ArticleLiterature Review

Synthetic Tannins in Dermatology—A Therapeutic Option in a Variety of Pediatric Dermatoses

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Abstract

Synthetic tannins are established adjuvants in the therapy of itchy, inflamed, weeping, superficial skin diseases. The therapeutic effects of synthetic tannins are based on their tanning action as well as on their antimicrobial, anti-inflammatory, and antipruritic effects. In terms of pharmacology and clinical applicability, synthetic tannins are particularly versatile substances. They have also been used as steroid-free, anti-inflammatory treatment alternatives, especially in pediatric dermatoses. Systemic absorption is not to be expected. Because of their high safety profile and good tolerance, they are appropriate for the treatment of all age groups. Thus, synthetic tannins can be safely used for infants and children and also during pregnancy and lactation.

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... The binding and precipitation properties of tannins allow for them to bind with protein-rich structures of the skin such as collagen. Tannins have also been proposed to interact with the plasma glycoproteins fibronectin and fibrinogen [19]. Tannin phytochemicals possess potent astringent properties. ...
... Tannin phytochemicals possess potent astringent properties. In medicine, tannins have been used for the treatment of inflamed superficial skin diseases, and as a desiccant in the treatment of weeping skin inflammations such as shingles and acute eczema [19]. The mechanism of action is thought to be related to the cross-linking of structural proteins [19]. ...
... In medicine, tannins have been used for the treatment of inflamed superficial skin diseases, and as a desiccant in the treatment of weeping skin inflammations such as shingles and acute eczema [19]. The mechanism of action is thought to be related to the cross-linking of structural proteins [19]. The precipitation of proteins and sealing of cell membranes reduces tissue exudate, allowing for dessication of the affected area and expedited healing. ...
Article
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Slippery elm is an herbal medicine derived from the inner bark of the slippery elm (Ulmus rubra - also known as Red Elm or Indian Elm) tree. It has been used to treat edema and inflammation as an alternative/complimentary form of medicine for many years. In the United States, slippery elm is marketed commercially to treat upper airway inflammatory conditions, and its reported benefits in treating these conditions are ubiquitous in anecdotal contexts. Individuals with voice disorders and other inflammatory conditions of the upper airway (e.g., laryngitis) are increasingly seeking information related to the use of herbal medications such as slippery elm, although most clinicians are unfamiliar with these medications and do not understand their biological actions and purported benefits. Furthermore, no scientific evidence is available to support the validity of slippery elm’s use in treating upper airway inflammatory conditions. The purpose of this manuscript is to review the biochemical composition, biological actions, and purported societal use of slippery elm as a complementary or alternative medicine specific to upper airway inflammatory conditions, present results from a pilot study investigating the soothing effects of slippery elm on the tissue of the upper airway, and present a framework for potential scientific investigation of slippery elm and related herbal medications.
... 50-70%, gallic acid, syringic acid, ellagic acid, b-sitosterol, amentoflavone, hexamethyl ether, isocryptomerin, methyl betulate, methyl oleanate and hexagalloyl glucose (Ikram and Nowshad 1977;Dar and Ikram 1979;Hwang et al. 2000). Tannins have been used for hundreds of years for medical purposes and are currently indispensable in dermatology (Folster-Holst and Latussek 2007). Although, catechins, a condense tannin, have been intensively studied on their mechanisms of actions on bacterial cells. ...
Article
To investigate the antimethicillin-resistant Staphylococcus aureus (MRSA) mechanism of Quercus infectoria (nutgalls) extract and its components. Ethanol extract, an ethyl acetate fraction I, gallic acid and tannic acid could inhibit the growth of clinically isolated MRSA strains with minimum inhibitory concentration values between 63 and 250 microg ml(-1). Clumps of partly divided cocci with thickened cell wall were observed by transmission electron microscopy in the cultures of MRSA incubated in the presence of the ethanol extract, the ethyl acetate fraction I and tannic acid. Because cell wall structure of the organism structures seemed to be a possible site for antibacterial mechanisms, their effect with representative beta-lactam antibiotics were determined. Synergistic effects with fractional inhibitory concentration index ranged from 0.24 to 0.37 were observed with 76% and 53% of the tested strains for the combination of the ethanol extract with amoxicillin and penicillin G, respectively. The appearance of pseudomulticellular bacteria in the treated cells and the synergistic effect of the plant extract with beta-lactamase-susceptible penicillins suggest that the extract may interfere with staphylococcal enzymes including autolysins and beta-lactamase. Our results provide scientific data on the use of the nutgalls, which contain mainly tannin contents up to 70% for the treatment of staphylococcal infections.
... hydrolysable tannins), flavone subunit (non-hydrolysable or condensed tannins) or phloroglucinol subunits (phloro-tannins). Tannins from different sources have been studied for their antiviral (Ueda et al., 2013), antibacterial (Akiyama et al., 2001), antioxidant (Gu et al., 2008;Tourino et al., 2008), pediatric dermatoses (Fölster-Holst and Latussek, 2007), anti-inflammatory (Mota et al., 1985;Liu et al., 2015) and radioprotective effects (Zhou et al., 2016). Tannins have been used medically for many years and their importance in dermatological application have gained significant importance because of their astringent effects, management of superficial skin condition, weeping, inflammation and itching with acceptable tolerability. ...
