Tolerance profile of a sterile moisturizer and moisturizing cleanser in irritated and sensitive skin.

BACKGROUND: This study evaluates the tolerance of preservative free sterile cleanser and sterile moisturizer in irritated and sensitive face skin. MATERIALS AND METHODS: An exploratory, open-label study using the cleanser and the moisturizer in combination was performed with 98 patients with a documented history of allergic contact dermatitis. The 2 products could each be used once or twice daily for 28 days. The assessment parameters at baseline and end of treatment (day 28) included the intensity of erythema, dryness/scaling by the investigator and subjective signs (burning, pruritus and stinging), according to a defined 4-point scale (absent to severe). In addition, a global assessment of the change from baseline and the overall tolerance of the products were performed by the investigator at the end of treatment. RESULTS: Ninety-four patients were included for the efficacy analysis and 96 patients for the safety analysis. At baseline, a majority of patients expressed some degree of erythema (63%), and dryness/scaling (56%). Fewer patients experienced subjective signs at baseline (44%). At the end of treatment, the results showed a statistically significant improvement of all the objective signs of irritated skin (P = .0001, Mac Nemar test), as well as the subjective signs of sensitive skin (P < 0.02). This was confirmed by the overall investigator assessment, showing an excellent or good response in 90% of the patients. In the safety analysis, 1 patient developed contact allergy to 1 ingredient of the test products (carbomer), and 3 patients exacerbated their dermatitis. CONCLUSION: Taken together, these results suggest that adequately formulated cosmetics might reduce both irritated and sensitive skin, with clinical improvement of dryness, erythema and stinging.     

0.1%他克莫司软膏治疗成年人面部敏感性皮肤的疗效和观察

目的观察0.1%的他克莫司软膏治疗成年人面部敏感性皮肤的疗效和安全性。方法给予36例诊断为敏感性皮肤的患者外用0.1%他克莫司软膏,每日2次,共3周,如果用药不到3周痊愈,可停止用药。于治疗前及治疗后1、3周和停药后4周各随访1次,评估病情严重程度及临床疗效。采用皮肤病生活质量调查问卷评估敏感性皮肤对生活质量的影响。结果 36例患者中32例完成临床试验。治疗3周后皮炎症状的临床痊愈率、显效率分别为46.9%、40.6%,有效率为87.5%。治疗3周后10项评估指标及生活质量均有明显改善(P0.001)。主观症状改善最明显的是自觉干燥、针刺感。客观症状中脱屑、干燥症状对治疗的反应最好。药物不良反应发生率为72.2%(瘙痒占30.8%,烧灼感占69.2%,刺痛占7.7%),其中有50%只出现于用药后2 d内。结论 0.1%他克莫司软膏治疗成年人面部敏感性皮肤安全、有效,刺激反应较普遍,多为一过性,可耐受。     

A randomized,double‐blind,placebo‐controlled study to evaluate the efficacy in AD of liquid soap containing 12% ammonium lactate + 20% urea

Atopic dermatitis (AD) is a common chronic skin disease, which mainly affects children. Xerosis is one of the most troublesome signs of the disease. The aim of this study was to evaluate the efficacy of liquid soap containing 12% ammonium lactate + 20% urea in patients with AD. In a randomized, double‐blind study, 36 patients (both male and female patients; age range 3–40 years) with mild to moderate AD were enrolled. Patients were divided randomly into two groups, in a ratio of 2 : 1 (active : placebo). The prescribed soap was used on a daily basis during a shower for 3 weeks. All patients continued all other systemic or topical medication but avoided any other soap or emollients. After 3 weeks of treatment, efficacy was assessed both by clinician and patient. There were significant improvements in scaling (P < 0.0001), skin dryness (P < 0.0001) and redness (P = 0.03) as rated by the investigator, and subjective patient assessment of itch also improved (P < 0.001) in the study group compared with the control group. The liquid soap was found to be effective in patients with AD, as use of this soap in patients with stable mild to moderate AD improved the parameters studied.     

