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At least 19 recordsLinked to original sources

Contact allergy to petrolatums. (I). Sensitizing capacity of different brands of yellow and white petrolatums.

46 yellow and white petrolatums were screened for their skin sensitizing properties in 3 subjects with known histories of contact sensitivity to yellow petrolatum. Patch testing revealed that all the petrolatums examined contain sensitizing substances in varying amounts. The results were analyzed with regard to origin, color, purification procedures involved in the production of pharmaceutical grade petrolatum, and pharmacopoeial requirements satisfied. Allergenicity correlated positively with these parameters, but only among petrolatums of the same brand. Petrolatum sensitivity may sometimes account for false positive patch test reactions to substances diluted in it. A petrolatum which causes no reaction on healthy skin may cause eczematous reactions on damaged skin.

Color↗

Sensitization to petrolatum: an unusual cause of false-positive drug patch-tests.

We report on an unexpected sensitization to petrolatum diagnosed with the occurrence of multiple nonrelevant and false-positive drug patch-tests performed while investigating a patient suffering from many cutaneous adverse drug reactions. All the positive drug patch-tests were prepared with GILBERT vaseline. This petrolatum reaction is positive as it was tested with five other brands of petrolatums a few months later. As the same petrolatums, but from different batches were tested, patch-tests with GILBERT petrolatum were doubtful, while other petrolatums were positive. White petrolatum is a mixture of semisolid hydrocarbons of the methane series. The sensitizing impurities of petrolatum are polycyclic aromatic hydrocarbons, e.g. phenanthrene derivatives. The purity of petrolatum depends on both the petroleum stock and on the production and packaging methods. Even if rare, contact sensitization to petrolatum can disturb the interpretation of drug patch-tests. It is necessary in the interpretation of drug patch-tests to test both in petrolatum and other vehicles and with all the different petrolatums used in preparing the material for drug patch-tests. So, it is essential to advise the patients sensitized to petrolatum to remove all the topical drugs, such as all the cosmetics, which contain petrolatum in their formulation.

Dermatitis, Contact↗

Effects of topical petrolatum and salicylic acid on the erythemogenicity of UVB.

Various topical agents used in combination with phototherapy have blocking effects, however in contrast to in vitro studies there were not enough in vivo studies about this subject. Our purpose was to examine the photoprotective effects of white petrolatum and salicylic acid which can be used before UVB therapy in psoriasis patients. In 35 volunteers, a phototest was performed to determine the minimal erythema dose (MED) and the test was repeated with thin (0.1 cc/25 cm2) and thick (0.3 cc/25 cm2) petrolatum, thin and thick salicylic acid (20%) in petrolatum and sunscreen. After 24 hrs, the effects of each agent on MED was investigated. MED values detected after pure UVB and after application of topical agents were compared one by one, and the differences between all of them have been found statistically significant. These showed that MED values were increased by thin or thick petrolatum and also by thin and thick salicylic acid (20%) in petrolatum. The highest MED values were detected with thick salicylic acid in petrolatum followed by thin salicylic acid in petrolatum, thick petrolatum and thin petrolatum. The application of petrolatum and salicylic acid, which can block UVB, before phototherapy is not recommended.

Emollients↗

Effects of topical petrolatum and salicylic acid upon skin photoreaction to UVA.

Various agents which can be used in combination can also interfere with phototherapy. In this study, the effects of topical petrolatum and 20% salicylic acid in petrolatum upon skin photoreaction to UVA were investigated, in an in vivo test. Minimal phototoxic dose (MPD) test was performed on 31 volunteers and the test was repeated with thin (0.1 cc/25 cm(2)) petrolatum, thick (0.3 cc/25 cm(2)) petrolatum, thin 20% salicylic acid in petrolatum, thick 20% salicylic acid in petrolatum and sunscreen. The effect of each agent on MPD was investigated. MPD was increased with thin and thick applications of all agents. Also, MPD was increased with 20% salicylic acid in petrolatum when compared with pure petrolatum, in the same thickness. The application of petrolatum and salicylic acid in petrolatum just before PUVA therapy is not recommended because of their blocking effects.

Administration, Topical↗

Infection and allergy incidence in ambulatory surgery patients using white petrolatum vs bacitracin ointment. A randomized controlled trial.

