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Clinical, Cosmetic and Investigational... 2022Seborrheic dermatitis (SD) is a common chronic inflammatory skin disorder that mostly affects young adults in areas rich in sebaceous glands (scalp, face, and trunk). In... (Review)
Review
Seborrheic dermatitis (SD) is a common chronic inflammatory skin disorder that mostly affects young adults in areas rich in sebaceous glands (scalp, face, and trunk). In adolescents and adults, SD clinical presentation may range from mild patches to diffuse scalp scaling. In infants, it mainly occurs on the scalp as yellowish, scaly patches ("cradle cap"). In adults, several environmental triggers are likely to promote SD development, along with fungal colonization by spp., sebaceous gland activity, as well as immunosuppression, endocrine, neurogenic and iatrogenic factors. In children, early occurrence in the first trimester suggests the role of excessive sebaceous gland activity from maternal hormones, along with cutaneous microbiome alterations. The diagnosis of SD is usually clinical, and specific laboratory and/or instrumental investigations are seldom required. Treatment is aimed at modulating sebum production, reducing skin colonization by spp., and controlling inflammation. In adults, mild-to-moderate scalp SD forms can be managed with topical antifungals (ketoconazole, ciclopirox, miconazole) or antiinflammatory (mild-to-moderate potency corticosteroids) or keratolytic/humectant (propylene glycol) agents. Recommended topical therapeutic options for mild-to-moderate facial or body areas SD include topical ketoconazole, ciclopirox, clotrimazole, mild-to-moderate potency corticosteroids, lithium succinate/gluconate, and topical calcineurin inihibitors (). In severe and/or resistant cases, the use of systemic antifungal drugs (terbinafine, itraconazole), as well as UVB phototherapy, may be considered. In children, scant scientific evidence supports the effectiveness and safety of topical drugs, and "cradle cap" is usually successfully managed with baby shampoos enriched with emollient agents and vegetable oils. Alternatively, similarly to adult scalp SD, medical device shampoos with antiinflammatory and antifungal properties, containing piroctone olamine, bisabolol, alyglicera, telmesteine, may be used. Beyond pharmacological treatments, an appropriate cosmetic approach, if correctly prescribed, may improve therapeutic outcomes.
PubMed: 35967915
DOI: 10.2147/CCID.S284671 -
BioMed Research International 2022The purpose of our study is to see how beneficial is tea tree oil (TTO) for treating chronic blepharitis topically, with a focus on the Demodex mite. To discover all... (Review)
Review
The purpose of our study is to see how beneficial is tea tree oil (TTO) for treating chronic blepharitis topically, with a focus on the Demodex mite. To discover all possibly relevant published papers, an accurate Pubmed database search analysis of the current literature was undertaken from 2012 to December 2021. Fourteen papers dealing with the use of TTO to treat chronic blepharitis have been found. The effectiveness of TTO treatment was tested in vitro by 4 authors and in vivo by 10 authors. All studied confirmed efficacy of TTO treatment, even cyclic, on Demodex mite blepharitis. TTO can be used for lid scrubs, facial cleanser, eyelid patch, eyelid gel, eyelash shampoo or, more commonly, as TTO impregnated eyelid wipes. The scientific evidence of TTO for chronic blepharitis treatment gives a lot of confidence for the progress that this treatment may have in the future clinical practice.
