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FIRST PRESENTATION
Use of DermaSilk textile in recurrent vulvovaginal candidiasis
MILAN, 14 – 17 NOVEMBER 2010
D’Antuono A., Bellavista S., Banzola N., Gaspari V., Patrizi A.
Clinica Dermatologica - Dipartimento di Medicina Interna, Geriatria e Nefrologia – Ospedale Sant’Orsola-Malpighi - Università di Bologna
INTRODUCTION
MATERIAL & METHODS
Recurrent vulvovaginal candidiasis (VVC), defined as 4 or more episodes of A randomized double-blind study versus placebo DermaSilk® versus cotton was conducted.
candida vaginitis in a year, affects about 5-8% of adult women. In our study we have recruited 100 women of which 96 completed the study, attending to the
Pathogenesis of recurrent VVC is complex and a lot of factors influence its Centre for Sexually Transmitted Diseases for recurrent VVC from a long period (from 1 to 6
appearance. For example, the use of tight, synthetic briefs may create a years, mean time 2,4 years). All these patients had already been treated with weekly fluconazole
favourable environment for Candida germination. Recently, it has been for a period exceeding 6 months with incomplete resolution, presenting recurrences and vulvar
supposed that women with recurrent VVC may develop a vaginal allergic irritation also during treatment.
immune response towards Candida.
At the recruitment, eligible patients presented an episode of acute VVC with culture of vaginal
According to the literature, the best treatment of recurrent VVC is oral discharge positive for Candida and a vaginitis severity score ≥3 according to the evaluation
fluconazole 150 mg weekly for at least 6 months during which, in about 90% of previously described by Sobel et al. In each patient bacterial vaginosis was excluded with pH cases, no recurrences occur. Despite the excellent results achieved with measurement and Gram stain microscopy.
fluconazole, it is our experience that some patients with a long history of Women that entered the study were treated with fluconazole 150 mg for 6 months weekly. In addition, a recurrent VVC do not reach a complete resolution during antimycotic treatment sealed anonymous envelop, containing three pairs of DermaSilk ® briefs or white cotton briefs, was and often require additional tools to control their symptoms. Therefore, we
have decided to investigate whether underwear made of DermaSilk®, a
DS GROUP: Fluconazole 150 mg + Dermasilk ® Briefs (48 patients) pure fibroin silk fabric impregnated with a permanent antimicrobial
protection (AEM 5772/5), could be an additional tool in the management
CT GROUP: Fluconazole 150 mg + Cotton Briefs (48 patients) of recurrent VVC, as it has been shown useful in the treatment of atopic
Patients were asked to wear only the assigned briefs for the entire period of the study. During the dermatitis, decreasing eczema and reducing flares.
follow-up visits, after 1, 3 and 6 months, cultural examination for Candida and scoring of symptoms and signs were repeated. A severity score ≥3 with positive culture was considered a recurrence.
AIM OF THE STUDY The aim of our study was to investigate if DermaSilk® underwear may be an effective adjuvant tool in the management of recurrent VVC which has not completely
responded to antimycotic treatment.
All symptoms and signs statistically improved across the whole sample. The improvement was important considering in particular erythema, itching, burning, vulvar irritation, and edema (Fisher exact test p<0,0001).
PREVALENCE OF ERYTHEMA IN DERMASILK AND COTTON GROUPS
PREVALENCE OF ITCHING IN DERMASILK AND COTTON GROUPS
PREVALENCE OF BURNING IN DERMASILK AND COTTON GROUPS
AT THE BEGINNING, AFTER 1, 3 AND 6 MONTHS
AT THE BEGINNING, AFTER 1, 3 AND 6 MONTHS
AT THE BEGINNING, AFTER 1, 3 AND 6 MONTHS
IMPROVEMENT DUE TO DermaSilk® ACTION
Comparing the two groups, at the last follow-up the DermaSilk group (DS) showed a significantly greater decrease in erythema, itching and burning than the cotton
briefs (CT) group
as shown in the graphs above.
Recurrences: 11/48 (22,9%) patients of DS group reported
NUMBER OF
DS
CT
no recurrences during the study, compared with only 4/48 RECURRENCES
GROUP
GROUP
(8,3%) patients of CT group (Fisher exact test p=0,036). Most
of patients of DS group (32/48, 66.7%) had none or one
recurrence; most of patients of CT group (29/48, 60.5%)
had 2 recurrences or more.
DISCUSSION
DERMASILK® is a high technology fine-knitted fabric made of 100% pure fibroin (medical grade sericin-free silk) impregnated with a non-migrating permanent antimicrobial protective
finish (AEM 5772/5)
-DermaSilk is considered an effective adjunctive therapy in the management of atopic dermatitis and had been included in the latest European guidelines for atopic dermatitis
-in vitro studies demonstrated that DermaSilk induces a significant decrease in S.Aureus, Pseudomonas aeruginosa and Candida albicans levels
-in the present study, the use of DermaSilk briefs generated statistically better results in reducing itching, burning and erythema, compared to cotton briefs in a group of patients
with a history of recurrent VVC which has been previously treated with long term antimicotic treatment with incomplete response
-the study shows that the use of DermaSilk briefs diminished the number of recurrences of VVC during antimycotic treatment compared with cotton briefs
DERMASILK ®
• decreases external sources of vulvar irritation • absorbs sweat maintaining a good water balance in vulvar mucosa • does not exacerbate the immuno-mediated inflammatory processes already present in many women • hygroscopic and heat regulating properties + Antimicrobial agent (AEM 5772/5)
• aims to restore the skin barrier function, altered by inflammation, irritation and infections • in vitro is able to decrease Candida contamination DermaSilk® briefs appear to be an adjuvant tool, free of side effects, that can be added to classical antimycotic treatment in difficult patients in order to
diminishing vulvar discomfort and reduce recurrences of VVC.

Sobel JD. Vulvovaginal candidosis. Lancet 2007; 369:1961-71.
Weissanbacher TM, Witkin SS, Gingelmaier A, Scholz C, Friese K, Mylonas I. Relationship between recurrent vulvovaginal candidosis and immune mediators in vaginal fluid. Eur J Obstetr Gynecol 2009; 144:59-63.
Senti G, Steinmann LS, Fischer B, Kurmann R, Storni T, Johansen P, Schmid-Grendelmeier P, Wuthrich B, Kundig TM. Antimicrobial silk clothing in the treatment of atopic dermatitis proves comparable to topical corticosteroid treatment. Dermatology 2006; 213:228-233 Darsow U, Wollenberg A, Simon D, Taieb A, Werfel T, Oranje A, Gelmetti C, Syensson A, Deleuran M, Calza AM, Giusti F,Lubbe J, Seidenari S, Ring J. European Task Force on Atopic Dermatitis. EADV Eczema Task Force. ETFAD/EADV eczema task force 2009 position paper on diagnosis and treatment of atopic dermatitis. J Eur Acad Dermatol Venereol 2010 Mar; 24(3): 317-28.
Haug S Roll A, Schmid-Grendelmeier P, Johansen P, Wüthrich B, Kündig TM, Senti G. Coated textiles in the treatment of atopic dermatitis. Curr Probl Dermatol 2006; 33:144-151.

Source: http://www.dermasilkintimo.be/files/studi-scientifici-eng/poster%20recurrent%20vulvovaginal%20candidosis.pdf

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