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Journal of the European Academy of... May 2024Keratinopathic ichthyoses are a group of hereditary skin disorders caused by pathogenic variants in keratin genes such as KRT1, KRT2 and KRT10, resulting in conditions...
BACKGROUND
Keratinopathic ichthyoses are a group of hereditary skin disorders caused by pathogenic variants in keratin genes such as KRT1, KRT2 and KRT10, resulting in conditions such as epidermolytic ichthyosis (EI), autosomal-recessive EI, superficial EI and epidermal nevus. Case reports highlight the diversity of clinical manifestations, but only limited information exists regarding the quality of life and burden of disease.
OBJECTIVES
The objective of this study was to assess the clinical spectrum, genotype-phenotype correlations and burden of disease in patients with epidermolytic ichthyosis in Germany.
METHODS
We conducted an observational study involving 48 patients diagnosed with EI. Evaluations included the severity of skin involvement using the Investigator's Global Assessment (IGA), the modified Ichthyosis Area Severity Index (mIASI) and complications. The burden of disease was evaluated using the Dermatology Life Quality Index (DLQI) or the Children's Dermatology Life Quality Index (cDLQI).
RESULTS
Based on clinical features, mIASI and IGA, EI can be categorized into localized, intermediate and severe forms. Patients with keratin 1 mutations tended to have severe EI, while the three forms were evenly distributed in those with keratin 10 mutations. The study highlights that around half of the patients with EI experienced itch and severe pain. Quality of life was affected, with daily life restrictions of 78% due to care and therapies. Reimbursement for moisturizing ointments by health insurance was insufficient for one-quarter of cases.
CONCLUSIONS
The results emphasize the need for targeted interventions and comprehensive care strategies to enhance the quality of life for affected individuals.
PubMed: 38741524
DOI: 10.1111/jdv.20096 -
Dermatology and Therapy Jun 2024Tirbanibulin 1% ointment has been licensed to treat non-hyperkeratotic actinic keratosis (AKs) on the face and scalp in adults to ensure excellent patient tolerability...
INTRODUCTION
Tirbanibulin 1% ointment has been licensed to treat non-hyperkeratotic actinic keratosis (AKs) on the face and scalp in adults to ensure excellent patient tolerability due to the mild side effects and the brief application time compared to other topical therapies on the market. A growing body of evidence suggests that, beyond their primary function, the treatments for AKs and the cancerization field may inadvertently confer substantial cosmetic benefits to patients.
METHODS
We report a single-center retrospective case series of patients referred to the Dermatology Unit of the University Hospital of Messina, Italy, between February and December 2023 seeking treatment for AKs in the context of photodamaged areas in which the application of tirbanibulin 1% ointment induced, besides clearance of AKs, anti-aging effects on both skin texture and solar lentigos.
RESULTS
Seven patients affected by Olsen grade 1-2 AKs experienced a powerful rejuvenating effect in the treated areas, with a marked efficacy in skin lightening and clearance of solar lentigo.
CONCLUSIONS
Tirbanibulin 1% ointment seems able to improve skin aging as a desirable side effect at the site of application for AKs on chronic photodamaged skin. Such preliminary observation needs further confirmation in real-life studies on larger cohorts of patients, to explain the pathogenic mechanisms responsible for such aesthetically relevant results.
PubMed: 38740726
DOI: 10.1007/s13555-024-01178-0 -
Molecules (Basel, Switzerland) Apr 2024The root of L. has been widely used in traditional medicine for its antimicrobial properties. In this study, the fractionation of methanol extract from the root was...
The root of L. has been widely used in traditional medicine for its antimicrobial properties. In this study, the fractionation of methanol extract from the root was conducted. Four fractions (A, B, C, and D) were obtained and tested against a range of bacteria and fungi. The results showed promising antibacterial activity, especially against , where the minimal inhibitory concentration (MIC) was determined to be equal to 0.08 mg/mL and 0.16 mg/mL for heptane (fraction B) and ethyl acetate (fraction C), respectively. In the case of the methicillin-resistant (MRSA) ATCC 43300 strain, the same fractions yielded higher MIC values (2.5 and 5.0 mg/mL, respectively). This was accompanied by a lack of apparent cytotoxicity to normal human BJ foreskin fibroblasts, enterocytes derived from CaCo2 cells, and zebrafish embryos. Further analyses revealed the presence of bioactive chlorogenic acids in the fractionated extract, especially in the ethyl acetate fraction (C). These findings support the traditional use of the root from and pave the way for the development of new formulations for treating bacterial infections. This was further evaluated in a proof-of-concept experiment where fraction C was used in the ointment formulation, which maintained high antimicrobial activity against MRSA and displayed low toxicity towards cultured fibroblasts.
