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Yakugaku Zasshi : Journal of the... 2019In this symposium, we present a novel breathable protective ointment (BPO) formulation developed at the University of Shizuoka for the prevention of moisture-associated... (Review)
Review
In this symposium, we present a novel breathable protective ointment (BPO) formulation developed at the University of Shizuoka for the prevention of moisture-associated skin damage (MASD) intended for use in healthcare settings. MASD occurs when moisture is in constant contact with the skin for prolonged periods of time, causing degradation of the skin barrier. Exposure to physical or chemical stimuli in addition to moisture may lead to different types of moisture-associated dermatitis such as incontinence-associated or periwound dermatitis. Another type of moisture-associated dermatitis, diaper dermatitis, is treated with protective ointments such as white petrolatum and zinc ointment. These ointments protect the skin from irritants but also block insensible dermal perspiration, which promotes further skin maceration. Therefore, we have developed a BPO formulation from white petrolatum and calcium carbonate, which serve as a protectant and pore-forming agent, respectively. In vitro water-proof tests confirmed the skin-protective properties of the BPO, and moisture-permeation tests indicated its breathability. Moreover, the BPO protected the skin from irritants without the loss of skin hydration in rats. Our next step involves the trial of BPO in infants with diaper dermatitis. In the future, this BPO could be used as an ointment base for active pharmaceutical ingredients used to prevent MASD.
Topics: Animals; Diaper Rash; Drug Compounding; Humans; Ointment Bases; Ointments; Permeability; Petrolatum; Pharmacy Service, Hospital; Rats; Skin; Water
PubMed: 31582613
DOI: 10.1248/yakushi.19-00121-3 -
MBio Jun 2022Candida albicans is one of the most prevalent human fungal pathogens. Its ability to transition between budding yeast and filamentous morphological forms (pseudohyphae...
Candida albicans is one of the most prevalent human fungal pathogens. Its ability to transition between budding yeast and filamentous morphological forms (pseudohyphae and hyphae) is tightly associated with its pathogenesis. Based on studies, the cAMP-protein kinase A (PKA) pathway is a key regulator of C. albicans morphogenesis. Using an intravital imaging approach, we investigated the role of the cAMP-PKA pathway during infection. Consistent with their roles , the downstream effectors of the cAMP-PKA pathway Efg1 and Nrg1 function, respectively, as an activator and a repressor of filamentation. Surprisingly, strains lacking the adenylyl cyclase, , showed only slightly reduced filamentation despite being completely unable to filament in RPMI + 10% serum at 37°C. Consistent with these findings, deletion of the catalytic subunits of PKA (Tpk1 and Tpk2), either singly or in combination, generated strains that also filamented but not . transcription profiling of C. albicans isolated from both ear and kidney tissue showed that the expression of a set of 184 environmentally responsive genes correlated well with filamentation (, 0.62 to 0.68) genes. This concordance suggests that the and transcriptional responses are similar but that the upstream regulatory mechanisms are distinct. As such, these data emphatically emphasize that C. albicans filamentation is a complex phenotype that occurs in different environments through an intricate network of distinct regulatory mechanisms. The fungus Candida albicans causes a wide range of disease in humans from common diaper rash to life-threatening infections in patients with compromised immune systems. As such, the mechanisms for its ability to cause disease are of wide interest. An intensely studied virulence property of C. albicans is its ability to switch from a round yeast form to filament-like forms (hyphae and pseudohyphae). Surprisingly, we have found that a key signaling pathway that regulates this transition , the protein kinase A pathway, is not required for filamentation during infection of the host. Our work not only demonstrates that the regulation of filamentation depends upon the specific environment C. albicans inhabits but also underscores the importance of studying these mechanisms during infection.
Topics: Candida albicans; Cyclic AMP-Dependent Protein Kinases; Fungal Proteins; Gene Expression Regulation, Fungal; Hyphae
PubMed: 35475642
DOI: 10.1128/mbio.00851-22 -
Frontiers in Psychiatry 2021We identified the first-generation antihistamine hydroxyzine as the earliest and most frequently prescribed drug affecting the central nervous system in children under...
