Randomized, double-blind, split-side comparison study of moisturizer containing licochalcone vs. 1% hydrocortisone in the treatment of infantile seborrhoeic dermatitis.

BACKGROUND: Infantile seborrhoeic dermatitis (ISD) is a common skin lesion in infants. There may be differences in recommendation for treatment of ISD. OBJECTIVE: To compare the efficacy of moisturizer containing licochalcone vs. 1% hydrocortisone for the treatment of ISD. METHODS: This was a randomized, prospective, split-side, double-blind study that was conducted in 75 infants between the age of 2 weeks and 1 year. Patients with a clinical diagnosis of ISD were treated twice daily, simultaneously with either moisturizer containing 0.025% licochalcone or 1% hydrocortisone on opposite sides of the lesion. The scoring system was used to assess the severity of the rash by the presence of erythema, scale and crusts. The lesions on each side were evaluated on day 0, 3-4, 6-7 and 14. RESULTS: A total of 72 patients completed the study. The moisturizer containing licochalcone group had a higher clearing rate (42%) compared to 1% hydrocortisone group (32%) (P=0.03) on day 3-4. Both products were equally effective in the treatment at day 6-7 and 14 (P=0.45 and 1, respectively). By the end of the second week, the cure rate of the moisturizer containing 0.025% licochalcone and 1% hydrocortisone group was 90% and 92%, respectively. LIMITATIONS: The small sample size was a study limitation. CONCLUSION: Moisturizer containing 0.025% licochalcone had higher cure rate compared to 1% hydrocortisone for the treatment of ISD at day 3-4. However, by the end of the first week, this difference was no longer significant.

Declining trend in the seroprevalence of infection with hepatitis A virus in Thailand.

Since the mid 1970s, infection with hepatitis A virus (HAV) in Thailand has shifted from hyper-endemic to mesoendemic. In 2004, to explore this trend in prevalence further, 3997 subjects from four geographically distinct provinces of Thailand were tested, in a commercial ELISA, for antibodies to HAV. The results indicate that the seroprevalence of HAV continues to fall, almost certainly because the profound socio-economic development that has occurred over the last few decades in Thailand has brought with it significant improvements in sanitation and personal hygiene. As exposure to HAV declines, however, the risks of symptomatic and potentially severe infection in adulthood (rather than asymptomatic infection during childhood) and of epidemics of such infection, which would lead to profound economic loss, increases. Improvements in hygiene and sanitation to reduce exposure to the virus and measures to reduce the incidence of symptomatic disease in those infected, such as vaccination (which may only be cost-effective when targeted at high-risk groups), need to be carefully considered.

Scurvy: a case report.

An 8-year-old child with cerebral palsy came with progressive purpuric rash affecting the trunk and legs. He had tenderness on palpation of his extremities. Physical examination revealed a moderately pale and cachectic boy. There was bleeding per swollen gums and petichiae on the hard palate. Generalized multiple discrete palpable petichiae spots at hair follicles along the whole body, more on both legs, were observed. He also had tenderness on palpation of his extremities. His hemoglobin was 6.6 g/dl. Platelet count and coagulogram were normal. Roentgenographic findings showed generalized osteoporosis, metaphyseal white line of distal femur, proximal tibia. proximal fibula, distal radius, and distal ulna with submetaphyseal lucency bilaterally. Skin biopsy showed dilated hair follicles, filled with keratinous material and a small corkscrew hair. A diagnosis of scurvy was made; and vitamin C at a dosage of 300 mg per day was given. His swollen gums, bleeding per gums and muscle tenderness improved within 2 days. Perifollicular hemorrhage, follicular hyperkeratosis, and anemia improved in 2 and 3 weeks respectively.