OBJECTIVE: To assess the effect of white petrolatum vs bacitracin ointment on wound infection incidence, allergic contact dermatitis incidence, and healing characteristics. DESIGN: Randomized, double-blind, prospective trial comparing white petrolatum with bacitracin ointment in postprocedure wound care. SETTING: A general outpatient dermatology clinic and a tertiary referral advanced surgical procedure clinic at Walter Reed Army Medical Center, Washington, DC. PATIENTS: A total of 922 patients who had dermatologic surgery with a total of 1249 wounds. MAIN OUTCOME MEASURES: The incidence of infection and allergic contact dermatitis during a follow-up period of 4 weeks. Healing characteristics were secondary outcomes. RESULTS: Of the 922 patients enrolled, 440 in the white petrolatum group and 444 in the bacitracin group were evaluable for clinical response. The 2 treatment groups had comparable baseline characteristics. Thirteen patients developed postprocedure infection (1.5%), 9 (2.0%) in the white petrolatum group vs 4 (0.9%) in the bacitracin group (95% confidence interval for difference, -0.4% to 2.7%; P=.37). Eight infections (1.8%) in the white petrolatum group were due to Staphylococcus aureus vs none in the bacitracin group (P=.004). No patient in the group using white petrolatum developed allergic contact dermatitis vs 4 patients (0.9%) in the group using bacitracin (P=.12). Additionally, there were no clinically significant differences in healing between the treatment groups on day 1 (P=.98), day 7 (P=.86), or day 28 (P=.28) after the procedure. CONCLUSIONS: White petrolatum is a safe, effective wound care ointment for ambulatory surgery. In comparison with bacitracin, white petrolatum possesses an equally low infection rate and minimal risk for induction of allergy.

Adult↗

Split-thickness skin graft donor site management. A randomized prospective trial comparing a hydrophilic polyurethane absorbent foam dressing with a petrolatum gauze dressing.

OBJECTIVE: Traditionally, skin graft donor sites have been covered with fine-mesh gauze dressings, and a dry eschar has been allowed to form. Newer dressings that can provide a moist wound environment may facilitate reepithelialization. We compared a hydrophilic semipermeable absorbent polyurethane foam dressing that provides a moist wound environment with a petrolatum gauze dressing for donor sites. DESIGN: Prospective randomized trial; follow-up at 14 days. SETTING: Department of head and neck surgery in a tertiary care center. PATIENTS: Sixty-eight eligible patients received one of the two dressings. Harvested skin grafts were 0.375-mm (0.015-in) thick; donor site surface areas were recorded. At postoperative day 14, the dressings were removed, and wound epithelialization was scored: 1, none; 2, scattered or spotty; and 3, complete. Donor site and operative site pain intensities were assessed by a visual numeric scale: none (0) to the worst (100) experienced over the preceding 24-hour period. Pain scores were available for 58 patients. MAIN OUTCOME MEASURES: Dressings were compared based on these criteria: healing at 14 days, infection, and donor site and operative site pain. RESULTS: A healing score of 3 was seen in 37% (14/38) of patients with hydrophilic semipermeable absorbent polyurethane foam dressings and in 17% (5/30) of patients with petrolatum gauze dressings (P = .06) by day 14. Overall, however, mean healing scores were similar in both groups. Mean healing scores for the patients who received a hydrophilic semipermeable absorbent polyurethane foam dressing was 2.3 (SD = 0.6) vs 2.2 (SD = 0.6) for patients who received the petrolatum gauze dressing (P = .20). Numbers of days required for complete epithelialization in these groups were 20.6 (SD = 10.1) and 19.3 (SD = 5.1), respectively (P = .49). One infection occurred in the group who received the petrolatum gauze dressing. The mean maximum pain intensity scores were lower for those who were given the hydrophilic semipermeable absorbent polyurethane foam dressing on postoperative days 1 through 3 (P = .003, .03, and .04, respectively). Pain increased with a larger donor site surface area for the patients with the petrolatum gauze dressing but not for the patients with the hydrophilic semipermeable absorbent polyurethane foam dressing. CONCLUSIONS: The hydrophilic semipermeable absorbent polyurethane foam dressing appears to have potential advantages over the petrolatum gauze dressing; it produces less initial patient donor site discomfort and tends to produce more complete donor site healing by postoperative day 14.

Absorption↗

Comparison of tazarotene 0.1% gel plus petrolatum once daily versus calcipotriol 0.005% ointment twice daily in the treatment of plaque psoriasis.

