A Recalcitrant Skin Fissure Treated with an Anionic Polar Phospholipid Emulsion

Purpose: Recalcitrant fissures located on weight-bearing skin surfaces are often challenging to heal. This study compares the efficacy of an Anionic Polar Phospholipid (APP)-based skin cream emulsion to a standard moisturizing cream treatment regimen in a patient with a foot fissure unresponsive to conventional treatment. Methods: Treatment included a twice daily topical application to the cutaneous surface of the foot fissure as well as the peri-fissure area with an APP-skin cream (test product) for 3 wks. The APP-skin cream was comprised of phospholipids including phosphatidylglycerol, phosphatidylinositol, and phosphatidylserine, in an aqueous emulsion of hydrogenated vegetable oil. Skin cream treatment was then discontinued for a wash-out period of 4 wk. Treatment was then reinstated twice daily using a standard reference moisturizing cream for 3 weeks. Subjective and objective dermatologic findings were recorded at baseline and weekly throughout the 10-week period. Results: There were marked subjective and objective improvements in the fissure using the test product following the initial 3-week treatment. After the subject had discontinued the test treatment for 4 weeks, the fissure resembled its nascent pretreatment appearance and baseline symptoms reoccurred. The treatment regimen was reinstituted using the reference moisturizer for a 3-week course. In contrast to the marked improvement in signs and symptoms with the test product, there was only mild to moderate improvement using the reference moisturizing cream. Conclusions: This case demonstrates the superior resolution of a painful skin fissure using an oil-in-water-based skin cream supplemented with APP compared to a skin cream reference common moisturizer. Topical treatment of a recalcitrant skin fissure using APP in an oil-in-water emulsion skin cream is a novel application for this phospholipid technology.