{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:20:05Z","timestamp":1787318405416,"version":"build-2736575974"},"reference-count":96,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceutics"],"abstract":"<jats:p>Background\/Objectives: Sulfated hyaluronic acid (sHA) is a chemically modified derivative of native hyaluronic acid (HA), characterized by enhanced physicochemical stability and increased biological activity. Glycosaminoglycans (GAGs), including HA, are key regulators of skin structure, hydration, and immune homeostasis. This review aims to critically summarize current knowledge on the structural and functional properties of GAGs\u2014particularly HA and its sulfated forms\u2014and to explore their potential dermatological applications in skin aging and inflammatory diseases such as atopic dermatitis, psoriasis, and acne. Methods: A narrative literature review was conducted using PubMed and Scopus databases up to June 2025, including experimental, preclinical, and clinical studies investigating the biological effects, mechanisms of action, and dermatological uses of sHA compared with native HA and other HA derivatives. Results: Compared with HA, sHA demonstrates increased enzymatic resistance, higher charge density, and improved water-binding and antioxidant capacity. These properties contribute to the restoration of skin barrier function, modulation of oxidative stress and inflammation, and promotion of extracellular matrix remodeling. Preclinical evidence supports the efficacy of sHA in reducing dryness, irritation, and inflammatory responses in atopic dermatitis, psoriasis, and acne. Preliminary findings also suggest potential benefits in wound healing and skin barrier repair. Conclusions: sHA represents a promising multifunctional molecule in dermatology and cosmetology, capable of reducing inflammation and supporting tissue regeneration. However, current evidence remains limited to preliminary studies. Future controlled clinical trials are required to confirm efficacy, optimize formulations, and establish standardized treatment protocols.<\/jats:p>","DOI":"10.3390\/pharmaceutics17121600","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T08:30:17Z","timestamp":1765528217000},"page":"1600","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sulfated Hyaluronan in Dermatology: What\u2019s New? Overview of Evidence in Specific Dermatological Diseases"],"prefix":"10.3390","volume":"17","author":[{"given":"Giovanni","family":"Pellacani","sequence":"first","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3374-7384","authenticated-orcid":false,"given":"Simone","family":"Michelini","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9092-6183","authenticated-orcid":false,"given":"Federica","family":"Trovato","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University, 00185 Rome, Italy"},{"name":"Department of Regenerative and Immunological Dermatology, Istituto Dermopatico dell\u2019Immacolata IDI-IRCCS, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Rallo","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University, 00185 Rome, Italy"},{"name":"Department of Regenerative and Immunological Dermatology, Istituto Dermopatico dell\u2019Immacolata IDI-IRCCS, 00167 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Gemma","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Chello","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Science, Sapienza University, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Pavan","sequence":"additional","affiliation":[{"name":"Fidia Farmaceutici S.p.A., 35031 Abano Terme, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristian","family":"Guarise","sequence":"additional","affiliation":[{"name":"Fidia Farmaceutici S.p.A., 35031 Abano Terme, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3328-3089","authenticated-orcid":false,"given":"Alberto Giuseppe","family":"Passi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Insubria, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref_1","first-page":"959","article-title":"Hyaluronic Acid Gel in Skin Rejuvenation","volume":"5","author":"Carruthers","year":"2006","journal-title":"J. Drugs Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Abatangelo, G., Vindigni, V., Avruscio, G., Pandis, L., and Brun, P. (2020). Hyaluronic Acid: Redefining Its Role. Cells, 9.","DOI":"10.3390\/cells9071743"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"116364","DOI":"10.1016\/j.carbpol.2020.116364","article-title":"Hyaluronic Acid\u2014Based Wound Dressings: A Review","volume":"241","author":"Miguel","year":"2020","journal-title":"Carbohydr. Polym."