Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 976
Filtrar
1.
Medicine (Baltimore) ; 99(18): e19764, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358349

RESUMO

INTRODUCTION: Acne vulgaris is a chronic inflammatory disease of the sebaceous glands that occurs in adolescent men and women. In recent years, the incidence of acne has increased year by year, so it is of great significance to find a precise and effective treatment and further explore its possible mechanism of action. The purpose of this study will be to explore a treatment method that has both traditional Chinese medicine characteristics and significant effects, and provides a higher level of evidence for acupuncture for acne vulgaris. It also provides patients with more treatment options. METHODS/DESIGN: The study will be a randomized controlled trial divided into 2 parallel groups. This pragmatic randomized controlled trial will recruit 66 patients who are diagnosed with acne vulgaris. 30-minutes acupuncture sessions will be provided to patients assigned to the intervention group. All participants will continue to receive conventional treatment. The selection of outcomes will be evaluated by the skin lesions score scale. DISCUSSION: This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of acupuncture for patients with acne vulgaris. TRIAL REGISTRATION NUMBER: CTR2000030427.


Assuntos
Acne Vulgar/terapia , Terapia por Acupuntura/métodos , Medicina Tradicional Chinesa/métodos , Creme para a Pele/administração & dosagem , Vitamina A/administração & dosagem , Administração Tópica , Adolescente , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Adulto Jovem
2.
Chem Biol Interact ; 318: 108980, 2020 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-32044340

RESUMO

In this study, we assessed the efficacy of the Reactive Skin Decontamination Lotion (RSDL®) Kit against parathion and aldicarb pesticide dermal exposure in a guinea pig model. The pesticides inhibit acetylcholinesterase (AChE) leading to signs and symptoms of hyperactivity of organs due to accumulation of acetylcholine. The RSDL Kit has been shown to physically remove and chemically degrade chemical warfare agents. Degradation occurs from a nucleophilic substitution reaction between an active ingredient in the RSDL lotion, potassium 2,3-butanedione monoximate (KBDO), with susceptible sites in these compounds. In the present study, guinea pigs dermally exposed to parathion and aldicarb were decontaminated with RSDL to mitigate the toxic effects of the pesticides. It is observed that animals exposed to 749 mg/kg of parathion (n = 3) died within 24 h without RSDL decontamination; however, RSDL-treated animals (n = 3) showed only mild signs of neurotoxicity. The RSDL-treated animals had an AChE inhibition of 0-58% while the untreated animals had up to 86% inhibition. Similarly, RSDL has been demostrated to prevent aldicarb neurotoxicity effects. The percent inhibition of AChE activity during the 24 h post challenge of 9 mg aldicarb/kg of animal weight ranged from 25% to 61% with severe signs of intoxication while only up to 5% with mild or no signs of intoxication in the case of RSDL-decontaminated animals. Generally, it has been shown that the toxic effects of the organophosphate and carbamate pesticides can be prevented via decontamination using the RSDL Kit.


Assuntos
Aldicarb/toxicidade , Descontaminação/métodos , Inseticidas/toxicidade , Paration/toxicidade , Aldicarb/química , Animais , Cobaias , Inseticidas/química , Paration/química , Higiene da Pele/métodos , Creme para a Pele
3.
J Forensic Sci ; 65(1): 84-89, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31454431

RESUMO

Impressions of friction ridges left on a surface are important evidence for identifying an individual and can be used to confirm his or her presence at the scene of an incident. Factors influencing the durability of fingerprints include the physiological characteristics and cleanliness of the individual, environmental factors, and time. The aim of the study was to determine the effect of atmospheric factors, gender, hand cleanliness and time on the width of friction ridge impressions and the amount of material forming the print. The research shows that factors such as gender, ambient conditions, and hand cleanliness affect the width of the ridge impressions and the quantity of material forming the print. The passage of time significantly reduces both the width of the ridge impressions and the quantity of the material forming the print.


Assuntos
Dermatoglifia , Higiene das Mãos , Manejo de Espécimes , Adulto , Escuridão , Exposição Ambiental , Feminino , Humanos , Luz , Masculino , Microscopia , Fatores Sexuais , Creme para a Pele , Temperatura , Fatores de Tempo , Adulto Jovem
4.
Toxicol Lett ; 319: 237-241, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31738974

RESUMO

The RSDL® (Reactive Skin Decontamination Lotion) Kit contains a lotion-impregnated sponge extensively studied for the removal or neutralization of chemical warfare agents from skin. Pilot investigation of efficacy with industrial threat compounds noted that synthetic opioid fentanyl citrate was removed by the RSDL Kit but not chemically inactivated by the lotion. This implies that after use the RSDL Kit will contain intact fentanyl, which may pose a dermal health hazard if the fentanyl is then transferred to skin after use without proper handling. This in vitro investigation studied the contaminated RSDL Kit using three different concentrations of fentanyl with a skin contact time of 15 min under direct interaction from passive contact, light touch, and leaning with one hand. It was demonstrated that the expected transfer of fentanyl from contaminated RSDL depends on 1) the concentration of fentanyl and 2) the area of the exposed surface. From a toxicological perspective, the contact risk of fentanyl under the conditions tested can be considered low but not absent. The present study determined that a contaminated RSDL Kit, used for removal of fentanyl, should be handled with proper care. Use of protective gloves in operational use and washing skin afterwards is advised to prevent undesired contamination.


