Protective effects of a day/night dual-antioxidant serum on skin: A randomized,regimen-controlled study in Chinese women exposed to air pollution

Background

Chronic exposure to air pollution can negatively affect skin health.

Aims

To assess the efficacy of the LUMIVIVE^® System (LVS), a skincare system consisting of individual day and night serums, in Chinese women exposed to air pollution.

Patients/Methods

In this single-center, vehicle-controlled study, eligible females (mean age, 49.02 years) were randomized 1:1 to treatment group (LVS plus basic moisturizer) or control group (basic moisturizer). Skin color, sebum content, barrier function, elasticity, and texture were measured at baseline and at each follow-up visit (days 28, 56, and 84). Air pollution parameters were collected throughout the study.

Results

Air pollution levels, including PM_2.5 and NO₂, were consistently high during the study. The treatment group showed significantly higher skin color L* (p ≤ 0.0001) and lower a* values (p ≤ 0.05) at all follow-up visits compared with the control group, indicating lower skin pigmentation and redness, respectively. Skin color L* and a* values remained unchanged over time for the control group but were significantly different at all follow-up visits compared to baseline (p ≤ 0.0001 and p ≤ 0.05, respectively) for the treatment group. There was an increasing trend for sebum content in the control group, which was not observed in the treatment group. Both groups showed improvements over time in other skin physiology parameters.

Conclusions

The current analysis demonstrates the efficacy of LVS plus basic moisturizer compared with basic moisturizer alone to reduce skin pigmentation and redness, as well as to mitigate sebum production, in Chinese women exposed to air pollution.     

Therapeutic patient education in children with moderate to severe atopic dermatitis: A multicenter randomized controlled trial in China

Background

Therapeutic patient education is a continuous, systematic, patient‐centered learning process to help patients and their families acquire and maintain the skills they need to manage their lives with a chronic disease. It has been proven effective in increasing treatment adherence and improving quality of life for patients with atopic dermatitis (AD) in Western countries. We introduce the first multicenter, randomized controlled clinical trial of therapeutic patient education in Chinese children with AD.

Objectives

To evaluate the effects of therapeutic patient education on the severity of AD, quality of life, and understanding and successful use of emollients in Chinese children with eczema.

Methods

We recruited 580 children, ages 2‐14 years, with moderate to severe AD from six hospitals in China. Participants were randomized (1:1) to an intervention (n = 293) or control (n = 249) group. In addition to the severity of AD, data on quality of life and a questionnaire on family and patient knowledge of emollients were evaluated at the 6‐month follow‐up.

Results

On study completion, we found that the intervention group showed a significantly greater reduction in mean SCORing Atopic Dermatitis (P < .001) and Infant's Dermatology Life Quality Index (P = .030) scores than the control group. In addition, knowledge about the use of emollients improved significantly in the intervention group. There was no significant difference between groups in Children's Dermatology Life Quality Index scores.

Conclusions

The first randomized controlled trial of a therapeutic patient education program in China had positive long‐term effects on decreasing eczema severity and improvement of quality of life in children 2‐4 years of age with AD, as well as in promoting greater understanding of the use of emollients.     

Efficacy and safety of total glucosides of paeony combined with acitretin in the treatment of moderate-to-severe plaque psoriasis: a double-blind,randomised, placebo-controlled trial

Background

Although acitretin has been widely used for the treatment of psoriasis, additional safer and more effective approaches, including traditional Chinese medicine, are needed.

Objectives

To investigate the efficacy and safety of total glucosides of paeony (TGP) combined with acitretin in the treatment of moderate-to-severe plaque psoriasis.

Materials & methods

A randomised, double-blind, placebo-controlled, multi-centre clinical study was conducted. In total, 108 patients with moderate-to-severe plaque psoriasis were randomly assigned to treatment with “TGP plus acitretin” (group A) or “placebo plus acitretin” (group B) for 12 weeks.

Results

After 12 weeks of therapy, the percentage of patients achieving a 50% reduction in Psoriasis Area and Severity Index was 90% in group A and 70.5% in group B (p<0.05). The rate of serum alanine aminotransferase elevation was 6.25% in group A and 20.4% in group B (p<0.05).

Conclusion

TGP is conducive to enhancing anti-psoriatic efficacy and reducing liver damage due to acitretin. TGP combined with acitretin is a safe and effective treatment approach for moderate-to-severe plaque psoriasis.