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Iaconisi, G.N., Lunetti, P., Gallo, N., Cappello, A.R., Fiermonte, G., Dolce, V., and Capobianco, L. (2023). Hyaluronic Acid: A Powerful Biomolecule with Wide-Ranging Applications\u2014A Comprehensive Review. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241210296"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.cps.2022.12.004","article-title":"Hyaluronic Acid Basics and Rheology","volume":"50","author":"Wu","year":"2023","journal-title":"Clin. Plast. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1016\/j.ijbiomac.2018.09.188","article-title":"Hyaluronic Acid, a Promising Skin Rejuvenating Biomedicine: A Review of Recent Updates and Pre-Clinical and Clinical Investigations on Cosmetic and Nutricosmetic Effects","volume":"120","author":"Bukhari","year":"2018","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"956","DOI":"10.1016\/j.reth.2025.10.006","article-title":"Sulfated Hyaluronic Acid for Wound Repair: Mechanisms, Materials, and Translational Challenges","volume":"30","author":"Lin","year":"2025","journal-title":"Regen. Ther."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"545","DOI":"10.5352\/JLS.2016.26.5.545","article-title":"Structural Characteristics and Anti-Inflammatory Activities of Chemically Sulfated-Hyaluronic Acid from Streptococcus Dysgalactiae","volume":"26","author":"Hong","year":"2016","journal-title":"J. Life Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1021\/bc9700493","article-title":"Photoimmobilization of Sulfated Hyaluronic Acid for Antithrombogenicity","volume":"8","author":"Chen","year":"1997","journal-title":"Bioconjug. Chem."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1016\/j.carbpol.2012.05.085","article-title":"Synthesis and Antiherpetic Activity of Carboxymethylated and Sulfated Hyaluronan Derivatives","volume":"90","author":"Schmidtke","year":"2012","journal-title":"Carbohydr. Polym."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Sturabotti, E., Consalvi, S., Tucciarone, L., Macr\u00ec, E., Di Lisio, V., Francolini, I., Minichiello, C., Piozzi, A., Vuotto, C., and Martinelli, A. (2022). Synthesis of Novel Hyaluronic Acid Sulfonated Hydrogels Using Safe Reactants: A Chemical and Biological Characterization. Gels, 8.","DOI":"10.3390\/gels8080480"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.matbio.2019.02.002","article-title":"Hyaluronan biology: A complex balancing act of structure, function, location and context","volume":"78\u201379","author":"Garantziotis","year":"2019","journal-title":"Matrix Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"18143","DOI":"10.1038\/s41598-019-54211-0","article-title":"Dual Action of Sulfated Hyaluronan on Angiogenic Processes in Relation to Vascular Endothelial Growth Factor-A","volume":"9","author":"Koehler","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Marinho, A., Nunes, C., and Reis, S. (2021). Hyaluronic Acid: A Key Ingredient in the Therapy of Inflammation. Biomolecules, 11.","DOI":"10.3390\/biom11101518"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Fallacara, A., Baldini, E., Manfredini, S., and Vertuani, S. (2018). Hyaluronic Acid in the Third Millennium. Polymers, 10.","DOI":"10.3390\/polym10070701"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1093\/glycob\/cww089","article-title":"Hyaluronan Synthase Control of Synthesis Rate and Hyaluronan Product Size Are Independent Functions Differentially Affected by Mutations in a Conserved Tandem B-X7-B Motif","volume":"27","author":"Baggenstoss","year":"2017","journal-title":"Glycobiology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.biomaterials.2006.09.041","article-title":"Effects of Sulfated Hyaluronan on Keratinocyte Differentiation and Wnt and Notch Gene Expression","volume":"28","author":"Nagira","year":"2007","journal-title":"Biomaterials"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/j.1600-0625.2009.00889.x","article-title":"Extrinsic Ageing in the Human Skin Is Associated with Alterations in the Expression of Hyaluronic Acid and Its Metabolizing Enzymes","volume":"18","author":"Tzellos","year":"2009","journal-title":"Exp. Dermatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.jdermsci.2011.02.007","article-title":"Intrinsic Aging- and Photoaging-Dependent Level Changes of Glycosaminoglycans and Their Correlation with Water Content in Human Skin","volume":"62","author":"Oh","year":"2011","journal-title":"J. Dermatol. Sci."