Randomized double-blind trial to evaluate the effectiveness of topical administration of propylene glycol in arsenical palmar keratosis
DOI:
https://doi.org/10.3329/bjp.v5i2.7527Keywords:
Arsenic, Clinical trial, Keratosis, Palmar, Propylene glycolAbstract
Keratosis, one of the earliest skin manifestations of arsenicosis, can be treated by either oral or topical formulation of drug. In this study we examined the effectiveness and tolerance of propylene glycol for the treatment of arsenical palmar keratosis. Sixty patients of arsenicosis with palmer keratoses were randomly divided into three groups and different concentrations (15, 30 and 45%) of propylene glycol were applied topically into their palms once at bedtime for eight weeks. The perception of the patient about the progress of treatment was scored with 'Likert scale'. The mean (±SD) score of patient's perception following completion of treatment were 1.27 ± 1.26 (using 15% propylene glycol), 2.88 ± 1.26 (30% propylene glycol), and 3.75 ± 1.06 (45% propylene glycol) respectively. The scores increased with higher concentrations. Thirty percent or more concentration of propylene glycol was effective for mild to severe form of keratosis. Propylene glycol was well tolerable. In conclusion, both roughness and thickness of arsenical palmar keratosis can be reduced using propylene glycol and as the concentration of the drug increases it increases its effectiveness without any significant adverse effect.
Downloads
365
101 Read
3
References
Ahmad SK, Faruquee MH, Sayed MHSU, Khan MH, Hadi SA, Khan AW. Chronic arsenic poisoning: management by vitamin A, E, Cregimen. J Pre Social Med (JOPSOM) 1998; 17: 19-26.
Baden HP, Alper JC. A keratolytic gel containing salicylic acid in propylene glycol. J Invest Dermatol.1973; 6: 330-33.
Brinkel J, Md, Khan MMH, Kraemer A. Systematic review of arsenic exposure and its social and mental health effects with special reference to Bangladesh. Int J Environ Res Public Health 2009; 6: 1609-19.
Bangladesh Arsenic Control Society. Double blind, randomized, placebo-controlled trial of antioxydent vitamins and minerals in the treatment of chronic arsenic poisoning in Bangladesh, BACS. Dhaka, Bangladesh, 2003; 1-103.
Egelrud T. Desquamation in the stratum corneum. Acta Derm Venereol. 2000; Supp 208: 44-45.
Franzke CW, Baici A, Bartels J, Christophers E, Wiedow O. Antileukoprotease inhibits stratum corneum chymotryptic enzyme. Evidence for a regulative function in desquamation. J Biol Chem. 1996; 271: 21886-89.
Frost P, Weinstein GD, Van Scott EJ. The ichthyosiform dermatoses. II. Autoradiographic studies of epidermal proliferation. J Invest Dermatol. 1966; 47: 561-67
Hall AF. Arsenical keratosis disappearing with vitamin A therapy. Derm Syph 1946; 53: 154.
Islam AZM M, Sikdar S, Biswas AK, Islam Z, Hadiuzzaman, Misbauddin M, Khandaker S, Mahmud I, Ahmad SA. Randomized controlled trial to evaluate the effectiveness of topical use of salicylic acid for treatment of keratosis in arsenicosis patient. Applied research on arsenic in Bangladesh. 2007; p 101.
Marino C. Skin physiology, irritants, dry skin and moisturizers. Washington State Department of Labor and Industries 2001, August 2001.
McNeer G. Arsenical kératoses and epitheliomas. Ann Surg 1934; 99: 348-53.
Misbahuddin M, Islam AZMM, Khandker S, Mahmud IA, Islam N, Anjumanara. Efficacy of spirulina extract plus zinc in patients of chronic arsenic poisoning: A randomized placebo-controlled study. Clin Toxicol. 2006; 44: 135-41.
OÈhman H, Vahlquist A. In vivo studies concerning a pH gradient in human stratum corneum and upper epidermis. Acta Derm Venereol (Stockh). 1994; 74: 375-79.
Vaddi HK, HO PC, Chan YW, Chan SY. Oxide terpenes as human skin penetration enhancers of haloperidol from ethanol and propylene glycol and their modes of action on stratum corneum. Biol Pharm Bull. 2003; 26: 220-28.
Walsh A, Chapman SJ. Sugars protect desmosome and corneosome glycoproteins from proteolysis. Acta Dermatol Res. 1991; 283: 174-79.
Warner RR. Water content from analysis of freeze-dried thin section. J Microsc. 1986; 142: 363-69.
Wells RS, Kerr CB. The histology of ichthyosis. J Invest Dermatol. 1966; 46: 530-35
Williams ML. Lipids in normal and pathological desquamation. Adv Lipid Res. 1991; 24: 211-62.
Additional Files
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).