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Journal of the American Academy of... Apr 2024Petrolatum, also known as petroleum jelly, is a widely used topical agent, with a variety of uses in dermatology. Despite its popularity, many myths surround this... (Review)
Review
Petrolatum, also known as petroleum jelly, is a widely used topical agent, with a variety of uses in dermatology. Despite its popularity, many myths surround this ubiquitous dermatologic staple. This review details the history of petrolatum and how it is manufactured as well as how its biologic properties make it a great moisturizer. Additionally, data on its potential for flammability, allergenicity, and comedogenicity are detailed, dispelling misconceptions about petrolatum use around oxygen and as a cause of acne. The uses and benefits of petrolatum in dermatology are wide-ranging-a patch test instrument, a vehicle for medicated ointments, and a wound care essential. Given its ubiquitous presence, it is important for dermatologists to understand the history, safety profile, and myths surrounding this humble skincare staple.
Topics: Humans; Petrolatum; Ointments; Allergens; Patch Tests
PubMed: 37315800
DOI: 10.1016/j.jaad.2023.06.010 -
International Journal of Nursing Studies Mar 2020In aged nursing care receivers, the prevalence of adverse skin conditions such as xerosis cutis, intertrigo, pressure ulcers or skin tears is high. Adequate skin care...
BACKGROUND
In aged nursing care receivers, the prevalence of adverse skin conditions such as xerosis cutis, intertrigo, pressure ulcers or skin tears is high. Adequate skin care strategies are an effective method for maintaining and enhancing skin health and integrity in this population.
OBJECTIVES
The objective was to summarize the empirical evidence about the effects and effectiveness of non-drug topical skin care interventions to promote and to maintain skin integrity and skin barrier function in the aged, to identify outcome domains and outcome measurement instruments in this field.
DESIGN
An update of a previous systematic review published in 2013 was conducted.
DATA SOURCES
Databases MEDLINE and EMBASE via OvidSP and CINAHL (original search January 1990 to August 2012, update September 2012 to May 2018) and reference lists were searched. Forward searches in Web of Science were conducted.
METHODS
A review protocol was registered in Prospero (CRD42018100792). Main inclusion criteria were primary intervention studies reporting treatment effects of basic skin care strategies in aged people with a lower limit of age range of 50 years and published between 1990 and 2018. Primary empirical studies were included with experimental study designs including randomized controlled trials and quasi-experimental designs. Methodological quality of included randomized controlled trials was evaluated using the Cochrane Collaboration's Tool for assessing risk of bias. Levels of evidence were assigned to all included studies.
RESULTS
Sixty-three articles were included in the final analysis reporting effects of interventions to treat and/or to prevent skin dryness, pruritus, general skin barrier improvement, incontinence-associated dermatitis, skin tears and pressure ulcers. Skin cleansers containing syndets or amphotheric surfactants compared with standard soap and water improved skin dryness. Lipophilic leave-on products containing humectants decreased skin dryness and reduced pruritus. Products with pH 4 improved the skin barrier. Application of skin protectants and structured skin care protocols decreased the severity of incontinence-associated dermatitis. Formulations containing glycerin and petrolatum reduced the incidence of skin tears. Thirty-five outcome domains were identified with nearly 100 different outcome measurement instruments.
CONCLUSION
Included studies showed substantial heterogeneity regarding design, interventions and outcomes. Basic skin care strategies including low-irritating cleansers and lipophilic humectant-containing leave-on products are helpful for treating dry skin and improving skin barrier in the aged. Lower pH of leave-on products improves the skin barrier. The number of different outcome domains was unexpectedly high. We recommend to identify critical outcome domains in the field of skin care to make trial results more comparable in the future and to measure possible performance differences between different skin care strategies and products.
Topics: Aged; Humans; Skin; Skin Care
PubMed: 31945604
DOI: 10.1016/j.ijnurstu.2019.103509 -
Dermatitis : Contact, Atopic,...Acetophenone azine (CAS 729-43-1) was recently discovered as a potent allergen in shin pads and footwear containing the foam elastomer ethyl vinyl acetate. The compound...
