Eczema Symptoms Research Articles

Prevalence of atopic eczema in adolescents from a very low prevalence area (Kosovo): role of wheezing, gender, exercise, and paracetamol.

The epidemiology of atopic eczema in adolescents in Kosovo is virtually unknown, and the risk factors for the condition in very low-prevalence areas (as it was the case) are not well studied. The objective of the present study was to better know those factors and whether the presence of comorbid wheezing symptoms modifies the factors. The cross-sectional survey, Global Asthma Network-validated questionnaire, which includes questions on eczema symptoms and environmental factors (such as smoking, pet ownership, paracetamol usage, truck traffic, siblings, time spent using screens or watching television, and physical exercise), was administered to adolescents in the following main cities of Kosovo: Ferizaj, Gjakova, Gjilan, Peja, Prishtina, and Prizren. Additionally, height and weight were measured at school. Prevalence of eczema symptoms ranged from 2.2% in Ferizaj to 5.5% in Gjakova. Severe symptoms were <1% in all cities. Eczema ever ranged from 3.0% in Ferizaj to 6.4% in Prizren. Factors significantly associated with the prevalence of current eczema symptoms in the meta-analysis were males (pooled adjusted odds ratio [aOR] 0.50, 95% Confidence Interval [95% CI] 0.37-0.66); physical exercise (pooled aOR 2.79, 95% CI 1.89-4.10); and paracetamol intake (pooled 1.86, 95% CI 1.32-2.64). The corresponding figures for eczema ever were as follows: pooled aOR: 0.68, 95% CI 0.44-1.06; pooled aOR 2.07, 95% CI 1.48-2.90; and pooled aOR 1.19, 95% CI 0.88-1.60. The associations tended to be higher in the subpopulation with eczema and wheezing comorbidity. The prevalence of atopic eczema is very low in Kosovo and is associated with females, physical exercise, and paracetamol intake. These associations are higher when eczema and wheezing are comorbid conditions.

Mulberry's healing Touch: Exploring ethnobotanical roots and medicinal potentials in the treatment of atopic dermatitis

Ethnopharmacological relevanceMorus alba L., mulberry, has played a significant role in providing food, medicine, and materials throughout human history. From its historical importance to its diverse cultural uses, mulberry remains a versatile and valuable resource, enriching various aspects of human life across civilizations. Mulberry exhibits ethnopharmacological applications for treating various ailments including atopic dermatitis, also known as eczema.Aim of the study: The objective of the study was extracting the putative active substances from white mulberry, evaluating potential of the extract in treating and reducing reliance on chemical medications by providing a chemical composition of the extract along with effect of extracts on eczema symptoms. Materials and methodsFor testing the impact of mulberry extract on relieving eczema symptoms, white mulberry fruit extracts were prepared by butanol extraction. Water-in-oil (W/O) emulsification was used to prepare ointment. Analysis of the mulberry extract was conducted using GC-MS after additional processing of extracts. Clinical trials on 110 individuals, divided into patient-treatment, normal-treatment, and patient-placebo groups, involved applying the ointment containing 0.5% mulberry fruit extract for 4–6 weeks, with blood sample analysis before and after the trial. Blood samples were analyzed for various parameters including Granzyme B, Vit. E, TC, TG, HDL, and LDL levels. The antibacterial activity of the extract against Staphylococcus aureus was determined using involve growth curve analysis and inhibition of colony formation on LB plates. Morus alba L. name was checked from “World Flora Online” (www.worldfloraonline.org) and MPNS (mpns.kew.org) ResultsWe monitored a noticeable enhancement in the skin ulceration after the treatment. In addition, Granzyme B, Vitamin E, TC, TG, HDL, and LDL levels were improved in the patient-treatment group closer to healthy levels, indicating potential therapeutic benefits of Morus alba extract. The extract's efficacy was also tested on S. aureus, a bacterium commonly associated with eczema. Results showed that extract obtained from white mulberry fruits has an inhibitory impact on S. aureus growth. ConclusionsThe findings suggest that Morus alba extract holds promise as a therapeutic intervention for atopic dermatitis, demonstrating significant improvements in key biomarkers towards levels observed in healthy individuals.

