Topical Vitamin Research Articles

Efficacy of microneedling with topical vitamin C in treatment of acne scars

Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. There is no single treatment modality that has been shown to be universally effective. Microneedling is a relatively new minimally invasive procedure used as a collagen induction therapy for skin rejuvenation and facial scars. Aim of the work: Evaluation of efficacy of microneedling with topical vitamin C in treatment of acne scars. Patients and Methods: Ten patients with post acne atrophic facial scars attending the outpatient clinic of Dermatology in Sohag University Hospitals between June 2014 to September 2017 were offered six microneedling sessions plus topical vit. C (during the session of microneedling and daily topical application in between sessions) microneedling sessions were four weeks apart. They were evaluated monthly and one month after completion of sessions for both efficacy and safety of the procedure. Results: The mean ± SD of the patients' age in the study population were 28.900 ±5.384yers old nine females and one males with mean acne scars duration ± SD 11.900±5.506 years, 90%% of patients had psychological distress from their acne scars. At the end of study duration Out of the ten patients 6(60%) achieved one grade reduction in their Goodman and Baron qualitative grading score and 2 (20%) achieved two grade reduction. According to the quantitative ECCA Echella d'e valuation Clinique des cicatrices d'acne score 80% 0f patients achieved reduction in their score with 27.5% improvement in the ECCA score. The mean ECCA score value of V scar started to decrease earlier than both U scar, and M scar. 40% of patients had excellent satisfaction and 60% had very good satisfaction. All treated patients, had adverse events of temporary erythema, edema, bleeding, or a serous ooze resolving with crusting or scabbing following each session of microneedling, bacterial infection not occurred in any of our patients. Conclusion: Multiple minimally invasive sessions of skin microneedling with topical vitamin C during sessions and daily application is an effective treatment for post-acne atrophic scars with the advantage of being a relatively risk-free, in-office procedure with minimal patient recovery time.

Low Vitamin D in Psoriasis: Reality or Myth?

Context:Psoriasis is a chronic, systemic disease with the beneficial effect of topical vitamin D3 analogs, known for a long time. Low levels of vitamin D are increasingly found to be associated with the initial development of some autoimmune diseases. There are contradictory reports of low serum levels of vitamin D3 in the pathogenesis of psoriasis.Aims:(1) To determine the serum levels of vitamin D, calcium and C-reactive protein (CRP) in patients with psoriasis vulgaris, (2) To compare these levels with the serum levels of controls, and (3) To correlate them with the severity of the disease.Subjects and Methods:A hospital-based case–control study with 61 patients of psoriasis and 61 age- and sex-matched controls was undertaken. A detailed history was taken and examination including body mass index, Psoriasis Area and Severity Index (PASI) was done. Estimations of serum vitamin D, serum calcium, and CRP levels were done.Results:Mean 25(OH) vitamin D level was not significantly different between persons with and without psoriasis. Mean vitamin D level in cases was 18.41±9.41 and that in controls was 17.24±13.03 (P =0.63). However, vitamin D level were significantly lower in females than in males in both cases (P =0.02) and controls (P =0.006). There was no significant correlation between the severity of psoriasis and serum levels of vitamin D, serum calcium, and CRP.Conclusions:Serum level of vitamin D did not correlate with the severity of psoriasis in our study.

Drug-induced psoriasis: clinical perspectives.

Exposure to certain drugs can elicit an induction or exacerbation of psoriasis. Although well-conducted systematic studies on drug-related psoriasis are mostly lacking, traditionally strong associations have been documented for beta-blockers, lithium, antimalarial drugs such as (hydroxy)chloroquine, interferons, imiquimod, and terbinafine. More recently, new associations have been reported for monoclonal antibody- and small-molecule-based targeted therapies used for oncological and immunological indications, such as tumor necrosis factor-alpha antagonists and anti-programmed cell death protein 1 immune checkpoint inhibitors. Recognizing potential drug-related psoriasis is of clinical relevance to allow an optimal management of psoriasis. However, in clinical practice, identifying medication-related exacerbations and induction of psoriasis can be challenging. The clinical and histopathological features of drug-provoked psoriasis may differ little from that of “classical” nondrug-related forms of psoriasis. In addition, the latency period between start of the medication and onset of psoriasis can be significantly long for some drugs. Assessment of the Naranjo adverse drug reaction probability scale could be used as a practical tool to better differentiate drug-related psoriasis. The first step in the management of drug-related psoriasis is cessation and replacement of the offending drug when deemed clinically possible. However, the induced psoriasis skin lesions may persist after treatment withdrawal. Additional skin-directed treatment options for drug-related psoriasis follows the conventional psoriasis treatment guidelines and includes topical steroids and vitamin D analogs, ultraviolet phototherapy, systemic treatments, such as acitretin, methotrexate, and fumaric acid esters, and biological treatments.

