Biophysical skin properties of grade 1 pressure ulcers and unaffected skin in spinal cord injured and able-bodied persons in the unloaded sacral region

Aim of the study

To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.

The Reappraisal of the Slide-Swing Skin Flap: A Versatile Technique for Surgical Defects

BackgroundThe slide-swing skin flap is a combination of transposition and adjacent skin sliding and can be used to close large, round defects with a flap that is smaller than the primary defect to produce aesthetically good results.ObjectiveTo evaluate the efficacy and safety of the slide-swing skin flap for various surgical defects caused by skin tumor excisions.MethodsThis retrospective case series, which includes 33 Asian patients between the ages of 25 and 86 years, describes the slide-swing skin flap after primary excision for malignant or premalignant skin conditions. The outcomes were assessed 12 weeks after surgery using the patient and observer scar assessment scale (POSAS).ResultsPatients were 25 male and 8 female, and the causes of surgery were various malignant skin tumors including malignant melanoma, dermatofibrosarcoma protuberans, and malignant nodular hidradenoma. Tumors were on the lower limb in eleven patients, back in nine patients, chest in five patients, face in three patients, buttock in three patients and two patients had tumors in other locations. The mean defect size was 3.5×3.1±1.9×2.2 cm (range, 1.4×0.9~9.0×12.0 cm). The mean patient POSAS total score was 9.7±3.0 and mean patient overall opinion score was 1.8±0.7. The mean observer POSAS total score was 11.0±2.7 and mean observer overall opinion score was 1.9±0.5. All flaps survived and postoperative recoveries were uneventful.ConclusionThe slide-swing skin flap is highly versatile and can be used to cover various surgical defects, irrespective of size and location, with excellent functional and cosmetic results.     

大连汉族414名正常人皮肤摩擦系数检测

目的 探讨大连汉族正常人皮肤摩擦系数是否与性别和年龄有关.方法 414名汉族志愿者参加本项研究,年龄2个月至79岁,男187例,女227例;平均年龄(35.80±1.33)岁.根据生长发育期将其分为3组:0～12岁为青春期前组;20～40岁为青壮年组;60～80岁为老年组.利用Courage-Khazaka多功能皮肤生理仪Frictiometer(R) FR 770 and Corneometer(R) CM 825探头分别测量不同部位皮肤摩擦系数和角质层的含水量(电容).结果 在男性,除老年组前额部位皮肤摩擦系数明显低于手背部位外(P＜0.05),在其他各年龄组中,各部位之间皮肤摩擦系数差异无统计学意义;而在女性,除青壮年组前额部位的皮肤摩擦系数明显低于手背和眼外眦部位外(P＜0.001),在其他各年龄组中,各部位之间皮肤摩擦系数差异也无统计学意义.在男性,同一部位各年龄组之间皮肤摩擦系数差异无统计学意义;然而在女性的前额部位,老年的皮肤摩擦系数明显大于青春期前和青壮年(P值均＜0.01);在女性的眼外眦和手背部位,青壮年的皮肤摩擦系数明显大于青春期前和老年(P值均＜0.01).除青壮年女性手背和眼外眦部位的皮肤摩擦系数明显大于男性外(P分别＜0.05和0.001),在其他各年龄组和各部位中,男女间皮肤摩擦系数差异无统计学意义.在青壮年男性,各部位皮肤摩擦系数与角质层的含水量呈正相关性(前额r=0.6342,P＜0.0001;眼外眦r=0.4501,P＜0.001;手背r=0.3627,P＜0.01);而在女性,仅老年前额和眼外眦的皮肤摩擦系数与角质层含水量呈正相关性(前额r=0.2797,P＜0.05;眼外眦r=0.486,P＜0.001).结论 汉族正常人皮肤摩擦系数与性别、年龄、部位及角质层含水量有关.

