Significant Improvement In Erythema Research Articles

Clinical evaluation of anti-aging effects of combined therapy-Azelaic acid, phytic acid, and vitamin C applied layer by layer in females with Fitzpatrick skin types II and III.

Vitamins C, E, and A and substances of plant origin, including azelaic acid and phytic acid are frequently used in cosmetic preparations to counteract oxidative stress and negative effects of free radicals. The aim of the study was to evaluate a novel combined therapy consisting of azelaic acid, ascorbic acid, and phytic acid applied layer on layer. Twenty study participants received a series of eight treatments performed every 7 days. Twenty percent azelaic acid and then 30% phytic acid were applied to the entire face, while 40% l-ascorbic acid only on the left side. The preparations were applied layer by layer. Skin parameters were measured before the series of treatments (T0), after the series of eight treatments (T1-8 weeks), and 1 month after the end of the treatment (T2-12 weeks). The application of two and three active compounds resulted in a significant improvement in erythema and hyperpigmentation both on the forehead and the cheeks, however, more pronounced effects were observed when all the three active compounds were used. Both applied types of treatment considerably increased skin moisture. All the participants (100%) were satisfied with the effects of the treatment. A majority of them reported an improvement in skin hydration, firmness, and elasticity, more uniform skin tone and a reduction of skin redness and wrinkles. Topical application of these active compounds resulted in improvement of skin elasticity and flexibility, reduction of wrinkles, hyperpigmentation, erythema, and telangiectasia as well as amelioration of skin tone.

Epidermal-cell-based therapy as an adjunct to healing second degree burns—A randomized controlled pilot study

BackgroundHealing of partial-thickness (2a and 2b) burns is notoriously unpredictable as far as healing time, scarring and (hypo)pigmentation is concerned. Epidermal blister grafting is an autologous grafting technique involving transfer of epidermal islands without dermal elements. Cellutome™ is an FDA-acknowledged epidermal harvesting device. This proof-of-concept study evaluates whether blister grafting of partial-thickness burns results in improved healing compared to standard acellular treatment. MethodsThis is a randomized controlled trial with 8 patients in which each patient received both treatments randomized to different burn sites. Healing was assessed at regular intervals. Twelve months after treatment, outcomes were measured with the Vancouver Scar Scale (VSS), Patient and Observer Scar Assessment Scale (POSAS), photography, spectrometry, Semmes-Weinstein Filaments, cutometry and high-resolution ultrasound. ResultsAreas treated with epidermal blister grafting healed slightly faster than acellular treatment. Epidermal treatment yielded healing with less erythema, closer to that of surrounding normal skin (p = 0.0404). Donor sites were not visible and not measurably different than normal skin. ConclusionsResults favor cellular over acellular technique for the treatment of partial-thickness (2a and 2b) burns. Significant improvement in erythema implies a higher quality healing process. Further studies should look primarily at larger areas of treatment, and larger sample size.

Clinical, dermoscopic, and histopathologic evaluation of topical methotrexate 1% hydrogel versus topical Calcipotriol 0.005% cream in the treatment of plaque psoriasis.

Psoriasis Vulgaris is a common immune-mediated skin disease. Its high prevalence, disability, chronicity, disfiguration, and associated comorbidities make it a challenge for physicians. Topical agents remain the mainstay of treatment for patients with mild to moderate psoriasis. To evaluate the efficacy and tolerability of topical methotrexate 1% gel (MTX) versus topical calcipotriol 0.005% cream (CPL) in the treatment of localized plaque psoriasis. This prospective comparative study included 40 patients with localized plaque psoriasis instructed to apply MTX to one side (group A) and CPL to the other side lesions (group B) twice daily for 12 weeks. Clinical and dermoscopic evaluations before, weekly during and after 3months of treatment were done. The immunohistopathological assessment was done for skin biopsies from 10 patients in each group before and after treatment. At the end of 12 weeks, there was marked-complete improvement in 97.5% of group A lesions treated with MTX 1% gel compared with 37.5% of group B lesions treated with calcipotriol 0.005% cream (p< 0.001). There was a very high statistically significant improvement in erythema that was cleared totally in 67.5% vs 22.5%, scaling in 75% vs 17.5%, and infiltration in 72.5% vs 27.5% in group A vs B, respectively (p< 0.001). These results were confirmed by dermoscopic and immunohistopathological findings. Methotrexate 1% gel is a marvelous promising well-tolerated effective topical agent that can be used safely in the treatment of localized plaque psoriasis.

Use of a novel 589-nm solid-state laser for treatment of facial erythema.