Safety and tolerability of a body wash and moisturizer when applied to infants and toddlers with a history of atopic dermatitis: results from an open-label study

Abstract: Improving skin barrier function and moisturizing without irritation are important components of managing patients with atopic dermatitis. This study evaluated the safety and tolerability of a body wash and moisturizer regimen for infants and toddlers with atopic dermatitis. This was an open‐label study involving 56 children (3–36 months old) with a history of atopic dermatitis. The skin care regimen (Cetaphil Restoraderm Skin Restoring Body Wash and Cetaphil Restoraderm Skin Restoring Moisturizer; Galderma Laboratories, L.P.) was used at least once daily, but no more than twice daily, for 4 weeks. The primary variable of interest was the worst postbaseline scores for local tolerability (expressed as success or failure) using a 4‐point scale for each component (erythema, edema, scaling and dryness, rash, and signs of discomfort upon application). Assessments of moisture content of the stratum corneum and transepidermal water loss were also performed. Fifty‐three children completed the study. The percentage of subjects with no erythema increased from 33.9% to 50.0% by Week 4. The percentage of subjects with no scaling or dryness increased from 58.9% to 85.2% at Week 4. A statistically significant increase in corneometry from baseline (p < 0.001) and a statistically significant decrease in transepidermal water loss (p = .009) were observed. The body wash and moisturizer regimen was safe and well tolerated and improved hydration and skin barrier function in infants and toddlers as young as 3 months of age with a history of atopic dermatitis.     

A double-blind study comparing the effect of glycerin and urea on dry,eczematous skin in atopic patients

Moisturizing creams have beneficial effects in the treatment of dry, scaly skin, but they may induce adverse skin reactions. In a randomized double-blind study, 197 patients with atopic dermatitis were treated with one of the following: a new moisturizing cream with 20% glycerin, its cream base without glycerin as placebo, or a cream with 4% urea and 4% sodium chloride. The patients were asked to apply the cream at least once daily for 30 days. Adverse skin reactions and changes in skin dryness were assessed by the patient and a dermatologist. Adverse skin reactions such as smarting (a sharp local superficial sensation) were felt significantly less among patients using the 20% glycerin cream compared with the urea-saline cream, because 10% of the patients judged the smarting as severe or moderate when using glycerin cream, whereas 24% did so using urea-saline cream (p < 0.0006). No differences were found regarding skin reactions such as stinging, itching and dryness/irritation. The study showed equal effects on skin dryness as judged by the patients and the dermatologist. In conclusion, a glycerin containing cream appears to be a suitable alternative to urea/sodium chloride in the treatment of atopic dry skin.     

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.     

Serum antibody to staphylococcal teichoic acid and α-haemolysin in dermatological patients

Teichoic acid antibody (TAA) titres and antibody to α-haemolysin of Staphylococcus aureus (ASta) were measured in 274 dermatological patients and 200 normal controls. Positive Asta values (≥2.0 iu/ml) were common in patients with chronic pruritic dermatoses such as atopic dermatitis (44% ASta positive) and infective eczema (28% ASta positive), but patients with primary pyoderma were all ASta negative. Positive TAA titres (≥1:4) were seen less frequently than positive ASta values, but still significantly more often in atopic dermatitis patients than in controls. Routine skin swabs were taken from all patients, but positive TAA or ASta tests correlated neither with growth of Staphylococcus aureus from skin lesions nor with signs of clinical infection. This study shows that the TAA test cannot be used as an indicator of septic staphylococcal infection in patients with atopic dermatitis.     

X-linked recessive ichthyosis: an impaired barrier function evokes limited gene responses before and after moisturizing treatments

Background X‐linked recessive ichthyosis (XLRI) is due to deletions or inactivating mutations in the steroid sulfatase (STS) gene. This results in an accumulation of cholesterol sulphate affecting the packing of intercorneocyte lipids. XLRI is characterized by dry, scaly skin and increased skin barrier permeability; patients are often dependent on daily use of moisturizers. Objectives To examine the biophysical and molecular changes in the skin of patients with XLRI compared with healthy volunteers, and to analyse the effects of moisturizers on the patients’ barrier function. Methods Patients with XLRI (n = 14) and healthy controls (n = 14) were included in the study. Skin dryness score, transepidermal water loss (TEWL) and skin surface pH were monitored at baseline, and punch biopsies were obtained for mRNA expression profiles determined by oligonucleotide arrays. Measurements were repeated in the patients with XLRI after a 4‐week treatment with three different moisturizers on the volar forearms. Results Patients with XLRI showed, compared with healthy controls, increased dryness and TEWL, equal skin pH and altered expression of 27 genes. There were no signs of activation of inflammation or repair pathways. Five selected genes were significantly altered also on quantitative polymerase chain reaction analysis. Treatment with the moisturizers showed similar effects: they improved skin dryness but had no effect on TEWL, pH or expression of selected genes. Conclusions Despite a dysfunctional skin barrier, the limited number of genes altered in XLRI skin suggests that no inflammatory or repair mechanisms are triggered. Treatment with moisturizers does not have any major impact on the skin barrier properties of patients with XLRI.     

