Systematic review and meta-analysis of the effectiveness of urea-based moisturizer on dry skin in diabetes melitus patients with parameters stratum corneum hydration and xerosis assessment scale

Authors

  • Tamara Friska Ristia Soesman Departement of Dermatovenereology, Faculty of Medicine, Diponegoro University/ Dr. Kariadi General Hospital Medical Center
  • Asih Budiastuti
  • Diah Adriani Malik
  • Retno Indar Widayati
  • Puguh Riyanto
  • Muslimin
  • Hardian

Abstract

Background  Diabetic patients have dry skin which tends to progress to diabetic feet, secondary infections to amputations which can reduce the patient's quality of life. The high prevalence of diabetes in Indonesia causes diabetic ulcers and ends in amputation. In Indonesia, the amputation rate is still high, which is around 25%. Moisturizer is used as a daily treatment for dry skin in diabetic patients. Therefore, moisturizers are needed as a preventive and treatment step to prevent these complications. Based on available scientific data, urea is the gold standard in the treatment of dry skin. This is based on various studies that report that most show, urea is superior to other moisturizers to restore skin hydration.   Methods Searching the electronic information service Pubmed-MEDLINE, Scopus, EBSCO, ProQuest, Scopus, Cochrane library, ClinicalTrials.gov, and Google Scholar, discovered 6 articles were considered in the qualitative analysis The meta-analysis includes 5 publications (n=331 subjects) and 371 subjects (n=371 participants).   Results  The findings of a meta-analysis revealed that after the treatment of urea-based moisturizer, the SCH values after urea administration was higher than the control and XAS scores after urea administration was lower than the control. The mean difference of the total standardized in SCH values between subjects receiving urea compared to those receiving control was 0.493±0.186 (95% CI, 0.129 to 0.857). These findings show that the group receiving topical urea had considerably higher in the total of SCH levels than the control group. (P=0.008). The total standardized mean XAS score difference between participants receiving Urea and those receiving controls was -2.184±0.140 (95% CI, -2.458 to -1.909.) These results indicate the overall XAS score the group receiving topical urea was substantially lower than the comparison group overall (P=0.000).   Conclusion Based on data from a systematic review and meta-analysis, it could be inferred that urea-based moisturizer administration is superior to other control in improving dry skin hydration in diabetic patients.   Key words Diabetic skin, xerosis, skin hydration. Methods: Searching the electronic database Pubmed-MEDLINE, Scopus, EBSCO, ProQuest, Scopus, Cochrane library, ClinicalTrials.gov, and Google Scholar, found 6 articles included in the qualitative (n = 371 subjects) and 5 articles (n = 331 subjects) included in the meta-analysis. Results: Meta-analysis results showed that after the administration of urea-based moisturizer, the SCH values after urea administration was higher than the control and XAS scores after urea administration was lower than the control. The overall standardized mean difference in SCH values ​​between subjects receiving urea compared to those receiving control was 0.493 ± 0.186 (95% CI, 0.129 to 0.857). These results indicate that the overall SCH values of the group receiving topical urea was significantly higher than the control group overall (P = 0.008). The overall standardized mean difference in XAS score between subjects receiving Urea compared to those receiving controls is -2.184±0.140 (95% CI, -2.458 to -1.909.) These results indicate the overall XAS score the group receiving topical urea was significantly lower than the control group overall (P = 0.000). Conclusions: Based on data from a systematic review and meta-analysis, it can be concluded that urea-based moisturizer administration is superior to other control in improving dry skin hydration in diabetic patients. Keywords: diabetic skin, xerosis, skin hydration.  

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Published

2022-06-01

How to Cite

1.
Soesman TFR, Budiastuti A, Malik DA, Widayati RI, Riyanto P, Muslimin, Hardian. Systematic review and meta-analysis of the effectiveness of urea-based moisturizer on dry skin in diabetes melitus patients with parameters stratum corneum hydration and xerosis assessment scale. J Pak Assoc Dermatol [Internet]. 2022Jun.1 [cited 2024Jun.17];32(2):299-313. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/1876

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