Investigating the therapeutic potential of a probiotic in a clinical population with chronic hand dermatitis

Abstract

BackgroundHand dermatitis or hand eczema (HD) is one of the most common dermatologic conditions. Lesions, scaling, pruritus and pain are chronic and relapsing. Improved HD has been reported with the probiotic composed of Lactobacillus acidophilus CL1285, Lactobacillus casei LBC80R and Lactobacillus rhamnosus CLR2 (Bio-K+).PurposeInvestigation of the therapeutic potential of this probiotic as the sole systemic treatment for adults with nonacute HD.Subjects and methodsA single-center study documented clinical ratings and patient-reported outcomes in adults with chronic HD. The probiotic was taken orally for 12 weeks, adjunctive to standard topical treatments and preventative measures.ResultsMost of the 30 subjects with mild to severe HD were compliant with the probiotic. Around 22 of the 30 subjects were able to complete the study, and of these subjects, an improvement was noted in 19. One required systemic therapy, and one subject was not able to tolerate the probiotic and therefore discontinued the study. 23% of the subjects achieved clear or almost clear hands by the end of 12 weeks. Pruritus, which was a common complaint at baseline, was improved with 59% of symptomatic patients within 2 weeks.ConclusionIt is feasible and safe to administer Bio-K+ for HD. Clinicians saw an improvement in most subjects’ hands, and cases of significant improvement in dermatitis were documented. Pruritus was the most rapidly relieved symptom, as reported by patients.

Mechanisms of microbe-immune system dialogue within the skin

“…Nevertheless, one trial reported that probiotics alone provided little benefit, yet reported significant clinical improvement when combined with the potential prebiotic lactoferrin [ 85 , 86 ]. Other recent studies have shown potentially beneficial effects of oral probiotics in plaque psoriasis [ 87 , 88 ], adult AD [ 89 ], hand dermatitis [ 90 ], papulopustular rosacea, seborrhoeic dermatitis [ 86 ] and dandruff [ 91 ].…”

Exposure to greenspaces could reduce the high global burden of pain

“…Associations between the human microbiome and a range of painful conditions have been reported. These conditions include endometriosis (Leonardi et al, 2019), fibromyalgia (Malatji et al, 2017), myalgic encephalomyelitis/chronic fatigue syndrome (Nagy-Szakal et al, 2017), interstitial cystitis/bladder pain syndrome (Nickel et al, 2019), chronic prostatitis/chronic pelvic pain syndrome (Shoskes et al, 2016), dermatitis (Gulliver et al, 2018), and inflammatory bowel disease (Knights et al, 2013). Furthermore, there is emerging experimental evidence that changing the gut microbiome through probiotics (Lactobacillus casei Shirota (Lei et al, 2017), L. gasseri OLL2809 (Itoh et al, 2011), and combined L. acidophilus, L. plantarum, L. fermentum and L. gasseri (Khodaverdi et al, 2019)) reduces pain in people with knee osteoarthritis (Lei et al, 2017), and endometriosis (Itoh et al, 2011;Khodaverdi et al, 2019).…”

Current and emerging therapies for hand eczema

“…In an exploratory, single‐center, open‐label trial of 30 adult patients with mild to severe CHE >6 months, supplementation with daily Lactobacillus acidophilus , Lactobacillus asei , and Lactobacillus rhamnosus for 12 weeks resulted in an improvement of 1–50% (86%) or 75–100% improvement (27%) based on PGA scoring. Furthermore, patients reported relief of pruritus (59%), development of new lesions (52%), and overall skin condition improvement (45%) within 2 weeks (Gulliver et al, ). However, the small sample size, lack of placebo control, withdrawal due to diarrhea likely resulting from the study medication N = 1, aggravation of eczema N = 1, and withdrawal due to consent N = 5 and loss‐to‐follow up N = 1 should be noted.…”