Acetophenone azine (CAS 729-43-1) was recently discovered as a potent allergen in shin pads and footwear containing the foam elastomer ethyl vinyl acetate. The compound is probably not intentionally added to ethyl vinyl acetate but is likely the result of reactions between other additives that take place during the manufacturing process. A patch testing concentration of 0.1% in acetone or petrolatum is recommended. Acetophenone azine should be part of patch testing shoe series, as well as plastics and glues series. The compound is not currently available from patch testing materials suppliers, a situation that hopefully will be corrected.
Topics: Allergens; Dermatitis, Allergic Contact; Humans; Hydrazines; Imines; Protective Devices; Shoes; Sports Equipment; Vinyl Compounds
PubMed: 33273242
DOI: 10.1097/DER.0000000000000697 -
Dermatitis : Contact, Atopic,...Exposure to elemental aluminum and its salts is unavoidable. Aluminum as a metal is present in transport, construction, packaging, and electronic equipment. Aluminum...
Exposure to elemental aluminum and its salts is unavoidable. Aluminum as a metal is present in transport, construction, packaging, and electronic equipment. Aluminum salts are present in consumer products, food items and drinking water, vaccines, drugs, and antiperspirants. Aluminum in vaccines and preparations for allergen-specific immunotherapy are the major sensitization sources. The predominent clinical manifestations of aluminum allergy are pruritic subcutaneous nodules and eczematous dermatitis. Patch testing shall be performed with aluminum chloride hexahydrate (ACH) in petrolatum. The preparation with ACH 10% detects substantially more aluminum allergy than ACH 2%. A patch test with elemental aluminum, for example, an empty Finn Chamber, is only positive when there is a strong aluminum allergy. A patch test reading should be performed 1 week after the application so as not to miss 15% to 20% of aluminum allergy. Aluminum should be included in any baseline patch test series for children and investigated for a possible inclusion in baseline series for adults. Aluminum test chambers can interfere with the testing resulting in both false-negative and false-positive patch test reactions to nonaluminum contact sensitizers.
Topics: Adult; Allergens; Aluminum; Aluminum Compounds; Child; Dermatitis, Allergic Contact; Humans; Patch Tests
PubMed: 35029347
DOI: 10.1097/DER.0000000000000836 -
Proceedings (Baylor University. Medical... 2021Full-thickness skin grafts are a commonly used reconstructive method following Mohs micrographic surgery. The literature varies on the most appropriate methods of... (Review)
Review
Full-thickness skin grafts are a commonly used reconstructive method following Mohs micrographic surgery. The literature varies on the most appropriate methods of suturing and securing grafts as well as best practices to dress the graft postoperatively. Our objective was to review various approaches to management of full-thickness skin grafts, including suturing the graft, securing the graft, and topical emollient use on the graft postoperatively. It was found that absorbable sutures, plain gut, provide preferable outcomes with full-thickness skin grafts. The tie-over bolster is the most-used method for securing skin grafts after placement, although several other methods have demonstrated efficacy, including the polyurethane foam, sandwich, and quilting suture methods. While various topical emollients are used in the immediate postoperative period, plain white petrolatum is the least likely to form allergic contact dermatitis.
PubMed: 34732986
DOI: 10.1080/08998280.2021.1953867 -
Ophthalmic Plastic and Reconstructive...Surgical fires pose a substantial risk to patients and can cause significant injury, especially in oculofacial surgery. Ocular surface lubricants can potentially act as...
PURPOSE
Surgical fires pose a substantial risk to patients and can cause significant injury, especially in oculofacial surgery. Ocular surface lubricants can potentially act as fuel for an operating room fire. We present an experimental analysis of the flammability of 9 commonly used ophthalmic lubricants under 4 ignition sources used in oculofacial surgery with and without supplemental oxygen.
METHODS
The flammability of 9 ophthalmic lubricants were tested under various operating room conditions. Each lubricant was exposed to 4 different ignition sources: an open flame lighter, monopolar cautery, bipolar cautery, and hand-held high temperature cautery, and the response of the lubricant was recorded. The testing was conducted both in room air and with 6 L/minute of 100% oxygen directed at the lubricant through a nasal cannula. Any reaction in which there was ignition, sparking, smoking, or a transient or permanent change in appearance of the lubricant was deemed notable.
