Effects of Siegesbeckia herba extract against particulate matter 10 (PM10 ) in skin barrier-disrupted mouse models.

OBJECTIVES: Skin barrier disruption is a significant problem of the older population in an aging society. It is characterized by increased transepidermal water loss and decreased skin water content, and particulate matter (PM) is a social issue that can contribute to the exacerbation of skin inflammation. Thus, addressing this problem is urgent. METHODS: Skin barrier-disrupted mouse models were induced by two methods using acetone application or tape-stripping. This study investigated the antioxidative and anti-inflammatory properties of the Siegesbeckia herba extract (SHE) on PM-induced changes in skin barrier-disrupted mouse models. To examine changes in skin water content, inflammatory cytokines, and keratinocyte differentiation markers, mouse models were treated with vehicle 100 µL, PM10 100 µL (100 µg/mL), SHE 100 µL, or PM10 100 µL (100 µg/mL) plus SHE 100 µL. RESULTS: SHE preserved skin hydration in the skin barrier-disrupted mouse models regardless of the presence of PM10 . SHE also inhibited the upregulation of inflammatory cytokines such as interleukin (IL)-1ß, IL-4, IL-6, IL-8, and tumor necrosis factor-α and normalized the downregulation of keratinocyte differentiation markers against PM10 in skin barrier-disrupted mouse models. CONCLUSIONS: This study elucidated the therapeutic effects of SHE against PM10 in skin barrier-disrupted mouse models.

[New possibilities for reparative therapy of dry eye syndrome]. / Novye vozmozhnosti reparativnoi terapii sindroma «sukhogo glaza¼.

In recent years, among artificial tear preparations that have additional metabolic properties, in addition to moisturizing the ocular surface, there has been a drug Optinol Soft Recovery (LLC JADRAN). In addition to 0.15% sodium hyaluronate, it contains 2% dexpanthenol, which stimulates reparative regeneration of the corneal epithelium, in particular in patients with dry eye syndrome (DES). PURPOSE: This study evaluates the clinical efficacy of the drug Optinol Soft Recovery in the treatment of patients with DES accompanied by xerotic changes in the corneal epithelium. MATERIAL AND METHODS: The study included 82 patients (15 children and 65 adults) with moderate and severe DES accompanied by the following corneal pathology: filamentous keratitis (20 patients, 33 eyes), persistent corneal erosion (28 patients, 49 eyes) and punctate keratopathy (34 patients, 68 eyes). RESULTS: All patients receiving fourfold instillations of the studied drug were observed already during the first 7 days to have increased stability of the tear film and decreased severity of staining of the cornea and conjunctiva with vital dyes (0.1% sodium fluorescein and 3% lissamine green, respectively). Further, as the patients were transferred to an individual instillation regimen, a progressive decrease in the Ocular Surface Disease Index (OSDI), an increase in corneal sensitivity and tear meniscus index were also recorded. The differences in most parameters of the course of xerosis compared to the initial ones were statistically significant starting from day 10-20 of therapy, depending on the initial severity of corneal xerosis (p<0.05-0.001). CONCLUSION: Patients with moderate DES complicated by punctate keratopathy were the most susceptible to therapy with the drug Optinol Soft Recovery, while patients with filamentous keratitis secondary to a severe clinical form of DES were the least susceptible.

A novel hydrogel-based moisturizing cream composed of hyaluronic acid for patients with xerosis: An intraindividual comparative analysis.

