Effect of hormonal replacement therapy on skin biophysical properties of menopausal women

BACKGROUND/PURPOSE: Hormonal replacement therapy (HRT) has been shown in the past to influence well being as well as several somatic features in menopausal women. The aim of this analysis was to study the effect of HRT on various biophysical properties of the skin of menopausal women. Two sub-samples were built to test the effect (1) of 'short-term' HRT in recently menopausal women (n=15), and (2) the effect of 'medium- and long-term' HRT in menopausal women (n=78). METHODS: The analysis was performed on data from a study of 106 menopausal Caucasian women with apparent healthy skin. Self-report data on the menopausal status, the duration of the menopause, whether or not HRT has been taken and the duration of the HRT were collected. A series of biophysical measurements on the cheek, the forehead and the inner forearm were performed under controlled environmental conditions. Twenty women were menopausal for less than 5 years (eight with HRT for at least 1 year and seven who had never taken HRT) and 86 women for at least 5 years (35 with HRT for at least 5 years and 43 who had never taken HRT). Analyses of covariance with adjustment for age were performed. RESULTS: With regard to skin colour, the measurements in women treated for at least 1 year were significantly higher for red intensity (a*) and lower for brightness (L*) on the forearm as compared with the non-treated women. Furthermore, yellow intensity (b*) mean values were higher on the forehead and the forearm in women treated for at least 5 years compared with the non-treated women. Concerning sebum casual level, the mean values were significantly higher on the forehead and the cheek in women treated for at least 5 years. Regarding skin surface parameters reflecting hydration, the mean values for capacitance on the forehead and the cheek were significantly higher in women treated for at least 5 years. Finally, as regards with skin relief, parameters mean values for amplitude and roughness on the forehead were significantly higher in women treated for at least 5 years. CONCLUSION: The skin colour parameters showed a higher red intensity value in menopausal women who had been treated for at least 1 year. In menopausal women who had been treated for at least 5 years, the biophysical measurements were significantly higher for the parameters reflecting hydration and sebum secretion, which generally decrease after the menopause. These features were associated with higher values for the yellow intensity parameter and the skin relief parameters on the forehead. Our results support the subjective impression and the clinical evaluation concerning the impact of HRT on the development and the evolution of some skin properties after menopause.     

Epidermal thickness,skin pigmentation and constitutive photosensitivity

The important factors for UV sensitivity in humans are considered to be the skin pigmentation and the epidermal thickness. In this study on 73 Caucasians (age 20–85 years), we investigated in UV unexposed buttock skin the relationship between the UV sensitivity and constitutive skin pigmentation and thickness of the stratum corneum and the cellular part of the epidermis, in 34 normal people and in 39 skin cancer patients (20 patients with cutaneous malignant melanoma and 19 patients with basal cell carcinoma of the skin). Skin pigmentation was measured by skin reflectance spectroscopy, and UV sensitivity by phototest with a solar simulator. Thicknesses of the stratum corneum and the cellular part of the epidermis were determined by light microscopic evaluation of skin biopsies from the phototest areas. We found that epidermal thickness was independent of skin type and was not correlated to constitutive skin pigmentation. Thickness of the stratum corneum was statistically not different in normal persons and in skin cancer patients (P=0.4l) and was independent of gender (P=0.61) and age (P=0.56), while thickness of the cellular epidermis decreased with age (P<0.01). Stratum corneum thickness was found to be of minor importance for the constitutive UV sensitivity (accounting for on average 11% of the total photoprotection), which was mainly determined by the constitutive skin pigmentation (goodness-of-fit for correlation r=0.83). A theoretical model for the relationship of UV dose to induction of clinical erythema grade and skin pigmentation and thickness of the stratum corneum was developed. Objective measurements of skin pigmentation in UV unexposed skin by skin reflectance spectroscopy in Caucasians, normal people and people with cutaneous malignant melanoma and basal cell carcinoma of the skin predicts the constitutive UV sensitivity with a high degree of precision.     

Effect of dermal thickness, tissue composition, and body site on skin biomechanical properties

