Skin Care In Patients Research Articles

Diabetes-related skin problems and proper cosmetic care as a simple and affordable way to correct them: A review

Diabetes mellitus (DM) is a non-communicable epidemic. The number of people with this pathology is growing every year. DM leads to a decrease in quality and life expectancy due to vascular complications. However, the manifestations of diabetes are varied, including possible skin manifestations, which often receive insufficient attention. This article analyzes and summarizes current knowledge about dermatological complications in patients with DM, with an emphasis on the pathogenetic mechanisms underlying these problems. This article focuses on xerosis, intertrigo and disorders of the skin's protective mechanisms during the development of diabetic foot. The article is aimed at developing practical recommendations for endocrinologists on skin care in patients with diabetes, in order to improve their quality of life and prevent complications. The need to expand patient education on skin care in Diabetes Schools is also discussed.

Acne during Covid-19-The effect of pandemic and quarantine on skin care of patients with acne

Acne during Covid-19-The effect of pandemic and quarantine on skin care of patients with acne

Skin care habits of patients with eczema at Kiambu Level 5 Hospital, Kiambu county, Kenya: A retrospective cross-sectional study

BackgroundThere is a dearth of data on eczema from the African continent despite the purported increasing burden. ObjectivesTo describe the prevalence of eczema at Kiambu Level 5 Hospital and patient skincare. MethodsA descriptive retrospective cross-sectional research design was used describing the period between 2016 and 2020. Data analysis was done using STATA Version 13. Geo spatial mapping of patient residence was also done. ResultsEczema was the most common skin condition diagnosed with a prevalence of 25.5%. Majority of the patients favoured the use of non-conventional products such as bar soap and milking jelly as routine skincare products. Geospatial mapping demonstrated a higher prevalence of eczema in the urban areas and also revealed access to a specialist as a contributor to health-seeking behaviour. LimitationsSubtypes of eczema were not described and this data only reflects one facility serving an entire county. ConclusionThe prevalence of eczema in KL5H mirrors the increasing global burden of eczema and that Kenya is not exempted from the affliction of eczema. Urban environments have a higher density of eczema in Kiambu. More research is needed to decipher the impact of the preferred non-conventional skin care products on eczema.

Impact of educational intervention on nurses’ knowledge of pressure ulcer risk assessment and prevention: A pilot study

Background: Professional nurses are saddled with a unique role in patient's skincare among hospitalized patients. Inadequate nurses’ knowledge of pressure ulcer risk assessment (PURA) and prevention as a major contributory factor to development of pressure ulcer among “at risk” patients has been identified by previous studies. Aim: To evaluate the impact of an educational intervention on nurses’ knowledge of pressure ulcer risk assessment and prevention at a tertiary hospital, Ibadan, Nigeria. Methods: A pilot study with sample size of 26 nurses selected through simple random sampling technique from selected nursing units of the facility. Data collection was done through a structured questionnaire. Hypotheses were tested with inferential statistics using t-test. Results were presented in descriptive statistics and charts. Level of significance was p-value <0.05. Results: Almost all participants’ knowledge mean score of PURA increased from 4.92 ±1.26 at pre-test to 14.00 ± 0.71 at post-test (p<0.001). Also, knowledge mean score of pressure ulcer prevention improved among intervention group (14.00 ± 0.707) post educational intervention as compared to their counterparts in control group (11.85±1.41). Educational intervention was statistically significant with participants’ knowledge of PURA and prevention (p<0.001). Conclusion: The results of this study confirmed that educational intervention was impactful positively on nurses’ knowledge regarding PURA and prevention strategies at UCH, Ibadan, Nigeria. Thus, a structured educational program on the subject matter is needed to promote quality nursing care delivery according to international best practices among Nigerian nurses.

Hospital practitioner views on the benefits of continence education and best ways to provide training.

