Herbals Popular In Treatment Of Dermatitis

Licorice (Glycyrrhizin) Glycyrrhizinic acid has also been shown to improve dermatitis. In a study by Saeedi and associates, 2% glycyrrhizinic acid gel was reported to significantly decrease scores for erythema, edema, and itching over the 2-week treatment period. A recent study by Dieck and associates found that licochalcone A exhibited a potent anti-inflammatory action on a broad range of skin cells involved in skin inflammation.

Glycyrrhiza glabra L. has been used in herbal medicine for skin eruptions, including dermatitis, eczema, pruritus and cysts. The effect of licorice extract as topical preparation was evaluated on atopic dermatitis. The plant was collected and extracted by percolation with suitable solvent. The extract was standardized, based on Glycyrrhizinic acid by using a titrimetry method. Different topical gels were formulated by using different co-solvents. After standardizing of topical preparations, the best formulations (1% and 2%) were studied in a double-blind clinical trial in comparison with base gel on atopic dermatitis over two weeks (30 patients in each group). Propylene glycol was the best co-solvent for the extract and Carbopol 940 as gelling agent showed the best results in final formulations. The quantity of glycyrrhizinic acid was determined 20.3% in the extract and 19.6% in the topical preparation. Two percent licorice topical gel was more effective than 1% in reducing the scores for erythema, oedema and itching over two weeks. The results showed that licorice extract could be considered as an effective agent for treatment of atopic dermatitis.

Saeedi M, Morteza-Semnani K, Ghoreishi MR., Department of Pharmaceutics, Mazandaran University of Medical Sciences, Sari, Iran

Topical B-12 Vitamin For Treatment of Atopic Dermatitis

Topical vitamin B12--a new therapeutic approach in atopic dermatitis-evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial.

Stucker M, Pieck C, Stoerb C, Niedner R, Hartung J, Altmeyer P. Clinic for Dermatology and Allergology, Ruhr University Bochum, Germany.

BACKGROUND: Vitamin B(12) is an effective scavenger of nitric oxide (NO). As the experimental application of a NO synthase inhibitor, N omega-nitro-L-arginine, led to a clear decrease in pruritus and erythema in atopic dermatitis, it would be reasonable to assume a comparable effect of vitamin B(12). OBJECTIVES: The efficacy and tolerability of a new vitamin B(12) cream as a possible alternative to current therapies was examined. METHODS: A prospective, randomized and placebo-controlled phase III multicentre trial, involving 49 patients was conducted. For the treatment duration of 8 weeks, each patient applied twice daily (in the morning and evening) the vitamin B(12)-containing active preparation to the affected skin areas of one side of the body and the placebo preparation to the contralateral side according to the randomization scheme. RESULTS: On the body side treated with the vitamin B(12) cream, the modified Six Area Six Sign Atopic Dermatitis score dropped to a significantly greater extent than on the placebo-treated body side (for the investigational drug 55.34 +/- 5.74 SEM, for placebo 28.87 +/- 4.86 SEM, P < 0.001). At the conclusion of the study, the investigator and patients awarded mostly a 'good' or 'very good' rating to the active drug (58% and 59%, respectively) and a 'moderate' or 'poor' rating to the placebo (89% and 87%, respectively). CONCLUSIONS: Topical vitamin B(12) is a new therapeutic approach in atopic dermatitis. These results document a significant superiority of vitamin B(12) cream in comparison with placebo with regard to the reduction of the extent and severity of atopic dermatitis. Furthermore, the treatment was very well tolerated and involved only very low safety risks for the patients.

Seborrheic Dermatitis Or Scalp Psoriasis

Scalp psoriasis and seborrheic dermatitis of the scalp can be hard to differentiate. Both are common skin disorders that often affect the scalp. They share some similar symptoms — such as itchy, red, scaly skin. Fortunately, they also share some similar treatments, including daily use of an over-the-counter medicated shampoo, containing:
Ketoconazole
Tar
Pyrithione zinc
Selenium sulfide
Salicylic acid
There is no single test to confirm a diagnosis of psoriasis or seborrheic dermatitis. These skin disorders typically are diagnosed with a visual exam of the affected skin. Sometimes, however, a skin biopsy may be used to help differentiate between the two disorders.