We identified the first-generation antihistamine hydroxyzine as the earliest and most frequently prescribed drug affecting the central nervous system in children under the age of 5 years in the province of British Columbia, Canada (1. 1% prevalence). Whereas, the antagonism of H1-receptors exerts anti-pruritic effects in atopic dermatitis and diaper rash, animal studies suggest an adverse association between reduced neurotransmission of histamine and psychomotor behavior. In order to investigate hydroxyzine safety, we characterized the longitudinal patterns of hydroxyzine use in children under the age of 5 years and determined mental- and psychomotor disorders up to the age of 10 years. We found significantly higher rates of ICD-9 and ICD-10 codes for disorders such as tics (307), anxiety (300) and disturbance of conduct (312) in frequent users of hydroxyzine. Specifically, repeat prescriptions of hydroxyzine compared to a single prescription show an increase in tic disorder, anxiety and disturbance of conduct by odds ratios of: 1.55 (95%CI: 1.23-1.96); 1.34 (95%CI: 1.05-1.70); and 1.34 (95%CI: 1.08-1.66) respectively in children up to the age of 10 years. Furthermore, a non-significant increased trend was found for ADHD (314) and disturbance of emotions (313). This is the first study reporting an association between long-term neurodevelopmental adverse effects and early use of hydroxyzine. Controlled studies are required in order to prove a causal relationship and to confirm the safety of hydroxyzine in the pediatric population. For the time being, we suggest the shortest possible duration for hydroxyzine use in preschool-age children.
PubMed: 35153845
DOI: 10.3389/fpsyt.2021.721875 -
Journal of Clinical and Diagnostic... Jan 2016Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and...
INTRODUCTION
Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and usually itchy, which could cause bacterial or candida infection, and predispose the infants to penis or vaginal and urinary infection and lead to discomfort, irritability, and restlessness. The drugs which have been so far administered for this disease (topical steroids) cause special complications for the sensitive skin in this area. Magnesium (Mg) is known for its anti-inflammatory and wound-healing properties.
AIM
The aim of the present study was to study the effect of the cream containing Mg 2% on treatment of diaper dermatitis and diaper rash in children.
MATERIALS AND METHODS
In this clinical trial study, 64 children aged less than two years old with diaper dermatitis referring Paediatric Ward of Hajar Hospital were randomly assigned to two groups of 32. Group one was treated with the combined cream Mg 2% and Calendula and group two with Calendula cream alone. The duration of recovery was compared between the two groups.
RESULTS
The duration of recovery was significantly lower in the intervention group than the control group (p-value<0.001), but there was no significant difference in the lesions size and diapers' number between the two groups.
CONCLUSION
Based on the finding of this study, Mg is effective on treatment of diaper dermatitis and could be used for treating diaper dermatitis and other types of dermatitis.
PubMed: 26894161
DOI: 10.7860/JCDR/2016/14997.7143 -
Regulatory Toxicology and Pharmacology... Nov 2017Diaper rash can adversely impact the barrier properties of skin, with potential implications for increased absorption of chemicals through the skin, and this should be...
Diaper rash can adversely impact the barrier properties of skin, with potential implications for increased absorption of chemicals through the skin, and this should be accounted for in any exposure assessment used in the safety evaluation of consumer products used in the diaper ("nappy") area. In the absence of a quantitative evaluation of the potential impact of diaper rash, a default assumption of 100% dermal penetration is often made for substances applied in the diaper area. We consider here the extent, duration and severity of diaper rash and make a recommendation for conservative assumptions to incorporate into exposure assessments. Using a time-weighted average, the potential impact of diaper rash is illustrated for substances that have varying degrees of absorption through healthy skin. Results confirm that for assessments that already assume dermal absorption of 50% or higher, there is no impact on the overall exposure assessment. For substances that have a very low degree of dermal penetration (1%) through healthy skin, the impact of rash is expected to be less-than four-fold. This can be refined with additional data as there are many examples of poorly absorbed compounds for which dermal penetration is still low even for compromised skin.