     

Impact of defensins-containing body cream on skin composition

Background and Aims

Defensins are peptides capable of reactivating latent LGR6 stem cells in the basal layer. When applied topically, these peptides can reduce signs of skin aging and increase dermal thickness. This study investigates the effects of a topical defensin formulation on extremity skin composition.

Methods

An open label, single arm clinical trial was conducted on participants with dry, photoaged, or dull skin. A defensin-containing hand and body cream was applied twice daily for 6 weeks to the hands, forearms, elbows, and knees. Photographs and objective measurements of skin hydration, viscoelasticity (VE), retraction time (RT), thickness, density/transepidermal water loss (TEWL), as well as self-evaluation of skin quality and characteristics were obtained pre- and post- intervention.

Results

After the study period, RT decreased by 56% across all body sites (p < 0.001) and VE improved at the elbow (125%, p = 0.009) and knee (110%, p < 0.001). Skin density also increased in all 4 body sites (40%, p < 0.001), while skin thickness increased at the elbow (29%, p = 0.03) and knee (17%, p = 0.04). Skin hydration increased at the elbow, knee, and forearm by 99%, 28%, and 16%, respectively (p < 0.05), while TEWL improved at the elbow only (−39%, p = 0.02). Patients' self-evaluations showed improvements in overall skin quality and in the domains of dryness, ashiness, wrinkling, pigmentation, redness, roughness, and discomfort (p < 0.05).

Conclusions

Following 6-week use of a defensin-containing cream, subjects reported significant improvement across many subjective skin domains. Similarly, objective measurements demonstrated significant improvement in skin architecture at select sites.     

Gender differences in health-related and family quality of life in young children with atopic dermatitis

Background Atopic dermatitis (AD) has an established impact on health‐related quality of life (HRQoL) and family QoL. Objectives This study was designed to investigate gender differences in health‐related and family QoL in children with AD. Methods Cohorts of 25 girls and 25 boys with AD aged <4 years were selected from 102 children with AD. Children in the girls’ and boys’ groups were individually matched across groups for age and severity of AD according to their scores on the SCORAD Index (SCORing of Atopic Dermatitis). The children’s parents filled in the Infants’ Dermatitis Quality of Life (IDQoL) Index and the Dermatitis Family Impact (DFI) questionnaires. Results The impact of AD on QoL (P < 0.05) and family QoL (P < 0.05) was more severe in girls. The severity of AD as assessed by the parents was equal in both groups. More parents of girls reported that AD impacted on the “child’s mood” (P < 0.05) and “enjoying family activity” (P < 0.05). “Child’s mood” and “sleep disturbance” were highly scored by parents of girls (P = 0.01 and P < 0.05, respectively). Severity of AD as assessed by parents and IDQoL Index scores correlated with SCORAD scores in both groups. Scores on the DFI correlated with patient age in boys. The child’s age correlated with the emotional distress of parents in both groups and had an impact on “relationships in the family” in girls only. Several DFI items and overall family QoL correlated with patient age in boys. Conclusions The impact of AD on QoL and family QoL was more severe for girls. Relationships between parents progressively worsen with patient age in girls. Reported gender differences should be further investigated and may influence educational programs and advice given to parents of children with AD.     

Assessment of quality of life and self-esteem in male patients with androgenetic alopecia before and after hair transplantation

Background

Patients with androgenetic alopecia experience a significant decrease in self-esteem and quality of life. There are several methods by which these factors may be improved.

Aims

Determining whether patients feel better about themselves with a better quality of life after undergoing hair transplant procedure.

Patients/Methods

35 people were chosen from Jordan Skin and Hair Clinic in Tehran, Iran. Following hair transplant, follow-up subjects had their quality of life and level of self-esteem assessed using the Rosenberg Self-Esteem Scale (RSES) and Dermatology Life Quality Index (DLQI), respectively. The means of quantitative results were compared using paired T-test. The chi-square test was done to compare preoperative and postoperative characteristics qualitatively. Differences were regarded significant if p < 0.05. Analysis of covariance was applied to evaluate the effect of marital status and educational level on outcome variables (ANCOVA).

Results

Our findings showed a statistically significant difference (p < 0.001) between pre- and post-operative hair transplantation for quality of life, and mean score increased to 2.17. There was a statistically significant difference between the two groups, with an average self-esteem score on RSES rising to 5.35 (p < 0.001). A statistically significant link between educational achievement and quality of life was found (p < 0.001).

