Clinical, Cosmetic and Investigational Dermatology (Dec 2020)
Efficacy of a Topical Product Containing Purified Omental Lipids and Three Anti-Itching Compounds in the Treatment of Chronic Pruritus/Prurigo Nodularis in Elderly Subjects: A Prospective, Assessor-Blinded, 4-Week Trial with Transepidermal Water Loss and Optical Coherence Tomography Assessments
Abstract
Marco Ardigò,1 Chiara Franceschini,1 Elena Campione,2 Terenzio Cosio,2 Caterina Lanna,2 Luca Bianchi,2 Massimo Milani3 1Clinical Dermatology, San Gallicano Dermatological Institute, Rome, Italy; 2Dermatology Institute, Università Tor Vergata, Rome, Italy; 3Medical Department, Cantabria Labs Difa Cooper, Caronno Pertusella, VA, ItalyCorrespondence: Massimo MilaniMedical Department, Cantabria Labs Difa Cooper, Caronno Pertusella, ItalyEmail [email protected]: To investigate the efficacy of a cream containing purified omental lipids 10% and three anti-itching substances (polidocanol/stimutex/palmitoylethanolamine) in elderly subjects with chronic pruritus/prurigo nodularis (CP/CPN).Patients and Methods: Thirty-five subjects (6 men; mean age 67± 4 years) with CP/CPN were enrolled in a prospective, assessor-blinded, 4-week study. The cream was applied twice daily in the most affected body area. The primary endpoints were the evolution of the 10-cm visual analogue itch severity scale (VAS) and the 4-point verbal itching rating scale (VRS) (from 0 to 3). Secondary endpoints were the evolution of optical coherence tomography (OTC) of four skin parameters (acanthosis/hyperkeratosis/scale/dermal vascular pattern), assessed in a target lesioned area, and the transepidermal water loss (TEWL). Study endpoints were evaluated at baseline and after 2 and 4 weeks by an investigator unaware of the type of treatment.Results: All the enrolled subjects concluded the trial. At baseline, the mean±SD scores for VAS and VRS were 4.9± 2.2 and 1.7± 0.7, respectively. The treatment was associated with a significant reduction (p=0.0001) of VAS score of 60% at week 2 and of 86% at week 4. VRS score was significantly reduced by 49% after 2 weeks and by 81% after 4 weeks, in comparison with baseline. TEWL (expressed as g/m2/h) mean values were 18± 5.4 at baseline and 12.7± 4.4 at week 2 and 9.8± 4.7 at week 4 (P=0.0001 vs baseline). All the OCT parameters evaluated improved during active treatment; acanthosis grade was 0.22 mm at baseline, 0.19 mm at week 2 and 0.17 mm at week 4 (p=0.0005), representing a 23% reduction in comparison with baseline. The product was very well tolerated.Conclusion: This purified omental lipid with three anti-itching components cream reduces significantly itch intensity in subjects with chronic pruritus/prurigo nodularis, improving the skin barrier function and skin structure.Trial Number: ISRCTN869561669.Keywords: chronic pruritus, prurigo nodularis, purified omental lipids, itch, antipruritic