246名女性皮肤老化特征及相关因素的调查分析

目的 探讨女性面部皱纹的发生情况及相关影响因素.方法 采用问卷表调查的方法,将研究对象根据工种及日均日晒时间分为室内组和室外组,使用图像分析仪SIA0612标准化拍照,结合Visioscan VC98定量测量皱纹的结果,将研究对象面部皱纹分0～9级分析.利用SPSS 17.0分析防晒情况、护肤美容、皱纹发生时间、发生部位等并对皱纹产生可能相关因素进行室内外组对比分析.结果 246名19～71岁女性,回顾各不同年龄阶段使用防晒措施的比例是:6～11岁年龄段为11%;12～18岁为13.5%;19～29岁为38.5%;30～39岁为39.2%;40～59岁为44%;60～75岁为0.在近5年阶段的为最多达44.1%.出现皱纹与色素斑时间及情况比较:目前无皱纹的占5.7%,目前无色素斑的占21.7%.发现皱纹时间以30～35岁为最多,发现色素斑时间以25～30岁为最多.室内组人群面部皱纹发生的顺序由多到少依次是眶下、外眦、鼻唇沟区域、眉间;室外组皱纹最多出现的依次顺序依次是:外眦、眶下、眉间、鼻唇沟.室内人群皱纹最常发生于鱼尾纹,至少在45岁达100%.而室外人群的皱纹发生普遍早,鱼尾纹至少在30岁就达100%.结论 皱纹和色素斑均为中国女性皮肤老化的主要表现.色素斑出现时间略早于皱纹.女性皮肤光老化的主要表现依次为肤色灰黄、皮肤干燥、粗糙、皮革样外观、显著的红血丝和(或)严重的色素斑、脆性增加等.室内组女性皱纹出现次序和时间都有别于室外组.

Abstract：

Objective To estimate the prevalence and associated factors of facial wrinkling in females.Methods Questionnaires were designed and delivered to collect related data on volunteers. The subjects were divided into outdoor and indoor groups. Wrinkles were classified into 9 grades based on photos taken by SIA0612 image analyzer and quantification analysis via Visioscan VC 98. SPSS 17.0 software was used to assess the associated factors of wrinkling, including sun-protective measures, skin care and cosmetology, onset age and location of wrinkles in these subjects. Results A total of 246 patients aged 19 - 71 years were recruited in this study. Sun-protective measures were applied in 13.5% of the subjects between 12 and 18 years of age,38.5% of those between 19 and 29 years of age, 39.2% of those between 30 and 39 years of age, 44% of those between 40 and 59 years of age, and in none of those between 60 and 75 years of age, 44.1% of all the subjects in the latest 5 years. Wrinkles were absent in 5.7% of the subjects, and pigmentation macules absent in 21.7%. The first development of wrinkles was mainly observed in subjects aged 30 to 35 years, and that of pigmentation macules in those aged 25 to 30 years. The most common locations of facial wrinkles, in order of decreasing frequency, were infraorbital area, lateral angle of eye, nasolabial fold, glabella in the indoor group,lateral angle of eye, infraorbital area, glabella and nasolabial fold in the outdoor group. Fishtail lines seemed to be the commonest wrinkles with an earliest onset among these wrinkles, and showed a prevalence of 100% in subjects aged 45 years or older in the indoor group, and in those aged 30 years or older in the outdoor group.Conclusions Wrinkles and pigmentation macules are dominate manifestations of skin aging in Chinese females. The onset of pigmentation macules is earlier than that of wrinkles. The main manifestations of skin aging in Chinese females, in order of decreasing frequency, are yellow-grey skin, skin dryness, roughness,leather-like appearance, teleangiectasia, and (or) severe pigmentation macules, increase in skin fragility, etc.The order and age of wrinkle appearance are different between indoor and outdoor females.     