},{"key":"ref_20","unstructured":"Passi, A. (2017). (Data on file) Why Low Molecular Weight HA in Wound Healing?. Hyaluronic Acid Biological Activity vs. Molecular Weight, Insubria University."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"D\u2019Agostino, A., Stellavato, A., Busico, T., Papa, A., Tirino, V., Papaccio, G., La Gatta, A., De Rosa, M., and Schiraldi, C. (2015). In Vitro Analysis of the Effects on Wound Healing of High- and Low-Molecular Weight Chains of Hyaluronan and Their Hybrid H-HA\/L-HA Complexes. BMC Cell Biol., 16.","DOI":"10.1186\/s12860-015-0064-6"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.immuni.2021.03.011","article-title":"Golgi Apparatus-Synthesized Sulfated Glycosaminoglycans Mediate Polymerization and Activation of the CGAMP Sensor STING","volume":"54","author":"Fang","year":"2021","journal-title":"Immunity"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"115291","DOI":"10.1016\/j.watres.2019.115291","article-title":"Aerobic Granular Sludge Contains Hyaluronic Acid-like and Sulfated Glycosaminoglycans-like Polymers","volume":"169","author":"Felz","year":"2020","journal-title":"Water Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3196723","DOI":"10.1155\/2019\/3196723","article-title":"In Vitro Evaluation of the Biological Availability of Hyaluronic Acid Polyethylene Glycols-Cross-Linked Hydrogels to Bovine Testes Hyaluronidase","volume":"2019","author":"Zerbinati","year":"2019","journal-title":"Biomed. Res. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1054\/mehy.1999.0954","article-title":"Sulfated Glycosaminsglycan and Glucosamine May Synergize in Promoting Synovial Hyaluronic Acid Synthesis","volume":"54","author":"McCarty","year":"2000","journal-title":"Med. Hypotheses"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Uribe-Gomez, J., Farina, P.P., Srinath, P., Russo, L., and Pandit, A. (2025). Exploring the Extracellular Matrix: Engineering Native Glycosaminoglycans to Modulate Host Responses. Cell Biomater.","DOI":"10.1016\/j.celbio.2025.100187"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/0003-9861(85)90017-7","article-title":"Influences of Sulfated Glycosaminoglycans on Biosynthesis of Hyaluronic Acid in Rabbit Knee Synovial Membrane","volume":"240","author":"Nishikawa","year":"1985","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jdermsci.2016.05.016","article-title":"Glycosaminoglycan and Proteoglycan in Skin Aging","volume":"83","author":"Lee","year":"2016","journal-title":"J. Dermatol. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1093\/glycob\/cwq162","article-title":"Age-Related Differences in Human Skin Proteoglycans","volume":"21","author":"Carrino","year":"2011","journal-title":"Glycobiology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2422","DOI":"10.1038\/srep02422","article-title":"Age-Dependent Alterations of Decorin Glycosaminoglycans in Human Skin","volume":"3","author":"Li","year":"2013","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/978-3-642-23056-1_8","article-title":"Heparin and Heparan Sulfate: Analyzing Structure and Microheterogeneity","volume":"207","author":"Shriver","year":"2012","journal-title":"Handbook of Experimental Pharmacology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1093\/glycob\/cww017","article-title":"Keratan Sulfate Glycosaminoglycan from Chicken Egg White","volume":"26","author":"Fu","year":"2016","journal-title":"Glycobiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4277","DOI":"10.3390\/molecules20034277","article-title":"Discrepancies in Composition and Biological Effects of Different Formulations of Chondroitin Sulfate","volume":"20","author":"Farran","year":"2015","journal-title":"Molecules"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.carbpol.2010.05.009","article-title":"Dermatan Sulfate: Recent Structural and Activity Data","volume":"82","author":"Volpi","year":"2010","journal-title":"Carbohydr. Polym."