RESUMEN
Objective: To evaluate the efficacy and safety of nonpharmacological topical interventions for treating breastfeeding nipple pain. Methods: Randomized clinical trials (RCTs) assessing lactating women suffering from breastfeeding painful nipples were included. Primary outcomes were pain, healing process, and adverse events. A comprehensive search was conducted on June 02, 2023, without date or language restrictions. Methodological quality was assessed using the Cochrane risk of bias tool and the certainty of the evidence, the GRADE approach. Results: Nineteen RCTs with unclear to high risk of bias were included. There was uncertain evidence regarding the effects of photobiomodulation versus placebo on pain reduction (mean difference [MD] -0.15; 95% confidence interval [95% CI] -1 0.49 to 1.19; 139 participants, 2 RCTs). There are uncertainties concerning the effects of lanolin versus breast milk on pain (MD -1.80; 95% CI -2.43 to -1.17; 1 RCT; 180 participants), wound healing (MD 0.10; 95% CI -0.26 to -0.46; 1 RCT; 180 participants), and any adverse events (zero events in both groups). Similar effects were observed by the other interventions assessed. Conclusion: The evidence of nonpharmacological topical interventions for painful nipples is imprecise, and future RCTs with higher methodological quality are needed to support recommendations. Considering the accessibility and low cost of these alternative treatments, the findings of this evidence synthesis could support clinical decision-making and guide future research. PROSPERO CRD42020170320.
Asunto(s)
Lactancia Materna , Pezones , Manejo del Dolor , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Femenino , Manejo del Dolor/métodos , Lactancia , Lanolina/uso terapéutico , Dolor , Terapia por Luz de Baja IntensidadRESUMEN
Background: To investigate the efficacy of aloe gel in reducing pain and promoting wound healing in postpartum women with nipple trauma. Method: There were 80 postpartum women who took part in this study having developed nipple trauma during breastfeeding in the obstetrics department of a tertiary grade A hospital in Suzhou from January to December 2021. Postpartum women with nipple trauma whose hospital bed numbers ranged between 15 and 33 were included in the test group, whereas those whose hospital bed numbers ranged between 35 and 53 were included in the control group. Both groups received health education and breastfeeding guidance. The control group applied lanolin cream to their nipple trauma, whereas the test group used aloe gel. We used a nipple trauma severity assessment table to determine the severity of nipple trauma in lactating women and a Visual Analogue Scale (VAS) to determine the level of nipple pain and referred to the Traditional Chinese Medicine Standard for Diagnosis and Therapeutic Efficacy for Diseases and Syndromes to determine the healing time of their wounds. Results: The test group scored 3.70 ± 1.24 and 1.65 ± 0.74 points on the VAS on the first and third days following the intervention, whereas the control group scored 4.30 ± 0.94 and 2.23 ± 1.07 points, respectively. It took 3.75 ± 1.08 days and 4.45 ± 1.15 days for the nipple pain to completely disappear in the test group and the control group, respectively. The healing period for nipple trauma was 5.28 ± 1.26 days for the test group and 6.03 ± 1.61 days for the control group. All of the aforementioned distinctions were statistically significant (p < 0.05). Conclusions: Aloe gel can significantly alleviate the pain associated with nipple trauma in lactating women, accelerate wound healing, and reduce the duration of nipple trauma.
