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Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dry skin symptoms such as scaling and itching are often treated with lipophilic moisturizers. The aim of this study was to investigate the effect of lipophilic moisturizers on the stratum corneum (SC) ultra-structure and lipid organization. Lipophilic moisturizers were applied on the forearms of 4 healthy volunteers for 3 h. Subsequently, the application sites were tape stripped, and selected tape strips prepared for Freeze Fracture Electron Microscopy (FFEM), a method to visualize the SC intercellular lipid parallel to the skin surface. To investigate the effect of lipid moisturizers on the lipid lamellae, isolated SC was pretreated with the lipophilic moisturizers for 24 h prior to performing small angle X-ray diffraction (SAXD) measurements. Additionally, the lipid organization of mixtures prepared with ceramides, cholesterol, free fatty acids and lipophilic moisturizer in a 2:1:1:1 molar ratio were studied using SAXD. The FFEM data (in vivo) as well as the SAXD data (in vitro) show that the lipophilic moisturizers do not change the lipid lamellar organization in the SC. Addition of 20% m/m lipophilic moisturizer to the ceramide:cholesterol:free fatty acids mixture did not inhibit the formation of the long periodicity phase, the characteristic lamellar phase in the SC, even though there was clear evidence that two of the three moisturizers were at least partially incorporated in the long periodicity phase. Concluding, all findings suggest that the lipophilic moisturizers investigated in this study do not drastically change the lamellar organization of the SC intracellular lipid matrix, but that the moisturizers form separate domains in the SC, as was visualized by FFEM.
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PMID:Interaction of lipophilic moisturizers on stratum corneum lipid domains in vitro and in vivo. 1739 52

Atopic dermatitis is a common disease which varies widely in clinical presentation at different ages and places. Although authors working in western countries on white races have suggested many criteria, there is no uniform set which can be used in large population studies in this part of the world. Hence keeping in mind differences in environment and ethnicity of population, the present study was carried out. Seventy-three patients of atopic dermatitis and 71 age matched controls were studied. All the subjects were examined using a set of 34 potentially useful clinical features selected from different studies, including features for evaluation of photosensitivity. Multiple regression technique was used for analysing the data. It was found that 6 clinical features were diagnostic, 1. presence of itch, 2. history of flexural involvement, 3. history of dry skin, 4. family history of atopy, 5. personal history of diagnosed asthma and 6, visible flexural dermatitis. Photosensitivity was not a significant feature.
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PMID:Diagnostic clinical features of atopic dermatitis. 1766 94

Dry skin is a common skin condition as well as a key aspect of a number of diseases such as atopic dermatitis and psoriasis but also of other diseases and systemic conditions. Dry skin has an impact on the patient in terms of discomfort, pruritus and impaired quality of life. Within the overall treatment regimen for these diseases, the use of emollients to manage dry skin plays a considerable role in managing skin conditions. In atopic dermatitis and psoriasis, emollients help to improve skin condition and to reduce pruritus alongside more potent pharmacological agents. It is important to choose an emollient that not only soothes and rehydrates the skin but also offers numerous other dermatological supporting roles, especially induction of proper epidermal differentiation. This review will explain the role of emollients within the management of diseases with dry skin as a major symptom and the components of an ideal emollient.
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PMID:The role of emollients in the management of diseases with chronic dry skin. 1818 66