Article
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Diospyros kaki L.f. belonging to family Ebenaceae, commonly known as persimmon is used as a medicinal plant in Chinese traditional medicine since many years for different ailments including cosmetics and dermatologic applications. Traditionally this plant is used to treat different skin conditions including pimples, skin eruptions and eczema. Present interest has been focused toward use of natural bioactive compounds in various curative and beautifying applications in dermatological and cosmeceutical disciplines. The objective of this article is to present cumulative data on potential use of D. kaki for its possible role in dermatologic and cosmetic applications. Scientific data has revealed an excellent position of D. kaki in both dermatology and cosmetic discipline making it a valuable choice in respective field. Active principles from different plant parts have shown to possess anti-inflammatory, antiallergic, photo-protective, and anti-wrinkle effects with appreciable activities against tyrosinase, elastase, and collagenase enzymes. Promising antioxidant activity and skin whitening potential, augmented by reduction in sebum contents, and reduction in size and number of skin pores make it a suitable choice as cosmetic ingredient. Data has been summarized and presented on available molecular mechanism that can contribute toward phytoconstituents usage in cosmetics and dermatology mediated by different cellular pathways. Crude extracts and some of phytochemical obtained from this plant such as isoquercitrin and hyperin have better reported activities than well-known cosmetic ingredients viz., arbutin, kojic acid and hydroquinone with possibility of having no side effects. Photo protection against degenerative effects of UVA, UVB and gamma radiation can help skin to fight well against oxidative stress and reactive oxygen species. Further investigation need to be directed toward human subjects for evaluation of these reported activities for obtaining optimum commercial and industrial benefits from this valuable plant.
... Myricitrin has antiallodynic properties via antiinflammatory actions (Meotti et al., 2006). Of course, the utility of tannins in skin dermatitis is well established (Folster-Holst and Latussek, 2007). ...
Article
Flavonoids are a family of polyphenolic compounds which are widespread in nature (vegetables) and are consumed as part of the human diet in significant amounts. There are other types of polyphenols, including, for example, tannins and resveratrol. Flavonoids and related polyphenolic compounds have significant antiinflammatory activity, among others. This short review summarizes the current knowledge on the effects of flavonoids and related polyphenolic compounds on inflammation, with a focus on structural requirements, the mechanisms involved, and pharmacokinetic considerations. Different molecular (cyclooxygenase, lipoxygenase) and cellular targets (macrophages, lymphocytes, epithelial cells, endothelium) have been identified. In addition, many flavonoids display significant antioxidant/radical scavenging properties. There is substantial structural variation in these compounds, which is bound to have an impact on their biological profile, and specifically on their effects on inflammatory conditions. However, in general terms there is substantial consistency in the effects of these compounds despite considerable structural variations. The mechanisms have been studied mainly in myeloid cells, where the predominant effect is an inhibition of NF-κB signaling and the downregulation of the expression of proinflammatory markers. At present there is a gap in knowledge of in vitro and in vivo effects, although the pharmacokinetics of flavonoids has advanced considerably in the last decade. Many flavonoids have been studied for their intestinal antiinflammatory activity which is only logical, since the gastrointestinal tract is naturally exposed to them. However, their potential therapeutic application in inflammation is not restricted to this organ and extends to other sites and conditions, including arthritis, asthma, encephalomyelitis, and atherosclerosis, among others.
... According to Monteiro et al. [43], so far there are only a few studies investigating the activity of these compounds for the treatment of diseases from medicinal plants. For the treatment of inflammation, tannins form complexes with proteins and polysaccharides [44] which may, for example, form protective layers on injured epithelial tissues [45] that present antimicrobial and antifungal activity [46]. Therefore, tannins may exert anti-inflammatory activity in epithelial tissues. ...
Article
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We use the model of utilitarian redundancy as a basis for research. This model provides predictions that have not been tested by other research. In this sense, we sought to investigate the stem bark extraction between preferred and less-preferred species by a rural community in Caatinga environment. In addition, we sought to explain local preferences to observe if preferred plants have a higher content of tannins than less-preferred species. For this, we selected seven preferred species and seven less-preferred species from information obtained from semistructured interviews applied to 49 informants. Three areas of vegetation around the community were also selected, in which individuals were tagged, and were measured the diameter at ground level (DGL) diameter at breast height (DBH), and measurements of available and extracted bark areas. Samples of bark of the species were also collected for the evaluation of tannin content, obtained by the method of radial diffusion. From the results, the preferred species showed a greater area of bark removed. However, the tannin content showed no significant differences between preferred and less-preferred plants. These results show there is a relationship between preference and use, but this preference is not related to the total tannins content.
... For acute dermatitis, hand baths, wet dressings and soaks with solutions that have astringent and drying effects are recommended. Synthetic tannins are cosmetically more acceptable than the outdated staining solutions such as Burrow or potassium permanganate [35]. Apart from reducing exudation, these wet dressings and soaks help soften and remove dried crusts and scales. ...
Article
Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.
... In situations where there is minimal exudate, dryness and peeling, the use of tannins in the form of creams is preferred. The mechanism of action of tannins and emollient cream base make this formulation effective in inflammatory skin diseases with skin dryness, either alone in mild forms of AD, or in combination with local corticosteroids, antifungals and antibiotics in more severe cases complicated with secondary infection [53]. The lotion form of tannins additionally contains zinc oxide and talc, which exhibit hygroscopic properties, making it favorable for use as monotherapy or adjunctive therapy of skin lesions accompanied by exudate and located in the vicinity of intertriginous areas. ...
Article
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A b s t r a c t Atopic dermatitis (AD) is a condition frequently encountered in medical practices across the country. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). Patients with AD have a unique predisposition to colonization or infection by Staphylococcus aureus. Treatments for AD need to rapidly control symptoms of the disease, improve quality of life and prevent exacerbations. Given the chronic and relapsing nature of the disease, therapies need to encourage good compliance and be well tolerated.
... In situations where there is minimal exudate, dryness and peeling, the use of tannins in the form of creams is preferred. The mechanism of action of tannins and emollient cream base make this formulation effective in inflammatory skin diseases with skin dryness, either alone in mild forms of AD, or in combination with local corticosteroids, antifungals and antibiotics in more severe cases complicated with secondary infection [53]. The lotion form of tannins additionally contains zinc oxide and talc, which exhibit hygroscopic properties, making it favorable for use as monotherapy or adjunctive therapy of skin lesions accompanied by exudate and located in the vicinity of intertriginous areas. ...
