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An audit of teledermatology as part of service provision from a district general hospital, United Kingdom
P1053
P1055
USING SUGAR SURFACTANTS TO ACHIEVE MILDNESS AND CLEANSING Otto Mills, PhD, Robert Wood Johnson Medical School, Doylestown, PA, United States; Ronald Rizer, PhD, Thomas J. Stephens and Associates, Inc., Colorado Springs, CO, United States; Anthony DeRosa, BSc, Sugar Surfactants LLC, North Wales, PA, United States
ANTI-INFLAMMATORY PROPERTIES OF LICOCHALCONE A FROM GLYCYRRHIZA INFLATA ON VARIOUS HUMAN SKIN CELLS Karen tom Diek, BSc, Jeannine Immeyer, MS, Rainer Wolber, PhD, Ludger Kolbe, PhD, Beiersdorf AG, Hamburg, Germany
Cleansing the skin before applications of leave-on treatments is almost universal. In addition, mild cleansers have become an important part of skin care in general. As mildness has been emphasized, cleansing ability frequently has been reduced. To achieve the highest mildness to cleansing ratio, we decided to evaluate sugar surfactants under controlled laboratory condition. We tested polyhydroxy fatty acid amides (PFAAs) at 5% and 10% active in water in the scarified chamber assay and in an assay to evaluate the removal of opaque camouflage cream. Both pilot studies were investigator blinded with randomized assignment of test materials. Included in the assays were a soap bar, a sensitive skin liquid soap, a liquid cleanser, a salon brand cleanser, and control sites. The PFAA samples were rated as very low in irritation potential along with two of the marketed samples and physiological saline in the scarification test. Evaluations in the make-up removal assay showed the PFAA samples to be the most effective. Under the conditions of these preliminary trials, the sugar surfactants were mild and most effective for removing make-up. By demonstrating mildness and cleaning, these sugar surfactant samples indicate the potential to contribute to the care of the skin. 100% supported by Sugar Surfactants LLC
In Western countries licorice is frequently used as a base for candies or as a sweetener in the food and tobacco industry. In the Far East, however, licorice is a basic compound of several traditional medicines for a broad range of diseases. Pharmacological activities have been attributed to several low molecular weight terpene saponins and phenolic ingredients found in different species of licorice. This study focuses on anti-inflammatory properties of Licochalcone A, a retrochalcone from Glycyrrhiza inflata, which has previously been shown to possess antibacterial and antiparasitic properties. The data presented in this report clearly demonstrate, for the first time, that Licochalcone A is a potent inhibitor of proinflammatory in vitro responses of a variety of dermatologically relevant cell types, including formylmethionyl-leucyl-phenylalanine or zymosan-induced oxidative burst of granulocytes, UVB-induced prostaglandin E2 (PGE2) release by keratinocytes, LPS-induced PGE2 release by adult dermal fibroblasts, fMLP-induced leukotriene B-4 release by granulocytes, and LPS-induced interleukin 6/tumor necrosis factor-a secretion by monocyte-derived dendritic cells. Based on our data, one anti-inflammatory mode of action of Licochalcone A, reported for other chalcones, might be dual inhibition of cyclooxygenase and lipoxygenase. Direct interference with signal transduction pathways seems rather unlikely, given the diverse range of different signal transduction pathways leading to the assessed proinflammatory reactions. The anti-inflammatory properties of Licochalcone A at submicromolar concentrations makes it a promising candidate for dermatological and cosmetic applications. This work was performed at the Beiersdorf Research Center in Hamburg, Germany.
Digital/Electronic Technology P1100 AN AUDIT OF TELEDERMATOLOGY AS PART OF SERVICE PROVISION FROM A DISTRICT GENERAL HOSPITAL, UNITED KINGDOM Geeta Belgi, MBBS, MD, Rokhsana Rahman, MBBS, Saul Halpern, MBBS, Medway Maritime Hospital, Gillingham, Kent, England Telemedicine has been defined as the practice of medicine at a distance.1 Teledermatology provides an advice-only service, reducing the need for dermatology patients to attend outpatient clinics. With the current underprovision of dermatology services in the United Kingdom (UK) and waiting list targets set by the government, it has been proposed as a possible solution.