Conclusion

This study found postoperative psychological aspects of AGA patients significantly improve than preoperative. Our results show that there is a statistically significant difference between the self-esteem and quality of life of AGA patients before and after hair restoration surgery.     

A short period of breastfeeding in infancy,excessive house cleaning,absence of older sibling,and passive smoking are related to more severe atopic dermatitis in children

Background

Atopic dermatitis (AD) is one of the most common, chronic or chronically relapsing inflammatory skin diseases that affect children. Multiple genetic and environmental factors appear to regulate the pathogenesis of AD.

Objectives

Our aim was to investigate the possible association between family, social, dieting, atopic and environmental factors and the severity of AD evaluated by SCORAD scores in children.

Materials & methods

The study group included 100 children with AD who attended a paediatric dermatology outpatient clinic with a median age of 18.5 months. The diagnosis of AD was established on the basis of the clinical criteria according to the American Dermatology Society, while the SCORAD score was used to evaluate disease severity.

Results

Multivariate linear regression analysis disclosed that excessive cleanliness (p<0.001), RAST level greater than 0.7 KU/l (p<0.001), breastfeeding for less than two months (p = 0.001), and the absence of an older sibling (p = 0.049) were statistically significant independent determinants for high SCORAD scores. Multivariate logistic regression analysis showed that excessive cleanliness (p<0.001) was the strongest independent risk factor for severe AD (SCORAD>36) (aOR: 59.4; 95% CI: 10.9-322.6). RAST level greater than 0.7 KU/l (aOR: 7.9; 95% CI: 1.5-41.0; p = 0.014) and severe passive smoking (aOR: 4.6; 95% CI: 1.0-22.1; p = 0.050) also showed a significant independent, but clearly weaker, association with severe AD.

     

Clinical benefit and tolerance profile of a keratolytic and hydrating shampoo in subjects with mild to moderate psoriasis. Results from a double-blind,randomized, vehicle-controlled study

Introduction

Scalp psoriasis frequently goes with other disease location and may lead to a significant burden and impairment of quality of life (QoL). Adherence to local treatments is a frequent problem. A keratolytic and hydrating shampoo containing 2% salicylic acid, 5% urea, and 1% glycerin (active shampoo) has been developed for psoriasis-prone scalp.

Objective

To assess the efficacy and tolerability of an active shampoo in subjects with mild to moderate scalp psoriasis.

Materials and methods

A single-center, randomized, double-blind, vehicle-controlled study was conducted on 67 adults with mild to moderate psoriasis. The active shampoo or its vehicle were applied daily for 14 days and 3 times/week for another 14 days. Assessments included the Psoriasis Scalp Severity Index (PSSI), Investigator Global Assessment (IGA), calculated total surface affected hair, scalp greasiness, irritation, and assessed scalp dermatitis–specific quality-of-life issues using SCALPDEX and product acceptability.

Results

The active shampoo significantly (p < 0.05) reduced the PSSI by 39.0%, 37.2%, 63.0%, and 69.0% immediately after washing compared to a 22.8%, 5.5%, 19.6%, and 13.0% with the vehicle at Days 1, 8, 15, and 30, respectively. SCALPDEX items, IGA, and irritation significantly (p < 0.05) reduced with the active shampoo. Hair and scalp greasiness improved continuously with both products until Day 21. Subject-reported symptom scores paralleled the positive evolution of clinical signs. The active shampoo was well tolerated, subjects were highly satisfied and had an improved QoL.

Conclusion

The active shampoo significantly improved clinical signs, symptoms, and QoL of mild-to-moderate scalp psoriasis compared to the vehicle. It was very well tolerated and highly appreciated by the subjects.     

Transition readiness in adolescents and young adults with chronic genetic skin conditions

Background/Objectives

Healthcare transition (HCT) refers to movement from pediatric to adult healthcare models. Lack of HCT preparation contributes to poor health outcomes. This study measures readiness to transition in individuals with genetic skin conditions.

Methods

Participants signed IRB-approved consents/assents. Participants ages 14–22 years with genetic skin disorders were surveyed with measures of QoL (Children's Dermatology Life Quality Index/CDLQI or DLQI) and HCT readiness using the Transition Readiness Assessment Questionnaire (TRAQ) and adapted non-validated measures of Skin Knowledge and Psychosocial Factors (5 = highest readiness). Mean TRAQ was compared with historical data on controls and other chronic conditions (t-tests) and correlated (Pearson) with Skin Knowledge and Psychosocial. Multivariable regression compared demographics and QoL with transition readiness.