BACKGROUND: Hyaluronic acid (HA) is mainly used to treat xerosis. It also exerts wound-healing, moisturizing, and antiaging effects. Although HA is considered an effective and safe ingredient in cosmetics, there is a constant demand for a more money-saving and effective formulation. This study aimed to evaluate the safety and efficacy of a novel hydrogel-based moisturizer containing HA cross-linked with silicone polymers, produced solely through irradiation without the use of cross-linking agents. MATERIALS AND METHODS: A safety study enrolled 30 participants with healthy skin to perform patch and photopatch tests while recording adverse events. For the efficacy study, 30 participants with xerosis were compared before and after using the novel hydrogel, evaluating the cutaneous barrier function, xerosis severity scale (XSS) score, participant's satisfaction, and Investigator's Global Assessment (IGA). Furthermore, the efficacy of the novel hydrogel-based moisturizer was evaluated by comparing it with a conventional moisturizer, Physiogel, in another 30 participants with xerosis. RESULTS: In the safety study, no serious adverse events were observed. In the efficacy study before and after use, skin hydration and skin surface lipid increased (p < 0.05) whereas the XSS scores decreased (p < 0.05) with time. In the comparative efficacy study with Physiogel, skin hydration increased whereas the XSS scores decreased (p < 0.05) over time in both groups. Furthermore, IGA improved in 100% of participants in both groups. Also, 100% and 93% of participants were satisfied with the novel hydrogel-based moisturizer and Physiogel, respectively. CONCLUSIONS: The novel hydrogel-based moisturizer proved to be safe and effective for xerosis, showing comparable results to the conventional moisturizer.

Psychosocial Burden in People with Atopic Dermatitis: Effects of a Substance-Free Basic Skincare in a Randomized Health Care Study.

INTRODUCTION: Atopic dermatitis (AD) is a physical, emotional, and social burden for patients. Most suffer from itching, pain, and dry skin as well as sleep disturbances, experienced stigmatization, anxiety, or depression. Therefore, it is important to consider the psychosocial well-being and also stigmatization in the treatment of people with AD. The aims of this study were to compare clinical and psychosocial parameters between patients with a different severity of AD and to analyse the effect of an omega-6-fatty-acid-skin therapy. METHODS: Adult patients with clinically confirmed AD were asked about quality of life, stigmatization, and well-being after dermatological diagnosis. A second examination took place after 2-5 weeks. Meanwhile, after randomization, half of the patients used an omega-6-fatty-acid-skin therapy. RESULTS: Seventy-nine patients were included in the study. The use of omega-6-fatty-acid-skin therapy resulted in a significant reduction in the severity of xerosis cutis compared to patients using another basic therapy. In addition, the health-related quality of life of all patients improved significantly in both groups (F = 7.56; p = 0.008), and no significant difference was found between the groups over time in the patient-reported outcomes. CONCLUSION: Basic therapy for AD leads to relevant improvements in clinical status as well as quality of life. Patients using omega-6-fatty-acid-skin therapy experience greater improvement in xerosis cutis compared to free-choice basic therapy.

The prevalence and interventions of xerosis cutis among older adults: A systematic review and meta-analysis.

BACKGROUND: Xerosis cutis in older adults is a geriatric public health issue that severely affects healthy aging, associated with adverse outcomes and increased nursing burden. Skin care plays a significant role in the management of xerosis cutis. AIM: To assess the pooled prevalence and interventions of xerosis cutis among older adults. METHODS: We searched ten databases systematically from inception to August 29, 2023. We estimated pooled prevalence of xerosis cutis using Stata 15.0. RESULTS: 28 articles were included in this review. The pooled prevalence of xerosis cutis was 53 %(95 %CI:36-69 %). We found the prevalence of xerosis cutis was highest in nursing homes and developed countries. The prevalence of xerosis cutis was similar in males and females. The prevalence of mild xerosis cutis and xerosis cutis at lower limbs was relatively high. Regular use of humectant-containing leave-on skin care products and structured skin care regimens were helpful in alleviating xerosis cutis. CONCLUSION: Older adults are at high risk for xerosis cutis. The research provides health professionals with a basic framework for the prevention and management of xerosis cutis.

The prevalence and severity of dry skin and related skin care in older adult residents in institutional long-term care: A cross-sectional study.

OBJECTIVES: To identify possible factors associated with different severities of xerosis cutis and to describe possible associations between (skin) care dependency and application of moisturizers. DESIGN: Cross-sectional study using baseline data from a cluster-randomized controlled trial. Demographic and health characteristics, skin physiological measurements, functional abilities and application of moisturizers were compared between the participants with mild and severe dry skin. Frequency of moisturization were also compared based on the participants' skin care dependency. RESULTS: The more distal the body area, the more severe xerosis were observed. There were no or minor differences between the groups, except for the stratum corneum hydration and skin surface pH. Participants with severe xerosis received moisturizers less often. Skin care dependent residents received moisturizers frequently. CONCLUSION: There is under-application regarding xerosis cutis treatment in long-term care. Skin care provided by nurses, in adequate frequencies, might be helpful compared to skin care performed by the residents themselves.