Tazarotene and calcipotriol are both effective in the treatment of psoriasis. An investigator-blind, bilateral comparison of 44 lesion pairs in 19 patients was conducted to evaluate the efficacy, side effects and duration of therapeutic effects of once-daily tazarotene 0.1% gel plus petrolatum with twice-daily calcipotriol 0.005% ointment in plaque psoriasis. It consisted of a 12-week treatment phase, followed by a 4-week post-treatment observation phase. At the end of the treatment phase, tazarotene-petrolatum was as effective as calcipotriol in both objective and subjective overall efficacy assessment. Calcipotriol had a significantly greater effect in reducing erythema than tazarotene-petrolatum at weeks 2-8. At week 16, tazarotene-petrolatum demonstrated a significantly better maintenance effect in all parameters. Local irritation was noted only in tazarotene-petrolatum-treated lesions. Once-daily tazarotene 0.1% gel plus petrolatum was as effective as twice-daily calcipotriol 0.005% ointment in the treatment of plaque psoriasis, but had a better maintenance effect after the cessation of therapy.

Administration, Cutaneous↗

White petrolatum (Ph. Eur.) is virtually non-sensitizing. Analysis of IVDK data on 80 000 patients tested between 1992 and 2004 and short discussion of identification and designation of allergens.

UNLABELLED: Sporadic cases of contact allergy to white petrolatum, which is used as a vehicle in patch test preparations, have been reported. The quantitative relevance of the phenomenon remains yet to be elucidated. METHODS: Retrospective analysis of patch test data of the Information Network of Departments of Dermatology (IVDK, http://www.ivdk.org) between 1992 and 2004. RESULTS: Analysis of 79 365 patients patch tested with pure petrolatum yielded 27 '+' (0.03%) and 2 '+++' (0.003%) reactions. The majority of non-negative reactions (0.3%) was interpreted as doubtful (235) or mild irritant (32). The negative reaction index (RI) (-0.8), and the high positivity ratio (PR) (93%) especially a lack of concordance with patch test preparations containing > or=99% petrolatum indicate that many of the 'positive' (+) reactions have to be considered as irritant. There were 2 '+++' reactions. In 1 case, an 'angry back reaction' was confirmed. The other case is probably a reading or documentation error, as the majority of patch test reactions to preparations containing petrolatum remained negative in this case also. CONCLUSIONS: True allergic patch test reactions to white petrolatum are extremely rare and probably due to an individually increased susceptibility to allergens and/or irritants. This is in agreement with considering petrolatum as a non-sensitizer.

Allergens↗

Effect of topical application of medicinal grade petrolatum on various species of laboratory animals and man.

Medicinal grade yellow and white petrolatum (soft paraffin) were tested for dermatoxic effects on laboratory animals and man. Yellow petrolatum produced redness, thickening of skin, hyperkeratosis and reversible total hair loss in rabbit and rat but no dermatoxic effect was observed in man and dog. White petrolatum which is similar in composition to yellow petrolatum produced less redness and keratosis. Refluxing of yellow soft paraffin with 95% alcohol could dissolve out dermatoxic fraction. The results have been discussed and it is suggested that drugs with petrolatum as ointment base should not be tested on rats and rabbits as petrolatum itself is dermatoxic in these species.

Administration, Cutaneous↗

Gentamicin ointment versus petrolatum for management of auricular wounds.

BACKGROUND: Surgeons frequently create defects on the ear in the treatment of cutaneous malignancies. Potentially significant complications of second-intention healing on the ear are suppurative and inflammatory chondritis. Consequently, many physicians advocate the use of oral or topical prophylactic antibiotics after auricular surgery. OBJECTIVE: The purpose of this study is to compare the efficacy of gentamicin ointment with that of petrolatum for the prevention of suppurative chondritis during second-intention healing of auricular wounds after Mohs surgery. METHODS: One hundred forty-two patients with a total of 147 second-intention wounds were prospectively selected to receive either gentamicin ointment or petrolatum postoperatively. RESULTS: One hundred forty-four wounds were evaluated in a follow-up examination or by telephone interview. Eight (5.56%) wounds developed suppurative chondritis. Four wounds received gentamicin and four received petrolatum, for incidences of 4.76% and 6.67%, respectively. Twelve (8.33%) other wounds developed inflammatory chondritis. Ten (11.90%) received gentamicin and two (3.33%) received petrolatum. CONCLUSIONS: There is no statistically significant difference between the use of gentamicin ointment and petrolatum in the prevention of postoperative auricular suppurative chondritis. The data also demonstrate a disproportionate number of cases of inflammatory chondritis in the gentamicin-treated group. This study supports the cost-effective and potentially less irritating use of petrolatum for wound care in this difficult to manage area.