Results

A total of 45 participants were enrolled (mean age 17.8 years, 67% female, 71% White; disorders of cornification [n = 31], ectodermal dysplasias [n = 7], epidermolysis bullosa [n = 4], tuberous sclerosis [n = 3]). Mean TRAQ (3.3 ± 0.9) was lower than controls (3.9; p < .001) and some chronic disorders (sickle cell [3.7; p < .05], type 1 diabetes [3.7; p < .01]), but higher than with spina bifida (2.8; p < .001) and congenital heart disease (2.9; p < .01). Mean Skin Knowledge was 4.2 ± 1.0, and mean Psychosocial was 3.4 ± 0.8. TRAQ correlated strongly with Skin Knowledge (r = .61; p < .05), but not Psychosocial (r = .12; p = .6). Ages 14–17 years versus 18–22 years and public versus private insurance predicted lower TRAQ scores. Poor DLQI predicted higher TRAQ and Skin Knowledge, but poor DLQI and CDLQI predicted lower Psychosocial.

Conclusions

Adolescents and young adults with genetic skin disorders demonstrated low transition readiness, especially among younger-aged and lower socioeconomic groups. We recommend a HCT intervention to improve health outcomes.     

Comparative effectiveness and safety of topical methimazole 5% monotherapy versus combination of Q-Switched Nd: YAG Laser and topical methimazole 5% in patients with refractory melasma

Introduction

Melasma is an acquired pigmentary disorder which currently has no definitive treatment. Although topical drugs containing hydroquinone are the basis of treatments, they are usually associated with recurrence. We aimed to evaluate the effectiveness and safety of monotherapy with topical methimazole 5% versus combination of Q-Switched Nd: YAG Laser and topical methimazole 5% in patients with refractory melasma.

Methods

A total of 27 women with refractory melasma were included. We applied topical methimazole 5% (once a day) with three passes of QSNd: YAG laser (Wavelength: 1064 nm, pulse energy: 750 mJ, fluence: 1.50  J/cm², spot size: 4 × 4 mm, hand piece: fractional, JEISYS company) for six sessions on the right half of the face, and topical methimazole 5% (once a day) on the left half of the face, for each patient. The treatment course was 12 weeks. Evaluation of effectiveness was done with the Physician Global Assessment (PGA), Patient Global Assessment (PtGA), Physician satisfaction (PS), Patients satisfaction (PtS), and mMASI score.

Results

PGA, PtGA, and PtS were not significantly different between the two groups at any time (p > 0.05). PS in the laser plus methimazole group was significantly better than methimazole group at 4th, 8th, and 12th weeks (p < 0.05). The rate of PGA improvement in the combination group was significantly better than the monotherapy over time (p < 0.001). The changes of mMASI score between the two groups did not significantly differ at any time (p > 0.05). There was no significant difference in the adverse events between the two groups.

Conclusion

Combination therapy with topical methimazole 5% and QSNY laser can be considered as an effective way to treat refractory melasma.     

A prospective randomized controlled study of Mycobacterium Indicus Pranii vaccine,Measles Mumps Rubella vaccine and Vitamin D3 in extragenital cutaneous warts

Design

Interventional, prospective, four arm randomized control.

Setting

Outpatient department, Department of Dermatology, Venereology and Leprology, AIIMS Jodhpur (Rajasthan), India.

Participants

Two hundred patients.

Methods

The intervention administered in the groups were normal saline (A), vitamin D₃ (B), MIP (C), and MMR (D). The injections were given into the largest wart at 2-weekly intervals until complete clearance or for a maximum of seven sittings. Post-treatment clearance of the injected wart and the distant wart was compared on the basis of change in wart number, percentage clearance, and mean time to complete clearance. Side effects were recorded.

Results

A total of 197 patients were recruited. The mean percentage improvement in the injected and non-injected warts was 68.4% and 66.8%, respectively. Intention to treat analysis (ITT) showed that complete clearance of lesions in injected wart occurred in placebo, vit D₃, MMR, and MIP arms in 64%, 66%, 58%, and 55% patients, respectively (p > 0.05), while in the non-injected warts in 62%, 64%, 52%, and 53%, respectively (p > 0.05). The mean time to achieve complete clearance of wart was fastest in MIP at 7.1 weeks followed by MMR at 7.2 weeks, VIT D₃ at 7.4 weeks and in placebo group 7.8 weeks (p > 0.05). Side effects noted were fever, pain, erythema, and swelling which was highest in VIT D₃ group (p < 0.05).