To evaluate the efficacy and safety associated with use of a 589-nm solid-state laser for treatment of facial erythema. A prospective, IRB-approved study was conducted. Participants who were interested in treatment for facial erythema were recruited. They received four monthly treatments with the 589-nm laser. Erythema of the right and left face was graded on a scale of 0-4, 4 being most severe, by both investigators and participants prior to each treatment and at follow-up. Safety was assessed by any reported side effects. Twenty-four participants enrolled in the study, 16 women (67%) and 8 men (33%), with an average age of 51.1years. Investigator grades showed a statistically significant improvement in erythema of 31% for both the right and left face. Participant grades showed a statistically significant improvement in erythema of 23.2% for the right face and 22.8% for the left face. Side effects were limited to transient erythema posttreatment. A 589-nm solid-state laser achieved a modest improvement in facial erythema when evaluating results 1month after four monthly treatments. No major safety issues were reported.

A Study to Assess The Efficacy of Local Application of Oral Probiotic in Treating Recurrent Aphthous Ulcer and Oral Candidiasis

To study the efficacy of local application of oral probiotics in improving oral health in recurrent aphthous ulcer and oral candidiasis. Eighty patients with diagnosis of recurrent aphthous ulcer and oral candidiasis were included in the study. They were divided into group A=40 patients (patients treated with oral application of probiotic as an adjuvant) and group B=40 patients (patients treated without probiotic). Both the groups were divided into two subgroups, group AU and group BU for recurrent aphthous ulcer and group AC and BC for oral candidiasis. Clinical signs and symptoms were assessed at the beginning of the study and at the end of the study. Pregnant or lactating women, patients with localised or systemic diseases such as Steven Johnson syndrome, ulcerative colitis, Behcet's syndrome and patients on chemotherapy or radiotherapy were excluded from the study. Bacillus Clausii, was used as a probiotic in our study. Patients in group A showed significant improvement in erythema (p=0.001), pain reduction (p=0.0001), decreased oral thrush (p=0.006) and burning sensation in the mouth (p=0.005) on day 5, whereas there was no significant difference on day 10 follow up. The study demonstrated the efficacy and rapidity of response to oral probiotic as an adjuvant in treating aphthous ulcer and oral candidiasis. Hence, oral application of probiotics can be used as an adjuvant in treating various oral pathology.

Proactive Treatment of Adult Facial Seborrhoeic Dermatitis with 0.1% Tacrolimus Ointment: Randomized, Double-blind, Vehicle-controlled, Multi-centre Trial

The effectiveness of intermittent topical tacrolimus to prevent relapse in patients with stabilized facial seborrhoeic dermatitis has not been evaluated. The aim of this study was to determine whether proactive use of 0.1% tacrolimus ointment can keep adult facial seborrhoeic dermatitis in remission. A total of 75 patients who had stabilized facial seborrhoeic dermatitis after 2 weeks' (open-label induction) treatment with 0.1% tacrolimus were randomized in a double-blind fashion to treatment with 0.1% tacrolimus once a week, twice a week, or vehicle twice a week, for 10 weeks (maintenance). Significant improvement in erythema, scaling and pruritus compared with baseline was maintained during the maintenance phase in both tacrolimus groups, but not in the vehicle group. The mean recurrence rate according to global assessment was significantly higher in the tacrolimus once-weekly group than in the twice-weekly group. In conclusion, twice-weekly treatment with 0.1% tacrolimus ointment had superior effects in keeping facial seborrhoeic dermatitis in remission.

Effectiveness of topical calcineurin inhibitors as monotherapy or in combination with hydroxychloroquine in cutaneous lupus erythematosus

Calcineurin inhibitors show potent anti-inflammatory effects and favorable safety profile when used in the treatment of cutaneous lupus erythematosus (CLE). The present study investigates the change in clinical parameters of erythema, desquamation and edema, when calcineurin inhibitors are used as monotherapy or in combination with hydroxychloroquine in CLE for a period of 60 days. 18 patients were treated with topical tacrolimus and 20 patients with topical pimecrolimus, as monotherapy or in combination with hydroxychloroquine. Clinical parameters of erythema, desquamation and edema were assessed on a scale from 0 to 3 for erythema and edema and 0 to 2 for desquamation. Statistically significant improvement in erythema, desquamation and edema was observed in patients on monotherapy with calcineurin inhibitor and combination treatment with hydroxychloroquine, regardless of disease type. Combination treatment resulted in improvement of edema in 100% of patients, while monotherapy did so in 75% of patients. Topical calcineurin inhibitors enhance the therapeutic effect of systemic agents in cutaneous lupus erythematosus, and result in improvement of the clinical parameters studied.