Diagnosis of bacteria isolated from patients with cutaneous eczema by PCR technique at Azadi Hospital, Kirkuk, Iraq

Eczema is a common skin condition that can be worsened or caused by a bacterial infection. This study aimed to investigate the bacterial pathogens associated with skin eczema in patients admitted to Azadi Hospital in Kirkuk using polymerase chain reaction (PCR) technology. The goal was to enhance the accuracy and efficiency of bacteria identification compared to traditional methods. A total of [300] patients suffering from symptoms of skin eczema between the ages of 1-40 years, females and males, were included. Bacterial isolates were obtained from skin samples, and conventional microbiological techniques were initially used for identification. Subsequently, molecular analysis using PCR was performed to confirm and characterize the bacterial species. The study included 165 male patients represented (55%), 135 female (45%), of participants who had symptoms of skin eczema. The PCR test targeted specific genes associated with common bacteria implicated in skin infections, such as Staphylococcus. aureus (33 %), Staphylococcus epidermidis (28%), Klebsiella pneumoniae (20 %) , pseudomonas aeruginosa (13 %), respectively, and the remaining( 6 %). of the samples were natural flora. The genetic fingerprints of these bacterial species were identified, an image of them was taken on an agarose gel electrophoreses , and the results were compared with those obtained through traditional methods to evaluate the sensitivity and specificity of PCR in diagnosing bacterial infections in cases of skin eczema. Preliminary results indicated that PCR significantly improved the accuracy and speed of bacterial identification compared to traditional methods. It has allowed the detection of specific bacterial species that might be missed using conventional methods. The prevalence and diversity of bacterial species causing skin eczema in Azadi Hospital in Kirkuk were also explored. This study contributes valuable insights into the microbial etiology of cutaneous eczema, emphasizing the importance of molecular techniques in accurate and rapid diagnosis. The findings may guide more targeted and effective treatment strategies for patients with bacteria-associated skin eczema, ultimately improving patient outcomes and reducing the risk of complications.

Survey on Eczema; Its Perceptions and Characterization

Eczema (atopic dermatitis) is a common inflammatory skin disease. It causes physical discomfort and also cause stress due to constant itching, which in the end leads to painful wounds. It can be triggered by environmental, genetic, stress, and anxiety factors. The symptoms of eczema are similar to other skin disorders. In some cases, incorrect diagnosis results in the administration of medication for other skin disorders. Objectives: To understand the patients’ knowledge about the disease and to create a sense of awareness for them. Methods: We prepared a questionnaire to get sense of people's understanding about eczema and surveyed students at Punjab University as well as we collected data with help of online google forms. There were 103 responses from people of both genders, age ranges from 20 to 35 years, and different educational backgrounds. Results: Most of the people think they understand what eczema is, but they have confused it with other skin conditions. According to the responses, sudden change in surroundings is the most triggering factor in causing eczema. Only 1% of people think it could be a contact disorder and can be triggered by pets and refined carbs. The most challenging weather for eczema is winter and the time is night. Conclusions: it was concluded that eczema is a really disturbing disease. This disorder is incurable yet. However, with proper care, timely treatment, and by taking preventive measures, can prevent to flare-up.

Capturing and reporting topical treatment use in childhood eczema: lessons for data collection in eczema trials.

Emollients and topical corticosteroids (TCS) prevent and treat flares in eczema. However, topical treatment use is poorly recorded and reported in clinical trials. There is no clear consensus of how best to capture and summarise topical treatment use. To explore different ways of capturing and reporting topical treatment use in childhood eczema. Secondary data analysis using 450 participants from the Best Emollients for Eczema (BEE) trial. Participants were allocated to use one type of emollient (lotion, cream, gel, or ointment) 'twice daily and when required' for 16 weeks. Otherwise, clinical management remained unchanged. Parents completed weekly questions about topical therapy use and eczema symptoms. Two versions of topical treatment use questionnaires were used. The first (n=202, 44.9%) asked parents to report treatment use on days 1-7, starting completion on the day they were randomised. The second (n=248, 55.1%) reported use by day of the week (Monday to Sunday), starting completion the first Monday after randomisation. Both underwent Patient and Public Involvement (PPI) review, but the second version was tested more thoroughly using cognitive interviewing techniques, following parent feedback that questions on the first version were confusing. Descriptive statistics compared questionnaire completion and differences in emollient and TCS use. Overall, questionnaire completion for both emollient and TCS use decreased with time: but at weeks 1 and 16 were 84.7% (381/450) and 58.9% (265/450) for emollient use, and 94.2% (424/450) and 80.4% (362/450) for TCS use, respectively. Fewer emollient use questionnaires were completed with first (33.5%) than the second (87.9%) version (p<0.001). TCS use questionnaire completion were similar for both (84.9% and 87.4%, p=0.002). We present different ways of summarising topical treatment use. While questionnaire completion was similar for TCS use, emollient use data completeness was higher in the second version. When designing questionnaires, balancing the detail and complexity of questions is important, especially if being collected as a secondary outcome measure. Numerous ways of summarising the same data can provide different information. Future collection and reporting of treatment use should reflect specific trial aims.