Assuntos
Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/análise , Contaminação de Medicamentos , Fentanila/efeitos adversos , Fentanila/análise , Creme para a Pele/efeitos adversos , Creme para a Pele/análise , Animais , Substâncias para a Guerra Química/química , Técnicas In Vitro , Projetos Piloto , Medição de Risco , Absorção Cutânea , Suínos
5.
Eur J Pharm Sci ; 141: 105110, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31654757

RESUMO

BACKGROUND: Allergic contact dermatitis (ACD) is a highly prevalent inflammatory and immune skin disease accompanied with persistent pruritus and pain. Oxymatrine (OMT) exhibits antipruritic and anti-inflammatory effects in squaric acid dibutyl ester (SADBE) induced ACD mice model, but the need for frequent administration stipulated by short half-life and low bioavailability limits clinical application. OBJECTIVE: To evaluate the analgesic and antipruritic effects of OMT gel (OG), OMT sustained release microgel powder (OMP) and OMT sustained release microgel cream (OMC) in SADBE induced ACD mice, with subsequent study of the mechanism and side effects (irritation) of optimal dosage form. METHOD: On day 11, the thickness of the right cheek skin of mice was measured and mice spontaneous behaviors were recorded for 1.5 h. In the OMC experiment, hematoxylin-eosin and toluidine blue staining were performed on the cheek skin, and the irritation of OMC was tested on the back skin of rabbits. Blood analyzer was used to measure the counts of inflammatory cells in peripheral blood. The mRNA expressions of IL-1ß, TNF-α, CXCR3, CXCL10, IL-6, IL-10, IL-17A and IL-31 in cheek skin, TRPA1 and TRPV1 channels in trigeminal ganglion (TG), IFN-γ in spleen and IL-17A in thymus were measured by RT-qPCR. RESULTS: OMC, OMP and OG significantly decreased wipes and scratching bouts, alleviated skin inflammation. OMC required less frequent administration and is easier to apply, while its antipruritic effect was stronger than the analgesic effect. OMC rescued the deficits in epidermal keratinization and inflammatory cell infiltration, decreased the leukocyte count in peripheral blood, had no irritation to the broken rabbit's skin. Furthermore, OMC significantly down-regulated the mRNA expression of IL-1ß, TNF-α, CXCR3, CXCL10, IL-6, IL-10, IL-17A and IL-31 in cheek skin, TRPA1 and TRPV1 channels in TG, IFN-γ in thymus and IL-17A in spleen. CONCLUSION: We have demonstrated that OMC exhibits advanced analgesic, antipruritic and anti-inflammatory effects when compared with OG and OMP in ACD mice by regulating inflammation, chemokines, immune mediators and inhibiting the mRNA expression of TRPA1 and TRPV1. OMC has no irritation to the intact and damaged skin of rabbits.


Assuntos
Alcaloides/administração & dosagem , Analgésicos/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Antipruriginosos/administração & dosagem , Dermatite Alérgica de Contato/tratamento farmacológico , Dor/tratamento farmacológico , Prurido/tratamento farmacológico , Quinolizinas/administração & dosagem , Creme para a Pele/administração & dosagem , Animais , Comportamento Animal/efeitos dos fármacos , Citocinas/genética , Citocinas/imunologia , Preparações de Ação Retardada/administração & dosagem , Dermatite Alérgica de Contato/genética , Dermatite Alérgica de Contato/patologia , Modelos Animais de Doenças , Géis , Masculino , Camundongos Endogâmicos C57BL , Dor/genética , Dor/imunologia , Dor/patologia , Prurido/genética , Prurido/imunologia , Prurido/patologia , Coelhos , Pele/efeitos dos fármacos , Pele/imunologia , Pele/patologia
6.
Medicine (Baltimore) ; 98(52): e18230, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876704

RESUMO

BACKGROUND: Acute radiation dermatitis (ARD) is a common adverse effect in patients undergoing radiotherapy. Mometasone furoate cream (MMF) was reported to significantly reduce ARD, especially in breast cancer. Clinically, ARD is more critical and more difficult to prevent in patients with head and neck squamous cell carcinoma (HNSCC) than in those with breast cancer, because a higher dose of radiotherapy is required in HNSCC cases. The aim of this study was to evaluate the effect of MMF local application on radiation dermatitis in patients with HNSCC. METHODS: HNSCC patients scheduled for bilateral radical radiotherapy to the neck with identical radiation doses were enrolled. One side of the neck skin (test groups) of the patients were randomized to apply a thin layer of MMF once a day from the date of first radiotherapy until either 2 weeks after end of radiotherapy or until the test side skin developed ARD lesions, while the other side of neck (control groups) didn't apply any medication. The severity of ARD was evaluated weekly by using the modified radiation therapy oncology group score, pain intensity, and itch stages. RESULTS: Forty-one patients (82 targets) were analyzed. There was a significant difference between the ARD scores on the test side and the control side. MMF reduced the stages of ARD when the radiotherapy dose was <6000 cGY (P = .01) but showed no improvement when the dose was ≥6000 cGY (P = .699). Compared to the control side, local application of MMF significantly reduced the itch and pain scores of the test side skin regardless of the radiotherapy dose and ARD stage (P < .001) during radiotherapy. CONCLUSIONS: This study showed that MMF inunction after high-dose radiotherapy (>50 Gy) can prevent ARD, especially when the radiation dose is <6000 cGY.