Dermatologic toxicities to inhibitors of cyclin-dependent kinases CDK 4 and 6: An updated review for clinical practice.

Cyclin-dependent kinase (CDK) 4/6 inhibitors (palbociclib, ribociclib and abemaciclib) have revolutionized the treatment of metastatic breast carcinoma. They currently form the first-line treatment, in combination with endocrine agents, for the management of locally advanced or metastatic hormone receptor-positive (HR + ), human epidermal growth factor receptor 2-negative (HER2-) breast cancer, the largest subtype of breast carcinoma. CDK 4/6 inhibitors have shown comparable efficacy outcomes with predictable and manageable adverse events. In this setting, dermatologic toxicity appears to be relatively frequent, accounting for up to 15% of all reported adverse events. It is usually mild to moderate in intensity and does not normally constitute a dose-limiting toxicity. The range of dermatologic adverse events includes both non-specific entities (maculopapular rash, pruritus, alopecia) and more characteristic toxicities related to CDK4/6 inhibitors, such as vitiligo-like lesions or cutaneous lupus erythematosus. Finally, more severe or life-threatening skin reactions can occasionally occur. The main dermatologic manifestations associated with CDK4/6 inhibitors, as well as management thereof, are described in this comprehensive review.

Reliability and validity of the Japanese version of the overall dry skin score in older patients.

BACKGROUND: Dry skin is the most common skin problem, especially in the elderly. However, there is no effective instrument to assess dry skin in Japan. This study aimed to evaluate the reliability and validity of the Japanese version of the overall dry skin score (ODS-J), the gold standard for dry skin assessment. MATERIALS AND METHODS: A cross-sectional study was conducted on 47 patients aged > 65 years. Images of skin on their limbs were captured using a digital camera; both upper and lower limbs were assessed (n = 4/patient). One dermatologist; two wound, ostomy, and continence nurses; and three nursing researchers independently evaluated the images using the ODS-J to assess the intraclass correlation coefficient (ICC) for inter-rater reliability. Stratum corneum hydration (SCH) and transepidermal water loss (TEWL) were the external criteria used to verify concurrent and known-groups validity. RESULTS: In total, 182 sites at which the SCH and TEWL could be measured were evaluated for the ODS-J. The ICC for inter-rater reliability of the six raters was 0.939 (p < 0.001). A higher ODS-J was associated with lower SCH (ρ = -0.374; p < 0.001) and lower TEWL (ρ = -0.287; p < 0.001) values. The ODS-J for the lower legs was significantly higher than that of the forearms (p < 0.001). CONCLUSIONS: The ODS-J showed good inter-rater reliability, concurrent validity, and known-groups validity. It can be used by clinical nurses in Japan to observe patients' skin and is an effective indicator for the evaluation of skin care.

Depth-dependent hydration dynamics in human skin: Vehicle-controlled efficacy assessment of a functional 10% urea plus NMF moisturizer by near-infrared confocal spectroscopic imaging (KOSIM IR) and capacitance method complemented by volunteer perception.

