Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EG...Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EGFR-TKI treatment,namely skin toxicity.Antibiotics and corticosteroids are usually used to treat the EGFR inhibitor-associated skin rash,with prominent side effects over long-time use.Pien Tze Huang(PZH)Unguentum Compositum is a traditional product for external application which is made of traditional Chinese medicine and oil base.Herein,we reported the case of a 50-year-old man who presented with skin rash on the face,head,and back induced by an EGFR-TKI named erlotinib.By using PZH Unguentum Compositum,we observed that the skin rash was mitigated and eventually disappeared.This case report suggests that PZH Unguentum Compositum may be an effective therapy in treating skin rash caused by EGFR-TKI with fewer side effects.展开更多
<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming...<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming to protect baby’s buttocks and repair diaper dermatitis. Dexpanthenol is a well-known moisturizer with barrier-improving properties and the oily phase of the water in oil preparation forms a lipophilic film on the skin surface that isolates the skin from irritants (feces and urine). Prolonged contact with irritants triggers a local inflammation cascade responsible for the cutaneous erythema. To further investigate the protective properties of skin barrier preparations, we took advantage of an <i>ex vivo</i> model of healthy human skin discs especially designed to evaluate protective and/or repairing effects of topical preparations recommended for baby’s buttocks through the measurement of interleukin-1 alpha release (a cytokine considered as the <em>Primum movens</em> of the skin inflammatory reaction), following the application of different irritants. <strong>Methods: </strong>Healthy human skin discs have been incubated in the absence (control) or in the presence of two irritants,<em> i.e.</em> a “urine like + urease” preparation and sodium dodecyl sulfate, and in the presence of three ointments, one containing dexpanthenol, but not the other two. At the end of the incubation period, interleukin-1 alpha (IL-1<em>α</em>) was quantified in the explants culture media.<strong> Results: </strong>“Urine like + urease” preparation (ULU) and sodium dodecyl sulfate (SDS) both increased IL-1<em>α</em> production of skin explants by 181.1% (p < 0.001) and 88.3% (p < 0.001), respectively. The dexpanthenol containing formula significantly inhibited the ULU- and the SDS-induced IL-1<em>α</em> release by 67.42% (p < 0.001) and 46.55% (p < 0.001), respectively. Under the same experimental conditions, one of the formulas without dexpanthenol significantly inhibited the ULU-induced IL-1<em>α</em> release by 45.94% (p < 0.01) but not the SDS-induced one, and the other tested formulation displayed no significant effect on the IL-1<em>α</em> production regardless of the irritant applied. Moreover, the effect of the dexpanthenol containing formula on the ULU-induced IL-1<em>α</em> release was significantly higher than the effect of the other formula;a difference of 19.6 % (p < 0.05) was observed.<strong> Conclusion: </strong>Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>) provides good protection of baby’s buttocks against irritants. Its protective effect seems to be superior compared with other products, which did not contain this ingredient. Moreover, the results obtained in the present study suggest that dexpanthenol displays <i>per se</i> a real IL-1<em>α</em> production inhibitory effect. This work, however, consists of preliminary studies and additional investigations involving more formulas and end-points such as the quantification of other pro- or anti-inflammatory cytokines and/or resolvins for example, are needed to better understand the cutaneous protective effect of dexpanthenol.展开更多
目的系统评价外用维生素K预防和治疗靶向表皮生长因子受体(EGFR)单抗相关性皮疹的有效性和安全性。方法检索PubMed、Embase、The Cochrane Library、Web of Science、中国知网、维普和万方数据库,检索时限为各数据库自建库起至2022年4...目的系统评价外用维生素K预防和治疗靶向表皮生长因子受体(EGFR)单抗相关性皮疹的有效性和安全性。方法检索PubMed、Embase、The Cochrane Library、Web of Science、中国知网、维普和万方数据库,检索时限为各数据库自建库起至2022年4月。筛选文献、提取数据,评价文献质量,对结果数据进行描述性分析或采用RevMan 5.3软件进行Meta分析。结果纳入12项研究。涉及的EGFR单抗主要为西妥昔单抗,外用维生素K的剂型主要是乳膏,给药方法多为浓度0.05%~0.1%的维生素K每天外用1次或2次,大部分研究所用维生素K亚型为K1。3项对照试验的Meta分析结果显示,相比对照组,试验组≥2级皮疹的发生率未显著降低[RR=1.18,95%CI(0.96,1.45),P=0.12],同时凝血功能异常及其他皮肤不良事件发生率也无显著差异;除3项对照试验外,纳入的病例系列结论虽均认为外用维生素K可降低≥2级皮疹的发生率,并缩短皮疹持续时间,但以上研究未设置对照组,不能排除外用制剂中保湿剂等辅料的保护作用。结论当前证据表明,浓度0.05%~0.1%的维生素K每天外用1次或2次预防和治疗靶向EGFR单抗相关性皮疹有效性不明确,也未见额外的安全性问题。未来需在维生素K给药剂量、频次、人群分层等方面进一步探索。展开更多