Head and neck dermatitis: the role of Malassezia furfur, topical steroid use and environmental factors in its causation

The aetiology of head and neck dermatitis (HND), one subgroup of postpubertal atopic dermatitis (AD), is still unclear. The aim of this study was to evaluate the influence on HND of common environmental factors, long-term topical steroid use, and the role of Malassezia furfur infection. Relevant information was obtained from 100 patients with HND attending our dermatology clinic by means of both physical examinations and questionnaires. Corticosteroid-induced vasoconstriction was estimated by visual scoring of laser-Doppler flowmetry. and the following immunological studies were performed: skin prick test, measurement of total IgE, eosinophil cationic protein, and specific IgE antibodies to several fungal antigens including those of M. furfur. The questionnaire revealed that sweating (81%), heat (71%), dryness (70%), psychic stress (67%), and sun exposure (50%) were responsible for aggravation of skin lesions. The vascular response to topical steroid was reduced in HND patients as compared with that of normal healthy controls (P < 0.05). Fifty-four of 80 patients with HND (68%) had anti M. furfur-specific IgE antibodies and 36 of 80 patients (45%) showed positive skin prick tests for M. furfur. The clinical severity and serum total IgE of HND patients were higher in patients with positive response to anti-M. furfur-specific IgE antibodies than in patients with negative response (P < 0.05). These results suggest that HND can be aggravated not only by M. furfur but also by environmental factors such as sweating, heat, dryness, psychic stress and sun exposure. Furthermore, long-term use of topical steroid might be associated with the development of diffuse erythematous lesions with telangiectasia on the head and neck areas.     

Clinical features of atopic dermatitis in a hospital‐based setting in China

Background Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. There have been few detailed reports of the clinical evaluation of Chinese patients with AD. Objectives To give a profile of the clinical features of Chinese AD patients in a university hospital setting. Methods A total of 1008 cases met Hanifin and Rajka diagnostic criteria of AD were recruited at Xinhua Hospital, Shanghai Jiaotong University School of Medicine, China. Results In our survey, 22.7% patients were mild, 66.6% were moderate and 10.7% were severe according to the SCORAD index. Both the frequency and severity of the male patients were slightly higher. The frequency of asthma among the AD patients was 16.7% and it was increased with the age (χ² = 205.20, P = 0.000). The frequencies of objective minor signs were demonstrated with age‐related changes. Besides, three localized variants including eyelid eczema (49.8%), scalp dermatitis (49.7%), infra‐auricular and retroauricular fissuring (44.8%) were commonly observed, especially in the infantile phase (P < 0.01). It was showed significant differences in serum total immunoglobulin E (IgE) and eosinophil cationic protein (ECP) levels of different age groups. The positive rate of Phadiatop was raised after 3 years old and that of the common food allergens were decreased after 6 years old. Conclusions More males than females had ongoing AD in our survey. Most AD debuted in the first year of the cases. High incidence of the three clinical signs: eyelid eczema, scalp dermatitis and infra‐auricular and retroauricular fissuring among the patients suggests it can be a potential valuable diagnostic clue to AD.     

The new scoring system for evaluation of skin inflammation extent and severity in patients with atopic dermatitis

The new scoring system for assessment of the extent and severity of skin inflammation index in atopic dermatitis patients, W-AZS, is presented. The system provides detailed assessment of both subjective and objective signs and symptoms of atopic dermatitis. With the use of W-AZS, acute and chronic skin manifestations of inflammatory process are appropriately evaluated and scored. It also enables the practitioner to assess various localizations of skin lesions at different time points. W-AZS is a relatively easy and rapid index to perform, and it seems very beneficial for clinicians. Other scoring systems used in atopic dermatitis are also presented, analyzed and compared, e.g., Atopic Dermatitis Area and Severity Index (ADASI), SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), Six Area, Six Sign Atopic Dermatitis (SASSAD), and Three-Item Severity score (TIS). There is a strong necessity to standardize clinical evaluation of the extent and severity of skin diseases such as atopic dermatitis, as laboratory techniques and parameters are not really of great use for practitioners.     

