Topical Irritation Research Articles

Erythrodermic Flare-Up of Psoriasis with Uncontrolled, Undiagnosed Diabetes Mellitus: A Case Report

Erythrodermic psoriasis is a rare and life-threatening variant of psoriasis. Multiple triggering factors have been described, including emotional stress, alcohol consumption, medications, infections, less common phototherapy, photo chemotherapy, application of topical irritants, Sars-Cov 2 vaccine, HIV and hypocalcemia.

Topical hydrophilic gel with itraconazole-loaded polymeric nanomicelles improves wound healing in the treatment of feline sporotrichosis

Sporotrichosis is a superficial fungal disease that can affect animals and humans. The high number of infected cats has been associated with zoonotic transmission and contributed to sporotrichosis being considered by the World Health Organization as one of the main neglected tropical fungal diseases for 2021–2030. Oral administration of itraconazole (ITZ) is the first choice for treatment, but it is expensive, time-consuming, and often related to serious adverse effects. As a strategy to optimize the treatment, we proposed the development of a hydrophilic gel with nanomicelles loaded with ITZ (HGN-ITZ). The HGN-ITZ was developed using an I-optimal design and characterized for particle size, Zeta potential, drug content, microscopic aspects, viscosity, spreadability, in vitro drug release, in vitro antifungal activity, and clinical evaluation in cats. The HGN-ITZ showed a high content of ITZ (97.3 ± 2.1 mg/g); and characteristics suitable for topical application (viscosity, spreadability, globules size, Zeta potential, controlled drug release). In a pilot clinical study, cats with disseminated sporotrichosis were treated with oral ITZ or HGN-ITZ + oral ITZ. A mortality rate of 21.3% was observed for the oral ITZ group compared to 5.3% for the HGN-ITZ + oral ITZ group. In a cat with a single lesion, topical treatment alone (HGN-ITZ) provided complete healing of the lesion in 45 days. No signs of topical irritation were observed during the treatments, suggesting that HGN-ITZ can be a promising strategy in the treatment of sporotrichosis.

Esophageal Stricture: Not Your Usual Culprit?

Question: A 60-year-old woman with past medical history of ATTR amyloidosis and status post heart and liver transplantation presented with complaints of progressive esophageal dysphagia to solids and liquids. She was on tacrolimus, mycophenolate mofetil (MMF), and prednisone. Other pertinent medications included trimethoprim sulfamethoxazole and valganciclovir for infection prophylaxis. Physical examination and laboratory data were unremarkable. Esophagogastroduodenoscopy (EGD) with histopathologic examination of biopsies from the middle third of the esophagus showed the findings presented in Figure A and B. Despite high-dose proton pump inhibitor therapy and repeated dilations, symptoms were unchanged and little progress was made in maintaining an increase in luminal diameter. What is the most likely diagnosis? Look on page 400 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI. The EGD demonstrates a long, benign-appearing, intrinsic moderate stenosis with extensive fibrotic stricturing in the middle one-third of the esophagus (8 mm inner diameter × 4 cm in length) (Figure A). The stenosis was dilated with a through the scope dilator to 11 mm. Esophageal biopsies demonstrated extensive ulceration with fibrinopurulent exudate and inflamed granulation tissue (Figure B). No fungal or viral infection or malignancy was seen. The patient underwent placement of a percutaneous gastrostomy tube. Over the next year, despite continuous high-dose proton pump inhibitor therapy, she continued to experience dysphagia and required monthly dilations. After ruling out an infectious etiology, MMF was suspected as the possible culprit. Immediately upon withdrawal of MMF, the patient reported significant clinical improvement. A follow-up EGD 4 months later showed a widely patent esophageal lumen with only mild mucosal variance characterized by flattening and scarring in the mid esophagus. MMF has well-known gastrointestinal (GI) adverse effects, including nausea, vomiting and diarrhea. Although the entire GI tract is susceptible to MMF-related toxicity, the colon and, less commonly, the small bowel are the most affected areas.1Nguyen T. Park J.Y. Scudiere J.R. Montgomery E. Mycophenolic acid (CellCept and Myofortic) induced injury of the upper GI tract.Am J Surg Pathol. 2009; 33: 1355-1363Crossref PubMed Scopus (59) Google Scholar A variety of mucosal changes can be seen in the lower GI tract, ranging from inflammatory bowel disease–like changes to features akin to graft-versus-host disease. Upper GI tract toxicities of MMF have included features ranging from those compatible with nonsteroidal anti-inflammatory drug use with topical irritation and damage to ulcerative esophagitis, reactive gastropathy, and duodenal ulceration.2Panarelli N.C. Drug-induced injury in the gastrointestinal tract.Semin Diagn Pathol. 2014; 31: 165-175Crossref PubMed Scopus (24) Google Scholar MMF-related esophageal strictures are rare.3Kim J.J. Mulki R.H. Sebastian K.M. Recalcitrant esophageal stricture secondary to mycophenolate mofetil.Case Rep Gastrointest Med. 2020; 2020: 8817801PubMed Google Scholar This case highlights an uncommon cause of a refractory esophageal stricture that should be considered as a potential etiology for dysphagia, especially in a transplant recipient, when more common etiologies have been excluded or when esophagitis is refractory to proton pump inhibitor therapy.

