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The use of Otoprof® as a cleaning agent in canine ceruminous otitis externa

Efficacy and tolerability of Zincoseb® shampoo against canine keratoseborrhoeic disorders (clinical study of 20 cases)

Use of an ear flushing solution Otodine® in bacterial otitis Results of a randomized, controlled vehicle, study

Study of the effectiveness of the spray moisturizer Ermidrà® versus placeboon the restoration of skin barrier function in a model of skin

barrier breakdown in the dog

Scientific papers of ICF products presented at the ESVD Congress 2011


Oliveira Ana Dipl. ECVD, DVM et coll.Centro de Investigação em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universidade Lusófona de

Humanidades e Tecnologias, Campo Grande n°376, Lisboa


Authors of clinical study: Giovanni Ghibaudo DVM, Lisa Graziano DVMtext and graphics : Giovanni Ghibaudo

Photos: Lisa Graziano


C Noli (1), S. Belova (2), E. Bensignor (3), K. Bergvall(4), G. Ghibaudo (5), M. Linek (6), C. Lorente (7), L. Ordeix(8), M. Galzerano (9)

(1) Ospedale Veterinario Cuneese, Borgo S. Dalmazzo, Italy

(2) Department of Therapy, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia

(3) Dermatology Referral Service, Rennes-Cesson, Paris and Nantes, France

(4) Department of Clinical Sciences, Swedish University of Agriculture, Uppsala, Sweden

(5) Clinica Veterinaria Malpensa, Samarate, Italy

(6) Tieraerztliche Spezialisten, Hamburg, Germany

(7) Centro de Dermatología Veterinaria ADERVET, Madrid, Spain

(8) Hospital Ars Veterinaria, Barcelona, Spain

(9) University of Turin, Italy

Study of the effectiveness of the spray moisturizer Ermidrà® versus placeboon the restoration of skin barrier function in a model of skin

barrier breakdown in the dogPin D. Dr. Med. Vet, Vidémont E. Dr. Med. Vet. , Ghibaudo G. Dr. Med. Vet. .

Abstract

Scientific research and Veterinary information

Scientific papers of ICF products presented at the ESVD Congress 2011

Lecture presented at the Pre-Congress Symposium of the 25th European Con-gress of Veterinary Dermatology in Brussels on September 7, 2011


Oliveira Ana Dipl. ECVD, DVM et coll.Centro de Investigação em Ciências Veterinárias, Faculdade de Medicina Veterinária, Universi-dade Lusófona de Humanidades e Tecnologias, Campo Grande n°376, Lisboa

Clinical studyCeruminolytics are commonly used to remove the cerumen in veterinary practice. These are substances that can soften, disperse and dilute wax and facilitate its removal from the ear canal. Otoprof® is a ceruminolytic containing dioctyl sodium sulfosuccionate, carbamide peroxide and propylene glycol. The goal of this field study is to evaluate the ceruminolytic activity of Otoprof® and compare it with saline in dogs with ceruminous otitis externa in a single office visit. This study was designed as a prospective, randomized, observer-blind field study.A total of 35 dogs presented with otitis, 20 dogs were found to fulfill the study inclusion criteria. This group of dogs was diagnosed with bilateral ceruminous otitis externa. The breeds most represented were cross-breed, Labrador Retrievers, Poodles and Golden Retrievers (65% of the dogs). Dogs with pendulous ears were present more often (70% of the dogs). Patients enrolled in the study varied in age (1 - 15 years), weight (2 – 45 kg) and gender (10 females and 10 males). Cytology revealed Malassezia in 24 ears (60%), a mixed population of Malassezia and bacteria in 5 ears (12.5%), bacteria in 2 ears (5%), and no microorganisms were found in 9 ears (22.5%). All the ears (n=40) had cerumen in the external ear canal and were randomly allocated to Otoprof® or saline group. Before cleaning, the amount of cerumen was graded has mild (14 ears, 35%), moderate (15 ears, 37%) or severe (11 ears, 28%).

Table 1 - Comparison between the level of cerumen between the two groups at baseline

Inflammation was present in 28 ears (70%, total 40 ears) and the number of inflamed ears was homogeneously distributed between the two groups. The grade of erythema was compared before and after the procedure by a blind investigator.