Neuroimmunomodulatory compound for sensitive skin care: in vitro and clinical assessment

Background The pathophysiology of sensitive skin consists of an inflammatory reaction resulting from the abnormal penetration in the skin of potentially irritating substances, which occurs due to skin barrier dysfunction and changes in the production of local neuromediators. Aims The therapeutic potential of l ‐carnosine and Rhodiola rosea, as antioxidant and neuromodulatory, respectively, leads us to investigate the effects of the R. rosea extract/l ‐carnosine–associated compound (RCAC) on sensitive skin alterations. Methods A double‐blind comparative study was conducted on 124 volunteers with sensitive skin, who were selected by their reactivity to stinging test. Two randomized groups of 62 each received either a formulation containing 1% of RCAC or placebo, which was applied twice a day for 28 consecutive days. One perceptibility questionnaire was applied at the onset and at the end of the treatment to evaluate the subjective response to test product. Additionally, in vitro studies were performed to investigate RCAC neuroimmunomodulatory mechanisms. Results RCAC treatment produced in vivo protective effects in skin barrier function and a positive subjective response of sensitive skin volunteers. In vitro treatment promoted the release of proopiomelanocortin peptides and restored to normal the increased levels of neuropeptides and cytokines produced by keratinocytes exposed to ultraviolet radiation. Clinical effectiveness was measured by reduction of transepidermal water loss, positive perceptions of improvements in skin dryness and skin comfort sensation, and reduction of discomfort sensation after stinging test. Conclusions The protective effect of RCAC in skin barrier function and the positive response produced in human subjects with sensitive skin could be partially explained by our in vitro results showing a significant increase in opioid peptides release, an inhibitory effect on neuropeptides production, and modulation of cytokines production by keratinocytes under ultraviolet stress.     

Impaired skin barrier and atopic diathesis in perioral dermatitis

Background: Perioral dermatitis (PD) is a common dermatological disease whose aetiology and pathogenesis remain speculative. We investigated skin barrier function and various markers of the atopic diathesis to elucidate their impact on the development of perioral dermatitis. Patients and methods: Forty patients (24 to 69 years of age) with PD were evaluated. Transepidermal water loss was measured in three regions of the face (lateral chin, perinasal cheek and side of the nose) and the patients were assessed for clinical criteria for atopy. Prick tests were performed, and specific IgE against a mixture of aeroallergens (CAP SX1) was measured. The control group consisted of 62 individuals (20 to 68 years of age) without a history of PD or active disease. Results: Transepidermal water loss was significantly increased (P < 0.001) on all regions of the face in the patient over the control group. Significantly (P < 0.001) higher values were also found for the patient group regarding history (52.5 % vs. 17.7 %) and clinical signs of atopic diathesis (≥ 4 features: 72.5 % vs. 0 %), prick test reactivity (≥ 2 reactive prick tests: 60 % vs. 12.9 %), and specific IgE against aeroallergens (CAP SX1 classes ≥ 2: 60.0 % vs. 17.7 %). Conclusions: Our findings emphasize the relevance of impaired skin barrier function as a pathogenic factor in the causation of perioral dermatitis. The susceptibility of atopic skin to irritants increases as soon as the skin becomes eczematous. Therefore, we propose that atopic diathesis serves as an intensifier, supporting development and continued presence of perioral dermatitis after nonspecific irritant mechanisms have induced impaired skin barrier function.     

PREVALENCE OF EYELID DERMATITIS IN PRIMARY SJÖGREN'S SYNDROME

Background. The eyelid dermatitis seen in elderly patients is a relatively heterogenous and troublesome disease. Most cases seem to be idiopathic and show resistance to standard dermatologic therapy. Methods. Fifty-two patients with primary definite Sjögren's syndrome (4 men, 48 women, mean age 54 years) were enrolled in this study, and the prevalence of eyelid dermatitis was investigated. Diagnostic criteria for Sjögren's syndrome were based on the criteria proposed by the Japanese Ministry of Health and Welfare. Patch test was performed using ICDRG-European standard allergens and/or eye drops, hair dye, and cosmetics. Results. Of the 52 patients, 22 showed eyelid dermatitis. These changes were much more frequent in elderly patients and showed a good correlation with the presence of ocular dry sensation. No significant difference was observed in clinical and other laboratory findings between patients with or without eyelid dermatitis. Although 8 of the 13 patients showed positive patch test reaction to various allergens, no close relationship existed between the use of a suspected substance and the onset or severity of eyelid dermatitis. Conclusions. These results suggest that the presence of rubbing dermatitis of the eyelid may be one of the cutaneous manifestations of Sjögren's syndrome.     