Retinoic acid core-shell lipoplexes for the treatment of colorectal cancer

The use of retinoic acid restricts the application in cancer using oral and intravenous drug delivery systems due to rapid decrease in plasma concentration. Moreover, low aqueous solubility and topical irritation limits the usage of retinoic acid in clinical studies. DNA, a non-viral vector stimulates the immune system against the cancerous cell by inhibiting the growth of tumour cell. The aim of the present research work was to formulate lipid-complexed with DNA using cationic lipid in the form of lipoplexes of retinoic acid on colorectal cancer cell lines. Lipoplexes are lipid-based systems with DNA attached to the cationic branch of the liposomes for easy and faster penetration inside the cell. Lipoplexes were prepared by film-hydration method and followed by complexation with DNA in presence of retinoic acid. The lipoplexes were characterized by surface morphology, surface charge, % drug encapsulation, in-vitro release profile and stability studies. Particle size of the lipoplexes of retinoic acid was found to be in the range of 306.12 ± 1.23–526.4 ± 4.25 nm. The smaller particle size and higher zeta potential indicated better stability of the formulations due to the development of more surface resistance for aggregation. The encapsulation efficiency was found to be 79.46 ± 2.12 % due to the complex formation of lipophilic retinoic acid and the lipid nature of liposomes. The in-vitro release study of retinoic acid from lipoplex network was found to be 78.56 ± 2.58 % with the first-order controlled release pattern for 24 h. Therefore, lipoplex formulation showed a novel approach for the delivery of retinoic acid in colorectal cancer for site-specific action.

A retrospective evaluation of systemic and/or topical pilocarpine treatment for canine neurogenic dry eye: 11 cases.

To assess the response to topical and/or systemic pilocarpine in dogs with neurogenic dry eye. Medical records of dogs diagnosed with dry eye between 2015 and 2018 were reviewed. Cases were excluded if STT values were decreased bilaterally, if dogs were lost to follow-up, or if surgical measures (parotid duct transposition) were undertaken within thirty days of presentation. Dogs were on treatment with topical pilocarpine (0.1%, every 6hours) and/or oral pilocarpine (starting dose 2%, one drop per 10kg every twelve hours). Eleven cases were included in the study, seven females and four males with mean age of 10years. Seven cases had xeromycteria, two cases had facial nerve paralysis, and one case had Horner's syndrome. Seven cases (63.6%) had successful outcome following pilocarpine treatment, return to normal STT (15-25mm/minute), in an average of 24±5.1days. Of these cases, five had both systemic and topical treatment, one had just topical treatment, and one had just systemic treatment. The average time to normal tear production on treatment with topical pilocarpine±systemic was 23days (range 9-48days). The number of systemic drops until a positive response varied between individuals from 0.8drops/10kg to 7drops/10kg. Pilocarpine treatment (topical±systemic) is an effective therapy for unilateral dry eye disease in cases suspected to be neurogenic in origin. Most cases responded within 30days. Side effects included topical irritation to the ophthalmic solution and systemic effects from oral pilocarpine, such as diarrhea and regurgitation.