Rosacea Dermatitis

The Rosacea Sufferer often has Seborrheic Dermatitis which co-exist in 35% of sufferers which makes for a most delicate skin condition. Seborrheic dermatitis involves overactive sebaceous glands which cause inflammation, flaking and a red rash in the central portion of the face. If one looks closely, the flakes usually have a greasy look, smell and feel. The dryness of seborrheic dermatitis is perceived because of the flaking which consists of dried layers of accumulated oil.

A new entitiy of rosacea has been clasified as rosacea dermatitis. This varies but is similar to seborrheic dermatitits.

Rosacea dermatitis is caused by chronic dermal inflammation from damaged or dysfunctional blood vessels. Over time this can alter the skin’s immune system, the health of the dermal cells and the growth rate of epidermal cells.

Rosacea dermatitis is often confused with atopic dermatitis, eczema or seborrheic dermatitis. A rosacea sufferer with rosacea dermatitis is much more prone to itching, burning, stinging, “angry face syndrome’, and scaling. In certain areas of the face rosacea dermatitis can result in extremely thin skin by slowing the growth of epidermal cells and in other areas of the face can result in dry patches of skin from a natural protective reaction to the inflammatory cycle. Physicians must now consider this dermatitis also instead of just making a quick diagnosis of atopic dermatitis, eczema, or seborrheic dermatitis.

Shoe Allergy Dermatitis

If you are experiencing itchiness on your feet that does not respond to treatment, you may have a shoe allergy. Such feet allergies are common, yet the symptoms are often overlooked or misdiagnosed, says Cleveland Clinic dermatologist James S. Taylor, M.D.
Shoe allergy is a form of contact dermatitis, which is inflammation caused by contact of the skin with a particular substance. The rash is often confined to a specific area and has clearly defined boundaries. The allergy can cause red and swollen skin that may blister. Shoe allergy is often confused with atopic dermatitis, a chronic itchy inflammation of the skin that is common in people who have hay fever or asthma. There are two types of contact dermatitis. In the irritant type, exposure to substances such as soaps, detergents or metals may irritate the skin. In the allergic type, exposure to a substance is the cause, but the initial exposure or even numerous subsequent exposures will not cause an allergic reaction.
Allergic contact dermatitis of the foot develops over time, as the skin of the foot is repeatedly exposed to an allergen, a substance that causes an allergic reaction. "Building an allergic reaction can take years," notes Dr. Taylor, who heads the Clinic’s section of industrial and environmental dermatology, and writes and lectures on shoe allergies. "So it’s not unusual for someone to ‘suddenly’ become allergic to a substance they’ve had contact with for a long time."
Diagnosis can be trickyThe most common shoe allergens include rubber, chemicals used in tanning leather, and adhesive materials and dyes. Sometimes metal buckles or shoelace grommets may cause contact allergy. Sport shoes are often implicated in shoe allergy, although this may be because they are widely worn by many people. Footwear that keeps feet in a warm, moist environment—work shoes are a good example—are common culprits. Sandals, on the other hand, are less often associated with shoe allergy. Their open design allows feet to "breathe," and there isn’t as much shoe material to irritate the feet.
Because allergic contact dermatitis can be difficult to distinguish from other rashes, the diagnosis can be elusive. A skilled dermatologist will use the location of the rash to help identify shoe allergy. For example, dermatitis on the sole of the foot points to an allergy to the insole or shoe lining. A rash on the top of the foot suggests an allergy to the shoe upper. Dermatitis between the toes, however, is likely caused by a bacterial or fungal infection, says Dr. Taylor.
Patch testingIdentifying the specific allergen can be challenging, and patch testing is the procedure useful in making the diagnosis. Patch tests are performed by applying small amounts of potential allergens directly onto the skin with tape. The tape strips are removed after 48 hours. A reaction is characterized by a small red spot that appears at the patch site.
"If the allergen can be identified and avoided, most shoe allergies can be cleared up completely," says Dr. Taylor. In some patients, treatment may include medication to control excessive sweating, since sweat can aggravate dermatitis.

© Copyright 1995-2005 The Cleveland Clinic Foundation. All rights reserved