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Cowman, M.K., Lee, H.-G., Schwertfeger, K.L., McCarthy, J.B., and Turley, E.A. (2015). The Content and Size of Hyaluronan in Biological Fluids and Tissues. Front. Immunol., 6.","DOI":"10.3389\/fimmu.2015.00261"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"130128","DOI":"10.1016\/j.ijbiomac.2024.130128","article-title":"Sulfation of Hyaluronic Acid Reconfigures the Mechanistic Pathway of Bone Morphogenetic Protein-2 Aggregation","volume":"263","author":"Behera","year":"2024","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"106489","DOI":"10.1016\/j.ejps.2023.106489","article-title":"Aerosolized Sulfated Hyaluronan Derivatives Prolong the Survival of K18 ACE2 Mice Infected with a Lethal Dose of SARS-CoV-2","volume":"187","author":"Pavan","year":"2023","journal-title":"Eur. J. Pharm. Sci."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Yasin, A., Ren, Y., Li, J., Sheng, Y., Cao, C., and Zhang, K. (2022). Advances in Hyaluronic Acid for Biomedical Applications. Front. Bioeng. Biotechnol., 10.","DOI":"10.3389\/fbioe.2022.910290"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S1357-2725(99)00116-8","article-title":"Heparan sulfate proteoglycans on the cell surface: Versatile coordinators of cellular functions","volume":"32","author":"Tumova","year":"2000","journal-title":"Int. J. Biochem. Cell Biol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Gantumur, M.A., Jia, X., Hui, J.H., Barber, C., Wan, L., Furenlid, L.R., Martin, D.R., Hui, M., and Liu, Z. (2024). Characterization, Bioactivity, and Biodistribution of 35 kDa Hyaluronan Fragment. Life, 14.","DOI":"10.3390\/life14010097"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Hintze, V., Schnabelrauch, M., and Rother, S. (2022). Chemical Modification of Hyaluronan and Their Biomedical Applications. Front. Chem., 10.","DOI":"10.3389\/fchem.2022.830671"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3290","DOI":"10.1021\/bm9008827","article-title":"Modifications of Hyaluronan Influence the Interaction with Human Bone Morphogenetic Protein-4 (HBMP-4)","volume":"10","author":"Hintze","year":"2009","journal-title":"Biomacromolecules"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1080\/08927014.2018.1491555","article-title":"Dopamine-Functionalized Sulphated Hyaluronic Acid as a Titanium Implant Coating Enhances Biofilm Prevention and Promotes Osseointegration","volume":"34","author":"Guarise","year":"2018","journal-title":"Biofouling"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"113601","DOI":"10.1016\/j.biopha.2022.113601","article-title":"Targeting Deregulated Oxidative Stress in Skin Inflammatory Diseases: An Update on Clinical Importance","volume":"154","author":"Khan","year":"2022","journal-title":"Biomed. Pharmacother."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1016\/j.actbio.2012.03.021","article-title":"Sulfated Hyaluronan and Chondroitin Sulfate Derivatives Interact Differently with Human Transforming Growth Factor-\u03921 (TGF-\u03921)","volume":"8","author":"Hintze","year":"2012","journal-title":"Acta Biomater."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1007\/BF00213143","article-title":"Sulfated Hyaluronic Acid as Heparin-like Material: Physicochemical and Biological Characterization","volume":"5","author":"Barbucci","year":"1994","journal-title":"J. Mater. Sci. Mater. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1515\/ntrev-2020-0084","article-title":"Hyaluronic acid as a bioactive component for bone tissue regeneration: Fabrication, modification, properties, and biological functions","volume":"9","author":"Xing","year":"2020","journal-title":"Nanotechnol. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"100900","DOI":"10.1016\/j.adro.2022.100900","article-title":"High-Sulfated Hyaluronic Acid Ameliorates Radiation-Induced Intestinal Damage Without Blood Anticoagulation","volume":"7","author":"Miura","year":"2022","journal-title":"Adv. Radiat. Oncol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"986594","DOI":"10.1155\/2014\/986594","article-title":"Improvement of the Digestibility of Sulfated Hyaluronans by Bovine Testicular Hyaluronidase: A UV Spectroscopic and Mass Spectrometric Study","volume":"2014","author":"Lemmnitzer","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1021\/bm040048v","article-title":"Assessment of in Vitro Bioactivity of Hyaluronic Acid and Sulfated Hyaluronic Acid Functionalized Electroactive Polymer","volume":"5","author":"Cen","year":"2004","journal-title":"Biomacromolecules"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.bbrc.2019.08.082","article-title":"Highly Sulfated Hyaluronic Acid Maintains Human Induced Pluripotent Stem Cells under Feeder-Free and BFGF-Free Conditions","volume":"518","author":"Miura","year":"2019","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.matbio.2022.04.001","article-title":"Sulfated Hyaluronic Acid Inhibits the Hyaluronidase CEMIP and Regulates the HA Metabolism, Proliferation and Differentiation of Fibroblasts","volume":"109","author":"Schmaus","year":"2022","journal-title":"Matrix Biol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1021\/bm049642v","article-title":"Fibroblast Cell Behavior on Bound and Adsorbed Fibronectin onto Hyaluronan and Sulfated Hyaluronan Substrates","volume":"6","author":"Barbucci","year":"2005","journal-title":"Biomacromolecules"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1002\/pat.486","article-title":"The Research on Physiological Property of Functionalized Hyaluronan: Interaction between Sulfated Hyaluronan and Plasma Proteins","volume":"15","author":"Satoh","year":"2004","journal-title":"Polym. Adv. Technol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Volpi, N. (2019). Chondroitin Sulfate Safety and Quality. Molecules, 24.","DOI":"10.3390\/molecules24081447"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41572-018-0001-z","article-title":"Atopic dermatitis","volume":"4","author":"Weidinger","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.alit.2021.10.002","article-title":"Exacerbating Factors and Disease Burden in Patients with Atopic Dermatitis","volume":"71","author":"Murota","year":"2022","journal-title":"Allergol. Int."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s12016-021-08880-3","article-title":"Update on the Pathogenesis and Therapy of Atopic Dermatitis","volume":"61","author":"Li","year":"2021","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Kvedariene, V., Vaskovic, M., and Semyte, J.B. (2025). Role of Oxidative Stress and Antioxidants in the Course of Atopic Dermatitis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26094210"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Evrard, C., Lambert de Rouvroit, C., and Poumay, Y. (2021). Epidermal Hyaluronan in Barrier Alteration-Related Disease. Cells, 10.","DOI":"10.3390\/cells10113096"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2147\/CCID.S116548","article-title":"Reactivating the Extracellular Matrix Synthesis of Sulfated Glycosaminoglycans and Proteoglycans to Improve the Human Skin Aspect and Its Mechanical Properties","volume":"9","author":"Chajra","year":"2016","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jdermsci.2021.04.007","article-title":"Atopic Dermatitis: Role of the Skin Barrier, Environment, Microbiome, and Therapeutic Agents","volume":"102","author":"Luger","year":"2021","journal-title":"J. Dermatol. Sci."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Lugovi\u0107-Mihi\u0107, L., Me\u0161trovi\u0107-\u0160tefekov, J., Poto\u010dnjak, I., Cindri\u0107, T., Ili\u0107, I., Lovri\u0107, I., Skalicki, L., Be\u0161li\u0107, I., and Pondeljak, N. (2023). Atopic Dermatitis: Disease Features, Therapeutic Options, and a Multidisciplinary Approach. Life, 13.","DOI":"10.3390\/life13061419"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Gatmaitan, J.G., and Lee, J.H. (2023). Challenges and Future Trends in Atopic Dermatitis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241411380"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/j.ijbiomac.2019.11.066","article-title":"Hyaluronic Acid: A Review on Its Biology, Aspects of Drug Delivery, Route of Administrations and a Special Emphasis on Its Approved Marketed Products and Recent Clinical Studies","volume":"151","author":"Vasvani","year":"2020","journal-title":"Int. J. Biol. Macromol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"120591","DOI":"10.1016\/j.lfs.2022.120591","article-title":"Different Molecular Weight Hyaluronic Acid Alleviates Inflammation Response in DNFB-Induced Mice Atopic Dermatitis and LPS-Induced RAW 264.7 Cells","volume":"301","author":"Zheng","year":"2022","journal-title":"Life Sci."