Rational Design of Rapidly Separating Dissolving Microneedles for Precise Drug Delivery by Balancing the Mechanical Performance and Disintegration Rate

The precise delivery of traditional dissolving microneedles (TDMNs) is often limited by the incomplete insertion due to the skin deformation, and the topical irritation is inevitable after long application, which ultimately results in compromised therapeutic efficacy. The aim of this study is to develop a rapidly separating dissolving microneedles (RSDMNs) system to achieve precise drug delivery. Therapeutic molecules are concentrated in the needle tip, while the blank separating part allows it to counteract skin indentation and rapidly separate from the base part. For rational design of an ideal separating part, and the molecular interactions between polymer and sugar are explored to make a good balance between mechanical performance and disintegration rate. The optimal RSDMNs can rapidly disintegrate in the mimic skin within 30 s, and the generated micropores in the skin reseal quickly. The ex vivo drug permeation of RSDMNs is significantly higher than that of TDMNs due to the complete needle imbed aided by the separating part. Furthermore, RSDMNs exhibit excellent in vivo anti-inflammation effect by remarkably down regulating the expression of TNF-α, IL-1β, and IL-6. In conclusion, the RSDMNs can reach precise drug delivery in a short time, which are more reliable for the self-administration strategy in the future.

Inhibition of Muscular Nociceptive Afferents via the Activation of Cutaneous Nociceptors in a Rat Model of Inflammatory Muscle Pain.

Topical irritants such as capsaicin (CAP), peppermint oil (PO), and mustard oil (MO) are effective in relieving inflammatory muscle pain. We investigated the effects of topical irritants in a rat model of inflammatory muscle pain produced by injecting complete Freund's adjuvant (CFA) into the tibialis anterior muscle. CFA-induced mechanical hypersensitivity and the spontaneous activity of muscular nociceptive afferents, and decreased weight-bearing of the hindlimb were relieved by topical application of CAP, PO, or MO on the skin overlying the inflamed muscle. The effects of topical irritants were abolished when applied to the skin on the ipsilateral plantar region or on the contralateral leg, or when the relevant cutaneous nerve or dorsal root was transected. Our results demonstrated that topical irritants may alleviate inflammatory muscle pain via activating cutaneous nociceptors and subsequently inhibiting the abnormal activity of muscular nociceptive neurons.

Uji Mutu Ekstrak Daun Sirsak (Annona muricata Linn.) Yang Di Ekstraksi Secara Maserasi Dengan Pelarut Etanol 70%

Background : Gastric ulcer is wound to the mucosal layer (epithelial layer) of the stomach and mucosal irritation of 5 mm or more in diameter with depth down to submucosa. The basic pathogenesis of gastric ulcers in when there is an imbalance of aggressive factor enhancement. Non-steroidal antiinflammantory drug can cause stomach ulcers in two ways, either directly or topical irritation of the epithelial tissue and inhibit the endogeneous system of gastrointestinal mucosa of prostaglandins. In this case inhibition of prostaglandin systhesis is the dominant factor of peptic ulcers by NSAIDs.
 Objectives : The purpose of this study was to determine the effct of NSAID drug administration on the formation of peptic ulcers and to know the difference in the rate of formation of peptic ulcers from each class.
 Method : Sampel method mice performed surgery on the stomach is done in Pharmacology Laboratory of Pharmacy Institute Deli Husada Deli Tua.
 Results : The results of this study indicate that faster drugs cause gastric ulcers with a degree of redness are Aspirin 4.03 mm, 2.01 mm mefenamat and 1.02 mm Diclofenac Sodium while Ibuprofen mwdication does not cause peptic ulcers.
 Conclusion : The results of this study it can be concluded that Aspirin administration with doses of 21 mg/kg faster causes gastric ulcers from other NSAID groups such as Mefenamat with a dose of 21 mg/kg BW, Diclofenac sodium at a dose of 2 mg/kg while administration, Ibuprofen for ten days does not couse ulcers in the stomach of experimetal animals.

