Exploring Anti-Fungal, Anti-Microbial and Anti-Inflammatory Properties of a Topical Non-Steroidal Barrier Cream in Face and Chest Seborrheic Dermatitis

Dermatology and Therapy - Tập 10 - Trang 87-98 - 2019
Anna Balato1, Giuseppina Caiazzo1, Roberta Di Caprio2, Emanuele Scala2, Gabriella Fabbrocini2, Corinne Granger3
1Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italy
2Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
3Innovation and Development, ISDIN, Barcelona, Spain

Tóm tắt

The pathogenesis of seborrheic dermatitis (SD) is multifactorial and traditional treatments may not target all aspects of it. The aim of this study was to evaluate short-term anti-fungal, anti-microbial, anti-inflammatory and anti-pruritus properties of a novel non-steroidal cream (NSC) containing piroctone olamine, zinc salt of l-pyrrolidone carboxylate (PCA), hydroxyphenyl propamidobenzoic acid, biosaccharide gum-2 and stearyl glycyrrhetinate in patients with face and chest SD. Twelve male subjects affected by SD, presenting face and chest manifestations, were enrolled. Patients were instructed to apply NSC twice a day, performing regular visits at baseline (W0), after 7 (W1) and 14 (W2) days of treatment. A limitation of the study was that no control group treated with the vehicle without active ingredients was enrolled. To evaluate the efficacy of the NSC, investigator’s assessments were represented by scoring index (SI) and investigator’s global assessment score (IGA). In order to assess NSC anti-fungal and anti-microbial effects, skin scale scrapings were collected and used for Malassezia furfur (MF) and Staphylococcus epidermidis (SE) cultures. In parallel, in order to assess NSC anti-inflammatory effects, gene expression of IL-1α, IL-1β, IL-6, IL-8, and TNF-α was assessed. In addition, anti-pruritus effects were also evaluated through gene expression of cathepsin S and l-histidine decarboxylase. SI mean scores significantly decreased at W1 and, to a greater extent, at W2 compared with W0. The IGA score registered an important improvement efficacy both for face and chest, from W1 to W2. MF and SE growth was already inhibited at W1, with a more pronounced decrease at W2. Gene expression of all analyzed mediators was significantly reduced at W1 compared to W0. In conclusion, our assessment is that NSC is an effective and well tolerated treatment option for SD with anti-fungal, anti-microbial and anti-inflammatory properties. ISRCTN registry, ISRCTN77871064 (retrospectively registered October 17, 2019). EudraCT number, 2019-003813-32. ISDIN.