The aim of the study was to explore practitioners' experiences and perspectives on continence training, in order to understand its relevance to practice and how take-up of, and engagement with, such training may be improved. 27 qualitative interviews were conducted with nursing, medical and allied health practitioners in three hospitals. We analysed data thematically, both manually and with the aid of NVivo software. The research adheres to the consolidated criteria for reporting qualitative research checklist. Practitioners asserted the likely benefits of evidence-based continence training, including more judicious use of products, reduction in associated infection, better patient skin care and more facilitative communication with patients. Practitioners also identified preferred methods of continence training, according to their role and workload. To ensure better take-up of, and engagement with, continence training, it must be authorized as essential and provided in ways that reflect professional preferences and pragmatic resource considerations.

Phytoecdysteroids from Serratula coronata L. for Psoriatic Skincare.

Phytoecdysones from Serratula coronata seem to be promising agents for skincare in patients with psoriasis. The aim of the study was to determine the effects of creams containing the extract of S. coronata on psoriatic lesions. Creams with different formulas were prepared: 0-Lekobaza®, 1-Lekobaza®, S. coronata, 2-Lekobaza®, Salicylic acid, 3-Lekobaza®, S. coronata, Salicylic acid. After examination of skin penetration and biosafety, the designated cream was applied twice daily for 6 weeks on 72 psoriatic plaques located on elbows or knees. The lesions were assessed at baseline and follow-up of 6 weeks. The lesions area was measured, and severity of scaling, erythema, and infiltration was assessed using a 5-point scale (from 0—none to 4—very severe). Skin hydration and structure, pH, transepidermal water loss, erythema, and melanin index were analyzed instrumentally. Creams 1, 2, and 3 significantly reduced the area of psoriatic plaques. Improvement in erythema and infiltration was observed for creams 1 and 3. Creams 1–3 reduced scaling. Our study confirmed a beneficial effect of creams containing S. coronata extract on psoriatic lesions.

Casein-derived peptides from the dairy product kashk exhibit wound healing properties and antibacterial activity against Staphylococcus aureus: Structural and functional characterization

Kashk is a fermented dairy product typical of the Middle East, traditionally produced with sour milk and/or dairy waste. The kashk water-soluble peptide fraction was characterized at the molecular level by liquid chromatography–mass spectrometry and its antibacterial and skin healing activity was evaluated. Antibacterial assays showed a significant antibacterial activity against clinical isolates of Staphylococcus aureus (S. aureus) from patients with atopic dermatitis, inhibiting bacterial growth by approximately 45% (500 μg/mL). Skin repair activity was evaluated on keratinocytes through scratch tests showing accelerated wound closure in vitro in the presence of TNF-α, by approximately 44% (500 μg/mL), compared to control cells. Furthermore, based on the MTT assay, the kashk peptide fraction did not show toxicity on keratinocytes. The results suggested that the peptide kashk extract may be useful in skin care for patients with atopic dermatitis.

Allergic contact dermatitis to phenoxyethanol: A rare, but possible cause of hand dermatitis.

