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Oatmeal in dermatology: A brief review

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Abstract

The purpose of this review is to gather and summarize in vitro, in vivo, and clinical trials on oatmeal preparations and their uses in dermatology. Literature searches have been carried out to collect in vivo and in vitro studies as well as clinical trials on this subject. The results suggest that oatmeal possesses antioxidant and anti-inflammatory properties and its administration is effective on a variety of dermatologic inflammatory diseases such as pruritus, atopic dermatitis, acneiform eruptions, and viral infections. Additionally, oatmeal plays a role in cosmetics preparations and skin protection against ultraviolet rays. Although some promising results citing the use of oatmeal to treat numerous dermatologic conditions have been found, the complete efficacy of oatmeal has not been sufficiently explored. This paper proposes accurate and useful information concerning the use of oatmeal in clinical practice to dermatologists.
Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2142
Oatmeal in dermatology: A brief review
Nader Pazyar, Reza Yaghoobi, Afshin Kazerouni, Amir Feily
Review
Article
ABSTRACT
The purpose of this review is to gather and summarize in vitro, in vivo, and clinical trials on
oatmeal preparations and their uses in dermatology. Literature searches have been carried out
to collect in vivo and in vitro studies as well as clinical trials on this subject. The results suggest
that oatmeal possesses antioxidant and anti-inammatory properties and its administration is
effective on a variety of dermatologic inammatory diseases such as pruritus, atopic dermatitis,
acneiform eruptions, and viral infections. Additionally, oatmeal plays a role in cosmetics
preparations and skin protection against ultraviolet rays. Although some promising results
citing the use of oatmeal to treat numerous dermatologic conditions have been found, the
complete efcacy of oatmeal has not been sufciently explored. This paper proposes accurate
and useful information concerning the use of oatmeal in clinical practice to dermatologists.
Key words: Dermatology, oatmeal, colloidal oatmeal, review
Department of Dermatology,
Jundishapur University of
Medical Sciences, Ahvaz, Iran
Address for correspondence:
Dr. Amir Feily,
Skin and Stem Cell Research
Center, Tehran University of
Medical Sciences, Tehran, Iran.
E-mail: dr.feily@yahoo.com
How to cite this article: Pazyar N, Yaghoobi R, Kazerouni A, Feily A. Oatmeal in dermatology: A brief review. Indian J Dermatol Venereol
Leprol 2012;78:142-5.
Received: June, 2011. Accepted: August, 2011 Source of Support: Nil. Conict of Interest: None declared.
INTRODUCTION
Oat (Avena sativa) is unique among the cereals for its
multifunctional characteristics and nutritional profile.
Recent developments in food and nutrition have
shown the importance of its various components. Oat
bran especially, is a good source of B complex vitamins,
vitamin E, protein, fat, and minerals. Additionally, it
is rich in beta-glucan which is heart healthy soluble
fiber in particular.[1-3]
Oatmeal is a natural product which has an excellent
safety record and a long history in the treatment of
dermatologic disorders. Oatmeal possesses antioxidant
and anti-inflammatory properties. Colloidal oatmeal
produced by finely grinding the oat and boiling it to
extract the colloidal material and became available in
1945. It is noteworthy that many clinical properties
of colloidal oatmeal result from its chemical
polymorphism.[2,4]
BIOACTIVE CONSTITUENTS OF OATMEAL
Oatmeal possesses different types of phenols which
exert the antioxidant and anti-inflammatory activity.
