos adversos , Extratos Vegetais/efeitos adversos , Adulto , Emolientes/química , Feminino , Formaldeído/análise , Humanos , Dermatoses da Perna/induzido quimicamente , Lonicera/química , Testes do Emplastro , Extratos Vegetais/química , Embalagem de ProdutosRESUMO
OBJECTIVE: To observe the clinical effectiveness of a topical application of Xiaozheng Zhitong: Paste (, XZP) in alleviating the cancerous pain of patients with middle/late stage cancer METHODS: By: adopting a random number table, 124 patients enrolled were randomized into the treatment group (64 patients) and the control group (60 patients). In addition to the basic therapy [including the three-ladder (3L) analgesia] used in both groups, topical application of XZP was given to patients in the treatment group for pain alleviation. The analgesic efficacy was recorded in terms of pain intensity, analgesia initiating time and sustaining time, and the optimal analgesic effect revealing time. Meanwhile, the quality of life (QOL) and adverse reactions that occurred in patients were recorded as well. RESULTS: The total effective rate in the treatment group was: 84.38% (54/64), and in the control group it was 88.33% (53/60), showing no significant difference between them (P>0.05), but the analgesia initiating time and the optimal analgesia effect revealing time in the treatment group were significantly shorter (both P<0.01). Moreover, XZP was better in improving patients' QOL, showing more significant improvements in the treatment group than those in the control group in aspects of mental condition, walking capacity, working capacity, social acceptability, sleep and joy of living (P<0.05 or P<0.01). Lower incidence of adverse reactions, such as nausea, vomiting, mouth dryness, dizziness, etc., especially constipation, was noted in the treatment group (P<0.05 or P<0.01). CONCLUSION: Applying an external compress: of XZP showed a synergistic action with 3L analgesia for shortening the initiating time and the optimal effect revealing time, and could evidently enhance patients' QOL with fewer adverse reactions.
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Analgésicos/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Emolientes/uso terapêutico , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Dor/complicações , Dor/tratamento farmacológico , Idoso , Analgésicos/efeitos adversos , Medicamentos de Ervas Chinesas/efeitos adversos , Emolientes/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fitoterapia , Qualidade de Vida , Fatores de Tempo , Resultado do TratamentoRESUMO
INTRODUCTION: Prurigo nodularis is a distressing condition characterized by the presence of multiple nodules associated with intense pruritus. OBJECTIVE: To assess the clinical efficacy and safety of betamethasone valerate 0.1% tape and a moisturizing itch-relief cream in prurigo nodularis. METHODS: Twelve patients were enrolled in this pilot comparison of betamethasone valerate 0.1% tape versus a moisturizing itch-relief cream containing feverfew. The study period was 4 weeks. Clinical evaluation was performed weekly. RESULTS: Eleven subjects completed the 4 weeks of therapy. The mean visual analogue scale (VAS) for pruritus at baseline was 8.75 for both sides of the body. The side treated with betamethasone valerate 0.1% tape showed a higher clinical response (VAS score at week 4: 3.9; p < 0.005) compared with the side treated with moisturizing itch-relief cream (VAS score at week 4: 5.6; p < 0.005). CONCLUSION: Both treatments were effective. However, the occlusive dressing enhanced the efficacy of the treatment, preventing scratching.
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Antipruriginosos/uso terapêutico , Valerato de Betametasona/uso terapêutico , Emolientes/uso terapêutico , Curativos Oclusivos , Prurigo/tratamento farmacológico , Fita Cirúrgica , Adulto , Idoso , Antipruriginosos/efeitos adversos , Antipruriginosos/química , Valerato de Betametasona/efeitos adversos , Valerato de Betametasona/química , Emolientes/efeitos adversos , Emolientes/química , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fitoterapia/métodos , Projetos Piloto , Tanacetum parthenium , Resultado do TratamentoAssuntos
Dermatite Atópica/tratamento farmacológico , Emolientes/administração & dosagem , Vitamina A/administração & dosagem , Vitamina D/administração & dosagem , Óleo de Fígado de Bacalhau/administração & dosagem , Óleo de Fígado de Bacalhau/efeitos adversos , Emolientes/efeitos adversos , Humanos , Lanolina/administração & dosagem , Lanolina/efeitos adversos , Pomadas , Parabenos/administração & dosagem , Parabenos/efeitos adversos , Vitamina A/efeitos adversos , Vitamina D/efeitos adversosRESUMO
The etiology of cheilitis is often not readily apparent. We present a case series of four patients with allergic contact cheilitis (ACC) secondary to exposure to peppermint oil contained in a lip balm product. These patients developed eczematous dermatitis involving their lips and perioral skin. They were tested with the North American Contact Dermatitis Group standard series as well as with an expanded series of flavoring agents, sunscreens, plant and fragrance components, and their own products. The lip balm contained potential sensitizers such as propolis, lanolin, coconut oil, almond oil, peppermint oil, and vitamin E. Our patch-test results showed that peppermint oil was the most likely culprit in these patients' ACC. Peppermint oil is less commonly reported as causing ACC than are more common contactants such as balsam of Peru or nickel sulfate. However, with the widespread use of lip balms containing peppermint oil, more cases of peppermint oil-induced ACC may be expected.