Conclusion

The efficacy of immunotherapies was comparable to placebo with minimal side effects.     

Evaluation of Oxidant–Antioxidant Balance in Children with Atopic Dermatitis: A Case–Control Study

Background

Increased reactive oxygen species (ROS) and oxidative stress (OS) has been reported in many allergic and inflammatory skin diseases, including urticaria, psoriasis, and atopic dermatitis (AD). Melatonin is a hormone secreted from the pineal gland and is a potent antioxidant.

Objective

The aim of the study was to measure serum antioxidant melatonin, oxidants of nitric oxide (NO), and malondialdehyde levels to calculate the serum oxidant–antioxidant balance based on the NO/melatonin and malondialdehyde/melatonin ratios and to determine the correlation with the disease severity in children with AD.

Methods

Seventy-three children with AD and 67 healthy controls were included in the study. The clinical diagnosis of AD was based on the diagnostic criteria of Hanifin-Rajka. The severity of AD was evaluated by the scoring AD (SCORAD) index, and atopy was determined by skin prick tests (SPTs) with commercial extracts. The OS-related parameters of serum melatonin, NO, malondialdehyde, and the NO/melatonin and malondialdehyde/melatonin ratios were calculated and compared with the results of healthy controls.

Results

Serum melatonin levels were higher (p < 0.0001) and serum NO levels and the NO/melatonin and malondialdehyde/melatonin ratios were lower in children with AD than in healthy controls (p = 0.045, p < 0.0001, p < 0.0001, respectively). There was no difference between children with AD and healthy controls in terms of serum malondialdehyde levels (p = 0.119). Serum melatonin levels were significantly lower in severe AD than in mild AD (p = 0.012). However, in terms of serum melatonin levels, there was no difference between mild and moderate AD (p = 0.742) and moderate to severe AD (p = 0.301). There was no significant difference in serum NO and malondialdehyde levels and NO/melatonin and malondialdehyde/melatonin ratios among children with mild, moderate, and severe AD (p > 0.05). A negative correlation was found between serum melatonin levels and the SCORAD index (r = ?0.252, p = 0.031), and a positive correlation was found between NO/melatonin and malondialdehyde/melatonin ratios (r = 0.511, p < 0.0001). There was no statistically significant relationship between age (≤24 or >24 months), disease duration (≤6 or >6 months), and sex for the OS-related parameters (p > 0.05).

Conclusion

The serum oxidant–antioxidant balance was impaired in children with AD. Serum melatonin levels were higher in children with AD; however, this was negatively correlated with disease severity. Serum NO levels and NO/melatonin and malondialdehyde/melatonin ratios were lower in children with AD than in healthy controls. Melatonin might be used as a promising antioxidant to evaluate disease severity in children with AD. Thus, further studies are needed to clarify the role of melatonin in AD pathogenesis.

     

Efficacy of metformin vs. doxycycline in treating acne vulgaris: An assessor-blinded,add-on,randomized, controlled clinical trial

Introduction

Insulin-like growth factor 1 (IGF-1) plays a role in the pathogenesis of acne vulgaris. Metformin can reduce IGF-1 levels and insulin resistance, so it may be useful in treating acne.

Objective

This study compared the efficacy of metformin and doxycycline in treating patients with acne vulgaris.

Methods

In this assessor-blind, add-on, randomized controlled clinical trial, we enrolled 40 patients with moderate acne vulgaris aged 15–40 and randomly divided them into two groups. For two months, the first group received doxycycline 100 mg capsules daily, and the second received metformin 500 mg tablets twice daily. The patients in both groups were adminitered to apply a fingertip (fourth finger) of 5% benzoyl peroxide gel (Pangel®) topically every night over the lesions, and to wash it off after 30 min. Patients were evaluated using the Global Acne Grading System (GAGS) score, Investigator Global Assessment for Acne (IGA) score, Cardiff Acne Disability Index (CADI), Total Acne Lesion Count (TLC), and the number of inflammatory and noninflammatory lesions.