Avenanthramides are phenolic compounds present in
oats at approximately 300 parts per million (ppm) and
exhibit antioxidant activity in various cell types. They
are responsible for the potent anti-inflammatory effect of
oatmeal that appears to mediate the anti-irritant effects
of oats.[2] The composition of colloidal oatmeal consists
mainly of starch (65%–85%), proteins (15%–20%), lipids
(3%–11%), fiber (5%), and beta-glucans (5%).[4]
FORMULATIONS
Today’s the formulations of colloidal oatmeal are
offered in various forms such as bath treatments,
cleansing bars, body washes, shampoos, lotions,
creams, and shaving gels.[2]
OATMEAL BATH DIRECTION
Oatmeal bath remedy is formulated with 100% natural
colloidal oatmeal. About 10 CC of oatmeal should be
sprinkle directly under the faucet into the running
water. The approximate time to soak in oatmeal bath is
15–20 min. The oatmeal bath gently cleans and soothes
sensitive skin and, therefore, soap is not necessary.[5]
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143Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2
MECHANISM OF ACTION
It has been demonstrated that oatmeal extract decrease
arachidonic acid, cytosolic phospholipase A2 and
tumor necrosis factor-alpha (TNF-alpha).[6] Additionally,
oatmeal extract can inhibit the activity of nuclear factor
kappa B (NF-kappa B) in keratinocytes and the release
of proinflammatory cytokines and histamine, which are
well known key mechanisms in the pathophysiology
of inflammatory dermatoses. Interestingly, it has been
shown that avenanthramides inhibit TNF-alpha induced
NF-kappa B luciferase activity and diminish secretion of
the proinflammatory cytokine interleukin-8 (IL-8).[7] Also
oatmeal extract oligomer, significantly mitigate the mean
surface of dilated vessels and edema in comparison with
vasoactive intestinal peptide (VIP) treated skin.[8]
DERMATOLOGIC APPLICATIONS OF OATMEAL [TABLE 1]
Anti-itch activity
Oatmeal has been used for centuries to decrease
itching in a variety of xerotic dermatoses.[7] It has been
illustrated that avenanthramides reduce oxazolone-
induced contact hypersensitivity, resiniferatoxin-
induced neurogenic inflammation, and compound
48/80-induced, histamine-mediated itch. Another
in vitro study has shown that avenanthramides caused
a considerable reduction in histamine release from
mast cells stimulated by substance P.[4] Matheson and
colleagues evaluated the efficacy of liquid paraffin
with 5% colloidal oatmeal in comparison with
other contained liquid paraffin in the management
of patients with burn injuries. They reported that
product contains liquid paraffin with 5% colloidal
oatmeal significantly decreased itching and patients
requested significantly less antihistamine.[9]
Atopic dermatitis
Colloidal grain suspensions of oatmeal are considered
as adjuncts in atopic dermatitis therapy, especially
in the United States. On the other hand, many
young children have been treated by colloidal grains
in Italy.[8] Studies have demonstrated that topical
formulation of natural colloidal oatmeal, particularly
avenanthramide, alleviates symptoms by restoring the
cutaneous barrier. Additionally, it may play a crucial
role in decreasing the use of corticosteroids and
calcineurin inhibitors in atopic dermatitis.[4,10,11]
In a double-blinded, randomized patch study, Pigatto
and colleagues showed that topical colloidal grains
could be used as an adjunct in the management of
mild atopic dermatitis in children under 2 years of age.
Furthermore, no sensitivity to topical colloidal grains
reported in the patients.[10] In contrary, another study
demonstrated that oat sensitization for allergy testing
is higher than expected in atopic dermatitis children.
It is possibly due to repeated applications of cosmetics
with oats on an impaired epidermal barrier.[12]
Psoriasis
Psoriasis is a chronic, recurring inflammatory disease
that affects 1%–3% of the population worldwide.
Psoriasis is considered a psychosocial and medically
debilitating disorder.[13,14] It is hypothesized that
colloidal oatmeal can be effective in the treatment of
psoriasis due to its anti-inflammatory properties.[1,15]
Acneiform eruptions
It has been illustrated that treatment with colloidal
oatmeal lotion is efficient in controlling the acneiform
eruptions associated with epidermal growth factor
receptor (EGFR) inhibitor drugs such as cetuximab,
erlotinib, panitumumab, sorafenib, and multiple
tyrosine-kinase inhibitors. As such, it increases
patients’ compliance with antineoplastic therapy.[16]
Antigenotoxicity
It has been found that avenanthramides show
antigenotoxic activities that are comparable to those
of ascorbic acid, which have the potential to exert
beneficial physiological effects.[17]
Antiviral activity
The dramatic antiviral properties of oatmeal extract
is likely due to inhibitory effects on eicosanoid
formation, expression of cytosolic phospholipase A2
(PLA2), and arachidonic acid mobilization in human
keratinocytes.[18] In an open trial study conducted
by, Safa et al, patients with molluscum contagiosum
were treated successfully with a zinc oxide cream
containing colloidal oatmeal.[19]
Table 1: Dermatologic applications of oatmeal
Anti-itchactivity
Atopicdermatitis
Psoriasis
Acneiformeruptions
Antiviralactivity
Antifungal activity
Skinprotection
Moisturizing
Cosmetics
Sterilization
Pazyar, et al. Oatmeal in dermatology
Indian Journal of Dermatology, Venereology, and Leprology | March-April 2012 | Vol 78 | Issue 2144
Antifungal activity
Oat seed extracts show a high degree of antifungal
activity and can be applied directly on rye bread to
prevent the formation of P. roqueforti colonies.[20]
Skin protection
Ultraviolet A (UVA) in the range of 320–370 nm is
absorbed by flavonoids in oats. The use of colloidal
oatmeal as a skin protectant is regulated by the U.S.
