Randomized double-blind trial to evaluate the effectiveness of topical administration of propylene glycol in arsenical palmar keratosis

Authors

  • Ashrafun Naher Dina Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, Kazi Nazrul Islam Avenue, Shahbag, Dhaka
  • Mir Misbahuddin Department of Pharmacology, Bangabandhu Sheikh Mujib Medical University, Kazi Nazrul Islam Avenue, Shahbag, Dhaka

DOI:

https://doi.org/10.3329/bjp.v5i2.7527

Keywords:

Arsenic, Clinical trial, Keratosis, Palmar, Propylene glycol

Abstract

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

Download data is not yet available.
Abstract
365
Download
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

2011-04-27

How to Cite

Dina, A. N., and M. Misbahuddin. “Randomized Double-Blind Trial to Evaluate the Effectiveness of Topical Administration of Propylene Glycol in Arsenical Palmar Keratosis”. Bangladesh Journal of Pharmacology, vol. 5, no. 2, Apr. 2011, pp. 98-102, doi:10.3329/bjp.v5i2.7527.

Issue

Section

Clinical Trial