Age-dependent changes in skin surface assessed by a novel two-dimensional image analysis

Background/purpose: Skin microrelief has been studied using various methods and devices. However, the long duration of time needed to process one sample or the expensive equipment hampered the use of those systems for routine diagnosis. Today, the emergence of new software and hardware technologies may allow this issue to be resolved.
Methods: To characterize objectively the skin surface, we introduced a new parameter SPm , namely, the area mean of superficial skin texture block formed by primary and secondary lines crossing each other. Based on the skin detector produced by the Boseview Technology Company, we developed a software for acquiring automatically skin images and calculating SPm . The relationship between SPm and age was studied on the dorsal and ventral midway of the forearm (sun-exposed and sun-protected areas) of 94 healthy volunteers without a history of smoking.
Results: The skin surface topography can be conveniently quantified with the new parameter SPm . The value of SPm of both sites increases with age, independent of sex, with the site more exposed to light being more affected.
Conclusion: With the software developed, the details of the skin surface can be observed. SPm appears to be a new valid parameter for characterizing the property of the skin surface. Our method, alone or in combination with other technologies of skin topography analysis may be applied in routine diagnosis for a quantified evaluation of skin aging.     

痤疮患者皮肤生理功能测定

目的 探讨痤疮患者面部皮肤生理功能的特点，以期指导痤疮患者的治疗。方法 选取受试对象120例，试验组为痤疮患者60例，其中男20例，女40例，平均年龄23.4岁；对照组为健康志愿者60例，其中男20例，女40例，平均年龄25.1岁。运用无创性皮肤生理功能测试仪，测量受试者的面颊及T区（油脂分泌旺盛区域）皮肤油脂、面颊皮肤弹性和水分。结果 试验组面部T区油脂量为（199.98 ± 58.21） μg/cm2，健康对照组为（117.55 ± 63.16） μg/cm2，两组差异有统计学意义（t = 7.34，P < 0.05）。试验组面颊油脂量为（154.45 ± 55.06） μg/cm2，健康对照组为（87.50 ± 47.36） μg/cm2，两组差异有统计学意义（t = 7.14，P < 0.05）。试验组皮肤弹性（0.7931 ± 0.0755R）与健康对照组（0.7882 ± 0.0498R）比较，差异无统计学意义（P > 0.05），试验组皮肤水分（30.75% ± 3.87%）与健康对照组（30.94% ± 2.91%）比较，差异也无统计学意义（P > 0.05）。结论 痤疮患者颜面皮肤油脂分泌过多。     

Paired unilateral scapular pits in a neonate

Congenital skin pits have been observed as a sporadic anatomic variant as well as in association with trauma, maternal infection, genetic syndromes, and metabolic disorders. We present a case of a neonate with paired unilateral scapular pits, which to our knowledge has not yet been reported. Although this is favored to be a benign finding in an otherwise healthy baby, we review important considerations in the clinical evaluation of a neonate with congenital skin pitting.     

Fluorescence diagnostic imaging in patients with acne

Background: Orange‐red fluorescence in the follicle openings, induced by ultraviolet A light, originates from porphyrins, the metabolic products of Propionibacteria acnes. Purpose: To investigate the relationship of orange‐red follicular fluorescence with the severity of acne and the amount of sebum secretion. Methods: Twenty‐five volunteers were included. The severity of acne was rated on a 4‐point scale. The casual sebum level was measured using a Sebumeter and the follicular fluorescence was determined using the camera Visiopor. Results: Casual sebum level and the intensity of fluorescence (percentage of the area and number of orange‐red spots) were higher at the T zone than at the U zone in all patients regardless of their skin type. Sebum amount and area of fluorescence spots were significantly negative in correlation with the clinical grade of acne. There was a significant positive correlation between the orange‐red fluorescence and the casual sebum level. Conclusion: The orange‐red fluorescence showed stronger correlation with the presence of non‐inflammatory acne lesions (comedones) and high sebum amount than the presence of inflammatory acne lesions (pustules) and low sebum amount. The fluorescence diagnostic imaging could be useful in the objective evaluation and monitoring of treatment efficacy in subjects with acne‐prone skin and patients with acne.     

New vision in fractional radiofrequency technology with switching,vacuum and cooling

Introduction: Since the introduction of fractional technology, various systems were launched to the market. The first generation of fractional RF systems created epidermal ablation with coagulative/necrosis of the dermis with sufficient clinical outcomes, but with some limitations. The aim of this study was to evaluate the efficacy and safety of SVC technology, based on the principle of separate biological responses. Material and methods: Fifty-two patients were treated for 3–6 sessions using fractional RF handpiece and eight patients received combination treatments with non-invasive RF handpiece. Results: All volunteers showed notable to significant improvement in the photoageing symptoms, without any significant complications or adverse events. Discussion: Due to its wide spectrum of parameters, the SVC technology can promote different biological responses. Owing to the “Switching” technology, the control of energy depth penetration enables delivery of the necessary thermal dose to the targeted skin layer. In addition, this novel technology includes the “Vacuum” and “Cooling” mechanisms, each contributing to the safety of the treatment. The Smart Heat function reduces the necessary energy levels and thereby reduces the pain level and risks for side effects.     

Antimicrobial peptides activity in the skin

This review presents the current state of knowledge regarding multifunctional role of human skin antimicrobial peptides (AMPs), including (a) protection from microbial infection, (b) improvement of skin barrier homoeostasis, (c) modulation of inflammation responses, and (d) promotion of wound healing. In addition, association of AMPs with skin diseases as well as challenges and future prospects for AMP therapeutics has also been discussed.     