Split face comparative study for efficacy of microneedling alone versus microneedling combined with vitamin c in treating facial acne scars

Background: Microneedling a newer treatment modality for facial acne scars induces collagen production through mechanical stimulation of the dermis and leads to the softening of scars, realignment of collagen bundles and stimulation of new collagen. Topical vitamin C have beneficial effect on acne and improves acne scarring when used in conjunction with glycolic acid peels and post-laser resurfacing. Aims: Split face comparative assessment of the efficacy of microneedling therapy versus microneedling therapy in conjunction with topical vitamin C in facial acne scars. Materials and Methods: This study was performed on 50 patients having facial acne scars after taking informed written consent. The face was divided into right and left half from midline. On the half of face only microneedling and on other side of face microneedling therapy with topical vitamin C (5% L-ascorbic acid) has been used. A total of three session at 4 weeks interval was done in each patient. Facial scars was assessed clinically to grade the severity of scarring, as per the ECCA grading system. Results: Gradual improvement in global score & acne scar types after each sitting of Microneedling as well as Microneedling + Topical Vitamin-C observed. Overall mean percentage improvement with Microneedling + Topical Vitamin-C was more than the mean percentage improvement with Microneedling alone. Conclusion: Microneedling shows significant clinical improvement in the M type scars (rolling), and U type scars (boxcar) and modest improvement in V type scars (ice-pick). Effect of microneedling is enhanced by combining the procedure with application of topical vitamin C.

Epidemiological survey from 2009 to 2012 of psoriatic patients in Japanese Society for Psoriasis Research.

Since 1982, the Japanese Society for Psoriasis Research has conducted annual epidemiological surveys of patients with psoriasis. Kawada etal. have reported data for 1982-2001 and Takahashi etal. have reported data for 2002-2008. The present study evaluated 9290 psoriatic cases according to age and sex (2009-2012). The male:female ratio was 2.08:1 (6281 male patients [67.6%] to 3009 female patients [32.4%]). The most prevalent type was psoriasis vulgaris (85.6% of all cases), which was followed by psoriasis arthropathica (6.0%), psoriasis guttate acuta (3.2%), Zumbusch-type generalized pustular psoriasis (1.8%) and psoriasis erythroderma (1.5%). Psoriasis vulgaris was the most prevalent type for all ages, while psoriasis arthropathica and psoriasis guttate acuta were most prevalent among patients aged less than 65years. The present survey detected an increased number of cases with comorbid diabetes and/or arthritis symptoms compared with the previous surveys. We found that treatments frequently involved topical corticosteroids (89.7% of cases) and vitamin D3 ointments (78.0% of cases), with a notable increase in the use of vitamin D3 ointments. Systemic treatments were used in 33.3% of cases, including cyclosporin (33.6%), etretinate (19.5%), methotrexate (8.6%), infliximab (11.4%), adalimumab (10.9%) and ustekinumab (6.2%). Phototherapy was used in 30.9% of cases. Although psoralen plus ultraviolet A therapy was the predominant phototherapy during previous studies, the present survey revealed that narrowband ultraviolet B therapy was used in 84.5% of phototherapy-treated cases. Thus, the present survey revealed major changes in treatment trends.

Adverse Reactions to Biologics in Psoriasis.