Results

By the end of the study, the GAGS, IGA, CADI, and TLC scores and the number of inflammatory and noninflammatory lesions decreased significantly in both groups (p < 0.001), with no significant difference between the two groups (p > 0.05).

Conclusion

This trial indicates equal efficacy of doxycycline and metformin in reducing acne vulgaris severity, with doxycycline performing better in reducing lesions of the inflammatory type. Confirmatory or equivalence clinical trials should be performed to confirm our results.     

Evaluation of pro-atherogenic lipid profile and high atherohenic indexes in patients with Behçet's disease: A case–control study

Background

Behçet's disease is a systemic auto-immune and auto-inflammatory chronic disease in which genetic and environmental factors play a role. Patients with Behçet's are at significant risk for developing many comorbidities, including cardiovascular diseases.

Aims

It was aimed to investigate the relationship between serum lipid parameters and atherogenic indexes to evaluate the cardiovascular risk status in patients with Behçet's disease.

Patients/Methods

This study was designed as a single-center, retrospective case–control study. The study was conducted with 212 patients over 18 years of age, 106 in the case group and 106 in the control group.

Results

There was a significant difference in lipid values between the patients with Behçet's disease and the control group. While the serum triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (NHC) levels were significantly higher, the high-density lipoprotein cholesterol (HDL-C) level was low in patients with Behçet's disease. From atherogenic indexes, Atherogenic Index of Plasma (AIP) (0.03 ± 0.27 vs. −0.07 ± 0.23, p = 0.003), Castelli Risk Index I (CRI-I) (4.24 ± 1.07 vs. 3.02 ± 0.96, p < 0.001), Castelli Risk Index II (CRI-II) (2.65 ± 0.81 vs. 1.84 ± 0.59, p < 0.001) and Atherogenic Coefficient (AC) (3.24 ± 1.07 vs. 2.02 ± 0.96, p < 0.001) levels were significantly higher in patients with Behçet's disease.

Conclusion

Our study shows that patients with Behçet's have a higher pro-atherogenic lipid profile and atherogenic indexes at high risk. Patients with Behçet's have an increased risk of cardiovascular diseases associated with atherosclerosis.     

Probiotic Supplement Reduces Atopic Dermatitis in Preschool Children

Background: The role of probiotics in the treatment of atopic dermatitis (AD) remains controversial. A recent systematic review of the available evidence called for further clinical trials with new probiotic formulations. Objective: To assess the clinical efficacy and impact of Lactobacillus acidophilus DDS-1, Bifidobacterium lactis UABLA-12 with fructo-oligosaccharide on peripheral blood lymphocyte subsets in preschool children with moderate-to-severe AD. Method: Randomized, double-blind, placebo-controlled, prospective trial of 90 children aged 1–3 years with moderate-to-severe AD who were treated with a mixture of L. acidophilus DDS-1, B. lactis UABLA-12 with fructo-oligosaccharide at a dosage of 5 billion colony-forming units twice daily for 8 weeks versus placebo. The primary outcome measure was the percentage change in Scoring of Atopic Dermatitis (SCORAD) value. Other outcome measures were changes in Infant Dermatitis Quality Of Life (IDQOL) and Dermatitis Family Impact (DFI) scores, frequency and amount of topical corticosteroid used, and lymphocyte subsets in peripheral blood measured by laser flow cytometry. Results: At the final visit, the percentage decrease in SCORAD was 33.7% in the probiotic group compared with 19.4% in the placebo group (p = 0.001). Children receiving probiotic showed a greater decrease in the mean [SD] SCORAD score than did children from the placebo group at week 8 (?14.2 [9.9] vs ?7.8 [7.7], respectively; p = 0.001). IDQOL and DFI scores decreased significantly from baseline by 33.0% and 35.2% in the probiotic group and by 19.0% and 23.8% in the placebo group, respectively (p = 0.013, p = 0.010). Use of topical corticosteroids during the 8-week trial period averaged 7.7 g less in probiotic patients (p = 0.006). CD3, CD16, and CD22 lymphocyte subsets remained unchanged, whereas the percentage of CD4, and the percentage and absolute count of CD25 decreased, and the percentage and absolute count of CD8 increased in the probiotic group at week 8 (p < 0.007 vs placebo). There was a significant correlation between CD4 percentage, CD25 percentage, CD25 absolute count, and SCORAD values (r = 0.642, r = 0.746, r = 0.733, respectively; p < 0.05) in the probiotic group at week 8. Conclusion: The administration of a probiotic mixture containing L. acidophilus DDS-1, B. lactis UABLA- 12, and fructo-oligosaccharide was associated with significant clinical improvement in children with AD, with corresponding lymphocyte subset changes in peripheral blood. The efficacy of probiotic therapy in adults with AD requires further investigation.     