Tài liệu tham khảo

Borda L, Wikramanayake TC. Seborrheic dermatitis and dandruff: a comprehensive review. J Clin Invest Dermatol. 2015;2015:3–10. Karakadze MA, Hirt PA, Wikramanayake TC. The genetic basis of seborrhoeic dermatitis: a review. J Eur Acad Dermatol Venereol. 2018;32:529–36. Gupta AK, Nicol K, Batra R. Role of antifungal agents in the treatment of seborrheic dermatitis. Am J Clin Dermatol. 2004;5:417–22. Schwartz JR, Messenger AG, Tosti A, Todd G, Hordinsky M, Hay RJ, et al. A comprehensive pathophysiology of dandruff and seborrheic dermatitis—towards a more precise definition of scalp health. Acta Derm Venereol. 2013;93:131–7. Hay RJ. Malassezia dandruff and seborrhoeic dermatitis: an overview. Br J Dermatol. 2011;165:2–8. Ro BI, Dawson TL. The role of sebaceous gland activity and scalp microfloral metabolism in the etiology of seborrheic dermatitis and dandruff. J Investig Dermatol Symp Proc. 2005;10:194–7. Heng MC, Henderson CL, Barker DC, Haberfelde G. Correlation of Pityrosporum ovale density with clinical severity of seborrheic dermatitis as assessed by a simplified technique. J Am Acad Dermatol. 1990;23:82–6. McGinley KJ, Leyden JJ, Marples RR, Kligman AM. Quantitative microbiology of the scalp in non-dandruff, dandruff, and seborrheic dermatitis. J Invest Dermatol. 1975;64:401–5. DeAngelis YM, Saunders CW, Johnstone KR, Reeder NL, Coleman CG, Kaczvinsky JR, et al. Isolation and expression of a Malassezia globosa lipase gene, LIP1. J Invest Dermatol. 2007;127:2138–46. Plotkin LI, Squiquera L, Mathov I, Galimberti R, Leoni J. Characterization of the lipase activity of Malassezia furfur. J Med Vet Mycol. 1996;34:43–8. Warner RR, Schwartz JR, Boissy Y, Dawson TL Jr. Dandruff has an altered stratum corneum ultrastructure that is improved with zinc pyrithione shampoo. J Am Acad Dermatol. 2001;45:897–903. Faergemann J, Bergbrant IM, Dohse M, Scott A, Westgate G. Seborrhoeic dermatitis and Pityrosporum (Malassezia) folliculitis: characterization of inflammatory cells and mediators in the skin by immunohistochemistry. Br J Dermatol. 2001;144:549–56. Tanaka A, Cho O, Saito C, Saito M, Tsuboi R, Sugita T. Comprehensive pyrosequencing analysis of the bacterial microbiota of the skin of patients with seborrheic dermatitis. Microbiol Immunol. 2016;60:521–6. Piquero-Casals J, Hexsel D, Mir-Bonafé JF, Rozas-Muñoz E. Topical non-pharmacological treatment for facial seborrheic dermatitis. Dermatol Ther (Heidelb). 2019;9:469–77. Dall’Oglio F, Tedeschi A, Fusto CM, Lacarrubba F, Dinotta F, Micali G. A novel cosmetic antifungal/anti-inflammatory topical gel for the treatment of mild to moderate seborrheic dermatitis of the face: an open-label trial utilizing clinical evaluation and erythema-directed digital photography. G Ital Dermatol Venereol. 2017;152:436–40. Schmidt-Rose T, Braren S, Fo¨lster H, Hillemann T, Oltrogge B, Philipp P, et al. Efficacy of a piroctone olamine/climbazol shampoo in comparison with a zinc pyrithione shampoo in subjects with moderate to severe dandruff. Int J Cosmet Sci. 2011;33(3):276–82. Granger C, Goni F, Martinez G, Garre A. Ex-vivo determination of antifungal activity of a new prescription non-steroidal facial cream against Malassezia furfur in human skin explants. Skin J Cutan Med. 2017;1:137. Takino Y, Okura F, Kitazawa M, Iwasaki K, Tagami H. Zinc l-pyrrolidone carboxylate inhibits the UVA induced production of matrix metalloproteinase-1 by in vitro cultured skin fibroblasts, whereas it enhances their collagen synthesis. Int J Cosmet Sci. 2012;34(1):23–8. Rostan EF, DeBuys HV, Madey DL, Pinnell SR. Evidence supporting zinc as an important antioxidant for skin. Int J Dermatol. 2002;41:606–11. Lang C, Murgia C, Leong M, Tan LW, Perozzi G, Knight D, et al. Antiinflammatory effects of zinc and alterations in zinc transporter mRNA in mouse models of allergic inflammation. Am J Physiol Lung Cell Mol Physiol. 2007;292:L577–84. Valdera-Martinez P, Garre A, Granger C. Efficacy and tolerance of a new non-steroidal prescription cream in the treatment of mild facial seborrheic dermatitis. Skin J Cutan Med. 2017;1:s134. Oyama K, Kawada-Matsuo M, Oogai Y, Hayashi T, Nakamura N, Komatsuzawa H. Antibacterial effects of glycyrrhetinic acid and its derivatives on Staphylococcus aureus. PLoS One. 2016;11(11):e0165831. Koca R, Altinyazar HC, Eştürk E. Is topical metronidazole effective in seborrheic dermatitis? A double-blind study. Int J Dermatol. 2003;42:632–5. Lembo S, Di Caprio R, Balato A, Caiazzo G, Fabbrocini G, Skroza N, et al. The increase of mTOR expression is consistent with FoxO1 decrease at gene level in acne but not in psoriasis. Arch Dermatol Res. 2019. https://doi.org/10.1007/s00403-019-01959-0. [Epub ahead of print]. Livak KJ, Schmittgen TD. Analysis of relative gene expression data using real-time quantitative PCR and the 2(-Delta Delta C(T)) method. Methods. 2001;25:402–8. Dall’ Oglio F, Lacarrubba F, Luca M, Boscaglia S, Granger C, Micali G. Clinical and instrumental evaluation of a new topical non-corticosteroid antifungal/anti-inflammatory/antiseborrheic combination cream for the treatment of mild-to-moderate facial seborrheic dermatitis. Clin Cosmet Investig Dermatol. 2019;12:103–8. Granger C, Balato A, Goñi-de-Cerio F, Garre A, Narda M. Novel non-steroidal facial cream demonstrates antifungal and anti-inflammatory properties in ex vivo model for seborrheic dermatitis. Dermatol Ther (Heidelb). 2019;9:571–8. Dessinioti C, Katsambas A. Seborrheic dermatitis: etiology, risk factors, and treatments: facts and controversies. Clin Dermatol. 2013;31:343–51. An Q, Sun M, Qi RQ, Zhang L, Zhai JL, Hong YX, et al. High Staphylococcus epidermidis colonization and impaired permeability barrier in facial seborrheic dermatitis. Chin Med J (Engl). 2017;130:1662–9. Kloos WE, Musselwhite MS. Distribution and persistence of Staphylococcus and Micrococcus species and other aerobic bacteria on human skin. Appl Microbiol. 1975;30:381–5. Turlier V, Viode C, Durbise E, Bacquey A, LeJeune O, Oliveira Soares R, et al. Clinical and biochemical assessment of maintenance treatment in chronic recurrent seborrheic dermatitis: randomized controlled study. Dermatol Ther (Heidelb). 2014;4:43–59. Okokon E, Verbeek J, Ruotsalainen J, Ojo O, Bakhoya V. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev. 2015;4:CD008138. Marseglia A, Licari A, Agostinis F, Barcella A, Bonamonte D, Puviani M, et al. Local rhamnosoft, ceramides and l-isoleucine in atopic eczema: a randomized, placebo controlled trial. Pediatr Allergy Immunol. 2014;25:271–5. Asl MN, Hosseinzadeh H. Review of pharmacological effects of Glycyrrhiza sp. and its bioactive compounds. Phytother Res. 2008;22:709–24.