Pengaruh Kecepatan Pembentukan Tukak Lambung Terhadap Pemberian Berbagai Golongan NSAID Pada Tikus Jantan

Background : Gastric ulcer is wound to the mucosal layer (epithelial layer) of the stomach and mucosal irritation of 5 mm or more in diameter with depth down to submucosa. The basic pathogenesis of gastric ulcers in when there is an imbalance of aggressive factor enhancement. Non-steroidal antiinflammantory drug can cause stomach ulcers in two ways, either directly or topical irritation of the epithelial tissue and inhibit the endogeneous system of gastrointestinal mucosa of prostaglandins. In this case inhibition of prostaglandin systhesis is the dominant factor of peptic ulcers by NSAIDs.
 
 Objectives : The purpose of this study was to determine the effct of NSAID drug administration on the formation of peptic ulcers and to know the difference in the rate of formation of peptic ulcers from each class.
 
 Method : Sampel method mice performed surgery on the stomach is done in Pharmacology Laboratory of Pharmacy Institute Deli Husada Deli Tua.
 
 Results : The results of this study indicate that faster drugs cause gastric ulcers with a degree of redness are Aspirin 4.03 mm, 2.01 mm mefenamat and 1.02 mm Diclofenac Sodium while Ibuprofen mwdication does not cause peptic ulcers.
 
 Conclusion : The results of this study it can be concluded that Aspirin administration with doses of 21 mg/kg faster causes gastric ulcers from other NSAID groups such as Mefenamat with a dose of 21 mg/kg BW, Diclofenac sodium at a dose of 2 mg/kg while administration, Ibuprofen for ten days does not couse ulcers in the stomach of experimetal animals.

654 Epidermal pigmentation regulates cutaneous inflammation

Epidemiologic data suggest that inflammatory disorders related to skin barrier function, such as atopic dermatitis (AD), are more common and/or severe in racial/ethnic groups with deep pigmentation. Yet, due to a lower surface pH, darkly pigmented (type IV/V) humans display superior permeability barrier function, stratum corneum (SC) integrity, and antimicrobial peptide expression in comparison with lightly pigmented (types I/II) skin types, which instead could indicate a lesser propensity to develop inflammation. To resolve this apparent paradox, we assessed whether dark pigmentation confers resistance to inflammation in closely-related strains of pigmented vs. non-pigmented hairless mice, treated with either a topical irritant or repeated hapten applications. We demonstrate that pigmented animals display a lesser tendency to develop inflammation after repeated challenges with either the topical irritant or the topical hapten in comparison to non-pigmented mice. Inflammation is linked to the presence of pigment, because depigmentation of pigmented murine skin with topical hydroquinone reduced inflammatory thresholds, while simultaneously enhancing expression of epidermal mRNAs and protein for the pro-inflammatory cytokines, IL-1α, IL-1β and TNFα. Finally, topical acidification of non-pigmented murine skin increased inflammatory thresholds and reduced cytokine expression to levels comparable to dark-skinned mice, indicating that the anti-inflammatory benefits of pigmentation are linked to the impact of pigmentation on surface pH. Because epidermal pigmentation attenuates cutaneous sensitivity to inflammatory stimuli, darkly-pigmented humans should exhibit a reduced, rather than an enhanced susceptibility to inflammatory skin disorders.

The effects of topical aqueous sirolimus on tear production in normal dogs and dogs with refractory dry eye.