The structure, composition, formation and function of the stratum corneum have been the subject of intense research over the last few decades. As has become apparent, stratum corneum barrier function is not only dependent on one single component but also on its total architecture. Recent developments in understanding lipid composition have led to a new ceramide nomenclature system, a new proposal for a molecular model of the interactions between ceramides, cholesterol and fatty acids, and the demonstration of the presence of crystalline orthorhombic and gel hexagonal lipid phases in the stratum corneum. Linoleate-containing ceramide one, now known as CER EOS, have been shown to be essential for the formation of the 13 nm long periodicity phase (LPP) observed by electron microscopy and X-ray diffraction studies, whereas long-chain fatty acids are important for the formation of the crystalline lipid phases essential for barrier function. The role of the corneocyte envelope, its constituent proteins and its transglutaminase-mediated maturation processes have been shown to be essential for good skin condition. Several proteases may have a role in corneodesmolysis, particularly serine and cathepsin-like enzymes. Novel filaggrin polymorphisms have been identified that may be involved in the expression of a dry skin phenotype. Disturbances in lipid packing states, reduction in ceramide levels (particularly the phytosphingosine-containing ceramides), reductions in the levels of long-chain fatty acids and loss of the LPP largely account for the perturbations in lipid structure that occur in dry skin. The reduced corneodesmolysis that occurs in this xerotic skin disorder is now well accepted and is caused by reductions in the levels and activities of stratum corneum proteases together with elevated levels of corneodesmosomal glycoproteins in the superficial layers of the stratum corneum. Additionally, increased levels of fragile corneocytes are associated with reduced transglutaminase activity and corneocyte envelope cross-linking events. However, in comparison with the advances in our understanding of the textural changes that occur in dry skin, the somatosensory changes are poorly understood and the itching associated with dry skin is still an under-researched area. The unique biosensor role of the stratum corneum essential for a competent natural moisturizing barrier may also have a role to play in the action of anti-ageing technologies by controlling the expression and secretion of epidermal cytokines and growth factors. Technologies to treat the surface textural skin problems, enhance the differentiation process, particularly lipid biosynthesis, and to control the somatosensory problems in dry skin have received much attention in the last decade. This paper will review the state of the art of stratum corneum biology and the trends in the management of dry skin.
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PMID:Trends in stratum corneum research and the management of dry skin conditions. 1849 84

Itch is a common symptom in dry skin related to inflammatory skin diseases, normal aging, and systemic diseases such as chronic renal failure, and HIV. However, correlations between itch and objective measures of barrier function and skin dryness such as skin hydration and transepidermal water loss have been rarely found. Recent experimental evidence indicates that damage to the stratum corneum with acetone/ether and water elicits a scratching response in mice and rats. These responses correlate to the number of PGP 9.5 immunoreactive fibers in the epidermis and to FOS-like immunoreactivity in the spinal cord. Other neuromediators involved in the pathogenesis of itch in dry skin are nerve growth factor (NGF), muscarinic acetylcholine receptors, and opiates. Serine proteases such as tryptase and their respective proteinase-activating receptor 2 (PAR2), recently found in both skin and nerves of patients with atopic eczema, suggest that these molecules may have a role in itch in dry skin. This has also been exemplified in the itchy and hyperkeratotic phenotype of the stratum corneum chymotryptic enzyme (SCCE) transgenic mouse model, which is over-expressing a serine protease. Developing inhibitors to these neuropeptides and mediators may be an attractive strategy for anti-itch treatment. The significant progress made in development of moisturizers may have an additional benefit in reducing the itch associated with dry skin. Formulating topical combination therapies containing moisturizers and anti-pruritics can significantly reduce the itch associated with dry skin. This paper will review the current clinical knowledge on the association between dry skin and itch and the recent advances in understanding the pathophysiology of this problem.
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PMID:Dry skin and impairment of barrier function associated with itch - new insights. 1849 19

Atopic eczema (AE) is a chronic inflammatory skin disease characterized by pruritus, dry skin and an ongoing course of exacerbations and remissions. AE is a common disorder in children with a worldwide cumulative prevalence of 15-20% in this age group. AE has a strong familial predisposition. While AE is a complex disease with multiple gene involvement, recent interest has focused on genes involved in skin barrier/epidermal differentiation and in immune response/host defense. Recent developments and future directions on pathogenesis, diagnosis, natural course and prognosis are discussed.
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PMID:New visions for atopic eczema: an iPAC summary and future trends. 1866 60