Food and Drug Administration (FDA) according to
the Over-The-Counter Final Monograph for Skin
Protectant Drug Products issued in June 2003.[2]
Moisturizing
Today, colloidal oatmeal is available in the form
of moisturizing creams. The high concentration of
starches and beta-glucans in oat are responsible for its
protective and water-holding functions. The hydration
of the skin is one of the most important agents involved
in preserving the integrity of the stratum corneum
barrier. Oatmeal is a good option for moisturizing of
dry or sensitive skin.[2]
Cosmetics
Avenacins are other phenolic esters in oat which
structurally belonging to saponins. A large lipophilic
region and a short chain of sugar residues, which
interact with nonlipid components is characteristic of
avenacins. Saponins have a soap-like action for this
structure. Accordingly; saponins are mostly responsible
for the cleansing activity of oat. A variety of functional
properties make colloidal oatmeal as a cleanser, buffer,
as well as a soothing agent. Additionally, colloidal
oatmeal can be used in shampoos and shaving gels.[2,21]
Sterilization
Anecdotal reports have demonstrated that colloidal
oatmeal can play a role as a dusting powder in the
sterilization of surgical gloves[22] [Table 1].
GENERAL USES OF OATMEAL
Oatmeal has been documented to decrease serum low-
density lipoprotein cholesterol (LDL) and coronary
heart disease as an anti-atherosclerotic agent.[23,24]
It is also considered a remedy for diabetes with
reduction of insulin dosage[25] as well as the treatment
of inflammatory bowel disease.[26] Nuclear factor-
kappa B (NF-kappa B), a key regulator of inflammation,
has been identified as an essential modulator in cases
where inflammation could develop into cancer. It has
been shown that avenanthramides are responsible for
anticancer activity, partially through the inhibition of
NF-kappa B activation.[27]
REFERENCES
1. Sadiq Butt M, Tahir-Nadeem M, Khan MK, Shabir R, Butt MS.
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2. Kurtz ES, Wallo W. Colloidal oatmeal: History, chemistry and
clinical properties. J Drugs Dermatol 2007;6:167-70.
3. Panfili G, Fratianni A, Irano M. Normal phase high-performance
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4. Cerio R, Dohil M, Jeanine D, Magina S, Mahé E, Stratigos AJ.
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5. Scabies-killer. Available from: http://www.scabies-killer.com/
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induced by epidermal growth factor receptor and multiple
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7. Sur R, Nigam A, Grote D, Liebel F, Southall MD. Avenanthramides,
polyphenols from oats, exhibit anti-inflammatory and anti-itch
activity. Arch Dermatol Res 2008;300:569-74.
8. Boisnic S, Branchet-Gumila MC, Coutanceau C. Inhibitory
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peptide-induced inflammation in surviving human skin. Int J
Tissue React 2003;25:41-6.
9. Matheson JD, Clayton J, Muller MJ. The reduction of itch during
burn wound healing. J Burn Care Rehabil 2001;22:76-81.
10. Pigatto P, Bigardi A, Caputo R, Angelini G, Foti C, Grandolfo M,
et al. An evaluation of the allergic contact dermatitis potential of
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11. Eichenfield LF, Fowler JF Jr, Rigel DS, Taylor SC. Natural
advances in eczema care. Cutis 2007;80:S2-16.
12. Boussault P, Léauté-Labrèze C, Saubusse E, Maurice-Tison S,
Perromat M, Roul S, et al. Oat sensitization in children with
atopic dermatitis: Prevalence, risks and associated factors.
Allergy 2007;62:1251-6;quiz 82-3.
13. Kurian A, Barankin B. Current effective topical therapies in the
management of psoriasis. Skin Ther Lett 2011;16:4-7.
14. Afifi T, de Gannes G, Huang C, Zhou Y. Topical therapies
for psoriasis: Evidence-based review. Can Fam Physician
2005;51:519-25.