Topics: Methicillin-Resistant Staphylococcus aureus; Bacillus cereus; Plant Extracts; Humans; Microbial Sensitivity Tests; Anti-Bacterial Agents; Plant Roots; Animals; Caco-2 Cells; Methanol; Chemical Fractionation; Zebrafish
PubMed: 38731430
DOI: 10.3390/molecules29091939 -
Journal of Ethnopharmacology Sep 2024Wound healing is a complex and dysnamic process supported by a myriad of cellular events that are tightly coordinated to repair efficiently damaged tissue. Populus nigra...
ETHNOPHARMACOLOGICAL RELEVANCE
Wound healing is a complex and dysnamic process supported by a myriad of cellular events that are tightly coordinated to repair efficiently damaged tissue. Populus nigra L. (Salicaceae) flower buds are traditionally used in the treatment of dermatitis, upper respiratory tract infections, rheumatism and wounds.
AIM OF THE STUDY
The aim of this study was to assess the wound healing potential of black poplar ointment containing 10 or 20 % of Populus nigra ethanolic flower buds extract using the excision model in rats.
MATERIALS AND METHODS
Two ointments (10 and 20 %) were prepared from Populus nigra flower buds ethanolic extract and topically applied on the area of excised skin of the rats for either 14 or 20 days. Morphological, macroscopic, histological and biochemical parameters were evaluated.
RESULTS
The results showed that the extract contained high amounts of total phenols (89.5 ± 7.7 mg caffeic acid equivalent/g of extract) and hydrolysable tannins (142.05 ± 2.55 mg tannic acid equivalent/g of extract), in correlation with strong DPPH (2,2-diphenyl-1-picrylhydrazyl) radical scavenging activity and beta-carotene bleaching with values of 96.31 ± 3.42 and 85.27 ± 1.79 %, respectively. Anti-inflammatory potential was illustrated by lipoxygenase and cyclooxygenase inhibition (52.80 ± 0.2 and 53.88 ± 2.55 %, respectively). Treatment with Populus nigra ointment (10 and 20 %) promoted wound contraction of 97.37 ± 1.19 and 97.28 ± 0.91 %, respectively. The antioxidant marker enzymes, catalase (0.10 ± 0.001; 0.08 ± 0.003 U/mg protein) and superoxide dismutase (363.34 ± 24.37; 317.82 ± 53.83 U/mg protein) activities in the granulation tissues were upgraded with respective treatments of 10 or 20 % ointment. Concurrently, the myeloperoxidase activity (2.21 ± 1.01; 2.13 ± 0.75 U/mg protein) was repressed, indicating anti-inflammatory potential, when compared to untreated, standard and excipient groups. Moreover, a significant increase in respective levels of hydroxyproline (p < 0.001) (28.05 ± 1.20; 25.29 ± 1.17 μg/mg tissue) and hexosamine (p < 0.05) (20.18 ± 1.21; 18.95 ± 1.98 μg/mg tissue) was triggered, reflecting a high regeneration of collagen in the scarred tissue. Histological examination of treated skin tissue revealed higher rates of re-epithelialization, lower neutrophils infiltration and re-vascularization in comparison to the control group.
CONCLUSION
Given that the 10 % ointment was the optimal concentration, our findings offer an efficient drug formula for wound healing.
Topics: Populus; Animals; Wound Healing; Plant Extracts; Anti-Inflammatory Agents; Flowers; Rats, Wistar; Male; Rats; Ointments; Skin; Antioxidants
PubMed: 38729538
DOI: 10.1016/j.jep.2024.118319 -
ACS Applied Materials & Interfaces May 2024Fluconazole (FNL) is one of the first-line treatments for fungal keratitis as it is an effective broad-spectrum antimicrobial commonly administered orally or topically....
