Impact of defensins-containing body cream on skin composition

Background and Aims

Defensins are peptides capable of reactivating latent LGR6 stem cells in the basal layer. When applied topically, these peptides can reduce signs of skin aging and increase dermal thickness. This study investigates the effects of a topical defensin formulation on extremity skin composition.

Methods

An open label, single arm clinical trial was conducted on participants with dry, photoaged, or dull skin. A defensin-containing hand and body cream was applied twice daily for 6 weeks to the hands, forearms, elbows, and knees. Photographs and objective measurements of skin hydration, viscoelasticity (VE), retraction time (RT), thickness, density/transepidermal water loss (TEWL), as well as self-evaluation of skin quality and characteristics were obtained pre- and post- intervention.

Results

After the study period, RT decreased by 56% across all body sites (p < 0.001) and VE improved at the elbow (125%, p = 0.009) and knee (110%, p < 0.001). Skin density also increased in all 4 body sites (40%, p < 0.001), while skin thickness increased at the elbow (29%, p = 0.03) and knee (17%, p = 0.04). Skin hydration increased at the elbow, knee, and forearm by 99%, 28%, and 16%, respectively (p < 0.05), while TEWL improved at the elbow only (−39%, p = 0.02). Patients' self-evaluations showed improvements in overall skin quality and in the domains of dryness, ashiness, wrinkling, pigmentation, redness, roughness, and discomfort (p < 0.05).

Conclusions

Following 6-week use of a defensin-containing cream, subjects reported significant improvement across many subjective skin domains. Similarly, objective measurements demonstrated significant improvement in skin architecture at select sites.     

Mask-related adverse skin reactions in orientals during COVID-19: Prevalence,social-psychological impacts and risk factors for acne exacerbation

Background

COVID-19 pandemic has caused mask-related skin problems on health-care professions, yet very few studies have investigated the prevalence in oriental general population.

Objective

To investigate the prevalence of mask-related adverse skin reactions in Orientals, to explore psychological influence, to identify risk factors for mask-related acne exacerbation.

Methods

We performed a survey through social media. Participant demographics, skin condition before and after COVID-19, and the influence of adverse skin on social-psychological conditions were collected. We compared characteristics between individuals with or without acne exacerbation, and we performed a logistic regression to identify risk factors.

Results

Six hundred and six participants (62.3%) responded the survey and 23.3% complained their facial acnes become exacerbated since COVID-19. The social-psychological impact of acnes is more prevalent in women. Risk factors for mask-related acne exacerbation were occupation as health-care workers (OR = 1.861, p = 0.027), prolonged wearing of N95 masks (OR = 3.167, p = 0.001), and touching of acnes (OR = 2.65, p = 0.002). Sex, pre-existed acnes, and prolonged wearing time per day are also associated with acne exacerbation.

Conclusions

Mask-related adverse skin reactions are common in Orientals, and could lead to negative social-psychological effects.     

In situ assessment of PI3K and PTEN alterations in mycosis fungoides: correlation with clinicopathological features

Deregulated signalling through phosphatidylinositol 3‐kinase (PI3K) pathway plays a critical role in tumour initiation and progression. We have already shown that AKT is activated in skin lesions in Mycosis Fungoides (MF) and we herein further investigate the frequency and clinical significance of PTEN and PI3K at the protein and at the DNA level as well as the presence of AKT1 mutations in skin lesions from 50 patients with MF clinical stages I‐IV in relation to clinicopathological features. Increased p‐AKT expression correlated with poor prognosis in plaques (P = 0.0198), whereas p‐AKT was an independent predictor of poor survival in the entire cohort (P = 0.017, HR = 1.012). PTEN cytoplasmic expression was found low or absent in all 77.3% of cases and inversely correlated with advanced clinical stages (P = 0.0744). Molecular analysis showed no AKT1 mutation, no PI3KCA copy number gain, only 1 case with PI3KCA mutation in exon 9 and 3 cases with PTEN mutations (7%) in exons 7, 8 and 5. The latter correlated with disease (P = 0.0253) and progression (P < 0.0001) free survival in tumour stage. Although activation of PI3K/AKT signalling pathway due to PTEN alterations is rarely attributed to abnormalities in PTEN, PI3K, and AKT1 genes, PTEN mutations exert a negative effect on patients’ prognosis with tumours.     

