Application Of Cream Research Articles

Analgesia for Infant Circumcision: Eutectic Mixture of Local Anesthetic (EMLA) Cream versus Dorsal Penile Nerve Block using Bupivacaine

Context: Circumcision is a painful procedure; thus, analgesia for neonatal circumcision is advocated for every male infant, and its use is considered essential by the American Academy of Pediatrics. Aim: This study aimed to compare the analgesic, hemodynamic effects, and complications of an eutectic mixture of a local anesthetic cream versus dorsal penile nerve block using bupivacaine for infants coming for circumcision. Materials and Methods: This was a prospective randomized interventional study involving 64 infants scheduled for circumcision at the Jos University Teaching Hospital. Infants were randomized into one of two groups through allocation concealment technique. Group I received dorsal penile nerve block with plain bupivacaine 0.5 mL/kg of 0.25%, while group II received 1 g of an eutectic mixture of a local anesthetic cream (EMLA). Circumcision started 5 minutes after penile block for group I and 1 hour after EMLA cream application for group II. Pain levels using CRIES scale, hemodynamic parameters, duration of surgery, and postoperative complications were noted and documented. Data were analyzed using SPSS version 23. A P value of less the 0.05 was considered statistically significant. Results: The study groups were comparable in demographic characteristics (P = 0.054). Less infants had CRIES scores of >4 in the DPNB group up to 2 hours postoperative period. Hemodynamic parameters were within normal ranges but higher in the EMLA group. No complication was noted in both study groups. Conclusion: Dorsal penile nerve block with bupivacaine provided better analgesia in infants undergoing circumcision than EMLA.

Utilizing integrated testing strategy (ITSv1) defined approach and read across to predict skin sensitization of cannabidiol

Cannabidiol (CBD) is increasingly being used as an ingredient in cosmetics, but to date no pre-clinical studies have been published to address the skin sensitization end point. This case study investigated its skin sensitization potential for use in a face cream application at 0.3 % using Next Generation Risk Assessment (NGRA) framework. Based on chemical structure and in-silico prediction using Derek Nexus, CBD was predicted to be weak sensitizer with a resorcinol alert moiety. In vitro testing was conducted confirming it to be sensitizer, but the New Approach Methodologies (NAM) data could not provide sufficient confidence to determine a point of departure (PoD). Integrated testing strategy (ITS)v1 Defined Approach (DA), adopted in OECD Guideline No. 497, was used for skin sensitization potency categorization. However, ITSv1 DA alone is not used for further refinement of the potency prediction based on EC3 (the estimated concentration that produces a stimulation index of 3 in murine local lymph node assay) values. Therefore, the application of read-across using Derek Nexus derived a PoD derived from the LLNA EC3 of 42 %. This led to a favorable NGRA conclusion and to support use of CBD at 0.3 % in face cream application.

Purple Sweet Potato (Ipomea batatas L.) Cream Extract Increase Superoxide Dismutase (SOD) - Malondialdehyde (MDA) Ratio and Higher Collagen Expression in Rats (Rattus novergicus) Exposed to Ultraviolet B

Introduction: Aging can occur in all parts of the body. Superoxide dismutase (SOD) enzyme is an enzyme that interacts with collagen, especially in types I and IV. UVB rays can trigger the presence of free radicals and lipid peroxidation, which form malondialdehyde (MDA) compounds. This study aimed to determine the effect of cream application of purple sweet potato (Ipomoea batatas L.) extract on increasing the ratio of SOD to MDA levels and increasing collagen in rats exposed to UVB. Methods: This was experimental, using a post-test only with a control group design. The irradiation was carried out for 4 weeks with a total radiation dose of 840 mJ/cm2. Purple sweet potato cream concentration was 4%, 8%, and 16%. Rat blood was taken to check the ratio of SOD/MDA and collagen levels using the ELISA kit and Sirius red staining. This study used descriptive analysis and ANOVA using SPSS.25.sav Results: The highest ratio of SOD/MDA levels was found in the treatment group with an 8% purple sweet potato extract concentration of 3.346 ± 0.113. In the collagen expression, the highest percentage was found at 8% levels of 83,290 ± 1,885%. There was a significant mean difference between the treatment and control groups, with the treatment group having a higher result than the control group (p<0.001). Conclusion: The administration of purple sweet potato cream extract could inhibit aging by increasing the ratio of SOD/MDA levels and collagen expression.