Asunto(s)
Aloe , Lactancia Materna , Geles , Lactancia , Pezones , Cicatrización de Heridas , Humanos , Pezones/lesiones , Femenino , Adulto , Lactancia/efectos de los fármacos , Cicatrización de Heridas/efectos de los fármacos , Lanolina , Dimensión del Dolor , Periodo Posparto , Dolor/tratamiento farmacológico , Dolor/etiologíaRESUMEN
BACKGROUND: Burn damage to skin often results in scarring; however in some individuals the failure of normal wound-healing processes results in excessive scar tissue formation, termed 'hypertrophic scarring'. The most commonly used method for the prevention and treatment of hypertrophic scarring is pressure-garment therapy (PGT). PGT is considered standard care globally; however, there is continued uncertainty around its effectiveness. OBJECTIVES: To evaluate the benefits and harms of pressure-garment therapy for the prevention of hypertrophic scarring after burn injury. SEARCH METHODS: We used standard, extensive Cochrane search methods. We searched CENTRAL, MEDLINE, Embase, two other databases, and two trials registers on 8 June 2023 with reference checking, citation searching, and contact with study authors to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) comparing PGT (alone or in combination with other scar-management therapies) with scar management therapies not including PGT, or comparing different PGT pressures or different types of PGT. DATA COLLECTION AND ANALYSIS: At least two review authors independently selected trials for inclusion using predetermined inclusion criteria, extracted data, and assessed risk of bias using the Cochrane RoB 1 tool. We assessed the certainty of evidence using GRADE. MAIN RESULTS: We included 15 studies in this review (1179 participants), 14 of which (1057 participants) presented useable data. The sample size of included studies ranged from 17 to 159 participants. Most studies included both adults and children. Eight studies compared a pressure garment (with or without another scar management therapy) with scar management therapy alone, five studies compared the same pressure garment at a higher pressure versus a lower pressure, and two studies compared two different types of pressure garments. Studies used a variety of pressure garments (e.g. in-house manufactured or a commercial brand). Types of scar management therapies included were lanolin massage, topical silicone gel, silicone sheet/dressing, and heparin sodium ointment. Meta-analysis was not possible as there was significant clinical and methodological heterogeneity between studies. Main outcome measures were scar improvement assessed using the Vancouver Scar Scale (VSS) or the Patient and Observer Scar Assessment Scale (POSAS) (or both), pain, pruritus, quality of life, adverse events, and adherence to therapy. Studies additionally reported a further 14 outcomes, mostly individual scar parameters, some of which contributed to global scores on the VSS or POSAS. The amount of evidence for each individual outcome was limited. Most studies had a short follow-up, which may have affected results as the full effect of any therapy on scar healing may not be seen until around 18 months. PGT versus no treatment/lanolin We included five studies (378 participants). The evidence is very uncertain on whether PGT improves scars as assessed by the VSS compared with no treatment/lanolin. The evidence is also very uncertain for pain, pruritus, adverse events, and adherence. No study used the POSAS or assessed quality of life. One additional study (122 participants) did not report useable data. PGT versus silicone We included three studies (359 participants). The evidence is very uncertain on the effect of PGT compared with silicone, as assessed by the VSS and POSAS. The evidence is also very uncertain for pain, pruritus, quality of life, adverse events, adherence, and other scar parameters. It is possible that silicone may result in fewer adverse events or better adherence compared with PGT but this was also based on very low-certainty evidence. PGT plus silicone versus no treatment/lanolin We included two studies (200 participants). The evidence is very uncertain on whether PGT plus silicone improves scars as assessed by the VSS compared with no treatment/lanolin. The evidence is also very uncertain for pain, pruritus, and adverse events. No study used the POSAS or assessed quality of life or adherence. PGT plus silicone versus silicone We included three studies (359 participants). The evidence is very uncertain on the effect of PGT plus silicone compared with silicone, as assessed by the VSS and POSAS. The evidence is also very uncertain for pain, pruritus, quality of life, adverse events, and adherence. PGT plus scar management therapy including silicone versus scar management therapy including silicone We included one study (88 participants). The evidence is very uncertain on the effect of PGT plus scar management therapy including silicone versus scar management therapy including silicone, as assessed by the VSS and POSAS. The evidence is also very uncertain for pain, pruritus, quality of life, adverse events, and adherence. High-pressure versus low-pressure garments We included five studies (262 participants). The evidence is very uncertain on the effect of high pressure versus low pressure PGT on adverse events and adherence. No study used the VSS or the POSAS or assessed pain, pruritus, or quality of life. Different types of PGT (Caroskin Tricot + an adhesive silicone gel sheet versus Gecko Nanoplast (silicone gel bandage)) We included one study (60 participants). The evidence is very uncertain on the effect of Caroskin Tricot versus Gecko Nanoplast on the POSAS, pain, pruritus, and adverse events. The study did not use the VSS or assess quality of life or adherence. Different types of pressure garments (Jobst versus Tubigrip) We included one study (110 participants). The evidence is very uncertain on the adherence to either Jobst or Tubigrip. This study did not report any other outcomes. AUTHORS' CONCLUSIONS: There is insufficient evidence to recommend using either PGT or an alternative for preventing hypertrophic scarring after burn injury. PGT is already commonly used in practice and it is possible that continuing to do so may provide some benefit to some people. However, until more evidence becomes available, it may be appropriate to allow patient preference to guide therapy.
