Evaluation of Topical Vitamin B<sub>12</sub> for the Treatment of Childhood Eczema

Januchowski, Ronald

doi:10.1089/acm.2008.0497

Cited by 29 publications

(23 citation statements)

References 6 publications

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“…The trial by Januchowski 218 also reported a significant decrease in eczema severity, measured using modified SCORAD scores (maximum of 27 points), for topical vitamin B 12 cream compared with the base cream after 4 weeks of treatment. Taking data from a graph, the decrease in total SCORAD scores for topical B 12 treatment after 4 weeks was 4.5 whereas that for the placebo treatment was 1.7 (p = 0.011).…”

Section: Assessment Of Risk Of Biasmentioning

confidence: 94%

“…The two trials 217,218 appear to show a significant beneficial effect of topical vitamin B 12 cream on the severity of eczema. The lack of CIs for the results presented in both trials means that there is no way to judge the statistical robustness of the results.…”

Section: Overall Implications For Research and Practicementioning

confidence: 95%

“…217,218 These two within-person trials, 217,218 both industry funded, compared cyanocobalamin (0.07%) cream with a base cream. In the trial by Stücker and colleagues, 217 48 adults aged 18-70 years applied the treatments twice a day for 8 weeks.…”

Section: Studiesmentioning

confidence: 99%

“…In the trial by Stücker and colleagues, 217 48 adults aged 18-70 years applied the treatments twice a day for 8 weeks. In the trial by Januchowski, 218 22 children aged from 6 months to 18 years (no severity inclusion criteria stated) were randomised to treatment for 4 weeks, but it was not clear how often they were instructed to use the treatment. The trial by Stücker and colleagues 217 found that there was a significant decrease in eczema severity after 8 weeks of topical vitamin B 12 treatment compared with the base cream, as measured using a modified SASSAD score (maximum of 240 points).…”

Section: Studiesmentioning

confidence: 99%

“…In the trial by Januchowski, 218 only one adverse event was reported, which resulted in withdrawal from the trial. The participant had a reaction to both the active and placebo treatments but the nature of the reaction was not reported.…”

Section: Harmsmentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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BackgroundEczema is a very common chronic inflammatory skin condition.ObjectivesTo update the National Institute for Health Research (NIHR) Health Technology Assessment (HTA) systematic review of treatments for atopic eczema, published in 2000, and to inform health-care professionals, commissioners and patients about key treatment developments and research gaps.Data sourcesElectronic databases including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Skin Group Specialised Register, Latin American and Caribbean Health Sciences Literature (LILACS), Allied and Complementary Medicine Database (AMED) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched from the end of 2000 to 31 August 2013. Retrieved articles were used to identify further randomised controlled trials (RCTs).Review methodsStudies were filtered according to inclusion criteria and agreed by consensus in cases of uncertainty. Abstracts were excluded and non-English-language papers were screened by international colleagues and data were extracted. Only RCTs of treatments for eczema were included, as other forms of evidence are associated with higher risks of bias. Inclusion criteria for studies included availability of data relevant to the therapeutic management of eczema; mention of randomisation; comparison of two or more treatments; and prospective data collection. Participants of all ages were included. Eczema diagnosis was determined by a clinician or according to published diagnostic criteria. The risk of bias was assessed using the Cochrane Collaboration risk-of-bias tool. We used a standardised approach to summarising the data and the assessment of risk of bias and we made a clear distinction between what the studies found and our own interpretation of study findings.ResultsOf 7198 references screened, 287 new trials were identified spanning 92 treatments. Trial reporting was generally poor (randomisation method: 2% high, 36% low, 62% unclear risk of bias; allocation concealment: 3% high, 15% low, 82% unclear risk of bias; blinding of the intervention: 15% high, 28% low, 57% unclear risk of bias). Only 22 (8%) trials were considered to be at low risk of bias for all three criteria. There was reasonable evidence of benefit for the topical medications tacrolimus, pimecrolimus and various corticosteroids (with tacrolimus superior to pimecrolimus and corticosteroids) for both treatment and flare prevention; oral ciclosporin; oral azathioprine; narrow band ultraviolet B (UVB) light; Atopiclair™ and education. There was reasonable evidence to suggest no clinically useful benefit for twice-daily compared with once-daily topical corticosteroids; corticosteroids containing antibiotics for non-infected eczema; probiotics; evening primrose and borage oil; ion-exchange water softeners; protease inhibitor SRD441 (Serentis Ltd); furfuryl palmitate in emollient; cipamfylline cream; andMycobacterium vaccaevaccine. Additional research evidence is needed for emollients, bath additives, antibacterials, specialist clothing and complementary and alternative therapies. There was no RCT evidence for topical corticosteroid dilution, impregnated bandages, soap avoidance, bathing frequency or allergy testing.LimitationsThe large scope of the review coupled with the heterogeneity of outcomes precluded formal meta-analyses. Our conclusions are still limited by a profusion of small, poorly reported studies.ConclusionsAlthough the evidence base of RCTs has increased considerably since the last NIHR HTA systematic review, the field is still severely hampered by poor design and reporting problems including failure to register trials and declare primary outcomes, small sample size, short follow-up duration and poor reporting of risk of bias. Key areas for further research identified by the review include the optimum use of emollients, bathing frequency, wash products, allergy testing and antiseptic treatments. Perhaps the greatest benefit identified is the use of twice weekly anti-inflammatory treatment to maintain disease remission. More studies need to be conducted in a primary care setting where most people with eczema are seen in the UK. Future studies need to use the same core set of outcomes that capture patient symptoms, clinical signs, quality of life and the chronic nature of the disease.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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Section: Assessment Of Risk Of Biasmentioning