Topics: Animals; Blepharitis; Eye Infections, Parasitic; Eyelashes; Humans; Mite Infestations; Mites; Tea Tree Oil
PubMed: 35941981
DOI: 10.1155/2022/9204251 -
Annals of Agricultural and... Jun 2022Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors,... (Review)
Review
Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors, instruction for diagnosis and guideline for treatment, are limited. The review aims to provide a detailed synthesis of this condition that could be used by clinicians in their practise. Whether single-centre or multi-centre, studies of more than 60 cases less than 5 years old were mainly taken into consideration. Results obtained were that FFA affects mainly postmenopausal Caucasian women; the most common comorbidities are hyperlipidaemia, arterial hypertension, osteoporosis, hypothyroidism, depression, alongside dermatological disorders such as atopic dermatitis, rosacea, seborrheic dermatitis and androgenetic alopecia. Autoimmune, genetic, hormonal (e.g. estrogen deficiency, pregnancy, lactation, HRT and raloxifene) and environmental (e.g. daily use of facial sunscreens and less frequent use of hair dyes and shampoo) hypotheses were proposed for pathogenesis, as well as association with various predisposing factors (patient's health-social profile, disease's history and comorbidities). Clinical presentation of FFA can be divided into 3 specific patterns, each with a different prognosis. Diagnosis is usually made clinically with the use of trichoscopy; however, scalp biopsy remains the gold standard. The condition is regarded as a variant of lichen planopilaris (LPP) due to the similarity of the prominent histopathological findings, but the clinical image is distinct and therapeutic options vary. 5α-reductase inhibitors, intralesional steroids, and hydroxychloroquine provide the highest level of evidence for the treatment of FFA. The conclusion is that a better understanding of the disease is crucial for proper disease management.
Topics: Alopecia; Child, Preschool; Female; Forehead; Humans; Hydroxychloroquine; Lichen Planus; Scalp
PubMed: 35767748
DOI: 10.26444/aaem/141324 -
International Journal of Trichology 2022Plica polonica is a rare condition presenting as a mass of scalp hair with irregular twists and irreversibly entangled plaits, which are firm to hard impenetrable mass...
Plica polonica is a rare condition presenting as a mass of scalp hair with irregular twists and irreversibly entangled plaits, which are firm to hard impenetrable mass of keratin cemented together with dirt and exudates. The exact etiopathogenesis of plica neuropathica is not known, but it can be due to longitudinal splitting or weathering of hair shaft due to vigorous friction and frequent use of harsh shampoos and cleansers or long hair with poor hair care Drug-induced hair matting due to chemotherapeutic drugs and due to neurotic illness like hysteria, anxiety, to psychotic illness have also been reported. Dermatoscopy showed interwining of hair shaft with matting and honey-colored concretions mimicking "wrangled mesh of wires" appearance. The treatment of plica neuropathica involves cutting the matted hair and evaluating underlying psychiatric illness to prevent recurrence.
PubMed: 35755958
DOI: 10.4103/ijt.ijt_156_20 -
Skin Health and Disease Mar 2022Treatment of onychomycosis is challenging, and there is much literature on optimal treatment strategies. In contrast, information on how onychomycosis is actually...
BACKGROUND
Treatment of onychomycosis is challenging, and there is much literature on optimal treatment strategies. In contrast, information on how onychomycosis is actually treated in primary care is scarce. Information on practice is important as it can reveal much, such as, to what extent national guidelines are followed and which population groups seek/receive treatment or do not do so.
OBJECTIVES
To describe the pattern of onychomycosis treatment in primary care in the UK, by patient's gender and age.
METHODS
A population-based retrospective cross-sectional study was conducted. The Health Improvement Network (THIN) database was used to calculate incidence rates of onychomycosis in the years 2001-2017. The prescription of oral and topical anti-fungal drugs to patients with onychomycosis was reviewed.
RESULTS
THIN data showed an onychomycosis incidence rate of about 50 per 100,000. More males than females (52% vs. 48%), and more people aged 50-59 years had received treatment for onychomycosis. Oral terbinafine was the most commonly prescribed drug, followed by topical amorolfine, although terbinafine was used more commonly by men and amorolfine by women. Patients with onychomycosis were also prescribed other antifungals, including itraconazole, griseofulvin, tioconazole, ketoconazole shampoo, fluconazole and clotrimazole. A greater proportion of women, compared to men, were prescribed fluconazole.
CONCLUSIONS
Onychomycosis treatment in primary care in the UK is broadly in concordance with national guidelines.
PubMed: 35665209
DOI: 10.1002/ski2.84 -
Cureus Apr 2022Confluent and reticulated papillomatosis (CARP) of Gougerot and Carteaud is a rare chronic disease with exacerbation and remissions typically affecting young people....
