Identifying The Cause Of Dermatitis

The steps taken to identify the cause of dermatitis are akin to a detective story, in which a few clues may lead to a suspected allergen or irritant. Try to remember anything that changed prior to the reaction.
Was there any change in clothing, detergents, personal care items, behaviors, habits, or foods? A specific area of the body may point to a possible offender. For instance, if dermatitis is confined to the eyelids, the culprit may be a recent change in makeup procedures. The preservatives, vehicles, or colorants in eye makeup or eyelid cleansing products should be reviewed. Hair care products, eyelash curlers, or other facial cosmetics may also be the cause.
If an allergy to a ring has developed, often, there will be a ring of dermatitis under the ring. If the ring is a gold alloy, allergy to nickel in the ring is possible, but the probable cause is a detergent or other product to which the hands are exposed. An allergen or irritant residue can remain under the ring, where dermatitis eventually develops. To reduce this problem it is best to remove the ring until the hands are thoroughly washed and completely dried.
Parents may find that a child has dermatitis around the mouth. If the irritation extends in a complete circle at least one or more inches out from the lips, the culprit may be lip-licking. The child may have a nervous habit of licking the lips and face as far as the tongue will extend. Oral fluids are irritating to skin with constant exposure, and the child needs to be taught that licking causes the problem rather than soothes it. Other causes of lip inflammation include lip makeup, ingestion of oranges, apples, mangoes, potatoes, carrots, tomatoes and kiwi.
An underappreciated sensitizer is neomycin; a component of the most commonly sold topical antibiotic products (e.g., Mycitracin, Neosporin). These products are only safe for preventing infections in minor injuries. If a person develops an allergic reaction when using them as directed, they must be immediately discontinued. Since the appearance of an allergy to neomycin can cause cross-sensitivities with other aminoglycosides, such as gentamicin, one should choose a topical antibiotic free of neomycin.
Patients using veterinary products, such as Bag Balm, as hand softening agents may develop a quinolone sensitivity. In order to avoid this, you should be urged to only use products labeled for human use. Benzocaine is a sensitizer that is found in topical products for itch, burns, dermatitis, canker sores, insect bites, teething, and hemorrhoids. If you develop a sensitivity to these products, an alternate local anesthetics (e.g., pramoxine) should be chosen.

Alternative Treatments May Not Reduce Dermatitis Symptoms

Call it swimming against the tide of alternative medicine. It is a futile effort costing taxpayers tens of millions of dollars a year.

Last week’s study showing that the widely touted and sold supplement DHEA does nothing to slow the effects of aging was only the latest major piece of research with powerfully negative results from the National Institutes of Health Center for Complimentary and Alternative Medicine. Previous placebo-controlled trials proved the uselessness of St. John’s Wort for depression and saw palmetto for enlarged prostates, shark cartilage for cancer, echinacea for the common cold and glucosamine plus chondroitin sulphate for arthritis.
But it doesn’t matter much — few seem to care.

The NIH launched its office of Complementary and Alternative Medicine (CAM) in 1991 in response to the public’s huge interest in finding ways around mainstream medicine. At first, those heading the effort brought dubious credentials. Much of the research ranged from mediocre (meaningless animal studies) to laughable (passing magnets over sore knees).
But, in 1999, with the name changed to the National Center for CAM, Dr. Stephen E. Straus took over. Straus, who spent much of his career at the National Institute on Allergy and Infectious Diseases, enjoys a reputation as an accomplished scientist. In his time as director, the Center for CAM has spent much of its $122 million annual budget on clinical trials putting most popular alternative treatments to the same rigorous tests as those required of pharmaceuticals and medical devices before approval by the Food and Drug Administration.

Except for acupuncture, already proven effective in China, almost all the research has come to the same conclusion: the stuff doesn’t work.

The powerful industry that sells these products ignores the results and often finds allies who believe in them because of an anecdote or advertisement.

After the chondroitin results appeared, Jane Brody, the longtime health columnist for the New York Times who has always prided herself in offering advice based on scientific research, wrote that she would continue taking chondroitin for her knee pain because “it transformed my 11-year-old spaniel from an arthritic wreck into a companion with puppylike agility, giving him nearly six more active years."

CAM means many things — often just the search for care beyond the 12-minute visit to a harried physician. Some treatments under the alternative medicine heading, like massage, clearly do no harm and could make anyone feel better. CAM can offer a vehicle for a sick person simply to spend time with someone attentive to their symptoms.

As long as it doesn't kill anyoneSo-called “dietary supplements,” such as DHEA, saw palmetto and chondroitin, present the biggest problem.

Marketers often sell them under the guise of a mom-and-pop alternative to big pharma. Yet the $29 billion-a-year dietary supplement industry wields such power that it got Congress to pass a law in 1994 that basically frees it to peddle almost anything that doesn’t kill people with claims of medical benefit that need not be proven.

No doubt some of the thousands of products sold as dietary supplements work well, but the industry that sells them has neither motivation nor desire to know which ones work and which don’t.