Assuntos
Carcinoma de Células Escamosas/radioterapia , Neoplasias de Cabeça e Pescoço/radioterapia , Furoato de Mometasona/uso terapêutico , Radiodermatite/prevenção & controle , Administração Cutânea , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Furoato de Mometasona/administração & dosagem , Estudos Prospectivos , Autocuidado/métodos , Creme para a Pele , Adulto Jovem
7.
BMC Infect Dis ; 19(1): 1005, 2019 Nov 28.
Artigo em Inglês | MEDLINE | ID: mdl-31779597

RESUMO

BACKGROUND: Lupoid cutaneous leishmaniasis (LCL) is known as a rare but serious complication of anthroponotic cutaneous leishmaniasis (ACL) resistant to conventional treatments. Sodium chlorosum, a pro-oxidative preparation of pharmaceutical sodium chlorite (NaClO2), has been successfully used for the treatment of Old World cutaneous leishmaniasis lesions (OWCL) and of some LCL cases in Afghanistan. This clinical trial study aimed to evaluate the effect of a last resort therapy with topical 0.09% sodium chlorosum on LCL in Iran. METHODS: Twenty Iranian patients (12 women and 8 men) with LCL refractory to treatment were included in this salvage study. A magistral preparation of sodium chlorosum (10 mM NaClO2 in amphiphilic basic cream) was applied twice daily to the lesions for 6 weeks and continued up to 12 weeks in patients who showed a clinical response within the first 6 weeks. Responders were followed up for a maximum of 1 year. Lesions were photographed during weekly visits. Disappearance of erythema and indurated lesions were rated as complete clinical response. RESULTS: Patients with a mean age of 28.6 (±24.3) and with an ACL proven lesion history of 3.8 (±1.4) years were treated for an average of 7.9 (±1.8) weeks. At the end of the treatment period (12th week), a complete response was observed in 9 of 20 patients (45%). During the one-year follow-up period, LCL lesions recurred in 4 of these 9 patients (with one patient showing only a tiny lesion) and one case lost to follow up whereas the other four remained completely lesion-free. Mild temporary side-effects such as erythema and itching were seen in 4 of 20 patients (20%). CONCLUSIONS: Topical sodium chlorosum showed promising therapeutic results and can be considered as safe, painless, and relatively effective treatment for LCL, an ethical prerequisite for a two-armed controlled trial. TRIAL REGISTRATION: This study was registered in Iranian registry of clinical trials on 2019-02-02 with registration number IRCT20190114042356N1.


Assuntos
Cloretos/uso terapêutico , Leishmaniose Cutânea/tratamento farmacológico , Administração Tópica , Adolescente , Adulto , Criança , Pré-Escolar , Cloretos/efeitos adversos , Resistência a Medicamentos , Eritema/etiologia , Feminino , Humanos , Irã (Geográfico) , Leishmaniose Cutânea/terapia , Masculino , Pessoa de Meia-Idade , Terapia de Salvação , Creme para a Pele/efeitos adversos , Creme para a Pele/química , Creme para a Pele/uso terapêutico , Resultado do Tratamento , Adulto Jovem
8.
Pharm Res ; 36(12): 180, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31728737

RESUMO

PURPOSE: To examine the potential of stratum corneum (SC) sampling via tape-stripping in humans to assess bioequivalence of topical acyclovir drug products, and to explore the potential value of alternative metrics of local skin bioavailability calculable from SC sampling experiments. METHODS: Three acyclovir creams were considered in two separate studies in which drug amounts in the SC after uptake and clearance periods were measured and used to assess bioequivalence. In each study, a "reference" formulation (evaluated twice) was compared to the "test" in 10 subjects. Each application site was replicated to achieve greater statistical power with fewer volunteers. RESULTS: SC sampling revealed similarities and differences between products consistent with results from other surrogate bioequivalence measures, including dermal open-flow microperfusion experiments. Further analysis of the tape-stripping data permitted acyclovir flux into the viable skin to be deduced and drug concentration in that 'compartment' to be estimated. CONCLUSIONS: Acyclovir quantities determined in the SC, following a single-time point uptake and clearance protocol, can be judiciously used both to objectively compare product performance in vivo and to assess delivery of the active into skin tissue below the barrier, thereby permitting local concentrations at or near to the site of action to be determined.


Assuntos
Aciclovir/farmacocinética , Antivirais/farmacocinética , Creme para a Pele/farmacocinética , Aciclovir/administração & dosagem , Administração Tópica , Adulto , Antivirais/administração & dosagem , Disponibilidade Biológica , Transporte Biológico , Liberação Controlada de Fármacos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Permeabilidade , Pele/metabolismo , Absorção Cutânea , Creme para a Pele/administração & dosagem , Equivalência Terapêutica
9.
Forensic Sci Int ; 305: 109968, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31622855