Effect of moisturizers on epidermal barrier function

A daily moisturizing routine is a vital part of the management of patients with atopic dermatitis and other dry skin conditions. The composition of the moisturizer determines whether the treatment strengthens or deteriorates the skin barrier function, which may have consequences for the outcome of the dermatitis. One might expect that a patient's impaired skin barrier function should improve in association with a reduction in the clinical signs of dryness. Despite visible relief of the dryness symptoms, however, the abnormal transepidermal water loss has been reported to remain high, or even to increase under certain regimens, whereas other moisturizers improve skin barrier function. Differing outcomes have also been reported in healthy skin: some moisturizers produce deterioration in skin barrier function and others improve the skin. Possible targets for barrier-influencing moisturizing creams include the intercellular lipid bilayers, where the fraction of lipids forming a fluid phase might be changed due to compositional or organizational changes. Other targets are the projected size of the corneocytes or the thickness of the stratum corneum. Moisturizers with barrier-improving properties may delay relapse of dermatitis in patients with atopic dermatitis. In a worst-case scenario, treatment with moisturizing creams could increase the risks of dermatitis and asthma.     

Instrumental and dermatologist evaluation of the effect of glycerine and urea on dry skin in atopic dermatitis

Background/aims: Moisturising creams are useful treatment adjuncts in inflammatory dermatoses and have beneficial effects in the treatment of dry, scaly skin. The effects on dryness and skin permeability of a new moisturising cream with 20% glycerine was compared with its placebo and with a medicinally authorised cream with 4% urea (combined with 4% sodium chloride) in the treatment of dry skin.
Methods: Patients ( n =109) with atopic dermatitis were treated for 30 days with a moisturiser in a randomised, parallel and double-blind fashion. Transepidermal water loss (TEWL) and skin capacitance were assessed instrumentally, and changes in the dryness of the skin were assessed by the dermatologist.
Results: No difference in TEWL was found between glycerine treatment and its placebo, whereas a lower value was found in the urea-treated area compared to the glycerine-treated area. No difference in skin capacitance was found. The clinical assessment of dryness showed urea to be superior to glycerine in treating the condition.
Conclusions: Moisturising creams are different, not only with respect to composition but also with respect to their influence on skin as a barrier to water in patients with atopic dermatitis.     

Comparison of epidermal hydration and skin surface lipids in healthy individuals and in patients with atopic dermatitis

BACKGROUND: The water content of the stratum corneum and skin surface lipids are important factors in the appearance and function of the skin. A disruption of the balance between the two may lead to the clinical manifestation of dryness of skin in patients with atopic dermatitis. OBJECTIVE: The aim of our study was to examine the so-called dry skin of patients with atopic dermatitis using objective parameters. We compared the epidermal hydration and the skin surface lipids, the so-called hydro-lipid film, of the clinically unaffected skin of patients suffering from atopic dermatitis with that of healthy subjects. METHODS: A total of 48 patients of either gender were included in this retrospective case-control study. We used the Corneometer CM 820 (Courage+Khazaka Electronic GmbH, Cologne, Germany) and the Sebumeter SM 810 (Courage+Khazaka Electronic GmbH) as noninvasive measuring methods. RESULTS: The results showed marked decreases in the atopic dermatitis group for both the Corneometer and Sebumeter measuring methods. CONCLUSION: Our results show that the dry skin of patients with atopic dermatitis, as previously shown, is due not only to a decrease in skin moisture but also to a reduction of skin lipids. This finding gives rise to a new understanding of the condition, and therefore one should always speak of a hydro-lipid film.     

Does autonomic dysfunction play a role in atopic dermatitis?