Neither do many of those who advocate their use, such as the guru of alternative medicine Dr. Andrew Weil.

On his Web site someone recently inquired if a supplement called NT was useful for fatigue. “I'm not convinced by the scant literature on the subject that there's anything to recommend taking NT Factor for fatigue,” Dr. Weil replied, in a surprisingly forthright response.

But, then he added that the fatigue sufferer might want to try “Siberian ginseng (Eleutherococcus senticosus), coenzyme Q10, the Ayurvedic herb ashwaganda or cordyceps, a traditional Chinese medicinal mushroom that may help fight fatigue and boost energy levels.”
I can find no evidence that any of these relieve fatigue any better than NT.

It gets better.

Dr. Weill concluded his answer by advising that a better-studied treatment might be something called Juvenon. At the bottom of the Web page appeared an ad from the manufacturer of Juvenon with the quote “I take Juvenon every day — Dr. Andrew Weil.”

Such crass commercialism would put most big drug companies to shame.

Dr. Weill has claimed he approaches medicine with a new way of thinking. But, in the end, no matter what the hype, either something is effective or it isn’t. If no one really cares, maybe we should stop spending millions to find the answer.

By Robert Bazell
Chief science and health correspondent
NBC News

SkinMedica Receives FDA Approval For Dermatitis Treatment

SkinMedica Receives FDA Approval
Pharmaceutical company SkinMedica Inc. announced Oct. 23 that the company’s new drug application has received approval from the U.S. Food and Drug Administration, allowing SkinMedica to take another step forward into a billion dollar market.
SkinMedica’s dermatologic gel Desonate — created in partnership with Dow Pharmaceutical Sciences — is a corticosteroid treatment that helps improve the appearance of skin affected by atopic dermatitis.
Atopic dermatitis affects more than 15 million people and gives patients itchy skin, leading to rash, redness, swelling and scaling.
Steroids are considered the best treatment for atopic dermatitis and more than $1 billion in prescriptions are written annually by physicians in the United States for the treatment of inflammatory dermatoses.
Carlsbad-based SkinMedica specializes in developing dermatological products to improve the appearance of skin.
— Andy Killion

Seborrheic dermatitis treatmenrt

By Jill Stein
RHODES, GREECE --
MAS064D cream is safe and effective for the management of mild to moderate seborrhoeic dermatitis (SD) of the face, according to results presented here at the 15th Congress of the European Academy of Dermatology and Venereology (EADV).MAS064D is a steroid-free cream that contains multiple active ingredients with anti-inflammatory properties and is approved in the European Union as a class II medical device.Stefano Veraldi, MD, specialist, department of dermatology and venereology, University of Milan, Milan, Italy, presented results in 60 adults who applied the MASO64D cream or a vehicle cream to the face 3 times per day for 28 days."Mainstream treatment options for SD include topical corticosteroids, topical and oral antimycotics, and a range of ointments, emollients and moisturizers, although the quality of evidence supporting their efficacy is often low," Dr. Veraldi said.The primary efficacy endpoint was the investigator's global assessment (IGA) score on day 28 compared with baseline (graded on a scale of 0 (clear) to 4 (severe). A score of 0 (clear) or 1 (almost clear) was classified as treatment success; a score of 2-4 (mild, moderate or severe, respectively) was classified as failure.Results showed that MADO64D had a high IGA success rate. A 4-week course of MAS064D was effective in 68% of 40 of the MASO64D group compared with 11% of 18 patients in the vehicle group (P < .0001), Dr. Veraldi noted.Reductions in erythema and desquamation scores between baseline and day 28 were significantly higher in the MAS064D group (P < .0001 and P < .01, respectively).For pruritus, MAS064D was significantly superior to vehicle at day 14 and 28. Scores on the Visual Analog Scale (VAS) show that patients rated pruritus as having decreased by 20 mm at day 14 and 28 in those receiving MASO46D, whereas vehicle-treated patients showed no or slight improvement in their perception of pruritus at both time points.Patients' assessment of global response between baseline and day 28 showed statistically significant improvement at days 14 and 28 for the MAS064D group (P < .01 and P < .0001, respectively).No patient in the MASO64D group required rescue medication compared with 2 in the vehicle group.Two patients in each group (5% MAS064D; 10% vehicle) reported a total of 6 non-serious adverse events. One patient stopped MAS064D due to a flare.Dr. Veraldi said the study is the first pilot, randomized, double-blind, parallel-open group, vehicle-controlled, phase 4 study of the efficacy and safety of MASO64D in the treatment of adult patients with mild to moderate SD of the face.Seborrheic dermatitis is an inflammatory disease of the skin characterized by erythema and scaling that is confined to areas such as the scalp, face, upper chest, shoulders, flexures, and pubis. The condition is frequently accompanied by itch.The study was sponsored by Sinclair Pharmaceuticals, Ltd and Chester Valley Pharmaceuticals, Inc.