RESUMO

In the present study, an ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed, validated, and applied for measuring cortisol in human hair. Baseline levels of cortisol in hair were taken from 12 control subjects, with concentrations for adult controls (n = 8) of 1.7 to 9.1 pg/mg and a median of 4.7 pg/mg and for child controls (n = 4) of 1.1 to 7.2 pg/mg and a median of 3.1 pg/mg. However, the concentrations in the hair of two children whose mother had been applying a cortisol-containing hand cream 2-3 times per week ranged from 30 to 390 pg/mg. No external contamination was observed with the children as judged from wash water concentrations. The mother had hair cortisol concentrations of 80-220 pg/mg. External contamination was observed in her proximal hair segments (0-4 cm) but not in distal ones (8-12 cm). In an experiment, cortisol cream (1%) was applied on the fingers of a subject, who then scratched the head hair once in a while. Hair was collected 1, 5, and 30 days after exposure to the cream. The cortisol level in the hair one day after exposure was 20-186 times higher than the pre-exposure level. High levels in the wash fraction agreed with external contamination. Cortisol concentrations in the hair at 5 and 30 days after exposure were 15-38 and 9-11 times higher, respectively, than the pre-exposure levels. However, no external contamination was suggested from the wash water concentrations in the hair collected 5 and 30 days after exposure. The results showed that the externally applied cortisol had, after some time, been incorporated into the hair matrix and was not removed by a pre-analysis washing. Therefore, the use of a standard decontamination procedure prior to analysis of hair may not be able to prevent the spread of cortisol from applied hand cream within a family.


Assuntos
Anti-Inflamatórios/análise , Cabelo/química , Hidrocortisona/análise , Creme para a Pele , Anti-Inflamatórios/uso terapêutico , Estudos de Casos e Controles , Pré-Escolar , Cromatografia Líquida , Dermatite Atópica/tratamento farmacológico , Família , Feminino , Dermatoses da Mão/tratamento farmacológico , Humanos , Hidrocortisona/uso terapêutico , Lactente , Masculino , Espectrometria de Massas em Tandem
10.
J Drugs Dermatol ; 18(10): 1012-1018, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584780

RESUMO

Background: The use of topical therapy is a key component in the management of almost all psoriasis patients. Topicals are considered first-line therapy for mild disease and are having an increasing role in moderate or severe psoriasis as an integral part of combination therapy. Halobetasol has been shown be effective in moderate or severe localized plaque psoriasis, and tazarotene affords important effects on epidermal hyperproliferation that may be important in more severe disease. Objective: To investigate the efficacy, safety and tolerability of a once-daily application of a fixed combination halobetasol propionate 0.01% and tazarotene 0.045% (HP/TAZ) lotion in comparison with its vehicle in patients with severe localized plaque psoriasis (as defined by an Investigator Global Assessment (IGA) of 4 and Body Surface Area (BSA) of 3%-12%. Methods: Post hoc analysis of two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies. Sixty-two patients with severe localized psoriasis (mean BSA 7.4) randomized (2:1) to receive HP/TAZ lotion or vehicle, once-daily for 8 weeks, with a 4-week posttreatment follow-up. Efficacy assessments included treatment success (defined as at least a 2-grade improvement from baseline in the IGA score and a score of 'clear' or 'almost clear'), impact on individual signs of psoriasis (erythema, plaque elevation, and scaling) at the target lesion, BSA, reduction in mean baseline IGAxBSA and achievement of a clinically meaningful response (number of patients who achieved at least a 75% improvement in IGAxBSA). Safety and treatment emergent adverse events (TEAEs) were evaluated throughout. Results: By week 8, 34.8% of patients were treatment successes compared with 0.0% on vehicle (P=0.004). HP/TAZ lotion was also significantly superior in reducing psoriasis signs and symptoms and improving BSA. At week 8, 47.4% (erythema), 66.4% (plaque elevation), and 65.4% (scaling) subjects achieved at least a 2-grade improvement, compared with 14.0% (P=0.016), 14.8% (P<0.001) and 14.7% (P<0.001) respectively with vehicle. Patients treated with HP/TAZ lotion achieved a 32.8% reduction in baseline mean BSA, compared with a 39.6% increase with vehicle (P=0.013). HP/TAZ lotion achieved a statistically significant superior reduction in mean IGAxBSA compared to vehicle from week 2 (P<0.001 versus vehicle). By week 8, almost half of the patients treated with HP/TAZ lotion achieved a clinically meaningful response (IGAxBSA-75) and a 52.9% reduction in mean IGAxBSA score compared with a 17.5% increase in those patients treated with vehicle (P<0.001). One patient (2.6%) treated with HP/TAZ lotion discontinued due to AE. Most frequently reported treatment related AEs were application site pain (7.9%), contact dermatitis (5.3%) and pruritus (5.3%). Conclusions: HP/TAZ lotion provides significantly greater efficacy than vehicle that is both rapid and sustained, in patients with severe localized plaque psoriasis, with good tolerability and safety over 8 weeks' once-daily use. J Drugs Dermatol. 2019;18(10):1012-1018.


Assuntos
Clobetasol/análogos & derivados , Fármacos Dermatológicos/administração & dosagem , Ácidos Nicotínicos/administração & dosagem , Psoríase/tratamento farmacológico , Creme para a Pele/administração & dosagem , Adulto , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Dermatite de Contato/epidemiologia , Dermatite de Contato/etiologia , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ácidos Nicotínicos/efeitos adversos , Dor/epidemiologia , Dor/etiologia , Prurido/epidemiologia , Prurido/etiologia , Psoríase/diagnóstico , Índice de Gravidade de Doença , Creme para a Pele/efeitos adversos , Resultado do Tratamento
11.
J Drugs Dermatol ; 18(10): 1029-1036, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584782