BACKGROUND: Stratum corneum (SC) hydration is vital for the optimal maintenance and appearance of healthy skin. In this context, we evaluated the efficacy of an NMF-enriched moisturizer containing 10% urea on different aspects of SC hydration of dry skin. MATERIAL AND METHODS: In two clinical studies, the hydration efficacy of the moisturizer in comparison to its vehicle was investigated. In the first study, 42 subjects applied the moisturizer and the vehicle to one lower leg each. Thirty minutes and 24 h after this single treatment, SC hydration was measured by corneometry. Volunteers also rated skin moisturization and evaluated product properties. In the second study, 27 subjects each treated one forearm twice daily for 2 weeks with the moisturizer and the vehicle. Then, depth-resolved water-absorption spectra were measured by near-infrared confocal spectroscopic imaging (KOSIM IR). RESULTS: The moisturizer exerted a superior hydrating effect compared to the vehicle. KOSIM IR measurements show that, compared to the vehicle, the moisturizer significantly improved the water gradient in the SC from the surface to a depth of 15 µm. Moreover, the moisturizer received high acceptance ratings from the volunteers and was preferred to the vehicle. CONCLUSION: The humectants applied in the investigated moisturizer improved SC water content in total and as a function of depth. The combination of depth-resolved data (KOSIM IR) with classical corneometry provides an integrated concept in the measurement of skin hydration, rendering both methods complementary. These findings were in line with the volunteers` self-assessments of the moisturizer properties that are relevant to treatment adherence.

A Biomimetic Combination of Actives Enhances Skin Hydration and Barrier Function via Modulation of Gene Expression: Results of Two Double-Blind, Vehicle-Controlled Clinical Studies.

INTRODUCTION: Xerosis cutis is characterized by a decreased stratum corneum (SC) hydration and an impaired skin barrier function. Urea, the most prevalent natural moisturizing factor (NMF), is currently considered the gold standard. Its efficacy can further be increased by combining urea with other NMF and skin barrier lipids (SBLs). OBJECTIVE: We set out to evaluate physiological effects of a novel functional moisturizer containing 10% urea, additional NMF components, and a combination of SBLs on skin hydration and skin barrier integrity on a cellular and phenotypic level in female volunteers suffering from xerosis. METHODS: Two double-blind, vehicle-controlled clinical studies were conducted. In the first study, 44 female subjects having very dry body skin applied the moisturizer or its vehicle twice daily to their volar forearms. Twenty-four hours after a single product application as well as 24 h after 2 weeks of treatment, SC hydration was measured by corneometry. Skin barrier function was assessed by transepidermal water loss 24 h and 48 h after 2 weeks of regular use. Twenty-four hours after 2 weeks of application, skin tape stripping was performed, and urea content was determined in the 3rd strip by means of high-performance liquid chromatography/tandem mass spectrometry. In the second study, 22 women with self-reported very dry skin applied the moisturizer or vehicle twice daily to their volar forearms for 2 weeks. Then, suction blister samples were obtained for gene expression analysis using RT-PCR. RESULTS: Application of the actives led to significantly improved skin hydration and barrier function at all points in time. Compared to the vehicle, application of the moisturizer for 2 weeks resulted in a significant increase in SC urea content. Relative gene expression data revealed significant upregulation of genes associated with skin barrier function, hydration, differentiation, and lipid metabolism compared to the vehicle-treated area. CONCLUSIONS: Overall, our data demonstrate that the functional moisturizer provides an adequate bioavailability of urea and a beneficial biophysical impact on xerotic skin. Topical treatment with a combination of urea and additional NMF as well as SBL can modify mRNA expression of important epidermal genes stimulating cellular processes and functions. The well-tolerated novel functional moisturizer stimulates molecular mechanisms involved in skin hydration and barrier function and is a profoundly effective treatment option for xerosis cutis.

Dermatologic conditions in Down syndrome.

Down syndrome (DS) is the most common chromosomal condition and affects many organs including the skin. Dermatologists are an integral part of the DS care team. This is a review of both common and rare dermatologic conditions in DS. We provide practical strategies for a successful dermatology interview and examination. We explore the downstream effects of trisomy of chromosome 21, in particular on the immune system, and how these insights may enhance our pathophysiologic understanding of their cutaneous conditions.

[Implementation of advanced social practices based on innovative gerontotechnologies in the system of long-term care for elderly and senile patients.]

