126 J. Cosmet. Sci., 73, 126–139 (May/June 2022) Physalis angulata Cream for Reducing Inflammatory Effects of Intense Pulsed Light Treatment for Solar Melanosis GLAUCIA RODRIGUES CARDOSO, PAULA MONTANHINI FAVETTA, JULIETA RAHAL CARDOSO BARUCCI, IRINÉIA PAULINA BARETTA, EMERSON LUIZ BOTELHO LOURENÇO, ODAIR ALBERTON AND RICARDO DE MELO GERMANO Universidade Paranaense, Praça Mascarenhas de Morães, Umuarama, Paraná, Brazil (G.R.C., I.P.B., E.L.B.L., O.A., R.M.G., P.M.F.) Praça Arthur Thomas, Umuarama, Paraná, Brazil (J.R.C.B.) Accepted for publication January 14, 2022. Synopsis Intense pulsed light (IPL) effectively treats solar hand melanosis but causes inflammation afterward. The aim of this study was to compare the anti-inflammatory effects of the supercritical extract of Physalis angulata L. with the effects of 1% hydrocortisone and a placebo. The participants treated with IPL (n = 60), aged 26–73 years, were divided into two groups (n = 30). In group 1, the left hands of participants were treated with 0.5% P. angulata L. extract, and the right hands were treated with 1% hydrocortisone. In group 2, the left and right hands were treated with 0.5% P. angulata L. extract and the placebo, respectively. In group 1, the hands treated with P. angulata extract had pain (16.6%), higher temperature (66.6%), and higher perilesional erythema (40%) compared to the hands treated with hydrocortisone. In group 2, only the hands treated with the placebo had pain (30%), higher temperature, and greater perilesional erythema than the hands treated with the P. angulata extract. The results show the superiority of hydrocortisone in treating melanosis, but the P. angulata extract exhibited significant efficacy when compared to the placebo and can act as a potential anti-inflammatory agent. INTRODUCTION The symptoms of solar hand melanosis consist of brownish macules resulting from chronic sun exposure and are treated for aesthetic reasons since the hands play an important social role (1). Among the numerous available treatments, the efficacy of intense pulsed light (IPL) has been proven (2,3). After IPL treatment (in combination with improved melanin distribution in the treated skin), an increase of collagen and elastic fibers, a reduction of CD4 lymphocyte without changing CD8, the formation of new vessels without ectasia, and an increase of intercellular adhesion glycoprotein (ICAM-1) induced by inflammatory response (4,5) are evident.

127 PHYSALIS ANGULATE CREAM FOR SOLAR MELANOSIS IPL is high-intensity, polychromatic, noncoherent, and uncollimated. The treatment was idealized by Goldman in 1963 and improved utilizing the principles of selective photothermolysis. In IPL, selective destruction of a target pigment, called chromophore, is achieved by a specific light length with a minimal thermal effect at a distance (6–8). IPL is used in folk medicine as an antirheumatic, hepatoprotective, and in cases of jaundice (9), as a diuretic, trypanocide, cough suppressant, analgesic, and anti-inflammatory substance (10,11). Plants of the Solanaceae family are rich in polyoxygenated compounds that produce intact or modified structures of ergostane. These compounds are called vitasteroids (12). In P. angulata, phytosteroids are the most important compounds and are responsible for the anti- inflammatory and immunomodulatory effects (12). These phytosteroids have not yet been fully identified, although it is known that they are present in larger quantities in the leaves and the stem of the plant. P. angulata steroids such as vamolideo and fisangulideo were isolated from the leaves. Other phytosteroids and B, D, E, F, G, H, I, J, and K physalins were isolated from the stem. The fisangolide together with the epoxide D show anti-inflammatory activity similar to hydrocortisone in inflammatory processes (12). The extract of fruits and roots of P. angulata were found to have antimicrobial activity without any phototoxic effects (13). The aqueous extract of the P. angulata root shows efficacy in pain relief (14). Physalin E showed efficacy in improving dermatitis induced in animals (15) as well as the ability to inhibit myeloperoxidases, neutrophil migration, and the production of free radicals (16,17). In addition to phytosteroids, phytochemical studies reported the existence of other compounds such as alkaloids (18) and flavonoids (19) however, these results have not been fully identified. Moreover, P. angulata has also demonstrated antiseptic properties (20). The hydroalcoholic extract of P. angulata was shown to effectively modulate the production of inflammatory response mediators such as histamines, prostaglandin E2, interleukin-1 alpha, interleukin-6, and interleukin-10 in vitro (21). An experimental study of a cream containing the supercritical extract of P. angulata, in a culture of human keratinocytes exposed to sodium dodecyl sulfate (irritant surfactant), showed an ability to inhibit interleukin-1 alpha similar to that of dexamethasone 17-valerate (22). Considering the need to discover new anti-inflammatory drugs in dermatology and to explore the properties of P. angulata described in literature, the aim of this study was to evaluate the anti-inflammatory action of the cream containing 0.5% supercritical extract of P. angulata L. in comparison to 1% hydrocortisone. We observed this effect in an inflammatory process that occurs after IPL treatment of hand melanosis. MATERIALS AND METHOD EXPERIMENTAL PROCEDURE This was a double-blind, placebo-controlled clinical study conducted with 60 participants (n = 60) in a private dermatological office from July 01, 2019 to August 01, 2019 after approval by the Ethics Committee (CAAE 11089219.20000.0109). The study was conducted with participants who wished to undergo IPL treatment for cosmetic improvement of solar hand melanosis and consequently developed inflammation in both hands immediately after IPL application. The following inclusion criteria were applied: both genders were included, aged 26–73 years, in phototype II to IV, and all participants wished to be treated for solar melanosis