0123456789

10

Mild Moderate Severe

Grade of cerumen

Num

ber o

f ear

s

OtoprofSaline

Otoprof®

0

2

4

6

8

10

12

0-25% 25-50% 50-75% 75-100%

Amount of cerumen removed

Num

ber o

f ear

s

OtoprofSaline

In the Otoprof® group, two ears increased the erythema score after the procedure. In the saline group, the erythema scores didn't sustain any change after the procedure.

The effect of each product was defined as the overall ability for removing and dispersing ceru-men from the ear canal. The amount of cerumen that was removed/dispersed is shown in table 2

Table 2 – Percentage of cerumen reduction - comparison of Otoprof® versus saline.

In the saline group, most of the ears scored less than a 25% reduction of cerumen. In the Otoprof® group, all the ears had more than 25% of the cerumen removed. In this group, most of the ears had 50%-75% of the cerumen removed. In the highest grade, Otoprof® had six cases compared with two cases for saline.Mild discomfort was observed in five dogs (four dogs in Otoprof® group and one dog in saline group).

This study suggests that Otoprof® is an effective product in removing wax in cases of canine ceruminous otitis externa after a single application. The ears treated with this product show higher wax removal scores when compared to saline. It is likely that all of the active ingredients (docusate, peroxide carbamide and propylene glycol) contribute to the performance of the pro-duct. These ingredients have been reported as ceruminolytic agents in vitro using standardized synthetic canine cerumen (Robson et al, 2008). Wilson (2002) reported docusate to be the most effective product facilitating cerumen removal during a single office visit. Another ingredient contributing to ceruminolytic activity is peroxide carbamide which releases oxygen and starts to foam on contact with the cerumen. It is a ceruminolytic that helps to disperse debris and aerates the ears canals (Nuttall & Cole, 2004). In this study, we could visually confirm that the Otoprof® releases foam and disperses debris. Likely, the mild discomfort noticed in four patients was due to the bubbling activity of the carbamide peroxide as it can cause anxiety in some animals (Nuttall & Cole, 2004). This adverse effect resolved after rinsing the ear canal of the patients with saline. Although this reaction was not statistically significant, we recommend rinsing the ear canal with saline in order to remove any remaining product and debris.

References1) Nuttall T & Cole LK. Ear Cleaning: The UK and US Perspective. Veterinary Dermatology 2004; 15(2): 127-136.

2) Robson DC, Morton D, Burton GG, Basset RJ. In vitro ceruminolytic activity of 23 ear cleaners against standardized synthetic canine cerumen: preliminary results. Australian College of Veterinary Scientists Dermatology Chapter Science Week Proceedings 2008, Gold Coast: 98-103.

3) Wilson S.A. 2002. What is the best treatment for impacted cerumen? The Journal of Family Practice, 2002, 51 (2): 117.

In conclusion, Otoprof® is an ear canal ceruminolytic that can be used in dogs with ceruminous otitis externa. It helps to remove and disperse accumulated cerumen in a single office visit.

Features• Colloidal sulphur has a keratolytic and keratoplastic action, it acts on mitotic activity of the

epithelial basal cells and it promotes removal of surface layers.• Chlorhexidine digluconate antimicrobial action (bacteria and yeast) ; it is not inactivated by

pus and debris, and at low concentration it is not irritating.• Salicylic acid acts as a keratolytic, breaking selectively the keratinic proteic chain present in

the corneocytes, for this reason it is well tolerated by the underlying cells. Moreover it pene-trates in the inflammatory lesions where it has astringent, antibacterial and anti-inflammatory activities.

• Lanolin has softening and moisturizing activity. • Zinc Gluconate has anti-inflammatory , lenitive and softening properties.

Purpose of the studyThe aim of this study was to assess the efficacy and tolerability of a shampoo composed by salicylic acid 2%, colloidal sulphur 0,25%, chlorhexidine digluconate 0,3%, lanolin 2% and zinc Gluconate 2% against canine keratoseborrhoeic disorders (clinical study of 20 cases). Material and methods 20 dogs with seborrheic dermatitis were selected; for each animal were recorded the signal-ment, the primary disease, treatment in course (which were not changed during the test).At the day 0 (D0) –inclusion day- clinical examination, cytology and dermatology were perfor-med, these examinations were repeated at day 14 (D14) and day 28 (D28); dogs were treated with shampoo-therapy* twice a week for 1 month.