Optical coherence tomography imaging of psoriasis vulgaris: correlation with histology and disease severity

Epidermal thickness (ET) has been suggested as a surrogate measure of psoriasis severity. Optical coherence tomography (OCT) is a recent imaging technology that provides real-time skin images to a depth of 1.8 mm with a micrometre resolution. OCT may provide an accurate in vivo measure of ET. It is, therefore, speculated that OCT may be used in the assessment of psoriasis vulgaris. A total of 23 patients with psoriasis vulgaris were systematically evaluated by OCT imaging and skin biopsy during treatment. Biopsies were graded for disease severity, and additional evaluation was done by the physician via psoriasis area and severity index (PASI) score, and by the patient through measures such as self-administered PASI, psoriasis life stress inventory index and dermatology life quality index. ET was calculated from OCT images. In comparison to normal skin, psoriasis appeared with a more irregular surface with a stronger entrance signal, a serrated dermo-epidermal junction was found and a less signal intensity in the dermis as shown in OCT images. ET measured in untreated plaques was thicker reflecting epidermal hyperproliferation and inflammation. The changes were significantly correlated with the biopsy grading (r ² = 0.41, p = 0.001) and ET significantly decreased with treatment (p = 0.0001). ET correlated significantly with self-reported measures of disease severity, but not with physician-assessed global PASI. The data suggest that OCT may be used to measure ET in psoriasis and the measurements correlate with several other parameters of disease severity. This implies that OCT assessment of psoriatic plaques may provide a useful method for non-invasive in vivo method to follow the evolution of psoriasis lesions.     

Antifungal effect of TONS504‐photodynamic therapy on Malassezia furfur

Numerous reports indicate therapeutic efficacy of photodynamic therapy (PDT) against skin tumors, acne and for skin rejuvenation. However, few reports exist regarding its efficacy for fungal skin diseases. In order to determine the antifungal effect, PDT was applied on Malassezia furfur. M. furfur was cultured in the presence of a novel cationic photosensitizer, TONS504, and was irradiated with a 670‐nm diode laser. TONS504‐PDT showed a significant antifungal effect against M. furfur. The effect was irradiation dose‐ and TONS504 concentration‐dependent and the maximal effect was observed at 100 J/cm² and 1 μg/mL, respectively. In conclusion, TONS504‐PDT showed antifungal effect against M. furfur in vitro, and may be a new therapeutic modality for M. furfur‐related skin disorders.     

Increased angiogenesis and mast cells in the centre compared to the periphery of vitiligo lesions

The larger number of T-lymphocytes in the periphery of vitiligo lesions and their association with angiogenesis are reported. The objective of this study was to investigate angiogenesis, VEGF and mast cell in vitiligo lesions. Specimens of 30 patients' biopsies, from lesional and perilesional nondepigmented skin were stained for mast cells, CD34 and VEGF. The evaluation was made by image analysis and the measured variables were statistically analyzed. A significantly increased number of CD34 and VEGF positive vessels and mast cells were detected in the centre of the lesion than in the periphery (p < 0.0001, p < 0.0001 and p = 0.001). There was a positive correlation of CD34, VEGF and mast cell number between the centre and the periphery of the lesions (r = 0.877, p < 0.0001; r = 0.946, p < 0.0001 and r = 0.863, p < 0.0001, respectively). The increased angiogenesis and mast cell numbers in the area where lymphocyte number is lower may be explained with the stepwise inflammatory process in vitiligo.     

Abnormal nuclear expression of aquaporin-3 in lesional and perilesional skin of vitiligo patients: A novel immunohistochemical finding

Background

Vitiligo is a skin disease characterized by a complex etiopathogenesis. Keratinocyte apoptosis may play a role in vitiligo pathogenesis. Aquaporin-3 (AQP-3) is an aqua-glyceroporin that controls keratinocyte proliferation and differentiation.

Aim

To assess the immunohistochemical expression of AQP-3 in lesional and perilesional skin of vitiligo patients compared to healthy control skin.