To evaluate the effect of twice daily aqueous 0.02% sirolimus drops on tear production in normal dogs and dogs with refractory keratoconjunctivitis sicca (KCS). Two groups of dogs were studied. Ten normal dogs with no signs of ocular disease were administered topical 0.02% sirolimus ophthalmic solution in right eye, and a vehicle control in the left eye twice daily for 4 weeks. Complete ophthalmic examinations, including Schirmer tear test were performed weekly. Eighteen dogs with refractory KCS were randomly assigned to receive 0.02% sirolumus ophthalmic solution or 0.02% tacrolimus ophthalmic solution twice daily. Complete ophthalmic examinations were was performed at 2 and 6 weeks following treatment. Tear production in the sirolimus-treated eyes of normal dogs was greater when compared to vehicle controls with a mean difference over all time points of 3.46 mm (95% CI 1.17, 5.75; P = 0.006). After 4 weeks of treatment, the mean difference was 5 mm (95% CI 1.95, 8.05; P = 0.002). In dogs with refractory dry eye, 37.5% of eyes treated with sirolimus exhibited increased tear production >4 mm/min after 6 weeks of treatment, compared to 20% of eyes receiving tacrolimus (P = 0.433). One normal dog experienced topical irritation to both sirolimus and vehicle-treatment. Side effects were not reported in any treated eyes with chronic KCS. Topical 0.02% sirolimus might be an alternative treatment for canine patients with keratoconjunctivits sicca. The drug appears safe when applied topically in an aqueous suspension for up to 6 weeks. While initial results are promising, further studies are warranted.

Rosácea: puesta al día

Rosacea is a chronic inflammatory disease. Its frequency is higher in pale-skinned people and women over 30 years. Disease mechanisms include: abnormalities in innate immunity, inflammatory reactions to microorganisms, ultraviolet radiation damage, and vascular dysfunction. There are four clinical subtypes: erythematotelangiectatic, pustular papules, phymatous and ocular rosacea. Patients may present one or more characteristics of each subtypes. Injuries are classically located in midface area. Extreme temperatures, UV radiation, hot beberages, spicy foods, alcohol, exercise, topical irritants, psychological symptoms and drugs are associated to exacerbations. Clinical evaluation of the patient is usually enough for diagnosis. Nonpharmacologic interventions are essential for treatment. These include avoiding use of cosmetic, and triggers, skin care, and broad-spectrum sun protection. Patients with no response to general measures can respond to pharmacological agents. Topical metronidazole and azelaic acid are considered
 first-line treatments in mild to moderate disease. Oral tetracycline, have been used for many years for the treatment of papulopustular rosacea. Isotretinoin is useful in refractory disease. Treatment must be continous to maintain the response.

Dermatoprotective effects of some plant extracts (genus Ficus) against experimentally induced toxicological insults in rabbits

Present study was conducted to evaluate the dermatoprotective effects of plant extracts (Ficus religiosa, Ficus benghalensis, and Ficus racemosa) against known irritants such as sodium dodecyl sulfate (SDS), atrazine, and petrol. The study was conducted in adult male rabbits. Ethanol extracts of plants were obtained through Soxhlet. All irritants and Ficus extracts were topically applied to the backs of rabbits daily for 4 days, while pure ethanol served as control. Skin was examined after 24, 48, and 96 h for erythema. Skin biopsies were taken on 5th day for microscopic examination. Erythema produced by irritants reduced significantly with the simultaneous application of Ficus extracts. The mean ± SEM epidermal thickness (micrometer) with SDS was 45.40 ± 1.89, F. religiosa + SDS was 18.60 ± 0.51, F. benghalensis + SDS was 18.40 ± 0.25, F. racemosa + SDS was 18.80 ± 0.37, and mixture of three Ficus species + SDS was 16.80 ± 0.37. Similar findings were revealed after using plant extracts with atrazine and petrol. The mean ± SEM epidermal layer count for SDS was 3.60 ± 0.25, atrazine was 3.40 ± 0.25, petrol was 3.40 ± 0.25, and ethanol (control) was 1.00 ± 0.20. This count reduced to 1.20 ± 0.20 for three Ficus species + SDS, 1.40 ± 0.25 for Ficus species + atrazine, and 1.40 ± 0.25 for Ficus species + petrol. Ficus species demonstrated the potential to block the dermatotoxic effects of topical irritants and could be used successfully to prevent skin toxicity.

