Therapy of psoriasis using topical glucocorticosteroids

Combined preparations are commonly used in the topical treatment of many inflammatory skin diseases. The simultaneous use of two substances with different mechanisms of action can produce an additive effect, thereby increasing their effectiveness. Topical glucocorticosteroids are the basis of the treatment for many inflammatory, autoimmune, allergic, or hyperproliferative dermatological conditions. Betamethasone dipropionate is a potent glucocorticosteroid receptor agonist, classified as class III according to the World Health Organization (WHO) classification. Salicylic acid has keratolytic and anti-inflammatory properties and stimulates the regeneration process. Exfoliation of keratinocytes from areas affected by hyperkeratosis with the help of salicylic acid promotes the penetration of active substances deep into the skin, directly to the sites of disease. The application of a combination preparation containing both betamethasone dipropionate and salicylic acid increases the effectiveness of pharmacotherapy for many inflammatory dermatoses, with particular emphasis on dermatological conditions with hyperproliferation.

Recalcitrant psoriasis responding to new bilogic drug: Ustekinumab

Psoriasis is a common condition which, at times, can be difficult to treat. Patients with psoriasis face many social challenges and can suffer a great deal with their disease. As a result, any new topical agent is a welcomed addition to our therapeutic armamentarium. We present here a report of a case using a novel topical preparation of zinc pyrithione for the treatment of psoriasis. Topical zinc pyrithione appears to be a safe and effective treatment for psoriasis.

Analgesic and antipruritic effects of oxymatrine sustained-release microgel cream in a mouse model of inflammatory itch and pain

Bioactive compounds from Octopus vulgaris ink extracts exerted anti-proliferative and anti-inflammatory effects in vitro

A double-blind study has shown that 0.05% betamethasone-17,21- dipropionate ointment with 3% salicylic acid is more effective than 0.02% flumethasone-21- pivalate ointment with 3% salicylic acid in patients with psoriasis vulgaris treated for three weeks.

This narrative review presents a comprehensive overview of the diagnosis and management of pityriasis versicolor (PV), a common superficial fungal infection caused by the yeast Malassezia. PV is characterised by scaly hypopigmented or hyperpigmented patches, primarily affecting the upper trunk, neck, and upper arms. Regarding commensal interactions, Malassezia utilises nutrient sources without affecting the human host. In cases of pathogenicity, Malassezia can directly harm the host via virulence factors or toxins, or indirectly by triggering damaging host responses. The diagnosis typically relies on recognising characteristic clinical features. Due to the wide variability in its clinical presentation, recognising the differential diagnosis is critical. In this paper, we discuss the clinical differentials, with their dermatoscopic presentation, but also describe a range of helpful diagnostic techniques (microscopy, conventional and ultraviolet-induced fluorescence dermatoscopy, and confocal microscopy). Topical therapies are the primary treatment for PV, encompassing non-specific antifungal agents like sulphur with salicylic acid, selenium sulphide 2.5%, and zinc pyrithione. Additionally, specific topical antifungal medications with either fungicidal or fungistatic properties may also be incorporated into the topical treatment regimen, such as imidazoles, allylamines, and ciclopirox olamine. Systemic therapies might occasionally be used. Patient education and the promotion of good personal hygiene are pivotal to reduce the risk of recurrence. In recurrent cases, particularly during warmer and more humid periods, prolonged prophylaxis with topical agents should be considered.

Like most laws, the German Drug Law (Arzneimittelgesetz, AMG) [1] presents a rough framework within which a few items are settled in detail; the majority, however, are mostly not regulated in a specific respect. Hereby, the complete regulation is oriented to the mutual EEC jurisdiction. The basis for this orientation has been laid down in the “The Rules Governing Medicinal Products in the European Community”. In this connection, the “Notice to Applicants for Marketing Authorizations for Medicinal Products for Human Use in the Member States of the European Community” [2] is of essential importance, but without the force of law. Also, some specific guidelines for the regulation of the registration of topicals that also are recommendations by nature are to be particularly emphasized here [3-5]. Especially considering these European implications, the “framework” of the Drug Law should be “filled” for each new medicinal product with data that are scientifically clearly comprehensible, based on the state of the art and prove the clinical efficacy and tolerability of the medicinal product. In doing this, every term is to be taken literally. Thus, the detumescence of a provoked edema of a rat’s paw (after oral administration) is no indication of an anti-inflammatory effect after local administration and even less proof for an anti-inflammatory effect in diseases of human skin. Likewise, the clinically proven local anti-inflammatory effect of a cream that contains substance A does not indicate that substance A indeed has an anti-inflammatory effect. This could also be caused by e.g. the physical property of the cream (detumescence, vasoconstriction and antipruritic effects), by cooling via the cream base.

Soluble tumor necrosis factor-α receptor type 1 during selenium supplementation in psoriasis patients