Efficacy and anti-inflammatory properties of low-molecular-weight fucoidan in patients with atopic dermatitis: a randomized double-blinded placebo-controlled trial

ABSTRACT Atopic dermatitis (AD) is a chronic recurrent inflammatory skin disease. Fucoidans are reportedly effective in treating AD; however, their clinical efficacy requires further exploration. This study aimed to investigate the clinical efficacy of low-molecular-weight fucoidan (LMF) supplementation in patients with AD and reveal the underlying mechanism of its effects; this is a randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to a study or control group to receive conventional AD therapy with oral supplementation of either LMF or placebo for 12 weeks. Symptom severity was measured by the SCORing Atopic Dermatitis (SCORAD) index. Each participant used a diary to record daily medication use. Blood samples were collected at three time points for assessing AD-related cytokines, immunoglobulin E (IgE), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, the percentage of eosinophils, and biochemical profiles of hepatic and renal functions. The study group showed significant symptom relief, whereas the control group showed no significant improvements. The frequency of steroid ointment application significantly decreased, and the frequency of oral antihistamine use decreased in the study group, whereas no significant changes were observed in the control group. The AD-related immune parameters serum IgE, eosinophils, CD8+ T cells, interferon-γ (IFN-γ), ESR, and CRP significantly decreased in the study group but not the control group. There were no severe adverse events in either group. This study is the first to demonstrate the effectiveness and safety of LMF as a supplemental therapy for patients with AD via its anti-inflammatory activity.

Mupirocin–Induced Allergic Contact Dermatitis: A Case Report and a Review of the Literature

Background: Mupirocin, an antibiotic, is frequently used to treat special traumatic infected skin lesions, such as impetigo, methicillin-resistant Staphylococcus aureus (MRSA), burn, scratch after operation, etc. Topical use of mupirocin can lead to some adverse drug reactions (ADR). Objectives: To report a case of mupirocin-induced contact dermatitis and a review of the literature to identify the causative factors and clinical characteristics. Methods: We report a case of contact dermatitis in a 39-year-old woman which happened 2 days after mupirocin ointment application on her hand. Also, a review of the literature was done according to PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched. Time or language filters were not used and all related reports were included. Results: In the mentioned case, mupirocin has a causative role in dermatitis. The review showed 10 cases of mupirocin-induced allergy. The clinical presentations included serum sickness, diffuse urticaria, fever, arthralgias, toxic epidermal necrolysis, pruritus, rash, breathlessness, palpitations, flushing, redness all over the body, low blood pressure, severe allergic contact dermatitis, pruritic papular eruption, extensive contact dermatitis, allergic contact hypersensitivities. All cases were improved after anti-allergic treatments except one who had been tracheostomy and was in serious condition. Conclusions: this is the first review of mupirocin-induced allergy. Although these incidences are rare, clinicians should be aware to prevent severe reactions with serious consequences.

Cyanidin-3-O-glucoside and its derivative vitisin A alleviate androgenetic alopecia by exerting anti-androgen effect and inhibiting dermal papilla cell apoptosis

Androgenetic alopecia (AGA), one of the most common forms of hair loss, lacks satisfactory treatment methods in modern society. This study employed an experimental design combining in vitro and in vivo approaches to explore the effects of Cyanidin-3-O-glucoside (C3G) and Carboxypyranocyanidin-3-O-glucoside (Vitisin A) on AGA. In human dermal papilla cells (HDPCs), both anthocyanins demonstrated inhibitory effects on androgen receptors, significantly reduced dihydrotestosterone (DHT) induced apoptosis of HDPCs, and regulated the secretion of Fibroblast growth factor 7 and Transforming growth factor beta 1. In vitro transdermal experiment revealed that both C3G and Vitisin A could penetrate mice skin, aided by the application of cream. Furthermore, in vivo experiments with mice indicated that application of C3G or Vitisin A cream effectively improved hair follicles miniaturization, regression, and apoptosis caused by DHT. The repression of Wnt10b and β-catenin expression induced by DHT was prevented by C3G and Vitisin A in both cell and mouse model. Consequently, these findings suggest that C3G and Vitisin A could be considered as alternative methods for alleviating AGA.

Application Site of Transdermal Scopolamine Influences Efficacy and Drug Concentration in Salivary Glands in Rats.