Phenoxyethanol (PE; Syn. 2-Phenyoxethanol; CAS no. 122-99-6) is one of the most commonly used preservatives in cosmetics and is also found in industrial products, including metalworking fluids. It is considered to have a low sensitization potential.1-3 A 59-year-old male toolmaker presented with therapy-resistant, 1-year lasting hand dermatitis suspected to be of occupational origin. Despite being on work leave and treatment with alitretinoin for the past 5 months, severe dermatitis of hands and lower arms was observed (Figure 1). We performed patch tests and readings according to the guidelines of the German Contact Dermatitis Research Group (DKG)4 using the DKG baseline series; the DKG series for topical preparations, preservatives, rubber, disinfectants, acrylates, industrial biocides, and metalworking fluids; and the patient's own metalworking fluid. Patch tests were removed at day (D) 2 with the exception of the metalworking fluid, which was removed already at D1 and reactions were evaluated at D2, D3, D4, and D7. Solely, a 2+ reaction to PE 1% pet. (SmartPractice, Greven, Germany) from D2 to D7 was noted (Figure 2A). PE was not found in any of the available safety datasheets of the patient's workplace products, including the metalworking fluid. However, according to the product labels, it was an ingredient of the patient's skin care products “Eucerin UreaRepair PLUS 5% Hand Creme” and “Nivea 3IN1 Repair Hand Creme” (both from Beiersdorf AG, Hamburg, Germany), which he had regularly applied on his hands and lower arms after the onset of dermatitis. Repeated open application test (ROAT) with “Eucerin UreaRepair PLUS 5% Hand Creme,” two times daily for 6 days on the inner sides of the patient's upper arm resulted in a positive reaction (Figure 2B). Dermatitis of hands and lower arms improved significantly after avoidance of these skin care products, indicating clinical relevance of the sensitization to PE as the contributing factor to the initially occupational irritant contact dermatitis. Despite its widespread use as preservative in cosmetic and pharmaceutical products as well as for other applications, only very few cases of allergic contact dermatitis and contact urticaria to PE have been reported.2, 5-7 Accordingly, a retrospective study of the Information Network of Departments of Dermatology (IVDK) revealed a very low sensitization rate of 0.24% among 6932 individuals patch tested in Germany, Austria, and Switzerland between 1996 and 2009.1 Similarly, in 681 cutting metalworkers patch tested with the DKG metalworking fluids series in IVDK centres from 2010 to 2018, sensitization to PE was rarely observed (0.3%).8 Although rare, allergic contact dermatitis to PE should be considered and if undiscovered may lead to longstanding disease and inefficient treatments. The present case illustrates the importance of performing early patch tests to avoid delays in diagnosis and prevention measures. Diagnostic workup of patients with suspected occupational hand dermatitis should include patch testing and in doubtful cases also ROAT with patient's own skin care products. The authors declare no conflicts of interest. Michaela Kolodziej: Conceptualization (equal); investigation (equal); writing – original draft (equal); writing – review and editing (equal). Alexander Kiewert: Investigation (supporting); writing – review and editing (equal). Christoph Skudlik: Investigation (supporting); writing – review and editing (equal). Richard Brans: Conceptualization (equal); investigation (equal); supervision (lead); writing – original draft (equal); writing – review and editing (equal).

Clinical assessment of novel plant-based moisturizer “Elovera” in management of dry skin conditions

<p class="abstract"><strong>Background: </strong>Moisturizers are major component of basic daily skin care in patients with eczema/dermatitis. Botanical ingredients like aloe vera extract having anti-inflammatory property can be useful in reducing signs and symptoms along with improvement in dry skin in such patients.</p><p class="abstract"><strong>Methods: </strong>It was retrospective data analysis conducted across 145 centres in India. Patients with eczema/dermatitis who were prescribed Elovera a novel plant-based moisturizer were included in the study. Effectiveness was assessed by evaluating improvement in DASI score, physicians, and patients’ global assessment of disease. Safety was assessed by monitoring all the adverse events reported by the patients.</p><p class="abstract"><strong>Results:</strong> 402 patients were included in the study. There was significant improvement in mean baseline DASI score with with a reduction of 40.57% and 84.8% at week 2 and week 4, respectively. 86.31% (n=347) and 85.32% (n=343) patients reported significant improvement in their disease as per physician’s and patients’ global assessment of disease. Elovera was well tolerated and only 5 patients reported mild irritation and erythema during treatment.</p><p class="abstract"><strong>Conclusions: </strong>The result of our study proves that “Elovera” a novel plant-based moisturizer is associated with significant improvement in dry skin, signs, and symptoms of patients with eczema/dermatitis. Based on these results concomitant use of Elovera can be considered along with standard treatment for better outcome in patients with eczema/dermatitis. </p>

Experience of using an emollient with an anti-inflammatory effect based on ammonium glycyrrhizinate in the complex therapy of patients with atopic dermatitis

