Management of xerosis cutis with cream of cashew shell oil: A case report

Abstract

Xerosis cutis is one of the common clinical conditions in clinical practice. Reduced skin hydration is the alarming characteristic of xerosis, that if ignored, can lead to insidious onset of cutaneous infections and chronic ulcers. Although various studies have been in vogue in this field, no standard method of treatment has yet been formulated. An abundantly available drug, cashew shell oil, has been used as a folklore practice in various parts of Kerala, for this condition. This case study is an attempt to evaluate the efficacy of cashew shell oil in cream form in the management of xerosis cutis of plantar surface. A 31-year-old female presented with the complaints of dry skin in the plantar region of the right foot with deep cracks, fissures, and flakes in the skin for two years. Diagnosis was done based on the clinical examination. Pre and post assessments were done based on DermaLab Combo parameters, namely hydration, transepidermal water loss (TEWL), skin pH, elasticity, temperature, skin color, videoscope, and Specified Symptom Sum Score system (scaling, roughness, redness, crack or fissure). Cashew shell oil cream was applied for a period of 30 days. Skin hydration levels improved and TEWL reduced after treatment. Skin pH, though raised during the period of intervention, came to normalcy by the end of treatment. There was improvement in skin viscoelasticity (VE), with reduced retraction time. The oil constituent being an antioxidant, reduces lipid peroxidation and protects from cell membrane damage, thus maintaining skin barrier function. Digital images evaluated using the DermaLab Combo parameters also depicted flaky dry skin being replaced by normal Stratum Corneum (SC) cells, with increased skin hydration. Cashew oil, though being a skin irritant, can be efficiently used in skin conditions, especially xerosis cutis, when administered in appropriate dose and formulation.