Stratum Corneum Ceramide Profiles Provide Reliable Indicators of Remission and Potential Flares in Atopic Dermatitis.

Atopic dermatitis (AD) is a chronic inflammatory skin disease. Prevention of exacerbation of AD is a crucial issue for all physicians. However, exacerbation of AD often is seen during reduction of AD treatment, even with appropriate follow-up by tapered topical corticosteroids and daily topical moisturizers, indicating the need for good indicators of AD remission. We hypothesized that the presence of mutations in FLG or the stratum corneum ceramide profile on AD remission phase may predict the ease of AD exacerbation. This study examined the differences in the frequency of FLG mutations or stratum corneum ceramide profiles (stratum corneum levels and carbon chain length for 11 ceramide classes [ceramides containing nonhydroxy fatty acids and dihydrosphingosines; nonhydroxy fatty acids and sphingosines; nonhydroxy fatty acids and 6-hydroxysphingosines; nonhydroxy fatty acids and phytosphingosines; a-hydroxy fatty acids and dihydrosphingosines; a-hydroxy fatty acids and sphingosines; a-hydroxy fatty acids and 6-hydroxysphingosines; a-hydroxy fatty acids and phytosphingosines; ester-linked fatty acids, o-hydroxy fatty acids, and sphingosines; ester-linked fatty acids, o-hydroxy fatty acids, and 6-hydroxysphingosines; and ester-linked fatty acids, o-hydroxy fatty acids, and phytosphingosines]) at AD remission phase between the two AD study groups: subsequent exacerbation (‒) and (+) of AD. The frequency of FLG mutations did not differ between the study groups. On the other hand, the carbon chain lengths of ceramides containing nonhydroxy fatty acids and dihydrosphingosines, nonhydroxy fatty acids and sphingosines, and nonhydroxy fatty acids and 6-hydroxysphingosines were shorter in the exacerbated AD group than in the maintained-AD group. Thus, the stratum corneum ceramide profile at the remission phase of AD is a potential biomarker, predicting the likelihood of substantial AD remission or subsequent AD exacerbation.

Effects of a moisturizer containing pseudo-ceramide and a eucalyptus extract on sweating function in adult atopic dermatitis: a double-blind, randomized, controlled left-right comparison clinical trial.

BACKGROUND: Many patients with atopic dermatitis (AD) have a decreased ability to sweat. Several factors can cause decreased perspiration, such as weak tight junctions of sweat ducts, reduced acetylcholine receptor function, and inhibition of perspiration by histamines. Parakeratosis of AD skin also decreases sweating by occluding sweat pores. Increased ceramide levels in the stratum corneum reduce parakeratosis by improving stratum corneum functions. Furthermore, ceramides and/or ceramide derivatives may affect claudin-3 and acetylcholine receptors. OBJECTIVE: In this study, we investigated the efficacy of a moisturizer containing pseudo-ceramide and a eucalyptus extract to increase ceramide levels in the epidermis to improve the sweating ability of patients with AD. METHODS: Nineteen patients with AD applied moisturizers with or without pseudo-ceramide and a eucalyptus extract on the cubital fossa of either arm twice a day for 4 weeks. Skin conditions and sweating ability, measured as the response to acetylcholine stimulation, were evaluated prior to the start of the study (Week 0) and at the end of Weeks 2 and 4. RESULTS: Both moisturizers improved the visually evaluated skin symptoms and skin hydration. However, only the moisturizer containing pseudo-ceramide and the eucalyptus extract significantly improved cutaneous barrier function and significantly increased the ceramide level in the stratum corneum. That moisturizer also increased the sweating volume and shortened the latency time for sweating, an indicator of sweating ability, but the other moisturizer did not. CONCLUSION: Based on these results, the moisturizer containing pseudo-ceramide and a eucalyptus extract helps recover the sweat function of AD patients.

Efficacy of a moisturizer containing a pseudo-ceramide and a eucalyptus extract for Japanese patients with mild atopic dermatitis in the summer.