RESUMO

Background: Psoriasis is a chronic, immune-mediated disease that varies widely in its clinical expression. Topical corticosteroids (TCS) are the mainstay of treatment. Long-term safety remains a concern, limiting use, and posttreatment flare is common. Recently data were reported on the use of halobetasol propionate (HP) 0.01% lotion in moderate or severe localized plaque psoriasis, once-daily for 8 weeks. In addition, a 2-week label-restricted study reported comparable efficacy to HP 0.05% cream. Data evaluating efficacy in specific locations has not been reported and while psoriasis commonly affects lower extremities treatment can be more problematic and burden of disease heightened. Objective: To investigate the efficacy of a once-daily application of HP 0.01% lotion in comparison with its vehicle in patients with moderate-to-severe plaque psoriasis of the lower extremities. Methods: A post hoc analysis of two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies in moderate or severe psoriasis. Subjects (N=234) where the leg was identified as the target lesion were randomized (2:1 ratio) to receive HP 0.01% lotion or vehicle, once-daily for 8 weeks. Efficacy assessments included treatment success (defined as at least a 2-grade improvement from baseline) in each individual sign of psoriasis (erythema, plaque elevation, and scaling) at the target lesion (leg) and overall treatment outcomes including at least a 2-grade improvement from baseline in the Investigator Global Assessment (IGA) score, and 'clear' or 'almost clear', improvement in Body Surface Area (BSA) and reduction in IGAxBSA. Quality of Life (QoL) was assessed using the Dermatology Life Quality Index (DLQI) at baseline, week 4, 8, and 12. Results: At the end of the 8-week treatment period, more than half of subjects had achieved treatment success, with 52.1%, 55.5%, and 58.2% of subjects achieving at least a 2-grade reduction in erythema, plaque elevation and scaling severity on the leg, compared with 15.7% and 22.9%, and 22.2% of those treated with vehicle (P<0.001). In addition, overall treatment success (IGA) was achieved in 37.1% of these subjects who had been treated with HP 0.01% lotion compared with 8.4% treated with vehicle (P<0.001); with a corresponding 34.2% reduction in baseline BSA and 50.5% change in mean baseline IGAxBSA (both P<0.001 versus vehicle). Overall, a clinically relevant improvement in QoL was achieved by week 4; by week 8 37.7% of subjects where the leg was the target lesion had a clinically meaningful improvement in disease severity (IGAxBSA-75). Conclusions: In conclusion, halobetasol propionate 0.01% lotion provides statistically significant efficacy following 8 weeks' therapy compared with vehicle in subjects where the leg was identified as the target lesion, with clinically relevant improvements in QoL and more than a third of subjects achieving a clinically meaningful result. J Drugs Dermatol. 2019;18(10):1029-1036.


Assuntos
Clobetasol/análogos & derivados , Fármacos Dermatológicos/administração & dosagem , Psoríase/tratamento farmacológico , Creme para a Pele/administração & dosagem , Adulto , Idoso , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Extremidade Inferior , Masculino , Pessoa de Meia-Idade , Psoríase/diagnóstico , Qualidade de Vida , Índice de Gravidade de Doença , Creme para a Pele/efeitos adversos , Resultado do Tratamento
12.
J Drugs Dermatol ; 18(10): 1038-1045, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584783

RESUMO

Objective: The study was conducted to determine the efficacy of the botanical combination incorporated in Kamedis Eczema Therapy Cream (the test product) for children with mild to moderate atopic dermatitis. Design: The study was designed as an interventional, multi-center, double-blind, randomized, controlled study. Setting: Children subjects were a sub-population of the 108 combined population of adults and children evenly randomly divided into three treatment groups: test product, vehicle, and comparator. The vehicle used was the identical test product without the botanical combination while the comparator was a leading OTC brand in the US market. All three groups used the same Kamedis body wash followed by one of the three randomized treatment creams for the affected areas. Participants: Thirty-nine (39) children subjects with uncomplicated, stable, mild to moderate atopic dermatitis were recruited and qualified for the study, 24 female and 15 male, ages varying between 3 and 18. Measurements: Investigators assessed the severity of each subject using the Investigator Global Assessment (IGA), affected Body Surface Area (BSA) extent evaluated parameters at each of the visit days 0, 7, 14, and 28. Subjective symptoms of pruritus and insomnia were evaluated by the patient or their legal guardian. The SCORAD and EASI indexes were calculated based on the collected parameters. Results: The test product demonstrated an improvement in all evaluated and calculated clinical parameters over the vehicle at the end of the treatment duration, proving the validation that the test product is much more effective and beneficial than the vehicle. The test product reached 40% of 'clear' IGA subjects out of the enrolled subjects and 60% out of the 'clear' and 'almost clear' IGA subjects comparing to 8% and 38%, respectively, with the vehicle, presenting a clear advantage over the vehicle. The BSA improvement comparison analysis of the test product over the vehicle yielded P value of less than 0.05, which is statistically significant. The SCORAD and EASI indexes also showed an advantage of the test product versus the vehicle at week 4. Conclusion: The study results validate that the botanical combination is the key factor for the efficacy and improvement of the AD symptoms within this population of children. J Drugs Dermatol. 2019;18(10):1038-1045.