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Queilite/etiologia , Dermatite Alérgica de Contato/etiologia , Emolientes/efeitos adversos , Óleos de Plantas/efeitos adversos , Adolescente , Adulto , Bálsamos/administração & dosagem , Bálsamos/efeitos adversos , Queilite/diagnóstico , Óleo de Coco , Dermatite Alérgica de Contato/diagnóstico , Eczema/etiologia , Feminino , Humanos , Lanolina/efeitos adversos , Lanolina/análise , Masculino , Mentha piperita , Pessoa de Meia-Idade , Testes do Emplastro , Óleos de Plantas/administração & dosagem , Óleos de Plantas/análise , Própole/efeitos adversos , Própole/análise , Vitamina E/efeitos adversos , Vitamina E/análiseRESUMO
(1) Plaque psoriasis is the most common form of psoriasis in children. Topical agents should be tried first, especially well-tolerated products such as emollients. Topical corticosteroids are sometimes useful during exacerbations but, given adverse effects, they should only be used for short periods; (2) UVB phototherapy is an option for extensive psoriasis refractory to local treatments, but it carries a long-term risk of skin cancer. Immunosuppressants have not been well assessed in this setting, but methotrexate has been better evaluated than the others.
Assuntos
Emolientes/uso terapêutico , Imunossupressores/uso terapêutico , Psoríase/tratamento farmacológico , Esteroides/uso terapêutico , Acitretina/administração & dosagem , Acitretina/efeitos adversos , Acitretina/uso terapêutico , Administração Tópica , Antralina/administração & dosagem , Antralina/efeitos adversos , Antralina/uso terapêutico , Calcitriol/administração & dosagem , Calcitriol/efeitos adversos , Calcitriol/análogos & derivados , Calcitriol/uso terapêutico , Criança , Ciclosporina/administração & dosagem , Ciclosporina/efeitos adversos , Ciclosporina/uso terapêutico , Fármacos Dermatológicos/administração & dosagem , Fármacos Dermatológicos/efeitos adversos , Fármacos Dermatológicos/uso terapêutico , Emolientes/administração & dosagem , Emolientes/efeitos adversos , Etanercepte , Humanos , Imunoglobulina G/administração & dosagem , Imunoglobulina G/efeitos adversos , Imunoglobulina G/uso terapêutico , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Metotrexato/administração & dosagem , Metotrexato/efeitos adversos , Metotrexato/uso terapêutico , Ácidos Nicotínicos/administração & dosagem , Ácidos Nicotínicos/efeitos adversos , Ácidos Nicotínicos/uso terapêutico , Extratos Vegetais/administração & dosagem , Extratos Vegetais/efeitos adversos , Extratos Vegetais/uso terapêutico , Psoríase/terapia , Receptores do Fator de Necrose Tumoral/administração & dosagem , Receptores do Fator de Necrose Tumoral/uso terapêutico , Salicilatos/administração & dosagem , Salicilatos/efeitos adversos , Salicilatos/uso terapêutico , Esteroides/administração & dosagem , Esteroides/efeitos adversos , Alcatrões/efeitos adversos , Alcatrões/uso terapêutico , Resultado do Tratamento , Terapia UltravioletaRESUMO
There have been concerns regarding the interference in the absorption of fat-soluble vitamins in long-term treatment with mineral oil; however, there is no clear evidence in the literature to support this claim. We present a case report illustrating the effect of prolonged (5 months) large doses of mineral oil on the fat-soluble vitamin absorption in a 17-year-old girl.