Efficacy of topical hydrating and emollient lotion containing 10% urea ISDIN® plus dexpanthenol (Ureadin Rx 10) in the treatment of skin xerosis and pruritus in hemodialyzed patients: an open prospective pilot trial.

Dry skin and pruritus are common complication of end-stage renal diseases (ESRD), affecting up to 80% of dialysis patients. They are chronic, unpleasant skin manifestations with a strong negative impact on patients' quality of life, often inducing sleeplessness and mood disorders. The pathogenesis of skin xerosis (SX) and uraemic pruritus (UP) are multifactorial. Moisturizing emollients are commonly used for the treatment of SX and UP. Urea is used in dermatology due to its excellent hydrating and moisturizing properties. Urea is useful in all cases of dry skin and, depending on the concentration levels, will act as moisturizing or keratolitic agent. Ureadin Rx 10 is a topical hydrating and emollient lotion formulation. So far no data are available regarding the efficacy of topical application of urea in lotion in the treatment of SX and UP in dialysed patients. In a prospective open pilot trial we assessed the effect of topical 10% Urea ISDIN® plus dexpanthenol lotion in the treatment of SX and UP in dialyzed patients.A total of 15 hemodialyzed patients (3 men; 12 women, mean age 66 years) with SX and UP were enrolled after their informed consent in the trial. Topical 10% Urea ISDIN® plus dexpanthenol (Ureadin RX; ISDIN) lotion (URx) was applied twice daily over the arm and the legs for 28 consecutive days. Primary outcomes were a 5-point SRRC Index score (evaluating scaling roughness, redness and cracks) and a 4-point itching score (IS) both measured at baseline and after 2 and 4 weeks of treatment.At baseline mean (SD) SRRC was 5 (2.3). After URx treatment SRRC significantly (P=0.0001) decreased to 1.6 (2.1) and to 0.9 (1.2) after two and four weeks respectively (a relative reduction of 82% at week 4). IS at baseline was 1.0 (1.4). URx reduced IS significantly (P=0.008) to 0.2 (0.5) at week 2 and to 0.06 at week 4 (a relative reduction of 94% at week 4). Local tolerability was excellent/good in 14 out of 15 patients. One patient reported mild burning sensation after application of the product.In this pilot trial topical application of 10% Urea ISDIN ® plus dexpanthenol lotion has shown to improve skin dryness and pruritus in haemodialysis patients.