Asunto(s)
Quemaduras , Cicatriz , Adulto , Niño , Humanos , Cicatriz/etiología , Cicatriz/prevención & control , Lanolina , Geles de Silicona/uso terapéutico , Quemaduras/complicaciones , Quemaduras/terapia , Dolor , Prurito/etiología , Prurito/prevención & controlRESUMEN
In 2023, lanolin was named the American Contact Dermatitis Society Allergen of the Year. Despite its widespread use in personal care products and industrial goods, lanolin is thought to be a rare sensitizer in patients with healthy skin; however, those with chronic inflammatory skin conditions are at a higher risk for allergic contact dermatitis (ACD) to lanolin. The proper patch test formulation for lanolin is a source of contention. In this article, we discuss ACD to lanolin with a focus on its paradoxical nature and the subtleties to consider when patch testing to this controversial allergen.
Asunto(s)
Alérgenos , Dermatitis Alérgica por Contacto , Humanos , Estados Unidos , Alérgenos/efectos adversos , Lanolina/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Pruebas del ParcheRESUMEN
The Expert Panel for Cosmetic Ingredient Safety reviewed updated information that has become available since their original assessment from 1980, along with updated information regarding product types, and frequency and concentrations of use, and reaffirmed their original conclusion that Isopropyl Lanolate is safe as a cosmetic ingredient in the practices of use and concentration as described in this report.
Asunto(s)
Seguridad de Productos para el Consumidor , Cosméticos , Lanolina , Cosméticos/toxicidadRESUMEN
Lanolin is a complex mixture of high molecular weight esters, aliphatic alcohols, sterols, fatty acids, and hydrocarbons that has been widely used for centuries for its emollient properties. The purification of crude lanolin into lanolin wax and the processing of this wax into various derivatives began in 1882 and continue to this day with newer highly purified anhydrous lanolins. Controversy as to lanolin's allergenicity began in the 1920s and remains an issue. The most appropriate patch test preparation(s) for detecting allergy remain disputed. Detection of lanolin-induced contact dermatitis in diseased skin by patch testing on normal skin may lead to false negative results. Patients with a positive patch test to lanolin may tolerate use of lanolin on normal skin. Although lanolin is a weak sensitizer and the frequency of contact allergy to it in the European population reportedly is 0.4%, there are high-risk concomitant conditions: stasis dermatitis, leg ulcers, perianal/genital dermatitis, and atopic dermatitis (AD). Children and the elderly are also at greater risk of developing contact allergy to lanolin, partly because of comorbidities (AD and stasis dermatitis/leg ulcers, respectively). Finally, in the United States, non-Hispanic white patients are more likely than their non-Hispanic black counterparts to be lanolin allergic.