Background. Despite the advances achieved in recent years in the treatment of AD, prevention and rehabilitation of patients, who suffering from this disease, belong to the most difficult tasks of practical dermatovenerology.
 Objective. The aim of this study was to assess the efficacy, safety and tolerability of Reglisam Cream in the complex therapy of patients with atopic dermatitis.
 Methods. The study involved 48 patients with atopic dermatitis, who were divided into two groups. There were two observation periods for each patient: 28 days the period of exacerbation therapy, and 6 months basic care and prevention of relapses.
 In exacerbation period all patients used external moisturizers in addition to topical glucocorticosteroids: in group I (study group) patients applied Reglisam Cream to the skin; in group II (control group) cold cream. After the period of exacerbation patients of group I were prescribed basic therapy Reglisam Cream for 6 months, patients of group II cold cream. In each group were assessed the therapeutic efficacy, safety and tolerability of treatment. During the study were conducted registration of adverse events, assessment of the dermatological status with the determination of the intensity of pruritus according to the visual analogue 10-point scale, the calculation of the severity index of the disease and the area of the lesion in eczema / atopic dermatitis (EASI) and the dermatological index of quality of life (DLQI), measurement of skin moisture, general clinical research.
 Results. In the first 28 days of acute atopic dermatitis period therapy, the EASI index decreased on average by 76% from 20.4 to 4.8 points (p 0,05), in group II by 57% from 19.7 to 8.4 points (p 0,05); the intensity of pruritus after treatment with Reglisam Cream in the dynamics decreased by 70% and amounted to 2.3 points, which was lower than in the comparison group 4.1 points (p 0,05); the level of skin hydration in group I was 36.8 units, during the treatment period increased by 80%, and was higher than in group II 26.7 units. (p 0,05); DLQI in group I decreased by 68%, amounting to 4.7 points, and was almost 2 times less than in group II 9.2 points (p 0.05).
 In group I for 6 months were registered a statistically lower frequency of exacerbations of atopic dermatitis (28%) than in group II (63%). The average duration of atopic dermatitis remission in group I was 22.4 weeks, for 4 weeks more than in group II (p 0,05). Meanwhile the average duration for the exacerbation period of atopic dermatitis in group I was more than 3.5 times less in comparison with group II; the average EASI in group I did not exceed 6.4 points and was significantly lower than that in group II (p 0,05).
 Conclusion. The use Reglisam Cream as basic skin care in patients with AD increases the duration of remission and reduces the frequency and duration of relapses of the disease, leads to an improvement the quality of life, a decrease in the intensity of pruritus and a significant increase in the moisture content of the stratum corneum of the epidermis. The obtained clinical results allow us to recommend Reglisam Cream as an effective external agent in the complex therapy of patients with AD.

Nurses’ decision-making about cancer patients’ end-of-life skin care in Wales: an exploratory mixed-method vignette study protocol

IntroductionPatients with cancer are at high risk of developing pressure ulcers at the end of life as a result of their underlying condition or cancer treatment. There are many guidelines...

Adapting WOC Nursing Practice to the COVID-19 Pandemic: A View From Here.

The COVID-19 pandemic impacts all healthcare providers in all practice settings. As a healthcare provider, specializing in WOC nursing, the “daily routine” of how I provide care to patients, families, and other healthcare providers has been profoundly affected. I find myself focusing not only on pressure injury prevention strategies for my patients but also on skin care for colleagues providing care to our patients. Among the most apparent changes in my practice include the need to educate staff on skin care in patients who require prolonged placement in a prone position and teaching providers to use telehealth for routine WOC care consultations. Lastly, with a decrease in elective surgeries, I was tasked to develop a plan on how to refocus the medical department's various roles and responsibilities during this pandemic. I work in a level 1 Trauma, Academic Medical Center, in central New Jersey. I have been a nurse for 36 years and a WOC nurse for over 30 years. During my tenure, I have endured a strike, hurricanes (including Hurricane Sandy), outbreaks of severe acute respiratory syndrome (SARS), Ebola virus, and the terroristic acts of September 11, 2001. In my environment, we strive to handle such crises as a unified team. I write this View From Here to share my personal views and experience thus far during the COVID-19 pandemic. As a WOC nurse, I also want to share how I believe my education and experience have prepared me to perform the tasks, roles, and responsibilities I have assumed as the pandemic evolves. When I first heard about this novel form of coronavirus infection (COVID-19), I thought it similar to other viruses resulting in regional outbreaks. However, as the virus began to spread across the globe and in my region, my inner instincts about the threat it represented to my community, and my patients, began to change. My perception was also influenced through discussion with my husband, a public health epidemiologist. I began to see the influx of COVID-19 patients into our hospital and noticed how ill they were upon admission and how quickly their condition deteriorated. As an experienced nurse and a WOC nurse, I assumed I was reasonably prepared for every likely scenario, but this situation proved different as I suspect it has proved for you. Nevertheless, I was heartened to realize that my WOC nursing education and experience, along with the education tools, best practice documents, the Journal (JWOCN), and algorithms that the WOCN Society has developed over the years prepared me for even the unprecedented challenges posed by COVID-19. In addition, networking with my WOC nurse colleagues across the country and the WOCN Society COVID-19 forum has also helped me through this national pandemic. At this time, if someone was to ask me what is the most rewarding role that I have played, it would be the initiative that I implemented for preventing pressure injuries for our healthcare providers. While this represents an unforeseen shift from my typical WOC nurse practice, adding colleagues to my broad community of “patients” is especially rewarding.