BACKGROUND/PURPOSE: Quantitative measurement of skin biomechanical properties has been used effectively in the investigation of physiological changes in tissue structure and function and to determine treatment efficacy. As the methods are applied to new questions, tissue characteristics that may influence the resultant biomechanical properties are important considerations in the research design. For certain applications, variables such as dermal thickness and subdermal tissue composition, as well as age and/or solar exposure, may influence the skin biomechanics. METHODS: We determined the influence of dermal thickness, tissue composition, and age on the skin biomechanical properties at the shoulder, thigh, and calf among 30 healthy females. We compared two devices, the Biomechanical Tissue Characterization System and the Cutometer SEM 575 Skin Elasticity Meter , to determine the effect of tissue sampling size. Dermal thickness was measured with 20 MHz ultrasound (Dermascan C) and tissue composition was inferred from anthropomorphic data. RESULTS: Skin thickness was significantly correlated with stiffness, energy absorption, and U(r)/U(f) for the shoulder. Body mass index (BMI) was significantly correlated with stiffness (negative correlation), energy absorption (positive), and skin thickness (negative) for the shoulder. Significant differences across body sites were observed. The calf was significantly different from the thigh and shoulders for all parameters (P<0.05, one-way anova). The calf had significantly lower laxity, laxity%, elastic deformation, energy absorption, elasticity, elasticity %, U(r), U(f), and U(r)/U(f) and significantly higher stiffness compared with the thighs and shoulders. sites. The thigh and shoulder sites were significantly different for all parameters except U(r)/U(f), elasticity %, laxity%, and stiffness. The dominant and non-dominant sides were significantly different. The dominant side (right for 90% of the subjects) had increased stiffness and decreased energy absorption (tissue softness, compliance) compared with the left side. A significant (P< or =0.02) negative relationship with age was seen for all biomechanical measures except stiffness at the shoulder. For the thigh and calf sites, significant negative correlations with age were found for elasticity %, U(r), and U(r)/U(f). Age and skin thickness were not correlated in this population. Skin thickness and age influenced the energy absorption at the shoulder site. The biological elasticity at the calf site could be predicted by age and BMI. The biological activity at the thigh site could be predicted by skin thickness and BMI. CONCLUSIONS: Significant regional variations in biomechanical properties and dominant side effects were observed. The biomechanical properties were significantly influenced by age. Certain properties varied with dermal thickness and tissue composition. The parameters were well correlated between the two instruments. The Cutometer, with its smaller aperture, was found to be more sensitive to age relationships.     

Echographic assessment of age-dependent variations of skin thickness

Background/aims: Skin thickness relative to age is complex and may be influenced both by intrinsic changes, extrinsic changes related to sun exposure and constitution, including sex. Age-related changes may also differ in different anatomical sites. The object was to characterize skin aging relative to these influences.
Methods: A-mode and B-mode high-frequency (20 MHz) ultrasound examination was performed using the Dermascan C. 162 subjects were examined (91 women, 71 men) in the age range 27 to 90 years. 6 anatomical locations (forehead, cheek, volar forearm, dorsal forearm, upper abdomen, buttocks) were studied.
Results: Females have thinner skin than men. Subjects aged more than 70 years have significant thinning of the skin. Age-related thinning is more pronounced in women. Relative skin-thickness decrease is less at sun-exposed areas in comparison with protected areas.
Conclusion: Ultrasund examination allows characterization of skin aging, and the influences of sex and anatomical site with sun-induced changes were differently superimposed on intrinsic changes and constitution.     

透明质酸敷料对皮肤基础状态影响的研究

目的探讨透明质酸敷料提升皮肤基础状态的效果和安全性。方法招募女性健康志愿者200名。对所有受试者使用透明质酸敷料每晚1次,连续使用28 d。于透明质酸敷料使用前、使用第14天、第28天,检测皮肤水分、油分、弹性、黑色素、血红素等基础状态,评价使用满意度和安全性。结果透明质酸敷料使用前、后不同时间,其皮肤水分、弹性改善有统计学意义(F=76.26、7.07,P0.05),油分、黑色素、血红素差异无统计学意义(F=2.04、1.47、2.22,P0.05)。透明质酸敷料使用28 d后,其使用贴合度、气味及使用舒适度的满意度均为100%,即刻滋润度及皮肤改善度的满意度均为99.5%,无明显不良反应。结论透明质酸敷料可提升皮肤的水分和弹性,受试者满意度高,安全性好。     

Assessment of skin irritancy: measurement of skin fold thickness

It is desirable to use more objective methods than visual scoring for the assessment of skin irritancy reactions. The edema, or fluid accumulation in the exposed skin sites, can be accurately measured by a caliper and this alternative method of assessment is evaluated from different aspects. Sodium lauryl sulfate (SLS) and non-anoic acid in different concentrations were applied daily to human and animal (rabbit and guinea pig) skin, and a dose-response relationship established. Higher concentrations of the irritants induced an earlier response. With 5% SLS as the test substance and the increase in skin fold thickness as the single parameter of skin irritancy, the guinea pig was found to be less reactive than rabbit and man. Measurement techniques, reproduceability and advantages and disadvantages with different animal models are discussed.     