RESULTS
Of the 9 lubricants tested, 4 displayed a reaction to the ignition source. Without supplemental oxygen, 100% petrolatum and neomycin-polysporin-bacitracin-hydrocortisone ointment produced some smoke when applied with the high temperature cautery. Notably, under both the conditions of no supplemental oxygen and with the addition of 6 L/minute of 100% oxygen, the carboxymethylcellulose drops and lidocaine jelly both conducted and sparked with the monopolar cautery leaving visible burn marks on the paper.
CONCLUSIONS
The overall fire hazard posed by ocular surface lubricants is low. Some topical lubricants can conduct electricity from monopolar cautery, which could increase the risk of inadvertent electrical burns. Certain lubricants could potentially become a fuel source when used in combination with hand-held high temperature battery cautery. Bipolar cautery was not associated with either increased conductivity or flammability with any of the lubricants tested.
Topics: Humans; Fires; Operating Rooms; Burns; Oxygen; Lubricants
PubMed: 37486341
DOI: 10.1097/IOP.0000000000002469 -
The Journal of Dermatological Treatment Jun 2022Pityriasis alba is a common skin condition that may be challenging to treat, especially in patients with darker skin type where the hypopigmentation may be more...
BACKGROUND
Pityriasis alba is a common skin condition that may be challenging to treat, especially in patients with darker skin type where the hypopigmentation may be more noticeable and represents a major cosmetic concern.
OBJECTIVES
This study aims to evaluate the efficacy of three cost-effective treatments of PA in comparison with placebo.
PATIENTS/METHODS
This prospective study was conducted on 80 patients complaining from PA and divided into 4 equal groups according the received topical treatment on the target lesions twice daily for 8 weeks (Calcipotriol 0.005% cream, Tacrolimus 0.03% ointment, topical corticosteroid; Clobetasone butyrate 0.05% cream and Petrolatum as Placebo). Clinical evaluation, Physician Global Assessment, Patient's satisfaction levels as well as point counting planimetry were done for evaluation of the response.
RESULTS
Significant improvement of scaling and erythema within 3 weeks after initiation of therapy and hypopigmentation by the 8th week, except for those received placebo. Tarolimus 0.03% ointment showed simple superiority over both Calcipotriol 0.005% cream and topical corticosteroid as regards repigmenation, although, the later received the highest level of patient satisfaction.
CONCLUSION
The three treatments were superior to placebo with relative superiority to Tacrolimus 0.03% due to limited side effects.
Topics: Administration, Topical; Dermatologic Agents; Glucocorticoids; Humans; Hypopigmentation; Ointments; Pityriasis Rosea; Prospective Studies; Tacrolimus; Treatment Outcome
PubMed: 34289784
DOI: 10.1080/09546634.2021.1959014 -
Dermatologie (Heidelberg, Germany) Jan 2023Topical compounds are an important treatment option in dermatology. Many ingredients and packaging do not yet sufficiently fulfill sustainable criteria. (Review)
Review
BACKGROUND
Topical compounds are an important treatment option in dermatology. Many ingredients and packaging do not yet sufficiently fulfill sustainable criteria.
OBJECTIVES
This article aims to provide a compact overview of sustainability criteria of topical compounds and packaging.
MATERIALS AND METHODS
Based on a selective literature search and personal experience, common ingredients and packaging of topical preparations are summarized.
RESULTS
Topical preparations often contain mineral oils, acrylates, silicones and polyethylene glycols (PEG), which show poor biodegradability and may accumulate in the environment. As an alternative to these non-renewable substances, plant-based fats, oils, and waxes can be used. Biopolymers such as plant-based gum, agar-agar, pectin, and biologically produced hyaluronic acid are an alternative to plastic polymers. The environmental footprint of glass as packaging material is overestimated. Currently, plastics and aluminum may be preferable when recycled correctly.
CONCLUSION
The production of topical formulations without using mineral oils, silicones, acrylates, and PEGs is technically challenging. A sustainable packaging material that fulfills all relevant functionalities is not yet available. Packaging should meet high requirements regarding ecological, economic, and social factors. Better performance with respect to new opportunities in recycling and waste management should be incorporated. Overall, the legislative authorities should provide relevant incentives for more sustainable topical compounds and packaging.
Topics: Agar; Plastics; Polyethylene Glycols; Mineral Oil; Oils; Minerals
PubMed: 36592193
DOI: 10.1007/s00105-022-05086-2