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e07572","DOI":"10.1016\/j.heliyon.2021.e07572","article-title":"Efficacy of 0.2% Hyaluronic Acid in the Healing of Skin Abrasions in Rats","volume":"7","author":"Leite","year":"2021","journal-title":"Heliyon"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e14738","DOI":"10.1111\/iwj.14738","article-title":"The effect of hyaluronic acid and iodine complex gel compared to Vaseline on deep second-degree burn wound in rats","volume":"21","author":"Bagheri","year":"2024","journal-title":"Int. Wound J."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1111\/exd.14637","article-title":"Effects of Mucopolysaccharide Polysulphate on Tight Junction Barrier in Human Epidermal Keratinocytes","volume":"31","author":"Fujikawa","year":"2022","journal-title":"Exp. Dermatol."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/cbdv.201300130","article-title":"The Role of the Conformational Profile of Polysaccharides on Skin Penetration: The Case of Hyaluronan and Its Sulfates","volume":"11","author":"Cilurzo","year":"2014","journal-title":"Chem. Biodivers."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1700082","DOI":"10.1002\/pmic.201700082","article-title":"Sulfated Hyaluronan Attenuates Inflammatory Signaling Pathways in Macrophages Involving Induction of Antioxidants","volume":"17","author":"Jouy","year":"2017","journal-title":"Proteomics"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"170","DOI":"10.7861\/clinmed.2021-0257","article-title":"Psoriasis: A Brief Overview","volume":"21","author":"Raharja","year":"2021","journal-title":"Clin. Med."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1001\/jama.2020.4006","article-title":"Pathophysiology, Clinical Presentation, and Treatment of Psoriasis: A Review","volume":"323","author":"Armstrong","year":"2020","journal-title":"J. Am. Med. Assoc."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1111\/jdv.18851","article-title":"Generalized Pustular Psoriasis: A Global Delphi Consensus on Clinical Course, Diagnosis, Treatment Goals and Disease Management","volume":"37","author":"Puig","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_75","first-page":"377","article-title":"Practical recommendations for oncological psoriatic patients: Flow chart and statement","volume":"160","author":"Pellacani","year":"2025","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/BF00417708","article-title":"Urinary Excretion of Glycosaminoglycans in Psoriasis","volume":"280","author":"Priestley","year":"1988","journal-title":"Arch. Dermatol. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2347","DOI":"10.1007\/s00018-013-1496-9","article-title":"Heparanase Is Preferentially Expressed in Human Psoriatic Lesions and Induces Development of Psoriasiform Skin Inflammation in Mice","volume":"71","author":"Lerner","year":"2014","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2340\/0001555577105109","article-title":"Altered Distribution of Heparan Sulfate Proteoglycans in Psoriasis","volume":"77","author":"Seyger","year":"1997","journal-title":"Acta Derm. Venereol."},{"key":"ref_79","doi-asserted-by":"crossref","unstructured":"Dobric\u0103, E.-C., Cozma, M.-A., G\u0103man, M.-A., Voiculescu, V.-M., and G\u0103man, A.M. (2022). The Involvement of Oxidative Stress in Psoriasis: A Systematic Review. Antioxidants, 11.","DOI":"10.3390\/antiox11020282"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1515\/hsz-2021-0145","article-title":"Modulation of macrophage functions by ECM-inspired wound dressings\u2014A promising therapeutic approach for chronic wounds","volume":"402","author":"Torregrossa","year":"2021","journal-title":"Biol. Chem."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Iqbal, M., Yasin, A., Akram, A., Li, J.