Topics: Consumer Product Safety; Diaper Rash; Diapers, Infant; Humans; Infant; Infant Care; Severity of Illness Index; Skin; Skin Absorption; Time Factors
PubMed: 28916467
DOI: 10.1016/j.yrtph.2017.09.011 -
Drug Delivery Dec 2022Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical...
Topical conveyance of antifungal agents like itraconazole ITZ has been giving good grounds for expecting felicitous antifungal medicines. The defiance of topical delivery of this poorly water soluble and high-molecular-weight drug, however, mightily entail an adequate vehiculation. ITZ aspasomes, newer antioxidant generation of liposomes, have been designed and enclosed in a cream to ameliorate skin deposition. The proposed creams containing non-formulated ITZ or encapsulated in aspasomes (0.1% or 0.5%) were topically applied in patients with diagnosed diaper dermatitis complicated by candidiasis, tinea corporis (TC), and tinea versicolor (TVC). Placebos (void aspasomal cream and cream base) were also utilized. The obtained results for diaper rash revealed that aspasomal cream (0.5% ITZ) was eminent with respect to complete cure and negative candida culture after 10-day therapy relative to counterparts containing 0.1% ITZ aspasomes or non-formulated ITZ (0.1% and 0.5%). For tinea, the same trend was manifested in terms of 'cleared' clinical response in 90% of patients and absence of fungal elements after 4-week treatment. Relative to non-formulated ITZ, ITZ aspasomal cream was endorsed to be auspicious especially when ITZ concentration was lowered to half commercially available cream concentration (1%), pushing further exploitation in other dermal fungal infections.
Topics: Antifungal Agents; Humans; Itraconazole; Liposomes; Skin; Tinea
PubMed: 35506466
DOI: 10.1080/10717544.2022.2067601 -
Experimental Dermatology Oct 2021It has been recognized for nearly a century that human beings are inhabited by a remarkably dense and diverse microbial ecosystem, yet we are only just beginning to...
It has been recognized for nearly a century that human beings are inhabited by a remarkably dense and diverse microbial ecosystem, yet we are only just beginning to understand and appreciate the many roles that these microbes play in human health and development. Establishment of the microbiome begins at birth, but many previous studies on infant skin health have focused on Candida species. Little is known on the full microbial composition across different areas and even less is known on how these communities change during disease/inflammatory states. In this clinical study, infants were recruited during periods of diaper dermatitis (DD) and health to characterize the skin microbiome in these two states. Substantial shifts in the skin microbiome were observed across four sites in the diapered area (genitals, intertriginous, buttocks and perianal), as well as during periods of DD. As DD scores increased, there was a shift in relative abundance that demonstrated higher community percentages of faecal coliforms, such as Enterococcus, and lower percentages of Staphylococcus strains. In high-rash samples, the predominant Staphylococcus species is S aureus, potentially implicating S aureus as a DD aetiological agent. This study provides new information related to the microbiome on infant skin in the diapered area and provides insights into the role of the microbiome in the development of DD.
Topics: Buttocks; Diaper Rash; Diapers, Infant; Female; Humans; Infant; Infant Care; Longitudinal Studies; Male; Microbiota; Skin
PubMed: 32974911
DOI: 10.1111/exd.14198 -
International Journal of Biological... Jun 2024Diaper rash, mainly occurring as erythema and itching in the diaper area, causes considerable distress to infants and toddlers. Increasing evidence suggests that an...
