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Efficacy of adenosylcobalamin in relieving xerotic pruritus symptoms of atopic dermatitis
Author(s) -
Kim H.K.,
Kim B.J.,
Suk J.M.,
Park J.O.,
Jung S.W.,
Sun S.O.,
Koo J.,
Lee S.I.
Publication year - 2014
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.12149
Subject(s) - atopic dermatitis , medicine , dermatology , family medicine
Editor Multiple treatment modalities have been used in the treatment of atopic dermatitis (AD), although long-term use of corticosteroid has been associated with various adverse effects. Accordingly, a significant research effort now exists to identify steroid-sparing alternative therapeutic modalities, with topical vitamin B12 (adenosylcobalamin) potentially representing one specific agent. Emerging data indicate that cobalamin may prevent AD flares by reducing the production of nitric oxide (NO) and proinflammatory cytokines. To assess the efficacy of topical adenosylcobalamin in AD patients, we recruited the children between 2 and 12 years old diagnosed with AD. During 8-week treatment period, each patient was instructed to apply a vitamin B12-containing gel to all AD-affected area twice daily. The adenosylcobalamin gel was manufactured by HanAll BioPharma (Seoul, Korea). Specifically, the gel contains 0.07% of adenosylcobalamin by weight concentration in a moisturizer base. To evaluate the therapeutic efficacy, the following values were measured at baseline and 4 and 8 weeks after initial treatment: SCORing Atopic Dermatitis (SCORAD) index, transepidermal water loss (TEWL), skin hydration level, skin surface temperature and pH level. Patients rated their satisfaction after ending therapy using 5-grade scoring system. The overall degree of improvement was evaluated using the quartile grading scale. A total of 22 patients (12 male, 10 female, mean age = 7.09 2.72) were enrolled in the study. All 22 patients exhibited some degree of improvement, as defined by SCORAD score, investigator-assess improvement score and patient-rated satisfaction score. The mean SCORAD value improved significantly from 21.95 at baseline to 13.92 at week 4 and to 6.56 at week 8 (Fig. 1a) (P < 0.05). The mean skin hydration value at baseline was 17.02, which also significantly increased to 36.68 at week 4 and to 47.91 at week 8 (Fig. 1b) (P < 0.05). The average TEWL value significantly improved from 22.41 at baseline to 14.44 at week 4 and 11.46 at week 8 (Fig. 1c). The mean skin surface temperature and pH did not show statistically significant change (data not shown). Overall improvement was rated as excellent in 5 of 22 (22.73%) patients, marked in 11 of 22 (50.0%) patients and moderate in the remaining 6 patients (Fig. 2). Patient satisfaction scores indicate that 11 of 22 patients were highly satisfied with the therapy, whereas the other 11 were moderately satisfied. The optimal treatment algorithm for AD has not been well defined. Currently, topical corticosteroids represent the baseline therapy for AD, whereas steroid abuse can result in skin atrophy, thinning of the epidermis and striae distensae. Accordingly, new treatment modalities for AD are clearly needed, with substantial research now directed at identifying new efficacious non-steroidal topical agents. In previous in vivo studies, we demonstrated the preventative effects of this agent against AD symptoms. Similarly, this study also shows that topical adenosylcobalamin gel effectively improved skin lesions and subjective symptoms in AD patients.