15. Fowler JF Jr, Woolery-Lloyd H, Waldorf H, Saini R. Innovations
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Dermatol 2010;9:S72-81.
16. Alexandrescu DT, Vaillant JG, Dasanu CA. Effect of treatment
with a colloidal oatmeal lotion on the acneform eruption
induced by epidermal growth factor receptor and multiple
tyrosine-kinase inhibitors. Clin Exp Dermatol 2007;32:71-4.
17. Lee-Manion AM, Price RK, Strain JJ, Dimberg LH, Sunnerheim K,
Welch RW. In vitro antioxidant activity and antigenotoxic
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Food Chem 2009;57:10619-24.
18. Aries MF, Vaissiere C, Pinelli E, Pipy B, Charveron M. Avena
Rhealba inhibits A23187-stimulated arachidonic acid
mobilization, eicosanoid release, and cPLA2 expression in
human keratinocytes: Potential in cutaneous inflammatory
disorders. Biol Pharm Bull 2005;28:601-6.
19. Safa G, Darrieux L. Successful treatment of molluscum
contagiosum with a zinc oxide cream containing colloidal
oatmeal extracts. Indian J Dermatol 2010;55:295-6.
20. Sørensen HP, Madsen LS, Petersen J, Andersen JT, Hansen AM,
Beck HC. Oat (Avena sativa) seed extract as an antifungal food
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class I chitinase. Appl Biochem Biotechnol 2010;160:1573-84.
21. Baumann L, Rodriguez D, Taylor SC, Wu J. Natural
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considerations for skin of color. Cutis 2006;78:S2-19.
22. White AM, Jeffrey LP. Sterilization of colloidal oatmeal for use
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Public Health 1958;130:82-5.
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2008;44:415-29.
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Birck R, et al. Clinical benefit of a short term dietary oatmeal
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Key
1. d, 2. c, 3. d, 4. b, 5. d, 6. c, 7. b, 8. d, 9. a, 10. b
Multiple Choice Questions
1. Oatmeal is a good source of the following components, except:
a. Beta-glucan b. Vitamin B complex
c. Vitamin E d. Vitamin C
2. Which of the following interleukins may interact in proinflamatory pharmacodynamic in oatmeal?
a. IL-1 b. IL-2
c. IL-8 d. IL-10
3. Oatmeal does treat all the following disorders documented by clinical trial except:
a. Itching b. Acneiform eruptions
c. Atopic dermatitis d. Lichen planus
4. UV light is absorbed by oatmeal, which of the following UV band is the rang of the protection?
a. 300-320 b. 320-370
c. 320-330 d. 340-380
5. Which ingredient in oatmeal has a valuable effect for moisturizing?
a. Vitamin E b. Vitamin C
c. Vitamin B d. Beta-glucan
6. In cosmetic point of view which of the following ingredients is more effective:
a. Vitamin E b. Beta –glucan
c. Phenolic ester d. Vitamin B
7. How does the oatmeal act on lipid profiles:
a. Decreased VLDL b. Decreased LDL
c. Increased TG d. Increased HDL
8 Which of the following components is not bioactive constituent of oatmeal?
a. Fiber b. Lipid
c. Protein d. Glucose
9. How long (minutes) the affected area should be soaked in the oatmeal?
a. 10 b. 30
c. 40 d. 60
10. Which of the antimicrobial effect of oatmeal is more prominent?
a. Antibacterial b. Antiviral
c. Antifungal d. Antiprotozae

Supplementary resource (1)

... Nutritional profile Forage feed quality cosmetic, skin protection and anti-inflammatory properties (Singh et al. 2013;Rasane et al. 2015;Camilli et al. 2018;Mathews et al. 2020). It has been used to protect against cardiovascular disease, and has proved beneficial to celiac patients and for promotion of growth of prebiotic microorganisms (Othman et al. 2011;Pazyar et al. 2012;Gazal et al. 2014;Comino et al. 2015;Rasane et al. 2015;Tiwari et al. 2017). Phenolics such as flavonoids and avenanthramides have anti-allergic, anti-oxidant and anti-inflammatory properties similar to β-glucan (Singh et al. 2013;Raguindin et al. 2021). ...
... In vitro investigations have revealed that β-glucan protects DNA against mutagen damage, indicating an anti-carcinogenic activity (Oliveira et al. 2007;Benlier et al. 2022). It is also beneficial for dermatological inflammatory conditions and plays an important function in UV ray protection (Pazyar et al. 2012). ...