The Fixomull skin support method for wound closure in patients with fragile skin

We report the Fixomull (BSN Medical, Hamburg, Germany) skin support technique for wound closure, a novel method for closing elliptical incisions in patients with fragile skin. After the lesion of concern is excised, a strip of Fixomull is applied to the skin adjacent to the wound edge with an approximately 2 mm gap between the Fixomull and the incision edge. The wound is then closed with interrupted sutures through the Fixomull, with care to ensure wound edge eversion. Fixomull provides extra tensile strength. The sutures are removed at approximately 14 days, and the patient given a prophylactic course of oral antibiotics only if at high risk of infection. This is a simple, time efficient, inexpensive and effective measure to avoid skin grafts and reduce skin tears and trauma in patients with thin, fragile skin. In our practice there have been no significant skin infections using this technique.     

An improved method for measurement of change in skin roughness caused by cleansing products under mild application conditions

Background: The aim of this study was to develop a method for the evaluation of subtle change in skin roughness caused by cleansing products under mild application conditions using a non‐invasive three‐dimensional (3D) analysis system. Methods: A double‐blind comparative study of the modified soap chamber test was performed using two soap bars and a syndet bar. Skin changes were evaluated by visual scoring [mean cumulative irritation index (MCII)] and by bioengineering measurements [transepidermal water loss (TEWL), skin capacitance, and skin surface roughness]. Results: MCII of the syndet bar was statistically higher than that of one soap bar, and TEWL increase after application of the syndet bar was statistically higher than that of both soap bars. Skin capacitance decreased significantly only after application of the syndet bar. The change in the average roughness of the skin surface was significantly greater after the application of the syndet bar than with classic soap bars. Conclusion: A simple, fast, and objective evaluation of skin surface topography was performed using a modified soap chamber test and a non‐invasive 3D analysis system. The results suggest that measurement of skin roughness using a non‐invasive 3D analysis system might be a good method for the evaluation of a subtle change caused by cleansing products under mild application conditions.     

The difference between the constitutive and facultative skin color does not reflect skin phototype in Asian skin

BACKGROUND/PURPOSE: The assessment of the sensitivity of human skin to ultraviolet (UV) radiation is important in the area of phototherapy, photodermatoses, photo-aging, photo-carcinogenesis, and photo-protection. Some reports have shown that quantitatively measured skin color is a good indicator for predicting UV sensitivity to human skin in Caucasians. In this study, our aim was to define the correlation between skin color and the skin phototype assessed by the Fitzpatrick method in Asian brown skin. METHODS: A total of 180 medical students with similar life styles were included in this study. Their skin phototype was classified according to the system introduced by Fitzpatrick. Then, using a Minolta Spectrophotometer CM-2002, their skin color was determined on the buttocks and forehead. The buttock color was taken as the constitutive skin color, and the forehead color as the facultative skin color. Using these measured values, we compared the skin color with the skin phototype to find their correlation. Also, we investigated whether the difference between the constitutive and facultative skin colors of each individual had a relationship with his or her skin phototype. RESULTS: The constitutive skin color became darker with increasing skin phototype, and this change was statistically significant. As for the facultative skin color, it also became darker with increasing skin phototype, but was less well correlated with the skin phototype than the constitutive skin color. However, the difference between the constitutive and facultative skin colors did not show consistent results in predicting the skin phototype. CONCLUSION: In this study, we found that the constitutive skin color can be a good indicator of the skin phototype. However, the difference between the constitutive and facultative skin colors of each individual does not give any meaningful information for the assessment of his or her skin phototype in Asian skin.     

邻位皮瓣修复术修复面部肿瘤切除后皮肤缺损

目的总结面部肿瘤切除后邻位皮瓣修复术修复皮肤缺损的经验。方法在全身麻醉或局部麻醉下,行皮肤病变切除,根据切除肿瘤皮肤缺损大小、部位、深度,采取A-T皮瓣、旋转皮瓣、斧形皮瓣等修复创面。结果共46处皮肤缺损,通过皮瓣转移均达到理想修复效果,未出现皮瓣坏死及并发症。结论邻位皮瓣修复面部肿瘤切除后皮肤缺损,术后无组织和器官变形,瘢痕隐蔽,与周围皮肤颜色无差别。     

主观皮肤类型与皮肤屏障功能的关系

目的:比较不同主观皮肤类型(油性、中性和干性皮肤)屏障功能指标的差异。方法:利用无创性方法对自评为油性、中性和干性皮肤的20~25岁北京城市女性(各30例)进行皮脂分泌率(SER)、角质层含水量、p H值和经皮肤水分丢失(TEWL)值的检测,并采用胶带连续粘脱后监测TEWL值变化的方法评价角质层完整性,采用角质层取样蛋白定量的方法评价角质层黏合力和丝氨酸蛋白酶活性。结果:主观皮肤类型为中性皮肤者具有最佳的屏障功能;干性皮肤和油性皮肤者面颊部的屏障功能均有不同程度的受损,表现为TEWL值明显升高、p H值升高、丝氨酸蛋白酶活性增加;但二者也有区别,油性皮肤者角质层完整性下降更明显,而干性皮肤主要是角质层黏合力明显减弱。结论:自评为油性和干性皮肤者与中性皮肤者相比,屏障功能均存在一定程度的缺陷,油性皮肤与干性皮肤均具有不同特点,且与其屏障受损的机制不同有关。     

Skin hyporeactivity in relation to patch testing

False-negative patch tests are clinically relevant. Skin hyporeactivity has been suggested as one possible cause. Evidence supports that failure to respond to a specific antigen might be due either to a faulty immune response, a defective inflammatory response or both. Thus, skin hyporeactivity may have clinical relevance in routine patch testing. Articles on this topic are infrequent and there is no index keyword for skin hyporeactivity as this phenomenon is poorly defined and investigated. This article summarizes several observations of skin hyporeactivity, reviews theories of possible mechanisms and discusses further consequences.