浙江省339例迟发型白癜风临床分析

Objective To study clinical features and epidemiology of late onset vitiligo in Zhejiang province.Methods Using a standardized questionnaire,clinical analysis was carried out in 339 patients who developed vitiligo after 30 years of age(late onset)as well as on 758 patients developing vitiligo before 30 years of age(early onset)as control.The findings were analyzed by SPSS 16.0 software.Results There were 229 females and 110 males in the 339 patients with late onset vitiligo,while of the 758 patients with early onset vitiligo,375 were males and 383 females.In late onset vitiligo,the average onset age was 45.4±10.8 years with head and neck as the predilection sites.A significant increase was observed in the proportion of patients with upper limbs as the primary location in patients with late onset vifiligo than in those with early onset vitiligo(22.7%vs 12.9%,χ2=16.73,P<0.05).Compared with patients with early onset vitiligo,the prevalence of segmental vitiligo and localized vitiligo decreased (9.4%vs 20.1%,11.2% vs 16.5%,both P<0.05),while that of sporadic vifiligo and extremity vitiligo increased(57.8%vs 50.1%,16.8%vs 10.8%,both P<0.05)in those with late onset vitiligo.Of the patients with late onset vitiligo,252 (74.3%)were in progressive stage and 105(31.0%)suffered from leukotrichia.No significant difference was found in the prevalence of autoimmune or endocrine disorders between patients with late onset vitiligo and those with early onset vitiligo(8.8%vs 5.9%,P>0.05),while increased incidence of thyroid diseases and diabetes mellitus was noted in patients with late onset vitiligo(both P<0.05).A family history was observed in 31(9.1%)patients with late onset vitiligo and 97(12.8%)patients with early onset vitiligo(P>0.05).Compared with early onset vitiligo,late onset vitiligo was more vulnerable to environmental factors,and mental factors appeared to be the primary influencing factor.Conclusion There are some differences in clinical and epidemiological profiles between late onset vitiligo and early onset vitiligo.     

Visual Clues for the Histopathologic Diagnosis of Psoriasis: A Retrospective Case-Control Study

Objective: The histopathologic diagnosis of psoriasis remains challenging. This study aimed to uncover clues for the histopathologic diagnosis of psoriasis in patients whose lesions required differentiation from other inflammatory skin disorders.Methods: A retrospective analysis was conducted between psoriasis biopsy sections and other inflammatory skin diseases sections. The psoriasis and control groups were compared regarding the pathological characteristics, including the ? sign, hypogranulos...     

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.     

基底细胞癌组织病理类型与性别、年龄及部位的相关性分析

目的 分析基底细胞癌(BCC)组织病理类型与性别、年龄及部位的相关性.方法 回顾性分析2000年1月到2009年4月共243例BCC的临床病理资料,应用SPSS 13.0软件对资料进行分析.结果 243例BCC中,男118例,女125例,男女比例为0.94:1;平均年龄(65.16±12.62)岁;好发于头颈部,占77.4%;结节型是最常见的病理类型,占53.9%,其次为浅表型和浸润-硬化型,分别占18.9%和18.5%.女性患者就诊年龄早于男性(P＜0.05).不同组织病理类型BCC的性别构成差异无统计学意义(P＞0.05).浅表型BCC好发于躯干部位,就诊年龄早于非浅表型,女性就诊年龄早于男性,差异均有统计学意义(P＜0.05).结节型、浸润-硬化型及微小结节型BCC好发于头颈部,就诊年龄较晚,男女患者就诊年龄无差异(P＞0.05).结论 不同组织病理类型BCC的临床特征不同,可能存在不同的发病机制.

