Topical application of a linoleic acid-ceramide containing moisturizer exhibit therapeutic and preventive benefits for psoriasis vulgaris: a randomized controlled trial

Abstract

Psoriasis is a chronic skin inflammatory disorder with frequent relapse. Ceramides and their key enzymes are deficient in the lesions, resulting in impaired epidermal permeability barrier, which correlates with disease severity. We evaluated the efficacy of linoleic acid-ceramide moisturizer (LA-Cer) as an adjunctive and preventive therapy for psoriasis vulgaris. 106 patients were randomized into two groups. The control group (C1 ) received Mometasone Furoate 0.1% Cream (MF) while the treatment group (T1 ) was given 0.1% MF in combination with LA-Cer moisturizer. Psoriasis Area and Severity Index (PASI), pruritus, capacitance (CAP), and transepidermal water loss (TEWL) of normal skin and lesion were evaluated at Week 0, 2, 4, 8. Subsequently, T1 patients were randomized for another 1 year. LA-Cer-group (T2 ) maintained the use of moisturizer while control group (C2 ) discontinued. CAPs, TEWLs, PASI were assessed after 1 year. Primary endpoints (PASI-50 at Week 8) revealed superiority of LA-Cer-MF versus MF, less relapse, and rebound in LA-Cer-group than control (C2 ) at Year 1. There were time-by-therapy interaction effect on CAPs, lesional TEWL, and PASI. LA-Cer-MF induced higher CAP, an earlier reduction of lesional TEWL and PASI than control (C1 ). CAPs, lesional TEWL, and PASI remained stable in LA-Cer-group. CAPs, lesional TEWL, and PASI were comparable to the baseline levels in control group (C2 ). Topical LA-Cer moisturizer can alleviate psoriasis, and could be a valuable approach for the treatment and prevention of psoriasis.

Altered Epidermal Permeability Barrier Function in the Uninvolved Skin Supports a Role of Epidermal Dysfunction in the Pathogenesis of Occupational Hand Eczema

“…Lifetime prevalence of hand eczema was 9.7% (63/650). Prevalence of hand eczema did not differ significantly between genders in this cohort although female dominance has been documented [3,14]. Characteristics of these cohorts are summarized in Table 1.…”

“…In both adults and children with atopic dermatitis, TEWL rates positively correlate with disease severity [35][36][37]. Moreover, measurement of TEWL rates is a reliable approach to evaluate the therapeutic efficacy of the treatments for both atopic dermatitis and psoriasis [2,3,38]. In addition, infants with higher TEWL rates during the first week of life predict a higher risk of atopic dermatitis later in the life independently of filaggrin mutations [39].…”

“…Studies showed that improvements in epidermal permeability barrier with a topical lipid mixture markedly improved the severity scoring of atopic dermatitis in children [2]. Likewise, topical applications of a barrier repair emollient in combination with topical glucocorticoid cream reduced psoriasis area severity index scores by approximately 25% in comparison to glucocorticoid cream alone [3]. Moreover, recent studies demonstrated that improvements in epidermal permeability barrier function delayed the relapse of psoriasis [4].…”

Evaluation of moisturizing and irritation potential of sacha inchi oil

“…10,14,22 Previous studies have found that topical application of linoleic acid and/or linoleic acid can restore the permeability barrier and improve skin appearance. [23][24][25] Therefore, sacha inchi oil might be an alternative source of essential fatty acids for improvement of skin appearance and function through topical administration. with the fresh skin tissue according to the H&E staining results ( Figure 1A).…”

Short- and long-term effects of two emollients on itching and skin restoration in xerotic eczema

“…Ceramides are sphingolipids which are of major importance for the homeostasis of the stratum corneum. Among the various ceramides, it is predominantly the linoleic acid containing ceramide I, which is crucial for the stratum corneum integrity (Liu, Xia, Chen, Xue, & Zheng, 2015).…”