Study of the effect of using a foam form with ceramides and a cholesterol-phytosterol complex in patients with atopic dermatitis

Cover Page

Cite item

Abstract

Background. In developed countries more than 20% of children have atopic dermatitis (AD). Clinical guidelines unite in the recommendation to use moisturizers/emollients as therapy mainstay. Deeper understanding of AD pathogenesis stimulates development of new, therapeutic moisturizers. To such moisturizers belong ceramide-containing moisturizers, in particular foam for moisturizing and nourishing dry sensitive skin with ceramides and a cholesterol-phytosterol complex.

Aim. To study effects of foam for moisturizing and nourishing dry sensitive skin with ceramides and a cholesterol-phytosterol complex on the course mild to moderate severity AD.

Materials and methods. In this prospective cohort study 30 children 3 to 17 years of age with mild to moderate severity AD were enrolled. They applied moisturizing foam skin lesion, surrounding skin and dry skin areas for 4 weeks. For all participants severity of AD was scored with SOCARD, EASI, IGA, skin pH, moisture and transepidermal water loss (TEWL) were measured and severity of itching and xerosis was elicited with visual analogue scale.

Results. Severity of AD in children who applied foam decreased on 22.8 score points with SCORAD, and on 3.1 points with EASI (for both indices p<0.001). Skin moisture during treatment period increased (23.5% to baseline; p<0.001), and TEWL decreased (for 5.45 g/h×m2; p<0.001); skin pH decreased 0.2 unit to normal values (р=0.002). It was found that skin moisture and TEWL correlate with AD severity so that less severe AD associated with moisture increase and TEWL decrease. As “good” and “excellent” rated foam smell 100% (95% CI 88.4–100%) respondents, consistence – 90% (95% CI 73.5–98.0%), and ease of use – 97% (95% CI 82.8–99.9%) respondents.

Conclusion. Moisturizing foam with ceramides and a cholesterol-phytosterol complex might be used in AD therapy.

Full Text

Restricted Access

About the authors

Denis V. Zaslavsky

Saint-Petersburg State Pediatric Medical University

Author for correspondence.
Email: venerology@gmail.com
ORCID iD: 0000-0001-5936-6232
SPIN-code: 5832-9510

D. Sci. (Med.), Prof.

Russian Federation, Saint Peterburg

Anna N. Barinova

Mechnikov North-Western State Medical University; City Hospital No. 26

Email: anna_n_barinova@mail.ru
ORCID iD: 0000-0002-8180-9340
SPIN-code: 2010-4354