Asunto(s)
Dermatitis Alérgica por Contacto , Dermatitis Atópica , Úlcera de la Pierna , Niño , Humanos , Anciano , Lanolina/efectos adversos , Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/epidemiología , Alérgenos/efectos adversos , Dermatitis Atópica/complicaciones , Pruebas del Parche/métodos , Úlcera de la Pierna/complicacionesRESUMEN
The management of food and food-related wastes represents a growing global issue, as they are hard to recycle and dispose of. Foremost, waste can serve as an important source of biomasses. Particularly, fat-enriched biomasses are receiving more and more attention for their role in the manufacturing of biofuels. Nonetheless, many biomasses have been set aside over the years. Wool wax, also known as lanolin, has a huge potential for becoming a source of typical and atypical fatty acids. The main aim of this work was to evaluate and assess a protocol for the fractioning of fatty acids from lanolin, a natural by-product of the shearing of sheep, alongside the design of a new and rapid quantitative GC-MS method for the derivatization of free fatty acids in fat mixtures, using MethElute™. As the acid portion of lanolin is characterized by the presence of both aliphatic and hydroxylated fatty acids, we also evaluated a procedure for the parting of these two species, by using NMR spectroscopy, benefitting of the different solubilities of the components in organic solvents. At last, we evaluated and quantified the fatty acids and the α-hydroxy fatty acids present in each attained portion, employing both analytical and synthetic standards. The performed analyses, both qualitative and quantitative, showed a good performance in the parting of the different acid components, and GC-MS allowed to speculate that the majority of α-hydroxylated fatty acids is formed of linear saturated carbon chains, while the totality of properly said fatty acids has a much more complex profile.
Asunto(s)
Ácidos Grasos , Lanolina , Animales , Ovinos , Cromatografía de Gases y Espectrometría de Masas/métodos , Lanolina/química , Espectroscopía de Protones por Resonancia Magnética , Espectroscopía de Resonancia Magnética , Ácidos CarboxílicosRESUMEN
BACKGROUND: Painful and damaged nipples are frequently associated with breastfeeding cessation in the early postpartum period. The results of researchers' studies utilizing different treatments have been inconclusive. RESEARCH AIM: To compare the intensity of nipple pain and the healing of damaged nipples during the first 10 days postpartum using either lanolin or human milk treatments. METHODS: This single-blind randomized controlled trial included participants (N = 206) who were primiparous with painful and damaged nipples. Participants were recruited from the tertiary teaching hospital within the first 72 hr after delivery and randomized to the intervention group with lanolin (n = 103) and a human milk control group (n = 103). Data were collected in the maternity ward, 3 and 7 days after randomization. The primary outcome was nipple pain intensity and quality measured 3 and 7 days after randomization by the McGill Pain Questionnaire - short form. The nipple damage self-assessment questionnaire was used for the assessment of nipple healing. Breastfeeding self-efficacy, breastfeeding duration, and exclusivity were assessed as secondary outcomes. RESULTS: Participants in both groups reported a statistically nonsignificant reduction in pain (quality and intensity of pain) as well as improved nipple healing 7 days after randomization. Participants in the lanolin group exclusively breastfed their infants 3 days after randomization-significantly more often than participants in the control group (p = .026). The study did not reveal any statistically significant differences for other secondary outcomes. CONCLUSION: Both lanolin and human milk are equally effective in treating painful and damaged nipples.Registered with Clinicaltrials.gov (NCT04153513).
Asunto(s)
Lanolina , Leche Humana , Femenino , Humanos , Embarazo , Lanolina/farmacología , Lanolina/uso terapéutico , Lactancia Materna , Pezones , Método Simple Ciego , Dolor/etiologíaRESUMEN
Lanolin, also known as wool wax, is derived from sheep and has diverse applications in food, cosmetic, textile and lubricant industries. Owing to its direct contact with human, there is a need of studying pesticide residues as contaminants in lanolin. The present study describes a single novel hyphenated gas chromatography-tandem mass spectrometry (GC-MS/MS) technique for the quantification of 14 organophosphorus (OP) pesticides (tecnazene, propetamphos, diazinon, dichlofenthion, chlorpyrifos methyl, fenchlorphos, malathion, chlorpyrifos, pirimiphos ethyl, bromophos ethyl, tetrachlorvinphos, ethion, phosalone, and coumaphos) in lanolin using electrospray ionization (EI) with multiple reaction monitoring (MRM) acquisition mode. The method is simple in terms of sample preparation steps based on matrix solid-phase dispersion (MSPD). The method was found to be linear over the analytical range of 0.05-2.0 µg/g, with acceptable coefficient of determination (r2 ≥ 0.99) for all the 14 pesticides. The limit of detection (LOD) and limit of quantification (LOQ) of the method were found to be less than 0.05 and 0.1 µg/g, respectively, for all the 14 OP pesticide residues. The precision and accuracy of the method were found to be within the acceptable limits, that is, recoveries in the range of 83.5%-104.1% with less than 12.5% of relative standard deviation for all the pesticides. The multiresidue method for estimating pesticide residues employing GC-MS/MS technique will be useful for OP pesticide levels in large number of lanolin samples.