Article
Full-text available
Atopic dermatitis (AD) is a condition frequently encountered in medical practices across the country. More than 60% of children with AD are at risk to develop allergic rhinitis or asthma (the atopic march). Patients with AD have a unique predisposition to colonization or infection by Staphylococcus aureus. Treatments for AD need to rapidly control symptoms of the disease, improve quality of life and prevent exacerbations. Given the chronic and relapsing nature of the disease, therapies need to encourage good compliance and be well tolerated.
... Dostępna jest w trzech postaciach: totionu, |<remu oraz roztworu do |<ąpieli i ol<ładÓw.Gdy wysięk -jest niewiell<i i obserwuje się wysuszenie oraz złuszczanie naskÓr|<a, preferowane jest zastosowanie taniny w postaci l<remu. Mechanizm działania taniny i emoliencyjne podłoŻe |<remu sprawiają, że preparat ten moze byĆ stosowany w stanach zapalnych sl<Óry przebiegających z jej wysuszeniem zarÓwno w monoterapii łagodnych postaci AZS, jal< i w terapii sl<ojarzonej z mGl(S, Le|<ami przeciwgrzybiczymi i antybiotyl<ami w cięzszych postaciach powiI<łanych wtÓrną infel<cją[53]. Lotion oprÓcz taniny zawiera dodat|<owo tlenel< cynl<u i tal|<, l<tÓre mają działanie higroskopijne. ...
... Jeśli wysięk jest niewielki i występuje wysuszenie oraz złuszczanie naskórka, preferowane jest zastosowanie taniny w postaci kremu. Mechanizm działania taniny i emoliencyjne podłoże kremu sprawiają, że preparat ten może być stosowany w stanach zapalnych skóry przebiegających z wysuszeniem skóry zarówno w monoterapii łagodnych postaci AZS, jak i w terapii skojarzonej z mGKS, lekami przeciwgrzybiczymi i antybiotykami w cięższych postaciach powikłanych wtórną infekcją [53]. Lotion oprócz taniny zawiera dodatkowo tlenek cynku i talk, które wykazują działanie higroskopijne. ...
... For an acute dermatitis, hand baths, wet dressings, and soaks with solutions, which have astringent and drying effects, are recommended. Such solutions are saline, aluminum acetate (Burrow's solution, may cause irritation if used longer than 3 days [16]), potassium permanganate (e.g., 4 times a day to soak for vesiculobullous eruptions, stains the skin and nails brown but has excellent drying and antiseptic effects) and synthetic tannins [17]. Apart from reducing exudation, these wet dressings and soaks help soften and remove dried crusts and scales. ...
Chapter
Dermatika zählen in Deutschland zu den verordnungsstärksten Arzneimitteln. Ihre Anwendungsgebiete sind sehr unterschiedlich. Entsprechend heterogen sind die Stoffklassen, die von den Corticosteroidexterna über die dermatologischen Anti mykotika sowie die Wundbehandlungsmittel bis zu den Hautschutz- und Pflegemitteln reichen (Abbildung 25.1).
Article
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Background and purpose: Dental caries is a pathological infectious disease. It begins with the formation of dental plaques which is a structurally and functionally organized biofilm. Streptococcus mutans is the most important bacterium in the formation of dental plaque and dental caries. This study aimed at evaluating the antibacterial and antibiofilm activity of Quercus infectoria galls against Streptococcus mutans. Materials and methods: The bacterial strain used in this study was Streptococcus mutans (ATCC: 25923). Extracts were prepared by Soxehlet apparatus and maceration. They were then dissolved in sterile distilled water to a final concentration of 0.16 to 10.00 mg/ml. The antimicrobial activities of the extracts were determined using well diffusion method. The antibiofilm activities of the extracts were examined in a microdilution assay using TTC. Statistical analysis was performed in SPSS V.18. Results: The methanol, ethanol, and acetone extracts of Quercus infectoria galls showed strong inhibitory effects against Streptococcus mutans. The MIC values of extracts were similar and ranged from 160μg/ml to 320μg/ml, whereas the MBC values ranged from 320μg/ml to 640μg/ml. Aqueous extracts of oak galls did not show antimicrobial activity. The extracts of Quercus infectoria galls strongly inhibited the formation of Streptococcus mutans biofilms at concentrations higher than 19.5μg/ml. Conclusion: The extracts of Quercus infectoria galls displayed similarities in their antibacterial activity against Streptococcus mutans. Also, they were found effective in preventing biofilm formation of Streptococcus mutans. The galls of Quercus infectoria are considered potentially good sources of antimicrobial agent. Keywords: Antibacterial activity, dental plaque, oak gall, plant extract, Streptococcus mutans J Mazandaran
Article