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Background: Irritant contact dermatitis (ICD) is the most frequent cause of hand eczema (HE). There is promising evidence with the use of topical oatmeal compounds in the management of inflammation- and itch-responses associated with diverse dermatologic conditions. This study aimed to evaluate the clinical benefit of colloidal oatmeal cream in the management of chronic irritant HE. Methods: From October 2018 to November 2019, 79 patients with diagnosis of chronic irritant HE were allocated into either intervention or control groups by block randomization method. Besides fluocinolone 0.025% ointment for the first 2 weeks of treatment period, patients in the intervention and control groups were asked to use colloidal oatmeal 1% cream or base cream for additional 4 weeks as monotherapy. Changes in the HE severity based on the hand eczema severity index (HESCI) score, pruritus severity based on the visual analogue scale (VAS), and impact of skin disorder on patients quality of life based on the Dermatology Life Quality Index (DLQI) from baseline to weeks 2, 4, and 6 were assessed in the study groups. Results: Fifty subjects, 26 in intervention and 24 in control, completed the course of the study. The results indicated, though relatively comparable decrease in mean HESI and VAS scores was observed in both groups by the end of week 2, thereafter until end of the study a non-return of symptoms to baseline conditions was observed in the intervention group, while there was a significant return of symptoms to baseline conditions in the control group (p value<0.001 in both conditions). Further, a noticeable improvement in the DLQI score was seen in the intervention group compared with the control group (p value<0.001). Conclusion: Findings demonstrate that colloidal oatmeal, a natural product with proven barrier protection, moisturization, anti-inflammatory, and soothing properties, can have ameliorative effects on eczema severity symptoms in patients with chronic irritant HE.
Article
Background: Pruritus is a sensation that leads to the desire to scratch; its origin is unknown in 8% to 15% of affected patients. The prevalence of chronic pruritus of unknown origin (CPUO) in individuals with generalised pruritus ranges from 3.6% to 44.5%, with highest prevalence among the elderly. When the origin of pruritus is known, its management may be straightforward if an effective treatment for the causal disease is available. Treatment of CPUO is particularly difficult due to its unknown pathophysiology. Objectives: To assess the effects of interventions for CPUO in adults and children. Search methods: We searched the following up to July 2019: Cochrane Skin Group Specialised Register, CENTRAL, MEDLINE, Embase, and trials registries. We checked the reference lists of included studies for additional references to relevant trials. Selection criteria: We sought to include randomised controlled trials and quasi-randomised controlled trials that assessed interventions for CPUO, as defined in category VI ('Other pruritus of undetermined origin, or chronic pruritus of unknown origin') of the International Forum for the Study of Itch (IFSI) classification, in children and adults. Eligible interventions were non-pharmacological or topical or systemic pharmacological interventions, and eligible comparators were another active treatment, placebo, sham procedures, or no treatment or equivalent (e.g. waiting list). Data collection and analysis: We used standard methodological procedures expected by Cochrane. Our primary outcomes were 'Patient- or parent-reported pruritus intensity' and 'Adverse events'. Our secondary outcomes were 'Health-related quality of life', 'Sleep disturbances', 'Depression', and 'Patient satisfaction'. We used GRADE to assess the certainty of evidence. Main results: We found there was an absence of evidence for the main interventions of interest: emollient creams, cooling lotions, topical corticosteroids, topical antidepressants, systemic antihistamines, systemic antidepressants, systemic anticonvulsants, and phototherapy. We included one study with 257 randomised (253 analysed) participants, aged 18 to 65 years; 60.6% were female. This study investigated the safety and efficacy of three different doses of oral serlopitant (5 mg, 1 mg, and 0.25 mg, once daily for six weeks) compared to placebo for severe chronic pruritus; 25 US centres participated (clinical research centres and universities). All outcomes were measured at the end of treatment (six weeks from baseline), except adverse events, which were monitored throughout. A pharmaceutical company funded this study. Fifty-five per cent of participants suffered from CPUO, and approximately 45% presented a dermatological diagnosis (atopic dermatitis/eczema 37.3%, psoriasis 6.7%, acne 3.6%, among other diagnoses). We unsuccessfully