scholarly journals Effects of Patients’ Expectation in Dermatology: Evidence from Experimental and Clinical Placebo Studies and Implications for Dermatologic Practice and Research

Dermatology ◽  
2021 ◽  
pp. 1-15
Author(s):  
Wiebke Sondermann ◽  
Finja Reinboldt-Jockenhöfer ◽  
Joachim Dissemond ◽  
Oliver Pfaar ◽  
Ulrike Bingel ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Skin Diseases ◽  
Experimental Pain ◽  
Assay Sensitivity ◽  
Doctor Patient Communication ◽  
Inflammatory Dermatoses ◽  
Nocebo Effects ◽  
Treatment Expectation ◽  
New Compounds

Patients’ expectations towards the benefit of a treatment are key determinants of placebo responses and can affect the development and course of medical conditions and the efficacy and tolerability of active medical treatment. The mechanisms mediating these placebo and nocebo effects have been best described in the field of experimental pain and placebo analgesia. However, also in dermatology experimental and clinical studies demonstrate that various skin diseases such as inflammatory dermatoses and allergic reactions can be modulated by patients’ expectations. Dermatologists should consider the important modulatory role of patients’ expectations on the efficacy and tolerability of specific treatments and the key role of verbal information, patients’ prior treatment experiences (associative learning), and the quality and quantity of doctor-patient communication in shaping treatment expectation. As a consequence, techniques aiming at maximizing patients’ expectation effects should be implemented into daily clinical routine. By contrast, in clinical studies expectation effects should be maximally controlled and harmonized to improve the “assay sensitivity” to detect new compounds. Further translational studies, also in dermatoses that have not been investigated yet, are needed to better characterize the mechanisms underlying patients’ expectation and to gain further insights into potential clinical implications of these effects in dermatologic conditions. Therefore, in this review, we provide a brief overview on the concept of expectation effects on treatment outcome in general, summarize what is already known about this topic for dermatologic diseases, and finally present the relevance of this topic in clinical dermatology.

Update on Intralesional Steroid: Focus on Dermatoses

2010 ◽  
Vol 14 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Robert N. Richards
Keyword(s):  
Clinical Studies ◽  
Skin Diseases ◽  
Prurigo Nodularis ◽  
End Points ◽  
Package Inserts ◽  
Inflammatory Dermatoses ◽  
Lichen Simplex Chronicus ◽  
Intralesional Steroid ◽  
The 1960S ◽  
Product Package

Background: Intralesional steroid (ILS; usually triamcinolone acetonide) is commonly used, and the literature contains much information about its use in keloids, hemangiomas, and alopecia areata. Little has been written about its use in inflammatory dermatoses such as psoriasis and localized dermatitis since the 1960s, the conditions for which it was originallymost studied and used. Objective: To clarify the use of ILS and to encourage its use in psoriasis and localized dermatitis. Methods: Medline peer-reviewed literature in English (1956–2008) was searched for the use of ILS in all skin diseases. Six standard textbooks of dermatology were reviewed. Information as to how they used ILS was obtained from a questionnaire completed by 33 dermatologists and from personal discussions with 15 other dermatologists. Additional information was obtained from 40 years of personal ILS use and from observation of 42 dermatologists working intermittently in our office over the past 25 years. ILS product package inserts and company drug monographs were reviewed. Results: ILS is used by most dermatologists, but there are considerable divergences in technique and dosing. Current textbooks contain little on its use in psoriasis and localized dermatitis. There have been no clinical studies since the 1960s, and their end points and descriptions were somewhat vague by today's standards. Product package inserts are dated and not helpful. Nevertheless, the use of ILS is safe and economical, and the original authors and our office have found it consistently to be virtually 100% effective at 2.5 mg/mL in small plaques of psoriasis on the trunk and limbs and highly effective in localized dermatitis (such as lichen simplex chronicus, prurigo nodularis, and nonspecific eczema). Clinical studies indicate that we can safely increase our ILS from the usual 3 cc (7.5 mg) to 6 cc (15 mg) or even to 8 cc (20 mg) for patients over 50 kg every 3 to 4 weeks. Serum cortisol can be performed if there are concerns about adrenal suppression, with use in periorbital hemangiomas and with intranasal ILS. Blindness (from central artery occlusion) was reported with injections of ILS around the eyes wih older products during the early development stages; and more recently with the use of ILS for periorbital hemangiomas and with ILS used intranasally. It has never been reported with low pressure injections of ILS using triamcinalone acetonide at 2.5 mg around the eyes. Limitations: No formal clinical studies since the 1960s. Poor statistical end points. Conclusions: ILS at 2.5 mg/cc is safe, economical, and effective and its greater use should be encouraged in inflammatory dermatoses such as psoriasis and localized dermatitis. Further well-designed research would be helpful.