1. Die biologisch kontrollierte Fraktionierung eines Extraktes aus Blättern der traditionell verwendeten Euphorbiaceae Hieronyma alchorneoides Fr. Allemão, führte zur Isolierung und Strukturaufklärung (mittels NMR- und MS-Untersuchungen) der drei Biflavonoide 7,4‘‘-O-Dimethylamentoflavon (H.1), 7-O-Methyl-amentoflavon (H.2) und Amentoflavon (H.3) sowie von (+)-Catechin (H.4). Die Verbindungen H.1 und H.2 sowie H.4 sind im Rahmen dieser Arbeit erstmals für die Gattung Hieronyma beschrieben worden. 2. Die phytochemische Untersuchung eines Extraktes aus den Blättern von Siparuna thecaphora (Poepp. et Endl.) A. DC. (Siparunaceae), der im MTT-Test eine starke cytotoxische Aktivität aufwies, führte zur Isolierung des Flavonoids 3,7,4‘ Trimethoxykämpferol (S.1) und des Alkaloids Aristolactam AIIIa (S.2). S.1 ist hier für die Art, S.2 für die Gattung erstmals beschrieben. Zur Strukturaufklärung wurden MS- und NMR-Daten eingesetzt. 3. Es konnte gezeigt werden, dass Sesquiterpenlactone aus den Blüten von Arnica montana sowie Arnikazubereitungen die DNA-Bindung des Transkriptionsfaktors AP 1 in Jurkat-T-Zellen hemmen. Helenalinisobutyrat führte in einer Konzentration von 5 µM zu einer vollständigen Hemmung der IL-1β-induzierten Aktivierung von AP-1. Für den gleichen Effekt wurde von Dihydrohelenalinisovalerianat und Dihydrohelenalinmethacrylat eine Konzentration von ca. 20 µM benötigt. Dies steht im Einklang mit vorhergehenden Analysen mit dem Transkriptionsfaktor NF-κB, die ebenfalls eine stärkere Aktivität von Helenalinderivaten gezeigt haben. In Übereinstimmung damit zeigte eine Tinktur aus mitteleuropäischen (ME), getrockneten Arnikablüten eine deutliche Hemmung der AP-1-DNA-Bindung bei einer Konzentration von 2 µL/mL. Von der Tinktur aus frischen Blüten (ME) und einer Tinktur aus spanischen Arnikablüten waren 5 µL/mL für eine vollständige Hemmung der nach Stimulierung mit IL-1β induzierten Aktivierung von AP-1 erforderlich. Das Gel, das eine Tinktur aus frischen Blüten (ME) enthält, zeigte diesen Effekt bei 10 µL/mL. 4. Weitergehende Untersuchungen zum Wirkmechanismus der AP-1-Hemmung mit Parthenolid und 4β-15-Epoxymiller-9Z-enolid zeigten, dass Sesquiterpenlactone AP 1 direkt angreifen. 5. Die verschiedenen Arnikazubereitungen wurden außerdem auf ihre Hemmaktivität gegenüber der IL 1β-induzierten Expression von MMP1 und MMP13 auf Genebene in Chondrocyten mittels qRT-PCR untersucht. Alle Zubereitungen zeigten eine konzentrationsabhängige, zu der Vergleichssubstanz Helenalinisobutyrat (2 µM) ähnlich starke Verringerung der Genexpression in einem Bereich von 0,2 µL bis 5 µL/mL in bovinen Chondrocyten. Diese starke, konzentrationsabhängige Hemmung konnte exemplarisch auch für Arnikagel in humanen Chondrocyten gezeigt werden. 6. Agrimoniin, Pedunculagin und EGCG konnten als starke direkte Inhibitoren von Humaner Neutrophiler Elastase identifiziert werden. Die IC50 Werte lagen hierbei zwischen 0,9 µM und 25 µM. Sieben weitere phenolische Verbindungen zeigten keine oder nur eine geringe Hemmaktivität. Bei den Untersuchungen, in wieweit die Substanzen die Elastasefreisetzung aus Neutrophilen Granulocyten hemmen können, wurden als aktivste Verbindungen Genistein mit einem IC50-Wert von 0,5 µM sowie Resveratrol mit einem IC50-Wert von 12 µM ermittelt. Alle anderen Substanzen, wie Tyrosol, Hydroxytyrosol, Triacetoxystilben, (+) Epicatechin und (+)-Epicatechin-(4α-8)-(+)-epicatechin, waren schwächer aktiv, die Hemmung lag dort bei einer Konzentration von 50 µM teilweise deutlich unter 50 %. 7. Es wurde ein Elastase-Assay im Arbeitskreis etabliert, um das in Kooperation mit anderen Arbeitskreisen nach Bindungsstudien und chemischer Synthese zur Verfügung stehende Bornyl-3,4,5-trihydroxycinnamat zu testen. Die Aktivität lag mit einem IC50-Wert von 0,54 µM über der der Vergleichssubstanz Bornylcaffeat (IC50-Wert von 1,56 µM). 8. In einem weiteren Kapitel wurde eine Übersicht über die aktuelle Literatur zur Bedeutung von Gerbstoffen bei topischer Anwendung, ihren Einsatzgebieten und möglichen Wirkmechanismen zusammengestellt und diskutiert.
Chapter
Auf einen Blick Verordnungsprofil Seit Jahren verändert sich das Verordnungsspektrum der zahlreichen dermatologischen Wirkstoffklassen nur marginal. Wie in den Vorjahren werden topische Corticosteroide am häufigsten verordnet. Auf sie entfällt fast jede zweite verordnete Dermatikatagesdosis. Antimykotika (12 %), Psoriasismittel (10 %), Aknemittel (6 %), Antiinfektiva (5 %), Warzenmittel, Wundbehandlungsmittel und Mittel bei aktinischen Keratosen (jeweils 4 %) sowie Rosazeamittel und Antipruriginosa (jeweils 3 %) werden deutlich seltener verordnet. Die verbleibenden Gruppen hatten 2019 zusammen nur noch einen Verordnungsanteil von weniger als 3 %. Trend Die Verordnungen in den einzelnen Marktsegmenten werden weitgehend durch nationale und internationale Therapieempfehlungen gestützt. Die Gesamtverordnungsmenge bezogen auf DDD stieg 2019 im Vergleich zum Vorjahr lediglich um 2,3 %, mit deutlicheren Zuwächsen bei den Corticosteroidtopika und den Psoriasismitteln. Die Mehrverordnungen sind jedoch mit Kostensteigerungen von 13,5 % verbunden, die in erster Linie auf das Konto der hochwirksamen Biologika (Ustekinumab, Secukinumab, Guselkumab) zur Behandlung der Psoriasis gehen. Damit entfällt fast die Hälfte der gesamten dermatologischen Verordnungskosten (1.934 Mio. €) nur auf diese drei Präparate.