attempted to retrieve outcome data from study authors for the subgroup of participants with CPUO. Participants had pruritus for six weeks or longer. Total study duration was 10 weeks. Participants who received serlopitant 5 mg may have a greater rate of relief of patient-reported pruritus intensity as measured by the visual analogue scale (VAS; a reduction in VAS score indicates improvement) compared to placebo (126 participants, risk ratio (RR) 2.06, 95% confidence interval (CI) 1.27 to 3.35; low-certainty evidence). We are uncertain of the effects of serlopitant 5 mg compared to placebo on the following outcomes due to very low-certainty evidence: adverse events (127 participants; RR 1.48, 95% CI 0.87 to 2.50); health-related quality of life (as measured by the Dermatology Life Quality Index (DLQI); a higher score indicates greater impairment; 127 participants; mean difference (MD) -4.20, 95% CI -11.68 to 3.28); and sleep disturbances (people with insomnia measured by the Pittsburgh Sleep Symptom Questionnaire-Insomnia (PSSQ-I), a dichotomous measure; 128 participants; RR 0.49, 95% CI 0.24 to 1.01). Participants who received serlopitant 1 mg may have a greater rate of relief of patient-reported pruritus intensity as measured by VAS compared to placebo; however, the 95% CI indicates that there may also be little to no difference between groups (126 participants; RR 1.50, 95% CI 0.89 to 2.54; low-certainty evidence). We are uncertain of the effects of serlopitant 1 mg compared to placebo on the following outcomes due to very low-certainty evidence: adverse events (128 participants; RR 1.45, 95% CI 0.86 to 2.47); health-related quality of life (DLQI; 128 participants; MD -6.90, 95% CI -14.38 to 0.58); and sleep disturbances (PSSQ-I; 128 participants; RR 0.38, 95% CI 0.17 to 0.84). Participants who received serlopitant 0.25 mg may have a greater rate of relief of patient-reported pruritus intensity as measured by VAS compared to placebo; however, the 95% CI indicates that there may also be little to no difference between groups (127 participants; RR 1.66, 95% CI 1.00 to 2.77; low-certainty evidence). We are uncertain of the effects of serlopitant 0.25 mg compared to placebo on the following outcomes due to very low-certainty evidence: adverse events (127 participants; RR 1.29, 95% CI 0.75 to 2.24); health-related quality of life (DLQI; 127 participants; MD -5.70, 95% CI -13.18 to 1.78); and sleep disturbances (PSSQ-I; 127 participants; RR 0.60, 95% CI 0.31 to 1.17). The most commonly reported adverse events were somnolence, diarrhoea, headache, and nasopharyngitis, among others. Our included study did not measure depression or patient satisfaction. We downgraded the certainty of evidence for all outcomes due to indirectness (only 55% of study participants had CPUO) and imprecision. We downgraded outcomes other than patient-reported pruritus intensity a further level due to concerns regarding risk of bias in selection of the reported result and some concerns with risk of bias due to missing outcome data (sleep disturbances only). We deemed risk of bias to be generally low. Authors' conclusions: We found lack of evidence to address our review question: for most of our interventions of interest, we found no eligible studies. The neurokinin 1 receptor (NK1R) antagonist serlopitant was the only intervention that we could assess. One study provided low-certainty evidence suggesting that serlopitant may reduce pruritus intensity when compared with placebo. We are uncertain of the effects of serlopitant on other outcomes, as certainty of the evidence is very low. More studies with larger sample sizes, focused on patients with CPUO, are needed. Healthcare professionals, patients, and other stakeholders may have to rely on indirect evidence related to other forms of chronic pruritus when deciding between the main interventions currently used for this condition.
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Topical therapy forms the cornerstone of treatment in the management of psoriasis. It plays a significant role as monotherapy in mild to moderate psoriasis, and it is used predominantly as adjunctive therapy in moderate to severe forms of the disease. Over the past decade, the topical treatment of psoriasis has evolved from the age-old applications, such as coal tar, to the more cosmetically acceptable and efficacious options containing topical corticosteroids, vitamin D analogues, and combined agents. With the advent of topical therapies in tailored vehicles and sophisticated delivery modes, the outlook for effectively managing psoriasis with topical approaches appears promising. To ensure therapeutic success, patient education about the disease, treatment options, proper administration, and adverse effects is essential, which will alleviate the common problem of poor patient adherence and promote more optimal clinical outcomes.
