title: An urea, arginine and carnosine based cream (Ureadin Rx Db ISDIN) shows greater efficacy in the treatment of severe xerosis of the feet in Type 2 diabetic patients in comparison with glycerol-based emollient cream. A randomized, assessor-blinded, controlled trial.
abstract: BACKGROUND
  Xerosis is a common skin disorder frequently observed in diabetic patients. An effective hydration of foot skin in diabetics is a relevant preventive strategy in order to maintain a healthy foot. Urea is considered an effective hydrating and emollient topical product. The aim of the present study was to evaluate the efficacy of topical urea 5% with arginine and carnosine (Ureadin Rx Db, ISDIN Spain) (UC) in comparison with glycerol-based emollient topical product (Dexeryl, Pierre Fabre) (EC), in Type 2 diabetic patients.
  
  
  METHODS
  We assessed the effect of UC on skin hydration in a randomized, evaluator-blinded comparative study in 40 type II diabetic patients, aged 40-75 years, treated with UC or the comparator for 28 days with a twice-daily application. The principal outcomes were the Dryness Area Severity Index (DASI) Score and the Visual Analogue Score (VAS) for skin dryness evaluated at baseline and at the end of study period by an investigator unaware of treatment allocation.
  
  
  RESULTS
  UC induced significantly greater hydration than EC with an 89% reduction in DASI score (from 1.6 to 0.2; p < 0.001) in comparison with baseline values. After 4 weeks, compared with the control group, DASI score in UC treated group was significantly lower (0.2 vs. 1.0; p = 0.048). VAS score (high values mean better hydration) significantly increased in both groups during treatment. VAS score at the end of treatment period was significantly higher in UC group in comparison with EC group (9.8 vs. 8.2; p = 0.05).
  
  
  CONCLUSIONS
  Application of urea 5%, arginine and carnosine cream increases skin hydration and alleviates the condition of skin dryness in Type 2 diabetic patients in comparison with a control glycerol-based emollient product. (Dutch Trials Register trial number 3328).
authors.affiliation: Servizio Podologia, Via Nomentana 27 Monterotondo, Rome, Italy.
authors.forename: Adalberto
authors.initials: A
authors.lastname: Federici
authors.forename: Giovanni
authors.initials: G
authors.lastname: Federici
authors.forename: Massimo
authors.initials: M
authors.lastname: Milani
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D001120:Arginine / Q000008:administration & dosage; D002336:Carnosine / Q000008:administration & dosage; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000188:drug therapy* / Q000209:etiology; D004338:Drug Combinations; D004643:Emollients / Q000008:administration & dosage*; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000209:etiology; D005990:Glycerol / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016037:Single-Blind Method; D063465:Skin Cream / Q000008:administration & dosage*; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D004643:Emollients; D002336:Carnosine; D014508:Urea; D001120:Arginine; D005990:Glycerol