Abstract：

Objective To analyze the relationship of histopathological subtypes of basal cell carcinoma (BCC) with gender,age and anatomical location of skin lesions.Methods The clinical and histopathological data on 243 cases of BCC collected from Jan 2000 to Apr 2009 were reviewed retrospectively.Data analysis was carried out by using SPSS 13.0 software.Results A total of 243 patients were included in this study,including 118 males and 125 females with the male/female ratio being 0.94:1.The average age of patients was 65.16 ± 12.62 years.Head and neck were the predilection (77.4%) sites of BCC in these patients.Nodular type (53.9%) was the most common type,followed by the superficial type (18.9%) and infiltrative-morphoeic (sclerosing) type (18.5%).The age at visit was younger in female patients than in male patients(P ＜ 0.05),no significant difference was observed in the gender composition among patients with different subtypes of BCC (P ＞ 0.05).Superficial BCC was more common on the trunk; the age at visit was younger in patients with superficial BCC than in those with other subtypes of BCC,and younger in female patients than in male patients (all P ＜ 0.05).Nodular,infiltrative-morphoeic and micronodular subtypes of BCC showed a predilection for the head and neck with an old age at visit,and no differences were observed in the age at visit between female and male patients with these subtypes of BCC (au P ＞ 0.05).Conclusions Different subtypes of BCC show different clinical features,which may be attributed to their different pathogenesis.     

Panniculitis,an Uncommon Skin Manifestation in Adult Dermatomyositis

Objective: The skin manifestations of dermatomyositis (DM) are complex and diverse, with some rashes having diagnostic significance, while others have a certain suggestive effect on the patient’s condition, visceral damage, and prognosis. This case-cohort study was performed to investigate the skin manifestations of 205 adult inpatients with DM. We then analyzed the association between the clinical characteristics and panniculitis in adult patients with DM.Methods: This study was conducted at th...     

炎症浸润细胞在曝光和非曝光部位皮肤中的组织学表现

目的 观察、比较曝光及非曝光部位皮肤中炎症浸润细胞的类型、数目,探讨其在光老化过程中的作用.方法 应用免疫组化法分别对23例女性健康志愿者前臂伸侧(曝光)和上臂内侧(非曝光部位)皮肤石蜡标本中的细胞表面抗原CD3、CD45RO、CD68进行检测,计数阳性细胞数目.不同部位阳性细胞数比较采用配对t检验,阳性细胞数与年龄的相关性采用Pearson相关分析.结果 曝光部位皮肤组织CD3、CD45RO、CD68阳性细胞数分别为(48.91±13.17)/mm2、(46.83±12.92)/mm2、(85.43±22.35)/mm2,非曝光部位分别为(40.61±11.57)/mm2、(38.00±10.11)/mm2、(73.48±16.21)/mm2,曝光部位均显著高于非曝光部位(P<0.01或<0.05).曝光部位皮肤组织CD3、CD45RO阳性细胞数与年龄呈正相关(r=0.56、0.56,P<0.01),曝光部位CD68及非曝光部位皮肤组织CD3、CD45RO、CD68阳性细胞数与年龄无相关性.结论 T淋巴细胞、巨噬细胞可能在光老化过程中发挥作用.

Abstract：

Objective To investigate the role of infiltrating inflammatory cells in photoaging process by comparing the type and number of these cells in sun-exposed and-unexposed skin.Methods The expression of CD3,CD45RO and CD68 were detected by immunohistochemieal staining in 46 paraffin-embeded skin samples from the extensor forearms(sun-exposed)and upper-inner arms(sun-unexposed) of 23 healthy female volunteers.The number of positive cells in sun-exposed and -unexposed sites was counted and statistically tested by paired samples t test,and Pearson correlation analysis was performed to assess the relationship between the number of positive cells and age of these volunteers.Results The number of cells positive for CD3,CD45RO and CD68 per square millimetre in sun-exposed skin was significantly higher than that in sun-unexposed skin(48.91±13.173 vs.40.61±11.571,46.83±12.915 vs.38.00±10.109,85.43±22.346 vs.73.48±16.208,respectively,P<0.01 or 0.05).The number of cells positive for CD3 and CD45RO increased significantly with age (r=0.557,0.555,respectively,both P<0.01) in the sun-exposed skin but not in sun-unexposed skin,and the number of CD68-positive cells was uncorrelated with age in either sunexposed or -unexposed skin.Conclusion T lymphocytes and macrophages may play a role in the process of photoaging.     