D. Sci. (Med.)

Russian Federation, Saint Petersburg; Saint Petersburg

Sviatoslav L. Plavinskij

Mechnikov North-Western State Medical University

Email: s.plavinskij@szgmu.ru
ORCID iD: 0000-0001-9159-6177
SPIN-code: 5660-4661

D. Sci. (Med.)

Russian Federation, Saint Petersburg

Maria I. Zelianina

The Pierre Wolkenstein French Dermatological Clinic, LLC

Email: m.zelianina@rambler.ru
ORCID iD: 0000-0002-0172-9763

Dermatologist

Russian Federation, Saint Petersburg

Elena S. Manylova

Saint-Petersburg State Pediatric Medical University

Email: tulechka78@mail.ru

Dermatologist

Russian Federation, Saint Peterburg

References

  1. Roduit C, Frei R, Depner M, et al. Phenotypes of Atopic Dermatitis Depending on the Timing of Onset and Progression in Childhood. JAMA Pediatr. 2017;171(7):655-62.
  2. Saini S, Pansare M. New Insights and Treatments in Atopic Dermatitis. Pediatr Clin North Am. 2019;66(5):1021-33.
  3. Wollenberg A, Barbarot S, Bieber T, et al. Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part II. J Eur Acad Dermatol Venereol. 2018;32(6):850-78. doi: 10.1111/jdv.14888
  4. Lewis-Jones S, Mugglestone MA. Management of atopic eczema in children aged up to 12 years: summary of NICE guidance. BMJ. 2007;335(7632):1263-4.
  5. Strathie Page S, Weston S, Loh R. Atopic dermatitis in children. Aust Fam Physician. 2016;45(5):293-6.
  6. Атопический дерматит. Клинические рекомендации, 2021. Режим доступа: https://cr.minzdrav.gov.ru/recomend/265_2. Ссылка активна на 15.06.2022 [Atopicheskii dermatit. Klinicheskie rekomendatsii, 2021. Available at: https://cr.minzdrav.gov.ru/recomend/265_2. Accessed: 15.06.2022 (in Russian)].
  7. LePoidevin LM, Lee DE, Shi VY. A comparison of international management guidelines for atopic dermatitis. Pediatr Dermatol. 2019;36(1):36-65.
  8. Заславский Д.В., Баринова А.Н. Микробиом кожи при атопическом дерматите и особенности различных средств базисного ухода за кожей. Медицинский совет. 2018;(2):170-6 [Zaslavskii DV, Barinova AN. Mikrobiom kozhi pri atopicheskom dermatite i osobennosti razlichnykh sredstv bazisnogo ukhoda za kozhei. Meditsinskii sovet. 2018;(2):170-6 (in Russian)].
  9. Заславский Д.В., Баринова А.Н. Новая стратегия базовой увлажняющей терапии при атопическом дерматите – «эмоленты плюс». Дерматовенерология. Косметология. 2019;5(1):69-79 [Zaslavskii DV, Barinova AN. Novaia strategiia bazovoi uvlazhniaiushchei terapii pri atopicheskom dermatite – „emolenty plius“. Dermatovenerologiia. Kosmetologiia. 2019;5(1):69-79 (in Russian)].
  10. Pacha O, Hebert AA. Treating atopic dermatitis: safety, efficacy, and patient acceptability of a ceramide hyaluronic acid emollient foam. Clin Cosmet Investig Dermatol. 2012;5:39-42.
  11. Fujii M. The Pathogenic and Therapeutic Implications of Ceramide Abnormalities in Atopic Dermatitis. Cells. 2021;10(9):2386. doi: 10.3390/cells10092386
  12. Ishida K, Takahashi A, Bito K, et al. Treatment with Synthetic Pseudoceramide Improves Atopic Skin, Switching the Ceramide Profile to a Healthy Skin Phenotype. J Invest Dermatol. 2020;140(9):1762-70.
  13. McClanahan D, Wong A, Kezic S, et al. A randomized controlled trial of an emollient with ceramide and filaggrin-associated amino acids for the primary prevention of atopic dermatitis in high-risk infants. J Eur Acad Dermatol Venereol. 2019;33(11):2087-94.
  14. Hon KL, Pong NH, Wang SS, et al. Acceptability and efficacy of an emollient containing ceramide-precursor lipids and moisturizing factors for atopic dermatitis in pediatric patients. Drugs R D. 2013;13(1):37-42.
  15. Lynde CW, Andriessen A. A cohort study on a ceramide-containing cleanser and moisturizer used for atopic dermatitis. Cutis. 2014;93(4):207-13.
  16. Fischer CL, Drake DR, Dawson DV, et al. Antibacterial activity of sphingoid bases and fatty acids. Biol Chem. 2010;391(1): 65-71.
  17. Maurya AK, Singh M, Dubey V, at al. α-(-)-bisabolol Reduces Pro-inflammatory Cytokine Production and Ameliorates Skin Inflammation. Curr Pharm Biotechnol. 2014;15(2):173-81. doi: 10.2174/1389201015666140528152946
  18. Youn HJ, Kim SY, Park M, et al. Efficacy and Safety of Cream Containing Climbazole/Piroctone Olamine for Facial Seborrheic Dermatitis: A Single-Center, Open-Label Split-Face Clinical Study. Ann Dermatol. 2016;28(6):733-9. doi: 10.5021/ad.2016.28.6.733
  19. Hebert AA, Rippke F, Weber TM, Nicol NH. Efficacy of Nonprescription Moisturizers for Atopic Dermatitis: An Updated Review of Clinical Evidence. Am J Clin Dermatol. 2020;21(5):641-55.