Randomized double‐blind cross‐over trial of bath additive containing tannic acid in patients with atopic dermatitis

AbstractSkin care against aggravating factors is important to prevent skin lesions from flare‐up in the treatment of atopic dermatitis (AD). Tannic acid (TA), a natural polyphenolic and protein‐denaturing agent, has activity to denature antigens relevant to the AD flare. To assess the efficacy of a bath additive containing TA (TA‐bath additive) on pruritus of AD, we carried out a randomized double‐blind trial, in which 21 patients with AD completed the blinded sequential treatments with the TA‐bath additive and a bath additive without TA (placebo‐bath additive) in a cross‐over manner. A significant improvement of pruritus was observed in the afternoon and night by using the TA‐bath additive and in the afternoon by the placebo‐bath additive in patients with AD. No superiority of the TA‐bath additive to the placebo was revealed in the overall patient cohort. However, the added TA in the bath additive exerted its efficacy especially on itch at night in patients with mild‐to‐moderate disease. Bathing by using the series of the bath additive with TA and that without TA improved AD skin lesions throughout this study. No adverse effects related to the use of the TA‐ and placebo‐bath additives were observed. In conclusion, the bath additive containing TA may help skin care of patients with itch and skin lesions of the mild AD.

Decreasing Incontinence-Associated Dermatitis in the Surgical Intensive Care Unit: A Quality Improvement Project.

The purpose of this quality improvement (QI) project was to determine if use of an algorithm focusing on skin care in patients with fecal and urinary incontinence reduces the rate of hospital-acquired incontinence-associated dermatitis (IAD) over a period of 4 months. The QI setting was an 18-bed surgical intensive care unit (SICU) in an acute care urban hospital located in the southeastern United States. Two hundred eleven patients participated in this pre/postintervention QI project. The algorithm for skin care used evidence-based bundled interventions for patients with fecal and urinary incontinence. The project comprised education of the SICU nursing staff in January 2018 and implementation of the algorithm from February 5, 2018, to June 5, 2018. Weekly chart reviews were conducted to determine algorithm compliance, documentation of fecal and urinary incontinence, and accuracy of IAD documentation. Descriptive statistics were used to determine the rate of hospital-acquired IAD, algorithm compliance, and average length of time from admission to the onset of hospital-acquired IAD. Seventy-nine individuals with incontinence were included in the 3-month preintervention period and 132 individuals with incontinence in the 3-month postintervention period. We observed a 24% reduction in the rate of hospital-acquired IAD following implementation of the algorithm (29% vs 5%). The average length of time from admission to the onset of hospital-acquired IAD increased from 15 days in February 2018 to 25 days in May 2018. Our experience with this QI project suggest that IAD can be identified and managed at the bedside by first clinical nursing staff without expertise in skin assessment and wound care.

The Effect of Lipopolysaccharide-containing Moisturizing Cream on Skin Care in Patients With Mild Atopic Dermatitis.