P1054 VARIATION OF MALAZESSIA YEAST RESPONSE TO ZINC PYRITHIONE SHAMPOO IN DANDRUFF SUFFERERS Sidney Hornby, MS, Neutrogena Corporation, Los Angeles, CA, United States; Jan Faergemann, MD, PhD, Thomas Hedner, MD, PhD, Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden; Yohini Appa, PhD, Neutrogena Corporation, Los Angeles, CA, United States A cosmetically elegant daily-use dandruff shampoo was formulated with pyrithione zinc, and its effect on the scalps of dandruff sufferers was assessed in this blinded, controlled, 4-week trial. The shampoo was found to be highly effective in the treatment of dandruff with a reduction of more than two thirds in clinical scalp score. The lipophilic Malassezia yeasts were isolated from the scalp with contact plates containing a modified Leeming-Notman agar medium on which all strains grow well. Of the 7 different species of the genus Malassezia, these 4 species were observed: M restricta, M globosa, M obtuse, and M sympodialis. The published literature is not in agreement regarding which species dominate on the scalps of dandruff sufferers. Some investigators have found that M restricta and M globosa dominate in scalp swab specimens from the scalps of dandruff sufferers. The results of this study suggest that M restricta, M globosa, M obtuse, and M sympodialis are all present. M sympodialis was less frequently found compared with the other 3 species. M restricta was more sensitive to treatment compared with the other species. Further examination of the scalp using TEM demonstrated normalization of stratum corneum after treatment.
Data on 1474 patients seen over a 6-month period (AprileSeptember 2002) by teledermatology using a store-and-forward system, in a district general hospital in the UK were analyzed. An average of 245 patients (range, 200-291) was seen each month. Eight hundred ninety-five patients (60%) were discharged to their general practitioner with diagnosis and management advice. For the remaining 579 patients (40%), an outpatient clinic appointment was arranged, including 59 patients (4%) who were directly referred for surgery. Fifty-five patients (3.7%) failed to attend. Of the patients recalled, concordance of diagnosis between teledermatology and faceto-face consultation was seen in 429 (82%). In 58 patients (11%) telediagnosis and clinical diagnosis differed. The differences were minor, and no serious diagnoses were missed. In 37 patients (7%) with nondiagnostic images, diagnostic concordance could not be commented on. A patient satisfaction survey was conducted to evaluate patients’ views on their teledermatology experience. Three hundred one patients who had been discharged directly to their general practitioner were sent questionnaires by mail. The response rate was 40%. Ninety-nine (83%) attended their primary care physician after their dermatology appointment. Overall 84 (71%) were satisfied, 20 (16%) were dissatisfied, and 15 (13%) were neither satisfied nor dissatisfied. Given a choice, 89 (75%) would opt for a teledermatology appointment in 6 weeks, and 21 (18%) would prefer to wait to see a dermatologist instead within 17 weeks. However, if the waiting times were the same, 61 patients (77%) would prefer to see a dermatologist. The cost of the service was £63 per patient seen, which is comparable to or less than a dermatology face-to-face clinic appointment. In conclusion, we found teledermatology provided by experienced dermatologists to be effective, efficient, and cost-effective in reducing waiting lists.
The shampoo was effective against dandruff and gentle to hair, as was noted by a great majority of the subjects. Using the new Malassezia taxonomy we have, for the first time, demonstrated a statistically significant reduction in numbers of Malassezia after treatment and a difference in sensitivity between strains.
Reference
100% supported by Neutrogena Corporation
Nothing to disclose.