Lecture presented at the Pre-Congress Symposium of the 25th European Congress of Veterinary Dermatology in Brussels on September 7, 2011


authors of clinical study: Giovanni Ghibaudo DVM, Lisa Graziano DVMtext and graphics : Giovanni GhibaudoPhotos: Lisa Graziano

Composition Salicylic acid 2% Colloidal sulphur 0,25% Chlorhexidine digluconate 0,3% Lanolin 2% Zinc Gluconate 2%

Vial 250 ml

* wet the coat with tepid water- apply 0,5 ml/kg of shampoo and massage all over the body- Wait for 10 minutes rinse with tepid water- finally dry well

Zincoseb®

At D0, D14 e D28 ratings and scores for clinical and cytological parameters were determined

Clinical presentation Scale : 5 – 15 – 30 – 50 – 70 – 85 - 100%

Cytology Scale: 0 - 1 – 2 – 3– 4

Bacteria, corneocytes, leukocytes:mean of 5 fields 100x0- absent1- present < 5 /HPF 2- present 5/10 /HPF 3- present 10/25 /HPF 4- present > 25 /HPF.

Malassezia:mean of 5 fields 40x0 - absent1 - present < 1 /HPF 2- present 2-4 /HPF 3- present 4-8 / HPF 4- present > 8 /HPF

So the authors assigned scores to the following clinical parameters : alopecia, erythema, itching, scales, lichenification, hyperpigmentation, oily, smell and opacity mantle, and to the following cytological para-meters: keratinocytes, bacteria, Malassezia, leukocytes. Were also assessed the tolerability of the product in animals, the degree of satisfaction and compliance with owner.

Results: 11 males and 9 females, the age range was from 1 year to 15 years, with an mean of 7.5 years. 6 dogs were mongrels, three German shepherds, 3 Labrador, 3 pitbulls, two golden retrievers, a West Highland white terrier, a boxer and a beagle. The primary diseases were diagnosed: allergic dermatitis (10), hypothyroidi-sm (4), non-epidermolytic ichthyosis (2), while in 4 cases it was not possible to identify a precise cause underlying the seborrhoic dermatitis.

The clinical parameters were improved by 35.1% to 56.2% and G14 to G28. Cytological parameters are improved by 41.6% to 57.8% and G14 to G28. In particular, the reduction of clinical parameters was alrea-dy high in the first two weeks in that the scales (46.7%), smell (46.2%), oiliness (44.8%) opacity mantle (41.2%). Cytological parameters had a significant decrease after 2 weeks: 62.3% of the leukocytes, kerati-nocytes of 48.1%, 43.2% of the Malassezia and bacteria by 27.7%. After 4 weeks there was a further improvement of the parameters although to a lesser extent the first two weeks: the scales (67.1%), smell (69.9%), oiliness (65.5%) opacity mantle (61.6%). Cytological parameters after 28 days of therapy showed a reduction of 81.3% in leukocytes, 55.8%, in keratinocytes, 70.5% in Malassezia and 41.8% in bacteria. Compliance was maintained at 85% of both G14 to G28.

Only 1 out of 20 dog discontinued treatment after 1 week because of a rise of the itch in the hours following the shampoo; in all other cases were not reported any adverse reactions, with a tolerability and safety of 100% is that a G14 to G28. The percentage of satisfaction to the G14 was 100% and 80% after 4 weeks with explanations of no further apparent clinical improvement in comparison to the commitment of time necessary to make the shampoo from the owner.

Values curve of scores:

Clinical parameters Cytological parameters

Compliance

Satisfaction Tolerability

Male mongrel dog of 12 years suffer from dry seborrhea. You notice the dull coat and scales at D0,while at D14 the hair is more compact and sleek; shiny coat is finally visible and without seborrhea at the D28.