Correction of the cytokine status of patients with true eczema using supravenous laser blood irradiation and imunofan

Objective. To increase the effectiveness of treatment of patients with true eczema by including supravenous laser blood irradiation (NLBI) and imunofan into complex therapy. Material and methods: The study included 132 patients aged 18 to 70 years. The effectiveness of standard drug therapy, additional administration of immunofan, NLBI and complex therapy in improving the clinical symptoms of eczema and correcting circulating and intracellular pro- and anti-inflammatory cytokines was compared. Results: It was found that standard drug therapy poorly corrects clinical and laboratory parameters. A comprehensive treatment program for patients with true eczema, which additionally includes NLBI and Imunofan, helps reduce the percentage of CD3+, CD4+, CD8+ lymphocytes with the induction of pro-inflammatory interleukins (IL) — 2 and IFN-γ, respectively, by 37.9 % — 36.4 % —44.9 % and 42.1 % — 45.6 % — 47.8 %, an increase in the percentage of CD3+, CD4+, CD8+ lymphocytes with the induction of anti-inflammatory IL-4, respectively, by 65.8 % — 68.2 % — 58 %, reduces the levels of circulating pro-inflammatory blood cytokines IL-8, — 18, — 31 respectively by 55.5 % — 54.6 % — 55.4 % against the background of an increase in the level of antiinflammatory IL-4 in the blood — by 61.6 %, which exceeds the therapeutic effects each of the methods included in the treatment complex. The clinical effectiveness of combination therapy is characterized by a decrease in EASI by 76.5 %, which exceeds the results obtained when using individual methods that make up the treatment complex.Key words: true eczema, interleukins, CD+-lymphocytes, laser irradiation of blood, immunofan.

Association of psoriasis with allergic multimorbidity of asthma, rhinitis, and eczema among adolescents: a cross-sectional study

BackgroundAssociations between psoriasis and allergic diseases (asthma, rhinitis, and eczema) in children have been reported in a limited number of studies, and the association between psoriasis and multimorbidity (co-occurrence) of allergic diseases remains unclear. Hence, this study aimed to assess the association between psoriasis and the co-occurrence of asthma, rhinitis, and eczema in adolescents.MethodsThis school-based cross-sectional study enrolled adolescents (n = 3,864) aged 11–14 years. Parents completed a questionnaire on doctor-diagnosed psoriasis as well as symptoms and clinical history of asthma, rhinitis, and eczema. Eight nonoverlapping groups comprising single and co-occurring current (past 12 months) asthma, rhinitis, and eczema were identified. A multinomial logistic regression model was used to estimate the adjusted odds ratios (aOR) and 95% confidence intervals (CI).ResultsIn the analytical sample (n = 3,710; 1,641 male and 2,069 female participants), 3.5% reported doctor-diagnosed psoriasis, and 15.7%, 15.0%, and 10.3% had current asthma, rhinitis, and eczema symptoms, respectively. Doctor-diagnosed psoriasis was associated with “asthma only” (aOR = 2.11, 95% CI: 1.15–3.89), “eczema only” (6.65, 4.11–10.74), “asthma + eczema” (5.25, 2.36–11.65), “rhinitis + eczema” (3.60, 1.07–12.15), and “asthma + rhinitis + eczema” (7.38, 2.93–18.58). Doctor-diagnosed psoriasis was not statistically significantly associated with “rhinitis only” (1.42, 0.71-–2.84) and “asthma + rhinitis” (1.78, 0.69–4.56).ConclusionOur findings indicate that psoriasis is associated with the co-occurrence of allergic diseases among adolescents. However, further studies are required to investigate which biological mechanisms may be shared between psoriasis and allergic diseases.