Asunto(s)
Cloropirifos , Residuos de Plaguicidas , Plaguicidas , Ovinos , Animales , Humanos , Plaguicidas/análisis , Residuos de Plaguicidas/análisis , Espectrometría de Masas en Tándem/métodos , Lanolina/análisis , Lanolina/química , Compuestos Organofosforados/análisis , Cromatografía de Gases y Espectrometría de Masas/métodos , Cloropirifos/análisisRESUMEN
4,4-Dimethyl-substituted sterols are bioactive minor sterols of most animal fats and plant oils, but higher shares are present in lanolin (wool grease). Here, the isolation of the 4,4-dimethyl-substituted sterols dihydrolanosterol and lanosterol from lanolin by countercurrent chromatography (CCC) is described. An initial examination of the hexane extract of saponified lanolin showed the presence of relatively high portions of fatty alcohols which were known to co-elute with the target analytes in CCC. Hence, fatty alcohols were precipitated by urea complexation. Unexpectedly, 4,4-dimethyl-substituted sterols were also found in the crystalline fraction, while cholesterol and other desmethylsterols were detected in the liquid phase. Urea complexation represented a useful preparative method for the separation of desmethylsterols and 4,4-dimethyl-substituted sterols from lanolin. Shake flask experiments of 4,4-dimethyl-substituted sterols and fatty alcohols with 14 biphasic solvent systems indicated suitable partition coefficients (K values) with n-hexane/ethanol/water (12:8:1, v/v/v) and n-hexane/benzotrifluoride/acetonitrile (20:7:13, v/v/v). After initial tests with conventional CCC, the application of CCC in heart-cut recycling mode provided 4,4-dimethyl-substituted sterols with purities of 99 % (dihydrolanosterol) and 95 % (lanosterol).
Asunto(s)
Distribución en Contracorriente , Hexanos , Acetonitrilos , Animales , Colesterol , Distribución en Contracorriente/métodos , Etanol , Alcoholes Grasos , Lanolina , Lanosterol , Aceites de Plantas , Solventes , Esteroles , Urea , AguaRESUMEN
Wound healing is a complex biological process. In this context, hyaluronic acid (HA) plays an important role in all phases of wound healing, from inflammation to the remodelling process. Nevertheless, its presence in adults decreases by 50% compared to newborns, which drastically reduces tissue regeneration. In this sense, this work presented a new method of extracting HA from chicken combs, as well as the development and in vivo evaluation of an ointment composed of vaseline, lanolin and HA 1% (w/w) for wound healing. The rheological analysis showed that the ointment containing HA has a viscoelastic behaviour. The in vivo test showed on the 7th day that the group treated with the ointment containing HA had a wound area of 0.07 cm2 against 0.09 cm2 of the ointment without HA (vaseline, and lanolin). On the other hand, the groups treated with the HA ointment had a higher mean percentage of collagen and better healing on the 14th day. The results of this paper indicate that the new method used to obtain HA is feasible, low-cost, and easy to obtain. Furthermore, the HA containing ointment improved wound healing. Therefore, the obtained ointment has great potential for use as an effective biomaterial in wound healing.