Mutt sterilized female aged 15 suffering from dry seborrhea (atopy). You notice the dull coat and do not compact at D0, while at D14 the hair is more compact and sleek, and finally you see a shiny coat and without seborrhea at D28

G0 G14 G28

G0 G14 G28Conclusion:The results of this study show high effectiveness of shampoo therapy using Zincoseb®: in fact, this shampoo is particularly indicated for the treatment of seborrheic conditions associated with dry skin, oily and with the scaling (dandruff), which are often observed in cases of dermatitis caused by the yeast Malassezia pachydermatis and / or bacterial overgrowth. The presence of lanolin and zinc gluconate makes the wording is not as aggressive as these agents have anti-inflammatory properties, soothing and softening properties. The synergistic action of sulfur associated with salicylic acid, in addition to the functions keratolytic (removal of excess flakes on the skin surface) and keratoplastic (normalization of cell turnover in the basal layer of the epidermis), exerts an antibacterial, antifungal and antiparasitic activity. The antimicrobial action is mainly attributed to the in situ conversion of sulfur in hydrogen sulfide and pentatonic acid, besides the presence of chlorhexidine at low doses.

Recent in vitro studies of the same shampoo made at the Institute of Microbiology, University of Copenhagen by Prof. Guardabassi (see ICF Bulletin results Zincoseb® - Guardabassi Cod. DP0137/0) have confirmed the excellent efficacy against Malassezia and major bacterial pathogens associated with skin infections of dogs (including Staphylococcus pseudintermedius), with the sole exception of Pseu-domonas aeruginosa.Shampoo-therapy should always be recommended in the course of these skin diseases associated with the management of the underlying primary causes. Compliance in skin diseases is crucial: it must be remembered that one of the most common and important reasons that leads the owner to visit the dog is linked to smell bad, "rancid" and the presence of opaque and / or greasy animal's coat.The killing of these parameters by this anti-seborrheic shampoo even after the first two weeks are extre-mely important because they allow a rapid delivery from the owner that the next time you have positive clinical control. Finally, in view of the results obtained in the reduction of microorganisms by this shampoo, we can say that the rational use of antiseptic shampoos and other products may have positive effects on the prevention of antimicrobial resistance by reducing the use of broad-spectrum antibiotics in dermatology Veterinary and consequently reducing antibiotic selective pressure.

References1) Maddison JE, Page SW, Church DB. Topical dermatological therapy. In: Small animal clinical phar-macology, 2nd edition 2008. Saunders Ltd.

2) Taj A, Baqai R. Antimicrobial effects of alum and sulphur on bacteria isolated from mineral and hospital water. Infectious Disease Journal 2007;16:10-13.

3) Lloyd DH, Lamport AI. Activity of chlorhexidine shampoos in vitro against Staphylococcus interme-dius, Pseudomonas aeruginosa and Malassezia pachydermatis. Veterinary Records 1999; 144: 536-537.

4) Olivry T et coll. Treatment of canine atopic dermatitis: 2010 clinical practice guidelines from the International Task Force on Canine Atopic Dermatitis Veterinary Dermatology DOI 11.1111/j 2010

5) Halliwell REW. Rational use of shampoos in veterinary dermatology. J Small Anim Pract 32:401, 1991

Free comunication presented at the 25th European Congress of Veterinary Dermatology in Brussels on September 8-10, 2011


C Noli (1), S. Belova (2), E. Bensignor (3), K. Bergvall(4), G. Ghibaudo (5), M. Linek (6), C. Lorente (7), L. Ordeix(8), M. Galzerano (9)

(1) Ospedale Veterinario Cuneese, Borgo S. Dalmazzo, Italy(2) Department of Therapy, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia(3) Dermatology Referral Service, Rennes-Cesson, Paris and Nantes, France(4) Department of Clinical Sciences, Swedish University of Agriculture, Uppsala, Sweden(5) Clinica Veterinaria Malpensa, Samarate, Italy(6) Tieraerztliche Spezialisten, Hamburg, Germany(7) Centro de Dermatología Veterinaria ADERVET, Madrid, Spain(8) Hospital Ars Veterinaria, Barcelona, Spain(9) University of Turin, Italy

IntroductionBacterial otic overgrowth and purulent otitis are common conditions of dogs, particularly in allergic animals. Frequent ear washing with a desinfecting agent is a very important component of a successful therapy of bacterial otitis, even more now that multi-drug resistant bacteria are commonly isolated from ear infections (1).