Fluconazole (FNL) is one of the first-line treatments for fungal keratitis as it is an effective broad-spectrum antimicrobial commonly administered orally or topically. However, FNL has a very low water solubility, limiting its drug formulation, therapeutic application, and bioavailability through tissues. To overcome these limitations, this study aimed to develop FNL inclusion complexes (FNL-IC) with cyclodextrin (α-cyclodextrin, sulfobutylether-β-cyclodextrin, and hydroxypropyl-γ cyclodextrin) and incorporate it into a dissolvable microneedle (DMN) system to improve solubility and drug penetration. FNL-IC was evaluated for saturation solubility, Fourier transform infrared spectroscopy, differential scanning calorimetry, in vitro release, minimum inhibitory concentration, minimum fungicidal concentration, and time-killing assay. DMN-FNL-IC was evaluated for mechanical and insertion properties, surface pH, moisture absorption ability, water vapor transmission, and drug content recovery. Moreover, ocular kinetic, ex vivo antimicrobial, in vivo antifungal, and chorioallantoic membrane (HET-CAM) assays were conducted to assess the overall performance of the formulation. Mechanical strength and insertion properties revealed that DMN-FNL-IC has great mechanical and insertion properties. The in vitro release of FNL-IC was significantly improved, exhibiting a 9-fold increase compared to pure FNL. The ex vivo antifungal activity showed significant inhibition of from 6.54 to 0.73 log cfu/mL or 100-0.94%. In vivo numbers of colonies of 0.87 ± 0.13 log cfu/mL (F2), 4.76 ± 0.26 log cfu/mL (FNL eye drops), 3.89 ± 0.24 log cfu/mL (FNL ointments), and 8.04 ± 0.58 log cfu/mL (control) showed the effectiveness of DMN preparations against other standard commercial preparations. The HET-CAM assay showed that DMN-FNL-IC (F2) did not show any vascular damage. Finally, a combination of FNL-IC and DMN was developed appropriately for ocular delivery of FNL, which was safe and increased the effectiveness of treatments for fungal keratitis.
Topics: Fluconazole; Animals; Antifungal Agents; Keratitis; Candida albicans; Microbial Sensitivity Tests; Rabbits; Needles; Solubility; Eye Infections, Fungal
PubMed: 38728098
DOI: 10.1021/acsami.3c19482 -
Refining the rheological characteristics of high drug loading ointment via SDS and machine learning.PloS One 2024This paper presents an optimized preparation process for external ointment using the Definitive Screening Design (DSD) method. The ointment is a Traditional Chinese...
This paper presents an optimized preparation process for external ointment using the Definitive Screening Design (DSD) method. The ointment is a Traditional Chinese Medicine (TCM) formula developed by Professor WYH, a renowned TCM practitioner in Jiangsu Province, China, known for its proven clinical efficacy. In this study, a stepwise regression model was employed to analyze the relationship between key process factors (such as mixing speed and time) and rheological parameters. Machine learning techniques, including Monte Carlo simulation, decision tree analysis, and Gaussian process, were used for parameter optimization. Through rigorous experimentation and verification, we have successfully identified the optimal preparation process for WYH ointment. The optimized parameters included drug ratio of 24.5%, mixing time of 8 min, mixing speed of 1175 rpm, petroleum dosage of 79 g, liquid paraffin dosage of 6.7 g. The final ointment formulation was prepared using method B. This research not only contributes to the optimization of the WYH ointment preparation process but also provides valuable insights and practical guidance for designing the preparation processes of other TCM ointments. This advanced DSD method enhances the screening approach for identifying the best preparation process, thereby improving the scientific rigor and quality of TCM ointment preparation processes.
Topics: Ointments; Machine Learning; Rheology; Drugs, Chinese Herbal; Medicine, Chinese Traditional; Drug Compounding; Sodium Dodecyl Sulfate; Monte Carlo Method
PubMed: 38723048
DOI: 10.1371/journal.pone.0303199 -
Journal of the College of Physicians... May 2024To assess the efficacy of microneedling in combination with topical tacrolimus ointment 0.1% versus topical tacrolimus ointment 0.1% for treatment of refractory stable... (Comparative Study)
Comparative Study
OBJECTIVE
To assess the efficacy of microneedling in combination with topical tacrolimus ointment 0.1% versus topical tacrolimus ointment 0.1% for treatment of refractory stable vitiligo.
STUDY DESIGN
Comparative cross-sectional study. Place and Duration of the Study: Department of Dermatology, PNS Shifa, Karachi, Pakistan, from December 2022 to May 2023.
METHODOLOGY
The study included 30 clinically diagnosed individuals of either gender who had refractory symptoms and aged between 20 and 60 years. For every patient, two comparable lesions on two comparable limb regions were selected. Group A (right side) received treatment with both topical tacrolimus ointment 0.1% twice daily in addition to microneedling every two weeks, whereas, Group B (left side) was treated with topical tacrolimus ointment 0.1% only. Every lesion was investigated as a separate entity. Both groups were subsequently observed for a further six months.