Stratum corneum dysfunction in dandruff

SummarySynopsisDandruff is characterized by a flaky, pruritic scalp and affects up to half the world’s population post-puberty. The aetiology of dandruff is multifactorial, influenced by Malassezia, sebum production and individual susceptibility. The commensal yeast Malassezia is a strong contributory factor to dandruff formation, but the presence of Malassezia on healthy scalps indicates that Malassezia alone is not a sufficient cause. A healthy stratum corneum (SC) forms a protective barrier to prevent water loss and maintain hydration of the scalp. It also protects against external insults such as microorganisms, including Malassezia, and toxic materials. Severe or chronic barrier damage can impair proper hydration, leading to atypical epidermal proliferation, keratinocyte differentiation and SC maturation, which may underlie some dandruff symptoms. The depleted and disorganized structural lipids of the dandruff SC are consistent with the weakened barrier indicated by elevated transepidermal water loss. Further evidence of a weakened barrier in dandruff includes subclinical inflammation and higher susceptibility to topical irritants. We are proposing that disruption of the SC of the scalp may facilitate dandruff generation, in part by affecting susceptibility to metabolites from Malassezia. Treatment of dandruff with cosmetic products to directly improve SC integrity while providing effective antifungal activity may thus be beneficial.RésuméLes pellicules se caractérisent par un cuir chevelu prurigineux, squameux, et affectent jusqu’à la moitié de la population post-pubertaire du monde. L’étiologie des pellicules est multifactorielle, influencée par Malassezia, par la production de sébum, et par la susceptibilité individuelle. La levure commensale Malassezia est un facteur fortement contributif à la formation de pellicules, mais la présence de Malassezia aussi sur les cuirs chevelus sains indique que Malassezia seule n’est pas une cause suffisante. Un stratum corneum (SC) sain forme une barrière protectrice pour empêcher la perte d’eau et maintenir l’hydratation du cuir chevelu. Il protège également contre les agressions externes tels les micro-organismes, y compris Malassezia, ou des substances toxiques. Des dommages aigus ou chroniques au niveau de la barrière peuvent nuire à une bonne hydratation, conduisant à des effets atypiques de la prolifération épidermique, de la différenciation des kératinocytes, et de la maturation du SC, ce qui peut expliquer une partie des symptômes des pellicules. L’appauvrissement et la désorganisation des lipides structurels d’un stratum corneum sujet aux pellicules sont compatibles avec la notion d’une barrière affaiblie telle qu’indiquée par une perte d’eau transépidermique élevée. Une preuve supplémentaire d’une barrière affaiblie dans les cas des pellicules est fournie par un niveau d’inflammation infraclinique et une plus grande susceptibilité aux irritants topiques. Nous proposons que la perturbation du SC du cuir chevelu facilite la production de pellicules, en partie en augmentant la sensibilité aux métabolites de Malassezia. Le traitement des pellicules avec des produits cosmétiques pour améliorer directement l’intégrité du SC, tout en offrant une activité antifongique efficace peut donc être bénéfique.

Physical chemical, pharmacological and toxicologic properties of fomocaine metabolites] .

Fomocaine (4-[3-(4-phenoxymethylphenyl)-propyl]-morpholine, CAS 17692-39-6) is a highly effective local anaesthetic of low toxicity. The drug, which causes no allergic response, was introduced in the German Extrapharmacopoeia (DAC). Fourteen metabolites are formed after oral administration to rat and beagle dog. Less than 5% fomocaine are excreted unchanged. The metabolites were synthesized and their physico-chemical properties were investigated. No metabolite caused a surface or conduction anaesthesia with the exception of 2-hydroxyfomocaine (O/Se 4). After topical and parenteral administration irritation could not be observed. All metabolites except O/Se 10 and O/Se 11 showed a lower toxicity than fomocaine. In both species O/Se 10 and O/Se 11 are formed only in a small amount and are detoxified by conjugation.

Increased skin barrier disruption by sodium lauryl sulfate in mice expressing a constitutively active STAT6 in T cells