Psoriasis is a chronic autoimmune disease which affects millions of people worldwide. Not only can psoriasis itself be debilitating and significantly reduce an individual's quality of life, but it is also a risk factor for other systemic disorders, such as metabolic syndrome, cardiovascular disease, and malignancy. Tremendous strides were made in the treatment of psoriasis during the mid-to-late-20th century, including the emergence of topical corticosteroids and vitamin D analogs, methotrexate, systemic retinoids, and phototherapy. However, it was not until 2004 with the advent of systemic biologic agents, which precisely target components of the immune system involved in the pathophysiological process of psoriasis, that the primary treatment benchmark increased from 50% improvement in the Psoriasis Area and Severity Index (PASI 50) to PASI 75, PASI 90, and even PASI 100, or complete resolution of cutaneous disease. Today, many patients receiving biologic therapy routinely experience greater than 75% or 90% reduction in cutaneous disease burden and a significant improvement in overall quality of life. These biologic agents are generally well-tolerated and safe but, like any medication, have associated adverse effects, some of which are predictable based on the effects of immune modulation, animal model studies, and human populations with known cytokine deficiencies. Going forward, it will be important to carefully monitor the safety profiles of these agents in both clinical trials and post-marketing surveillance registries to ensure long-term safety. It is reassuring that large safety registries are consistent in demonstrating an improved safety profile with newer and emerging biologic therapies.

A5310 - Short-Term Body Composition Changes and Hematobiochemical Response to Topical Vitamin Patch Supplementation as Compared to Oral Vitamin Supplementation Pre- and Post-Laparoscopic Sleeve Gastrectomy

A5310 - Short-Term Body Composition Changes and Hematobiochemical Response to Topical Vitamin Patch Supplementation as Compared to Oral Vitamin Supplementation Pre- and Post-Laparoscopic Sleeve Gastrectomy

Inhibition of IL-17–committed T cells in a murine psoriasis model by a vitamin D analogue

A better understanding of the means by which topical vitamin D analogues exert their therapeutic effect on psoriasis is of theoretical and practical importance. We sought to clarify whether and how the topical vitamin D analogue calcipotriol (CAL) controls the IL-17A-mediated pathogenesis of murine psoriasis-like dermatitis invivo. Psoriasis-like dermatitis was induced by the topical application of an imiquimod (IMQ)-containing cream on the murine ear for 4 to 6 consecutive days. For topical CAL treatment, mice were treated daily with CAL solution on the ear before IMQ application. Mice treated topically with CAL exhibited much milder IMQ-induced psoriasis-like dermatitis compared with vehicle-treated mice, with impaired accumulation of IL-17A-committed T (T17) cells in the lesional skin. The IMQ-induced upregulation of Il12b and Il23a was marked in the epidermis and was abrogated by CAL application, suggesting CAL-mediated suppression of IL-23 expression. CAL inhibited Il12b and Il23a expression by Langerhans cells exvivo stimulated with IMQ and CD40 cross-linking. Topical CAL also inhibited T17cell expansion in the draining lymph nodes of IMQ-treated skin, implying a possible effect on T17 cell-mediated dermatitis at distant sites. In fact, topical CAL application on the IMQ-treated left ear resulted in amelioration of T17cell accumulation and psoriasis-like dermatitis in the right ear subsequently treated with IMQ. Topical CAL can exert its antipsoriatic effect on CAL-treated lesions and, concomitantly, distant lesions by attenuating the T17cell accumulation in both CAL-treated lesions and draining lymph nodes.

Bateman purpura (dermatoporosis): a localized scurvy treated by topical vitamin C - double-blind randomized placebo-controlled clinical trial.

Bateman purpura is characterized by diffuse senile skin atrophy, senile purpura and spontaneous stellar pseudocicatrices. Cutaneous changes in the course of ageing have been related to lower levels of ascorbic acid into the dermis of elderly people. In this study, we postulate that senile purpura could be linked to dermal vitamin C deficiency and could be corrected by topical administration of this vitamin. A 12-weeks, hemi-member (forearm or leg), randomized double-blind comparative study was conducted in 18 patients with Bateman purpura aged over than 60years. At each visit, clinical assessment and biometrological measurements were performed. Clinical examination and scoring by experts showed a significant improvement on the vitamin C-treated side compared with the control, with reduction of haemorrhage areas, increase of dermal thickness. Twice-daily application of 5% topical vitamin C led to a clinically apparent improvement of the skin symptoms and allows beneficial effects on skin elasticity and thickness. Bateman purpura, a classical sign of photoaging whose origin has not clearly been recognized could be improved by vitamin C applied on to the skin. These results confirm the hypothesis of the underlying role of vitamin C deficiency in the determinism of Bateman purpura.

