Aim: To investigate the efficacy and tolerability of a cream (Rilastil Xerolact PB) containing a mixture of prebiotics and postbiotics, and to validate the PRURISCORE itch scale in the management of atopic dermatitis.Methods: The study is based on 396 subjects of both sexes in three age groups (i.e., infants, children, adults) suffering from mild/moderate Atopic Dermatitis, recruited from 8 European countries and followed for 3 months.Results: The product demonstrated good efficacy combined with good/very good tolerability in all age groups. In particular, SCORAD, PRURISCORE and IGA scores decreased significantly over the course of the study. The PRURISCORE was preferred to VAS by the vast majority of patients.Conclusion: Even though the role of prebiotics and postbiotics was not formally demonstrated since these substances were part of a complex formulation, it can be reasonably stated that prebiotics and postbiotics have safety and standardization features that probiotics do not have. In addition they are authorized by regulatory authorities, whereas topical probiotics are not.
Dermatitis, Atopic , Probiotics , Child , Male , Infant , Adult , Female , Humans , Dermatitis, Atopic/drug therapy , Prebiotics , Probiotics/therapeutic use , Pruritus , Emollients , Severity of Illness Index
The tumor necrosis factor alpha (TNFα) inhibitors have been used with good clinical results in the treatment of juvenile idiopathic arthritis (JIA). Anti TNFα therapy is generally well tolerated. Besides the site injection reactions, other various cutaneous manifestations have been encountered as adverse events. Here, we report four young patients receiving treatment with anti-TNFα (infliximab, adalimumab, and etanercept) for JIA developing different skin manifestations more than 1 year after the initiation of therapy. They underwent a dermatological exam. All four patients were ACR-Ped 30 responders to anti-TNF drugs. The first patient developed cutaneous vasculitis, the second one had lichen planus manifestations, while the third and the fourth developed psoriatic palmoplantar pustulosis accompanied by plaque-type psoriasis localized to the scalp. None of the patients had a personal or family history of dermatological diseases. In the first two patients, skin lesions healed with topical treatment after the discontinuation of anti-TNF agent, while psoriatic lesions did not resolve despite discontinuation of the drug and dermatological treatment. TNF inhibition can be both anti-inflammatory and pro-inflammatory. Cutaneous manifestations could be considered as a paradoxical adverse event of the anti-TNF-alpha treatment not only in rheumatoid arthritis but also in juvenile idiopathic arthritis.
Antibodies, Monoclonal, Humanized/adverse effects , Antibodies, Monoclonal/adverse effects , Arthritis, Juvenile/pathology , Immunoglobulin G/administration & dosage , Immunotherapy , Receptors, Tumor Necrosis Factor/administration & dosage , Skin/pathology , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Adalimumab , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Antibodies, Monoclonal/administration & dosage , Antibodies, Monoclonal, Humanized/administration & dosage , Arthritis, Juvenile/drug therapy , Arthritis, Juvenile/immunology , Etanercept , Female , Follow-Up Studies , Humans , Immunoglobulin G/adverse effects , Infliximab , Lichen Planus/etiology , Lichen Planus/prevention & control , Male , Psoriasis/etiology , Psoriasis/prevention & control , Vasculitis, Leukocytoclastic, Cutaneous/etiology , Vasculitis, Leukocytoclastic, Cutaneous/prevention & control , Young Adult