Assuntos
Dermatite Atópica/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Creme para a Pele/administração & dosagem , Adolescente , Criança , Pré-Escolar , Dermatite Atópica/diagnóstico , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Masculino , Extratos Vegetais/efeitos adversos , Índice de Gravidade de Doença , Creme para a Pele/efeitos adversos , Resultado do Tratamento
13.
Nat Hum Behav ; 3(12): 1295-1305, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31636406

RESUMO

Medical treatments typically occur in the context of a social interaction between healthcare providers and patients. Although decades of research have demonstrated that patients' expectations can dramatically affect treatment outcomes, less is known about the influence of providers' expectations. Here we systematically manipulated providers' expectations in a simulated clinical interaction involving administration of thermal pain and found that patients' subjective experiences of pain were directly modulated by providers' expectations of treatment success, as reflected in the patients' subjective ratings, skin conductance responses and facial expression behaviours. The belief manipulation also affected patients' perceptions of providers' empathy during the pain procedure and manifested as subtle changes in providers' facial expression behaviours during the clinical interaction. Importantly, these findings were replicated in two more independent samples. Together, our results provide evidence of a socially transmitted placebo effect, highlighting how healthcare providers' behaviour and cognitive mindsets can affect clinical interactions.


Assuntos
Atitude , Empatia , Relações Interpessoais , Dor/prevenção & controle , Efeito Placebo , Adolescente , Adulto , Expressão Facial , Feminino , Resposta Galvânica da Pele , Humanos , Masculino , Motivação , Estimulação Física , Creme para a Pele , Adulto Jovem
14.
Pak J Pharm Sci ; 32(3 Special): 1361-1370, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31551216

RESUMO

The aim of the present study was the healing effect and anti-inflammatory effect of Jinjianling cream on skin lesions and to investigate the antibacterial activity in vitro, which proved that the preparation is safe and effective. The mouse scald model was established to observe the wound healing time and wound healing rate of mice, serum levels of TNF-α and IL-1 were measured by the ELISA method. The model of eczema in mice was induced by DNCB, and the degree of ear swelling in mice was calculated. The hematoxylin-eosin (HE) staining was used to make pathological sections and count inflammatory cells, and the change of serum IL-2 level was determined by the ELISA method. The bacteriostasis rate was determined by pour plate method, the diameter of inhibition zone (DIZ) was determined by filter paper diffusion method and the minimum inhibitory concentration (MIC) was determined by double dilution method. After treatment, the effect of Jinjianling cream groups on the healing of damaged skin in scalded mice was significant. The serum levels of TNF-a and IL-1 decreased, which were lower than those in the model group (p<0.05, p<0.01). In the mouse eczema model, the degree of ear swelling improved significantly, serum IL-2 level was decreased, and inflammatory cell count was significantly than the model group (p<0.05, p<0.01). The results of antibacterial experiments showed that bacteriostasis rate was positively correlated with drug concentration. DIZ values of bacteriostatic circle on Staphylococcus aureus and Escherichia coli were 17.25mm and 25.62mm. Moreover, the MIC values of two kinds of bacteria all were 64µg/mL. Jinjianling cream can promote the healing ability of damaged skin and reduce inflammation of the wound. It also has a strong inhibitory effect on wound pathogenic bacteria, can significantly improve wound healing and effectively treat dermatitis, eczema and other skin diseases.


Assuntos
Antibacterianos/farmacologia , Medicamentos de Ervas Chinesas/farmacologia , Eczema/tratamento farmacológico , Administração Tópica , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Citocinas/metabolismo , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/administração & dosagem , Eczema/patologia , Escherichia coli/efeitos dos fármacos , Masculino , Camundongos Endogâmicos BALB C , Testes de Sensibilidade Microbiana , Creme para a Pele , Staphylococcus aureus/efeitos dos fármacos , Cicatrização/efeitos dos fármacos
15.
J Drugs Dermatol ; 18(9): 910-916, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31524347

RESUMO

BACKGROUND: Acne is a common problem among Asian adolescents and adults. Generally, Asian skin is more pigmented, with a higher risk of acne sequelae. Potential for skin irritation and dryness, as well as pigmentary changes are key concerns that can have significant impact on Quality of Life (QoL). The first lotion formulation of tretinoin was developed using novel polymeric emulsion technology to provide an important alternative option to treat acne patients who may be sensitive to the irritant effects of other tretinoin formulations. OBJECTIVE: To evaluate the efficacy, tolerability, and safety of tretinoin 0.05% lotion in treating moderate-to-severe acne in an Asian population. METHODS: Post hoc analysis of two multicenter, randomized, double-blind, vehicle-controlled phase 3 studies. Asian subjects (aged 12 to 48 years, N=69 with 61% female) were randomized (1:1) to receive tretinoin 0.05% lotion or vehicle, once-daily for 12 weeks. Efficacy assessments included changes in baseline inflammatory and noninflammatory lesions and treatment success (at least 2-grade reduction in Evaluator's Global Severity Score [EGSS] and clear/almost clear). Quality of Life (QoL) was assessed using the validated Acne QoL scale. Safety, adverse events (AEs), cutaneous tolerability and hyper- or hypo-pigmentation (using 4-point scales where 0=none and 3=severe) were evaluated. RESULTS: At week 12, mean percent reduction in inflammatory and noninflammatory lesion counts were 58.6% and 51.4% respectively compared with 41.5% and 23.9% with vehicle (P=0.012 for noninflammatory lesions from week 8). Treatment success was achieved by 27.2% of subjects treated with tretinoin 0.05% lotion by week 12. For each Acne QoL domain, changes from baseline achieved with tretinoin 0.05% lotion were statistically significant compared to vehicle. Only five subjects reported any AE; all AEs were mild or moderate and transient. There were no serious AEs (SAEs). There were no treatment-related AEs with tretinoin 0.05% lotion. There were slight transient increases in scaling and burning over the first 4-8 weeks. Mild hyperpigmentation was reported at baseline (mean score, 0.8) and remained mild throughout the study. CONCLUSIONS: Post hoc analysis showed that tretinoin 0.05% lotion was significantly more effective than its vehicle in achieving reductions in noninflammatory acne lesions and improvements in QoL in an Asian population. The novel lotion formulation was well-tolerated, with no treatment-related AEs and no concerns with skin dryness, irritation, or hyperpigmentation. J Drugs Dermatol. 2019;18(9):910-916.