Effect of rosmarinic acid on atopic dermatitis

Rosmarinic acid is known to have anti‐inflammatory and immunomodulatory activities. This study was performed to evaluate the effect of rosmarinic acid on atopic dermatitis (AD), one of the inflammatory disorders of the skin. Twenty‐one subjects (14 women and seven men, 5–28 years of age) with mild AD participated in this study. Rosmarinic acid (0.3%) emulsion was topically applied to the elbow flexures of AD patients twice a day (once in the morning and once in the evening). All subjects were evaluated for skin conditions before treatment at the first visit, and then at 4 and 8 weeks after treatment. According to local Severity Scoring of Atopic Dermatitis index results, erythema on antecubital fossa was significantly reduced at 4 and 8 weeks (P < 0.05). Transepidermal water loss of the antecubital fossa was significantly reduced at 8 weeks compared to before treatment (P < 0.05). The results from self‐questionnaires on the efficacy of rosmarinic acid indicated that dryness, pruritus and general AD symptoms improved. Our investigation into the AD‐mitigating effect of rosmarinic acid through in vivo experiments demonstrated the possible clinical use of rosmarinic acid as a therapeutic agent for AD.     

A first prospective randomized controlled trial on the efficacy and safety of synchronous balneophototherapy vs. narrow‐band UVB monotherapy for atopic dermatitis

Background Data from an uncontrolled trial suggest synchronous balneophototherapy (sBPT), which simulates treatment conditions at the Dead Sea, to be effective in the management of atopic dermatitis (AD). Objectives The purpose of this prospective randomized controlled study was to compare the efficacy and safety of sBPT with narrow‐band (NB) UVB monotherapy (PT) for AD. Methods In this phase III multicentre trial, 180 patients with moderate‐to‐severe AD were allocated to two groups in a 1 : 1 ratio; group 1 received sBPT consisting of NB UVB treatment and synchronous bathing in 10% Dead Sea salt solution, group 2 monotherapy with UVB 311 nm. The confirmatory study design consisted of up to 35 treatment sessions. Primary endpoint, analysed on an intention‐to‐treat‐basis (n = 169), was the relative improvement of the severity SCORing of the Atopic Dermatitis Index (SCORAD) from baseline to the end of treatment (35 sessions or early cure). Sample‐size calculation aimed at establishing at least 15% superiority. Results SCORing of the Atopic Dermatitis Index at baseline was comparable between sBPT (61.8 ± 14.1) and PT (61.5 ± 12.4) group. At the end of therapy, a clinically relevant and statistically significant difference of 26.2% could be shown (P < 0.001). Exploratory testing showed statistically significant superiority of sBPT after 6 months. Mild adverse events more frequently occurred in the sBPT group (n = 46, PT: n = 31), whereas more patients withdrew early because of adverse events in the PT group (n = 6, sBPT: n = 2). Conclusions A clear advantage of sBPT in comparison to PT was proven. Tolerability was comparable; both treatments showed to be safe.     

Effect of fractional laser alone or in combination on alopecia areata: A systematic review and meta-analysis

Background

Alopecia areata (AA) is characterized by limited non-scarring patchy alopecia, which appears as round or oval patches and is prone to recurrence, causing severe psychological burdens to patients. No specific device has been approved by the FDA for the treatment of baldness, but new treatments are being investigated and treatments such as the excimer laser, He- Ne laser, and excimer lamp have been proposed. A growing number of studies have found that fractional lasers also have great potential in the treatment of AA.

Methods

A literature search and meta-analysis using Review Manager 5.4 software to investigate the efficacy of fractional laser treatment for AA.

Results

Fractional laser combined with minoxidil (RR 1.32, 95% CI 1.17–1.49, p < 0.00001) or cortisol (RR 1.39, 95% CI 1.15–1.67, p = 0.00006) was more effective than either drug alone in the treatment of AA. Of course, the fractional laser alone was also effective in the treatment of AA (RR 10.33, 95% CI 2.07–51.36, p = 0.004) and more effective than cortisol alone (RR 1.86, 95% CI 1.36–2.52, p < 0.00001), and there was no effect on the occurrence of adverse effects (p = 0.49 > 0.05). When compared to other physical treatments of a comparable kind, fractional laser therapy's effectiveness was not significantly different (p = 0.15 > 0.05).