Confluent and reticulated papillomatosis (CARP) of Gougerot and Carteaud is a rare chronic disease with exacerbation and remissions typically affecting young people. Classic clinical characteristics include asymptomatic scaly hyperpigmented macules, patches, and papules in the trunk's confluent and reticular pattern. A 12-year-old girl, otherwise healthy, presented with itchy, persistent skin lesions all over her body for one year. Skin examination revealed generalized scaly brownish patches, thin papules, and plaques all over her body, including her face, neck, middle of the chest, abdomen, back, upper extremities, elbows, lower extremities, and knees. Wood's lamp examination of her skin lesions was unrevealing. Skin biopsy showed papillomatosis, hyperkeratosis, acanthosis, and hypergranulosis. The dermis showed perivascular inflammatory cellular infiltrate. Based on the above clinicopathological findings, the patient was diagnosed with CARP. In our case, a generalized form was reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment. Our patient responded well to oral minocycline 85 mg one tablet daily, tacrolimus 0.1% ointment twice daily, and selenium sulfide shampoo twice weekly for two months. The classic clinical characteristics of CARP include asymptomatic scaly hyperpigmented macules, patches, and papules in a confluent and reticular pattern on the trunk. A generalized form, as in our case, has been reported. CARP is diagnosed based on clinical and histopathological features. Oral antibiotics are the cornerstone of treatment.
PubMed: 35651451
DOI: 10.7759/cureus.24557 -
Skin Research and Technology : Official... Jul 2022The purpose of this pilot study was to provide information about the washout-dependent depletion of important skin components in the horny layer of the scalp. They were...
BACKGROUND
The purpose of this pilot study was to provide information about the washout-dependent depletion of important skin components in the horny layer of the scalp. They were taken as markers for scalp drying effects of cosmetic cleansing products and were measured directly in vivo.
METHOD
In vivo confocal Raman spectroscopy was used to measure the depletion of the total natural moisturizing factor (total NMF) and some of its components (urea and lactic acid) as well as a fraction of stratum corneum lipids, after repeated washing with a standard shampoo on the human scalp.
RESULTS
The measurements showed a reduction in the amount of NMF and lipids of the stratum corneum caused by repeated shampooing.
CONCLUSION
Confocal Raman spectroscopy is an innovative technology that can be used successfully in vivo on the hairy scalp. The loss of the most important skin components caused by hair washing can be quantified directly with this technology. The method is valuable to support the development cosmetic cleansing products, as it is suitable to directly compare the effects of different product candidates on the human scalp in a most realistic way.
Topics: Cosmetics; Hair; Humans; Lipids; Pilot Projects; Scalp; Skin; Skin Abnormalities; Spectrum Analysis, Raman
PubMed: 35638406
DOI: 10.1111/srt.13157 -
Veterinary Dermatology Aug 2022Pseudomonas aeruginosa is the most commonly isolated bacterium from skin lesions of dogs with post-grooming furunculosis (PGF). It is frequently found in human hair and...
BACKGROUND
Pseudomonas aeruginosa is the most commonly isolated bacterium from skin lesions of dogs with post-grooming furunculosis (PGF). It is frequently found in human hair and skin care products, and may pose a health risk to consumers. Information regarding the prevalence of P. aeruginosa contamination of dog grooming products is lacking.
OBJECTIVES
To investigate the prevalence of P. aeruginosa contamination in nonmedicated dog grooming products after either home or professional use in pet grooming salons, and to identify risk factors that may be associated with contamination.
MATERIALS AND METHODS
Of 117 bottles of grooming products sampled for bacterial culture, 97 were used by pet grooming salons and 20 were used by private individuals. The following suspected risk factors were recorded: bottle size, relative remaining volume, content dilution, expiration date and ingredient list.
RESULTS
Pseudomonas aeruginosa was isolated from 14 of 117 samples [11.97%, 95% confidence interval (CI) 6.97-19.3%]. Diluted products were contaminated significantly more often compared to undiluted products (odds ratio = 15.5, 95%CI 2.05-117.23; P < 0.01). None of the other variables was significantly associated with P. aeruginosa contamination.