A Vitiation of Pitta Dosha in Sharad Ritu and its Management by Nitya Virechana Dravya

Pama Kushta is explained in Ayurveda which is outcome of Pitta Dosha Dushti it has similarities with eczema. Eczema is a chronic inflammatory skin condition characterized by redness, itching, and rash, affects a significant portion of the population worldwide. This case report presents the initial successful management of eczema in a patient using Ayurvedic interventions. A 30-year-old female patient presented with persistent eczema symptoms on her arms and legs. The patient underwent a thorough evaluation based on Ayurvedic principles, which identified imbalances in Doshas (bioenergies) according especially in autumn season and suggested a treatment plan accordingly. The interventions included internal medications to alleviate imbalances Pitta Dosha, external application of Marichyadi Oil to soothe the affected areas. After adhering to the treatment plan for two weeks, the patient experienced a significant reduction in eczema symptoms, including reduced redness, itching, and improvement in skin texture. This case report highlights the potential efficacy of Ayurvedic interventions with Siddhanta. The holistic approach of Ayurveda, addressing root cause, resulted in improved symptom control and enhanced quality of life for the patient. While further research is warranted to validate these findings, the present report suggests that Ayurveda could be a valuable complementary approach for individuals struggling with eczema. Health professionals and patients alike may consider exploring Ayurvedic interventions as an adjunct or alternative to conventional eczema management strategies.

Matrine-loaded self-adhesive swelling microneedle for inflammation regulation to improve eczema treatment

Eczema is a common chronic dermatological disease. Conventional treatments exhibit limited efficacy due to fast drug release resulting in short-term relief. Development of a new treatment strategy that enables sustained drug release and long-term maintenance on the skin surface is necessary. A self-adhesive swelling microneedle patch (SDSMNs) was designed and constructed using a two-step casting method. The adhesive substrate was prepared by blending gelatin and dopamine via oxidation of NaIO4, so it could adhere onto the skin surface as well as withstand repeated bending movement without detachment. The swelling needles were fabricated using polyvinyl alcohol (PVA) and polyvinylpyrrolidone (PVP), which could swell by absorbing interstitial fluid and release the drug in a controlled manner. SDSMNs also showed desirable antibacterial activities toward E. coli and S. aureus. The adhesive microneedles loaded with matrine (MAT-SDSMNs), an anti-inflammatory Chinese medicine, dramatically relieved eczema symptoms through IL-17 mediated inflammation responses. The use of MAT-SDSMNs significantly decreased the infiltration of inflammation cells and level of inflammatory cytokines, reduced the skin thickness, and increased collagen deposition fraction compared with conventional ointment or subcutaneous injection. The results suggested that MAT-SDSMNs can improve eczema treatment by regulating the local inflammatory microenvironment, providing a simple, self-administered sustainable strategy for eczema treatment.

Anti-apoptotic, anti-inflammatory, and anti-melanogenic effects of the ethanol extract of Picrasma quassioides (D. Don) Benn

Ethnopharmacological relevancePicrasma quassioides (D. Don) Benn is a vascular plant belonging to the genus Picrasma of Simaroubaceae family and grows in Korea, China, India, Taiwan, and Japan. Picrasma quassioides extract has been reported to have anti-inflammatory, anti-bacterial, and anti-cancer properties. Moreover, this plant has been also traditionally used to alleviate symptoms of eczema, atopic dermatitis, psoriasis, scabies, and boils in skin. Aim of the studyThe Pq-EE has been reported in Chinese pharmacopoeia for its pharmacological effects on skin. However, the detailed mechanism on alleviating skin conditions is not understood. Hence, we investigated the skin improvement potential of Pq-EE against skin damage. Materials and methodsWe used the human keratinocyte cell line (HaCaT) and mouse melanoma cell line (B16F10) to study the effects of Pq-EE on the epidermis. Additionally, in vitro antioxidant assays were performed using a solution that included either metal ions or free radicals. ResultsIn colorimetric antioxidant assays, Pq-EE inhibited free radicals in a dose-dependent manner. The Pq-EE did not affect cell viability and promoted cell survival under UVB exposure conditions in the MTT assay. The Pq-EE downregulated the mRNA levels of apoptotic factors. Moreover, MMP1 and inflammatory cytokine iNOS mRNA levels decreased with Pq-EE treatment. With regard to protein levels, caspases and cleaved caspases were more powerfully inhibited by Pq-EE than UVB-irritated conditions. p53 and Bax also decreased with Pq-EE treatment. The melanin contents and secretion were decreased at nontoxic concentrations of Pq-EE. The pigmentation pathway genes also were inhibited by treatment with Pq-EE. ConclusionsIn summary, we suggest the cell protective potential of Pq-EE against UVB and ROS, indicating its use in UV-protective cosmeceutical materials.