Phototherapy for vitiligo, what's new?

Vitiligo is a disorder characterized by the development of depigmented macules and patches. Existing treatments include topical and systemic immunosuppressants, topical vitamin D analogues in monotherapy or in association with phototherapy, phototherapy and surgical techniques, which together may serve to halt disease progression, stabilize depigmented lesions, and encourage repigmentation. Narrow-band UVB (NB-UVB 310-315 nm) radiation is now considered as the "gold standard" for the treatment of diffuse vitiligo. This article provides a brief overview of the different phototherapy based treatments in vitiligo.

Topical ayurvedic ointment-induced chemical injury presenting as bilateral acute keratitis

A 40-years-old female patient was referred to the cornea clinic as a probable case of bilateral keratitis. The patient had a history of headache followed by acute onset of redness,...

Prescription-level factors associated with primary nonadherence to dermatologic medications

Purpose: To analyze factors associated with primary nonadherence to dermatologic medications and study whether prescription-level factors are associated with primary nonadherence.Materials and methods: A retrospective review of medical records of new dermatology patients from January 2011 to December 2013 at a single urban safety-net hospital outpatient dermatology clinic with a closed pharmacy system.Results: A total of 4307 prescriptions were written for 2490 patients. The overall primary nonadherence rate was 24.7%. The most prescribed medication classes in order of frequency were topical corticosteroids, topical antibiotics, topical retinoids, oral antibiotics, and topical antifungals. After multivariable adjustment for patient, provider, and prescription characteristics, when compared to topical corticosteroids, topical antibiotics, oral antifungals, and oral antivirals were less likely to be filled (RR 0.9 [95% CI, 0.84–0.95]), (RR 0.69 [95% CI, 0.59–0.81]), and (RR 0.65 [95% CI, 0.46–0.93]), respectively. Conversely, topical vitamin D analogs, oral immunomodulators, and oral retinoids were more likely to be filled (RR 1.15 [95% CI, 1.02–1.28]), (RR 1.11 [95% CI, 1.04–1.19]), and (RR 1.15 [95% CI, 1.04–1.27]), respectively.Conclusions: Medication class or administration route may be associated with increased risk of nonadherence, and identifying these factors is important in considering ways to reduce primary nonadherence rates in dermatology.

Commentary on the safety of topical vitamin A in cosmetics

Commentary on the safety of topical vitamin A in cosmetics

Protective effects of topical vitamin C compound mixtures against ozone-induced damage in human skin

Protective effects of topical vitamin C compound mixtures against ozone-induced damage in human skin

Dermatophytosis (ringworm) and its treatment approaches in Red Chittagong Cattle (RCC) calves under on-station condition