MARCH 2005
1. Wootton R. Telemedicine: a cautious welcome. Br Med J 1996;313:1375-7.
J AM ACAD DERMATOL
P97
P1055
USING SUGAR SURFACTANTS TO ACHIEVE MILDNESS AND CLEANSING Otto Mills, PhD, Robert Wood Johnson Medical School, Doylestown, PA, United States; Ronald Rizer, PhD, Thomas J. Stephens and Associates, Inc., Colorado Springs, CO, United States; Anthony DeRosa, BSc, Sugar Surfactants LLC, North Wales, PA, United States
ANTI-INFLAMMATORY PROPERTIES OF LICOCHALCONE A FROM GLYCYRRHIZA INFLATA ON VARIOUS HUMAN SKIN CELLS Karen tom Diek, BSc, Jeannine Immeyer, MS, Rainer Wolber, PhD, Ludger Kolbe, PhD, Beiersdorf AG, Hamburg, Germany
Cleansing the skin before applications of leave-on treatments is almost universal. In addition, mild cleansers have become an important part of skin care in general. As mildness has been emphasized, cleansing ability frequently has been reduced. To achieve the highest mildness to cleansing ratio, we decided to evaluate sugar surfactants under controlled laboratory condition. We tested polyhydroxy fatty acid amides (PFAAs) at 5% and 10% active in water in the scarified chamber assay and in an assay to evaluate the removal of opaque camouflage cream. Both pilot studies were investigator blinded with randomized assignment of test materials. Included in the assays were a soap bar, a sensitive skin liquid soap, a liquid cleanser, a salon brand cleanser, and control sites. The PFAA samples were rated as very low in irritation potential along with two of the marketed samples and physiological saline in the scarification test. Evaluations in the make-up removal assay showed the PFAA samples to be the most effective. Under the conditions of these preliminary trials, the sugar surfactants were mild and most effective for removing make-up. By demonstrating mildness and cleaning, these sugar surfactant samples indicate the potential to contribute to the care of the skin. 100% supported by Sugar Surfactants LLC
In Western countries licorice is frequently used as a base for candies or as a sweetener in the food and tobacco industry. In the Far East, however, licorice is a basic compound of several traditional medicines for a broad range of diseases. Pharmacological activities have been attributed to several low molecular weight terpene saponins and phenolic ingredients found in different species of licorice. This study focuses on anti-inflammatory properties of Licochalcone A, a retrochalcone from Glycyrrhiza inflata, which has previously been shown to possess antibacterial and antiparasitic properties. The data presented in this report clearly demonstrate, for the first time, that Licochalcone A is a potent inhibitor of proinflammatory in vitro responses of a variety of dermatologically relevant cell types, including formylmethionyl-leucyl-phenylalanine or zymosan-induced oxidative burst of granulocytes, UVB-induced prostaglandin E2 (PGE2) release by keratinocytes, LPS-induced PGE2 release by adult dermal fibroblasts, fMLP-induced leukotriene B-4 release by granulocytes, and LPS-induced interleukin 6/tumor necrosis factor-a secretion by monocyte-derived dendritic cells. Based on our data, one anti-inflammatory mode of action of Licochalcone A, reported for other chalcones, might be dual inhibition of cyclooxygenase and lipoxygenase. Direct interference with signal transduction pathways seems rather unlikely, given the diverse range of different signal transduction pathways leading to the assessed proinflammatory reactions. The anti-inflammatory properties of Licochalcone A at submicromolar concentrations makes it a promising candidate for dermatological and cosmetic applications. This work was performed at the Beiersdorf Research Center in Hamburg, Germany.
Digital/Electronic Technology P1100 AN AUDIT OF TELEDERMATOLOGY AS PART OF SERVICE PROVISION FROM A DISTRICT GENERAL HOSPITAL, UNITED KINGDOM Geeta Belgi, MBBS, MD, Rokhsana Rahman, MBBS, Saul Halpern, MBBS, Medway Maritime Hospital, Gillingham, Kent, England Telemedicine has been defined as the practice of medicine at a distance.1 Teledermatology provides an advice-only service, reducing the need for dermatology patients to attend outpatient clinics. With the current underprovision of dermatology services in the United Kingdom (UK) and waiting list targets set by the government, it has been proposed as a possible solution.