Background: Colloidal grain suspensions have been used for decades as adjuncts in the treatment of atopic dermatitis, especially in the US. In Italy, many young children have been exposed to colloidal grains. Recently, it was suggested that these bath therapies may induce allergic contact dermatitis in some young atopic children. Objective: To evaluate the allergic skin reactions to topical oat and rice colloidal grain suspensions of normal and atopic children with and without previous exposure to colloidal grain suspensions. Methods: A double-blind, randomized patch study. Two concentrations of oat and rice colloidal grains (0.007% and 0.7%) were applied occlusively to the backs of 65 children living in Italy, ages 6 months to 2 years (43 were atopic and 22 were normal). Results: There were neither immediate urticarial nor allergic reactions in any of the 65 study subjects, atopic or nonatopic; 5 of 43 (12%) atopic subjects developed irritant reactions to the test materials. Radioallergosorbent tests (RAST) tests were performed on 55 subjects. The negative RAST test results found in the nonatopic group correlated well with nonatopic status, but positive RAST tests were found in only 8 of 35 (23%) atopic dermatitis subjects. None of the sera from positive RAST scores corresponded to subjects with irritant patch reactions. Conclusions: The data indicate that topical colloidal grains can be used as an adjunct in the management of mild atopic dermatitis in children under 2 years of age. There was no evidence of sensitization to topical colloidal grains in the group studied.
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Extracts from different higher plants were screened for the ability to inhibit the growth of Penicillium roqueforti, a major contaminating species in industrial food processing. Oat (Avena sativa) seed extracts exhibited a high degree of antifungal activity and could be used directly on rye bread to prevent the formation of P. roqueforti colonies. Proteins in the oat seed extracts were fractionated by column chromatography and proteins in fractions containing antifungal activity were identified by liquid chromatography–tandem mass spectrometry (LC-MS/MS) and database searches. Identified antifungal candidates included thaumatin-like proteins, 1,3-beta-glucanase, permatin precursor, pathogenesis-related protein type 1, and chitinases of class I and II. Class I chitinase could be specifically removed from the extracts and was found to be indispensable for 50% of the P. roqueforti inhibiting activity. The purified class I chitinase has a molecular weight of approximately 34kDa, optimal chitinase activity at pH7, and exists as at least two basic isoforms (pI values of 7.6 and 8.0). Partial sequencing of the class I chitinase isoforms by LC-MS/MS revealed a primary structure with high similarity to class I chitinases of wheat (Triticum aestivum), barley (Hordeum vulgare), and rye (Secale cereale). Oat, wheat, barley, and rye seed extracts were compared with respect to the abundance of the class I chitinase and decrease in antifungal activity when class I chitinase is removed. We found that the oat seed class I chitinase is at least ten times more abundant than the wheat, barley, and rye homologs and that oat seed extracts are highly active toward P. roqueforti as opposed to extracts of other cereal seeds. KeywordsOat-Chitinase-Protein purification-Antifungal-Mass spectrometry
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Colloidal oatmeal has a long history of beneficial use in dermatology. It is a natural product that has an excellent safety record and has demonstrated efficacy for the treatment of atopic dermatitis, psoriasis, drug-induced rash and other conditions. In recent years, in vitro and in vivo studies have begun to elucidate the multiple mechanisms of action of naturally derived colloidal oatmeal. Evidence now describes its molecular mechanisms of anti-inflammatory and antihistaminic activity. The avenanthramides, a recently described component of whole oat grain, are responsible for many of these effects. Studies have demonstrated that avenanthramides can inhibit the activity of nuclear factor kappaB and the release of proinflammatory cytokines and histamine, well known key mechanisms in the pathophysiology of inflammatory dermatoses. Topical formulations of natural colloidal oatmeal should be considered an important component of therapy for atopic dermatitis and other conditions and may allow for reduced use of corticosteroids and calcineurin inhibitors.
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Natural ingredients have been used traditionally for millennia and their application in topical creams, lotions and preparations within the traditional medicines and healing traditions of many cultures has been observed. Over the last 20 years, clinical and laboratory studies have identified the benefits of an array of natural ingredients for skin care. Consequently, a number of these ingredients and compounds are today being developed, used or considered not only for anti-aging effects, but also for use in dermatologic disorders. Certain ingredients, such as colloidal oatmeal and aloe vera, have been identified as beneficial in the treatment of psoriasis and atopic dermatitis, respectively, due to their anti-inflammatory properties. For combating acne and rosacea, green tea, niacinamide and feverfew are considered efficacious. As to hyperpigmentation and antioxidative capabilities, licorice, green tea, arbutin, soy, acai berry, turmeric and pomegranate are among those plants and compounds found to be most beneficial. Additional research is needed to determine to confirm and elucidate the benefits of these ingredients in the prevention and management of skin disease.