Otodine® contains chlorhexidine 0.15% and Tris-EDTA, both of which have established effica-cy against bacteria, and is a product designed for application into the external ear canal (2). A preliminary study suggested that Otodine® alone was able to significantly reduce clinical signs and bacterial and neutrophil numbers in bacterial otitis (3, 4).

Aim of this randomized blinded study was to evaluate the efficacy of Otodine® in the treatment of ears affected with bacterial overgrowth, with or without Malassezia pachydermatis, or puru-lent otitis, and compare it to that of the vehicle only.

Materials and methodsThis was a multicenter randomized double blinded vehicle-controlled field study. Animals were privately owned dogs recruited by the investigators from their every day practice. Dogs were not included if they were affected by otitis due to foreign bodies, ear mites or neopla-stic disease of the ear canal, had medium to severe stenosis, evidence of ruptured ear drum, or had been treated with topical otologic products or systemic antibiotics of any nature in the 10 days before inclusion.

Bacterial overgrowth and purulent otitis were diagnosed by cytology of smears of cerumen collected with a cotton swab introduced in both ear canals, and stained with a modified Write’s stain.

Animals were randomly assigned to two groups: one treated with placebo, one treated with Otodine® once daily. Ear washings were administered daily for 4 weeks. After a first ear flushing performed by the investigator, if necessary under general anaesthesia, the following ones were done at home by the owners.

Otodine®

Clinical signs (pruritus/pain, erythema, oedema, quantity and odour of the exsudate) were eva-luated on day 0, 14 and 28, with a 0-4 point scale (0=absent, 1=mild, 2=moderate, 3=severe, 4= very severe). Bacteria and neutrophil semiquantitative (0-4 scale) counts on cytological sam-ples were performed at each time point from each ear, with the following scoring system:

Within-group comparison of the baseline characteristics (age, weight and clinical parameters) was performed using a Friedman analysis of variance (ANOVA). The test of Bonferroni was usedto evaluate the post hoc differences between the groups. Between-group comparison of the reduction of clinical and cytological parameters was performed using the Paired-Samples Student’s t-test among three groups. P-value < 0.05 was considered statistically significant. Analyses have been performed using Predictive Analytics SoftWare 18.0 for Windows.

ResultsFiftynine ears of 33 dogs were included into the study. Twentyfive ears were given the placebo, 34 Otodine® once daily 28 days. There was no significant difference between groups for age, weight, clinical or cytological parameters at Day 0. Of 34 ears treated with Otodine®, 13 presented with a purulent otitis, copared to only 2/25 in the vehicle group. The distribution of the type of microorganism in the ears included in the study was as follows:

Both at D14 and at D28, in the active treatment group there was a significant improvement of all parameters, always greater that that observed in the vehicle group. In the vehicle group oedema and neturophil count did not improve significantly at D14 nor at D28.Comparison of average scores between the two groups are presented in tables 1-8. Percentages of improvements between D0 and D28 are descriptively reported in table 9.

No adverse event was reported in either group.

DiscussionIt is known that TriS-EDTA and chlorhexidine contained in Otodine® are able to potentiate the efficacy of topical antibotics when given 30-60 minutes after its administration, and its use as daily ear washing associated with topical antibiotic in bacterial otitis is a common therapeutical protocol.

Group Cocci Cocci and Malassezia rods Cocci + rods Total Otodine® 9 11 7 7 34 Vehicle 15 6 0 4 25 Total 24 17 7 11 59

Group Cocci Cocci and Malassezia rods Cocci + rods Total

Bacteria Neutrophils: 0- no bacteria 0 - absent

1 - present <1x10HPF 1- less than 5 bacteria/HPF 2- 5/10 bacteria/HPF

2- present 1-5x10HPF 3- present 5-10x10HPF

3- 10/25 bacteria/HPF 4- present >10x10HPF 4-> 25 bacteria/HPF.

Bacteria Neutrophils:

This study suggests that Otodine® is able to significantly reduce - on its own - clinical signs and cytological parameters of bacterial otitis, if used daily for a 14-28 days. No real advantage was seen if used twice daily versus once daily, albeit in a small number of animals and ears. Instruc-tions to apply Otodine® twice daily might make for poorer compliance than once daily applica-tion and is not recommended at this stage.

