Recent advances in chemical peeling in Japan

Chemical peeling is one of the dermatological treatments available for certain cutaneous diseases and conditions or aesthetic improvement. This treatment consists of the application of one or more chemical agents to the skin. Recently in Japan, chemical peeling has been very popular for medical as well as aesthetic treatment. Because the scientific background and an adequate approach have not been completely established, medical and social problems have been reported. To address these issues, the Japanese Dermatological Association has established standard guidelines for chemical peeling, and the scientific background and validity of chemical peeling has been assessed. In this review, a set of guidelines for chemical peeling is introduced, and we will discuss several clinical and histological studies including the effects of glycolic acid, and the application of deer peeling to skin tumors in our department.     

Chemical peeling in ethnic/dark skin

Chemical peeling for skin of color arose in ancient Egypt, Mesopotamia, and other ancient cultures in and around Africa. Our current fund of medical knowledge regarding chemical peeling is a result of centuries of experience and research. The list of agents for chemical peeling is extensive. In ethnic skin, our efforts are focused on superficial and medium-depth peeling agents and techniques. Indications for chemical peeling in darker skin include acne vulgaris, postinflammatory hyperpigmentation, melasma, scarring, photodamage, and pseudofolliculitis barbae. Careful selection of patients for chemical peeling should involve not only identification of Fitzpatrick skin type, but also determining ethnicity. Different ethnicities may respond unpredictably to chemical peeling regardless of skin phenotype. Familiarity with the properties each peeling agent used is critical. New techniques discussed for chemical peeling include spot peeling for postinflammatory hyperpigmentation and combination peels for acne and photodamage. Single- or combination-agent chemical peels are shown to be efficacious and safe. In conclusion, chemical peeling is a treatment of choice for numerous pigmentary and scarring disorders arising in dark skin tones. Familiarity with new peeling agents and techniques will lead to successful outcomes.     

Experiments on peeling adhesive tapes from human forearms

BACKGROUND/PURPOSE: Peeling of adhesive tape from hu-man skin can cause pain and trauma. The effects of the peel angle, peel rate, dwell time, subject, and order of testing were examined. METHODS: Adhesive tape was peeled from the volar forearms of four human subjects. The tape was 25.4-mm-wide Durapore by 3M. The rates ranged from 100 to 10,000 mm/min, the peel angle from 90 degrees to 180 degrees, and the dwell time from one to 15 min. The tensile testing machines'recorded the peel force and the displacement of the end of the tape. RESULTS: A range of maximum and average peel force values was observed. The peel force tended to be minimum for a peel angle around 150 degrees in most cases. As the peel rate was increased, the peel force generally tended to increases lightly, but the relationship was erratic. As the dwell time increased, the peel force increased and then settled down. Of the subjects tested, the skin of the oldest subject experienced the most displacement and highest peel forces(the maximum force over all tests was 3.6 N). The peel force tended to increase with repeated peeling from the same skin site. Compared with peeling from a rigid substrate such as steel, the peel force from skin was lower. CONCLUSION: The results improve understanding of the factors affecting the peel force, which has been correlated previously with trauma caused by peeling adhesive tape from skin.     

Novel TGM5 mutations in acral peeling skin syndrome

Acral peeling skin syndrome (APSS, MIM #609796) is a rare autosomal recessive disorder characterized by superficial exfoliation and blistering of the volar and dorsal aspects of hands and feet. The level of separation is at the junction of the stratum granulosum and stratum corneum. APSS is caused by mutations in the TGM5 gene encoding transglutaminase‐5, which is important for structural integrity of the outermost epidermal layers. The majority of patients originate from Europe and carry a p.(Gly113Cys) mutation in TGM5. In this study, we report both European and non‐European families carrying other mutations in the TGM5 gene. In 5 patients, we found 3 novel mutations: c.1001+2_1001+3del, c.1171G>A and c.1498C>T. To confirm their pathogenicity, we performed functional analyses with a transglutaminase activity assay, determined alternative splicing by reverse‐transcribed PCR analysis and used databases and in silico prediction tools.     

