What's new in the topical treatment of allergic skin diseases

Bathing and Associated Treatments in Atopic Dermatitis

Atopic dermatitis is one of the most common complaints presenting to dermatologists, and patients typically inquire as to appropriate bathing recommendations. Although many dermatologists, allergists, and primary-care practitioners provide explicit bathing instructions, recommendations regarding frequency of bathing, duration of bathing, and timing related to emollient and medication application relative to bathing vary widely. Conflicting and vague guidelines stem from knowledge related to the disparate effects of water on skin, as well as a dearth of studies, especially randomized controlled trials, evaluating the effects of water and bathing on the skin of patients with atopic dermatitis. We critically review the literature related to bathing and associated atopic dermatitis treatments, such as wet wraps, bleach baths, bath additives, and balneotherapy. We aim to provide readers with a comprehensive understanding of the impact of water and related therapies on atopic dermatitis as well as recommendations based upon the published data.

Nanoparticle-Enabled Transdermal Drug Delivery Systems for Enhanced Dose Control and Tissue Targeting

Transdermal drug delivery systems have been around for decades, and current technologies (e.g., patches, ointments, and creams) enhance the skin permeation of low molecular weight, lipophilic drugs that are efficacious at low doses. The objective of current transdermal drug delivery research is to discover ways to enhance skin penetration of larger, hydrophilic drugs and macromolecules for disease treatment and vaccination. Nanocarriers made of lipids, metals, or polymers have been successfully used to increase penetration of drugs or vaccines, control drug release, and target drugs to specific areas of skin in vivo. While more research is needed to identify the safety of nanocarriers, this technology has the potential to expand the use of transdermal routes of administration to a wide array of therapeutics. Here, we review the current state of nanoparticle skin delivery systems with special emphasis on targeting skin diseases.

Treating pediatric atopic dermatitis: current perspectives

Atopic dermatitis (AD) is a chronic, inflammatory skin condition which affects millions of people worldwide. It is most commonly seen in children but may also progress into adulthood. Management of this complex disease requires a multi-pronged approach which can address the myriad of issues which underscore its development. Avoidance of triggering factors is imperative in establishing consistent control of skin irritation while daily moisturization can be very effective in skin barrier repair and maintenance. Judicious use of anti-inflammatory medications has been shown to make a significant impact on both treatment as well as prevention of disease. Unfortunately, pruritus, a key feature of AD, has proven much harder to control. Finally, awareness of the risks of colonization and infection in patients with AD should be incorporated into their surveillance and management plans. While our understanding has progressed greatly regarding this disease, further research is still needed regarding future directions for both treatment and prevention.

Efficacy and cosmetic properties of drug forms of hydrocortisone 17-butyrate for patients with allergic contact dermatitis: a prospective observational program

Objective. To assess the duration of the therapy needed for complete eradication of clinical manifestations of allergic contact dermatitis (ACD) and evaluate how patients perceive cosmetic properties of Locoid, and to assess etiological factors of ACD based on the medical history. Materials and methods. The authors performed an open multicenter prospective observational program of observations of ACD patients receiving treatment with Locoid (in the form of Lipocream or Crelo). As many as 149 patients were involved. The patients received treatment with Locoid according to the routine practice until complete eradication of the lesions but for not more than 30 days. Prior to the onset of treatment, the etiological factor that caused ACD was evaluated. Upon the completion of the therapy, patients completed questionnaire forms to assess the cosmetic properties of the drug. Results. The authors demonstrated high clinical efficacy of the drug: ACD symptoms were eradicated in 96.64% of the patients; the median treatment duration amounted to 7 days. Cosmetic properties of the drug and general satisfaction with treatment were high regardless of the drug form (Lipocream or Crelo). In the sample under observation, the use of different cosmetic products was the most frequent reason of ACD. High safety of Locoid was demonstrated: adverse events were observed in one patient only. Conclusion. The duration of the therapy needed for complete eradication of clinical manifestations of allergic contact dermatitis is 7 days (median: quartiles of 5-9 days). The perception of cosmetic properties of both Locoid drug forms (Lipocream or Crelo) is positive; general satisfaction with treatment is high and does not depend on the drug form.