Background Atopic dermatitis (AD) is a chronic dermatitis characterized by intense itching and excessive skin dryness. The factor most commonly blamed for the pathogenesis of skin dryness in the disease is impaired barrier function of the stratum corneum. However, there are findings indicating that the autonomic nervous system, and the sympathetic nervous system in particular, is affected negatively in AD, and thus, autonomic dysfunction can be an important factor leading to skin dryness. Objective In this study we aimed to evaluate the functioning of the autonomic nervous system electrophysiologically using R‐R interval variation (RRIV) and the sympathetic skin response (SSR) in patients with AD, and to examine whether there is an underlying autonomic nervous system dysfunction. Patients and methods The study registered a total of 38 (12 males and 26 females) patients with AD, of whom 24 had active and 14 inactive disease, and 20 (10 males and 10 females) healthy control subjects. RRIV was used in our study as the electrophysiological test to evaluate the parasympathetic system. The SSR method, which is a noninvasive electrophysiological test with a significant role in evaluating the sudomotor activity of skin, as well as that of the unmyelinated fibres that take a part in this activity, was employed to assess the sympathetic nervous system. Results Our study revealed a significantly prolonged SSR latency and amplitude of the upper extremity in the patient group, relative to the control group (P < 0·05). When the group with active skin lesions was compared with the control group, the former was found to have prolonged SSR latency and amplitude in the upper extremity. The prolongation in SSR latency of the upper extremity was statistically significant (P < 0·05), while the prolongation in amplitude was not (P = 0·5). An evaluation of RRIV results did not show a significant difference between the patient and control groups. Conclusions These findings demonstrate that the sudomotor activity controlled by the sympathetic nervous system, as well as unmyelinated fibres that play a role in this activity are affected in patients with AD. We think that the involvement of sudomotor activity may be one of the causes that leads to dysfunction in sweat glands and skin dryness.     

Ciclopirox gel for seborrheic dermatitis of the scalp

Background Seborrheic dermatitis is a common inflammatory skin disorder that usually occurs in patients with pre‐existing seborrhea. The etiology of seborrheic dermatitis is uncertain. Typically, sites dense with sebaceous glands support growth of the lipophilic yeast Malassezia furfur. Ciclopirox (Loprox®) gel is a hydroxypyridone, broad‐spectrum antifungal agent proven effective against the yeast M. furfur. Objective A multicenter, randomized, double‐blind, vehicle controlled study of 178 subjects evaluated the efficacy of ciclopirox gel in treating seborrheic dermatitis of the scalp. Methods One hundred and seventy‐eight subjects were randomized to apply either ciclopirox gel 0.77% twice daily, or vehicle twice daily for 28 days. Subjects’ signs and symptoms of severity (erythema, scaling, pruritus and burning) were rated on a scale of 0–3 (none to severe); for inclusion, a minimum score of 4, for the sum of the individual ratings was required. Efficacy evaluations were performed at baseline, days 4, 8, 15, 22, 29, and at end‐point (final visit, up to day 33). The primary efficacy variable was clinical response assessed by a global improvement, based on a scale of 0–5 (100% clearance to flare of treatment area). Changes in signs/symptoms severity scores within the target lesion were also evaluated. Results Global evaluation scores demonstrated that significantly more ciclopirox‐treated subjects achieved over 75% improvement compared with vehicle at days 22, 29, and endpoint (P < 0.01). Change‐from‐baseline mean score for total signs and symptoms was significantly greater in ciclopirox subjects compared with vehicle subjects at the same time points as above (P < 0.001), as well as day 15 (P < 0.01). Twenty‐nine percent of subjects rated ciclopirox as having excellent cosmetic acceptability. There were only mild adverse events, with the most common being burning sensation in 13% of ciclopirox subjects and 9% of vehicle subjects. Conclusion Ciclopirox gel is effective and safe in the treatment of seborrheic dermatitis of the scalp.     

黄连、黄柏预防放射性皮肤损伤的临床观察

目的　探讨黄连、黄柏预防放射性皮肤损伤的临床效果。方法　观察组于放疗前 2日开始照射野外涂黄连、黄柏液 ,3～ 4次 /d ,至放疗结束 ,对照组常规处理。结果　Ⅱ、Ⅲ度皮肤损伤 ,观察组明显少于对照组 ,差异有显著性(P <0 .0 5 )。皮肤瘙痒、明显红斑、斑状湿性皮损、融合性皮损两组间差异有显著性 (P <0 .0 5 ) ,而对于皮肤烧灼感、干性皮损、轻度红斑两组间差异无显著性 (P >0 .0 5 )。结论　外用黄连、黄柏具有明显的预防放射性皮肤损伤的作用。