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The treatment of and rehabilitation methods in contact dermatitis and the evidence supporting them are presented, following the “rule of the four Rs”: recognize (the causative allergic/irritant agent), remove (the irritant/allergen), reduce inflammation and restore the skin barrier. Avoidance of the inducing allergen(s) and/or irritant(s) is the most important aspect in the management of contact dermatitis and the different measures are reviewed. The principles of basic topical therapy and the treatment modalities – topical corticosteroids, topical cacineurine inhibitors, retinoids, phototherapy, X-ray therapy and systemic corticosteroids and immunosuppressive agents – are described. Their effects on the skin barrier function, as well as those of moisturizers and other factors influencing barrier recovery, are examined separately.
Article
To date, there is no simple cure for atopic eczema (AE). Besides the avoidance of specific and unspecific trigger factors the stepped approach to management includes a basic emollients therapy and, according to the severity of symptoms, the addition of antiseptic and/or anti-inflammatory topical treatments. In cases of moderate to severe AE additional systemic treatment is needed to control the disease. Currently only cyclosporine is approved in Germany; oral corticosteroids can be used for a short time for severe acute exacerbations. Systemic immunosuppression with methotrexate, azathioprine, mycophenolat mofetil and leflunomide may also be used with success (off-label use), but these agents remain to be assessed in larger randomized trials. While in the past years a number of biologicals have been developed for the treatment of psoriasis vulgaris, there is currently no biological approved for the treatment of AE. Preliminary data points towards a potential efficacy of alefacept [fusion protein of lymphocyte function antigen (LFA)-3], efalizumab (anti-CD11a antibody, no longer available), rituximab (anti-CD20 antibody) and omalizumab (anti-IgE-antibody) at least in subgroups of AE patients. Apart from the extracorporeal photopheresis immunoadsorption could be an option for cases resistant to other treatments, but needs to be assessed in more detail. In patients with a clinically relevant sensitization towards aeroallergens specific immunotherapy might be an option. Based on many new insights into the pathogenesis currently a number of new therapeutic approaches are being developed; among others, target structures are filaggrin, epidermal proteases, tachykinine receptors, histamine receptor 4, interleukin 31 and phosphodiesterase 4.
Article
Background and purpose: Dental caries is a pathological infectious disease. It begins with the formation of dental plaques which is a structurally and functionally organized biofilm. Streptococcus mutans is the most important bacterium in the formation of dental plaque and dental caries. This study aimed at evaluating the antibacterial and antibiofilm activity of Quercus infectoria galls against Streptococcus mutans. Materials and methods: The bacterial strain used in this study was Streptococcus mutans (ATCC: 25923). Extracts were prepared by Soxehlet apparatus and maceration. They were then dissolved in sterile distilled water to a final concentration of 0.16 to 10.00 mg/ml. The antimicrobial activities of the extracts were determined using well diffusion method. The antibiofilm activities of the extracts were examined in a microdilution assay using TTC. Statistical analysis was performed in SPSS V.18. Results: The methanol, ethanol, and acetone extracts of Quercus infectoria galls showed strong inhibitory effects against Streptococcus mutans. The MIC values of extracts were similar and ranged from 160μg/ml to 320μg/ml, whereas the MBC values ranged from 320μg/ml to 640μg/ml. Aqueous extracts of oak galls did not show antimicrobial activity. The extracts of Quercus infectoria galls strongly inhibited the formation of Streptococcus mutans biofilms at concentrations higher than 19.5μg/ml. Conclusion: The extracts of Quercus infectoria galls displayed similarities in their antibacterial activity against Streptococcus mutans. Also, they were found effective in preventing biofilm formation of Streptococcus mutans.
Chapter
Die Verordnungen von Dermatika halten sich seit Jahren auf stabilem Niveau. Am häufigsten werden Corticosteroide verordnet. Auf sie entfällt 2015 wie bereits im Vorjahr fast die Hälfte der verordneten Tagesdosen aller Dermatika. Deutlich seltener verordnet werden dermatologische Antimykotika (13%), Aknemittel (8%), Psoriasismittel (7%), Wundbehandlungsmittel (6%), Warzenmittel (5%) und Antiinfektiva (4%). Die übrigen Gruppen hatten 2015 zusammen einen Verordnungsanteil von etwa 8%.
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Background: Dental caries is one of the most prevalent infectious diseases affecting humans of all ages. Streptococcus mutans has an important role in the development of dental caries by acid production. The purpose of this study was to evaluate the antibacterial and biofi lm disinfective effects of the oak tree Quercus infectoria galls against S. mutans. Materials and Methods: The bacterial strain used in this study was S. mutans (ATCC: 35668). Two kinds of galls, Mazouj and Ghalghaf were examined. Galls were extracted by methanol, ethanol and acetone by Soxhlet apparatus, separately. Extracts were dissolved in sterile distilled water to a fi nal concentration of 10.00, 5.00, 2.50, 1.25, 0.63, 0.31, and 0.16 mg/ml. Microdilution determined antibacterial activities. The biofi lm removal activities of the extracts were examined using crystal violet-stained microtiter plate method. One-way ANOVA was used to compare biofi lm formation in the presence or absence of the extracts. Results: The methanolic, ethanolic, and acetonic extracts of Q. infectoria galls showed the strong inhibitory effects on S. mutans (P < 0.05). The minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) values for the Mazouj and Ghalghaf gall extracts against S. mutans were identical. The MIC values ranged from 160 μg/ml to 320 μg/ml, whereas the MBC values ranged from 320 μg/ml to 640 μg/ml. All extracts of Q. infectoria galls signifi cantly (P < 0.05) reduced biofi lm biomass of S. mutans at the concentrations higher than 9.8 μg/ml. Conclusion: Three different extracts of Q. infectoria galls were similar in their antibacterial activity against S. mutans. These extracts had the highest biofi lm removal activities at 312.5 μg/ml concentration. The galls of Q. infectoria are potentially good sources of antibacterial and biofi lm disinfection agent.