BACKGROUND: Skin moisturizing is advocated to take care of the skin of patients with atopic dermatitis (AD). However, many patients stop using moisturizers in the summer because of excessive sweating and high humidity. OBJECTIVES: To examine the efficacy of a moisturizing gel containing a pseudo-ceramide and a eucalyptus extract, which enhances epidermal ceramide synthesis of patients with mild AD in the summer. METHODS: We performed a single-blinded 4-week clinical trial of body care on 44 Japanese subjects who had mild AD. They had not applied any moisturizer on their body in the summer. Twenty-seven subjects used the moisturizing gel containing a pseudo-ceramide and a eucalyptus extract twice a day and the 17 other subjects did not use any moisturizer. Prior to and at the end of weeks 2 and 4, the skin conditions of each subject were evaluated. RESULTS: During the test period, the atmospheric temperature increased and skin dryness and scaling significantly improved with or without application of the moisturizing gel. However, the improvement in dryness of the treated group was significantly higher than that of the nontreated group. Erythema and itchiness were significantly improved only in the treated group. The skin hydration on the forearm increased significantly only in the treated group. Accompanying those improvements, the quality of life of the subjects, evaluated by Skindex-16® , was significantly improved. CONCLUSION: The usage of a moisturizer containing a pseudo-ceramide and a eucalyptus extract is effective for care of the skin of AD subjects even in the summer.

The efficacy of a pseudo-ceramide and eucalyptus extract containing lotion on dry scalp skin.

OBJECTIVE: Dry and scaly conditions on the scalp are often observed in patients with atopic dermatitis, seborrheic dermatitis and/or pityriasis capitis. Those scalp lesions often exhibit low barrier function and reduced ceramide levels. Therefore, a clinical study was conducted to evaluate the efficacy of topical application of a pseudo-ceramide and eucalyptus extract-containing lotion on the scalps of patients with skin diseases. METHODS: Thirty-four subjects participated in this study (atopic dermatitis: 19 subjects; seborrheic dermatitis: 6 subjects; pityriasis capitis: 9 subjects). After 4 weeks of daily treatment with a pseudo-ceramide and eucalyptus extract-containing lotion, the skin symptoms had significantly improved in all patients with those skin diseases. RESULTS: Skin dryness, scaling, and erythema were significantly improved by treatment with the lotion. The moisture-retention ability of the scalp was significantly increased and itchiness, evaluated using a visual analog scale, decreased significantly. Accompanying those improvements was a significant improvement in the quality of life of the subjects, evaluated by the Skindex-16®. CONCLUSION: From these results, we conclude that this pseudo-ceramide and eucalyptus extract-containing lotion effectively improved the dry and scaly conditions of the scalp as well as the quality of life of subjects with atopic dermatitis, seborrheic dermatitis, or pityriasis capitis.

Effect of surfactant phase behavior on emulsification.

In order to improve our understanding of the effects that the equilibrium phase behavior and structure of amphiphiles have on the emulsification process and the properties of emulsions stabilized by these amphiphiles, we have exploited the known phase behavior of polyoxyethylene-polyoxypropylene-polyoxyethylene (POE-POP-POE) amphiphilic block copolymers (Pluronics) in the presence of two immiscible solvents. Specifically, we considered ternary systems consisting of Pluronic F38, L64, P84, P104, or L121 with water and p-xylene which exhibit a very rich phase behavior, including a variety of water-continuous and oil-continuous lyotropic liquid crystalline (LLC) phases. We prepared emulsions having the same (final) compositions but through different emulsification paths, and evaluated the emulsions on the basis of homogeneity and droplet size. We found finer and more homogenous emulsions to result when O/lamellar gel structures (as revealed by small-angle X-ray scattering) were formed during the emulsification process, or when the emulsification path traversed the lamellar LLC phase. This can be attributed to the favorable properties of the lamellar structure: high oil solubilization capacity with concurrent facile dispersibility in water, relatively low interfacial tension, and relatively low viscosity. The findings reported here are relevant to the preparation of emulsions for diverse applications such as skin-care products, pharmaceuticals, food products, coatings, inks, agrochemicals, oil dispersants, and nanomaterials synthesis.