Excellent long term patient and renal allograft survival after ABO-incompatible kidney transplantation:Experience of one center

AIM: To investigate the long-term results of ABOincompatible(ABOi) kidney transplantation in a single center in Greece.METHODS: Thirty consecutive ABOi kidney transplantations were performed from June 2005 to December 2013. All patients received rituximab one month prior to transplantation. Immunoadsorption therapy was performed for the removal of anti-A/B Ig G antibodies until the titer was ≤ 1:16. Additional apheresis sessions were performed post-operatively. Intravenous immunoglobulin and oral immunosuppression consisting of tacrolimus(TAC) in combination with either everolimus or mycophenolate acid was administered. We compared the long term results of our ABOi group to those of a matched group of 30 ABO compatible(ABOc) living kidney recipients with similar baseline characteristics. The ABOc recipients received an immunosuppressive regimen consisting of TAC and mycophenolate acid. All patients in both groups received induction therapy with Basiliximab or Daclizumab, whereas corticosteroids were instituted on the day of surgery. During the followup period, indication biopsies were performed and interpreted by an experienced nephropathologist. The parameters we analyzed included the following: Donor/recipient age, gender, blood type, human leukocyte antigen mismatches, panel reactive antibodies, primary cause of renal failure, mean time on dialysis, immunosuppressive regimen, patient survival, graft outcome, incidence of rejections, surgical and infectious complications.RESULTS: The mean follow-up period was 6 years(range 1 to 9 years). A mean of 5.0 ± 3.0(range 0-14) pre-transplant immunoadsorptions were required in order to reach the target titer. Patient survival in ABOi group in comparison to ABOc group at 1, 3, 5 and 8 years did not differ significantly(100% vs 100%, 96% vs 100%, 92% vs 100% and 92% vs 100%, P = ns). Additionally, graft survival was similar in the two groups at the same time points(100% vs 100%, 96% vs 96%, 92% vs 96% and 81% vs 92%, P = ns). The mean serum creatinine and the estimated glomerular filtration rate by the modification of diet in renal disease formula at 1, 3, 5 and 8 years did not differ significantly between ABOi and ABOc group. None of the patients in the ABOi group developed acute or chronic antibodymediated rejection evidenced by histological signs. Four patients(13.3%) in the ABOi group and 3(10%) in the ABOc group experienced acute cellular rejection, which was treated successfully in all cases. Bacterial and viral infections were also similar between the two groups.CONCLUSION: ABOi kidney transplantation is a safe and effective alternative that enables kidney transplantation in countries with unacceptably long deceaseddonor waiting lists.     

准分子激光治疗白癜风的临床疗效与安全性研究

Objective To assess the efficacy and safety of 308 nm excimer laser in the treatment of different types of vitiligo at different stages. Methods A total of 128 patients with vitiligo, who had 317 depigmented patches, were recruited in this study and treated with 308 nm excimer laser once a week for at least 8 weeks. The degree of repigmentation was evaluated and adverse effects were recorded at the end of every treatment and last treatment. Results All patients received efficacy and safety evaluation. Of the 317 patches, 97.5% achieved repigmentation at different degrees, 71.8% got more than 25% repigmentation, and 50.8% got more than 75% repigmentation. The degree of repigmentation increased with the number of treatments. A better response was observed in the lesions on the face and neck than those on the mink and limbs, and in short-duration (<1 year) lesions than in long-duration (≥1 year) lesions. And the lesions on extremities and mueosa showed a poorer response compared with those at other sites. There was no statistical difference in clinical efficacy between active vitiligo and stable vitiligo, or between adults and children. Moreover, the treatment was well tolerated. Conclusion 308 nm excimer laser is effective in the treatment of vitiligo with rapid onset, favorable tolerability and few adverse effects.     