P1054 VARIATION OF MALAZESSIA YEAST RESPONSE TO ZINC PYRITHIONE SHAMPOO IN DANDRUFF SUFFERERS Sidney Hornby, MS, Neutrogena Corporation, Los Angeles, CA, United States; Jan Faergemann, MD, PhD, Thomas Hedner, MD, PhD, Department of Dermatology, Sahlgrenska University Hospital, Gothenburg, Sweden; Yohini Appa, PhD, Neutrogena Corporation, Los Angeles, CA, United States A cosmetically elegant daily-use dandruff shampoo was formulated with pyrithione zinc, and its effect on the scalps of dandruff sufferers was assessed in this blinded, controlled, 4-week trial. The shampoo was found to be highly effective in the treatment of dandruff with a reduction of more than two thirds in clinical scalp score. The lipophilic Malassezia yeasts were isolated from the scalp with contact plates containing a modified Leeming-Notman agar medium on which all strains grow well. Of the 7 different species of the genus Malassezia, these 4 species were observed: M restricta, M globosa, M obtuse, and M sympodialis. The published literature is not in agreement regarding which species dominate on the scalps of dandruff sufferers. Some investigators have found that M restricta and M globosa dominate in scalp swab specimens from the scalps of dandruff sufferers. The results of this study suggest that M restricta, M globosa, M obtuse, and M sympodialis are all present. M sympodialis was less frequently found compared with the other 3 species. M restricta was more sensitive to treatment compared with the other species. Further examination of the scalp using TEM demonstrated normalization of stratum corneum after treatment.
Data on 1474 patients seen over a 6-month period (AprileSeptember 2002) by teledermatology using a store-and-forward system, in a district general hospital in the UK were analyzed. An average of 245 patients (range, 200-291) was seen each month. Eight hundred ninety-five patients (60%) were discharged to their general practitioner with diagnosis and management advice. For the remaining 579 patients (40%), an outpatient clinic appointment was arranged, including 59 patients (4%) who were directly referred for surgery. Fifty-five patients (3.7%) failed to attend. Of the patients recalled, concordance of diagnosis between teledermatology and faceto-face consultation was seen in 429 (82%). In 58 patients (11%) telediagnosis and clinical diagnosis differed. The differences were minor, and no serious diagnoses were missed. In 37 patients (7%) with nondiagnostic images, diagnostic concordance could not be commented on. A patient satisfaction survey was conducted to evaluate patients’ views on their teledermatology experience. Three hundred one patients who had been discharged directly to their general practitioner were sent questionnaires by mail. The response rate was 40%. Ninety-nine (83%) attended their primary care physician after their dermatology appointment. Overall 84 (71%) were satisfied, 20 (16%) were dissatisfied, and 15 (13%) were neither satisfied nor dissatisfied. Given a choice, 89 (75%) would opt for a teledermatology appointment in 6 weeks, and 21 (18%) would prefer to wait to see a dermatologist instead within 17 weeks. However, if the waiting times were the same, 61 patients (77%) would prefer to see a dermatologist. The cost of the service was £63 per patient seen, which is comparable to or less than a dermatology face-to-face clinic appointment. In conclusion, we found teledermatology provided by experienced dermatologists to be effective, efficient, and cost-effective in reducing waiting lists.
The shampoo was effective against dandruff and gentle to hair, as was noted by a great majority of the subjects. Using the new Malassezia taxonomy we have, for the first time, demonstrated a statistically significant reduction in numbers of Malassezia after treatment and a difference in sensitivity between strains.
Reference
100% supported by Neutrogena Corporation
Nothing to disclose.
MARCH 2005
1. Wootton R. Telemedicine: a cautious welcome. Br Med J 1996;313:1375-7.
J AM ACAD DERMATOL
P97