Assuntos
Acne Vulgar/tratamento farmacológico , Ceratolíticos/administração & dosagem , Tretinoína/administração & dosagem , Acne Vulgar/diagnóstico , Administração Cutânea , Adolescente , Adulto , Criança , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Ceratolíticos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Creme para a Pele/administração & dosagem , Resultado do Tratamento , Tretinoína/efeitos adversos , Adulto Jovem
16.
Biomed Pharmacother ; 118: 109394, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31545259

RESUMO

The renin-angiotensin system (RAS) plays an important role in scar formation. We have previously shown that oral administration of ramipril and losartan could inhibit scarring. For easier application, here we developed a series of topical ramipril and losartan creams in different concentrations and formulations to explore the effect on scar formation in a C57BL/6 mouse scar model. The harvested scar tissues were analyzed with H&E staining, Masson staining and immunohistochemical staining. We found the group treated with 0.2% losartan urea cream (Prep. 1) or 0.1% ramipril cream (Prep. 2) had significantly smaller scars compared to the negative control, while the proliferation of fibroblasts was less active and the collagen fibers were more regular; both groups showed similar efficacy with the positive control (triamcinolone acetonide urea). We also found that drug transdermalness couldn't directly determine the efficacy. Our findings indicate that local application of angiotensin converting enzyme inhibitor drugs (ACEIs) and angiotensin receptor blocker drugs (ARBs) can reduce scarring by reducing the expression of collagen I, collagen III, phosphorylated small mothers against decapentaplegic 3 (p-Smad3) and transforming growth factor-ß 1 (TGF-ß1). This may provide new insight on scar treatment in clinic.


Assuntos
Cicatriz/tratamento farmacológico , Losartan/administração & dosagem , Losartan/uso terapêutico , Ramipril/administração & dosagem , Ramipril/uso terapêutico , Creme para a Pele/uso terapêutico , Administração Tópica , Animais , Cicatriz/patologia , Fibroblastos/efeitos dos fármacos , Fibroblastos/patologia , Losartan/farmacologia , Masculino , Camundongos Endogâmicos C57BL , Proteína Smad3/metabolismo , Suínos , Fator de Crescimento Transformador beta1/metabolismo
17.
Acta Biochim Pol ; 66(3): 371-374, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31518087

RESUMO

The cosmetic and pharmaceutical industry is constantly on the lookout for new and efficient active substances. In this article, we focus on resveratrol, an active substance with beneficial health properties, which is obtained, among others, from vines and knotweed (Reynoutria japonica). In this study, we assessed the level of skin hydration in a group of probands who used cream with or without resveratrol. The compound has been shown to have moisturizing and tightening properties, improving the overall condition of the skin.


Assuntos
Emulsões/química , Epiderme/efeitos dos fármacos , Resveratrol/farmacologia , Envelhecimento da Pele/efeitos dos fármacos , Creme para a Pele/química , Resposta Galvânica da Pele/efeitos dos fármacos , Glicosaminoglicanos/metabolismo , Humanos , Testes do Emplastro , Inquéritos e Questionários , Voluntários , Cicatrização/efeitos dos fármacos
18.
J Drugs Dermatol ; 18(8): 815-820, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31424713

RESUMO

BACKGROUND: Psoriasis is a chronic, immune-mediated disease that varies widely in its clinical expression. Topical corticosteroids (TCS) are the mainstay of treatment. Long-term safety remains a concern, limiting use and recurrence is common. Tazarotene has also been shown to be effective in psoriasis, with efficacy maintained several weeks posttreatment. Fixed combination therapy with TCS and tazarotene may improve psoriasis signs and maintain efficacy between treatment sessions. OBJECTIVE: To investigate the maintenance of effect posttreatment with a once-daily application of halobetasol propionate 0.01%/tazarotene 0.045% (HP/TAZ) lotion in comparison with vehicle in patients with moderate or severe plaque psoriasis. METHODS: Two multicenter, randomized, double-blind, vehicle-controlled Phase 3 studies in moderate or severe psoriasis (N=418). Patients randomized (2:1) to receive HP/TAZ lotion or vehicle, once-daily for 8 weeks with a 4 week posttreatment follow-up. Efficacy assessments included treatment success (defined as at least a 2-grade improvement from baseline in the IGA score, and 'clear' or 'almost clear'), impact on individual signs of psoriasis (erythema, plaque elevation, and scaling) at the target lesion, and maintenance of improvements in Body Surface Area (BSA), IGAxBSA and clinically meaningful benefit (IGAxBSA-75). RESULTS: At week 8, 40.7% of patients achieved treatment success with HP/TAZ lotion, compared with 9.9% treated with vehicle (P<0.001). Four weeks posttreatment, 33.3% of patients achieved treatment success. Two thirds of patients (63%) who were treatment successes at week 8 remained treatment successes posttreatment. In addition, up to 20% of patients who were not treatment successes at week 8 became treatment successes by the end of the study. Three-quarters of patients maintained BSA improvements or reported further reductions in BSA that seemed to be unrelated to baseline BSA severity. At the end of the 4 week posttreatment period, patients who had been treated with HP/TAZ lotion achieved a 46.6% reduction in IGAxBSA, compared with 7.9% on vehicle. 41.7% of patients achieved a clinically meaningful effect at week 8 and this was maintained posttreatment. LIMITATIONS: The studies only had a 4 week follow-up period. CONCLUSIONS: In conclusion, HP 0.01%/TAZ 0.045% lotion provides effective maintenance of efficacy over a 4 week posttreatment period.


