Take 5: Recent Findings on Barrier Function and Repair

1. Understanding the Differences of Dry/Normal Skin.
Researchers have discovered physiologic differences between dry skin and normal skin. Researchers evaluated controlled barrier disruption in 28 patients with varying degrees of visual dryness (2011 AAD Meeting, P1305). While both dry skin and normal skin groups showed significant reduction in filaggrin after barrier disruption, the filaggrin levels were considerably lower in moderate dry skin compared to normal skin after 24 hours.

2. Barrier Cream Effective in Various Locations.
Lesion location does not appear to influence the efficacy of EpiCeram Emulsion (Promius Pharma) in the treatment of mild-to-moderate AD, new research suggests. Data from the EPIC study, presented at the AAD Meeting in New Orleans, showed that patients who used EpiCeram Emulsion either as monotherapy or in combination with a steroid or TCI reported high levels of satisfaction, regardless of location of lesion. Patients were grouped by location of AD lesion—either head or trunk only, extremities only, or both. Statistically significant improvement in IGA score and pruritus compared to baseline was seen after 21 days for all lesion location groups. Also, 71 percent of patients did not require adjunctive therapy during EpiCeram treatment.

3. Accelerate Barrier Recovery.
Phosphodiesterase inhibitors may accelerate recovery of the barrier following treatment with red light, according to a new study (Exp Dermatol. 2011 e-pub Mar 16). Researchers found that red light exposure reduced the epidermal hyperplasia induced by barrier disruption under low humidity, and the effect was blocked by pretreatment with zaprinast. They concluded that phosphodiesterase 6 is involved in the recovery-accelerating effect of red light on the disrupted epidermal permeability barrier.

4. OTC Moisturizer Provides Similar Efficacy to Barrier Cream.
A petroleum-based OTC moisturizer may be an effective, cost-effective option for treating mild-to-moderate AD (2011 AAD Meeting. P1303). Researchers randomized 39 patients aged 2 to 17 with mild-to-moderate AD to receive either Atopiclair (Graceway), Epiceram (Promius), or inexpensive, OTC Aquaphor (Beiersdorf). All three groups showed improvement in IGA, while the Aquaphor group demonstrated statistically significant improvement in EASI, VAS, and BSA after three weeks.

5. New Foam Shows Promise.
For patients whose barrier has been compromised with procedures such as PDT or cryotherapy, a new study suggests that HylatopicPlus (Onset Therapeutics) may offer relief (2011 AAD Meeting. P1316). Researchers described 10 post-procedure patients who were given HylatopicPlus to use on half of the procedure site. After five days of application, the improvement in application sites versus non-application sites was visually apparent. The investigators concluded that well-designed controlled clinical studies are indicated.