Download FIHM “The Skin” - REFERENCES AND ABSTRACTS FOR ATOPIC

FIHM “The Skin” - REFERENCES AND ABSTRACTS FOR ATOPIC DERMATITIS
CHAMOMILE
Patzelt-Wenczler R, Ponce-Pöschl E. Proof of efficacy of Kamillosan(R) cream in
atopic eczema. Eur J Med Res. 2000 Apr 19; 5(4):171-5.
Kamillosan(R) cream contains chamomile extract as active principle manufactured
from the chamomile sort Manzana which is rich in active principles and has been
proved not to exhibit a chamomile-related allergen potential. For this reason
Kamillosan(R) cream is suited for local therapy of atopic eczema. In a partially
double-blind, randomized study carried out as a half-side comparison,
Kamillosan(R) cream was tested vs. 0.5% hydrocortisone cream and the vehicle
cream as placebo in patients suffering from medium-degree atopic eczema. After a
2-week treatment Kamillosan(R) cream showed a mild superiority towards 0.5%
hydrocortisone and a marginal difference as compared to placebo.
SUNFLOWER SEED OIL
Danby SG, AlEnezi T, Sultan A, Lavender T, Chittock J, Brown K, Cork MJ. Effect of
olive and sunflower seed oil on the adult skin barrier: implications for
neonatal skin care. Pediatr Dermatol. 2013 Jan-Feb;30(1):42-50.
Academic Unit of Dermatology Research, Department of Infection and Immunity,
Faculty of Medicine, Dentistry and Health, University of Sheffield Medical School,
Sheffield, UK. [email protected]
Natural oils are advocated and used throughout the world as part of neonatal skin
care, but there is an absence of evidence to support this practice. The goal of the
current study was to ascertain the effect of olive oil and sunflower seed oil on the
biophysical properties of the skin. Nineteen adult volunteers with and without a
history of atopic dermatitis were recruited into two randomized forearm-controlled
mechanistic studies. The first cohort applied six drops of olive oil to one forearm
twice daily for 5 weeks. The second cohort applied six drops of olive oil to one
forearm and six drops of sunflower seed oil to the other twice daily for 4 weeks. The
effect of the treatments was evaluated by determining stratum corneum integrity
and cohesion, intercorneocyte cohesion, moisturization, skin-surface pH, and
erythema. Topical application of olive oil for 4 weeks caused a significant reduction
in stratum corneum integrity and induced mild erythema in volunteers with and
without a history of atopic dermatitis. Sunflower seed oil preserved stratum
corneum integrity, did not cause erythema, and improved hydration in the same
volunteers. In contrast to sunflower seed oil, topical treatment with olive oil
significantly damages the skin barrier, and therefore has the potential to promote
the development of, and exacerbate existing, atopic dermatitis. The use of olive oil
for the treatment of dry skin and infant massage should therefore be discouraged.
These findings challenge the unfounded belief that all natural oils are beneficial for
the skin and highlight the need for further research.
PROBIOTICS
Wickens K, Black P, Stanley TV, Mitchell E, Barthow C, Fitzharris P, Purdie G, Crane J.
A protective effect of Lactobacillus rhamnosus HN001 against eczema in the
first 2 years of life persists to age 4 years. Clin Exp Allergy. 2012;42(7):1071-9.
Source
Wellington Asthma Research Group, Wellington School of Medicine and Health
Sciences, University of Otago, Wellington, New Zealand.
[email protected]
BACKGROUND:
Using a double blind randomized placebo-controlled trial (Australian New Zealand
Clinical Trials Registry: ACTRN12607000518460), we have shown that in a high risk
birth cohort, maternal supplementation from 35 weeks gestation until 6 months if
breastfeeding and infant supplementation until 2 years with Lactobacillus
rhamnosus HN001 (HN001) (6 × 10(9) cfu/day) halved the cumulative prevalence
of eczema by age 2 years. Bifidobacterium animalis subsp lactis HN019 (HN019) (9
× 10(9) cfu/day) had no effect.
OBJECTIVE:
The aim of this study was to investigate the associations of HN001 and HN019 with
allergic disease and atopic sensitization among these children at age 4 years, 2 years
after stopping probiotic supplementation.
