BACKGROUND: Superficial bacterial infection is among the most common reasons for dermatologic consult. Numerous published articles suggest that the dried leaf of malunggay exhibits antibacterial property.
OBJECTIVES: To compare the effectiveness and safety of 15% malunggay ointment with 2% mupirocin ointment in treating localized pyoderma.
METHODS: Sixty-three patients with localized pyoderma (?10% of total body surface area) were enrolled in this randomized, double-blind study to apply either 15% malunggay or 2%  mupirocin ointment twice daily for 14 days. Clinical evaluation using the Global Assessment Score (GAS) for pruritus, pain, erythema, vesiculation, moistness and crusting were conducted at baseline and days 3, 7 and 14 of clinic visit.
RESULTS: Both malunggay and mupirocin groups showed significant decreases in GAS from baseline to days 3, 7 and 14 of treatment (p=0.000, Repeated measures, ANOVA). By days 7 and 14, median GAS of malunggay ointment was higher than mupirocin (1 vs. 0, p<0.05, Mann Whitney U Test). Cure rates were higher in the mupirocin arm comapred to the malunggay arm in Day 3 (53.13% vs. 38.71%), Day 7 (93.75% vs. 70.97%) and Day 14 (96.88% vs. 77.42%). No adverse events were noted after application of malunggay-based ointment at the end of the study period. There were no recurrence two weeks post treatment.
CONCLUSION: Patients in the mupirocin treatment arm had significantly lower global assessment scores and higher cure rates compared to those in the malunggay treatment arm.

Human ; Male ; Female ; Adult ; Child ; Ambulatory Care ; Anti-bacterial Agents ; Bacterial Infections ; Erythema ; Mupirocin ; Ointments ; Pain ; Pruritus ; Pyoderma

BACKGROUND

Long-term administration of conventional acne medications implies the potential risk of increasing microbial resistance, and safety risks. Recent interest has grown in probiotics as a potential treatment and as an adjunct for acne vulgaris.

OBJECTIVE

To conduct a systematic review of randomized controlled trials of oral probiotics in reducing the severity of acne vulgaris compared to placebo or conventional treatments.

METHODS

PubMed, Cochrane Central Register of Controlled Trials, Embase, WHO ICTRP and ClinicalTrials.gov were searched for relevant studies, and randomized controlled trials of acne vulgaris treatment with probiotic therapy were included. Outcomes include decrease in total lesion count/percent change from baseline, improvement of severity scores, inflammation related indicators, and gene expression. Changes in outcomes were calculated by effect size or pooled odds ratio.

RESULTS

A total of 2 RCTs involving 100 participants were included. Both studies show low risk on the risk bias criteria. The data of 2 RCTs reporting severity scores (AGSS and GAGS) supports that probiotics can improve their scores and thereby their condition. For inflammation-related indicators, only 1 RCT showed that probiotics can improve the IGF1 and FOXO1 gene expression in the skin. Regarding safety, only Eguren et al. reported adverse event. Their RCT showed that the incidence of adverse events was low and no serious adverse events.

CONCLUSION

In conclusion, the probiotics investigated in both studies may be given as adjuvant treatment for acne vulgaris as they improve the clinical course of patients.

Human ; Acne Vulgaris ; Probiotics ; Meta-analysis

Netherton Syndrome (NS) is characterized by a triad of congenital ichthyosiform erythroderma, trichorrhexis invaginata, and atopic diathesis. Diagnosis of NS poses a challenge due to its variable presentation and overlap with other dermatological conditions. Herein, we report a case of NS in a sibling pair, underscoring the challenges in diagnosis and genetic implications of this condition.

We present a case of an 8-year-old female and a 7-year-old male sibling pair, with Netherton Syndrome, who initially presented with atopic dermatitis and erythroderma without hair shaft abnormalities. Further investigation and genetic testing revealed homogeneous SPINK5 gene mutations in both patients, leading to the diagnosis of NS.

Early recognition and diagnosis of Netherton Syndrome are essential for proper management. In patients with early-onset atopic dermatitis resistant to treatment and recurrent erythroderma, further investigation is needed to exclude other diagnoses like Netherton Syndrome.

Human ; Male ; Female ; Child: 6-12 Yrs Old ; Netherton Syndrome

Nevus comedonicus is a rare developmental anomaly of the pilosebaceous unit presenting as grouped dilated follicular orifices plugged with keratin. The comedones are usually arranged unilaterally along the lines of Blaschko. As of year 2000, only 200 cases have been reported.