Novel Topical Treatment of Eczema

DESCRIPTION (provided by applicant): Irritant and allergic contact dermatitis affect approximately 10% of adults, and hand eczema represents one of the four most common occupationally related diseases, accounting for substantial lost earning potential in otherwise healthy populations. Both irritant and allergic contact dermatitis is characterized by erythema and vesicles, as well as dry skin that demonstrate changes in the biophysical properties of the stratum corneum, especially with respect to the water permeability barrier. Recent research in dermatology has investigated treatments that focus on restoring barrier homeostasis for skin conditions including hypertrophic scars and keloids, inflammatory dermatoses such as atopic dermatitis and psoriasis, disorders of keratinization, and eczema. The goal of this project is to develop a novel topical vehicle to treat contact dermatitis/eczema. The Specific Aims of the Research Plan are to optimize a novel coating formulation to include physiologic lipids, and then evaluate the optimized coatings in a prospective, randomized, double-blind left/right comparative clinical trial involving patients with hand eczema. Hand eczema is the most common occupational skin disease and affects a large population of those of working age. Hand eczema is common in professions such as mechanics, textile workers, hair dressers, and especially healthcare workers. In healthcare personnel, hand dermatitis including redness, dryness, and cracking occurs regularly (18.3%-72.9%) as a consequence to frequent hand washing, antisepsis techniques, and chronic occlusion from gloving. Damaged hands increase the risk of colonization of microorganisms on the skin and deter hand washing, and also provide a route for skin sensitization to natural rubber latex proteins. Notably, a positive correlation between the clinical diagnoses of latex protein allergy with pre-existing hand eczema (82%) has been shown.