Transdermal scopolamine applied to the postauricular area is used to treat drooling. We investigated the duration of action of scopolamine ointment and the effect of the application site on drug efficacy and concentration in the salivary glands of rats. Scopolamine ointment was applied to the skin over the salivary glands (SSG) and back (SB). Saliva volume was measured after intraperitoneal administration of pilocarpine. Blood and salivary glands were collected after scopolamine ointment application, and scopolamine concentrations in the plasma and salivary glands were measured. Saliva volume after application in the SSG group was significantly lower at all time points than in the non-treated group, and the change in saliva volume in the SSG group was greater than that in the SB group at all time points. This suggests that applying scopolamine ointment to the SSG strongly suppresses salivary secretion. Scopolamine concentration in the salivary glands of the SSG group was significantly higher at 9 h. The change in the efficacy of scopolamine ointment depending on the application site was due to the difference in transfer to the salivary glands. Transdermal administration of scopolamine to the skin over the salivary glands may have high efficiency in treating drooling.

Pain-Reducing Modalities Before Botulinum Type A Injections for Hemifacial Spasm Treatment: A Comparative Study

Background: Botulinum toxin A (Botox) therapy is safe and effective for hemifacial spasm, however, the associated discomfort and pain from injections limit its usefulness. Objective: To evaluate pain, preparation difficulty, and satisfaction following application of a eutectic mixture of local anesthetic (EMLA) cream, ice application, and placebo before Botox injections for hemifacial spasm. Materials and Methods: Twenty-two patients received four Botox injections in the facial area to treat hemifacial spasm, between June 2022 and March 2023. The initial treatment began in June 2022, followed by treatments at 3, 6, and 9 months. The EMLA cream, ice application, control, and placebo were administered consecutively for each Botox treatment. Pain, preparation difficulty, and satisfaction were evaluated on a 0 to 10 scale. Neurological and bleeding complications were recorded. Results: The mean pain score for EMLA cream application was the lowest, followed by cold compressions. The mean pain score in the control with placebo intervention was not significantly different from that in the control. The control without placebo intervention had the lowest difficulty in preparation score at 0.82 and showed no significant difference with EMLA application. Whereas cold compression had the highest difficulty in preparation score. The highest satisfaction score was obtained with the EMLA cream application at 9.45. The satisfaction score was higher in the control with placebo intervention at 8.32 than in the control, which had the lowest satisfaction score at 6.91. The number of injections and neurological complications did not differ among the four methods. The bleeding site ratio was the lowest with the cold compression method. Conclusion: EMLA cream application resulted in the lowest mean pain and the highest satisfaction scores. Control with placebo intervention increased the satisfaction score without reducing the mean pain score. Cold compression decreased bleeding complications, and the secondlowest mean pain scores. Keywords: Ice; Local anesthetics; EMLA; Hemifacial spasm; Botox injection; Pain reduction

Low-value home-based nursing care: A national survey study.

To explore potential areas of low-value home-based nursing care practices, their prevalence and related influencing factors of nurses and nursing assistants working in home-based nursing care. A quantitative, cross-sectional design. An online survey with questions containing scaled frequencies on five-point Likert scales and open questions on possible related influencing factors of low-value nursing care. The data collection took place from February to April 2022. Descriptive statistics and linear regression were used to summarize and analyse the results. A nationwide sample of 776 certified nursing assistants, registered nurses and nurse practitioners responded to the survey. The top five most delivered low-value care practices reported were: (1) 'washing the client with water and soap by default', (2) 'application of zinc cream, powders or pastes when treating intertrigo', (3) 'washing the client from head to toe daily', (4) 're-use of a urinary catheter bag after removal/disconnection' and (5) 'bladder irrigation to prevent clogging of urinary tract catheter'. The top five related influencing factors reported were: (1) 'a (general) practitioner advices/prescribes it', (2) 'written in the client's care plan', (3) 'client asks for it', (4) 'wanting to offer the client something' and (5) 'it is always done like this in the team'. Higher educational levels and an age above 40 years were associated with a lower provision of low-value care. According to registered nurses and certified nursing assistants, a number of low-value nursing practices occurred frequently in home-based nursing care and they experienced multiple factors that influence the provision of low-value care such as (lack of) clinical autonomy and handling clients' requests, preferences and demands. The results can be used to serve as a starting point for a multifaceted de-implementation strategy. STROBE checklist for cross-sectional studies. No Patient or Public Contribution. Nursing care is increasingly shifting towards the home environment. Not all nursing care that is provided is effective or efficient and this type of care can therefore be considered of low-value. Reducing low-value care and increasing appropriate care will free up time, improve quality of care, work satisfaction, patient safety and contribute to a more sustainable healthcare system.