微球菌属与相关皮肤病研究进展

微球菌属（Micrococcu+s）为氧化酶、触酶阳性,专性需氧革兰阳性球菌。微球菌是寄生于人体皮肤、咽部等对人体无害的腐生菌,但当机体抵抗力低下时,可以引起各种机会疾病,也会引起一系列皮肤疾病。本文就相关疾病进行概括介绍。     

Self-reported occupational skin contact with cleaning agents and the risk of disability pension

Background:  Occupational skin diseases often affect the hands and can lead to consequences at both the individual and the social level.
Objectives:  To investigate and quantify the association between self-reported occupational skin contact with cleaning agents and subsequent transition to disability pension.
Methods:  A sample of 8337 employees between 18 and 59 years of age participated in the Danish Work Environment Cohort Study in 1990, 1995, or 2000. They were followed up regarding disability pension until 2006 using the DREAM register on social transfer payments for all inhabitants in Denmark. The Cox proportional hazards model was used to estimate the impact of occupational exposure to cleaning agents on subsequent disability pension.
Results:  Among women, 11% of the disability pension cases were attributable to exposure to cleaning agents and/or disinfectants.
Conclusions:  The study suggests a potential for prevention of work-related disabilities among job groups exposed to cleaning agents.     

A follow-up study of occupational skin disease in Western Australia

From a total of 993 previously reported cases of occupational skin disease (OSD), 954 (96%) were contacted and 711 (75%) examined, The review time (i.e., period from original diagnosis of OSD until review] varied from u minimum of 6 months to a maximum of over 8 years. Over 60% of cases were reviewed more than 2 years after the original diagnosis was made. More than 50% were still suffering from OSD or consequences related thereto. Clearance was less likely in those who remained in their original, or similar, occupational environment. However, of those who changed their job due to OSD. Many suffered aggravation of the dermatitis from factors in the new work environment. Over 10% of cases had evolved into a persistent post occupational dermatitis without obvious cause. This condition is responsible for considerable impairment and is of medicolegal importance due lo confusion as to its relationship to the original occupational factors.     

Occupational contact dermatitis

The dermatologist should be aware of the many facets of occupational skin diseases, which can be caused by physical, chemical, and biological insults. The most common manifestation of occupational skin diseases is contact dermatitis (both irritant and allergic). Three factors point out the importance of occupational skin diseases as diseases that have a public health impact: 1) occupational skin diseases are common; 2) they often have a poor prognosis; and 3) they result in a noteworthy economic impact for society and for an individual. They are also diseases amenable to public health interventions. Specific industries and exposures may put a worker at risk of occupational contact dermatitis. The accuracy of the diagnosis of occupational contact dermatitis is related to the skill level, experience, and knowledge of the medical professional who makes the diagnosis and confirms the relationship with a workplace exposure. Prevention of occupational contact dermatitis is important, and a variety of prevention strategies are available.     

Skin roughness is negatively correlated to irritation with DMSO, but not with NaOH and SLS

Abstract While many endogenous and exogenous factors have been found to influence skin irritant reactivity, the role of skin roughness in irritation has not yet been studied. In this study we measured skin roughness by visiometry and performed irritation tests on the flexural side of the forearm with sodium hydroxide (NaOH), sodium lauryl sulphate (SLS) and dimethyl sulfoxide (DMSO) in two different concentrations in a population of 151 volunteers between 15 and 25 years of age. The results showed a significant negative correlation between most roughness parameters and DMSO irritation. The correlation between roughness parameters and irritation tests with SLS and NaOH was not significant. We conclude that smoother skin is more prone to DMSO irritation than rougher skin and that this may be due to differences in percutaneous penetration of the compound.     

Interdigital dermatitis: sentinel skin damage in hairdressers

In the course of a cohort study, 2275 hair-dressing apprentices were examined a median of 6 weeks after the start of their training in the years 1992. 1993 and 1994. Skin changes were noted in 821 (36%). The site most often affected was the interdigital web space (664 of those with skin changes: 81%). The proportion of participants with a high atopy score and previous hand and flexural dermatitis was larger in the subset with interdigital dermatitis than in healthy persons, but was particularly elevated in those affected by dermatitis involving other sites. Interdigital dermatitis can be regarded as a potential precursor of more severe hand dermatitis in hairdressers, and probably of irritant hand dermatitis in wet work occupations in general. Thus, it is an important sentinel for secondary prevention. e.g. regular and thorough application of emollients.     