Asunto(s)
Ácido Hialurónico , Lanolina , Pomadas , Vaselina , Cicatrización de HeridasRESUMEN
BACKGROUND: Lanolin is an important cause of allergic contact dermatitis. OBJECTIVES: The aims of this study were to describe the epidemiology of lanolin allergy and to assess trends in patch test reactions to lanolin over time. METHODS: This study used a retrospective analysis of patients patch tested with lanolin alcohol 30% or Amerchol L-101 50% in petrolatum by the North American Contact Dermatitis Group between 2001 and 2018 (n = 43,691). RESULTS: Overall, 1431 (3.3%) had a positive reaction, and 1238 (2.8%) were currently relevant. Prevalence of lanolin allergy was 4.63% between 2011 and 2018 (P < 0.0001). Most lanolin-allergic patients had + (52%) reactions; 18%, and 6% had ++ and +++ reactions, respectively. Common primary anatomic sites of dermatitis were the hands (20.7%), scattered/generalized distribution (19.6%), and face (17.0%). Allergic reactions to lanolin were more common in children (4.5%) than in adults (3.2%, P = 0.0018). Compared with nonallergic patients, lanolin-allergic patients were more likely to have history of eczema or hay fever, male sex, older than 40 years, or Black race (P < 0.05). Common lanolin sources were personal care products and drugs/medications. Only 2.24% of the positive reactions were linked to occupation. CONCLUSIONS: Lanolin sensitivity was common. Reactions were often clinically relevant and linked to personal care products and medications.
Asunto(s)
Cosméticos , Dermatitis Alérgica por Contacto , Adulto , Alérgenos/efectos adversos , Niño , Cosméticos/efectos adversos , Dermatitis Alérgica por Contacto/epidemiología , Dermatitis Alérgica por Contacto/etiología , Humanos , Lanolina/efectos adversos , Masculino , América del Norte/epidemiología , Pruebas del Parche/efectos adversos , Estudios RetrospectivosRESUMEN
BACKGROUND: Diagnosis of contact allergy (CA) to Amerchol L-101 (AL-101), a marker for lanolin allergy, is problematic. Positive patch test reactions are frequently doubtful or weakly positive and difficult to associate with clinical relevance. OBJECTIVE: To gain further insight on the allergic or irritant nature of skin reactions induced by AL-101 patch test. METHODS: We re-tested in a dose-response fashion, 10 subjects with AL-101 CA and performed comprehensive transcriptomic analysis (gene arrays, quantitative real-time polymerase chain reaction [qRT-PCR]) of samples of their skin reactions. RESULTS: Eight of the 10 CA subjects reacted positively upon re-test, whereas two did not react. Most of AL-101 positive patch tests expressed an allergy signature with strong activation of gene modules associated with adaptive immunity and downregulation of cornification pathway genes. In addition, the breadth of gene modulation correlated with the magnitude of patch test reactions and the concentration of AL-101 applied. However, we observed that some of the positive patch test reactions to AL-101 expressed no/few allergy biomarkers, suggesting the induction of an irritant skin inflammation in these samples. CONCLUSIONS: This study confirms that AL-101 is an allergen that can cause both contact allergy and contact irritation. Our results also highlight that molecular profiling might help to strengthen clinical diagnosis.
Asunto(s)
Dermatitis Alérgica por Contacto , Alérgenos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Dermatitis Alérgica por Contacto/genética , Humanos , Irritantes/efectos adversos , Lanolina , Pruebas del Parche/métodosRESUMEN
Accumulation of anthocyanins in detached leaves and in excised stems of Kalanchoë blossfeldiana kept under natural light conditions in the presence or absence of methyl jasmonate (JA-Me) was investigated. When the abaxial surface of detached leaves was held lower than the adaxial surface (the normal or natural position) under natural light conditions, anthocyanins were not accumulated on the abaxial side of the leaves. In contrast, when the adaxial surface of detached leaves was held lower than the abaxial surface (inverted position), anthocyanins were highly accumulated on the abaxial side of the leaves. These phenomena were independent of the growth stage of K. blossfeldiana as well as photoperiod. Application of JA-Me in lanolin paste significantly inhibited anthocyanin accumulation induced on the abaxial side of detached leaves held in an inverted position in a dose-dependent manner. Anthocyanin accumulation in the excised stem in response to natural light was also significantly inhibited by JA-Me in lanolin paste. Possible mechanisms of anthocyanin accumulation on the abaxial side of detached K. blossfeldiana leaves held in an inverted position under natural light conditions and the inhibitory effect of JA-Me on this process are described. The accompanying changes in the content of primary metabolites and histological analyses were also described.