From 2017 to the present a scientific project «The use of dermatoprotectors to improve the quality of life of geriatric patients with age-associated xerosis (AAX)¼ has been realized as part of a typical model of a long-term care system in order to introduce the innovative gerontotechnologies as advanced social practices in further optimization of social and medical care for elderly and senile patients in Leningrad Region. The article presents the results of a comparative analysis of the effectiveness of the dermatoprotectors application in the improvement of the quality of life, prevention and correction of AAX. The AAX clinical manifestations have been studied before and after the emollients use. The cohort under study has included geriatric patients with senile asthenia from seven institutions of social protection of the Leningrad Region. In the foreign literature, such patients are called «fragile¼. The data thus obtained indicate that AAX as a manifestation of skin «fragility¼ during aging can be considered as a component of the geriatric syndrome of senile asthenia in patients of older age groups. The development of skin «fragility¼ significantly reduces the quality of life of geriatric patients and requires timely prevention and correction with adequately selected dermatoprotectors.

Dermatologic conditions in Down syndrome: A single-center retrospective chart review.

BACKGROUND: Current literature addressing dermatologic conditions associated with Down syndrome is limited, with emphasis on rare skin conditions and lack of consensus on the incidence of more common disorders. OBJECTIVE: We sought to evaluate dermatologic conditions in patients with Down syndrome diagnosed and managed by dermatologists. METHODS: This was a retrospective analysis of 101 pediatric and adult patients with Down syndrome seen by the University of Massachusetts Dermatology Department between 2008 and 2018. RESULTS: Folliculitis was the most common diagnosis overall (30.7%), followed by seborrheic dermatitis (26.7%) and hidradenitis suppurativa (22.8%). Eczematous dermatitis, alopecia areata, and xerosis were the most common diagnoses observed in children aged 0-12 years; hidradenitis suppurativa, folliculitis, and seborrheic dermatitis in adolescents aged 13-17 years; and folliculitis, seborrheic dermatitis, and xerosis in adults 18 years and older. Other notable diagnoses present overall included onychomycosis (9.9%) and psoriasis (8.9%). Malignant cutaneous tumors were present in two patients, specifically basal cell carcinoma and malignant melanoma in situ. LIMITATIONS: This was a retrospective, single-institution study. CONCLUSION: Dermatologic conditions in patients with Down syndrome vary by age but are most often adnexal and eczematous disorders. Trisomy of chromosome 21 and the resulting downstream effects, specifically on the immune system, may account for these findings.

Dermatological side effects of targeted antineoplastic therapies: a prospective study.

INTRODUCTION: Epidermal growth factor receptor inhibitors (EGFRs) are chemotherapeutic agents used in multiple solid organ malignity. These medications have common dermatological side effects, particularly papulopustular (PPL) lesions. The management of the diagnosis and treatment processes for such side effects may facilitate the continuation of chemotherapy and enhance the patient's quality of life. OBJECTIVE: The objective of this study is to report the cutaneous side effects of EGFR inhibitors and to share treatment methods for such side effects. MATERIALS AND METHODS: In this prospective study, 59 patients using EGFR due to breast and colorectal carcinoma at the oncology unit of Haseki Training and Research Hospital were assessed. The patients for whom EGFR was initiated were examined at the beginning of the treatment at weeks 1 and 2, their demographic characteristics were recorded, and the patients who developed a skin rash were followed up from the onset of the lesion. The PPL side effects that developed in the patients and other dermatological findings were recorded. The PPL side effects were graded, and the treatment plans were reported. The study was conducted between February 2016 and February 2018 under the approval of the local ethical committee. RESULTS: The mean age of the 59 patients (47 females, 12 males) taking EGFR inhibitors was 52.4 ± 12.0 (range: 29-84). Forty-five patients had early stage and 14 patients had advanced stage carcinoma. Fourteen patients had colorectal carcinoma, three patients had renal cancer, and 42 patients had breast cancer. Forty-two patients were using trastuzumab (single therapy in 29 patients and combined therapy in 13 patients), five patients were using cetuximab, three patients were using sunitinib, eight patients were using panitumumab, and six patients were using pertuzumab. In 22 patients, PPL side effects were observed in the skin; it was G1 in 19 patients and G2 in three patients. In seven patients who developed acneiform side effects, systemic doxycycline was used, and in others, topical tetracycline and clindamycin were used. Except for one patient using trastuzumab, all patients has lesions on the face, upper trunk, and back. One patient exhibited an atypical rash, which was diagnosed as a granulomatous follicular reaction. Xerosis was present in two cases, and paronychia, pyogenic granuloma, trichomegaly, and madarosis were observed in one patient each. The patients who developed an acneiform rash were treated with topical and systemic antibiotics, light keratolytics, and emollients. The skin side effects of all patients were mild to moderate, and all patients completed the chemotherapy process. An acneiform skin rash and other dermatological side effects are common with EGFR inhibitors. To treat these side effects, emollients, topical steroids, and local, systemic antibiotics are recommended. Clindamycin may be preferred as a topical treatment, and doxycycline may be preferred as a systematic treatment.

