Department of Dermatology, Rui Jin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Dermatol Ther. 2019 Jul;32(4):e13017. doi: 10.1111/dth.13017. Epub 2019 Jul 28.
Atopic dermatitis (AD), chronic eczema, and pruritus hiemalis are a set of prevalent chronic xerotic skin disorders that share clinical features such as dryness, scales, and pruritus. A ceramide deficiency and defective epidermal functions are common in these diseases. This study was designed to assess the effect of ceramide-linoleic acid (LA-Cer)-containing moisturizer as an adjunctive therapy in the treatment of AD, chronic eczema, and pruritus hiemalis. In a 2-month study, patients with one of these three diseases were divided into two groups. The control group was treated with mometasone furoate (0.1%) cream (MF), whereas the treatment group received 0.1% MF in combination with an LA-Cer-containing moisturizer. Capacitance and transepidermal water loss were measured in normal and lesional skin, along with Eczema Assessment Severity Index and pruritus scores at Weeks 0, 2, 4, and 8. The results showed that tropical applications of an LA-Cer-containing moisturizer in combination with a topical glucocorticoid accelerated the reestablishment of epidermal permeability barrier and the amelioration of pruritus in patients with AD and pruritus hiemalis. However, it did not provide the same effect for chronic eczema. Thus, the efficacy of this combination therapy for this set of xerotic disorders requires further evaluation.
特应性皮炎(AD)、慢性湿疹和冬季瘙痒症是一组常见的慢性干燥性皮肤疾病,具有干燥、鳞屑和瘙痒等共同的临床特征。这些疾病中存在神经酰胺缺乏和表皮功能缺陷。本研究旨在评估含有神经酰胺-亚油酸(LA-Cer)的保湿剂作为 AD、慢性湿疹和冬季瘙痒症辅助治疗的效果。在一项为期 2 个月的研究中,患有这三种疾病之一的患者被分为两组。对照组接受莫米松糠酸酯(0.1%)乳膏(MF)治疗,而治疗组则接受 0.1%MF 联合含有 LA-Cer 的保湿剂治疗。在正常皮肤和病变皮肤处测量电容和经表皮水分丢失,以及在第 0、2、4 和 8 周时评估湿疹严重程度指数和瘙痒评分。结果表明,在 AD 和冬季瘙痒症患者中,局部应用含有 LA-Cer 的保湿剂联合局部糖皮质激素可加速表皮通透性屏障的重建,并改善瘙痒。然而,对于慢性湿疹,这种方法并没有相同的效果。因此,这种联合治疗方案对这组干燥性疾病的疗效需要进一步评估。