Primary hyperidrosis (PH) is a disorder characterized by excessive eccrine sweat gland production that primarily involves the axillae as well as palms and soles. Common first-line topical treatment for PH consists of aluminum salts (AS) that act by physically blocking eccrine sweat gland ducts. However, primary irritant contact dermatitis is a common side effect of AS treatment. Recently, a new low-residue, thermophobic foam formulation containing 20% aluminum sesquichlorohydrate has been developed (Nidrox, Mipharm S.p.A.). To evaluate the local tolerability and efficacy of 20% aluminum sesquichlorohydrate foam in the treatment of axillary and palmar PH. Twenty subjects affected by PH were enrolled in a multicenter, open-label study. Local tolerability was evaluated by physicians assessing itching, burning, and skin irritation using a four-point score (from 0: no symptoms to 3: severe symptoms). Skin irritation was quantified with a visual score. Efficacy was assessed by means of Minor test score using a four-point score (range 0-3). The foam was applied to clean dry skin, every night during the first 2 weeks and three times a week during the following 2 weeks. Clinical evaluations were performed at baseline, at day 14 and at day 28. Patients were monitored throughout the study for adverse events. All 20 subjects completed the study. The foam induced a significant reduction of the Minor score in comparison with baseline values (p = 0.0002) both at day 14 and at day 28. At the end of the 4-week treatment period, the foam reduced eccrine sweating by 61% (Minor score: 3.3 vs. 8.5). No skin irritation was observed during the trial except for one subject who experienced a mild and transient itching sensation. No other side effects were reported during the study. This new foam appears to be an effective and well-tolerated topical treatment in reducing sweating in patients with axillary and palmar PH.
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PMID:An open-label tolerability and efficacy study of an aluminum sesquichlorohydrate topical foam in axillary and palmar primary hyperhidrosis. 1872 13

Xerosis or dry skin is a common skin disorder among the general population. It is characterized clinically by rough, scaly, and often itchy skin. This disorder is present in the course of some dermatoses such as atopic dermatitis, although it can also occur in healthy individuals if a combination of certain etiologic factors is present. It is characterized pathophysiologically by a disrupted stratum corneum, dehydration, and impaired keratinocyte differentiation. Treatment of xerosis should seek to restore physiologic lipids in the epidermis and provide substances that facilitate epidermal differentiation.
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PMID:[Xerosis: a dysfunction of the epidermal barrier]. 1908 5

EpiCeram consists of a specific combination of ceramides, cholesterol and fatty acids that mimics those naturally found in the skin. EpiCeram was approved by the FDA in April 2006 for use as a nonsteroidal lipid barrier emulsion to manage symptoms of burning and itching associated with dry skin conditions such as atopic dermatitis, irritant contact dermatitis, radiation dermatitis and other dermatoses. EpiCeram has shown comparable efficacy to a mid-strength topical corticosteroid in a clinical study involving 113 children with moderate to severe atopic dermatitis. Unlike topical steroids and immunomodulators such as calcineurin inhibitors that have clinically well-recognized undesirable side effects and usage restrictions (including FDA black box warning for the latter), current data suggests that EpiCeram has a favorable safety profile. Additionally, EpiCeram does not appear to have substantial restrictions associated with its use, especially with regards to the duration of use or patient age, compared to the other classes of prescription products.
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PMID:Epiceram for the treatment of atopic dermatitis. 1913 28

Atopic dermatitis affects 15 to 20% of the populations, the proportion being even larger in children. The diagnosis is a clinical one. Essential symptoms include itching and eczema on typical regions of the skin, as well as dry skin. The prognosis is good, but development of respiratory allergy is common. Instructed self-care constitutes the basis of therapy. The skin is inflamed and its care is essential. First line treatment comprises regular application of emollient cream and intermittent use of ointments containing corticosteroids.
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PMID:[Treatment of atopic eczema]. 1938 43


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