Article
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The therapeutic effects of synthetic tannins are based on their binding action, as well as on their anti-pruritic, antimicrobial and anti-inflammatory effects. Materials and methods. A clinical study of Neotanin spray, Neotanin lotion (suspension) and Neotanin cream was carried out in 8 clinical centres during the period from June, 2017 to January, 2018. The study had an open and non-comparative character. The study included 68 patients of both sex es aged from 1 month to 80 years suffering from eczema dermatosis in the acute weeping phase, including cases with complications after secondary infections (including eczema elements localized on the face). Before the study, information on the clinical history, demographic data, co-morbidities, physical examination data of the patients was collected. The treatment regimen included 2 stages: 1) Neotanin in the spray or lotion (suspension) form 3–4 times per day during 1–5 days, up to the full drying of eczema elements; 2) Neotanin in the cream form 3 times per day, up to the disappearance of the clinical manifestations of skin dermatosis. The duration of the study ranged from 5 to 14 days: the study was completed when a patient had achieved remission. The criteria for assessing the drug efficacy were as follows: dynamics of subjective complaints, objective assessment of the patient's condition (the presence and severity of clinical symptoms), dynamics of the Dermatology Life Quality Index (DLQI). Results. Neotanin preparations showed a high efficacy in the acute and subacute stages of the inflammatory process as an antipruritic agent. Itching stopped within 5 minutes after the drug application, with the antipruritic effect lasting for an average of 3–4 hours. In 85 % of the patients, marked excoriations were absent on the 3rd day of treatment. Neotanin demonstrated a pronounced anti-inflammatory effect. In 92 % of the patients, the symptoms of erythema and edema were significantly reduced one week after the beginning of treatment, with the manifestations of inflammatory exudation being conclusively decreased. One week following the beginning of treatment, 100 % of the patients demonstrated no oozing lesions. The absence of serious undesirable effects in the patients during the study evidences to the good tolerability and safety of this drug.
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The treatment of and rehabilitation methods in contact dermatitis and the evidence supporting them are presented, following the “rule of the four Rs”: recognize (the causative allergic/irritant agent), remove (the irritant/allergen), reduce inflammation, and restore the skin barrier. Avoidance of the inducing allergen(s) and/or irritant(s) is the most important aspect in the management of contact dermatitis, and the different measures are reviewed. The principles of basic topical therapy and the treatment modalities – topical corticosteroids, topical calcineurin inhibitors, retinoids, phototherapy, X-ray therapy, and systemic corticosteroids and immunosuppressive agents – are described. Their effects on the skin barrier function, as well as those of moisturizers and other factors influencing barrier recovery, are examined separately.
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Objective: to evaluate the effectiveness and safety of combined use of creams Prednicarbum and synthetic tannin (phenol-methanal-of urea-polycondensate) in the treatment of exacerbation of atopic dermatitis in children. Material and methods: 50 children, 1 to 12 years, with atopic dermatitis with the exacerbation of the skin process different degrees of severity. Results: In children with mild localized form of atopic dermatitis after the monotherapy whith cream synthetic tannin, noted a marked clinical improvement up to 7 days of treatment. The noted expressive positive dynamics of the skin process and reduction of objective symptoms during the first days after of combination treatment with Prednicarbatet cream and synthetic tannin, also after combination therapy Prednicarbate and moisturizing cream in mode of step therapy. Conclusions: The combined application of Prednicarbate cream and phenol-methanal-of urea-polycondensate increases the effectiveness of anti-inflammatory treatment of atopic dermatitis, which can reduce the duration of use of topical corticosteroids and reduce the risk of adverse reactions in children with moderate and severe course skin process.
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Dermatika zählen in Deutschland zu den verordnungsstärksten Arzneimitteln. Ihre Anwendungsgebiete sind sehr unterschiedlich. Entsprechend heterogen sind die Stoffklassen, die von den Corticosteroidexterna über die Wundbehandlungsmittel bis zu den Hautschutz — und Pflegemitteln reichen (Abbildung 22.1). Auch die früher in einem eigenen Kapitel besprochenen Antimykotika werden — sofern sie präferenziell zur Behandlung von Dermato- bzw. Onychomykosen zugelassen sind — hier gelistet. Antimykotika mit anderen Indikationen finden sich in Kapitel 9 (Antibiotika und Chemotherapeutika), Kapitel 26 (Gynäkologika) sowie in Kapitel 34 (Mund- und Rachentherapeutika). Abbildung 22.1 Verordnungen von Dermatika und Wundbehandlungsmitteln 2008. Gesamtverordnungen nach definierten Tagesdosen
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Auf einen Blick Verordnungsprofil Seit Jahren verändert sich das Verordnungsspektrum der zahlreichen dermatologischen Wirkstoffklassen nur marginal. Wie in den Vorjahren werden topische Glukokortikoide am häufigsten verordnet. Auf sie entfallen 43 von 100 Dermatikatagesdosen. Antimykotika (11 %), Psoriasismittel (10 %), Mittel bei aktinischer Keratose (7 %), Aknemittel, Antiinfektiva und Warzenmittel (jeweils 6 %), Wundbehandlungsmittel (4 %) sowie Rosazeamittel und Antipruriginosa (jeweils 3 %) werden deutlich seltener verordnet. Trend Die Verordnungen in den einzelnen Marktsegmenten werden weitgehend durch nationale und internationale Therapieempfehlungen gestützt. Die Gesamtverordnungsmenge bezogen auf DDD stieg 2020 im Vergleich zum Vorjahr lediglich um 2 %, mit deutlicheren Zuwächsen bei den Psoriasismitteln, den Aknemitteln und den Glukokortikoidtopika. Wesentliche Veränderungen in der Therapie chronisch entzündlicher Hauterkrankungen werden vor allem bei Betrachtung der Kostenentwicklung deutlich: So entfällt 2020 in etwa die Hälfte der gesamten dermatologischen Verordnungskosten von 2.254 € auf die drei hier berücksichtigten Biologika Ustekinumab, Secukinumab, Guselkumab.