The indole scaffold is common in natural products and bioactive compounds, including anti-cancer and anti-inflammatory medicines. In this work, a series of indole-acrylamide derivatives was synthesized, and their antiproliferative and anti-inflammatory effects were evaluated on COX enzymes and against a panel of cancer cell lines. All the final compounds were characterized via HRMS and (1H & 13C)-NMR. Anticancer and anti-inflammatory activities were evaluated using standard biomedical techniques by SRB, MTS, and COX kit assays. Additionally, the molecular docking analysis was conducted using the AutoDock Vina tool. The results demonstrated that the produced compounds displayed significant inhibitory effects on the COX-2 enzyme, with IC50 values of 128 nM to 1.04 µM. 6a demonstrated significant COX-2 selectivity with an IC50 of 128 nM and an SI of 352, highlighting its preference for COX-2 over COX-1. 6c exhibited potent COX-2 inhibition with an IC50 of 0.215 µM and an SI of 10.6. The assessed compounds exhibited substantial cytotoxic effects on cancer cells, especially against liver cancer cell lines (Huh7, HepG2, Mahlavu, and SNU475), and breast cancer (MCF-7). 6d compound was the most COX-1 selective inhibitor, which observed potent activity against hepatocellular carcinoma, with IC50 values as low as 3.5 µM, and was highly effective against MCF-7. Additionally, COX-2 selective inhibitors, 6a and 6b, exhibited strong antiproliferative effects against both breast cancer (MCF-7) and melanoma (B16F1), with IC50 values ranging from 4.75 to 15.4 µM. Furthermore, the molecular docking of 6a demonstrated a strong affinity for the COX-2 enzyme, with energy scores (S) of −8.392 kcal/mol, comparable to celecoxib’s score of −10.96 kcal/mol. The findings suggest a possible correlation between COX-2 inhibition and anticancer efficacy, especially for compounds 6a and 6c, which demonstrate excellent COX-2 selectivity and notable antiproliferative effects, positioning them as prospective candidates for further advancement in cancer treatment.

What can we learn from treating atopic itch in dogs?

The objective was to prepare a novel nail lacquer formulation to improve the ungual and trans-ungual delivery of apremilast for the potential treatment of nail psoriasis. Nail lacquer formulation was prepared using Eudragit® S 100 as a film-forming polymer and the mixture of ethanol, ethyl acetate, and water as a solvent system. As a result of high-throughput screening studies, dexpanthenol and salicylic acid were found to be the potential penetration enhancers. After 7days of in vitro studies, the cumulative amount of apremilast delivered by the nail lacquer formulation across the nail plate was found to be ~3-fold (0.52±0.07μg/cm2) more compared to control (nail lacquer formulation without enhancers) (0.19±0.02μg/cm2). The cumulative amount of apremilast retained in the nail plate in the case of nail lacquer formulation was 1.26±0.18μg/mg which was found to be ~2-fold more compared to control (0.57±0.07μg/mg). Human subject studies were performed on the nails of thumb and index finger of six volunteers for 15days. As a result, the cumulative amount of apremilast retained in the free distal edge of the nail plate in the case of nail lacquer was found to be ~2-fold (0.93±0.14μg/mg) more related to control (0.41±0.04μg/mg). As a conclusion, nail lacquer formulation was found to be capable of delivering a substantial amount of apremilast into the nail apparatus; thus, it can be a potential option for the treatment of nail psoriasis.

Dermatitis of head and neck, also known as “head-and-neck dermatitis” (HNAD), is one of the specific manifestations of atopic dermatitis (AD) in adolescents and young adults. The epidermal barrier dysfunction, skin pathological immune responses, a direct damaging effect of the malassezial flora through the synthesis of virulence factors and mediated by maintaining immune inflammatory responses, as well as the attachment of secondary bacterial flora caused by scratching form the basis of pathogenetic mechanisms of this condition. The properties that define the HNAD rash is a focus on the seborrheic areas (a face, front surface of the neck, décolleté on the chest), severe itching, prolonged course, exacerbation characterized by excessive sweating. It appears that fungi of the genusMalasseziacan play a role in the development of the disease. While they are considered to be part of the normal skin microbiome, a significant increase in the severity of atopic dermatitis was observed in patients with Malassezial flora, which was the reason for the theories devoted to the role ofMalassezia spp. as a trigger of the disease. Atopic dermatitis can also develop as a side effect of using targeted therapy with IL4/13 blockers, which is explained at the present day by a shift of the immune response towards a Th-17-mediated reaction. The combination of both infectious and immune-mediated lesions in HNAD determines the necessity of an integrated approach to the therapy, in particular the use of topical combination drugs as the first-line therapy. The topical glucocorticosteroid (TGCS) therapy is aimed at suppressing the immune reactions that are responsible for inflammation in the skin, antifungal therapy is required to suppress the activity of the malassesial flora, and, finally, a secondary bacterial infection requires the prescription of topical antibacterial drugs.

Guidelines of care for the management of psoriasis and psoriatic arthritis: Section 3. Guidelines of care for the management and treatment of psoriasis with topical therapies

Psoriasis is a well-known autoimmune, progressive inflammatory condition having long-term impact on the patient's physical and psychological well-being with worldwide prevalence. The available allopathic and herbal medicines have their own merits and demerits. Allopathic drugs may produce potent beneficial as well as adverse effects while alone herbal drugs may exert slow and less potent effects. Hence the current study attempted to prepare and evaluate fixed dose combination of allo-herbal emulgel in order to minimize adverse effects and improve beneficial effects during the treatment of psoriasis. This study used a well-established, robust, and validated model (Imiquimod (IMQ)) for psoriasis induction. Emulgel was formulated and tested using phytochemical and physicochemical methods. The anti-psoriatic and anti-inflammatory activities of the prepared emulgel were investigated. In addition, percent release and in vivo absorption were done to ensure adequate release and absorption of emulgel content. Progress of psoriasis induction and treatment was analyzed by morphological and histopathological studies.The formulated emulgel was found to comply with the standard physicochemical test with the desired release pattern. Morphological and histological data showed induction of psoriasis using the IMQ model, and significant improvement was observed after emulgel treatment. All formulations were discovered to significantly reduce formalin-induced inflammation.The present study provided the rationale for the combination of C. amada and P. pinnata with salicylic acid. The selected allo-herbal combination and optimized dosage form are stable, biocompatible, and effective anti-inflammatory and anti-psoriatic with potentially fewer side effects.