Both bacterial overgrowth and purulent otitis showed significant improvement, making Otodine® an useful tool in all cases of otic bacterial infection. Due to its capability of significantly decrease bacterial counts even in purulent otitis, it can be considered an interesting option in cases of multi-drug resistant bacterial infections, when a decrease in antibiotic use or a non-antibiotic alternative is preferred.

Bibliografia1. Oliveira LC, Leite CA, Brilhante RS, Carvalho CB. Comparative study of the microbial profile from bilateral canine otitis externa. Canadian Veterinary Journal, 2008, 49(8):785-788.

2. Guardabassi L, Ghibaudo G, Damborg P. In vitro antimicrobial activity of a commercial ear antiseptic containing chlorhexidine and Tris-EDTA. Veterinary Dermatology 2010, 21: 282-286.

3. Ghibaudo G, Cornegliani L.,Martino P. Evaluation of the in vivo effects of tris-edta and chlorhexidine digluconate 0.15% solution in chronic bacterial otitis externa: 11 cases. Veterina-ry Dermatology 2004, 15:41-69.

4. Ghibaudo G, Cornegliani L, Martino P. Efficacia e tollerabilità di una soluzione con Tris-EDTA e clorexidinadigluconato 0,15%. Summa 2007, 4:1-8.

Table 1 – Pruritus

Table 2 – erythema

Table 3 – oedema

pruritus D0 pruritus D14 pruritus D28

erythema D0 erythema D14 erythema D28

oedema D0 oedema D14 oedema D28

vehicle

vehicle

vehicle

Table 4 – quantity of cerumen

Table 5 – odour

Table 6 – quantity of bacteria

vehicle

vehicle

vehicle

quantity D0 quantity D14 quantity D28

odour D0 odour D14 odour D28

bacteria D0 bacteria D14 bacteria D28

Table 7 – quantity of neutrophils- all otitis

Table 8 – quantity of neutrophils- only purulent otitis

Table 9 - percentage of decrease of parameters between day 0 and day 28

vehicle

vehicle

neutrophils D0 neutrophils D14 neutrophils D28

neutrophils D0 neutrophils D14 neutrophils D28

prurit

us

eryth

ema

oedema

odour

bacte

ria

quantit

y

neutrophils

Free comunication presented at the 25th European Congress of Veterinary Dermato-logy in Brussels on September 8-10, 2011

Study of the effectiveness of the spray moisturizer Ermidrà® versus placeboon the restoration of skin barrier function in a model of skin barrier breakdown in the dog

Pin D. Dr. Med. Vet, Vidémont E. Dr. Med. Vet. , Ghibaudo G. Dr. Med. Vet. .

The aim of the studyThe purpose of this study was to evaluate the efficacy dell'Ermidrà® in a model of chronic rupture of the skin barrier in the dog, made by the unit of dermatology Vetagro Sup Campus Vétérinaire of Lyon. To demonstrate the usefulness of Ermidrà® in impaired of the skin barrier, the study compares the effect of applying Ermidrà® to that of NaCl. This model of chronic of the skin barrier is rupture in the execution of stripping on the same site, most consecutive days, until a lichenification of the skin and transepidermal water loss (TEWL) of approximately 100 g.m2.h-1 as measured by an instrument VapoMeter (Delfin Technologies Ltd). The study of the restoration of skin barrier is to perform measurements of the histopathological examination of TELW and skin biopsies carried out in areas under investigation. For histopathological examination were performed emalun-eosin staining and immuno-marking to observe the evolution of cell prolifera-tion and epidermal differentiation' proteins.

1. Il metodo « tape stripping » consiste nell’applicare un nastro adesivo su una zona cutanea precedentemente individuata. La ripetizione di questa operazione permette di asportare i differenti strati dello strato corneo e di creare una breccia nella barriera cutanea.

ResultsAll microscopic lesions sign of chronicity of the rupture of the epidermal barrier (compact stratum corneum, epidermal acanthosis, proliferation of sites of basal and suprabasal layers and the presence of epidermic ridges, perivascular inflammatory infiltrates to be available widely), particularly in the stratum corneum, have disappeared or significantly decreased in the treated sites during 7 days with twice daily application of Ermidrà®, while still present, or a modest improvement in the control sites with the bi-daily application of saline.