Diaper rash, mainly occurring as erythema and itching in the diaper area, causes considerable distress to infants and toddlers. Increasing evidence suggests that an unequal distribution of microorganisms on the skin contributes to the development of diaper dermatitis. Probiotic bacteria, like Staphylococcus epidermidis, are crucial for maintaining a healthy balance in the skin's microbiome, among others, through their fermentative metabolites, such as short-chain fatty acids. Using a defined prebiotic as a carbon source (e.g., as part of the diaper formulation) can selectively trigger the fermentation of probiotic bacteria. A proper material choice can reduce diaper rash incidence by diminishing the skin exposure to wetness and faeces. Using 3D printing, we fabricated carbon-rich materials for the top sheet layer of baby diapers that enhance the probiotic activity of S. epidermidis. The developed materials' printability, chemical composition, swelling ability, and degradation rate were analysed. In addition, microbiological tests evaluated their potential as a source of in situ short-chain fatty acid production. Finally, biocompatibility testing with skin cells evaluated their safety for potential use as part of diapers. The results demonstrate a cost-effective approach for producing novel materials that can tailor the ecological balance of the skin microflora and help treat diaper rash.
Topics: Prebiotics; Diaper Rash; Humans; Printing, Three-Dimensional; Polysaccharides; Staphylococcus epidermidis; Infant; Skin; Probiotics
PubMed: 38697421
DOI: 10.1016/j.ijbiomac.2024.131958 -
Journal of the American Academy of... Jul 2016A psoriasis-like eruption develops in a subset of patients with Kawasaki disease (KD).
BACKGROUND
A psoriasis-like eruption develops in a subset of patients with Kawasaki disease (KD).
OBJECTIVE
We sought to systematically compare KD-associated psoriasiform eruptions with classic psoriasis and the outcomes of KD in children with and without this rash.
METHODS
This was a retrospective study of 11 KD cases with a psoriasiform eruption matched 1:2 by age, gender, and ethnicity with psoriasis-only and KD-only controls. Genotyping was performed in 10 cases for a deletion of 2 late cornified envelope (LCE) genes, LCE3C_LCE3B-del, associated with increased risk for pediatric-onset psoriasis.
RESULTS
Similar to classic psoriasis, KD-associated eruptions were characterized clinically by well-demarcated, scaly pink plaques and histopathologically by intraepidermal neutrophils, suprabasilar keratin 16 expression, and increased Ki-67 expression. They showed less frequent diaper area involvement, more crust and serous exudate, and an enduring remission (91% vs 23% with confirmed resolution; P < .001). Frequency of LCE3C_LCE3B-del and major KD outcomes were similar between cases and controls.
LIMITATIONS
The study was limited by the small number of cases, treatment variation, and availability of skin biopsy specimens.
CONCLUSIONS
Although the overall clinical and histopathologic findings were similar to conventional psoriasis, this appears to be a distinct phenotype with significantly greater propensity for remission. No adverse effect on KD outcomes was noted.
Topics: Adolescent; Case-Control Studies; Child; Child, Preschool; Cornified Envelope Proline-Rich Proteins; Female; Genotype; Humans; Infant; Infant, Newborn; Keratin-16; Ki-67 Antigen; Male; Mucocutaneous Lymph Node Syndrome; Phenotype; Prognosis; Psoriasis; Retrospective Studies; Sequence Deletion
PubMed: 26946987
DOI: 10.1016/j.jaad.2016.02.1146 -
Clinical Pediatrics Jun 2019The demand for natural infant care products, including diapers, has increased. However, few disposable diapers have been able to provide the performance caregivers...
The demand for natural infant care products, including diapers, has increased. However, few disposable diapers have been able to provide the performance caregivers desire while also incorporating ingredients consistent with the "natural" category. In an examiner-blinded clinical study, the performance of a new cotton-enhanced diaper with high-performance materials was compared with an existing natural diaper offering. A total of 131 infants wore 1 of the 2 diapers for a 4-week period. Diaper performance was assessed based on skin marking assessments, scored by a trained grader, and incidence of diaper dermatitis. Skin grading for diaper dermatitis was assessed at 4 sites in the diaper area. The new diaper offering was associated with less skin marking and significantly less diaper rash at the genitals and intertriginous regions versus the comparator. These data suggest that the new diaper provided significant improvement in both skin marking and prevalence of diaper rash.
Topics: Cotton Fiber; Diaper Rash; Diapers, Infant; Female; Humans; Infant; Infant, Newborn; Male; Materials Testing
PubMed: 30961367
DOI: 10.1177/0009922819841136