Diverticulitis or Cancer? That is the Question

Purpose: Introduction: Isolated diverticulitis is often known to mimic an inflammatory polyp or malignancy. Our patient is a 68 year old man who was found to have a suspicious appearing lesion arising in a diverticular pouch. This case represents the risk of endoscopic removal and appropriate conservative management with antibiotic treatment and laparoscopic removal of the lesion. Case Presentation: During a screening colonoscopy, our patient was found to have a 1.5 cm erythematous fungating lesion located in the sigmoid colon, within a diverticular pouch. The lesion was surrounded by multiple diverticuli. The site was marked with Spot ink for presumptive diagnosis of malignancy. Biopsies showed inflammatory changes and negative for malignancy. He denies abdominal pain, blood in the stool, and change in bowel habits, weight loss or fever. He denies any family history of colon cancer or polyps. Physical exam was unremarkable. His hemoglobin and MCV were within normal limits. The patient was empirically treated for diverticulitis with oral ciprofloxacin and metronidazole for 2 weeks. A colonoscopy was repeated in 2 months. The previously marked location was identified and there was significant improvement in erythema. However, the mucosa appeared multilobulated and suspicious for malignancy. This area was located in a diverticular pouch making endoscopic removal of the lesion high risk. Patient underwent laparoscopic resection of the affected colonic segment, which showed polypoid granulation tissue/inflammatory pseudopolyp arising in an inflamed diverticulum. Discussion: The prevalence of diverticulosis increases with age. By age 85, 65% of the population has diverticulosis. Most patients are asymptomatic (70%), however 15 to 25 percent develop diverticulitis, and 5 to 15 percent develop diverticular bleeding. Up to 30 percent of patients with uncomplicated diverticulitis require surgical intervention during the initial attack. Surgery has generally been advised after a first attack of complicated diverticulitis or after two or more episodes of uncomplicated diverticulitis. When compared to open sigmoid resection, laparoscopic colonic resection is associated with shorter recovery time. A laparascopic approach appears to be best suited for patients in whom the episode of acute diverticulitis has resolved and in patients with Hinchey classification stage I or II disease. Inflammation of a diverticulum can have a similar appearance to an inflammatory polyp or malignancy. Endoscopic removal of such lesions can lead to bowel perforation. Antibiotic treatment with or without laparoscopic removal should be recommended.

A Two-Year, Double-Blind, Randomized Placebo-Controlled Trial of Oral Green Tea Polyphenols on the Long-Term Clinical and Histologic Appearance of Photoaging Skin

Green tea polyphenols (GTPs) have significant antioxidant and antiinflammatory activities, and prior short-term studies suggest that these compounds may improve photoaging skin. To evaluate the long-term effects of oral GTPs on the clinical and histologic characteristics of photoaging skin. Double-blind, placebo-controlled trial of 56 women aged 25 to 75 randomized to 250 mg GTPs or placebo twice daily for 2 years. A blinded dermatologist scored the appearance of photodamaged facial skin at 0, 6, 12, and 24 months. A blinded dermatopathologist scored the histologic characteristics of sun-exposed arm skin at 0 and 24 months. Clinical assessment of facial skin revealed that the GTP group had significant improvement in overall solar damage at 6 months (p=.02) and significant improvement in erythema and telangiectasias at 12 months (p=.02). The placebo group did not have significant improvements in these parameters at 6 months or 12 months. There were no statistically significant differences in other photoaging parameters at 6, 12, or 24 months in the GTP or placebo groups. Histopathologic analysis of sunexposed arm skin showed no statistically significant difference in photoaging parameters in the GTP group or the placebo group at 24 months. Long-term supplementation with oral GTPs was not superior to placebo in improving clinical or histologic photoaging parameters after 24 months of use.

Pulsed dye laser treatment of rosacea improves erythema, symptomatology, and quality of life

Background Persistent erythema and dysesthetic symptoms are typical manifestations of rosacea. Objective We sought to assess improvement in erythema, symptoms, and quality of life after pulsed dye laser treatment. Methods Sixteen patients with erythematotelangiectatic rosacea participated. Spectrophotometric erythema measurements were taken from the right and left malar prominence; chin; and nasal alae, dorsum, and tip. A questionnaire rating the Dermatology Life Quality Index and symptoms of flushing, burning, itching, dryness, swelling, and skin sensitivity was completed. Treatment was undertaken with the pulsed dye laser at purpuragenic fluences. Measurements and treatment were repeated at 8-week intervals for a total of two treatments. Results A statistically significant improvement was observed in symptoms, quality-of-life score, and erythema in all areas with the exception of erythema of the left nasal ala. Conclusions Pulsed dye laser treatment at purpuragenic fluences is a safe and effective treatment for symptomatic rosacea, resulting in a significant improvement in erythema, symptoms, and quality of life.

Treatment of keloid sternotomy scars with 585 nm flashlamp-pumped pulsed-dye laser

Despite increasing knowledge of wound healing and collagen metabolism, hypertrophic scars and keloid scars are difficult to eradicate. Median sternotomy scars are often hypertrophic or keloidal. We treated them with a 585 nm flashlamp-pumped pulsed-dye laser, which selectively injures cutaneous microvessels without inducing scars. 16 adult patients with hypertrophic or keloidal median sternotomy scars after heart surgery received two treatments to one half of their previously untreated scars every 6-8 weeks and were reviewed at 6 months. Symptoms and clinical, histological, photographic, and surface texture assessments were obtained for treated and untreated areas of scar and evaluated independently by two observers blind to the treatment and by digital image analysis of skin surface casts. There was a significant improvement in erythema, scar height, skin surface texture, and pruritis in laser-treated scar areas; this improvement persisted for at least 6 months.