118例志愿者紫外线最小红斑量值测定

目的 测定118例志愿者长波紫外线(UVA)和中波紫外线(UVB)的最小红斑量(MED)正常值。方法 以SUV1000型日光紫外模拟仪为光源,测定118例健康志愿者和非炎症性皮肤病患者UVA-MED和UVB-MED正常值。结果 UVA-MED均值男性为55J/cm²(18-95J/cm²),女性40J/cm²(15-100J/cm²);UVB-MED均值男性31mJ/cm²(12-95mJ/cm²),女性29mJ/cm²(8-95mJ/cm²)。男性UVA-MED显著高于女性(P<0.05),UVB-MED两性间差异无统计学意义(P>0.05)。皮肤光反应类型为Ⅲ型的受试者UVA-MED和UVB-MED均显著低于Ⅳ型(两种类型皮肤UVA-MED:在男性、女性均P<0.05;UVB-MED:在男性P<0.05,女性P<0.01)。女性的年龄与MED值无关;30-49岁男性UVB-MED低于其他年龄组,UVA-MED与年龄无关。遮光部位测得的UVA-MED和UVB-MED与户外停留时间长短无关。结论 皮肤光反应类型是决定MED的重要因素。     

Relationship between constitutive skin color and ultraviolet light sensitivity in Koreans

The assessment of skin sensitivity to ultraviolet (UV) radiation is important in treating a variety of skin diseases and preventing the deleterious effects of UV. Although there are many ways to predict the sensitivity to UVR, controversies exist over their objectivity, correlation, and applicability in various races. For the purpose of evaluating the relationship of skin color and UV responsiveness, this study was performed to assess the validity of constitutive skin color for an individual's UV sensitivity in 80 healthy Korean volunteers. The subjects were divided into two groups: a young-aged group with 40 subjects aged 20-39 years and an old-aged group with 40 subjects aged 43-63 years. A minimal erythema dose (MED) of UVB and minimal immediate pigment darkening dose (MIPDD) of UVA were assessed using a fluorescent lamp (Panasol II, National Biologic Co., Twinberg, USA) and a metal-halide lamp (Dermalight 2001, Mutzhas, Munich, Germany), respectively. The constitutive skin color of buttock was measured with a Minolta Chroma Meter CR-300 (Osaka, Japan), using the CIE (Commission International de l'Eclairege) L*a*b* system. Of the three L*a*b*, we used the L* value to estimate the skin color. For the MED and L* values, the values were inversely proportionate (P<0.05) in the young-aged group; however, no correlation existed in the old-aged group. No relationships existed among Fitzpatrick skin type and MED, skin type and MIPDD. The results of this study indicated that the constitutive skin colors in the young-aged group can be an objective and adequate predictor of cutaneous UV sensitivity.     

表皮p63和CD44与年龄及曝光部位的相关性

目的 探讨p63与CD44在皮肤衰老过程中与年龄、紫外线的关系。方法 采用免疫组化方法检测121例正常全厚皮肤标本中p63与CD44的表达,光镜下观察并计算表皮基底层p63阳性细胞百分比,用图像分析软件image proplus 6.0测量表皮层p63与CD44表达的吸光度值。结果 ①表皮基底层p63阳性细胞百分比与年龄呈负相关（r = -0.218,P < 0.05）,51 ~ 79岁组最低;但在曝光部位、半曝光部位与非曝光部位间的差异无统计学意义。②表皮p63的表达强度与年龄在曝光部位呈负相关（r = -0.389,P = 0.010）,在半曝光部位无相关性,在非曝光部位呈正相关（r = 0.341,P < 0.05）;三个部位表达强度的差异在10 ~ 30岁组无统计学意义,在31 ~ 50岁组与51 ~ 79岁组由强至弱依次为非曝光部位、半曝光部位、曝光部位。③表皮CD44的表达强度与年龄之间呈微弱负相关（r = -0.083,P < 0.05）,10 ~ 30岁组最高;但在曝光部位、半曝光部位与非曝光部位间的差异无统计学意义。结论 表皮基底层p63阳性细胞百分比、表皮CD44的表达强度和年龄呈负相关,和紫外线照射量无关。表皮p63表达强度在31 ~ 50岁组与51 ~ 79岁组的表达强度依曝光多少而递减。     