Abstract：

Objective To determine whether skin friction coefficient (SFC) is associated with gender and age in a normal Chinese Han population. Methods A total of 414 Chinese Han subjects including 187males and 227 females, who were aged from 0.15 to 79 years (mean age: 35.80 ± 1.33 years), were enrolled in this study. According to human development stages, subjects were divided into pre-puberty group (aged 0 - 12years), young group (aged 20 - 40 years) and old group (aged 60 - 80 years). SFC and stratum corneum capacitance were measured with A Frictiometer(R) FR 770 and Corneometer(R) CM 825 (C&K MPA 5), respectively,on the dorsal hand, forehead, as well as canthus. Results SFC was higher on the dorsal hand than on the forehead in old males (P ＜ 0.05 ), and higher on the dorsal hand and canthus than on the forehead in young females (both P ＜ 0.001 ), while no significant difference was observed between the three measured sites in other groups of females or males (all P ＞ 0.05 ). In males, SFC on each measured site was similar among the three groups. In contrast, SFC was significantly higher on the forehead of females in aged than in young and pre-puberty groups (both P ＜ 0.01 ), and on the canthus and dorsal hand of females in young than in pre-puberty and aged groups (all P ＜ 0.01 ). The SFC on the canthus and dorsal hands of young females was higher than that of age-matched males (P ＜ 0.0001 and 0.05, respectively). A positive correlation was found between SFC and stratum corneum hydration in young males (foreahead: r = 0.6342, P ＜ 0.0001; canthus: r = 0.4501, P ＜0.001; dorsal hands: r = 0.3627, P ＜ 0.01 ). Moreover, SFC on the forehead (r = 0.2797, P ＜ 0.05) and canthus (r = 0.486, P ＜ 0.001 ) was also positively correlated with stratum corneum hydration in old females.Conclusion Skin friction coefficient varies with age, gender, body sites and stratum comeum hydration in normal Han populations.     

以皮肤损害为首发表现的结外鼻型NK/T细胞淋巴瘤1例及文献复习

目的:报道1例皮肤结外鼻型NK/T细胞淋巴瘤,分析其临床表现、组织病理特点及治疗和预后,以提高皮肤科临床医生对本病的诊治水平.方法:通过临床表现、组织病理分析,结合免疫组化染色、EB病毒原位杂交确诊.结果:颈后皮损组织病理示真皮浅中层血管附属器周围几大灶淋巴样细胞浸润,细胞核大,胞浆透明,异型性明显.瘤细胞表达CD2、CD3、CD5、CD7、CD8、GranzymeB、Ki-67,而不表达CD56,EB病毒( + ).诊断为皮肤的结外鼻型NK/T细胞淋巴瘤.结论:结外鼻型NK/T细胞淋巴瘤具有独特的组织病理及免疫组化特征,恶性度高、易误诊、预后差.     

Epidermal curettage technique (ECT) for tissue harvest from the donor area for melanocyte autologous grafting in cases of vitiligo

Vitiligo is a dermatosis requiring complex treatment. In clinically stable cases,melanocyte autologous grafting has shown good results, using differentmethodologies for obtaining the donor area: dermatomes, punches, blisters.However, these techniques are complex and require specific instruments. Thisstudy presents a simple technique for melanocyte harvest that has been performedin our service for more than ten years and includes epidermal curettage of thedonor area, grafting of the obtained material, which was homogenized with salineor hyaluronic acid, on the achromic area, and the application of a semipermeabledressing that is removed 1 week later.     

Use of donor bone marrow mesenchymal stem cells for treatment of skin allograft rejection in a preclinical rat model

Recent studies indicate that mesenchymal stem cells (MSC) exhibit a degree of immune privilege due to their ability to suppress T cell mediated responses causing tissue rejection; however, the impact of allogeneic MSC in the setting of organ transplantation has been poorly investigated so far. The aim of our study was to evaluate the effect of intravenous donor MSC infusion for clinical tolerance induction in allogeneic skin graft transplantations in rats. MSC were isolated from Wistar rats and administered in Sprague-Dawley rats receiving Wistar skin graft with or without cyclosporine A (CsA). Graft biopsies were performed at day 10 post transplantation in all experimental groups for histological and gene expression studies. Intravenous infusion with donor MSC in CsA-treated transplanted rats resulted in prolongation of skin allograft survival compared to control animals. Unexpectedly, donor MSC infusion in immunocompetent rats resulted in a faster rejection as compared to control group. Cytokine expression analysis at the site of skin graft showed that CsA treatment significantly decreased pro-inflammatory cytokines IFN-γ and IL-2 and reduced TNF-α gene expression; however, the level of TNF-α is high in MSC-treated and not immunosuppressed rats. Results of our study in a rat tissue transplantation model demonstrated a possible immunogenic role for donor (allogeneic) MSC, confirming the need of adequate preclinical experimentation before clinical use. This work was supported by a grant from a collaborative study with the Ministero della Salute and Regione Toscana (D.Lgs. 502,1992), and funding from Fondazione Marchi.     