confidence: 94%

Section: Overall Implications For Research and Practicementioning

confidence: 95%

Section: Studiesmentioning

confidence: 99%

Section: Studiesmentioning

confidence: 99%

Section: Harmsmentioning

confidence: 99%

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Scoping systematic review of treatments for eczema

Nankervis

Kim

Delamere

et al. 2016

Programme Grants Appl Res

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Treatment of AD with Non-pharmacological Interventions

Kilimnik,

Jones

2024

Clinical Cases in Dermatology

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Integrative Medicine as Adjunct Therapy in the Treatment of Atopic Dermatitis—the Role of Traditional Chinese Medicine, Dietary Supplements, and Other Modalities

DiNicola¹,

Kekevian²,

Chang³

2012

Clinic Rev Allerg Immunol

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Atopic dermatitis (AD) is becoming increasingly prevalent in the pediatric population, with rates reportedly as high as 18-25 %. Westernized medicine has traditionally used a combination of emollients, antihistamines, corticosteroids, and immunomodulating agents to combat this often frustrating disease. Of late, integrative medicine has become the subject of more research as concerns grow regarding prolonged use of corticosteroids and their side effects in pediatric patients. Probiotics have been extensively studied to define their role in the treatment and prevention of AD in children. Unfortunately, results are varying showing significant improvement in some patients but not all. With regard to prevention, studies show that the use of probiotics during pregnancy does decrease the incidence of AD in children. Prebiotics and synbiotics are also a conceivable option for prevention of AD. A number of studies on Chinese herbal medicine have been performed, with a collective result of symptom improvement and decreased levels of inflammatory cytokines. However, there were reports of asymptomatic transaminitis in a few patients that warrant further testing. While the herbs tested in more recent randomized clinical trials were free from corticosteroids, a previous study showed high levels of dexamethasone in unlabeled herbal eczema creams. Vitamins and minerals have also been suggested as an alternative treatment of AD. Studies however have not yet demonstrated improvement of AD with vitamin or mineral supplementation. Topical vitamin B(12) is the exception to this; however, no topical vitamin B(12) preparation is available for use. Finally, relaxation techniques are also being investigated as adjunctive methods of treatment, but well-designed scientific studies are lacking.

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Evaluation of Topical Vitamin B₁₂ for the Treatment of Childhood Eczema

Abstract: Topical vitamin B(12) should be considered as a treatment option in children with eczema.

Cited by 29 publications

References 6 publications

Scoping systematic review of treatments for eczema

Scoping systematic review of treatments for eczema

Treatment of AD with Non-pharmacological Interventions

Integrative Medicine as Adjunct Therapy in the Treatment of Atopic Dermatitis—the Role of Traditional Chinese Medicine, Dietary Supplements, and Other Modalities

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Evaluation of Topical Vitamin B12 for the Treatment of Childhood Eczema

Abstract: Topical vitamin B(12) should be considered as a treatment option in children with eczema.

Cited by 29 publications

References 6 publications

Scoping systematic review of treatments for eczema

Scoping systematic review of treatments for eczema

Treatment of AD with Non-pharmacological Interventions

Integrative Medicine as Adjunct Therapy in the Treatment of Atopic Dermatitis—the Role of Traditional Chinese Medicine, Dietary Supplements, and Other Modalities

Contact Info

Product

Resources

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Evaluation of Topical Vitamin B₁₂ for the Treatment of Childhood Eczema