Prospects for the use of Lipster Mint cream in the complex treatment of herpes zoster

Objective — to investigate the clinical efficacy of Lipster Mint cream in the complex treatment of patients with herpes zoster. 
 Materials and methods. The study included 15 patients (11 women and 4 men) with acute herpes zoster. The age of the patients ranged from 38 to 70 years. The patients had severe clinical symptoms (typical vesicular rash, itching of varying intensity, burning sensation, intense pain along the affected nerves and sleep disturbance). The localization of pathological foci was unilateral: in 12 patients on the skin of the trunk, in 1 patient on the buttock and in 2 patients on the skin of the thigh. All patients reported a decrease in quality of life due to the disease. The complex treatment included Valavir, one of the valacyclovir drugs, according to the recommended regimens, which was administered orally in 1000 mg tablets three times a day for 7 days. Acute herpes-associated pain and heartburn were relieved with analgesics and topical application of Lipster Mint cream, manufactured by Farmak (Ukraine), which contains acyclovir 5 % and menthol. A distinctive advantage of Lipster Mint is that it contains the highest dose of acyclovir permitted for topical products — 5 %, as well as menthol which cools and reduces itching. The effectiveness of treatment of herpes zoster was assessed by the dynamics of clinical symptoms and subjective feelings on the 2nd, 5th and 10th days of treatment. 
 Results and discussion. As a result of the treatment, positive dynamics of all clinical manifestations was achieved. Inflammatory phenomena such as swelling and hyperemia of the skin significantly decreased, the appearance of fresh herpes rash stopped within 24 hours, body temperature normalized on the 2—3rd day, general condition improved, pain and discomfort in the affected areas significantly decreased, partial epithelialization of erosions and the appearance of crusts were observed on the 5—7th day. With the topical application of Lipster Mint, under the influence of menthol, from the first minutes of application, patients significantly reduced the sensations of burning, tingling and pain in the areas of skin lesions. 
 Conclusions. Despite the available arsenal of specific and non-specific antiherpetic drugs, treatment of patients suffering from herpes zoster continues to be an urgent medical problem that requires further improvement and individualized approach. Our clinical observations indicate the effectiveness of the systemic drug Valavir and the topical drug Lipster Mint cream in the complex treatment of herpes zoster, which makes it possible to reduce postherpetic neuralgia in the areas of skin lesions and improve the quality of life of patients.

The Effect of Topical Application of Mothers' Breast Milk versus Barrier Cream on Healing of Diaper Dermatitis in Infants

The Effect of Topical Application of Mothers' Breast Milk versus Barrier Cream on Healing of Diaper Dermatitis in Infants

Novel Vehicles For Drug Delivery in Atopic Dermatitis: A Narrative Review.

Atopic dermatitis (AD) causes dry and itchy skin and inflammation that severely impairs the quality of life of affected children and adults. While topical glucocorticosteroid application is typically the first-line treatment of choice, steroid treatment is associated with side effects and, increasingly, patient concerns about prolonged use. Novel drugs and drug delivery vehicles are required for patients with AD. To summarize the current literature on novel topical agents for atopic dermatitis and novel delivery vehicles. A literature search was conducted, and a narrative review was compiled to summarize recent evidence. Novel topical drugs approved or in late-phase clinical trials for the treatment of AD include the Janus kinase inhibitor ruxolitinib, the phosphodiesterase-4 inhibitors crisaborole, and roflumilast, and the aryl hydrocarbon receptor activator tapinarof. While current topical drugs for AD are delivered via creams, ointments, gels, and related vehicles, novel delivery approaches such as electrospun patches, sprays, liposomes, nanoparticles, and lasers are being developed to enhance transdermal delivery, reduce side effects, and increase treatment adherence. Topical application of creams or ointments is currently the predominant vehicle for the delivery of atopic dermatitis drugs. In vitro studies on novel vehicles show promising results to overcome the issues associated with topical delivery. Still, these findings have to be corroborated by controlled studies with human patients in the future.

Early treatment of vulvar synechiae in childhood - prevention of late complications.