Prevalence and determinants for xerosis cutis in the middle-aged and elderly population: A cross-sectional study.

BACKGROUND: Determinants and the extent of dry skin in healthy middle-aged and elderly populations have not been well established. OBJECTIVE: We aimed to identify the prevalence and determinants for generalized dry skin (GDS) and localized dry skin (LDS) within a large prospective population-based cohort of middle-aged and elderly individuals of the Rotterdam Study. METHODS: Dry skin was physician-graded as none, localized, or generalized. For GDS and LDS, separate multivariable logistic regression analyses were performed to search for association with participant characteristics, lifestyle factors, environmental factors, several comorbidities, and drug exposure. RESULTS: Among the 5547 eligible participants, 60% had dry skin, of whom a fifth had GDS. Age, female sex, skin color, body mass index, outside temperature, eczema, and chemotherapy in the past were significant determinants for both GDS and LDS. Smoking, the use of statins and diuretics, poorer self-perceived health, and several dermatologic conditions increased the likelihood of having GDS only. Daily cream use was associated with less LDS. LIMITATIONS: Interobserver variability and residual confounding could have influenced our results. Because of our cross-sectional design, we could not infer causality. CONCLUSION: We identified factors significantly associated with dry skin in a general middle-aged and elderly population, with health parameters more strongly associated with GDS.

The benefit of a ceramide-linoleic acid-containing moisturizer as an adjunctive therapy for a set of xerotic dermatoses.

Atopic dermatitis (AD), chronic eczema, and pruritus hiemalis are a set of prevalent chronic xerotic skin disorders that share clinical features such as dryness, scales, and pruritus. A ceramide deficiency and defective epidermal functions are common in these diseases. This study was designed to assess the effect of ceramide-linoleic acid (LA-Cer)-containing moisturizer as an adjunctive therapy in the treatment of AD, chronic eczema, and pruritus hiemalis. In a 2-month study, patients with one of these three diseases were divided into two groups. The control group was treated with mometasone furoate (0.1%) cream (MF), whereas the treatment group received 0.1% MF in combination with an LA-Cer-containing moisturizer. Capacitance and transepidermal water loss were measured in normal and lesional skin, along with Eczema Assessment Severity Index and pruritus scores at Weeks 0, 2, 4, and 8. The results showed that tropical applications of an LA-Cer-containing moisturizer in combination with a topical glucocorticoid accelerated the reestablishment of epidermal permeability barrier and the amelioration of pruritus in patients with AD and pruritus hiemalis. However, it did not provide the same effect for chronic eczema. Thus, the efficacy of this combination therapy for this set of xerotic disorders requires further evaluation.

The 24-hr, 28-day, and 7-day post-moisturizing efficacy of ceramides 1, 3, 6-II containing moisturizing cream compared with hydrophilic cream on skin dryness and barrier disruption in senile xerosis treatment.

Direct replacement of decreased ceramides in the stratum corneum can be efficacious for skin hydration, skin barrier function, and skin pH. Our study aimed to evaluate the 24-hr, 28-day, and 7-day post-moisturizing efficacy of ceramide-containing moisturizer in senile xerosis treatment. A split site, double-blinded, randomized, controlled study was conducted in 24 senile subjects (91.7% females, mean age 54.83 ± 5.45 years) with mild to moderate xerosis, who were randomized to receive ceramide-containing moisturizer or hydrophilic cream, daily applied on each side of the shin. A single application of ceramide-containing moisturizer increased skin hydration, while improving transepidermal water loss (TEWL) and skin pH for up to 24 hr, with statistically significant difference. After 28 days of twice-daily application, more significant improvement on skin hydration, barrier function, and skin pH was observed in those with ceramide-containing moisturizer at all-time points. At day 28, there was a statistically significant decrease of hemoglobin index, wrinkle, and texture on the ceramide treated side. The 7-day post-moisturizing efficacy on the ceramide treated side was superior for skin hydration, TEWL, skin pH, and wrinkle. Thus, the ceramide-containing moisturizer can be a novel promising treatment for senile xerosis.