Analysis of the Application Effect of Extended Care Combined with Family Health Education in The Treatment of Pediatric Eczema

Objective: To analyze the application effect of continuity of care combined with family health education in the treatment of pediatric eczema. Methods: Sixty cases of pediatric eczema children who were admitted from January 2021 to December 2023 were selected and divided into two groups of 30 cases each. The control group received routine care and the observation group received continuation of care combined with family health education. Family knowledge, eczema basic receding time, family satisfaction, and recurrence rate between the two groups were compared. Results: The aftercare family knowledge mastery score and family satisfaction of the observation group were higher than the control group, where eczema basic receding time and recurrence rate in six months were lower in the observation group as compared to the control group (P &lt; 0.05). Conclusion: In the treatment of pediatric eczema, continuity of care combined with family health education improved the family’s awareness of the disease, controlled eczema symptoms, and reduced the recurrence rate.

Brief parenting intervention (Triple P) for families of children with eczema: a randomized controlled trial.

To evaluate the efficacy and costs of a brief, group-delivered parenting intervention for families of children with eczema. A randomized controlled trial design was used. Families attending the Queensland Children's Hospital and from the community (n = 257) were assessed for eligibility (child 2-10 years, diagnosed with eczema, prescribed topical corticosteroids). Families who consented to participate (N = 59) were assessed at baseline for clinician-rated eczema severity, parent-reported eczema symptom severity, and electronically-monitored topical corticosteroid adherence (primary outcomes); and parenting behavior, parents' self-efficacy and task performance when managing eczema, eczema-related child behavior problems, and child and parent quality of life (secondary outcomes). Families were randomized (1:1, unblinded) to intervention (n = 31) or care-as-usual (n = 28). The intervention comprised two, 2-hr Healthy Living Triple P group sessions (face-to-face/online) and 28 intervention families attended one/both sessions. All families were offered standardized eczema education. Families were reassessed at 4-weeks post-intervention and 6-month follow-up, with clinician-raters blinded to condition. Costs of intervention delivery were estimated. Multilevel modeling across assessment timepoints showed significant intervention effects for ineffective parenting (d = .60), self-efficacy (d = .74), task performance (d = .81), and confidence with managing eczema-related child behavior (d = .63), but not disease/symptom severity, treatment adherence or quality of life. Mean cost per participating family with parenting behavior (clinically) improved was $159. Healthy Living Triple P is effective in reducing ineffective parenting practices and improving parents' self-efficacy and task performance when managing children's eczema and eczema-related behavior difficulties. There was no effect on disease/symptom severity, treatment adherence, or quality of life. ACTRN12618001332213.

Prenatal risk factors of indoor environment and incidence of childhood eczema in the Japan Environment and Children's Study

The quality of indoor environment is a risk factor for early childhood eczema and atopic dermatitis; however, its influence during pregnancy on childhood eczema in Japan has not been investigated. In this study, we aimed to determine the indoor environmental factors that are associated with eczema in children up to 3 years of age, using national birth cohort data from the Japan Environment and Children's Study (JECS).Information on indoor environments and eczema symptoms until 3 years of age was collected using self-administered questionnaires to the mothers. A total of 71,883 and 58,639 mother-child pairs at 1.5- and 3-years-old, respectively, were included in the former analyses. To account for prenatal indoor risk factors, 17,568 (1.5-years-old) and 7063 (3-years-old) children without indoor mold and/or ETS exposure were included in the final analysis. A higher mold index, gas heater use, parquet flooring use, and frequent insecticide use showed significantly increased risks for childhood eczema up to 3 years of age. These associations were consistent after stratification analysis among children whose parents did not have a history of allergies. The updated WHO guidelines on indoor air quality should be implemented based on recent findings regarding the effects of prenatal exposure to indoor dampness on health effects of children further in life, including asthma, respiratory effects, eczema, and other immunological effects.