Synechiae of the vulva occurs especially in girls in the so-called resting hormonal period with a minimal serum concentration of estrogens. If the external genitalia of the girl are not treated properly, the mucous membrane of the vaginal entrance is not regularly checked and mechanically removed, then the smegma of the opposite mucous membranes of the vulva can stick together. The place of the adhesion of epithelium in the vaginal introitus can be covered by a new epithelium and can create a firm adhesion, synechiae of the vulva, which is usually asymptomatic and is discovered incidentally during pediatric examination. Clinically significant vulvar synechiae can cause impaired bladder evacuation and recurrent lower urinary tract infections. Dissection of synechiae in the stage of conglutination or thin adhesion is performed manually on an outpatient basis, but extensive and firm adhesions must be divided surgically under general anesthesia. Local application of cream with estriol or betamethasone is also used for the therapy of synechiae of the vulva, but this treatment is more time-consuming compared to rapid manual separation and requires good compliance of the girls and their parents. The prevention of synechiae is based on the education of parents by pediatricians and gynecologists about the need for regular checks of the external genitalia and sufficient hygiene.

Gallic Acid Treats Hypertrophic Scar in Rabbit Ears via the TGF-β/Smad and TRPC3 Signaling Pathways.

Hypertrophic scars (HSs) develop due to excessive collagen deposition and abnormal fibroblast proliferation during wound healing, significantly impacting patient quality of life. Three dosages of GA ointments were administered to rabbit ear HS models to investigate the potential efficacy and mechanism of gallic acid (GA) on HS. Daily application of ointment was performed on the matrix group, the GA ointment groups, and the silicone gel group for 28 days. (No drug treatment was performed on the skin and model groups as a blank group and vehicle group, and silicone gel ointment was topically administered to the silicone gel group as a positive control group.) Scar specimens were collected for histopathology analysis, RNA sequencing analysis, real-time quantitative polymerase chain reaction, and Western blot analysis at the first, second, and fourth weeks after the treatment. Low-dose and medium-dose GA effectively suppressed HS formation and markedly decreased fibroblast infiltration levels and scar thickness. Moreover, decreased expression of TRPC3 mRNA and TGF-β1, p-Smad2/3, and Smad2/3 protein was observed in the low- and medium-dose GA groups and the silicone gel group. This study provides evidence for the efficacy of GA in treating HS and sheds light on its potential underlying pharmacological mechanisms.

Effects of skin moisturization on various aspects of touch showing differences with age and skin site

The human body is encompassed by a thin layer of tissue, the skin, which is heterogenous and highly specialized to protect the body and encode interactions with the external world. There is a fundamental scientific drive to understand its function, coupled with the need to preserve skin as we age, which impacts on our physiological and psychological well-being. In the present study, we aimed to define differences in touch perception between age groups and with skin cream application. We investigated touch on the finger, the forearm and cheek in younger (20–28 years, n = 22) and older (65–75 years, n = 22) females. We measured skin hydration, touch detection, finger spatial discrimination, forearm tactile pleasantness together with electrodermal activity, and perceptual ratings about cream use, skin dryness, and cosmetic habits. Glabrous finger skin became drier and touch performance was impaired with age, but these aspects were preserved in hairy skin. Skin moisturization immediately increased hydration levels, but did not significantly change touch perception. We also found that touch appreciation increased with age. We conclude that reduced finger capacity may impact self-evaluation of the skin and that long-term skin care strategies should focus on hydrating the hand to preserve touch capacities.

Labial Adhesions

Labial adhesion is characterized by partial or complete fusion of labia minora or labia majora. It is rare in menopausal women. It is usually a triad of estrogen deficiency, inflammatory skin disorders and lack of sexual activity. Patients are mostly asymptomatic until labial fusion is complete. The most common symptoms are urinary retention and urinary tract infections and incontinence. It is usually diagnosed on examination of external genitalia. The treatment is not well established, owing to low prevalence in menopausal population. The most common methods of treatment are manual separation and surgical excision. Postoperative application of local estrogen cream is vital to prevent recurrence.

Surgeons' practice and preferences for the anal fissure treatment: results from an international survey.