1

Ermidrà®spray

Figure 1: evolution during the first 8 hours

Difference in slope between the two curves in continuous line (control and treated) between T0 and T0 +2→ Curve controls (blue line): slope = -4.94→ Curve of treated (red line): slope = -9.20The difference is even more important, since the values at T0 TEWEL are higher for the treated sites than for the control sites.

• The same phenomenon is confirmed by the trend lines (dashed lines, blue for controls, red for treaties), even where the two curves are in opposite directions (upward to the controls, to down to the treaties) crossing.

• The curve of the treated (red continuous line) shows a rapid decrease of TEWEL in the first two hours, after a stabilization.

• The control curve (blue continuous line) has a less marked decline in the first two hours, then a significant spike upwards at T0 +8. This peak is classically observed in the healthy dog . Cor-responds to the fact that after a break in the skin barrier through the repeated application of scotch, the lipids present in the epidermis are rapidly mobilized to compensate for this break (visible with a TEWEL that drops). When cellular lipid reserves are depleted, the compensa-tion stops and TEWEL increases until the new lipids are synthesized and will return to repair the damage of the barrier. The application of Ermidrà prevents the peak, ie the increase of TEWEL, compensates for the injury because of the barrier (in the absence of cellular lipids) and then rehydrating with activity justifies its use.

Evolution of the average values of TELW of all test sites and all sites with Ermidrà of 6 dogs (36 control sites and 36 sites with Ermidrà) on the first 8 hours of study

average values of control sites

average values of Ermidrà sites

Linear (average values of control sites)

Linear (average values of Ermidrà sites)

Time (in hours), T0 = beginning of application of Ermidrà, immediately after using the tape

Figure 2: evolution during the 144 hours of study

The curves of controls and treaties have the same evolution, ie a slow down in time. Despite this, the values of TEWEL are, for the treated sites and at each evaluation time, lower than those obtained for the control sites (red continuous line is the higher and lower than the blue conti-nuous line). The slope of the curve tendency of the treated sites (red dotted line) is higher than that of the trend line of the control sites (blue dotted line). At 144 hours, there is a return to baseline for the TEWEL treated sites, while the value is more higher for the control sites.

Evolution of the average values of TELW of all test sites and all sites with Ermidrà of 6 dogs (36 control sites and 36 sites with Ermidrà) on the whole duration of study

average values of control sites

average values of Ermidrà sites

Linear (average values of control sites)

Linear (average values of Ermidrà sites)

time (in hours), T0 = beginning of application of Ermidrà, immediately after using the tape

• Beco L, Fontaine J. Cornéométrie et perte d’eau transépidermique : validation des techniques chez des chiens sains. Ann Méd Vét 2000 ; 144 : 329-33.

• Breternitz M, Flach M, Präbler J, Elsner P, Fluhr JW. Acute barrier disruption by adhesive tapes is influenced by pressure, time and anatomical location: integrity and cohesion assessed by sequential tape stripping; a randomized, controlled study. Br J dermatol 2007; 156: 231-240.

• Denda M, Wood LC, Emani S, Calhoun C, Brown BE, Elias PM, Feingold KR. The epidermal hyperplasia associated with repeated barrier disruption by acetone treatment or tape stripping cannot be attributed to increased water loss. Arch Dermatol Res 1996; 288: 230-8.

• Fluhr JW, Feingold KR, Elias PM. Transepidermal water loss reflects permeability barrier status: validation in human and rodent in vivo and ex vivo models. Exp Dermatol 2006; 15: 483-92.

• Hachem JP, Crumrine D, Fluhr J, Brown BE, Feinglod KR, Elias PM. pH regulates epidermal permeability barrier homeostasis, and stratum corneum integrity/cohesion. J Invest Dermatol 2003; 121: 345-53.

• Hachem JP, Houben E, Crumrine D et al. Serine protease signaling of epidermal permeability barrier homeostasis. J Invest Dermatol 2006; 126: 2074-86.

• Hester SL, Rees CA, Kennis RA, Zoran DL, Bigley KE, Wright AS, Kirby NA, Bauer JE. Evaluation of corneometry (skin hydration) and transepidermal water-loss measurements in two canine breeds. J Nutr 2004; 134: 2110S-3S.

References

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