Evaluation of Antioxidant Activity and Treatment of Eczema by Berberine Hydrochloride-Loaded Liposomes-in-Gel.

In this paper, berberine hydrochloride-loaded liposomes-in-gel were designed and developed to investigate their antioxidant properties and therapeutic effects on the eczema model of the mouse. Berberine hydrochloride-liposomes (BBH-L) as the nanoparticles were prepared by the thin-film hydration method and then dispersed BBH-L evenly in the gel matrix to prepare the berberine hydrochloride liposomes-gel (BBH-L-Gel) by the natural swelling method. Their antioxidant capacity was investigated by the free radical scavenging ability on 2,2-diphenyl-1-picrylhydrazyl (DPPH) and H2O2 and the inhibition of lipid peroxides malondialdehyde (MDA). An eczema model was established, and the efficacy of the eczema treatment was preliminarily evaluated using ear swelling, the spleen index, and pathological sections as indicators. The results indicate that the entrapment efficiency of BBH-L prepared by the thin-film hydration method was 78.56% ± 0.7%, with a particle size of 155.4 ± 9.3 nm. For BBH-L-Gel, the viscosity and pH were 18.16 ± 6.34 m Pas and 7.32 ± 0.08, respectively. The cumulative release in the unit area of the in vitro transdermal study was 85.01 ± 4.53 μg/cm2. BBH-L-Gel had a good scavenging capacity on DPPH and H2O2, and it could effectively inhibit the production of hepatic lipid peroxides MDA in the concentration range of 0.4-2.0 mg/mL. The topical application of BBH-L-Gel could effectively alleviate eczema symptoms and reduce oxidative stress injury in mice. This study demonstrates that BBH-L-Gel has good skin permeability, excellent sustained release, and antioxidant capabilities. They can effectively alleviate the itching, inflammation, and allergic symptoms caused by eczema, providing a new strategy for clinical applications in eczema treatment.

Effects of abrocitinib on pruritus and eczema symptoms and tolerance in patients with moderate‑to‑severe atopic dermatitis in randomized, double‑blind and placebo‑controlled trials: A systematic review and a meta‑analysis.

Abrocitinib is a highly selective Janus kinase 1 (JAK1) inhibitor that can block a multitude of inflammatory signaling pathways that underlie atopic dermatitis (AD). In addition, abrocitinib inhibits JAK1 signaling in sensory neurons to alleviate acute and chronic pruritus during AD. However, substantial variations in efficacy and safety risks remain due to variations in doses applied in clinical use. Therefore for the present study, differences in the efficacy and tolerability of 100 and 200 mg abrocitinib for treating pruritus and eczema symptoms in patients with moderate-to-severe AD were evaluated compared with placebo. Specifically, randomized controlled trials (RCTs) of abrocitinib compared with placebo for the treatment of moderate-to-severe AD were searched on Pubmed, E.B. Stephens Company, China National Knowledge Infrastructure, Wanfang Medical network, Web of Science and related Clinical Trials Registry up to November 2023. In total, two researchers evaluated the quality of the included literature according to the Cochrane Handbook of Systematic Reviews. RevMan 5.3 software was used to conduct a meta-analysis of the efficacy and safety indicators in a cross-comparison of the effects exerted by placebo and 100 and 200 mg abrocitinib. A total of 1,825 patients with moderate-to-severe AD were included across five double-blind, placebo RCTs. Compared with the placebo group, during the double-blind trial period, significant improvements were observed in the investigator's global assessment score, response rate of eczema area and severity index (EASI)-50, EASI-75, EASI-90 and pruritus numerical rating scale (P-NRS) in the 100 and 200 mg abrocitinib groups (P<0.05). However, pairwise control analysis of the 100 and 200 mg group yielded significant differences (P<0.05) in all of the aforementioned therapeutic indicators except for the P-NRS score. In terms of safety, compared with the placebo group, there were significantly higher incidence of nausea, upper respiratory tract viral infection, infections and infestations in the 100 mg abrocitinib group (P<0.05). In addition, there were significantly higher incidence of nausea, gastrointestinal disorder, headache and dizziness in the 200 mg group (P<0.05). There were also significant differences in the incidence of nausea, gastrointestinal disorder and dizziness between the 100 and 200 mg groups (P<0.05). For patients with moderate-to-severe AD, oral administration of 100 or 200 mg abrocitinib once/day was concluded to ameliorate skin pruritus and eczema symptoms to varying degrees, with the efficacy significantly superior at the 200 mg dose. However, the risk of a number of adverse reactions, such as headache, dizziness, nausea and gastrointestinal dysfunction, is also significantly increased. Therefore, patients should be made aware of the risk of adverse drug effects prior to the administration of long-term high abrocitinib doses. Furthermore, large-scale, multi-center, rigorous clinical trials remain necessary to validate the findings from the present study.