The best nonoperative or operative anal fissure (AF) treatment is not yet established, and several options have been proposed. Aim is to report the surgeons' practice for the AF treatment. Thirty-four multiple-choice questions were developed. Seven questions were about to participants' demographics and, 27 questions about their clinical practice. Based on the specialty (general surgeon and colorectal surgeon), obtained data were divided and compared between two groups. Five-hundred surgeons were included (321 general and 179 colorectal surgeons). For both groups, duration of symptoms for at least 6weeks is the most important factor for AF diagnosis (30.6%). Type of AF (acute vs chronic) is the most important factor which guide the therapeutic plan (44.4%). The first treatment of choice for acute AF is ointment application for both groups (59.6%). For the treatment of chronic AF, this data is confirmed by colorectal surgeons (57%), but not by the general surgeons who prefer the lateral internal sphincterotomy (LIS) (31.8%) (p = 0.0001). Botulin toxin injection is most performed by colorectal surgeons (58.7%) in comparison to general surgeons (20.9%) (p = 0.0001). Anal flap is mostly performed by colorectal surgeons (37.4%) in comparison to general surgeons (28.3%) (p = 0.0001). Fissurectomy alone is statistically significantly most performed by general surgeons in comparison to colorectal surgeons (57.9% and 43.6%, respectively) (p = 0.0020). This analysis provides useful information about the clinical practice for the management of a debated topic such as AF treatment. Shared guidelines and consensus especially focused on operative management are required to standardize the treatment and to improve postoperative results.

Diaper dermatitis and associated factors among 1–24 months children visiting public health facilities of Arba Minch town, Gamo zone, southern Ethiopia

BackgroundDiaper dermatitis is one of infants and toddlers' most common skin diseases; it accounts for 10–20 % of all skin diseases and 25 % of pediatric dermatology visits. Diaper dermatitis also increases parents' mental health problems and compromises the quality of life. Despite its ill outcome, diaper dermatitis's burden and risk factors are poorly studied in Ethiopia. Therefore, this study aimed to assess the magnitude of diaper dermatitis and associated factors among 1–24 months children visiting public health facilities in Arba Minch town, southern Ethiopia. MethodsA facility-based cross-sectional study was conducted among 671 mother-child pairs from May 15 to June 15, 2022. A structured and pretested interviewer-administered questionnaire and observational checklist were used to collect the information. The data was collected using an open data kit tools and analyzed using Stata version 17.0. Bivariable and multivariable analyses were carried out to identify factors associated with diaper dermatitis. P-value <0.05 was considered to declare statistical significance. ResultsIn this study, 664 mother-child pairs, yielded a response rate of 98.96 %, were involved. Overall, 35.69 % [95 % CI: 32.04, 39.47] of children encountered diaper dermatitis. Being government-employed (AOR: 2.49, 95 % CI: 1.42, 4.35), primiparity (AOR: 1.52, 95 % CI: 1.03, 2.23), unplanned pregnancy (AOR: 1.93, 95 % CI: 1.22, 3.04), having poor knowledge about diaper dermatitis (AOR: 1.74, 95 % CI: 1.19, 2.56), using both disposable and non-disposable diapers alternatively (AOR: 3.35, 95 % CI: 1.55, 7.22), and applying ointments on diaper area (AOR: 1.93, 95 % CI: 1.26, 2.97) all increase the likelihood of diaper dermatitis. ConclusionDiaper dermatitis was high in the study hospitals; over one-third experienced it. Maternal occupation, parity, pregnancy status, maternal knowledge of diaper dermatitis, diaper type, and ointment application were significantly associated with diaper dermatitis. Improving maternal/guardian knowledge about diapering and diaper dermatitis is critical to reducing the burden and severity of the problem.

Therapeutic efficacy, safety, and tolerability of a topical agent (foam cream 5 % urea)

The article presents the results indicating a high level of safety and good tolerability of the topical agent (foam cream 5 % urea). The results of the clinical studies have shown high therapeutic efficacy of foam cream 5 % urea in the complex treatment of topical dermatitis, psoriasis, itching, and damage to the integrity of the foot skin in diabetes mellitus. The index of quality of life of patients improves significantly against the background of the foam cream application; high efficiency and good tolerability of the agent with its regular use have been demonstrated. The conducted studies allow recommending the use of the topical agent (foam cream 5 % urea) as a safe and effective remedy, including for the treatment of pregnant women and children.

Surgical wound infection by Pluralibacter gergoviae in a diabetic patient

is reported to cause infections in immunocompromised patients and also nosocomial outbreaks. This is a case of soft tissue infection in a diabetic patient who underwent a surgery on the left breast and a bilateral reduction mammoplasty following all preliminary investigations. Post operatively, she presented with the complaints of poor wound healing and a wound gap. Immunocompromised state, uncontrolled diabetes and topical application of cream or ointment during post-operative period could be risk factors for an infection by Little is known about this organism and its clinical significance. Hence documentation of such case scenarios is essential to gather more clinically relevant information.