氧化铝磨砂膏治疗老年皮肤干燥的疗效观察

F. Andersen, K. H. Andersen, A. Kligman
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引用次数: 3

摘要

用于痤疮和干燥皮肤的磨砂剂被批评为双刃剑,因为过度使用可能会造成更多的皮肤损伤而不是益处。矛盾的是,已经证明磨砂膏可能会引起人体皮肤的有益变化,类似于局部维甲酸治疗。在本研究中,我们比较了氧化铝基磨砂膏联合α-羟基酸制剂与单独α-羟基酸制剂对12名老年女性志愿者腿部皮肤瘙痒干燥的疗效。洗脱期2周后,下外侧腿中部采用一条腿联合治疗,另一条腿采用α-羟基酸制剂治疗,疗程3周。在基线和末次治疗后3天进行临床评分、自我评估以及经皮失水(TEWL)和水化的客观测量。3名志愿者在同一时间点进行穿孔活检。两种治疗策略均改善了干燥和瘙痒,联合治疗在统计学上更有效。水合作用不受两种处理的影响,但TEWL均显著降低,α-羟基酸处理的效果更明显,表明屏障功能得到改善。联合治疗后的组织学结果支持临床和仪器检查结果,显示表皮增厚和表皮非典型性的部分纠正,表明表皮增殖增加。看来,以一种可控的方式使用的联合治疗有可能逆转由光老化引起的一些变化。诱导的变化很可能是由于表皮增生的非特异性机械刺激加上脱落增加。
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Efficacy of an Aluminum Oxide Scrub Cream in the Treatment of Xerotic Skin of the Elderly
Abrasive agents used as exfoliants in acne and xerotic skin conditions have been criticized for being double-edged swords that might create more skin damage than benefit due to exaggerated use. Paradoxically, it has been demonstrated that scrub creams may induce beneficial changes in human skin similar to treatment with topical tretinoin. In the present study, the efficacy of an aluminum-oxide-based scrub cream in combination with an α-hydroxy acid formulation was compared to the α-hydroxy acid formulation alone in 12 elderly female volunteers with itchy, xerotic leg skin. Following a 2-week washout period, the midportions of the lower lateral legs were treated with the combined treatment on one leg and with the α-hydroxy acid formulation on the other for 3 weeks. Clinical scoring, self-assessment as well as objective measurements of transepidermal water loss (TEWL) and hydration were performed at baseline and 3 days after the last treatment. In 3 volunteers, punch biopsies were obtained at the same time points. Both treatment strategies improved xerosis and pruritus, the combined treatment was statistically more effective. Hydration was not affected by the treatments, whereas TEWL was significantly reduced by both treatments, more so with the α-hydroxy acid formulation, indicating an improvement in barrier function. The clinical and instrumental findings were supported by histological findings following the combined treatment showing thickening of the epidermis and partial correction of epidermal atypia indicating increased epidermal proliferation. It appears that the combination treatment used in a controlled fashion has the potential for reversing some of the changes induced by photoaging. The changes induced are most likely due to unspecific mechanical stimulation of epidermal proliferation in combination with increased exfoliation.
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Acknowledgement to Referees for Exogenous Dermatology 2004 Contents Vol. 3, 2004 Author Index Vol. 3, 2004 Is There Evidence that Geraniol Causes Allergic Contact Dermatitis? Subject Index Vol. 3, 2004
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