INTRODUCTION:

The skin is a barrier between the body and the environment, it prevents foreign substances such as microorganisms from entering the body. The skin is involved in regulating the temperature of the body, removal of toxins, production of Vitamin D and prevents dehydration. 

Dermatitis is a general term for inflammation of the skin. Dermatitis is caused due to a number of factors from household chemicals to environmental pollution. The most common factors are cosmetics, household detergents and cleaning chemicals, pollen and microorganisms in the environment and in houses(carpets and mattresses are the main culprits). Various terms are used to describe a variety of skin diseases, the two most acute diseases are:

• Eczema: this is characterized by chronic dermal inflammation caused by cosmetics, dust, dryness, or excessive exposure to sunlight. The symptoms are, excessively red skin, blisters, scaly skin, itching, red rashes and dry spots. Eczema is aggravated by stress &lack of sleep.
• Psoriasis: it is characterized by well-defined erythematous plaques of varying sizes. The lesions are pink or dull red in color and are often surrounded by silvery scaling. It is a chronic disease occasionally with acute inflammation. It is usually caused by:
  • Laceration of the skin
  • Acute infection such as tonsillitis (in children)
  • Phycholigical factors such as genetic predisposition to the disease.

There are a host of treatments available today, most are powerful antibiotics and anti-inflammatory products containing corticosteroids. Other conventional treatments are PUVA ( a combination of drug and light), Radiation, Salicylic acid, Tar based products etc. Today newer and more powerful antibiotics are available, however resistance to these therapies are growing and stronger compounds are being used to treat skin diseases. The long term safety of such strong chemicals is questionable as the diseases seem to develop resistance to the drugs on continued usage.

THE PRODUCT:

AV DERMACARE is a proprietary formula, tested on over 500 patients. It is a combination of specific fractions of the listed herbs that display the highest zone of inhibition against known bacteria. Besides anti bacterial ingredients, AV DERMACARE contains herbs with wound healing properties to restore the infected skin to its unblemished state without scarring.

COMPOSITION:

Each 10 gm tube AV DERMACARE contains:

• Azadirachta Indica oil
• Psoralea corylifolia oil
• Pongamia glabra oil
• Glycyrrhiza glabra fraction
• Centella asiatica extract

RESEARCH:

Clinical evaluation of AV DERMACARE CREAM in cases of eczema and dermatitis

Glycyrrhiza glabra:
Bio-assay directed investigations by researchers at the Department of Medicinal Chemistry, Kansas University showed reproducible antimicrobial activity in vitro against Staphylococus aureus, Mycobacterium smegmalis and Candida albicans. Researchers at the Institute of Microbiology II, University of Cagliri, Italy reported the antiviral activity of Glycyrrhizic acid. The authors reported that the drug inhibits growth and cytopathology of several unrelated DNA and RNA viruses, while not affecting cell activity and ability to replicate. In addition they also reported that the drug inactivates herpes simplex virus particles irreversibly

Psoralea corylifolia:
The seeds of Psoralea corylifolia have been used as an ancient Hindu remedy for leucoderma and vitiligo. The furanocoumarin psoralen has been shown to be active against T cell lymphoma. In the review by Siddiqui and Ansari, Psoralea corylifolia was reported to have a marked action on undifferentiated protoplasm such as paramecium. In 1 in 50,000 dilutions of the oil, the paramecia remain alive and active fro 15 minutes after 25 minutes the movements are slowed and death is observed in 40-45 minutes. In 1 in 10,000 dilution death was reported in 10 minutes. The oil of the seeds was reported to exhibit antibacterial activity against gram positive and gram negative human pathogenic bacteria. The oil also showed anti-fungal activity against Asparagillus niger, A. candidus, Microsporum gypsum and Rhizopus nigricans. Rangari & Agarwal in their review have reported that the plant has antileucodermal activity. It was reported that after a few days of application pigmentation was noticed and the development of fresh patches was arrested. The authors reported that trials at the Calcutta School of Tropical Medicine showed that the extracts of P. corylifolia were effective in cases of Leucoderma. 

Centella asiatica:
Kakkar in his report on Centella asiatica has noted that Mandukparni has been used as an antileprotic drug for centuries. The first clinical study was conducted in 1904 at the Madras Leper Hospital. In 1942 Botemps isolated an active principle namely “ Asiaticoside”. Since that time many scientists have studied the action of this herb in treatment of skin diseases. Ratsimamanga in 1963 isolated Asiatic acid and this compound was shown to have bactericidal properties. The Martindale Extra Pharmacopoeia lists Centella asiatica as a dermatological agent Titrated Extract from Centella asiatica (TECA) is a drug which has been used for many years in Europe for the treatment of wound healing defects. It is a reconstituted mixture of 3 triterpenes extracted from the plant, asiatic acid, madecassic acid and asiaticoside. In this report, we studied the effects of TECA and its separated components in the wound chamber model described by Schilling et al. Stainless steel wound chambers were surgically inserted under the skin of rats and received serial injections of either TECA or its purified components. Chambers were collected at days 7, 14, 21 or 28 for biochemical analysis or histological examination. TECA-injected wound chambers were characterized by increased dry weight, DNA, total protein, collagen and uronic acid contents. Peptidic hydroproline was also increased, showing an increased remodeling of the collagen matrix in the wound. The 3 purified components of TECA were all able to reproduce the effects of the complete drug, with some differences depending on the product. Asiatic acid and asiaticoside were the most active of the 3 triterpenes. Asiaticoside exerted a preferential stimulation of collagen synthesis and was active at low doses only. In addition to collagen, the 3 components were also able to stimulate glycosaminoglycan synthesis

Azadirachta indica:
Effect of Azadirachta indica extracts on inflammatory oedema induced by chemical mediators ( 5-HT, Histamine, bradykinin, and PGE) was demonstrated in a study by Chattopahdy et al. The test material showed significant anti-inflammatory effect against 5-HT and PGe1 induced inflammation. The extracts of Azadirachta indica have been used in various topical applications due to its proven activity against inflammation as well as fungal infections.

Pongamia glabra:
The extracts of Pongamia glabra were tested against Trichopyton verrucosum, Trichopyhton mentagrophytes and Trichopyton simii by cup plate method. The extract showed a zone of inhibition greater than 100 mm in radius. The test showed that the extracts of Pongamia glabra demonstrated considerable anti-fungal activity making it useful in ythe treatment of skin disease.

INDICATIONS:

• Leucoderma
• Vitiligo
• Psoriasis
• Eczema

APPLICATION:

Wash hands with soap and water and dry. Apply a small amount of ointment to the finger tip and distribute evenly over the effected area without rubbing. Wipe away excess ointment. In case of open wounds or oozing, cover with light gauze.

CONTRAINDICATIONS:

The ointment is safe to use in all skin types and does not cause discomfort or allergies.

REFERENCES:

1. Antimicrobial Agents From Higher Plants. AntiMicrobial Isoflavoids and related substances from Glycyrrhiza Glabra: Lester A. Mitscher, Young Han Park and Donna Clark, J. Nat. Products, Vol 43, No. 2, Mar-Apr, 1980.
2. Anti viral activity of Glycyrrhizic acid. R Pompei et al,(reprint) Nature Vol. 281, October 25, 1979. 
3. Brevoort P. Pharmaceut News 1996;3:26
4. Phytochemicals and Pharmacological investigations on Psoralea corylifolia: A Review. Siddiqui A.A, Ansari, H. A; Hamdard, 109 –115,Vol.XXXVIII, No.3.
5. Chemistry and Pharmacology of Psoralea Corylifolia: A Review;Rangari, V.D. & Agarwal,S.R., Indian Drugs(29)15,662-670. 1992
6. Mandukparni-Medicinal Uses and Therapeutic activity: A review;Kakkar, K.K., INDIAN DRUGS26(3). 
7. MARTINDALE: The Extra Pharmacopoeia; pg 1084
8. Triterpenes from Centella asiatica stimulate extracellular matrix accumulation in rat experimental wounds. :F.X. Maquart, F. Chastang, A. Simeon, Ph. Birembaut, Ph. Gillery, Y. Wegrowski; European Journal of Dermatology; Issue 4, 1999 
9. Antinociceptive and smooth muscle contracting activities of the methanolic extract of Cassia tora leaf. Chidume FC, Kwanashie HO, Adekeye JO, Wambebe C, Gamaniel KS