Article
Since the last century, tannins have been an important constituent of dermatological therapy, but during the last years, they were considered a little less. Tannins may be used for primary prevention of occupational dermatoses because of their emphatic effect since wearing occluding materials may lead to hyperhidrosis and maceration. In this review, the contents and characteristics of different tannins are explained, and the published therapeutical experiences are shown.
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Tamol has been shown to affect specifically molecular inflammatory mechanisms in concentrations which are well below those required for tanning effects. To evaluate which tamol concentrations are reached in the skin, 14C-Tamol (1% aqueous solution) was topically applied to human cadaver skin which was either intact or from which the stratum corneum had been removed by stripping. In intact skin, about 20% of the applied dose penetrated rapidly and almost exclusively into the stratum corneum. When the horny layer had been removed, about 95% of the applied tamol penetrated into the skin and accumulated at highest concentrations in the epidermis (up to 1758 ± 188 pg/ml); about 100 times less was found in the lower dermis. The intact stratum corneum, therefore, functions as a barrier and possibly as a depot for the drug. In the damaged skin, tamol reaches the epidermis and upper dermis, the regions of the pathogenetic events ineczema, in amounts sufficient to induce pharmacological processes. Because it hardly penetrates into deeper layers of the skin, systemic drug effects are not to be expected.
Article
The earliest of Man’s uses of plant materials rich in polyphenolic metabolites was in the conversion of animal hides to leather, and archaeological records relate to this operation in Mediterranean regions around 1500 BC. Whilst a complete scientific understanding of the traditional tanner’s art remains, at best, incomplete,1 different light has been thrown on facets of this question from other sources. Thus, polyphenol interactions with proteins (and other biological molecules and macromolecules) underlie a wide range of other apparently unrelated properties of plant materials. These include: astringency; ecology and chemical defense in plants; foodstuffs, nutrition and beverages; fruit and floral pigmentation; natural glues, varnishes, and exoskeletons; and the influence of diet and the application of herbal medicines in the treatment of certain pathological conditions.2
Article
Hintergrund: Dexpanthenol ist ein seit langem in der topischen Anwendung eingesetzter Wirkstoff. Klinische und experimentelle Untersuchungen zeigen antientzündliche und wundheilungsfördernde Wirkungen in vitro und in vivo. Vergleichsstudien zum Goldstandard der topischen antientzündlichen Therapie, den Kortikosteroiden, aber auch zu anderen antientzündlichen Externa, fehlen jedoch. Diesem Aspekt widmet sich die vorliegende Untersuchung. Methode: Ingesamt wurden in drei Testansätzen 60 hautgesunde Probanden im Alter von 20 - 58 Jahren einbezogen. Mittels SDS-Irritation wurde ein Erythem der Unterarmbeugeseite ausgelöst und standardisiert chromametrisch im Verlauf von 6 Tagen vermessen. Der a*-Wert stellt hierbei ein Maß für die Erythemstärke dar. Unbehandelte Kontrollen wurden mitgeführt. Dexpanthenol wurde in drei Versuchsansätzen bezüglich seiner erythemmindernden Effektivität analysiert. Im Test 1 wurden vier kommerziell erhältliche topische Arzneimittelprodukte für entzündliche Hautzustände mit Hydrokortison, Kamillenauszügen, Gerbstoffen oder Bufexamac gegen Bepanthol® Handbalsam geprüft. Im Test 2 kamen 5 % Dexpanthenol und 0,25 % Hydrokortison in einer identischen Cremegrundlage zur Anwendung. Im Test 3 wurde die Wirkung von 5 % Dexpanthenol bzw. 0,25 % Hydrokortison in Abhängigkeit von der Grundlage (Wollwachsalkoholsalbe oder Hydrophile Salbe nach DAB 1999) analysiert. In allen drei Ansätzen ist das topische Präparat 2-mal täglich aufgetragen worden. Ergebnisse: Das Testverfahren führt zu einer deutlich messbaren Hautrötung mit Maximum am Tag 1 - 2, welche im Verlauf von 6 Tagen ohne Behandlung nur wenig abklingt ohne dass der Ausgangswert erreicht wird. Im Test 1 führten alle 5 geprüften kommerziellen Produkte zu einer signifikanten Erythemminderung im Vergleich zu den Kontrollen. In diesem Ansatz hat sich Bepanthol® Handbalsam als wirksamste Zubereitung erwiesen. Im Test 2 konnte eine Ebenbürtigkeit von Dexpanthenol zu Hydrokortison demonstriert werden. Diese Beobachtung wurde im letzten Testansatz unabhängig von der verwendeten Grundlage (W/O oder O/W-Creme) bestätigt. Schlussfolgerungen: Die topische Anwendung von 5 % Dexpanthenol an der Haut ist deutlich antientzündlich wirksam, wie an der Abblassung des SDS-induzierten Erythems in verschiedenen Ansätzen gezeigt werden konnte. Die Wirkungsstärke von 5 % Dexpanthenol ist der einer 0,25 %igen Hydrokortison-Zubereitung mindestens ebenbürtig. Unter Beachtung des Nebenwirkungsprofils beider Substanzen verfügt Dexpanthenol über einen zusätzlichen Sicherheitsvorteil auch in der wiederholten oder Langzeitanwendung.