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A considerable amount of evidence indicates that tumorigenesis is associated with inflammation. Nuclear factor-kappa B (NF-kappa B), a master regulator of infection and inflammation, has been identified as a key modulator in which inflammation could develop into cancer. Dietary polyphenols have been shown to have anti-inflammatory and anticancer activity partially through inhibition of NF-kappa B activation. This review summarizes the effect of polyphenols on inflammation and cancer; avenanthramides, a unique polyphenol from oats, are especially focused.
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Avenanthramides are substituted N-cinnamoylanthranilic acids, with hydroxycinnamic acid and anthranilic acid moieties. These alkaloid phenols, which are unique to oats, may confer health benefits via antioxidant or other mechanisms. Synthetic avenanthramides, hydroxycinnamic acids, Tranilast, and ascorbic acid were evaluated for antioxidant activity using two assays, DPPH (2,2-diphenyl-1-picrylhydrazyl) and FRAP (ferric reducing antioxidant potential), and for antigenotoxicity using the Comet assay with stressed human adenocarcinoma colon cells. Of all the compounds tested, N-(3',4'-dihydroxy-(E)-cinnamoyl)-5-hydroxyanthranilic acid (2c), an abundant oat avenanthramide, generally had the highest activity in all three assays. The drug Tranilast showed antigenotoxic effects, but not antioxidant activity, suggesting that antigenotoxicity is not dependent on antioxidant effects. Overall, results show that avenanthramides exert antioxidant and antigenotoxic activities that are comparable to those of ascorbic acid and which have the potential to exert beneficial physiological effects.
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The effects of oat bran and wheat bran on plasma lipid concentrations were compared in a crossover study. Each bran (123 g oat bran or 54 g wheat bran) added nearly 18 g of nonstarch polysaccharide to a background diet containing about 10 g nonstarch polysaccharide. Twenty-three men (average plasma cholesterol level = 5.84 mmol/L, and low-density-lipoprotein (LDL) cholesterol level = 4.11 mmol/L) were randomly assigned to either the oat or wheat bran diet for 4 weeks and then changed to the alternate bran diet for a similar period. The oat bran diet produced significantly lower levels of plasma total cholesterol and LDL cholesterol: 5.65 +/- 0.16 and 3.88 +/- 0.15 mmol/L (mean +/- standard error) for oat bran vs 5.89 +/- 0.16 and 4.11 +/- 0.16 mmol/L for wheat bran. Food intake diaries showed that average consumption of total fat and saturated fat was identical during the two test periods, which excluded displacement of fat as an explanation for lowering of plasma cholesterol by oat bran. Our results indicate that in mildly hypercholesterolemic men, a diet high in soluble oat fiber can significantly lower plasma total cholesterol and LDL cholesterol and thus potentially lower the risk of coronary heart disease.
Colloidal grain suspensions have been used for decades as adjuncts in the treatment of atopic dermatitis, especially in the US. In Italy, many young children have been exposed to colloidal grains. Recently, it was suggested that these bath therapies may induce allergic contact dermatitis in some young atopic children. To evaluate the allergic skin reactions to topical oat and rice colloidal grain suspensions of normal and atopic children with and without previous exposure to colloidal grain suspensions. A double-blind, randomized patch study. Two concentrations of oat and rice colloidal grains (0.007% and 0.7%) were applied occlusively to the backs of 65 children living in Italy, ages 6 months to 2 years (43 were atopic and 22 were normal). There were neither immediate urticarial nor allergic reactions in any of the 65 study subjects, atopic or nonatopic; 5 of 43 (12%) atopic subjects developed irritant reactions to the test materials. Radioallergosorbent tests (RAST) tests were performed on 55 subjects. The negative RAST test results found in the nonatopic group correlated well with nonatopic status, but positive RAST tests were found in only 8 of 35 (23%) atopic dermatitis subjects. None of the sera from positive RAST scores corresponded to subjects with irritant patch reactions. The data indicate that topical colloidal grains can be used as an adjunct in the management of mild atopic dermatitis in children under 2 years of age. There was no evidence of sensitization to topical colloidal grains in the group studied.