RESULTS
When topical tacrolimus ointment 0.1% was combined with microneedling, the total re-pigmentation rate was substantially higher than the usage of tacrolimus ointment 0.1% alone. Fifty-three percent of lesions treated with topical tacrolimus ointment 0.1% alone and 76.7% of lesions treated with microneedling in conjunction with it showed a good-to-excellent response. No adverse negative effects were noted. During the follow-up period, no problems or recurrences were noted.
CONCLUSION
Tacrolimus ointment combined with microneedling is a successful treatment for refractory stable vitiligo.
KEY WORDS
Dermapen, Depigmentation, Microneedling, Tacrolimus ointment, Vitiligo.
Topics: Humans; Vitiligo; Tacrolimus; Female; Male; Adult; Ointments; Middle Aged; Cross-Sectional Studies; Immunosuppressive Agents; Treatment Outcome; Combined Modality Therapy; Needles; Young Adult; Administration, Cutaneous; Administration, Topical; Dry Needling; Percutaneous Collagen Induction
PubMed: 38720208
DOI: 10.29271/jcpsp.2024.05.514 -
Journal of Research in Pharmacy Practice 2023Despite many attempts to treat leishmaniasis, new approaches are necessary to reduce the burden of disease. (Brazambel) has shown significant effects against parasites...
OBJECTIVE
Despite many attempts to treat leishmaniasis, new approaches are necessary to reduce the burden of disease. (Brazambel) has shown significant effects against parasites in some studies. This study aimed to investigate the effects of extract topical formulation on cutaneous leishmaniasis.
METHODS
In this randomized controlled clinical trial, patients with cutaneous leishmaniasis were assigned to experimental ( = 18) and control ( = 18) groups. Both groups received intralesional meglumine antimoniate (Glucantime). The experimental group also received 5% Brazambel extract ointment once a day. The interventions continued until the complete healing of the lesions (reepithelialization) for a maximum of 8 weeks. The clinical response, defined as complete response (reepithelialization >75%), partial response (reepithelialization 50%-75%), or treatment failure (reepithelialization <50%), was compared between the groups.
FINDINGS
The percentage of reepithelialization in the experimental group (4 week: 64.44 ± 25.13; 8 week: 83.85 ± 11.54) was higher than the control group (4 week: 53.97 ± 25.88; 8 week: 76.27 ± 21.67); however, the differences were not statistically significant ( = 0.252 and 0.494, respectively). Moreover, there was no significant difference between the experimental and control groups regarding the rate of complete healing (88.9% vs. 72.2%, respectively).
CONCLUSION
The use of extract 5% topical formulation does not affect the healing of cutaneous leishmaniasis.
PubMed: 38716320
DOI: 10.4103/jrpp.jrpp_13_24 -
Case Reports in Pediatrics 2024Orofacial granulomatosis (OFG) is a rare disease entity characterized by nonnecrotizing granulomatous inflammation in the oral and maxillofacial regions, typically...
Orofacial granulomatosis (OFG) is a rare disease entity characterized by nonnecrotizing granulomatous inflammation in the oral and maxillofacial regions, typically characterized by recurrent or persistent edema, primarily in the lips and occasionally in the gingiva. OFG is often associated with Crohn's disease and sarcoidosis, and an accurate diagnosis requires systemic examination of patients. Pediatric patients possess unique oral conditions where dental plaque rapidly forms, especially during tooth replacement due to tooth crowding. Moreover, controlling oral hygiene can be challenging, rendering it difficult to distinguish plaque-induced gingivitis from nonplaque-induced gingivitis. We elucidate the reports of pediatric patients who developed OFG in the lips and/or gingiva alone, which was well controlled through corticosteroid treatment. The patients demonstrated recurrent lips and/or gingival swelling with redness, which failed to improve despite oral health care and treatment with antibiotics and/or corticosteroid ointment. Incision biopsy was performed, which demonstrated granulomatous inflammation. Further systemic examination ruled out Crohn's disease and sarcoidosis and confirmed OFG diagnosis. Corticosteroid treatment orally or through gargling was administered to the patients, which provided improvement of symptoms after 1 month. As OFG may be associated with intractable diseases, monitoring the patient regularly is crucial. Pediatric patients with OFG require a collaborative approach with pediatricians and pediatric dentists to manage their oral and overall health.
PubMed: 38712012
DOI: 10.1155/2024/5685686