Adult↗

Petrolatum: interference with the oxidation of arachidonic acid.

Microsomal preparations from petrolatum-treated wound skin contained significantly less arachidonic acid-dependent oxidative capacity when compared to activities in untreated wounded skin (t = 6.06, P < 0.001). Microsomes from both untreated and petrolatum-treated wounded skin produced similar quantities of PGE2 and PGF2 alpha; however, microsomal lipoxygenase activity in petrolatum-treated wounded skin was depressed when compared to that in untreated wounded skin. Microsomal preparations from normal pig skin treated with petrolatum oxidized arachidonic acid at a similar rate to those from untreated control skin. Increasing quantities of petrolatum progressively inhibited the synthesis of PGE2 and PGF2 alpha by fetal calf skin microsomes in vitro as determined by both the oxidation of arachidonic acid and the quantification of radioactive product. Topical application of banal compounds that contain lipid substances may therefore alter the cutaneous inflammatory response by local suppression of pathways that generate hydroxy-fatty acids, substances that are known to be chemotactic and pro-inflammatory.

Animals↗

Effect of vehicle on topical liposomal drug delivery: petrolatum bases.

Liposornes used for topical applications are often incorporated into a vehicle to achieve suitable viscosity and application properties. The effect of incorporation of liposomes into white petrolatum as a possible dermatological base was investigated. A number of formulae were developed to determine the type of petrolatum base that would be compatible with the liposomes. The physical appearance and stability of the vaseline-liposome (VL) preparations were determined by organoleptic analysis and microscopy. The effect of petrolatum base on the drug release from the liposomes was determined in a flow-through diffusion cell system using a model silastic polymer membrane as barrier. A base containing white petrolatum 46.7% (w/w), stearyl alcohol 6.7% (w/w), cholesterol 13.3 (w/w), Tween 80 16.7% (w/w) and Span 16.7% (w/w) was selected for diffusion studies, since the mixture of this base and liposome preparation, at 1:1.9 (w/w) ratios, provided a stable, dermatologically acceptable dosage form, in which the liposomes were uniformly distributed and their structures were preserved. Diffusion studies showed that the drug release rate decreases 2.5x when the liposomes are incorporated into the vaseline base; however, after a temporary decrease they seem to extend the duration of release beyond that of the original liposomal formula. These studies revealed a possibility of using white petrolatum in the topical application of liposomes.

Administration, Topical↗

Assessment of diaper-clogging potential of petrolatum moisture barriers.

Petrolatum-based ointments often are used to treat and prevent incontinence dermatitis. However, anecdotal reports indicate that petrolatum ointments may affect the absorbency of disposable briefs also commonly used in incontinence management. To examine whether petrolatum ointments clog a commonly used absorbent brief, a randomized, balanced-block design study was conducted in a controlled laboratory setting to compare the brief-clogging potential of three petrolatum ointments to a non-alcohol barrier film. Test products were applied to 6-cm x 6-cm test sites on the volar forearms of 16 volunteers. Pre-weighed mini briefs were applied to the test sites in a manner that simulates normal brief wear. After 5 minutes of wear, the mini briefs were weighed to determine percent of product transfer from skin to mini brief. The mini briefs then were reapplied to the same test sites and a synthetic urine solution was introduced between the skin and the mini brief. Mini briefs subsequently were removed to determine fluid uptake by weight. Results indicate significant differences between the four test products (P < 0.01) both in percent transfer and in mini brief fluid absorption. From 59% to 69% of the petrolatum-based products transferred from the skin to the mini briefs and a 54% to 90% reduction in fluid uptake was noted, as determined by weight. The non-alcohol barrier film did not transfer to the mini brief and fluid uptake was minimally affected. Further study in the clinical and practice settings to determine the effect and consequences of barrier product transfer on absorbent garments is warranted.

Absorption↗

Periocular petrolatum.