Topical purified omental lipid formulations in the prevention of skin ulcers: a narrative review.

The omentum is a large peritoneal fold. Its main function is to protect abdominal organs, exerting a defensive action against infective agents. The tissue promotes repair after several types of injury. An extensive vascularisation is the key characteristic of this tissue and the omentum has the highest level of production and content of vascular endothelial growth factor (VEGF). A component of omentum is the lipid compound, which carries out important activities for the organism. Omentum is rich in neutral glycerides, phospholipids, glycolipids and gangliosides. Dermatological products containing purified omental lipids are commercially available and topical omental extracts have been useful in the softening, moisturising and smoothing of skin. Animal-derived omental lipids could be use in topical products with different textures (creams, fluids, emulsions and cleansers) and at different concentrations (10-25%) for the treatment of fragile skin or skin conditions causing risk of ulcer formation. This review summarises the pharmacological rationale of purified omental lipids in topical formulations for use in fragile skin conditions, the clinical efficacy data available in the scientific literature and the potential future perspectives. Efficacy of topical purified omental lipids have been demonstrated in numerous clinical controlled trials involving a total of 320 subjects. These studies demonstrated that this product helps prevent the formation of pressure ulcers (PU) in hospitalised high-risk subjects, improves wound healing process, normalises skin hydration in diabetic subjects with moderate-severe skin xerosis and improve the clinical evolution of diabetic foot. Therefore, purified omental lipid could be an effective tool for the management of fragile skin and the skin at high risk of PU formation.

Pruritus in patients with chronic leg ulcers: A frequent and often neglected problem.

There is a paucity of studies regarding pruritus in patients with chronic leg ulcers. Data were collected using newly developed questionnaires for patients and physicians to evaluate pruritus in individuals with chronic leg ulcers. The results show that a total of 50 patients with chronic leg ulcers were included in this prospective study. Frequent pruritus was observed in 32.0% of the participants, while 36.0% reported occasional pruritus. The average pruritus intensity was 3.5 points (0-10 numeric rating scale [NRS]) and was found to increase with age. Patients experiencing pruritus achieved a higher Wound-quality of life (QoL) score (32.1) as that of patients without pruritus (25.8). Additional dermatological findings around the wounds included xerosis (26.0%), eczema (4.0%), and excoriations (2.0%). Pruritus was reported by all subjects with eczema and 84.6% of those with xerosis. The pruritus lasted significantly longer in women (average 98.4 months) vs men (average 37.5 months). Interestingly, men reported more intense pruritus than women (4.4 vs 2.8). Females reported more frequent use of skin care products than males. In conclusion, the current data show that two-thirds of patients with chronic leg ulcers suffer from moderate intense pruritus. Therefore, pruritus is a frequent and often neglected problem that should be regularly evaluated in all patients with chronic leg ulcers and considered in future therapy concepts.

Topical urea in skincare: A review.

Alterations in barrier function are associated with a number of skin diseases, including xerosis, atopic dermatitis, and psoriasis. Urea, a component of the natural moisturizing factor of the skin, plays an important role in the preservation of skin hydration and integrity. Several studies have investigated the effects of urea in the clinical setting. Here, we summarize the available clinical evidence regarding the effects of urea in the maintenance of healthy skin and management of skin disorders. At lower doses (≤10%), urea-containing topical formulations act as a skin moisturizer, while at higher concentrations (>10% urea), urea-based preparations exert a keratolytic action. Urea is also useful in combination therapies with anti-inflammatory and anti-fungal drugs, due to its activity as a penetration enhancer.