Asunto(s)
Antocianinas , Kalanchoe , Antocianinas/farmacología , Antocianinas/metabolismo , Kalanchoe/metabolismo , Lanolina/metabolismo , Lanolina/farmacología , Hojas de la Planta/metabolismoRESUMEN
BACKGROUND/OBJECTIVE: Both active and inactive ingredients in topical ophthalmic agents may cause allergic contact dermatitis. Here, we examined ingredients in prescription topical ophthalmic medications available in the United States. METHODS: A comprehensive list of topical ophthalmic medications was generated using AccessPharmacy. Categories included antiglaucoma, antibiotic, antibiotic/corticosteroid, corticosteroid, antiviral, antifungal, mydriatic, and miotic agents. For each formulation, ingredients were investigated using the National Institutes of Health US National Library of Medicine database and/or manufacturer websites. Counts and proportions were calculated for inactive ingredients, including those in the American Contact Dermatitis Society (ACDS) Core 90 Allergen Series. RESULTS: Two hundred sixty-four unique prescription ophthalmic medications met the inclusion criteria. The most common ACDS Core 90 allergen/cross-reactor inactive ingredient was benzalkonium chloride (68.1%, 180/264), followed by sorbates (11.7%, 31/264), parabens (6.8%, 18/264), sodium metabisulfite (3.8%, 10/264), propylene glycol (3.0%, 8/264), and lanolin (3.0%, 8/264). Approximately 21% (20.8%, 55/264) of products had no ACDS Core 90 allergens/cross-reactor inactive ingredients. The most common ACDS Core 90 allergen/cross-reactor active ingredients were aminoglycoside antibiotics, bacitracin/polymyxin B, and corticosteroids. Important non-ACDS Core 90 allergens included inactive ingredients, such as EDTA 28.0% and thimerosal 2.7%, as well as active ingredients, especially ß-blockers. CONCLUSIONS: Benzalkonium chloride, sodium metabisulfite, propylene glycol, and lanolin were common inactive ingredient allergens. Most ophthalmic categories had low allergen formulations available for patients with contact allergy.
Asunto(s)
Alérgenos , Dermatitis Alérgica por Contacto , Hipersensibilidad a las Drogas , Alérgenos/efectos adversos , Dermatitis Alérgica por Contacto/etiología , Humanos , Lanolina/efectos adversos , Oftalmología , Pruebas del Parche , Prescripciones , Propilenglicol/efectos adversos , Sulfitos/efectos adversos , Estados UnidosRESUMEN
Most modern sunscreens contain physical filters, which scatter the sunlight, increasing the photons' pathway in the upper stratum corneum. This effect can lead to a better efficacy of the UV filters and improve the diffuse reflection. However, the addition of nanosized inorganic UV filters reduces the antioxidant capacity of sunscreen formulations. Two cream formulations (F1, F2) which differ in the ingredient PEG75 Lanolin (F2), have been characterized for their radical protection factor (RPF) and their optical properties in vitro using electron paramagnetic resonance (EPR) spectroscopy and UV/VIS spectrometry. The RPF for PEG-75 Lanolin was also determined. Furthermore, their radical protection properties were analyzed on porcine skin ex vivo after visible light irradiation by EPR. The structure of each formulation in the skin surface was determined by reflectance confocal microscopy in vivo. The addition of lanolin increased the reflectance and reduced the transmittance for visible light, improving the scattering drastically. Besides, the antioxidant capacity was also increased for F2, something unpublished until now. F1 presented a lower scattering provided by starches. The sunscreens showed high scattering properties and antioxidant capacity, especially for F2, which presented the lowest radical formation in the skin model. These results are consistent with the RPF measurements where F2 has a higher RPF value (193 ± 3 × 1014 radicals/mg) than F1 (155 ± 4 × 1014 radicals/mg) and for PEG-75 Lanolin (37 ± 1 × 1014 radicals/mg). The combination of starches and PEG-75 Lanolin is the first solution to provide both, light scattering and antioxidant capacity, in sunscreens.