Article
Tannins of natural or synthetic origin are well-known adjuvants in topical anti-inflammatory therapy of skin diseases. In this study, the influence of synthetic tannin on neutrophil accumulation, enzyme release, and on the proinflammatory activity of neutrophil-derived enzymes was investigated. The results show that synthetic tannin (Tamol) specifically inhibits the neutrophil serine protease human leukocyte elastase (HLE) in an irreversible manner with a half-maximal inhibitory concentration (IC50) of 0.3 microgram/ml. Exogenous protein partially abolished the tannin-dependent HLE inhibition (IC50 of Tamol at 1% protein-concentration:1.0 microgram/ml). Synthetic tannin did not influence the activities of other neutrophil enzymes like Cathepsin G, beta-glucuronidase, and myeloperoxidase. The specificity of Tamol for HLE was further substantiated by the lack of inhibition of other serine proteases. Additionally, Tamol had no effect on f-met-leu-phe-induced neutrophil chemotaxis and did not alter enzyme degranulation of neutrophils in response to f-met-leu-phe and opsonized zymosan. We conclude from our results that the anti-inflammatory properties of synthetic tannin may at least in part be due to inactivation of the proinflammatory protease HLE.
Article
Tamol is widely used in the therapy of inflammatory dermatoses. It has pronounced astringent properties and is able to inactivate the neutrophil-derived elastase. Since plasminogen activation and release of mast cell chymase may occur in acute dermatitis, we investigated the inhibitory properties of tamol for these enzymes. Tamol proved to be a potent inhibitor of plasmin and mast cell chymase in concentrations relevant for use in dermatotherapy. The inhibition of mast cell chymase and plasmin by tamol was linear and non-competitive. The inactivation of proteolytic enzymes with the capacity to degrade extracellular-matrix proteins may be one of the major clinical effects of tamol in the treatment of acute inflammatory dermatoses.
Article
Staphylococcus aureus colonizes the skin lesions of more than 90% of patients with atopic dermatitis (AD). The mechanism for increased S aureus colonization in AD is unknown. However, the initial event in colonization requires adherence of S aureus to the skin. The purpose of this study was to examine the roles of various bacterial adhesins on S aureus binding to AD skin. In an attempt to delineate the mechanism behind this adherence process, an in vitro bacterial binding assay was developed to quantitate the adherence of various S aureus strains to AD, psoriatic, and normal skin sections. S aureus strains used in this study were obtained either from cultures of AD skin lesions or from genetically manipulated strains of S aureus that lacked specific microbial surface components recognizing adhesive matrix molecules (MSCRAMMs)--namely, fibronectin-binding protein (Fnbp), fibrinogen-binding protein (Clf), collagen-binding protein (Cna), and their parent strains. In addition, S aureus strains from patients with AD were pretreated with fibronectin or fibrinogen to block MSCRAMM receptors and interfere with binding. Under all experimental conditions, binding of S aureus was localized primarily to the stratum corneum. Immunocytochemical staining of AD skin sections showed a redistribution of fibronectin to the cornified layer, an observation not seen in normal skin. S aureus binding to uninvolved AD skin was significantly greater than the binding to uninvolved psoriatic skin (P <.0001) and normal skin (P <.0005). The Fnbp-negative S aureus showed a significant reduction in binding to the AD skin (P <.0001) but not to the psoriatic and normal skin. In the AD skin, a significant reduction in the binding of S aureus was also observed in the Clf-negative strain (P <.0001) but not in the Cna-negative S aureus. Preincubation of S aureus with either fibronectin or fibrinogen also inhibited bacterial binding to AD skin (P <.0001). These data suggest that fibronectin and fibrinogen--but not collagen--play a major role in the enhanced binding of S aureus to the skin of patients with AD.
Article
Neutrophil infiltration and epidermal hyperproliferation are major histopathologic changes observed in psoriasis. Neutrophils contain human leukocyte elastase, which is thought to be released during neutrophil infiltration of the epidermis. As active human leukocyte elastase is known to be present in psoriatic lesions we were interested whether human leukocyte elastase induces hyperproliferation in keratinocytes in vitro and in vivo. In the cultured murine keratinocyte cell line PAM-212 concentrations of human leukocyte elastase from 1 to 30 nM induced significant proliferation as determined by 5-bromo-2'-deoxy-uridine-incorporation. Daily topical application of 0.043-434.8 pmol human leukocyte elastase per cm2 skin on hairless mice induced a concentration-dependent epidermal hyperproliferation and an increase in 5-bromo-2'-deoxy-uridine incorporation of up to 5-fold in basal keratinocytes within 3 d. Hyperproliferation resulted in a up to 2-fold increase of keratinocyte layers. Histologic analysis revealed marked vasodilatation but no inflammatory infiltrate. Application of porcine pancreatic elastase (3-300 pmol per cm2 skin) resulted in similar epidermal changes as observed for human leukocyte elastase. Hyperproliferative effects of human leukocyte elastase in vitro and in vivo were abolished by the addition of elastase inhibitors, such as elafin, anti-leukoprotease, and alpha1-protease inhibitor. In summary, human leukocyte elastase induces proliferation in murine keratinocytes in concentrations, which can be found on the skin surface of psoriatic lesions. These results may provide an explanation for the epidermal hyperproliferation observed in psoriasis.
Lokaltherapie mit synthetischem Gerbstoff—Erfahrungen mit einer neuen Anwendungsform
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Astringency and polyphenol protein interactions Phytochemicals in human health protection, nutrition, and plant defense
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Synthetischer Gerbstoff bei Analekzem—Das juckt mich nicht mehr
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Indications for tannin therapy in derma-tology. European Society for Pediatric Dermatology 8th Congress
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Foï-Holst R. Indications for tannin therapy in derma-tology. European Society for Pediatric Dermatology 8th Congress, Budapest, 2005:31–32.
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Behandlung der Varizellen mit einem synthetischen Gerbstoff
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