METHODS:
The presence (UK Working Party's Diagnostic Criteria) and severity SCORing Atopic
Dermatitis (SCORAD) of eczema and atopy (skin prick tests) and parent-reported
symptoms of asthma and rhinoconjunctivitis were assessed using standard
protocols and questions.
RESULTS:
Four-hundred and seventy-four infants were eligible at birth of whom 425 (90%)
participated in this follow-up. The cumulative prevalence of eczema by 4 years
(Hazard ratio (HR) 0.57 (95% CI 0.39-0.83)) and prevalence of rhinoconjunctivitis
at 4 years (Relative risk 0.38 (95% CI 0.18-0.83)) were significantly reduced in the
children taking HN001; there were also nonsignificant reductions in the cumulative
prevalence of SCORAD ≥ 10 (HR 0.74 (95% CI 0.52-1.05), wheeze (HR 0.79 (95% CI
0.59-1.07)) and atopic sensitization (HR = 0.72 (95% CI 0.48-1.06)). HN019 did not
affect the prevalence of any outcome.
CONCLUSIONS AND CLINICAL RELEVANCE:
This study showed that the protective effect of HN001 against eczema, when given
for the first 2 years of life only, extended to at least 4 years of age. This, together
with our findings for a protective effect against rhinoconjunctivitis, suggests that
this probiotic might be an appropriate preventative intervention for high risk
infants.
DIET AND ACNE
Bhate K, Williams HC. Epidemiology of acne vulgaris. Br J Dermatol. 2013
Mar;168(3):474-85. doi: 10.1111/bjd.12149.
Abstract
Despite acne being an almost universal condition in younger people, relatively little
is known about its epidemiology. We sought to review what is known about the
distribution and causes of acne by conducting a systematic review of relevant
epidemiological studies. We searched Medline and Embase to the end of November
2011. The role of Propionibacterium acnes in pathogenesis is unclear: antibiotics
have a direct antimicrobial as well as an anti-inflammatory effect. Moderate-tosevere acne affects around 20% of young people and severity correlates with
pubertal maturity. Acne may be presenting at a younger age because of earlier
puberty. It is unclear if ethnicity is truly associated with acne. Black individuals are
more prone to postinflammatory hyperpigmentation and specific subtypes such as
'pomade acne'. Acne persists into the 20s and 30s in around 64% and 43% of
individuals, respectively. The heritability of acne is almost 80% in first-degree
relatives. Acne occurs earlier and is more severe in those with a positive family
history. Suicidal ideation is more common in those with severe compared with mild
acne. In the U.S.A., the cost of acne is over 3 billion dollars per year in terms of
treatment and loss of productivity. A systematic review in 2005 found no clear
evidence of dietary components increasing acne risk. One small randomized
controlled trial showed that low glycaemic index (GI) diets can lower acne severity.
A possible association between dairy food intake and acne requires closer scrutiny.
Natural sunlight or poor hygiene are not associated. The association between
smoking and acne is probably due to confounding. Validated core outcomes in
future studies will help in combining future evidence.
TEA TREE AND ACNE
Bassett IB, Pannowitz DL, Barnetson RS.A comparative study of tea-tree oil
versus benzoylperoxide in the treatment of acne. Med J Aust. 1990 Oct
15;153(8):455-8.
Source
Department of Dermatology, Royal Prince Alfred Hospital, Camperdown, NSW.
Abstract
Tea-tree oil (an essential oil of the Australian native tree Melaleuca alternifolia) has
long been regarded as a useful topical antiseptic agent in Australia and has been
shown to have a variety of antimicrobial activities; however, only anecdotal
evidence exists for its efficacy in the treatment of various skin conditions. We have
performed a single-blind, randomised clinical trial on 124 patients to evaluate the
efficacy and skin tolerance of 5% tea-tree oil gel in the treatment of mild to
moderate acne when compared with 5% benzoyl peroxide lotion. The results of this
study showed that both 5% tea-tree oil and 5% benzoyl peroxide had a significant
effect in ameliorating the patients' acne by reducing the number of inflamed and
non-inflamed lesions (open and closed comedones), although the onset of action in
the case of tea-tree oil was slower. Encouragingly, fewer side effects were
experienced by patients treated with tea-tree oil.