A 31P NMR study of extracted phospholipid composition of human skin: full thickness skin,dermis, epidermis and granulation tissue

Background/aims: Phospholipids are the most important component of the plasma membrane in skin cells. Until recently, skin phospholipids have only been studied by chromatography and those results need confirmation by other methods such as ³¹PNMR spectroscopy. Methods: Phospholipid profiles were analyzed from human skin and granulation tissue using ³¹PNMR spectroscopy. Skin samples were taken from lower extremity amputation specimens and from one healthy volunteer. The granulation tissue was obtained from the wound bed of venous stasis ulcers, pressure ulcers and post-op non-healing surgical wounds. Phospholipid extractions were performed on full thickness skin samples (excluding the subcutaneous layer), epidermis, dermis, and granulation tissue biopsies. Results: Twelve phospholipid species were detected in each of the groups studied: PA, CL, DHSM, Eplas, PE, PS, SM, LPC, PI, AAPC, and PC. Statistically significant differences were found between epidermis and full thickness skin in relation to the quantity of PA, CL, DHSM, LPC, AAPC, and PC. The phospholipid ratio [(PE+Eplas+PI+PA)/PC] was calculated for each group: the epidermis value was 1.30, the dermis value was 0.62 and full thickness skin value was 0.49. Conclusions: These phospholipid profiles present a very unique distribution, which correlates with the physiological activity of the individual layer. The study of the phospholipid profile of granulation tissue opens a new line of research, evaluating changes in these profiles during the various phases of wound healing.     

Influence of body water distribution on skin thickness: measurements using high-frequency ultrasound

BACKGROUND: Although it is known that the skin acts as a water reservoir and participates in the fluid content of the whole body, no method has been established to quantify the fluid shifts in superficial tissue. OBJECTIVES: The aim of this study was to investigate changes in dermal and subcutis thickness and echodensity at the forehead and lower leg by high-frequency (20 MHz) ultrasound under various physiological conditions influencing water balance. METHODS: These parameters were measured in the skin of 20 healthy male volunteers at baseline and successively at 30 min after lying down, in a head-down position, after physical activity and after infusion of 10 mL kg-1 body weight of Ringer's solution. RESULTS: Dermal thickness at the forehead showed a significant increase from baseline to a horizontal position and a further increase in the head-down position. Physical activity did not lead to further changes, whereas after fluid infusion the dermal thickness also increased markedly. The echodensity showed inverse changes, with decreasing values. The thickness of the subcutis increased slightly from baseline to a lying position and decreased in the head-down position and after fluid infusion. At the lower leg, skin thickness decreased slightly in the head-down position with elevated legs, and increased after fluid infusion. CONCLUSIONS: Our results show that slight changes in the water distribution of the body influence the thickness and the echodensity of the dermis. Changes are more pronounced at the forehead than on the lower legs. Further, the fluid storage takes place mainly in the dermis and not in the subcutis. High-frequency ultrasound is able to quantify these effects and is a sensitive method for measuring fluid intake and balance during anaesthesia and therapy.     

Radiation-induced skin fibrosis after treatment of breast cancer: profilometric analysis

Background/aim: Treatment of breast cancer involves an association of conservative surgery and radiotherapy. This implies various cutaneous complications, well known for their clinical and histological aspects. Little data are available concerning modifications of the cutaneous microrelief after radiotherapy. We have done a profilometric analysis of the skin of breast cancer patients treated with surgery and radiotherapy. The results obtained on the irradiated breast have been compared with the ones of the controlateral normal breast. Methods: Twenty women, 43–55 year old were enrolled in the study 6–16 months after the end of a treatment associating conservative surgery and radiotherapy for breast cancer. Imprints using a silicone rubber material were performed over symmetrical areas of the treated breast and the controlateral one. All measures were performed over the upper‐medial quadrant of each breast. The imprints are then blindly analysed using an image analyser. The following parameters were measured: RA (average roughness of the skin), RZ (average of the furrows depth), RS (residual length), Rn (number of furrows) and AR (space between the furrows). Results: The comparison of the imprints shows important modifications of the microrelief after irradiation. We observe a slight increase of the skin roughness (RA: 26, 39 ± 2, 58 versus 21, 84 ± 1, 59), a significantly increase of the furrows depth (RZ: 121, 66 ± 10, 46 versus 101, 26 ± 6, 99) along with an increase of the residual length (RS: 580, 60 ± 60, 60 versus 450, 46 ± 48, 43). The number of furrows has not significantly decreased but the space between the furrows has increased on the irradiated breast. Conclusion: This study shows a breakdown effect of irradiation on the skin in correlation with the fibrosis inducing by ionising radiation. The imprints modifications are clearly different from those usually observed in the ageing process. Our results can be a basis for studying the effects of treatments on cutaneous complications linked to the radiation‐induced fibrosis.     