scholarly journals Microbiome of human skin - its immunohomeostatic role and the role in pathogenesis of skin diseases

2018 ◽  
Vol 15 (1) ◽  
pp. 63-81
Author(s):  
D D Petrunin
Keyword(s):  
Human Skin ◽  
Skin Diseases ◽  
Secondary Infection ◽  
Treatment Options ◽  
Infectious Complications ◽  
Special Importance ◽  
Skin Microbiome ◽  
Inflammatory Dermatoses ◽  
Pathogenic Microbes

In the last decade new methods of metagenomic analysis allowed to obtain important data regarding the microbiome of human skin. The problem of colonization and secondary infection by pathogenic microbes is of special importance for allergic dermatoses that require topical immunosuppressive therapy. One of treatment options in this case could be topical multicomponent drugs that allow successful treatment of infectious complications of inflammatory dermatoses. But there are still a lot of blanks regarding both fundamental questions regarding human skin microbiome and practice aspects of treatment of skin diseases where it plays a pathogenetic role. This literature review systematizes and structures the accumulated data regarding the composition and the role of human skin microbiome in normal conditions and in various skin diseases as well as summarizes clinical data of use of combinational topical glucocorticosteroid drugs. Furthermore, some algorithms concerning the choice and optimization of topical treatment of secondary infected dermatoses are outlined.

scholarly journals Cannabis sativa and Skin Health: Dissecting the Role of Phytocannabinoids

Planta Medica ◽  
2021 ◽  
Author(s):  
Giulia Martinelli ◽  
Andrea Magnavacca ◽  
Marco Fumagalli ◽  
Mario DellʼAgli ◽  
Stefano Piazza ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Skin Diseases ◽  
Cannabis Sativa ◽  
Therapeutic Potential ◽  
Current Evidence ◽  
Skin Disorders ◽  
Anti Inflammatory

AbstractThe use of Cannabis sativa is currently recognized to ease certain types of chronic pain, reduce chemotherapy-induced nausea, and improve anxiety. Nevertheless, few studies highlighted the therapeutic potential of C. sativa extracts and related phytocannabinoids for a variety of widespread skin disorders including acne, atopic dermatitis, psoriasis, pruritus, and pain. This review summarized the current evidence on the effects of phytocannabinoids at the cutaneous level through the collection of in vitro, in vivo, and clinical studies published on PubMed, Scopus, Embase, and Web of Science until October 2020. Phytocannabinoids have demonstrated potential anti-inflammatory, antioxidant, anti-aging, and anti-acne properties by various mechanisms involving either CB1/2-dependent and independent pathways. Not only classical immune cells, but also several skin-specific actors, such as keratinocytes, fibroblasts, melanocytes, and sebocytes, may represent a target for phytocannabinoids. Cannabidiol, the most investigated compound, revealed photoprotective, antioxidant, and anti-inflammatory mechanisms at the cutaneous level, while the possible impact on cell differentiation, especially in the case of psoriasis, would require further investigation. Animal models and pilot clinical studies supported the application of cannabidiol in inflammatory-based skin diseases. Also, one of the most promising applications of non-psychotropic phytocannabinoids is the treatment of seborrheic disorders, especially acne. In conclusion, the incomplete knowledge of the role of the endocannabinoid system in skin disorders emerged as an important limit for pharmacological investigations. Moreover, the limited studies conducted on C. sativa extracts suggested a higher potency than single phytocannabinoids, thus stimulating new research on phytocannabinoid interaction.