Dermatophytosis (ringworm), an infection of the superficial keratinized structures of the skin and hair, is the most common contagious skin disease in cattle. It is a remarkable public and veterinary health problem reported from different parts of the world and causes great economic loss. A number of calves were simultaneously affected with this disease in the cattle farm of Bangladesh Livestock Research Institute (BLRI). So, this study was undertaken to develop a suitable treatment approach for controlling the disease in the herd. A total of 20 calves of Red Chittagong Cattle (RCC) were selected for the trial. All the experimental calves were divided into five groups namely – T0, T1, T2, T3 and T4. T0 group was kept as control and T1, T2, T3 and T4 groups were allowed for treatment. The drugs used for treatment were griseofulvin, streptomycin-penicillin, antihistaminic and vitamin AD3E in group T1; ivermectin, streptomycin-penicillin, antihistaminic and vitamin AD3E in T2; topical antifungal ointment, griseofulvin, streptomycin-penicillin, antihistaminic and vitamin AD3E in T3; and topical antifungal ointment, ivermectin, streptomycin-penicillin, antihistaminic and vitamin AD3E in group T4. No drug was used in T0 (control).The duration of the experiment was about one month. The fungal spores of Trichophyton spp., and Microsporum spp. were observed in the samples (skin scrapping) under microscope using 20% potassium hydroxide solution. All experimental calves were observed after 7 days to know the response of the treatment. On the basis of visual observation the result was recorded on day 14. All experimental calves were observed after 7 days to know the response of the treatment. On the basis of visual observation the result was recorded on day 14. Calves in control group remain same. Calves suffering from chronic dermatomycosis or dermatophytosis (ringworm) can be treated with topical antifungal ointment, griseofulvin tablet, streptonmycin-penicillin injection, antihistaminic injection and vitamin AD3E injection as per dosages used in this experiment. If the case is acute, topical antifungal ointment and griseofulvin tablet may be recommended as treatment measures. Vitamin AD3E may or may not be used in this case.
 Asian Australas. J. Biosci. Biotechnol. 2017, 2 (1), 132-135

Intranasal vitamin A is beneficial in post-infectious olfactory loss.

Vitamin A plays a decisive role in the regeneration of olfactory receptor neurons. In this retrospective study we investigated the effectiveness of topical vitamin A in patients with post-infectious and posttraumatic smell disorders. Retrospective cohort. A total of 170 patients (age range 18-70years, mean age 52years) participated. Forty-six patients were treated with smell training only. The remaining 124 patients received smell training and topical vitamin A. Olfactory function was assessed using the Sniffin' Sticks test kit, a validated technique to measure odor thresholds, discrimination and identification. The duration of olfactory training was 12weeks. In patients receiving vitamin A, this was applied topically (head back position) at a dose of 10,000IU/day for 8weeks. Follow-up testing was performed approximately 10months after the first assessment. Thirty-seven per cent of all post-infectious patients treated with vitamin A exhibited clinical improvement, whereas only 23% improved in controls. Using a Chi-square test, this was a significant result (χ 2=7.06, df=2, p=0.03). In addition, when comparing change in score after treatment, olfactory training+vitamin A produced significantly greater improvement compared with training alone, in discrimination score for all patients (1.4 points, p=0.008), and in threshold and discrimination in the post-infectious group (1.6 points, p=0.01 and 1.4 points, p=0.04, respectively). Intranasal vitamin A at a dose of 10,000IU per day for 2months may be useful in the treatment of post-infectious olfactory loss. Further work with prospective, placebo-controlled studies is required to confirm these findings.

Acrokeratosis paraneoplastica (Bazex syndrome) - a systematic review on risk factors, diagnosis, prognosis and management.

Acrokeratosis paraneoplastica Bazex (Bazex syndrome) is a rare paraneoplastic skin disease defined by erythematous, violaceous, scaly plaques on the hands and feet and on other acral locations such as nose and ears. Bazex syndrome is linked to a variety of underlying malignancies. Usually the skin lesions develop prior to the diagnosis of an internal malignant neoplasm with spontaneous remission after tumour removal. The objective of this study was to review the so far reported risk factors, diagnostic work-up, prognosis and treatment options for Bazex syndrome in a systematic manner. This systematic review is based on a search in MEDLINE, EMBASE and Cochrane Central Register for English and German articles from 1990 to 2015. Evidence on the diagnosis and treatment of Bazex syndrome is limited predominately to case reports or to small case series. There are no randomized controlled trials. A number of underlying tumour entities, predominately oropharyngeal neoplasms and tumours of the gastroenterological tract, but other malignancies were reported. Treatment modalities including topical and systemic corticosteroids, salicylic acid, topical vitamin D analogues, etretinate and PUVA therapy are often ineffective. Due to the small number of patients and the frequent misdiagnosis of this clinical entity, the aim of this systematic review was to call attention to this rare condition and to help clinicians to diagnose and treat Bazex syndrome effectively. Because of the good prognosis of the skin lesions and the tendency to resolve spontaneously if the underlying tumour is treated early, the differential diagnosis of Bazex syndrome should be taken into consideration when dealing with atypical psoriasiform cutaneous lesions. An early diagnosis may improve the patient's prognosis substantially.