Studies of physiological factors affecting skin susceptibility to ultraviolet light irradiation and irritants

The relationships between two skin physiological factors and skin susceptibilities were investigated in 101 healthy Japanese females. Skin color and skin surface lipids chosen as the factors to be considered were measured by spectrophotometric colormeter and gravimetry, respectively. Photosensitivity was evaluated by minimal erythemal dose (MED) measurements. Skin susceptibility to irritants was evaluated by the patch test method using propylene glycol solution. The results were obtained as follows. (1) A significant correlation was found between skin color V values and photosensitivity scores. (2) A significant inverse correlation was found between skin color V values and replacement lipid values. (3) A correlation was observed between skin color V values and skin irritability scores. (4) A correlation was observed between skin irritability and photosensitivity scores. Thus, skin color and skin surface lipids were shown to be important physiological factors in skin susceptibility to UV irradiation and irritants.     

The Relationship of Sun Protection Factor to Minimal Erythema Dose,Japanese Skin Type,and Skin Color

The relationship of sun protection factor (SPF) to minimal erythema dose (MED), Japanese skin type, and skin color was investigated on the unexposed backs of 48 healthy subjects. SPF of a UVB-sunscreen was determined using sun lamps as a light source. A significant correlation was found between SPF and MED; subjects with lower MED showed higher SPF. The average SPF decreased with increasing skin type. There was no significant correlation between SPF and skin color (L*a*b* color system).     

The relationship of skin color, UVB-induced erythema, and melanogenesis

The relationship between skin color, delayed erythema, and delayed tanning (DT) elicited by a single exposure of UVB was investigated. Both constitutive and facultative pigmentation were determined by skin reflectance using a melanometer. Skin reflectance using visible light was well correlated to the minimal immediate pigment darkening dose elicited by UVA irradiation, which may relate to epidermal melanin content, a determinant of skin color. Minimal erythemal dose (MED) was well correlated to skin color, but there was less correlation between minimal melanogenic dose and skin color or the MED, since melanogenesis is controlled by genetic factors. DT also correlated to the dose of UVB in terms of MED. A coefficient of the regression line of DT may suggest the tanning capacity of skin. The possibility of detecting mild photosensitivity in individuals from a regression line of the MED on skin color is suggested.     

Topographic measurement of skin color by narrow-band reflectance spectrophotometer and minimal erythema dose (MED) in Koreans

Background/aims: Narrow-band reflectance spectrophotometer is one of the objective and quantitative devices for measuring the skin colors. There has been some controversy concerning the relationship between the objectively measured skin color and cutaneous responsiveness to ultraviolet radiation, including minimal erythema dose (MED). The aims of this study were to compare the color of Korean brown skin with that of Caucasians by objective measurement with the narrow-band reflectance spectrophotometer, and to determine whether the skin color has any correlation with MED in Koreans, and demonstrate differences in this correlation according to the anatomical sites. Methods: With narrow-band reflectance spectrometer, skin colors were measured at 17 body sites of 20 healthy Korean male volunteers after measuring MED for the same subjects. Results: The constitutional skin color, as measured by the melanin index of the nonexposed sites, showed a statistically significant correlation with MED values, whereas the facultative skin color did not. The Korean brown skin showed higher melanin index and lower erythema index compared with that of Caucasians. Conclusions: We confirmed significant differences in the correlation between MED and melanin indices, depending on the anatomic sites. This suggests that selection from various sites, even among the nonexposed sites, is quite important and deserves further evaluation.     