Dermal fluid translocation is an important determinant of the diurnal variation in human skin thickness

BACKGROUND: Ultrasonography has been used as a non-invasive approach to measure skin thickness. To date there have been no studies on diurnal variations in skin thickness. OBJECTIVES: To evaluate diurnal variations in skin thickness and to compare these with corresponding echogenicity and skin elasticity. METHODS: Measurements by ultrasonography B-mode and by Cutometer SEM 575 were carried out in the morning and in the afternoon on 20 men and 20 women (mean age 30 years) on three areas of the face (forehead, corner of the eye and cheek), the forearm and the upper arm, and the flank, thigh and calf. RESULTS: From the morning to the afternoon, the skin thickness in both sexes significantly decreased on three areas of the face, the forearm and the upper arm, but significantly increased on the thigh and calf. In parallel, the echogenicity significantly increased from the morning to the afternoon on the three areas of the face, the forearm and the upper arm, but decreased significantly on the thigh and calf. Measurements of mechanical properties at four sites demonstrated that from the morning to the afternoon, the major parameters of skin elasticity Ue* and Uf* increased significantly in both sexes on two areas of the face and slightly on the forearm, but decreased significantly on the calf. CONCLUSIONS: The diurnal profiles of skin thickness and skin elasticity in the upper half of the body are the reverse of those in the lower half of the body. These findings suggest that shifts of dermal fluid from the face to the leg by gravity during the day cause the diurnal variation in skin thickness.     

24MHz高频超声对健康成人不同部位皮肤厚度的检测

目的:利用高频超声检测健康成人全身多个部位皮肤表皮及真皮厚度。方法:招募80名健康成人,采用频率24MHz高频超声检测前额、颧部、面颊、下颌、颈部、前臂和腹部7个部位表皮及真皮厚度。结果:检测的7个部位中表皮最厚的部位为前臂[(0.2061±0.02862)mm],真皮最厚的部位为腹部[(1.5819±0.31710)mm],颈部的表皮[(0.1764±0.02812)mm]和真皮[(0.9616±0.18852)mm]最薄(P<0.05);男性所有检测部位表皮、真皮厚度显著大于女性(P<0.05);无论男性还是女性,<40岁组的前额、颧部和面颊的真皮厚度显著大于≥40岁组(P<0.05);BMI<24组的腹部表皮、颧部真皮、颈部真皮厚度显著小于BMI≥24组(P<0.05)。结论:健康成人不同部位的表皮、真皮厚度有差异;男性皮肤表皮、真皮厚度均大于女性;面部真皮厚度与年龄有关。     

Age and skin structure and function, a quantitative approach (I): blood flow, pH, thickness, and ultrasound echogenicity

BACKGROUND/PURPOSE: The aging process has been studied with fervor recently, given our shifting demographics. Since age's effects are so manifest in skin's appearance, structure, mechanics, and barrier function, it is not surprising that much effort has been placed in research to better understand them. Quantitative measurements permitted by bioengineering have allowed us to objectively and precisely study aging skin. These overviews piece together the immense amounts of information that have emerged from recent technological advances in dermatological research in order to develop a unified understanding of the quantitative effects of age on the skin. METHODS: We performed a literature on age-related changes in blood flow, pH, skin thickness, and ultrasound imaging data, searching Pub-med, Em-Base, Science Citation Index, and the UCSF dermatological library's collection of books on the topic of aging skin. RESULTS: Despite the many tools and techniques available for quantitative analysis of skin, age studies are often conflicting, especially in the areas of blood flow and skin thickness. Trends indicate that blood flow may decrease with age, especially in sites exposed to the environment. pH apparently varies little until the age of 70, after which it declines. Skin thickness data are difficult to interpret; while the stratum corneum is generally accepted to maintain its thickness during aging, dermal, epidermal, and whole skin thickness changes are controversial. Ultrasound reveals the appearance of a subepidermal low echogenic band that thickens with age, especially in environmentally exposed areas. Some studies also indicate the presence of an echogenic band in the lower dermis which thins with increased age. However, the whole dermis appears to become more echogenic in elderly people. CONCLUSION: Much remains to be done if we are to reach consensus on the effects of age on skin structure and function. Future studies would be benefited by increased standardization of skin sites tested, methodology, and increased sample size.     

78例面部敏感性皮肤患者的个性特征与心理状态调查分析

目的：调查面部敏感性皮肤患者的个性特征和心理状况。方法：采用艾森克个性问卷(EPQ)及症状自评量表(SCL-90)，对面部敏感性皮肤患者进行心理状态及个性特征的分析。结果：共收集面部敏感性皮肤患者78例，健康对照62例，面部敏感性皮肤组的精神质得分和神经质得分分别为4.77±2.01和10.78±4.65，显著高于正常对照组的3.01±1.71和7.31±3.88，差异有统计学意义(均P<0.01)；面部敏感性皮肤组SCL-90量表各因子中强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执以及精神病性方面分值均显著高于全国常模(均P<0.01)。结论：面部敏感性皮肤患者存在心理问题及个性改变，在治疗面部敏感性皮肤患者时，应关注患者心理因素。