BackgroundAsteatotic eczema (AE) is characterized by itchy, dry, rough, and scaling skin. The treatments for AE are mainly emollients, usually containing urea, lactic acid, or a lactate salt. N-palmitoylethanolamine (PEA) and N-acetylethanolamine (AEA) are both endogenous lipids used as novel therapeutic tools in the treatment of many skin diseases. The purpose of this study was to compare a PEA/AEA emollient with a traditional emollient in the treatment of AE.MethodsA monocentric, randomized, double-blind, comparative trial was conducted in 60 AE patients to evaluate and compare the efficacy of the two emollients. The level of skin dryness among the subjects ranged from mild to moderate. The subjects’ skin barrier function and the current perception threshold were tested for 28 days by clinical scoring and bioengineering technology.ResultsThe results showed that, although some aspects were improved in both groups, the group using the emollient containing PEA/AEA presented a better skin surface change in capacitance. However, the most impressive finding was the ability of the PEA/AEA emollient to increase the 5 Hz current perception threshold to a normal level after 7 days, with a significant difference between values at baseline and after 14 days. A current perception threshold of 5 Hz was positively and significantly correlated with skin surface hydration and negatively correlated with transepidermal water loss in the PEA/AEA emollient group.ConclusionCompared with traditional emollients, regular application of a topical PEA/AEA emollient could improve both passive and active skin functions simultaneously.

Taken together, sensitive scalp showed disrupted barrier function, abnormal sebum amount and composition, as well as perturbed microbiome, which might be the direct cause. Products targeting these features could be helpful for the treatment of sensitive scalp.

Questionnaires with more dimensions and details such as 10Q and 3S should be used for the diagnosis, prognosis, and treatment monitoring on sensitive scalp in Chinese female.

ConclusionsTo date, majority of studies on EMT have been carried out on airway epithelial cell (see Supplementary Reference 3) types as well as bronchial cells (see Supplementary Reference 4) and kidney cells (see Supplementary Reference 5) but not with primary keratinocytes that too from vitiligo patient tissues. Therefore, a better insight into the mechanisms underlying EMT during wound healing is highly relevant. However, an unequivocal role for keratinocytes in the repair of wound in vitiligo patients remains unclear. We are not certain whether it is an 'all-or-none' phenomena where all the keratinocytes have phenotypic plasticity or whether only a subpopulation of them is actually pliable. Nevertheless, our study offer convincing evidence that vitiligo patient-derived keratinocytes undergo EMT similar to their normal counterparts and probably contribute to the process of wound repair in skin tissue. AcknowledgementsKrupa Shankar (KS) provided the skin samples; Rajarshi Pal (RP) designed the study; Poulomi Banerjee (PB), Sandhyaa Venkatachalam (SV) and Murali Krishna Mamidi (MMK) performed the research; PB and RP analysed the data; PB wrote the manuscript; RP and Ramesh Bhonde (RB) edited it. Manipal University, Manipal, is gratefully acknowledged for the graduate fellowship to PB. Conflicts of interestThe authors have declared no conflicting interests. Supporting InformationAdditional supporting data may be found in the supplementary information of this article. Figure S1. The schematic depicts a flowchart for isolation of primary keratinocytes and the subsequent experiments to characterize the cells and validate our hypothesis. Figure S2. ( Data S1. Materials and methods. Table S1. Shows the details of the patient samples used for this study. Table S2. Details of antibodies used for this study. Vasoconstrictor assay described in 1962 was an interesting assessment of potency of topical corticosteroids at the beginning of these new therapies, however knowledge and technology have evolved and the classification should follow. A topical corticosteroids with a strong vasoconstrictor effect, as determined by vasoconstrictor assay, has not necessary a strong anti-inflammatory effect. Therefore a specific classification adapted to the therapeutic target is needed to be more efficient and thus reduce side effects and corticophobia.