Atopic dermatitis (AD) is a pruritic, chronic inflammatory skin disease that affects 10-20% of children and 1-3% of adults worldwide. Recent studies have indicated that the ability of Th2 cytokines, such as interleukin-4 (IL-4) to regulate skin barrier function may be a predisposing factor for AD development. The present studies examined the ability of increased Th2 activity to affect cutaneous barrier function in vivo and epidermal thickening. Mice that express a constitutively active Signal Transducer and Activator of Transcription 6 (STAT6VT) have increased Th2 cells and a predisposition to allergic inflammation were used in these studies, they demonstrate that topical treatment with the irritant sodium lauryl sulfate (SLS) caused increased transepidermal water loss and epidermal thickening in STAT6VT mice over similarly treated wild-type mice. The proliferation marker Ki-67 was increased in the epidermis of STAT6VT compared to the wild-type mice. However, these differences do not appear to be linked to the addition of an irritant as control-treated STAT6VT skin also exhibited elevated Ki-67 levels, suggesting that the increased epidermal thickness in SLS-treated STAT6VT mice is primarily driven by epidermal cell hypertrophy rather than an increase in cellular proliferation. Our results suggest that an environment with increased Th2 cytokines results in abnormal responses to topical irritants.

Investigation of anticholinergic and non‐steroidal anti‐inflammatory prodrugs which reduce chemically induced skin inflammation

As part of a continuous effort to develop efficient counter measures against sulfur mustard injuries, several unique NSAID prodrugs have been developed and screened for anti-inflammatory properties. Presented herein are three classes of prodrugs which dually target inflammation and cholinergic dysfunction. Compounds 1-28 contain common NSAIDs linked either to choline bioisosteres or to structural analogs of acetylcholinesterase (AChE) inhibitors. These agents have shown utility as anti-vesicants and anti-inflammatory agents when screened in a mouse ear vesicant model (MEVM) against both 2-chloroethyl ethyl sulfide (CEES), a blistering agent, and 12-O-tetradecanoylphorbol-13-acetate (TPA), a common topical irritant. Many of the prodrugs have activity against CEES, with 5, 18, 22 and 27 reducing inflammation by more than 75% compared with a control. Compounds 12, 13, 15 and 22 show comparable activity against TPA. Promising activity in the MEVM is related to half-lives of NSAID release in plasma, moderate to high lipophilicity, and some degree of inhibition of AChE, a potential contributor to sulfur mustard-mediated tissue damage.

Acute Hemolysis Following Iodine Tincture Ingestion

Iodine tincture poisoning is uncommon regardless of its widespread use as an antiseptic in daily practice. Previously reported effects of iodine-containing antiseptic poisoning included topical irritation, corrosive effects, allergic response, and hepatic or renal injury, which mainly resulted from complications of topical use during surgical procedures. We herein reported an unusual case of severe hemolysis and acute renal failure following intentional ingestion of iodine tincture containing 60 mg/ml iodine and 40 mg/ml potassium iodide in 70% v/v ethanol. The patient completely recovered 8 weeks later after receiving supportive treatment, plasma exchange, and temporary hemodialysis.

Treatment of alopecia areata with fractional photothermolysis laser

Many studies have documented an abnormal cell-mediated immune reaction in alopecia areata (AA) 1 . The key histopatho logic feature of AA is a lymphocytic infiltrate around the lower hair follicle, which may appear in a characteristic “swarm of bees” pattern. The affected hair follicles terminate their anagen phase prematurely and regress via the induction of massive apoptosis of the lower portion of the follicle (the catagen phase), which results in a resting hair follicle (the telogen phase). The hair follicles may then reenter the anagen phase, but in the presence of a lymphocytic infiltrate, the anagen is terminated prematurely, which results in miniaturized hair follicles. AA represents a disorder of hair follicle cycling in a dual sense: it almost exclusively attacks anagen hair follicles and then greatly disturbs hair follicle cycling by “catapulting” anagen follicles into the catagen phase 2 . The treatment of AA depends on the severity and extent of the disease. The medications include a topical irritant, and in mild cases, topical and intralesional steroids. More aggressive therapy is used for severe cases, however, such as systemic corticosteroids, immunosuppressive drugs, and immune modulators 3 . These treatments frequently show side effects and a relatively high relapse rate, though. Recently, laser treatment of different wavelengths has been used to manage this roblem 1,3-

In Vitro Release Behavior of Naproxen in Alginate–Chitosan Microparticles as Oral Drug Delivery Systems

Due to its topical irritant effect on gastric mucosa naproxen is an ideal candidate for encapsulation in pH sensitive drug delivery systems such as alginate– chitosan microparticles. [...]