Clinical and instrumental evaluation of the efficacy of an emollient cream and a cleansing cream in the management of mild to moderate adulthood atopic dermatitis.

BACKGROUND: Atopic dermatitis (AD) is a chronic, recurrent, inflammatory skin disorder which may persist or directly start in adults. This is an open-label prospective study to clinically and instrumentally evaluate the effects of an emollient glycerin and paraffin-based cream and a gentle refatting cleanser in the management of mild to moderate adulthood AD. METHODS: Fifty adult patient with mild to moderate AD were recruited at the Professional Dermatology and Allergology Outpatient Clinic of the San Gallicano Dermatological Institute of Rome, between November 2016 and January 2018. The patients applied the emollient cream twice daily for 2 months. To assess the efficacy of the cream, two different areas of treatment were identified in each patient's limbs. The outcome was evaluated at 30 days (T1) and 60 days (T2) of treatment comparing to baseline (T0) by means of clinical evaluation, Dermatology Life Quality Index (DLQI) questionary, transepidermal waterloss (TEWL) and corneometry measurements. RESULTS: Clinical evaluation showed significative improvement of skin xerosis, fissuring, itching and erythema. Consistently, a significative reduction of TEWL and an improvement in skin hydration was also detected. A significative improvement of DLQI score was also detected. CONCLUSIONS: Study treatment was well tolerated and showed significative improvement of clinical and instrumental parameters evaluated. The topical daily use of an emollient glycerin and paraffin-based cream and a gentle refatting cleanser seems to be a useful tool in the treatment of mild to moderate adulthood AD improving quality of life.

Multicenter clinical trial on a permanent hair dye containing paratoluenediamine.

BACKGROUND: Adverse reactions to hair dyes are frequent and usually caused by sensitization to paraphenylenediamine (PPD). The aim of the study was to evaluate the tolerability of a PPD-free permanent hair dye (Shine On, BioNike, Milan, Italy) containing paratoluenediamine (PTD) in a group of subjects sensitized to PPD. METHODS: The trial, which carried out at four dermatology centers, included subjects sensitized to PPD that turned out negative to patch testing to PTD. The subjects underwent to an open test consisting in the application of two hair dye colors of the product under examination. Finally, subjects who were negative upon the open test were offered to undergo the usage test with the dye, with dermatological evaluations carried out 48 and 96 hours after product application. RESULTS: Sixty subjects were enrolled. They underwent the open test with two shades of dyes: "color 1 - black," the dye color with the highest concentration of color intermediates, and "color 7.3 - golden blonde," the dye color with the highest number of chemically different color intermediates. No reactions occurred with "color 7.3 - golden blonde," while 3 cases (3 out of 60) showed erythema and edema reactions to color 1. The hair dye usage test was negative for all the 21 subjects that were enrolled. CONCLUSIONS: The hair dye evaluated in this study (Shine On, BioNike) can be a valid alternative for subjects sensitized to PPD.

Contact urticaria and protein contact dermatitis from corn in a patient with serum IgE specific for a salt-soluble corn protein of low molecular weight.

Among the cereals, wheat, rye, barley and oats, have been reported to cause protein contact dermatitis. However, in these cases neither the involvement of an immunological mechanism nor the role of specific protein(s) has been demonstrated. We present a case of protein contact dermatitis from corn. The patient presented with a Type I sensitization to corn, as shown by the presence of specific immunoglobulin (Ig)E and positivity to prick tests with both a flour suspension and the salt-soluble protein fraction of this cereal. The same corn preparations induced a strong urticarial reaction on scratch testing. This reaction was followed several days later by the appearance of erythema and then eczema at the site of application. When boiled, these preparations became inactive on both prick and scratch testing. Patch tests were negative in all cases. Immunoblotting performed with the patient's serum showed the presence of a unique IgE-binding protein band with a molecular weight of around 14 kDa, belonging to the salt-soluble corn protein fraction. Our results give the first clear evidence that cornflour can induce protein contact dermatitis. The IgE-binding 14-kDa protein has characteristics identical to those of the trypsin/alpha-amylase inhibitors from cereals.