Assuntos
Clobetasol/análogos & derivados , Fármacos Dermatológicos/administração & dosagem , Ácidos Nicotínicos/administração & dosagem , Psoríase/tratamento farmacológico , Creme para a Pele/administração & dosagem , Clobetasol/administração & dosagem , Clobetasol/efeitos adversos , Fármacos Dermatológicos/efeitos adversos , Método Duplo-Cego , Combinação de Medicamentos , Seguimentos , Humanos , Ácidos Nicotínicos/efeitos adversos , Psoríase/diagnóstico , Índice de Gravidade de Doença , Creme para a Pele/efeitos adversos , Resultado do Tratamento
19.
J Coll Physicians Surg Pak ; 29(9): 799-802, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31455470

RESUMO

OBJECTIVE: To determine the effects of commonly used commercial skin lightening creams on the thickness of epidermis of guinea pig skin. STUDY DESIGN: Animal experimental study. PLACE AND DURATION OF STUDY: Department of Anatomy, King Edward Medical University, Lahore, from March to May 2015. METHODOLOGY: Forty-eight adult, colored guinea pigs were used in this study. The animals were randomly divided into four groups. Group I was control group (no cream application). The animals of group II, III and IV were treated with skin whitening creams A, B and C respectively once daily, 6 days/week for eight weeks duration. The observations of skin specimens were made after 4 and 8 weeks for epidermal thickness at histological level. RESULTS: Microscopic examination showed variable degrees of epidermal thickening with the three creams applied for 4 weeks. The increase in thickness of epidermis ranged from 49.1 µm in control group to maximum of 106.4 µm in group ll. These effects were further intensified after 8 weeks application. CONCLUSION: The use of whitening creams caused skin damage by increasing the epidermal thickness of varying extent.


Assuntos
Epiderme/efeitos dos fármacos , Epiderme/patologia , Preparações Clareadoras de Pele/farmacologia , Animais , Cobaias , Creme para a Pele/farmacologia
20.
J Drugs Dermatol ; 18(7): 642-648, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31329402

RESUMO

Background: Pigmentation disorders are therapeutically challenging to treat, requiring complicated regimens. Objectives: Alternatives to hydroquinone (HQ) are desired. We evaluated the efficacy and tolerability of a non-HQ multi-action skin tone corrector (ETCS) developed to inhibit melanin production and improve skin quality. Design and Methods: Twice-daily use of ETCS and ETCS + AHA-Ret, a retinoid-based alpha hydroxy acid cream, was evaluated in subjects with mild to severe dyschromia. Digital images were obtained at baseline, 4, 8, and 12 weeks and included assessment of dyschromia, erythema, fine lines/wrinkles, pores, texture, and global improvement. Melanin Index (MI) measurements were obtained at baseline, 4, 8, and 12 weeks. Subject self-assessments were obtained over the course of the study. Adverse Events (AEs) were collected throughout the study. An extension study evaluated use over 16-weeks. Results: Significant mean reductions from baseline occurred in dyschromia for ETCS (n=42) and ETCS + AHA-Ret (n=10) over 12 weeks (P<0.0001, each). Significant mean reductions from baseline in MI were achieved in both groups at every timepoint (ETCS: P<0.0001; ETCS + AHA-Ret: P<0.02, 4 weeks; P<0.0001, 8 and 12 weeks). Substantial improvements were demonstrated in global improvement, fine lines/wrinkles, erythema, pores, and texture at 12 weeks. Reductions from baseline occurred in dyschromia and MI (P<0.0001, each) at 16 weeks. High levels of subject satisfaction were reported with nearly all subjects reporting reduced appearance of uneven skin tone/discoloration and lightened darker patches, and improvement in overall skin tone. Mild, transient AEs were reported with no discontinuations due to an AE. Conclusions: Twice daily use of ETCS led to early, significant reductions in dyschromia and melanin index. Combination use with a retinoid-based, AHA cream in the evening demonstrated enhanced reductions. ETCS effectively reduced hyperpigmentation, improved overall skin appearance, and was highly tolerable. J Drugs Dermatol. 2019;18(7):642-648.


Assuntos
Fármacos Dermatológicos/efeitos adversos , Hiperpigmentação/tratamento farmacológico , Melaninas/antagonistas & inibidores , Creme para a Pele/administração & dosagem , Preparações Clareadoras de Pele/administração & dosagem , Adulto , Idoso , Fármacos Dermatológicos/administração & dosagem , Combinação de Medicamentos , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Feminino , Humanos , Melaninas/metabolismo , Pessoa de Meia-Idade , Retinoides/administração & dosagem , Retinoides/efeitos adversos , Envelhecimento da Pele/efeitos dos fármacos , Creme para a Pele/efeitos adversos , Creme para a Pele/química , Preparações Clareadoras de Pele/efeitos adversos , Preparações Clareadoras de Pele/química , Pigmentação da Pele/efeitos dos fármacos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA