Acid-coated Textiles (pH 5.5-6.5)--a New Therapeutic Strategy for Atopic Eczema?

Adjunctive Management of Itch in Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin condition that can be difficult to treat due to a complex etiology and diverse clinical presentations. Itch is the most common symptom associated with AD with profound negative impact on quality of life. Thus, the adjunctive management of itch in patients with AD is needed to control and reduce disease burden. Supplemental treatment options are continuously emerging and undergoing testing in clinical trials. This article summarizes the latest data on topical and systemic adjunctive therapies for AD safety and efficacy in reducing itch.

Exploring Cationic Guar Gum: Innovative Hydrogels and Films for Enhanced Wound Healing

Background/Objectives: This study developed and characterized hydrogels (HG-CGG) and films (F-CGG) based on cationic guar gum (CGG) for application in wound healing. Methods: HG-CGG (2% w/v) was prepared by gum thickening and evaluated for pH, stability, spreadability, and viscosity. F-CGG was obtained using an aqueous dispersion of CGG (6% w/v) and the solvent casting method. F-CGG was characterized for thickness, weight uniformity, morphology, mechanical properties, hydrophilicity, and swelling potential. Both formulations were evaluated for bioadhesive potential on intact and injured porcine skin, as well as antioxidant activity. F-CGG was further studied for biocompatibility using hemolysis and cell viability assays (L929 fibroblasts), and its wound-healing potential by the scratch assay. Results: HG-CGG showed adequate viscosity and spreadability profiles for wound coverage, but its bioadhesive strength was reduced on injured skin. In contrast, F-CGG maintained consistent bioadhesive strength regardless of skin condition (6554.14 ± 540.57 dyne/cm2 on injured skin), presenting appropriate mechanical properties (flexible, transparent, thin, and resistant) and a high swelling capacity (2032 ± 211% after 6 h). F-CGG demonstrated superior antioxidant potential compared to HG-CGG (20.50 mg/mL ABTS+ radical scavenging activity), in addition to exhibiting low hemolytic potential and no cytotoxicity to fibroblasts. F-CGG promoted the proliferation of L929 cells in vitro, supporting wound healing. Conclusions: Therefore, CGG proved to be a promising material for developing formulations with properties suitable for cutaneous use. F-CGG combines bioadhesion, antioxidant activity, biocompatibility, cell proliferation, and potential wound healing, making it promising for advanced wound treatment.

Belgian atopic dermatitis guidelines

Atopic dermatitis (AD) is one of the most common, bothersome and difficult to treat skin disorders. Recent introduction of new systemic treatments has revolutionized the management of AD. The goal of this guideline is to provide evidence-based recommendations for the management of patients suffering from atopic dermatitis that easily can be implemented in clinical practice. These recommendations were developed by 11 Belgian AD experts. Comments of all experts on the proposed statements were gathered, followed by an online voting session. The most relevant strategies for the management and treatment of AD in the context of the Belgian health care landscape are discussed. General measures, patient education and adequate topical treatment remain the cornerstones of AD management. For moderate to severe AD, the introduction of biologics and JAK inhibitors show unprecedented efficacy, although currently access is limited to a subgroup of patients meeting the reimbursement criteria.

The Future of Functional Clothing for an Improved Skin and Textile Microbiome Relationship

The skin microbiome has become a hot field of research in the last few years. The emergence of next-generation sequencing has given unprecedented insights into the impact and involvement of microbiota in skin conditions. More and more cosmetics contain probiotics or bacteria as an active ingredient, with or without scientific data. This research is also acknowledged by the textile industry. There has been a more holistic approach on how the skin and textile microbiome interacts and how they influence the pH, moisture content and odour generation. To date, most of the ingredients have a broad-spectrum antibacterial action. This manuscript covers the current research and industry developments in the field of skin and textiles. It explores the nature of antimicrobial finishing in textiles which can disrupt the skin microbiome, and the benefits of more natural and microbiome friendly therapies to combat skin conditions, malodour and skin infection.

Fabric Selection in Atopic Dermatitis: An Evidence-Based Review

BACKGROUND

Clothing fabrics interact closely with the skin to shape our cutaneous microenvironment. Cotton and silk have been traditionally recommended for patients with atopic dermatitis because of reported patient comfort. New synthetic fabrics combine anti-microbial, anti-inflammatory, moisture-wicking, and soothing properties that may augment conventional management strategies in atopic patients.

OBJECTIVE

We review existing and emerging evidence for fabric selection in patients with atopic dermatitis including cotton, wool, lyocell, silk, anionic, cellulosic/cellulose based, zinc oxide coated, citric acid coated, chitosan coated, silver coated, borage seed oil coated, ethylene vinyl, and polyurethane and offer practical suggestions for clothing and bedding choices.

METHODS

A systematic search was conducted on PubMed and EMBASE electronic databases for articles from 1 January, 1994 to 1 January, 2020. Studies were included based on the following inclusion criteria: clinical trial, published in English, and fabric as the main agent being evaluated. Case reports, case series, conference abstracts, reviews, animal studies, and duplicates were excluded. Studies were then manually screened by title, abstract, and full-text articles and selected to specifically describe the effects of fabrics in patients with atopic dermatitis. Both adult and pediatric patient studies were included.

RESULTS

There appears to be an advantage to modern fabric manufacturing and processing techniques that have created smaller diameter, smoother fibers such as super- and ultrafine merino wool and anti-microbial finishes. Traditional cotton and silk fabrics have mixed evidence in improving atopic dermatitis symptoms and severity but have shown to be generally safe. Large-diameter wool has been shown to induce itching and irritation; ultra- or superfine merino wool is non-pruritic and may be recommended as an alternative. Emerging fabrics with potential efficacy in reducing atopic dermatitis severity and Staphylococcus aureus burden include silver-coated, chitosan-coated, and cellulose-based fabrics. Zinc oxide-coated, acid-coated, polyurethane-coated, borage seed oil-coated, anionic, lyocell, and ethylene vinyl fabrics have sparse evidence and require further study before conclusions can be made.

CONCLUSIONS

Appropriate fabric selection can reduce the symptom severity and exacerbations of atopic dermatitis.

Influence of silk clothing therapy in patients with atopic dermatitis

The existence of red, inflammatory, and chronic itchy condition in the skin is commonly speculated as the presence of Atopic Dermatitis (AD) in patients. The use of silk clothing as a non-pharmacological approach in the management of AD has been noticed as an effective alternative therapy; however, the evidence based on its usage is poorly served. Hence, we aim to evaluate the effectiveness of using pure silk clothing in the therapy of AD patients. The clinical trial was performed by recruiting 30 patients with AD for up to 8 weeks of observation. They were instructed to wear pure silk clothing for the whole day without any additional medication and were investigated using the AD-related questionnaires. The findings revealed a significant decrease of AD occurrence along with a great improvement of patient’s quality of life at each time point. Our investigation demonstrated that this treatment promotes good skin appearance, comfort, and remarkable improvement in the quality of life. This promising preliminary outcome warrants a further study; hence, it can be a potential non-pharmacological treatment choice for controlling the severity of AD.

Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II

This guideline was developed as a joint interdisciplinary European project, including physicians from all relevant disciplines as well as patients. It is a consensus-based guideline, taking available evidence from other guidelines, systematic reviews and published studies into account. This second part of the guideline covers antimicrobial therapy, systemic treatment, allergen-specific immunotherapy, complementary medicine, psychosomatic counselling and educational interventions, whereas the first part covers methods, patient perspective, general measures and avoidance strategies, basic emollient treatment and bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy. Management of AE must consider the individual clinical variability of the disease. Systemic immunosuppressive treatment with cyclosporine, methotrexate, azathioprine and mycophenolic acid is established option for severe refractory cases, and widely available. Biologicals targeting the T helper 2 pathway such as dupilumab may be a safe and effective, disease-modifying alternative when available. Oral drugs such as JAK inhibitors and histamine 4 receptor antagonists are in development. Microbial colonization and superinfection may cause disease exacerbation and can require additional antimicrobial treatment. Allergen-specific immunotherapy with aeroallergens may be considered in selected cases. Psychosomatic counselling is recommended especially in stress-induced exacerbations. Therapeutic patient education ('Eczema school') is recommended for children and adult patients. General measures, basic emollient treatment, bathing, dietary intervention, topical anti-inflammatory therapy, phototherapy and antipruritic therapy have been addressed in the first part of the guideline.

An Interaction of Rhamnolipids with Cu2+ Ions

This study was focused on the description of interaction between Cu²⁺ ions and the 1:1 mono- and dirhamnolipid mixtures in the premicellar and aggregated state in water and 20 mM KCl solution at pH 5.5 and 6.0. The critical micelle concentration of biosurfactants was determined conductometrically and by the pH measurements. Hydrodynamic diameter and electrophoretic mobility were determined in micellar solutions using dynamic light scattering and laser Doppler electrophoresis, respectively. The copper immobilization by rhamnolipids, methylglycinediacetic acid (MGDA), and ethylenediaminetetraacetic acid (EDTA) was estimated potentiometrically for the Cu²⁺ to chelating agent molar ratio from 16:100 to 200:100. The degree of ion binding and the complex stability constant were calculated at a 1:1 metal to chelant molar ratio. The aggregates of rhamnolipids (diameter of 43-89 nm) were negatively charged. Biosurfactants revealed the best chelating activities in premicellar solutions. For all chelants studied the degree of metal binding decreased with the increasing concentration of the systems. The presence of K⁺ lowered Cu²⁺ binding by rhamnolipids, but did not modify the complex stability significantly. Immobilization of Cu²⁺ by biosurfactants did not cause such an increase of acidification as that observed in MGDA and EDTA solutions. Rhamnolipids, even in the aggregated form, can be an alternative for the classic chelating agents.

Functionalized Textile Based Therapy for the Treatment of Atopic Dermatitis

Atopic dermatitis (AD) is a common chronic inflammatory skin condition characterized by intense puritus and skin dryness. The pathogenesis for AD has not been fully understood to date. Complementary therapies are very popular as effective treatment for AD among clinical practitioners. This study presents a comprehensive review of published works associated with textiles-based complementary therapies for AD treatment such as wet-wrap dressing, functionalized textiles, and the application of hydrogel techniques in the textile industry to provide a better understanding of the development and design of new textiles-based transdermal therapies.