Skin lipids in health and disease: A review

Atopic dermatitis (AD) is a common inflammatory skin disorder characterized by recurrent eczematous lesions and intense itch. Although it most often starts in infancy and affects children, it is also highly prevalent in adults. In this article, the main aspects of AD have been updated, with a focus on the pathogenetic and therapeutic aspects. The pathogenesis of AD is complex, and it is evident that a strong genetic predisposition, epidermal dysfunction, skin microbiome abnormalities, immune dysregulation, and the neuroimmune system are critical in AD development. Mutations in the genes associated with disrupted epidermal barrier, exaggerated pathological inflammation and inadequate antimicrobial peptides can promote enhanced Th2 inflammation and mediate pruritus. Current understanding of etiology highlights gut microbial diversity, NK cell deficiency, and different immunological phenotype with age and race. For topical anti-inflammatory treatment for mild-to-severe AD, phosphodiesterase 4 inhibitors (PDE-4), JAK inhibitors, and microbiome transplantation with Roseomonas mucosa provided more management selections. The treatment of moderate-to-severe AD has been limited to merely symptomatic and relatively nonspecific immunosuppressive approaches. In-depth understanding of the pathogenesis of AD has led to the development of innovative and targeted therapies, such as biologic agents targeting interleukin (IL)-4, IL-13 and JAK/STAT inhibitors. Other potential therapeutic agents for AD include agents targeting the T helper (Th) 22 and Th17/IL23 pathway. Antipruritic therapy and complementary probiotics therapy have also been reviewed.

Update on the Pathogenesis and Therapy of Atopic Dermatitis.

Ingredients found in the nail cosmetic industry, including but not limited to methacrylate and acrylate monomers, formaldehyde, and toluene sulfonamide-formaldehyde resin, can incite allergic contact dermatitis. An eczematous outbreak presents on areas surrounding the nail plate and may spread through contact transfer of the allergen, commonly to the face and neck. Even components that were originally deemed nonsensitizing, such as the ubiquitous cyanoacrylate adhesive family, have been found to be allergenic. They do not, however, cross-react with methacrylates and acrylates. Alternative options for individuals with allergic contact dermatitis reactions to these ingredients can be avoidance of these procedures or use of products that are "3, 4, 5 free" in which the common allergens dibutyl phthalate, toluene, and formaldehyde are absent. In cases where strengthening of the nail is the sole purpose, nail wraps or preformed nails can be applied for non-cyanoacrylate-sensitive individuals.

Contact Sensitization to Allergens in Nail Cosmetics.

Ceramide liposomes for skin barrier recovery: A novel formulation based on natural skin lipids

Ceramides play an essential role in forming a permeability barrier in the skin. Atopic dermatitis (AD) is a common chronic skin disease associated with skin barrier dysfunction and immunological abnormalities. In patients with AD, the amount and composition of ceramides in the stratum corneum are altered. This suggests that ceramide abnormalities are involved in the pathogenesis of AD. The mechanism underlying lipid abnormalities in AD has not yet been fully elucidated, but the involvement of Th2 and Th1 cytokines is implicated. Ceramide-dominant emollients have beneficial effects on skin barrier function; thus, they have been approved as an adjunctive barrier repair agent for AD. This review summarizes the current understanding of the mechanisms of ceramide abnormalities in AD. Furthermore, the potential therapeutic approaches for correcting ceramide abnormalities in AD are discussed.

The Pathogenic and Therapeutic Implications of Ceramide Abnormalities in Atopic Dermatitis.

Treatment with Synthetic Pseudoceramide Improves Atopic Skin, Switching the Ceramide Profile to a Healthy Skin Phenotype.

Objective Dry and scaly conditions on the scalp are often observed in patients with atopic dermatitis, seborrheic dermatitis and/or pityriasis capitis. Those scalp lesions often exhibit low barrier function and reduced ceramide levels. Therefore, a clinical study was conducted to evaluate the efficacy of topical application of a pseudo-ceramide and eucalyptus extract-containing lotion on the scalps of patients with skin diseases. Methods Thirty-four subjects participated in this study (atopic dermatitis: 19 subjects; seborrheic dermatitis: 6 subjects; pityriasis capitis: 9 subjects). After 4 weeks of daily treatment with a pseudo-ceramide and eucalyptus extract-containing lotion, the skin symptoms had significantly improved in all patients with those skin diseases. Results Skin dryness, scaling, and erythema were significantly improved by treatment with the lotion. The moisture-retention ability of the scalp was significantly increased and itchiness, evaluated using a visual analog scale, decreased significantly. Accompanying those improvements was a significant improvement in the quality of life of the subjects, evaluated by the Skindex-16®. Conclusion From these results, we conclude that this pseudo-ceramide and eucalyptus extract-containing lotion effectively improved the dry and scaly conditions of the scalp as well as the quality of life of subjects with atopic dermatitis, seborrheic dermatitis, or pityriasis capitis.