Conclusion

Our results show that the use of fractional lasers can effectively treat alopecia areata.     

Microneedle fractional radiofrequency in the treatment of periorbital dark circles

Background

Periorbital hyperpigmentation (POH) is a common disorder in the patients. Women are more upset with POH in compare to males. Several methods have been used to the POH, with different efficacy and adverse reactions.

Aim

The aim of the present study is to evaluate the efficacy of microneedle fractional radiofrequency (MRF) in treating POH.

Methods

So, nine patients with POH and the age range of 25–57 years, were treated by microneedle fractional radiofrequency (MRF). The outcome was evaluated via biometric assessment. The colorimeter was used to assess the skin lightness. Mexameter was used for evaluated the amount of Melanin in the periorbital skin. Cutometer was used for skin elasticity assessment. The skin ultrasound imaging system was utilized to estimate the epidermis and dermis diameter and density. Furthermore, Visioface was applied to assessed the skin color and wrinkles. Also patient's satisfaction and physician's assessment were evaluated.

Results

The results displayed that the periorbital skin lightness 32.38% ± 5.67 and elasticity of the R2: 40.29% ± 8.18, R5: 39.03 ± 5.38 and R7: 42.03% ± 14.16 were significantly improved after treatment (p < 0.05). Also the melanin content of the skin was decreased (49.41% ± 9.12). The skin layers were denser in the dermis and also in the epidermis (skin density: 30.21% ± 10.16 and skin thickness: 41.12% ± 13.21) (p < 0.05). The results revealed the decrease in the percent change of the skin color (30.34% ± 9.30) and wrinkle (area: 25.84% ± 6.43 and volume: 30.66% ± 8.12) (p < 0.05). Similarly, the physician and patient's assessment were confirmed the obtained outcomes.

Conclusion

In conclusion, the microneedle RF technique is practicable, effective and safe method for periorbital dark circles treatment.     

Rosacea and seborrheic dermatitis differentially respond to lactic acid sting and capsaicin tests in Chinese women

Background

Although rosacea and seborrheic dermatitis share some symptoms of sensitive skin, whether they respond differently to lactic acid sting and capsaicin tests, common tests for diagnosis of sensitive skin, is unknown.

Objectives

To reveal the cutaneous responses to lactic acid sting (LAST) and capsaicin test (CAT) in females with either rosacea vs. seborrheic dermatitis.

Methods

A total of 60 patients with rosacea, 20 patients with seborrheic dermatitis and 40 normal controls were enrolled in the study. Their skin sensitivity to stimuli were evaluated following topical application of either 10% lactic acid solution or 0.001% capsaicin solution. Transepidermal water loss (TEWL) rates and erythema indexes were also measured on the face.

Results

In comparison to normal controls, the positive rate to either LAST or CAT was significantly higher in subjects with rosacea (p < 0.001), but not in that with seborrheic dermatitis. Similarly, individuals with rosacea displayed a higher positive rate to both LAST and CAT than those with seborrheic dermatitis and normal controls (p < 0.001). In parallel, the LAST scores and CAT scores in individuals with rosacea were significantly higher than in that with either seborrheic dermatitis or normal controls (p < 0.001). The baseline TEWL rates and erythema indexes were higher in individual with rosacea than in normal controls (p < 0.001). But the baseline TEWL rates and erythema indexes did not differ significantly between subjects with rosacea and that with seborrheic dermatitis. Moreover, LAST scores and CAT scores correlated positively with TEWL (p < 0.0001). TEWL rates were higher in CAT positive than in CAT negative subjects (p < 0.0001). Finally, erythema index correlated positively with CAT scores (p < 0.0001), but not with LAST scores (p = 0.0842).

Conclusions

Skin responses to LAST and CAT differ between individuals with rosacea and those with seborrheic dermatitis, possibly due to the differences in epidermal permeability barrier and the neurovascular hyperreactivity. The higher LAST and CAT scores, as well as positive rates of both LAST and CAT can be attributable to inferior permeability barrier and the neurovascular hyperreactivity in subjects with rosacea.