文摘Epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI)plays an important role in cancer therapy.However,EGFR is highly expressed in the skin and gives rise to one of the most concerning issues for the EGFR-TKI treatment,namely skin toxicity.Antibiotics and corticosteroids are usually used to treat the EGFR inhibitor-associated skin rash,with prominent side effects over long-time use.Pien Tze Huang(PZH)Unguentum Compositum is a traditional product for external application which is made of traditional Chinese medicine and oil base.Herein,we reported the case of a 50-year-old man who presented with skin rash on the face,head,and back induced by an EGFR-TKI named erlotinib.By using PZH Unguentum Compositum,we observed that the skin rash was mitigated and eventually disappeared.This case report suggests that PZH Unguentum Compositum may be an effective therapy in treating skin rash caused by EGFR-TKI with fewer side effects.
文摘<strong>Background:</strong> Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>), formulated as a water in oil preparation, is currently widely marketed as a diaper care product aiming to protect baby’s buttocks and repair diaper dermatitis. Dexpanthenol is a well-known moisturizer with barrier-improving properties and the oily phase of the water in oil preparation forms a lipophilic film on the skin surface that isolates the skin from irritants (feces and urine). Prolonged contact with irritants triggers a local inflammation cascade responsible for the cutaneous erythema. To further investigate the protective properties of skin barrier preparations, we took advantage of an <i>ex vivo</i> model of healthy human skin discs especially designed to evaluate protective and/or repairing effects of topical preparations recommended for baby’s buttocks through the measurement of interleukin-1 alpha release (a cytokine considered as the <em>Primum movens</em> of the skin inflammatory reaction), following the application of different irritants. <strong>Methods: </strong>Healthy human skin discs have been incubated in the absence (control) or in the presence of two irritants,<em> i.e.</em> a “urine like + urease” preparation and sodium dodecyl sulfate, and in the presence of three ointments, one containing dexpanthenol, but not the other two. At the end of the incubation period, interleukin-1 alpha (IL-1<em>α</em>) was quantified in the explants culture media.<strong> Results: </strong>“Urine like + urease” preparation (ULU) and sodium dodecyl sulfate (SDS) both increased IL-1<em>α</em> production of skin explants by 181.1% (p < 0.001) and 88.3% (p < 0.001), respectively. The dexpanthenol containing formula significantly inhibited the ULU- and the SDS-induced IL-1<em>α</em> release by 67.42% (p < 0.001) and 46.55% (p < 0.001), respectively. Under the same experimental conditions, one of the formulas without dexpanthenol significantly inhibited the ULU-induced IL-1<em>α</em> release by 45.94% (p < 0.01) but not the SDS-induced one, and the other tested formulation displayed no significant effect on the IL-1<em>α</em> production regardless of the irritant applied. Moreover, the effect of the dexpanthenol containing formula on the ULU-induced IL-1<em>α</em> release was significantly higher than the effect of the other formula;a difference of 19.6 % (p < 0.05) was observed.<strong> Conclusion: </strong>Dexpanthenol containing formula (BEPANTHEN<sup>®</sup>) provides good protection of baby’s buttocks against irritants. Its protective effect seems to be superior compared with other products, which did not contain this ingredient. Moreover, the results obtained in the present study suggest that dexpanthenol displays <i>per se</i> a real IL-1<em>α</em> production inhibitory effect. This work, however, consists of preliminary studies and additional investigations involving more formulas and end-points such as the quantification of other pro- or anti-inflammatory cytokines and/or resolvins for example, are needed to better understand the cutaneous protective effect of dexpanthenol.