Vitamin D ointment for prevention of radiation dermatitis in breast cancer patients

Radiation dermatitis occurs frequently during adjuvant radiation therapy for breast cancer. Prevention of radiation dermatitis by applying various creams and ointments has a limited success, and Aqua cream which has urea as one of its active ingredients is used in many institutions as a preventive treatment. The primary goal of this study is to assess the effect of vitamin D (calcipotriol) ointment in prevention of radiodermatitis in breast cancer patients compared to Aqua cream. Twenty-three women with localized breast cancer who underwent breast-conserving surgery and opted to receive adjuvant radiotherapy to breast only were enrolled in this study. A cream containing an active vitamin D analog, calcipotriol (Daivonex), was randomly applied either to the medial or to the lateral half of the irradiated breast, while Aqua cream was applied to the complimentary half of the same breast along the whole treatment days, each day, after the delivery of radiation. Skin reaction was recorded and compared between the two halves of the breast. Vitamin D was well tolerated by patients with no local or systemic allergic reactions. Radiation dermatitis was not significantly different between both treatment arms. Topical vitamin D ointment is not superior to Aqua cream for prevention of radiation-induced dermatitis in women treated with adjuvant radiation for breast cancer.

Treatment of Porokeratosis: A Systematic Review.

Porokeratosis (PK) is a rare skin disease of unknown etiology. It consists of a keratinization disorder, which may appear in several clinical forms and can undergo malignant transformation. The histopathological hallmark of PK is the cornoid lamella. While many topical, systemic, and surgical treatment modalities for PK have been described, no randomized controlled trials have been performed yet. Because of a lack of treatment standards for PK, European and international guidelines cannot be created. The aim of this systematic review is to outline options for treating PK. We performed a systematic literature search in an electronic database for published literature. A total of 88 articles fulfilling our inclusion criteria were found. There were no randomized controlled trials on the treatment of PK, but mainly case reports and case series. Porokeratosis of Mibelli showed the best outcomes after treatment with imiquimod cream and linear PK responded well to topical or systemic retinoids. Topical vitamin D acid derivatives may be the best therapeutic option for disseminated PK. Surgical interventions and cryotherapy may be preferred in areas where the use of topical agents is difficult or contraindicated. To offer patients with PK an evidence-based high-quality standardized therapy, randomized controlled trials are needed.

Prenatal exposure to maternal bereavement and offspring psoriasis: a Danish nationwide cohort study.

Prenatal stress may alter immune competence of the fetus. Limited data exist on the role of antenatal stress in psoriasis development. To investigate whether prenatal exposure to maternal bereavement increases the risk of offspring psoriasis. This register-based cohort study included 1 811 917 live singletons born from 1978 to 2008 in Denmark. The children were assigned to the bereaved group if their mothers lost a child, partner/spouse, parent or sibling during pregnancy or up to 12 months before pregnancy. Follow-up started at the date of birth and ended at the date of first hospital treatment for psoriasis or a prescription redeemed for topical vitamin D derivatives (often used to treat psoriasis), emigration, death or 31 December 2010, whichever came first. We evaluated the hazard ratio (HR) of psoriasis in bereaved children using Cox proportional hazards regressions, compared with the nonbereaved group. During 28 million person-years of follow-up, 7956 children were hospitalized or prescribed medications for psoriasis. By the age of 30 years, 1·54% [95% confidence interval (CI) 1·25-1·90%] of children from the bereaved group were diagnosed with psoriasis, compared with 1·34% (95% CI 1·30-1·38%) of nonbereaved children. Overall, prenatal exposure to maternal bereavement was not associated with risk of psoriasis in general (HR 1·05, 95% CI 0·91-1·20). However, children born to mothers who lost a partner/spouse or an older child had an increased risk of psoriasis (HR 1·33, 95% CI 1·02-1·73). Prenatal exposure to the most stressful life event may contribute to the development and/or exacerbation of psoriasis.