CONCLUSIONS AND CLINICAL RELEVANCE
Pseudomonas aeruginosa contamination of dog grooming shampoos and conditioners was significantly associated with product dilution. Contaminated grooming products may predispose dogs to severe bacterial skin infections such as PGF.
Topics: Animals; Dogs; Humans; Dog Diseases; Grooming; Prevalence; Pseudomonas aeruginosa; Pseudomonas Infections; Risk Factors
PubMed: 35635240
DOI: 10.1111/vde.13072 -
Pharmaceutics May 2022Zinc pyrithione (ZnPT) is a widely used antifungal, usually applied as a microparticle suspension to facilitate delivery into the hair follicles, where it then...
Zinc pyrithione (ZnPT) is a widely used antifungal, usually applied as a microparticle suspension to facilitate delivery into the hair follicles, where it then dissociates into a soluble monomeric form that is bioactive against yeast and other microorganisms. In this study, we use multiphoton microscopy (MPM) and fluorescence lifetime imaging microscopy (FLIM) to characterise ZnPT formulations and map the delivery of particles into follicles within human skin. To simulate real-world conditions, it was applied using a massage or no-massage technique, while simultaneously assessing the dissolution using Zinpyr-1, a zinc labile fluorescent probe. ZnPT particles can be detected in a range of shampoo formulations using both MPM and FLIM, though FLIM is optimal for detection as it allows spectral and lifetime discrimination leading to increased selectivity and sensitivity. In aqueous suspensions, the ZnPT 7.2 µm particles could be detected up to 500 µm in the follicle. The ZnPT particles in formulations were finer (1.0-3.3 µm), resulting in rapid dissolution on the skin surface and within follicles, evidenced by a reduced particle signal at 24 h but enhanced Zinpyr-1 intensity in the follicular and surface epithelium. This study shows how MPM-FLIM multimodal imaging can be used as a useful tool to assess ZnPT delivery to skin and its subsequent dissolution.
PubMed: 35631659
DOI: 10.3390/pharmaceutics14051076 -
Archives of Toxicology Aug 2022In the recent past, the blister agent sulfur mustard (SM) deployed by the terroristic group Islamic State has caused a huge number of civilian and military casualties in...
In the recent past, the blister agent sulfur mustard (SM) deployed by the terroristic group Islamic State has caused a huge number of civilian and military casualties in armed conflicts in the Middle East. The vaporized or aerolized agent might be inhaled and have direct contact to skin and hair. Reaction products of SM with plasma proteins (adducts) represent well-established systemic targets for the bioanalytical verification of exposure. The SM-derived hydroxyethylthioethyl (HETE)-moiety is attached to nucleophilic amino acid side chains and allows unambiguous adduct detection. For shipping of common blood and plasma samples, extensive packaging rules are to be followed as these matrices are considered as potentially infectious material. In contrast, hair is considered as non-infectious thus making its handling and transportation much less complicated. Therefore, we addressed this matrix to develop a procedure for bioanalytical verification. Following optimized lysis of SM-treated human scalp hair and pepsin-catalyzed proteolysis of adducts of keratin type I and II, microbore liquid chromatography-electrospray ionization high-resolution tandem-mass spectrometry (µLC-ESI MS/HR MS) was used to detect three alkylated keratin-derived biomarker peptides: AE(-HETE)IRSDL, FKTIE(-HETE)EL, and LE(-HETE)TKLQF simultaneously. All bear the HETE-moiety bound to a glutamic acid residue. Protein adducts were stable for at least 14 weeks at ambient temperature and contact to air, and were not affected by washing the hair with shampoo. The biomarker peptides were also obtained from beard, armpit, abdominal, and pubic hair. This is the first report introducing stable local peptide adduct biomarkers from hair, that is easily accessible by a non-invasive sampling process.
Topics: Biomarkers; Chemical Warfare Agents; Hair; Humans; Hydroxyeicosatetraenoic Acids; Keratins; Mustard Gas; Peptides; Serum Albumin, Human; Spectrometry, Mass, Electrospray Ionization; Tandem Mass Spectrometry
PubMed: 35570235
DOI: 10.1007/s00204-022-03307-0