Psychological features of nursing in case of skin diseases in the department tumours of external localizations

2020 ◽  
pp. 19-23
Author(s):  
Lilia Shagvaleeva
Keyword(s):  
Patient Experience ◽  
Successful Treatment ◽  
Skin Diseases ◽  
Nursing Process ◽  
Oncological Patient ◽  
The Creation ◽  
Psychological Features

The article discloses the role of the medical sister of the oncological department in the creation of a positive psychological microclimate, which is the key to the successful treatment and rehabilitation of the oncological patient. Experience of organization of nursing process in the department of tumors of external localizations is presented.

Etiology, clinical presentation, laboratory diagnostics, pathogenesis of impetigo and treatment methods

2020 ◽  
pp. 64-70
Author(s):  
Anastasiya Laknitskaya
Keyword(s):  
Streptococcus Pyogenes ◽  
Skin Diseases ◽  
Group A Streptococcus ◽  
Antibiotic Sensitivity ◽  
Antioxidant Defense System ◽  
Laboratory Diagnostics ◽  
Treatment Methods ◽  
Group A ◽  
The Individual

Currently, one of the priority medical and social problems is the optimization of treatment methods for pyoderma associated with Streptococcus pyogenes — group A streptococcus (GAS). To date, the proportion of pyoderma, the etiological factor of which is Streptococcus pyogenes, is about 6 % of all skin diseases and is in the range from 17.9 to 43.9 % of all dermatoses. Role of the bacterial factor in the development of streptococcal pyoderma is obvious. Traditional treatment complex includes antibacterial drugs selected individually, taking into account the antibiotic sensitivity of pathognomonic bacteria, and it is not always effective. Currently implemented immunocorrection methods often do not take into account specific immunological features of the disease, the individual, and the fact that the skin performs the function of not only a mechanical barrier, but it is also an immunocompetent organ. Such an approach makes it necessary to conduct additional studies clarifying the role of factors of innate and adaptive immunity, intercellular mediators and antioxidant defense system, that allow to optimize the treatment of this pathology.

Redox State in Atrial Fibrillation Pathogenesis and Relevant Therapeutic Approaches

2019 ◽  
Vol 26 (5) ◽  
pp. 765-779 ◽  
Author(s):  
Alexios S. Antonopoulos ◽  
Athina Goliopoulou ◽  
Evangelos Oikonomou ◽  
Sotiris Tsalamandris ◽  
Georgios-Angelos Papamikroulis ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Studies ◽  
Redox State ◽  
Redox Balance ◽  
Therapeutic Approaches ◽  
Critical Determinant ◽  
Electrophysiological Properties ◽  
Antioxidant Agents ◽  
Clinical Benefits

Background: Myocardial redox state is a critical determinant of atrial biology, regulating cardiomyocyte apoptosis, ion channel function, and cardiac hypertrophy/fibrosis and function. Nevertheless, it remains unclear whether the targeting of atrial redox state is a rational therapeutic strategy for atrial fibrillation prevention. Objective: To review the role of atrial redox state and anti-oxidant therapies in atrial fibrillation. Method: Published literature in Medline was searched for experimental and clinical evidence linking myocardial redox state with atrial fibrillation pathogenesis as well as studies looking into the role of redoxtargeting therapies in the prevention of atrial fibrillation. Results: Data from animal models have shown that altered myocardial nitroso-redox balance and NADPH oxidases activity are causally involved in the pathogenesis of atrial fibrillation. Similarly experimental animal data supports that increased reactive oxygen / nitrogen species formation in the atrial tissue is associated with altered electrophysiological properties of atrial myocytes and electrical remodeling, favoring atrial fibrillation development. In humans, randomized clinical studies using redox-related therapeutic approaches (e.g. statins or antioxidant agents) have not documented any benefits in the prevention of atrial fibrillation development (mainly post-operative atrial fibrillation risk). Conclusion: Despite strong experimental and translational data supporting the role of atrial redox state in atrial fibrillation pathogenesis, such mechanistic evidence has not been translated to clinical benefits in atrial fibrillation risk in randomized clinical studies using redox-related therapies.