PURPOSE: This report describes the clinical and histopathologic features and discusses the diagnostic difficulties and management of periocular deposition of petrolatum-based materials. METHODS: Excision of orbital and eyelid tissue, tissue processing, and histopathologic examination was performed in patients with deposition of petroleum-based products. Transmission electron microscopy was performed in 3 cases. RESULTS: Between 1983 and 2003, 11 patients were diagnosed with periocular petrolatum deposition, based on clinical history and the characteristic histopathologic features of polymorphic dropout spaces, and varied from a noninflammatory lesion (paraffinoma) to those with an associated granulomatous inflammatory reaction. CONCLUSIONS: The diagnosis of petrolatum deposition can be challenging due to the range of symptoms and variable delay in presentation. Petrolatum products should be avoided during surgery and used judiciously in the postoperative period. To avoid confusion with nonspecific cases of lipogranulomatous inflammation, the terms "ointment granuloma" or "orbital paraffinoma" should be used to refer to patients presenting with orbital/eyelid lesions caused by ointment use.

Adolescent↗

Allergic contact dermatitis to white petrolatum.

White petrolatum is known for its nonsensitizing and nonirritating properties. Only a few cases of allergic contact dermatitis to white petrolatum have been reported. Although it is a rare event, the finding of contact sensitization to white petrolatum raises the potential problem of its usage of common topical agents or vehicles for patch testing. We herein report a case of allergic contact dermatitis to white petrolatum.

Allergens↗

Atopy patch test in patients with atopic eczema/dermatitis syndrome: comparison of petrolatum and aqueous solution as a vehicle.

BACKGROUND: The atopy patch test (APT) is an in vivo model to study the induction of eczema by inhalant allergens. This study was designed to compare two commonly used APT methods. METHODS: In the first method, the allergen is dissolved in aqueous solution, which is applied on tape-stripped skin. In the second method, the allergen is dissolved in petrolatum and applied without tape stripping. Thirteen patients with atopic dermatitis sensitized to inhalant allergens were patch tested using both methods. Reactions were evaluated macroscopically and microscopically after 48 h. RESULTS: Nine out of 13 patients displayed a positive reaction for both methods. One patient had a positive APT for the aqueous method alone and three for the petrolatum method alone. Reactions were significantly stronger when using the petrolatum method. Histological evaluation of the nine patients positive for both methods showed no significant differences in number of eosinophils, T-cells and neutrophils. CONCLUSION: The APT using the petrolatum vehicle induces a higher number of positive reactions and is significantly stronger relative to the APT using allergen in aqueous vehicle. The cellular influx in both test methods is comparable. Both methods can be used to study the mechanisms in the induction of eczema by inhalant allergens.

Adult↗

Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study.

BACKGROUND: Cutaneous scars resulting from surgical procedures can be erythematous, hypertrophic, pruritic, painful, or cosmetically unacceptable. An onion extract-based topical gel (Mederma, Merz Pharmaceuticals, Greensboro, NC, USA) has been marketed as a product to improve scar appearance and texture. However, few data are available to substantiate these claims. OBJECTIVE: To compare the efficacy between the onion extract gel and a petrolatum-based emollient (Aquaphor, Beiersdorf, Inc., Wilton, CT, USA) in improving the appearance and symptoms of new surgical scars. METHODS: Twenty-four patients with new surgical wounds of at least 4 cm in length were enrolled in the study. Using a randomized, double-blinded, split-scar study design, each scar was divided into two equal portions, and each half was assigned treatment with either onion extract gel or petrolatum ointment at the time of suture removal. Each product was applied three times daily for 8 weeks, and patients were evaluated at 2, 8, and 12 weeks following initiation of treatment. A follow-up telephone interview was conducted at least 11 months postoperatively. RESULTS: Scar halves were evaluated by blinded investigators for overall cosmetic appearance, erythema, and hypertrophy. Patients also independently rated side-specific erythema, pruritus, burning, and pain. Using the paired t-test and the Wilcoxon signed rank test, we found no statistically significant difference (p < .1) between the two treatment groups in any of the outcome variables studied. CONCLUSION: Petrolatum-based topical agents constitute standard therapy in the management of postoperative wounds. In this side-by-side, randomized, double-blinded, split-scar study, the onion extract gel did not improve scar cosmesis or symptomatology when compared with a petrolatum-based ointment.

Administration, Topical↗