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The efficacy of a pseudo-ceramide and eucalyptus extract containing lotion on dry scalp skin.

Hairdressers are exposed to numerous skin-damaging factors, such as wet work, skin irritants, and thermal changes. Skin protection is a very important factor for the prevention of occupational skin disorders. Therefore, we evaluated a hand cream that was specially formulated for highly stressed skin with regard to its capability to reduce dry, rough, and scaly skin. The objective of this study was to conduct a controlled use test of a barrier repair cream containing pseudo-ceramide and demonstrate its efficacy for hairdressers with dry, sensitive hands and/or occupational skin disorders. A total of 30 hairdressers (29 females and 1 male, aged 20 - 67) participated in the study. All subjects suffered from dry hands. Subjects applied the test cream on their hands for 28 days (four weeks). For each subject, the skin surface topography of the hands was measured by the Surface Evaluation of Living Skin (SELS) system at day 14 (week 2) and day 28 (week 4). Dryness, scaling, cracking, redness, and itchiness were evaluated and graded by experts at week 2 and week 4, and then compared to baselines. All 30 subjects completed the study. A comparison of the changes from baseline to endpoint revealed a statistically significant reduction in skin roughness, scaling, and volume measured according to SELS. These data were confirmed by photographic documentation. The results were further supported by the expert evaluation. For the symptoms dryness and scaling, improvement could be observed in almost all regions of the hands. In addition, according to subjective assessments of overall hand skin condition and the hand cream, subjects reported clear improvement over time (p value below 0.001) and good efficacy of the product. In this study, the test hand cream showed excellent skin compatibility. Therefore, the hand cream may be effective for hairdressers with dry, sensitive hands and/or occupational skin disorders.

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Evaluation of a Barrier Repair Cream Containing Pseudo-Ceramide for Practical Use by Hairdressers with Hand Skin Disorders Due to Daily Exposure to Chemical Irritants

Background/Objective: Dryness
is considered to be an early developmental mechanism of wrinkles, and fine line
formation is marked in atopic dermatitis (AD) accompanied by dry skin. To
evaluate the efficacy of a skincare product with a moisturizing effect
increased by lamellar formulation of pseudo-ceramide for fine lines and
wrinkles, a use test was performed applying the product to non-lesional dry
skin in patients with atopic dermatitis. Method: The test product was an
essence containing pseudo-ceramide formulated in a lamellar structure. The
study design was a nine-week single-center non-comparative study, and the
evaluation items were the grade of wrinkles at the corners of the eyes judged
by a dermatologist, replica analysis, and instrumental measurement (skin
surface moisture and transepidermal water loss). Results: Nine-week continuous
use of the test product significantly improved the score of wrinkles at the
corners of the eyes judged by a dermatologist and wrinkle area ratio on replica
analysis of the corners of the eyes and cheeks, compared with those at study
initiation. With this improvement, the losses of skin surface moisture and
transepidermal water were also significantly improved. Conclusion: It was
clarified that the tested pseudo-ceramide-formulated skincare product not only
improved the barrier function for atopic dermatitis, but also exhibited an
effect on fine lines and wrinkles of dry skin.

/pdf/efficacy-evaluation-of-unique-skincare-product-containing-3utz1tzs12.pdf

Efficacy Evaluation of Unique Skincare Product Containing Pseudo-Ceramide for Fine Wrinkles in Japanese Female Atopic Dermatitis Patients

https://www.jstage.jst.go.jp/article/skinresearch1959/43/4-5/43_4-5_278/_pdf

Akihiko Takahashi

Papers

Treatment with Synthetic Pseudoceramide Improves Atopic Skin, Switching the Ceramide Profile to a Healthy Skin Phenotype.

The efficacy of a pseudo-ceramide and eucalyptus extract containing lotion on dry scalp skin.

Evaluation of a Barrier Repair Cream Containing Pseudo-Ceramide for Practical Use by Hairdressers with Hand Skin Disorders Due to Daily Exposure to Chemical Irritants

Efficacy Evaluation of Unique Skincare Product Containing Pseudo-Ceramide for Fine Wrinkles in Japanese Female Atopic Dermatitis Patients

Clinical Evaluation of CurelR Medicated Cream in Patients with Atopic Dermatitis