健康成人皮肤对十二烷基硫酸钠刺激反应的反射式共聚焦显微镜特征分析

目的 观察十二烷基硫酸钠（SLS）刺激后18 ~ 60岁健康人皮肤反射式共聚焦扫描显微镜（RCM）特征的差异,分析年龄和性别对皮肤反应的影响,同时初步探讨RCM在客观评价皮肤反应中的价值。方法 采用封闭式斑贴试验,分别将0.1%和0.5% SLS贴敷于120例健康受试者背部48 h,并于去除后不同时间点进行临床评估和RCM检测。结果 0.1%和0.5% SLS组皮肤刺激反应的RCM特征主要有角化不全、角质层结构不清、棘层海绵水肿、表皮炎症细胞浸润和真皮乳突毛细血管扩张等。去除0.1%和0.5%SLS 刺激后24 h,RCM特征发生率达到高峰,其中真皮毛细血管扩张的发生率分别高达66.7%和95.0%。0.5% SLS去除后24 h,男性海绵水肿的发生率为68.9%（42/61）,显著低于女性［84.7%（50/59）,χ2 = 4.24,P < 0.05］; 0.1%SLS去除后24 h,18 ~ 40岁年龄组人群棘层海绵水肿的发生率为53.3%（32/60）,显著高于41 ~ 60岁［35.0%（21/60）,χ2 = 4.09,P < 0.05］;其余RCM参数,在0.1%和0.5% SLS刺激去除后,不同性别或不同年龄组之间差异均无统计学意义（P > 0.05）。临床评估显示去除0.1%和0.5% SLS后24 h,男女皮肤刺激反应发生率差异均无统计学意义（均P > 0.05）,18 ~ 40岁和41 ~ 60岁两个年龄组之间差异也无统计学意义（均P > 0.05）。Spearman相关性分析显示,临床评估结果与RCM特征之间具有良好的相关性,其中,去除0.1% SLS后24 h,海绵水肿和真皮毛细血管扩张与临床评估结果的相关系数均高达0.77（P < 0.001）。但去除SLS 0.5 h后,0.1%和0.5% SLS组表现出2项以上RCM特征的受试者比例分别为17.5%（21/120）和51.7%（62/120）,比同一时刻临床评估的阳性率［2.5%（3/120）和12.5%（15/120）］更接近去除SLS 24 h后的临床评估结果34.2%（41/120）和85.0%（102/120）。结论 性别和年龄对0.1%和0.5% SLS诱导的皮肤刺激反应无明显影响;相对临床评估,RCM在刺激反应早期能更加客观准确地评估皮肤反应。     

Urocanic acid isomers and photosensitivity in healthy children

Episodes of intense sun exposure, particularly in childhood, seem to carry a risk for the development of malignant melanoma in later life. However, little is known about photosensitivity and natural photoprotection in children. In adult subjects, photoprotection is provided mainly by the epidermal content of melanin and the thickness of the stratum corneum, while the amount of urocanic acid (UCA), a major ultraviolet-absorbing component of the stratum corneum, is not thought to contribute significantly to photoprotection. The minimal erythema dose (MED) was determined in 22 healthy children aged 6–13 years and in 36 healthy adults (mean age 28.1 years). Pigmentation was measured at six body sites by use of reflectance spectroscopy and the concentration of UCA isomers was measured in a sun-exposed area (upper back) and in unexposed buttock skin. No significant differences between children and adults were found, either in pigmentation at exposed and unexposed body sites, or in MED. The concentration of total UCA was significantly higher in the children than in the adults on the buttock (median 22.2 vs. 13.6 nmol/cm²), but not on the back. On exposed back skin, the children had a significantly higher percentage of cis -UCA than the adults (median 60.1 vs. 28.3%), while no difference was found on the buttock. In both groups, a significant correlation was found between pigmentation and MED (children: Spearman correlation coefficient 0.58, P  = 0.006; adults: Spearman correlation coefficient 0.69, P  < 0.0001), indicating that pigmentation is of major importance in determining photosensitivity in children as well as in adults. The concentration of total UCA did not correlate with the MED in either group.