Association between Outdoor and Indoor Air Pollution Sources and Atopic Eczema among Preschool Children in South Africa.

The objective of the study was to investigate the association between outdoor and indoor air pollution sources and atopic eczema among preschool children in South Africa. A cross-sectional design, following the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III protocol, was applied. The study was conducted in Mabopane and Soshanguve Townships in the City of Tshwane Metropolitan Municipality in Gauteng, South Africa. A total population of 1844 preschool children aged 7 years and below participated in the study; 1840 were included in the final data analysis. Data were analyzed using multilevel logistic regression analysis. The prevalence of eczema ever (EE) and current eczema symptoms (ESs) was 11.9% and 13.3%, respectively. The use of open fires (paraffin, wood, or coal) for cooking and heating increased the likelihood of EE (OR = 1.63; 95% CI: 0.76-3.52) and current ESs (OR = 1.94; 95% CI: 1.00-3.74). Environmental tobacco smoke (ETS) exposure at home increased the likelihood of EE (OR = 1.66; 95% CI: 1.08-2.55) and current ESs (OR = 1.61; 95% CI: 1.07-2.43). Mothers or female guardians smoking cigarettes increased the likelihood of EE (OR = 1.50; 95% CI: 0.86-2.62) and current ESs (OR = 1.23; 95% CI: 0.71-2.13). The use of combined building materials in homes increased the likelihood of EE, and corrugated iron significantly increased the likelihood of current ESs. The frequency of trucks passing near the preschool children's residences on weekdays was found to be associated with EE and current ESs, with a significant association observed when trucks passed the children's residences almost all day on weekdays. Atopic eczema was positively associated with exposure to outdoor and indoor air pollution sources.

Development and Psychometric Validation of a Patient-Reported Outcome Measure to Assess the Signs and Symptoms of Chronic Hand Eczema: The Hand Eczema Symptom Diary (HESD).

Chronic Hand Eczema (CHE) is an inflammatory skin disease of the hands. The Hand Eczema Symptom Diary (HESD) is a new patient-reported outcome measure of worst severity of core CHE signs/symptoms. This study aimed to evaluate content and psychometric validity of the HESD. The HESD was developed based on the literature and concept elicitation interviews. Qualitative cognitive debriefing interviews were conducted with CHE patients to assess relevance and understanding of items, response options and recall period. Psychometric properties of the HESD (item performance, dimensionality, reliability, validity, responsiveness and estimation of meaningful change thresholds) were then assessed, first using data from a phase 2b trial (NCT03683719), and confirmed using data from the first 280 participants completing the 16-week treatment phase of a phase 3 trial (NCT04871711). Cognitive debriefing supported item refinement and removal of items and confirmed all items were well understood and relevant to patients. Item properties and dimensionality analyses in the phase 2b data supported removal of additional items, resulting in the 6-item HESD included in the phase 3 trial. Unidimensionality was supported by inter-item correlations (all > 0.70) and Rasch analysis. Internal consistency (Cronbach's alpha = 0.96) and test-retest reliability (IntraclassCorrelationCoefficient > 0.89) results were very strong. Construct validity was supported by moderate correlations with concurrent measures (0.53-0.64) and significant differences between severity groups (p < 0.001). Large effect sizes for mean change scores in participantsthat improved and significant differences between change groups indicatedthe ability to detect change. Anchor-based analyses supported within-individual responder definitions of ≥ 4-points for improvements in 7-day average HESD scores. The HESD is the first CHE-specific, patient-reported outcome measure of CHE signs/symptoms developed and validated in line with regulatory guidance. This article provides evidence of strong content validity and psychometric validity and shows improvements of ≥ 4 points on 7-day average HESD scores represent clinically meaningful, important changes. NCT03683719, NCT04871711.