-A., and Zhang, K. (2023). Advances of Sulfonated Hyaluronic Acid in Biomaterials and Coatings\u2014A Review. Coatings, 13.","DOI":"10.3390\/coatings13081345"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"5754","DOI":"10.1038\/s41598-020-62715-3","article-title":"Systematic Review of the Epidemiology of Acne Vulgaris","volume":"10","author":"Heng","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1111\/exd.13296","article-title":"Skin Microbiome and Acne Vulgaris: Staphylococcus, a New Actor in Acne","volume":"26","author":"Dreno","year":"2017","journal-title":"Exp. Dermatol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/bjd.13638","article-title":"Acne in Women","volume":"172","author":"Carneiro","year":"2015","journal-title":"Br. J. Dermatol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"e13548","DOI":"10.1111\/dth.13548","article-title":"An Overview of Treatment Options for Mild-to-moderate Acne Based on American Academy of Dermatology, European Academy of Dermatology and Venereology, and Italian Society of Dermatology and Venereology Guidelines","volume":"33","author":"Conforti","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.fct.2017.01.012","article-title":"HA Metabolism in Skin Homeostasis and Inflammatory Disease","volume":"101","author":"Kavasi","year":"2017","journal-title":"Food Chem. Toxicol."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Mart\u00edn, C., Ordiales, H., V\u00e1zquez, F., Pevida, M., Rodr\u00edguez, D., Merayo, J., V\u00e1zquez, F., Garc\u00eda, B., and Quir\u00f3s, L.M. (2022). Bacteria Associated with Acne Use Glycosaminoglycans as Cell Adhesion Receptors and Promote Changes in the Expression of the Genes Involved in Their Biosynthesis. BMC Microbiol., 22.","DOI":"10.1186\/s12866-022-02477-2"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/j.ad.2021.02.001","article-title":"Glycosaminoglycans Are Involved in the Adhesion of Candida albicans and Malassezia Species to Keratinocytes But Not to Dermal Fibroblasts","volume":"112","author":"Ordiales","year":"2021","journal-title":"Actas Dermosifiliogr."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1111\/j.1574-695X.1997.tb01094.x","article-title":"Fibronectin Binding by Propionibacterium acnes","volume":"19","author":"Yu","year":"1997","journal-title":"FEMS Immunol. Med. Microbiol."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Nazipi, S., St\u00f8dkilde, K., Scavenius, C., Br\u00fcggemann, H., Nazipi, S., St\u00f8dkilde, K., Scavenius, C., and Br\u00fcggemann, H. (2017). The Skin Bacterium Propionibacterium Acnes Employs Two Variants of Hyaluronate Lyase with Distinct Properties. Microorganisms, 5.","DOI":"10.3390\/microorganisms5030057"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12951-023-01812-7","article-title":"Hyaluronic Acid-FGF2-Derived Peptide Bioconjugates for Suppression of FGFR2 and AR Simultaneously as an Acne Antagonist","volume":"21","author":"Su","year":"2023","journal-title":"J. Nanobiotechnol."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Cao, C.K., Shi, Z.Y., Chen, C.B., Li, X.K., and Su, Z.J. (2025). Fibroblast Growth Factor-Derived Peptides: Sources, Functions, and Applications. Bioengineering, 12.","DOI":"10.3390\/bioengineering12101019"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Popa, G.L., Mitran, C.I., Mitran, M.I., Tampa, M., Matei, C., Popa, M.I., and Georgescu, S.R. (2023). Markers of Oxidative Stress in Patients with Acne: A Literature Review. Life, 13.","DOI":"10.3390\/life13071433"},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Hurst, J.R., Shannon, B.A., Craig, H.C., Rishi, A., Tuffs, S.W., and McCormick, J.K. (2022). The Streptococcus Pyogenes Hyaluronic Acid Capsule Promotes Experimental Nasal and Skin Infection by Preventing Neutrophil-Mediated Clearance. PLoS Pathog., 18.","DOI":"10.1101\/2022.04.07.487539"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1128\/IAI.74.1.40-48.2006","article-title":"Role of Hyaluronidase in Subcutaneous Spread and Growth of Group A Streptococcus","volume":"74","author":"Starr","year":"2006","journal-title":"Infect. Immun."},{"key":"ref_96","unstructured":"(2025, May 05). Cosmile Europe. INCI Database. Available online: https:\/\/cosmileeurope.eu\/inci\/."}],"container-title":["Pharmaceutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4923\/17\/12\/1600\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T08:36:13Z","timestamp":1765528573000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4923\/17\/12\/1600"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":96,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["pharmaceutics17121600"],"URL":"https:\/\/doi.org\/10.3390\/pharmaceutics17121600","relation":{},"ISSN":["1999-4923"],"issn-type":[{"value":"1999-4923","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]}}}