Therapeutic and prophylactic effects of betulin emulsions on patients treated with chemotherapy causing hand-foot syndrome

Betulin-emulsions (BE-emulsion) consist of a triterpene extract (TE) from birch cork. The main TE-component is BE (81%). TE is able to stabilize a W/O emulsion without additives [1]. Experimental studies suggest that the BE emulsion exhibits anti-inflammatory and regenerative effects on irritated skin [2]. Thus, TE supports the natural process of epidermal regeneration and the reconstitution of the epidermal barrier function. Commonly, chemotherapy causes skin alteration accompanied with inflammation and the destruction of the epidermal barrier. The hand-foot-syndrome (=inflammatory skin alterations on the palm and sole of foot) is one of the side effects of capecitabine (Cap) and doxorubicine liposomal (DL). Different stages are defined: 1 no impairment of workaday life; paresthesia, dysesthesia, tingling, painless swelling, 2 erythema, painful swelling, tingling or burning, flaking; 3 flaking, ulceration and functional impairment. Case studies showed positive effects of the therapeutic and prophylactic use of BE-emulsions on skin alteration caused by chemotherapy. 13 patients were treated with skin alterations stage 2–3 and 13 patients received prophylactic application. The application of BE-emulsion for 7 and more days, decreased the alterations by reducing inflammation and ulceration of all 13 patients to stage 0–1. Prophylactic treatment of 13 patients protected their skin in all cases. In 5 cases only alterations of stage 1 were observed after chemotherapy with Cap or DL under supportive care. The present results suggest that the use of BE-emulsion is a promising treatment option of skin alterations caused by chemotherapy and everyffective in prophylactic application.

References: 1. Rolf Daniels, Melanie N. Laszczyk: Betulin für tensidfreie Emuldionen. Pharmazeutische Zeitung, 2008; 153: 34–35.

2. M. N. Laszczyk, I. Reitenbach-Blindt, W. Gehring: Regenerative und anti-entzündliche Effekte von Betulin-Emulsionen bei gestörter epidermaler Barrierefunktion. Aktuelle Dermatologie, 2009; 35: 1–5.