The mechanistic role of thymoquinone in Parkinson's disease: focus on neuroprotection in pre-clinical studies

2021 ◽  
Vol 14 ◽  
Author(s):  
Mohammad Najim Uddin ◽  
Mohammad Injamul Hoq ◽  
Israt Jahan ◽  
Shafayet Ahmed Siddiqui ◽  
Chayan Dhar Clinton ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Studies ◽  
Nigella Sativa ◽  
Biological Effects ◽  
Neuroprotective Activity ◽  
Substantia Nigra Pars Compacta ◽  
Movement Difficulties

: Thymoquinone (TQ) is one of the leading phytochemicals, which is abundantly found in Nigella sativa L. seeds. TQ exhibited various biological effects such as antioxidant, anti-inflammatory, antimicrobial, and anti-tumoral in several pre-clinical studies. Parkinson's disease (PD) is a long-term neurodegenerative disease with movement difficulties, and the common feature of neurodegeneration in PD patients is caused by dopaminergic neural damage in the substantia nigra pars compacta. The neuroprotective activity of TQ has been studied in various neurological disorders. TQ-mediated neuroprotection against PD yet to be reported in a single frame; therefore, this review is intended to narrate the potentiality of TQ in the therapy of PD. TQ has been shown to protect against neurotoxins via amelioration of neuroinflammation, oxidative stress, apoptosis, thereby protects neurodegeneration in PD models. TQ could be an emerging therapeutic intervention in PD management, but mechanistic studies have been remained to be investigated to clarify its neuroprotective role.

scholarly journals The Role of Network Science in Glioblastoma

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1045
Author(s):  
Marta B. Lopes ◽  
Eduarda P. Martins ◽  
Susana Vinga ◽  
Bruno M. Costa
Keyword(s):  
Personalized Medicine ◽  
Drug Development ◽  
Information Flow ◽  
Clinical Studies ◽  
Network Science ◽  
Cancer Genomics ◽  
High Dimensional ◽  
Network Discovery ◽  
Software Implementations

Network science has long been recognized as a well-established discipline across many biological domains. In the particular case of cancer genomics, network discovery is challenged by the multitude of available high-dimensional heterogeneous views of data. Glioblastoma (GBM) is an example of such a complex and heterogeneous disease that can be tackled by network science. Identifying the architecture of molecular GBM networks is essential to understanding the information flow and better informing drug development and pre-clinical studies. Here, we review network-based strategies that have been used in the study of GBM, along with the available software implementations for reproducibility and further testing on newly coming datasets. Promising results have been obtained from both bulk and single-cell GBM data, placing network discovery at the forefront of developing a molecularly-informed-based personalized medicine.

scholarly journals The Use of Micro- and Nanocarriers for Resveratrol Delivery into and across the Skin in Different Skin Diseases—A Literature Review

Pharmaceutics ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 451
Author(s):  
Beata Szulc-Musioł ◽  
Beata Sarecka-Hujar
Keyword(s):  
Transdermal Delivery ◽  
Bacterial Infections ◽  
Skin Diseases ◽  
Skin Surface ◽  
Non Invasive ◽  
Skin Abnormalities ◽  
Low Solubility ◽  
Active Substances ◽  
Poor Stability

In recent years, polyphenols have been extensively studied due to their antioxidant, anticancer, and anti-inflammatory properties. It has been shown that anthocyanins, flavonols, and flavan-3-ols play an important role in the prevention of bacterial infections, as well as vascular or skin diseases. Particularly, resveratrol, as a multi-potent agent, may prevent or mitigate the effects of oxidative stress. As the largest organ of the human body, skin is an extremely desirable target for the possible delivery of active substances. The transdermal route of administration of active compounds shows many advantages, including avoidance of gastrointestinal irritation and the first-pass effect. Moreover, it is non-invasive and can be self-administered. However, this delivery is limited, mainly due to the need to overpassing the stratum corneum, the possible decomposition of the substances in contact with the skin surface or in the deeper layers thereof. In addition, using resveratrol for topical and transdermal delivery faces the problems of its low solubility and poor stability. To overcome this, novel systems of delivery are being developed for the effective transport of resveratrol across the skin. Carriers in the micro and nano size were demonstrated to be more efficient for safe and faster topical and transdermal delivery of active substances. The present review aimed to discuss the role of resveratrol in the treatment of skin abnormalities with a special emphasis on technologies enhancing transdermal delivery of resveratrol.

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