  20. Chiu LS, Chow VC, Ling JM, Hon KL. Staphylococcus aureus carriage in the anterior nares of close contacts of patients with atopic dermatitis. Arch Dermatol. 2010;146:748-52.
  21. HanifIn JM, Rajka G. Diagnostic features of atopic dermatitis. Acta Derm Venereol. 1980;92(Suppl.):44-7.
  22. Панова О.С., Губанова Е.И., Лапатина Н.Г., и др. Современные методы оценки гидратации и биомеханических свойств кожи. Вестник дерматологии и венерологии. 2009;(2):80-7 [Panova OS, Gubanova EI, Lapatina NG, et al. Sovremennye metody otsenki gidratatsii i biomekhanicheskikh svoistv kozhi. Vestnik dermatologii i venerologii. 2009;(2):80-7 (in Russian)].
  23. Пинсон И.Я., Верхогляд И.В. Клиническая оценка эффективности радиочастотного фракционного воздействия при инволюционных изменениях кожи. Российский журнал кожных и венерических болезней. 2017;20(5):297-304 [Pinson IIa, Verkhogliad IV. Klinicheskaia otsenka effektivnosti radiochastotnogo fraktsionnogo vozdeistviia pri involiutsionnykh izmeneniiakh kozhi. Rossiiskii zhurnal kozhnykh i venericheskikh boleznei. 2017;20(5):297-304 (in Russian)].
  24. Oranje AP. Practical issues on interpretation of scoring atopic dermatitis: SCORAD Index, objective SCORAD, patient-oriented SCORAD and Three-Item Severity score. Curr Probl Dermatol. 2011;41:149-55.
  25. Hanifin JM, Baghoomian W, Grinich E, et al. The Eczema Area and Severity Index – A Practical Guide. Dermatitis. 2022;33(3):187-92.
  26. Юрьев В.К., Заславский Д.В., Моисеева К.Е. Методика расчета и анализ показателей деятельности учреждения здравоохранения. Учебно-методическое пособие для самостоятельной работы студентов. СПб., 2009 [Iur'ev VK, Zaslavskii DV, Moiseeva KE. Metodika rascheta i analiz pokazatelei deiatel'nosti uchrezhdeniia zdravookhraneniia. Uchebno-metodicheskoe posobie dlia samostoiatel'noi raboty studentov. Saint Petersburg, 2009 (in Russian)].
  27. Заславский Д.В., Харбедия Ш.Д., Хведелидзе М.Г., и др. Результаты оценки пациентами деятельности медицинского персонала. В: Новые горизонты: инновации и сотрудничество в медицине и здравоохранении. Материалы IX российско-немецкой научно-практической конференции Форума им. Р. Коха и И.И. Мечникова. Под ред. О.В. Кравченко, Г. Хана. 2010; 28-9 [Zaslavskii DV, Kharbediia ShD, Khvedelidze MG, et al. Rezul'taty otsenki patsientami deiatel'nosti meditsinskogo personala. In: Novye gorizonty: innovatsii i sotrudnichestvo v meditsine i zdravookhranenii. Materialy IX rossiisko-nemetskoi nauchno-prakticheskoi konferentsii Foruma im. R. Kokha i I.I. Mechnikova. Pod red. OV Kravchenko, G Khana. 2010; 28-9 (in Russian)].
  28. Мурашкин Н.Н., Иванов А.М., Заславский Д.В., Камилова Т.А. Вопросы эффективности и безопасности применения системных ретиноидов в терапии акне у подростков. Вестник дерматологии и венерологии. 2010;(5):112-6 [Murashkin NN, Ivanov AM, Zaslavskii DV, Kamilova TA. Voprosy effektivnosti i bezopasnosti primeneniia sistemnykh retinoidov v terapii akne u podrostkov. Vestnik dermatologii i venerologii. 2010;(5):112-6 (in Russian)].
  29. Юрьев В.К., Заславский Д.В., Витенко Н.В., и др. Некоторые результаты оценки пациентами качества медицинской помощи. Ученые записки СПбГМУ им. акад. И.П. Павлова. 2010;17(2):5-7 [Iur'ev VK, Zaslavskii DV, Vitenko NV, et al. Nekotorye rezul'taty otsenki patsientami kachestva meditsinskoi pomoshchi. Uchenye zapiski SPbGMU im. akad. I.P. Pavlova. 2010;17(2):5-7 (in Russian)].

Supplementary files

Supplementary Files
Action
1. Fig. 1. Improvement of SCORAD and EASI indices at the visits 2 and 3.

Download (92KB)
2. Fig. 2. Improvement of skin hydration at the visits 2 and 3 versus baseline.

Download (60KB)
3. Fig. 3. Improvement (reduction) of transepidermal water loss (TEWL) and pH depending on the baseline. Since there was no improvement of 50%, no data are reported.

Download (64KB)
4. Fig. 4. Patient A., mild-to-moderate AD before (a) and after 4-week therapy with the study drug (b).

Download (69KB)
5. Fig. 5. Patient B., mild-to-moderate AD before (a) and after 4-week therapy with the study drug (b).

Download (96KB)
6. Fig. 6. Patient C., mild-to-moderate AD before (a) and after 4-week therapy with the study drug (b).

Download (69KB)

Copyright (c) 2022 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 74329 от 19.11.2018 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies