Orientador: Ariel Antonio Mendes / Banca: Marcia Regina Fernandes Boaro Martins / Banca: Ibiara Correia de Lima Almeida Paz / Banca: Rodrigo Garofallo Garcia / Banca: José Roberto Sartori / Resumo: Com objetivo de avaliar a influência dos minerais orgânicos (selênio e zinco) e vitamina E sobre a incidência e identificação microbiológica de pododermatite, lesões de carcaça, resistência da pele, desempenho, rendimento de carcaça e partes, qualidade da carne e sistema imune em frangos de corte, dois experimentos foram conduzidos no aviário experimental da FMVZ, UNESP, Câmpus de Botucatu. Para isto, utilizou-se 1260 pintos de um dia de idade, machos, da linhagem Cobb® 500 para cada experimento, alojados com densidade populacional de 12 aves/m², por 42 dias. O programa alimentar foi dividido em quatro fases e o delineamento experimental adotado foi o inteiramente casualisado em esquema fatorial 3x2+1, no experimento 1, três níveis de zinco orgânico (0, 45, 90 mg/kg de ração) dois níveis de selênio orgânico (0 e 0,3 mg/kg de ração) e uma dieta controle, no experimento 2 três níveis de vitamina E (100, 150 e 200UI/kg de ração) e duas fontes microminerais inorgânico (0,3 mg/kg Se + 60 mg/kg de Zn) ou orgânico (0,3 mg/kg de Se e 45 mg/kg de Zn) e uma dieta controle, com 6 repetições de 30 aves cada. Aos 10 dias de idade todas as aves foram vacinadas contra a Doença de Newcastle (experimento 2), os parâmetros imunológicos foram avaliados por meio de colheitas de sangue aos 10, 21 e 42 dias. Aos 41 dias de idade todas as aves foram avaliadas no aviário quanto a incidência de pododermatite. Foi avaliado o desempenho e aos 42 dias de idade as aves foram abatidas no abatedouro experimental da FMVZ, UNESP para avaliação da incidência de lesões de carcaça, resistência da pele, rendimento de carcaça e partes, qualidade de carne, quantificação microbiológica, histologia do coxim plantar e pele. Aves que receberam zinco e selênio orgânico apresentaram maior quantidade de colágeno e a epiderme mais espessa (P≤0,05). Para lesões de carcaça houve diferença... / Abstract: In order to evaluate the influence of organic minerals (selenium and zinc) and vitamin E on the incidence and microbiological identification of foot pad dermatitis, carcass lesions, skin resistance, performance, carcass yield and parts, meat quality and immune system in chickens cutting, two experiments were conducted in the experimental avian FMVZ, UNESP, Botucatu. For this, we used 1,260 chicks at day old male Cobb® the 500 strain for each experiment, housed with a density of 12 birds / m² for 42 days ... / Doutor

<p>Transition metals such as nickel (Ni), cobalt (Co), palladium (Pd), chromium (Cr) and gold (Au) are widely used as alloys in jewelry and biomaterials such as orthodontic and orthopaedic appliances. These metals also cause cell-mediated allergic contact dermatitis (ACD) reactions in a significant proportion of the population upon prolonged direct exposure. The immune mechanisms underlying the response to these metals are not yet well defined. In the studies described in this thesis we therefore investigated the profile of cytokine responses to various metal ions <i>in vitro</i> and the relationship with the ACD reaction <i>in vivo</i>. In the first study, we investigated the relationship between the profile and magnitude of Ni²⁺-induced cytokine responses <i>in vitro</i> and the degree of <i>in vivo</i> reactivity to Ni²⁺. PBMC from Ni²⁺-reactive (ACD) and non-reactive control subjects were cultured with or without NiCl₂. The numbers of IL-4-, IL-5- and IL-13-producing cells and the concentrations of IFN-γ, IL-10 and IL-13 produced were analysed by ELISpot and ELISA respectively. Ni²⁺ elicited a mixed Th1- and Th2-type cytokine profile in PBMC from ACD subjects with a positive correlation observed between the levels of the elicited cytokines and the degree of patch test reactivity. Hence, suggesting an involvement of both Th1- and Th2-type cytokines in ACD to Ni²⁺ and a direct association between the magnitude of the Ni²⁺-induced cytokine response overall and the <i>in vivo</i> reactivity to Ni²⁺. The impact of the regulatory cytokine IL-10 on Ni²⁺-induced Th1- and Th2-type cytokine responses in human PBMC was investigated in the next study. PBMC from blood donors with a history of Ni²⁺ reactivity and non-reactive control donors were stimulated with Ni²⁺ <i>ex vivo</i> with or without addition of human recombinant IL-10 (rIL-10) or neutralising mAb to IL-10. Depletion/enrichment experiments were performed to phenotype the Ni²⁺-specific cytokine producing cells. Exogenous rIL-10 significantly down-regulated the production of all cytokines but with a more pronounced effect on IFN-γ. IL-10 neutralisation, on the other hand, enhanced the levels of Ni²⁺-induced IFN-γ only. Ni²⁺-specific cytokine-producing cells in PBMC were found to be predominantly CD4⁺ T cells. Thus, IL-10 may play a regulatory role <i>in vivo</i> by counteracting the ACD reactions mediated by CD4⁺ T cells producing Th1-type cytokines. In the third study, we investigated the relationship between <i>in vivo</i> patch test reactivity to a number of metals (Ni, Co, Pd, Cr and Au) included in the standard and/or dental patch test series and <i>in vitro</i> responses to the metals in question. PBMC from metal patch test positive and negative control subjects were stimulated with a panel of eight metal salts and cytokine responses analysed by ELISpot and/or ELISA. A mixed Th1- (IL-2 and/or IFN-γ) and Th2-type (IL-4 and/or IL-13) cytokine profile was observed in PBMC from most metal allergic subjects upon <i>in vitro</i> stimulation with the metal(s) to which the subject was patch test positive. Our data suggest that other metals included in the standard and dental patch test series, just like Ni2⁺, induce a mixed Th1- and Th2-type cytokine profile in PBMC from ACD subjects <i>in vitro</i>. We further developed a simplified ELISpot protocol utilising plates precoated with capture monoclonal antibodies (mAb) and subsequent detection in one step using enzyme-labelled mAb, for enumerating the frequency of allergen (Ni²⁺)-specific cytokine producing cells. This was compared with a regular ELISpot protocol, with an overnight incubation for capture mAb adsorbtion and detection with biotinylated mAb followed by enzyme-labelled streptavidin. PBMC from Ni²⁺-reactive and non-reactive subjects were incubated with or without NiCl₂ and the enumeration of cells producing IFN-γ, IL-4 or IL-13 by the two protocols were compared. PBMC from Ni²⁺-reactive subjects showed significantly higher Ni²⁺-induced IL-4 and IL-13 responses and the number of antigen-specific cytokine-producing cells determined by the two ELISpot protocols correlated well. In a nutshell, our data point to the potential use of <i>in vitro</i> cytokine assays as diagnostic tools in distinguishing ACD subjects sensitised to different metals and non-sensitised subjects.</p>

Transition metals such as nickel (Ni), cobalt (Co), palladium (Pd), chromium (Cr) and gold (Au) are widely used as alloys in jewelry and biomaterials such as orthodontic and orthopaedic appliances. These metals also cause cell-mediated allergic contact dermatitis (ACD) reactions in a significant proportion of the population upon prolonged direct exposure. The immune mechanisms underlying the response to these metals are not yet well defined. In the studies described in this thesis we therefore investigated the profile of cytokine responses to various metal ions in vitro and the relationship with the ACD reaction in vivo. In the first study, we investigated the relationship between the profile and magnitude of Ni2+-induced cytokine responses in vitro and the degree of in vivo reactivity to Ni2+. PBMC from Ni2+-reactive (ACD) and non-reactive control subjects were cultured with or without NiCl2. The numbers of IL-4-, IL-5- and IL-13-producing cells and the concentrations of IFN-γ, IL-10 and IL-13 produced were analysed by ELISpot and ELISA respectively. Ni2+ elicited a mixed Th1- and Th2-type cytokine profile in PBMC from ACD subjects with a positive correlation observed between the levels of the elicited cytokines and the degree of patch test reactivity. Hence, suggesting an involvement of both Th1- and Th2-type cytokines in ACD to Ni2+ and a direct association between the magnitude of the Ni2+-induced cytokine response overall and the in vivo reactivity to Ni2+. The impact of the regulatory cytokine IL-10 on Ni2+-induced Th1- and Th2-type cytokine responses in human PBMC was investigated in the next study. PBMC from blood donors with a history of Ni2+ reactivity and non-reactive control donors were stimulated with Ni2+ ex vivo with or without addition of human recombinant IL-10 (rIL-10) or neutralising mAb to IL-10. Depletion/enrichment experiments were performed to phenotype the Ni2+-specific cytokine producing cells. Exogenous rIL-10 significantly down-regulated the production of all cytokines but with a more pronounced effect on IFN-γ. IL-10 neutralisation, on the other hand, enhanced the levels of Ni2+-induced IFN-γ only. Ni2+-specific cytokine-producing cells in PBMC were found to be predominantly CD4+ T cells. Thus, IL-10 may play a regulatory role in vivo by counteracting the ACD reactions mediated by CD4+ T cells producing Th1-type cytokines. In the third study, we investigated the relationship between in vivo patch test reactivity to a number of metals (Ni, Co, Pd, Cr and Au) included in the standard and/or dental patch test series and in vitro responses to the metals in question. PBMC from metal patch test positive and negative control subjects were stimulated with a panel of eight metal salts and cytokine responses analysed by ELISpot and/or ELISA. A mixed Th1- (IL-2 and/or IFN-γ) and Th2-type (IL-4 and/or IL-13) cytokine profile was observed in PBMC from most metal allergic subjects upon in vitro stimulation with the metal(s) to which the subject was patch test positive. Our data suggest that other metals included in the standard and dental patch test series, just like Ni2+, induce a mixed Th1- and Th2-type cytokine profile in PBMC from ACD subjects in vitro. We further developed a simplified ELISpot protocol utilising plates precoated with capture monoclonal antibodies (mAb) and subsequent detection in one step using enzyme-labelled mAb, for enumerating the frequency of allergen (Ni2+)-specific cytokine producing cells. This was compared with a regular ELISpot protocol, with an overnight incubation for capture mAb adsorbtion and detection with biotinylated mAb followed by enzyme-labelled streptavidin. PBMC from Ni2+-reactive and non-reactive subjects were incubated with or without NiCl2 and the enumeration of cells producing IFN-γ, IL-4 or IL-13 by the two protocols were compared. PBMC from Ni2+-reactive subjects showed significantly higher Ni2+-induced IL-4 and IL-13 responses and the number of antigen-specific cytokine-producing cells determined by the two ELISpot protocols correlated well. In a nutshell, our data point to the potential use of in vitro cytokine assays as diagnostic tools in distinguishing ACD subjects sensitised to different metals and non-sensitised subjects.

Bronopol has been used as a preservative in drugs and cosmetics since 1964. Bronopol has low dermal irritancy at levels commonly used in cosmetics and pharmaceuticals but it is significantly irritating at higher concentrations. Laboratory testing of bronopol indicates a low potential for dermal sensitization; however, a number of case reports demonstrate human allergenic reactions. No reports were identified on the allergenic properties of bronopol for the inhalation route of exposure. In 1983 approximately 5,200 people in the United States were occupationally exposed to bronopol. Current novel uses of bronopol include mold remediation and the sanitizing of ventilation system components. These new applications have the potential to expose vast new populations to the chemical. Since 89 million people in the United States work in indoor environments and 50 million Americans suffer from allergies, it is likely that a sizeable portion of these populations will be exposed to bronopol. This is significant since the dermal sensitizing properties of bronopol suggest that the material may also be a respiratory sensitizer, potentially resulting in chemically induced asthma. More people are being diagnosed with asthma today than at any time in the past; the causes of this increased prevalence are largely unknown. In this work an existing ultraviolet spectrophotometric method for analysis of bronopol has been combined with conventional industrial hygiene air sampling techniques. No combined air sampling and analytical method for bronopol has previously been published in the literature. A calibration curve has been developed with a linear range of 1 ug/ml to 25 ug/ml. The instrumental limit of detection is 1 ug/ml with an instrumental limit of quantitation of ca. 3 ug/ml. During chamber sampling trials analytical recovery for treated glass fiber filters yielded a sampling recovery efficiency averaging 99.9 %. Bronopol concentration obtained during chamber sampling trials ranged from 10.80 mg/m3 to 21.59 mg/m3, with a pooled coefficient of variation of 4.33 % for all chamber sampling sets. Treated glass fiber filters spiked with bronopol were found to be stable for a period of 48 hours; derivatized bronopol solutions were found to be stable for a period of fourteen days.

Darbo tikslas – įvertinti dermatitu sergančių pacientų įsijautrinimą kontaktiniams alergenams ir su juo susijusius veiksnius. Darbo uždaviniai: 1. Nustatyti įsijautrinimo kontaktiniams alergenams dažnumą tarp dermatitu sergančių pacientų. 2. Įvertinti įsijautrinimo kontaktiniams alergenams dažnumo sąsajas su tiriamųjų amžiumi, lytimi ir profesija. 3. Nustatyti įsijautrinimo kontaktiniams alergenams klinikos ypatumus. 4. Įvertinti įsijautrinimo kontaktiniams alergenams sąsajas su atopiniu dermatitu, lėtine (-ėmis) kojos (-ų) opa (-omis) ir kitais veiksniais. Išvados: 1. Kontaktiniams alergenams įsijautrinę pusė dermatitu sergančių pacientų, dažniausiai – metalui nikeliui (17,1 proc.). Iš aromatinių medžiagų dažniausias yra įsijautrinimas Peru balzamui (8 proc.). Į pagrindinį alergenų rinkinį neįtrauktini retai (0,1 proc.) nustatyti alergenai: gumų medžiagos merkaptobenzotiazolas ir N-zopropil-N’-fenil-parafenilendiaminas. 2. Įsijautrinimas kontaktiniams alergenams jaunesniems nei 40 metų dermatitu sergantiems pacientams pasireiškia du kartus dažniau nei vyresniems, o moterims – du kartus dažniau nei vyrams. Žemės ūkio ir miškininkystės darbuotojai kontaktiniams alergenams įsijautrinę tris kartus dažniau nei kiti dirbantieji. Vertinant atskirus alergenus, jaunesni nei 40 metų pacientai dažniau nei vyresni yra įsijautrinę nikeliui, kobaltui ir kvaterniumui-15, o 40 metų ir vyresni – Peru balzamui, kanifolijai, aromatų mišiniui I, lanolinui, seskviterpenlaktonams ir... [toliau žr. visą tekstą] / The aim of the study: To evaluate contact sensitization and its associated factors in patients with dermatitis. The objectives of the study: 1. To determine the frequency of sensitization to contact allergens in patients with dermatitis. 2. To evaluate associations between the frequency of sensitization to contact allergens and age, sex and occupation in patients with dermatitis. 3. To determine clinical features of contact sensitization. 4. To evaluate associations between sensitization to contact allergens and atopic dermatitis, chronic leg ulcers and other factors. CONCLUSIONS 1.Half of the patients with dermatitis were sensitized to contact allergens, most frequently to metal nickel (17.1%). From the fragrances, bal¬sam of Peru was the most frequent contact allergen (8%). Rare allergens that should not be included in the baseline series are the substances present in the composition of rubber – mercaptobenzothiazole and N-isopropyl-N'-phenyl-p-phenylene diamine (IPPD). 2.Patients under 40 years of age are two times more frequently sensitized than the older ones. In women contact allergy is twice as more frequent as in men. Agricultural and forestry workers are sensitized to contact allergens three times as more often as other employees. What regards individual allergens, among patients under 40 years of age sensitization to nickel, cobalt and quaternium-15 is more prevalent than in the older ones. Among patients who are 40 years of age and over contact sensitization to... [to full text]

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 5 uppsatser.

L’allergie de contact est une pathologie très répandue. Il n’existe cependant aucun traitement permettant de la soigner. L’éviction de l’allergène reste à ce jour reste le seul moyen de la prévenir. De nombreux tests visant à déterminer le pouvoir allergisant des molécules ont été développés. L’un de ces tests est le Direct Peptide Reactivity Assay (DPRA), une méthode chimique visant à mimer une étape clé du mécanisme immunitaire menant à l’allergie de contact : la formation d’un complexe antigénique par réaction entre l’allergène et une protéine cutanée. Dans le cadre de la législation actuelle sur les cosmétiques, il pourrait être intéressant d’adapter ce test aux mélanges complexes. Le but de ce travail de thèse a été d’étudier la réactivité de différents mélanges d’allergènes connus vis-à-vis des trois peptides utilisés dans le DPRA et de la comparer à celle de chaque composant seul.Trois types de mélanges ont étés étudiés. Un mélange d’isothiazolinones utilisées comme conservateurs, trois mélanges binaires de trois aldéhydes utilisés comme parfums et enfin un mélange des deux responsables majeurs de l’allergie à l’absolu de mousse de chêne, un extrait utilisé en parfumerie. / Contact dermatitis is one of the most common health problems. It has unfortunately no cure yet. The only way to prevent it is to avoid contact with the allergen. Numerous tests have been developed in order to evaluate the allergenic potency of the tested chemical. One of these tests is the Direct Peptide Reactivity Assay (DPRA) which aim is to mimic one of the key steps leading to sensitisation: the formation of an antigenic complex by reaction between the allergen and a cutaneous protein. Due to the recent legislation on cosmetic which ask to test every chemical used in the formulation of cosmetics it could be interesting to adapt the DPRA to complex mixtures.The aim of this PhD work is to study the reactivity of some known mixtures of allergens towards the three peptides used in the DPRA and to compare it with the reactivity of each compound alone.In this approach three different types of mixtures have been studied. The first one concerns two isothiazolinones used as preservatives the second one three different aldehydes used as fragrance and the third one concerns the main responsible of contact dermatitis to oak moss absolute a natural extract used in perfumery.

Made available in DSpace on 2018-06-27T18:56:21Z (GMT). No. of bitstreams: 2 Liliani Mathias Brum.pdf: 1503888 bytes, checksum: ad2eacb7dc98b3e5fbf2604c9ae82084 (MD5) Liliani Mathias Brum.pdf.jpg: 3065 bytes, checksum: 9adf1c37fd40ed3180ec5d7ac9fc8754 (MD5) Previous issue date: 2008-09-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Since the extracellular nucleotides represent an important means of modulating the activity of lymphocytes, it is essential the presence of an enzymatic mechanism to keep constant the concentration of those in the extracellular space. The activity of NTPDase has been recognized as a marker of activation necessary for the function of effector lymphocytes, participate in the processes of recognition of antigen. Contact dermatitis occurs in a delayed hypersensitivity reaction of type IV, mediated by cells through a mechanism that sensitizes the immune T lymphocyte to an antigen protein or a hapten linked to a protein. Among the mediators able to modulate the actions of lymphocytes stand out from the nucleoside and nucleotide adenine, in particular the extracellular ATP that is able to regulate the cell-cell interactions are important processes of activation, differentiation, development, proliferation, cell death and responses of effector lymphocytes. This study sought to determine first of the hydrolysis of adenine nucleotides, the NTPDase (EC 3.6.1.5, nucleoside triphosphate difosfoidrolase, CD39) in lymphocytes from mice with dermatitis induced by nickel sulphate to 5%, before and after treatment with dexamethasone and dexamethasone nanostructured free to try to check the possible changes in the activity of this enzyme front of an inflammatory reaction of type IV hypersensitivity and immunosuppressive therapy. Moreover, it was possible to verify the relationship of submission of the drug in the formulation free and nanostructures with the hydrolysis of adenine nucleotides. The average enzymatic activity of the group with contact dermatitis was significantly higher in the control group by the test of hypotheses to averages T. The results are in line with work done earlier that showed an increase of enzyme activity by the activation of lymphocytes. The hydrolysis of ATP and ADP in the group treated with dexamethasone free and in the group treated with dexamethasone nanostructured was significantly higher in the control group by analysis of variance for a way (ANOVA) followed by Kruskal-Wallis test (P < 0001). The results are in line with work done earlier that showed an increase of enzyme activity by the activation of lymphocytes. Was observed greater hydrolysis of ATP and ADP in the group treated with dexamethasone nanostructures in relation to the group treated with dexamethasone free. However, this difference was not statistically significant. Work previously shown an increase of enzyme activity during treatment with dexamethasone as a possible compensatory effect of the decrease in the number of lymphocytes. The results of this study suggest that dexamethasone nanostructures possess a immunosuppressive effects greatest, which may be the beginning of the evaluation of a more effective and safe treatment for contact dermatitis. From these results we can conclude that the determination of the activity of NTPDase in lymphocytes could be used as an indicator of the efficiency of the treatment of contact dermatitis / Uma vez que os nucleotídeos extracelulares representam uma importante via de modulação da atividade dos linfócitos, é indispensável a presença de um mecanismo enzimático capaz de manter constante a concentração desses no espaço extracelular. A atividade da NTPDase tem sido reconhecida como um marcador de ativação necessário para a função efetora dos linfócitos, participando também dos processos de reconhecimento do antígeno. Na dermatite de contato ocorre uma reação de hipersensibilidade retardada tipo IV, mediada por células, através de um mecanismo imunológico que sensibiliza os linfócitos T frente a um antígeno protéico ou a um hapteno ligado a uma proteína. Dentre os mediadores capazes de modular as ações dos linfócitos destacam-se os nucleosídeos e nucleotídeos da adenina, em especial o ATP extracelular que é capaz de regular as interações célula-célula sendo importante nos processos de ativação, diferenciação, desenvolvimento, proliferação, morte celular e respostas efetoras dos linfócitos. Este estudo procurou determinar primeiramente a hidrólise de nucleotídeos da adenina, pela NTPDase (EC 3.6.1.5, nucleosídeo trifosfato difosfoidrolase, CD39) em linfócitos de ratos com dermatite induzida por sulfato de níquel, antes e após tratamento com dexametasona livre e dexametasona nanoestruturada, para tentar verificar as possíveis alterações na atividade desta enzima frente a uma reação inflamatória de hipersensibilidade tipo IV e na terapia imunossupressora. Além disso, procurou-se verificar a possível relação da apresentação do fármaco na formulação livre e nanoestruturada com a hidrólise de nucleotídeos da adenina. A atividade enzimática média do grupo com dermatite de contato foi significativamente maior em relação ao grupo controle pelo teste de hipóteses para médias T. Os resultados encontrados estão de acordo com trabalhos realizados anteriormente que demonstram um aumento da atividade enzimática pela ativação dos linfócitos. A hidrólise do ATP e do ADP no grupo tratado com dexametasona livre e no grupo tratado com dexametasona nanoestruturada foi significativamente maior em relação ao grupo controle pelo teste de análise de variância de uma via (ANOVA) seguido pelo teste de Kruskal-Wallis (P< 0,001). Observou-se uma maior hidrólise de ADP e ATP, no grupo tratado com dexametasona nanoestruturada em relação ao grupo tratado com dexametasona livre. No entanto, esta diferença não foi estatisticamente significativa. Trabalhos anteriores já demonstraram um aumento de atividade enzimática durante tratamento com dexametasona como um possível efeito compensatório à diminuição do número de linfócitos. Os resultados deste estudo sugerem que a dexametasona nanoestruturada possui um efeito imunossupressor maior, o que pode ser o início da avaliação de um tratamento mais eficaz e seguro para a dermatite de contato. A partir destes resultados podemos concluir que a determinação da atividade da NTPDase em linfócitos poderia ser utilizada como um indicador da eficiência da terapêutica da dermatite de contato.

M.Tech. / Diaper dermatitis (Nappy Rash) is an acute inflammation of the skin in the diaper area and is the most common cutaneous disease among infants and children (Concannon et al., 2001). It is estimated that 7% - 35% of diaper wearing infants are affected by Diaper dermatitis during the period of wearing diapers (Barkin and Rosen, 2003). The exact prevalence is not known as many cases are selfmedicated by parents or guardians (Wolf et al., 2000). Diaper dermatitis causes severe discomfort to the infants as well as anxiety and worry for the parents. Diaper dermatitis is characterised by redness, inflammation, dryness, scaling, itching, irritability, pain, satellite lesions, papulovesicular or pustular eruptions, and in severe cases ulceration of the skin (Visscher and Hoath, 2006). This study aimed to assess the efficacy of a Homoeopathic complex cream as a topical treatment for Diaper dermatitis. The complex consisted of Atropa belladonna 6cH, Calendula officinalis D1 and Sulphuricum acidum 6cH. Madaji milking cream was used as a base which contained: chlorhexidene; vitamin E; and lanolin. The treatment group received the medicated Madaji milking cream whereas the control group received the unmedicated Madaji milking cream. The Diaper dermatitis was evaluated using a 4-Point Grading Scale (Appendix D) and The Modified Lund and Browder Chart (Appendix E). Forty participants who met the inclusion and exclusion criteria were recruited to participate in this double blind control study by means of advertisements (Appendix A) that were placed on notice boards at the various campuses of the University of Johannesburg, nursery schools and hospitals, with relevant permission given. Participants were also recruited via word of mouth. Once participants were accepted into the study they were allocated to either Group A or Group B using matched pairs according to severity in order to ensure equal v distribution in both groups. There were 20 participants in each group. Group A was the treatment group which received the medicated Madaji milking cream. Group B was the control group which received the unmedicated Madaji cream. The study was completed over a seven day period. The ten areas most commonly affected by Diaper dermatitis were evaluated on the initial visit, day two, day four and day seven.

No description available.