Chloracne in seven organic chemists exposed to novel polycyclic halogenated chemical compounds (triazoloquinoxalines)

Chloracne is an acneiform eruption caused though poisoning by aromatic compounds (usually halogenated) showing a specific molecular configuration. We describe an outbreak of chloracne among seven discovery chemists who synthesized novel polycyclic halogenated chemical compounds which were classified as triazoloquinoxalines, not known to be chloracnegenic. The diagnosis of chloracne, made clinically, elicited a thorough risk assessment and monitoring programme by the occupational health department. The chemists were investigated by serum excretion rates, skin sampling for Propionibacterium acnes , skin biopsy and laboratory blood investigations. Sebum excretion was normal in five cases, raised in one case and severely reduced in another. Skin levels of P. acnes were normal in all patients except for the one subject who had low sebum excretion, in whom they were undetectable. One subject had a slightly raised serum level of alanine aminotransferase. There were no other signs of systemic toxicity. Two subjects were treated with an oral antibiotic, two received topical therapy only and three required no treatment at all. The patients have had thorough health surveillance at 6-monthly and yearly intervals. In each case the chloracne mostly resolved within 18–24 months although on examination about 3 years later, five of the seven still showed minor changes of chloracne. This outbreak emphasizes the need for vigilance in discovery science. The triazoloquinoxalines were not previously recognized as being chloracnegens although their chemical characteristics were subsequently identified as being in keeping with other chemicals that can cause chloracne. Chloracne can be a difficult diagnosis to make when it occurs in a novel setting: occupational physicians and dermatologists need to be vigilant when dealing with unusual eruptions in discovery chemists.     

Recurrent cutaneous necrotising eosinophilic vasculitis

Recurrent cutaneous necrotising eosinophilic vasculitis (RCNEV) is a rare disease that was first described in 1994. We report a case of RCNEV treated with corticosteroid, and 18 cases that we identified in the literature. Our review of the literature shows that RCNEV was frequently identified in middle‐aged females from Asia and usually presents as erythematous to purpuric papuloplaques, angio‐oedema on the extremities, as well as peripheral eosinophilia. Histopathologically, RCNEV is characterised by exclusively eosinophilic infiltration around the vascular plexus, the absence of leukocytoclasis and fibrinoid degeneration of vascular walls. Although, RCNEV responds to corticosteroid treatment, relapses have occurred during dose tapering. We also discuss the mechanisms of vascular destruction, the differential diagnosis and steroid‐sparing therapies for RCNEV.     

Type-1 reactions to commercial fish in non-exposed individuals

The frequency of type-I reactions (contact urticaria) to plaice, whiting, common dab, witch, codfish, Norwegian haddock, herring and halibut has been examined in 26 individuals; 23 of these carried through all the investigations. 65% of the volunteers had a positive scratch patch test to one or more species of fish. All 20 min closed patch tests were negative. 5 of the volunteers were atopics. They showed about twice as many positive scratch patch tests when compared to the non-atopics. The investigation shows that the "fish allergen" is destroyed by cooking but not by freezing. The possibility of common and specific fish allergens is discussed.     

Epoxy-based production of wind turbine rotor blades: occupational dermatoses

Occupational dermatoses were investigated in a factory producing rotor blades for wind turbines by an epoxy-based process. In a blinded study design, 603 workers were first interviewed and thereafter clinically examined. Based on a history of work-related skin disease, clinical findings of dermatitis, or both, 325 (53.9%) of the workers were patch tested with a specially profiled occupational patch-test series and the European standard patch-test series. Calculated on all investigated workers, 17.1% of the workers were diagnosed with occupational dermatoses caused by work. Occupational allergic contact dermatitis was found in 10.9% of the workers. The estimated frequency of irritant contact dermatitis caused by work was 6.1%. Dermatitis on the hands was associated with contact allergy to epoxy resin (P = 0.017). The number of days on leave before the clinical examination was negatively associated with the presence of dermatitis (P = 0.001). Among workers employed 7-12 months, the frequency of occupational contact allergy was higher than that among workers employed for 相似文献