European Journal of Dermatology最新文献

Small everyday wounds would benefit from optimal healing conditions, and the role of the microbiome in this process is being increasingly discussed. Objectives: To evaluate a wound repair cream (Cicabio Crème+, NAOS Ecobiology Company, Bioderma, France), assessing its effects on the skin microbiome and wound healing. The impact on the microbiome was evaluated by monitoring restoration of diversity after disinfection. The efficacy of the repair complex was assessed ex vivo using a 3D wound-healing human skin model to analyse closure and protein expression. Short-term evaluation of adherence, gas permeability, wound protection, and hydration was assessed. In vivo efficacy was examined through two clinical studies: one on healing erosive areas and another after chemical peel. After disinfection, the cream accelerated restoration of microbiome diversity (+31%, p=0.001) without promoting pathogenic/commensal bacteria or altering the level of Staphylococcus epidermidis (p=0.193). In a 3D wound-healing model, the repair complex enhanced wound closure, promoting protein expression (Ki67, loricrin, CD44, collagen XVII, VII, III) and re-epithelialisation. The cream adhered to the skin, allowed gas exchange, and provided protection and hydration. In vivo, the cream reduced transepidermal water loss (day 4: p=0.016; day 7: p=0.014), erythema (day 7: p=0.023), and functional signs (day 4: p=0.032) of erosive wounds. Following chemical peels, the cream reduced inflammation (day 7: p=0.037), visible damage (day 7: p=0.029), and skin pH (day 1: p<0.001). We demonstrate, for the first time, protection of microbiome diversity, stimulation of wound closure, and preservation of skin pH using a wound repair cream.

Generalised pustular psoriasis (GPP) is a rare, chronic, inflammatory skin disease that may manifest as a relapsing disease with recurrent flares or a persistent disease with intermittent flares. GPP is associated with a significant clinical burden, including pain, fatigue, and comorbidities, leading to severe, life-threatening complications. The frequency and severity of GPP flares have not been characterised comprehensively in epidemiological studies. Comprehensive literature searches were conducted to identify studies evaluating mortality, prevalence, comorbidities, and flares in the GPP population, with 121 studies included in total. As expected, mortality rates were generally higher in studies with longer durations; in three large European studies, mortality rates were 30.8%, 24.4%, and 4.8% across the years 2004-2015, 2010-2018, and 2016-2020, respectively. The most frequently reported cause of death was sepsis, followed by cardiovascular complications, and disease-related mortality. GPP prevalence was 0.88-198 patients per million in the general population (9/121 studies), although the higher estimate may be inflated due to methodological approaches. Plaque psoriasis and joint disorders (affecting >40% and <20% patients in most studies, respectively) were the most frequently reported GPP-associated comorbidities (73/121 studies). In two of the largest database studies, patients with GPP experienced approximately one flare per patient-year. Mean hospitalisation duration was 8.6-30 days. This comprehensive analysis highlighted substantial between-study heterogeneity, emphasising the need for standardization of diagnostic criteria and aspects of study design (including long-term studies with sufficient patient numbers and consistent follow-up durations). Nevertheless, the epidemiological evidence indicates that GPP is a rare, potentially lethal disease with frequent comorbidities. New treatment alternatives that might improve the management of patients with GPP, to treat and prevent flares, should be evaluated urgently.