Asunto(s)
Antioxidantes/química , Lanolina/química , Luz , Almidón/química , Protectores Solares/química , Animales , Composición de Medicamentos , Espectroscopía de Resonancia por Spin del Electrón , Piel/efectos de los fármacos , Piel/efectos de la radiación , Factor de Protección Solar , Protectores Solares/farmacología , PorcinosRESUMEN
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.
Asunto(s)
Dióxido de Carbono/administración & dosificación , Técnicas Cosméticas/efectos adversos , Eritema/tratamiento farmacológico , Terapia por Radiofrecuencia/efectos adversos , Rejuvenecimiento , Administración Cutánea , Adulto , Eritema/diagnóstico , Eritema/etiología , Cara , Femenino , Geles , Humanos , Lanolina/administración & dosificación , Persona de Mediana Edad , Pomadas/administración & dosificación , Pomadas/química , Satisfacción del Paciente , Petróleo , Fotograbar , Proyectos Piloto , Estudios Prospectivos , Hipofraccionamiento de la Dosis de Radiación , Terapia por Radiofrecuencia/métodos , Índice de Severidad de la Enfermedad , Método Simple Ciego , Piel/diagnóstico por imagen , Piel/efectos de los fármacos , Piel/efectos de la radiación , Envejecimiento de la Piel/efectos de la radiación , Resultado del TratamientoRESUMEN
BACKGROUND: Lanolin is often included when patch testing for common contact allergens. The clinical relevance of a positive patch test reaction to lanolin markers is, however, still a subject for debate. OBJECTIVES: To evaluate Amerchol L101 as a marker of lanolin allergy and investigate the clinical impact of lanolin-containing moisturizers on healthy and damaged skin using the repeated open application test (ROAT). METHODS: Twelve test subjects and 14 controls were patch tested with Amerchol L 101 and additional lanolin markers. Subsequently, a blinded ROAT was performed on the arms of the study participants for 4 weeks. Each participant applied a lanolin-free cream base and two different lanolin-containing test creams twice daily on one arm with intact skin and on the other arm with irritant dermatitis, induced by sodium lauryl sulfate (SLS). RESULTS: Eleven test subjects (92%) had positive patch test reactions to Amerchol L 101 when retested and one test subject (8%) had a doubtful reaction. None of the study participants had any skin reactions to the ROAT on intact skin and all participants healed during the ROAT on damaged skin. CONCLUSIONS: Lanolin-containing emollients do not cause or worsen existing dermatitis when performing ROAT in volunteers patch test positive to Amerchol L101.
Asunto(s)
Dermatitis Alérgica por Contacto/diagnóstico , Dermatitis Alérgica por Contacto/etiología , Lanolina/análogos & derivados , Pruebas del Parche/métodos , Crema para la Piel/efectos adversos , Estudios de Casos y Controles , Dermatitis Irritante/diagnóstico , Dermatitis Irritante/etiología , Método Doble Ciego , Humanos , Lanolina/efectos adversos , Crema para la Piel/químicaRESUMEN
BACKGROUND: Allergic contact dermatitis (ACD) from topical medication often occurs in occluded areas, for example, with wound treatment, but also in certain body locations, such as the anogenital area. OBJECTIVES: To investigate the demographics and specific lesion location of patients with ACD from topical drugs applied onto the (peri)anal/genital area, and to identify the respective causal topical pharmaceutical products and ingredients involved. METHODS: From January 2000 to December 10, 2018, 532 patients were tested with the baseline series, sometimes with additional series, and the topical medication used along with the ingredients. The relevant data were extracted from our electronic databases developed in-house. RESULTS: Forty-four patients (9%) out of 473 patients suffering from lesions in the (peri)anal/genital area had positive patch test results to topical drug preparations and/or their ingredients, sometimes in association with cosmetics for intimate hygiene. The most frequent sensitizing active principles were local anaesthetics and corticosteroids, while wool alcohols and to a minor extent benzoic acid were the most frequent culprits among the vehicle components and preservative agents, respectively. CONCLUSIONS: The local conditions (eg, occlusion, sweating, moist) in the anogenital area may favour skin sensitization to topical medication used to treat various skin diseases.