Efficacy of Topical Palmitoylethanolamide (Levagen+) for the Management of Eczema Symptoms: A Double-Blind, Comparator-Controlled, Randomized Clinical Trial

Introduction: Eczema is a debilitating skin disorder clinically characterised by the development of itchy, dry, rough, and scaling skin caused by a series of rudimentary clinical phenotypes. Methods: This double-blind, randomised, comparator-controlled trial evaluated the effectiveness of topical application of a novel palmitoylethanolamide formulation (Levagen+) compared with a standard moisturiser (comparator) to reduce eczema severity and improve patient outcomes. Seventy-two participants aged over 18 years old with atopic eczema (symptoms including redness, dry skin, scaling, and/or itchiness) on their hands or arm were recruited. Participants were randomly allocated to one of two treatment groups (Levagen + or comparator). Treatment was applied to the affected area twice daily for 4 weeks. Outcome measures included Self-Assessed Eczema Area Severity Index (SA-EASI) scoring and Patient-Oriented Eczema Measure (POEM) from baseline to week 4. Results: Levagen+ was effective at alleviating symptom severity of eczema over 4 weeks. Levagen+ significantly reduced redness, dryness, and total POEM score compared to a comparator cream. Conclusion: Levagen+ can significantly reduce eczema symptom severity compared to a comparator product, supporting its use as a potential treatment for eczema. Trial registration: <ext-link ext-link-type="uri" xlink:href="http://clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">clinicaltrials.gov</ext-link> Identifier: NCT05003453.

Case report on Ayurvedic management of Eczema with special reference to Charma Kushta

Skin inflammation is referred to as eczema, also referred to as dermatitis. Erythema, vesiculation, and oozing are the symptoms of acute eczema, followed by subacute scaling and crusting and chronic lichenification. According to Ayurveda, Charmakushta which is one among the 18 types of Kushta can be correlated to chronic stage of eczema. This condition can be managed with Sodhana and Shamana principles mentioned in Kushta. The subjective parameter like pruritus is assessed with NRS(numeric rating scale) and EASI score (eczema area and severity index) was taken for measuring area or extent along with severity. Sleep disturbance was measured using atopic dermatitis sleep score (ADSS) and DLQI (Dermatology Life Quality Index) was also assessed. All these parameters were assessed before and after treatment and also after follow up. DLQI of the patient was 66.6%before treatment which was reduced to 26.6% after treatment and 13.3% after follow up. NRS score has showed a 5 point decrease in the score and ADSS showed a marked decrease in mean score after follow up. EASI score also showed a marked reduction from 22 to 8.6 after follow up.

Staphylococcus aureus exacerbates dermal IL-33/ILC2 axis activation through evoking RIPK3/MLKL-mediated necroptosis of dry skin.

Atopic dermatitis (AD) is a persistent skin disease typified by symptoms of dry skin and recurrent eczema. Patients with AD are at heightened risk for Staphylococcus aureus infection. Group 2 innate lymphoid cells (ILC2s) are mainly activated by epithelial cell-derived cytokines IL-33 and involved in the pathogenesis of AD. However, little is known about the effect of skin delipidization on the epithelial cell-derived cytokines and dermal ILC2s in AD. In our study, we investigated the mechanism by which S. aureus infection modulates and exacerbates the pathogenesis of dry skin, leading to type 2 inflammation in the context of innate immunity. In vivo, we found that S. aureus infection aggravated delipidization-induced dermal IL-33 release and dermal ILC2 accumulation, which exacerbated skin inflammation. We also noticed that Il33fl/fl K14cre mice and Tlr2-/- mice exhibited attenuated skin inflammation. In vitro, treatment with necroptosis inhibitors reduced IL-33 release from S. aureus-infected keratinocytes. Mechanistically, we observed an increase in the necroptosis-associated kinases, MLKL and RIPK3, in S. aureus-infected mice, indicating that IL-33 release was associated with necroptotic cell death responses. Our results reveal that S. aureus infection-elicited keratinocyte necroptosis contributes to IL-33-mediated type 2 inflammation, which exacerbates the pathogenesis of dry skin.