自体与异体细胞混合构建的活性皮肤替代物修复隐性营养不良型大疱性表皮松解症患者手部瘢痕挛缩一例

目的 观察以人羊膜为基质、自体与异体细胞混合构建的活性皮肤替代物（AM?LSE）修复大疱性表皮松解症患者手部瘢痕挛缩的疗效。方法 采集1例隐性营养不良型大疱性表皮松解症（RDEB）患者及其母亲的皮肤组织,分别进行表皮角质形成细胞和真皮成纤维细胞分离、培养。将自体与异体细胞混合后构建AM?LSE并进行组织学检查和Ⅶ型胶原免疫荧光检查。移植AM?LSE皮片于RDEB患者手部瘢痕挛缩松解术后的皮肤缺损区域。术后观察皮片的成活以及创面修复效果。结果 构建的AM?LSE具有真皮层、重层分化良好的表皮层和发育完好的基底膜。免疫荧光检查显示,Ⅶ型胶原沿基底膜线性分布。术后观察半年,移植的AM?LSE存活良好,未发现明显的排异反应,未发现受皮区再发水疱及破溃,瘢痕挛缩不显著,皮片色泽接近正常皮肤,质地柔软,患手可抓握,满足一般生活自理的要求。结论 自体与异体细胞混合构建的AM?LSE具有良好的组织学形态,移植于RDEB患者瘢痕切除后的创面,无明显排异,不易因摩擦起水疱破溃或发生瘢痕挛缩。     

薇诺娜舒敏保湿特护霜对新冠疫情防控期间医护人员佩戴医用口罩后皮肤屏障的修复

目的 观察使用薇诺娜舒敏保湿特护霜对疫情期间医护人员佩戴医用口罩后皮肤屏障修复作用及皮肤敏感改善情况.方法 采用自身前后对照研究,选取受试者佩戴口罩后的右侧面颊为受试区.入组当天晨起及佩戴口罩4h后检测经表皮水分流失(transepidermal waterloss,TEWL)及角质层含水量,随后发放受试品(薇诺娜舒敏...     

人羊膜上皮细胞复合去表皮的真皮构建组织工程皮肤修复裸鼠皮肤缺损的实验研究

目的 探索由人羊膜上皮细胞(hAEC)、成纤维细胞与去表皮的真皮(DED)构建组织工程皮肤修复裸鼠全层皮肤缺损的可行性.方法 采用低浓度胰蛋白酶多步消化分离法提取hAEC,并用两步酶消化法处理健康小儿包皮,获得成纤维细胞悬液,传代培养.将体外扩增培养至第3～5代的成纤维细胞和第2代hAEC分别接种在DED真皮面和基底膜面,体外器官培养构建组织工程皮肤.取3～4周龄健康雄性裸鼠20只,抽签法随机分为2组,在所有小鼠背部正中制备全层皮肤缺损模型.组织工程组用构建的组织工程全层皮肤覆盖创面;对照组创面仅覆盖凡士林油纱.分别于术后第7、14、21、28天对裸鼠全身及移植部位大体观察,比较两组间创面愈合时间及创面愈合率,并对移植部位行组织学观察.结果 hAEC具有干细胞特征,免疫荧光显示其表达结合转录因子4(0CT-4)、阶段特异性胚胎抗原4(SSEA-4).器官培养2周后,体外构建的组织工程皮肤形成4～9层复层表皮,且表皮的组织结构形态与正常皮肤类似.移植组织工程皮肤至裸鼠创面后肉眼观察显示,在移植后第7、14、21天,组织工程组创面愈合率分别为57.49％±6.11％、92.80％±3.10％、98.83％±0.25％,均明显高于对照组(22.93％±4.26％、54.57％±7.94％、91.16％±4.79％),差异均有统计学意义(n=10,t值分别为27.36、32.23、11.80,均P＜0.001),组织工程组创面愈合时间[(21.51±1.51)d]明显短于对照组[(28.80±1.14)d](n=10,￡=42.23,P＜0.001),且在移植后第28天移植物颜色与自体皮肤颜色接近.组织学观察显示,组织工程组上皮层次清晰,角化明显,真皮层细胞生长良好;对照组移植区上皮较薄且有部分缺损,真皮层次欠佳,且可见炎症细胞浸润.结论 用hAEC、成纤维细胞复合DED构建的组织工程皮肤移植后能在裸鼠体内存活,且创面愈合更佳,可望成为一种较理想的组织工程皮肤.