Recently, the prevalence of atopic dermatitis (AD) has increased in developed countries. This study aimed to examine the usefulness of a moisturizing cream containing lipopolysaccharide derived from Pantoea agglomerans (LPSp) in patients with mild AD. A moisturizing cream containing LPSp or its placebo was randomly assigned and continuously used for 4 weeks in patients with mild AD. AD severity was evaluated in a double-blind manner by a dermatologist using the Eczema Area and Severity Index (EASI) score and by the patients' self-evaluation of itching and skin condition using a visual analog scale (VAS). Although there was no difference in the EASI score between the two groups, the VAS scores showed significantly greater symptom alleviation in the LPSp group than in the placebo group. A moisturizing cream containing LPSp may be effective for routine skin care and could help alleviate symptoms of mild AD.

Diagnosis and Management of Atopic Dermatitis: A Review.

The purpose of this learning activity is to provide information about the diagnosis and management of atopic dermatitis (AD). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After completing this continuing education activity, you should be able to:1. Recall the diagnostic process of AD.2. Identify nonpharmacologic therapies for skin care in patients with AD.3. Explain the pharmacologic management of AD. Atopic dermatitis is a chronic, relapsing, intensely pruritic inflammatory skin disease that affects both children and adults. This article provides an overview of the epidemiology, clinical features, pathophysiology, complications, and specific investigations of atopic dermatitis. The current and novel therapies for the treatment of atopic dermatitis will be discussed.

Особливості догляду за шкірою хворих на розацеа у різні періоди перебігу захворювання

Особливості догляду за шкірою хворих на розацеа у різні періоди перебігу захворювання

Radiotherapy related skin toxicity (RAREST-01): Mepitel\xae film versus standard care in patients with locally advanced head-and-neck cancer

BackgroundThe aim of the present trial is to investigate a new option of skin protection in order to reduce the rate of grade ≥ 2 skin toxicity in patients receiving radiotherapy alone or radiochemotherapy for locally advanced squamous cell carcinoma of the head-and-neck (SCCHN).Methods / DesignThis is a randomized, active-controlled, parallel-group multi-center trial that compares the following treatments of radiation dermatitis in patients with head-and-neck cancer: Mepitel® Film (Arm A) vs. standard care (Arm B). The primary aim of this trial is to investigate the rate of patients experiencing grade ≥ 2 radiation dermatitis (according to Common Toxicity Criteria for Adverse Events (CTCAE) Version 4.03) until 50 Gy of radiotherapy. Evaluation until 50 Gy of radiotherapy has been selected as the primary endpoint, since up to 50 Gy, the irradiated volume includes the primary tumor and the bilateral cervical and supraclavicular lymph nodes, and, therefore, is similar in all patients. After 50 Gy, irradiated volumes are very individual, depending on location and size of the primary tumor, involvement of lymph nodes, and the treatment approach (definitive vs. adjuvant). In addition, the following endpoints will be evaluated: Time to grade 2 radiation dermatitis until 50 Gy of radiotherapy, rate of patients experiencing grade ≥ 2 radiation dermatitis during radio(chemo)therapy, rate of patients experiencing grade ≥ 3 skin toxicity during radio(chemo)therapy, adverse events, quality of life, and dermatitis-related pain. Administration of Mepitel® Film will be considered to be clinically relevant, if the rate of grade ≥ 2 radiation dermatitis can be reduced from 85% to 65%.DiscussionIf administration of Mepitel® Film instead of standard care will be able to significantly reduce the rate of grade ≥ 2 radiation dermatitis, it could become the new standard of skin care in patients irradiated for SCCHN.Trial registrationclinicaltrials.gov NCT03047174. Registered on 26th of January, 2017. First patient included on 9th of May, 2017.

Use of 4MAT Learning Theory to Promote Better Skin Care During Radiation Therapy: An Evidence-Based Quality Improvement Project.

Radiation therapy is a key treatment modality for cancer patients, but it is associated with adverse side effects such as radiation dermatitis. To mitigate the adverse effects of radiation on the skin, patients must participate in skin-related self-care. However, even with self-care instruction, adherence can be poor. This quality improvement project used best available evidence for skin care in patients undergoing radiation therapy and a theoretical framework, 4MATing, to provide a structured approach to patient education designed to enhance adherence to skin care recommendations. Implementation of this approach resulted in increased adherence to a topical skin care protocol in our facility. Patients were highly satisfied with their education. While there was a 4-day delay in the onset of radiation dermatitis, this difference was not statistically significant.

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