Methods

A total of 20 patients with generalized non-segmental vitiligo and 20 age- and sex-matched healthy controls were included. Lesional and perilesional skin of vitiligo patients, as well as normal skin of control subjects, were biopsied. The immunohistochemical expression of AQP3 in the epidermis was examined.

Results

Compared to control skin, both lesional and perilesional skin showed a significant reduction in the intensity of membranous staining of AQP-3 (p < 0.001, p = 0.002, respectively). Moreover, the membrano-cytoplasmic pattern of AQP-3 staining was significantly detected in 80% of lesions and 85% of perilesional biopsies, while it was absent in control skin (p < 0.001). Additionally, nuclear AQP-3 expression was significantly detected in 35% of lesions and 55% of perilesional biopsies, while it was not detected in control skin (p = 0.012, p < 0.001, respectively). No statistically significant difference was detected between lesional and perilesional skin.

Conclusions

To our knowledge, this is the first immunohistochemical research to show a significant abnormal nuclear expression of AQP-3 in lesional and perilesional skin of vitiligo patients. This abnormality may reflect impaired functions of AQP-3, leading to keratinocyte apoptosis with subsequent melanocyte death and development of vitiligo.     

Protoporphyrin IX formation and photobleaching in different layers of normal human skin: Methyl‐ and hexylaminolevulinate and different light sources

Topical photodynamic therapy (PDT) is used for various skin disorders, and selective targeting of specific skin structures is desirable. The objective was to assess accumulation of PpIX fluorescence and photobleaching within skin layers using different photosensitizers and light sources. Normal human skin was tape‐stripped and incubated with 20% methylaminolevulinate (MAL) or 20% hexylaminolevulinate (HAL) for 3 h. Fluorescence microscopy quantified PpIX accumulation in epidermis, superficial, mid and deep dermis, down to 2 mm. PpIX photobleaching by light‐emitting diode (LED, 632 nm, 18 and 37 J/cm²), intense pulsed light (IPL, 500–650 nm, 36 and 72 J/cm²) and long‐pulsed dye laser (LPDL, 595 nm, 7.5 and 15 J/cm²) was measured using fluorescence photography and microscopy. We found higher PpIX fluorescence intensities in epidermis and superficial dermis in HAL‐incubated skin than MAL‐incubated skin (P < 0.001). In mid and deep dermis, fluorescence intensities were higher (37%) in HAL‐treated skin than MAL‐treated skin, although not significant (P = ns). At skin surface, photobleaching was significantly higher (90–98%) after LED illumination (18 and 37 J/cm²) than IPL (29–53%, 36 and 72 J/cm²) and LPDL (43–62%, 7 and 15 J/cm²) (P < 0.001). Within the skin, photobleaching was steady from epidermis to deep dermis by LED illumination (37 J/cm², P = ns), but declined from epidermis to mid and deep dermis for IPL‐treated skin and LPDL‐treated skin (IPL 72 J/cm²: 26–15%; LPDL 15 J/cm²: 37–23%) (P < 0.04). Clinically, erythema correlated linearly with MAL and HAL‐induced photobleaching (r² = 0.175, P < 0.001). In conclusion, selective PpIX accumulation indicates HAL as an alternative to MAL for epidermal‐targeted PDT. In clinically relevant doses, PpIX photobleaching throughout the skin was more profound following LED than LPDL and IPL exposure.     

Protective effects of a day/night dual-antioxidant serum on skin: A randomized,regimen-controlled study in Chinese women exposed to air pollution

Background

Chronic exposure to air pollution can negatively affect skin health.

Aims

To assess the efficacy of the LUMIVIVE^® System (LVS), a skincare system consisting of individual day and night serums, in Chinese women exposed to air pollution.

Patients/Methods

In this single-center, vehicle-controlled study, eligible females (mean age, 49.02 years) were randomized 1:1 to treatment group (LVS plus basic moisturizer) or control group (basic moisturizer). Skin color, sebum content, barrier function, elasticity, and texture were measured at baseline and at each follow-up visit (days 28, 56, and 84). Air pollution parameters were collected throughout the study.

Results

Air pollution levels, including PM_2.5 and NO₂, were consistently high during the study. The treatment group showed significantly higher skin color L* (p ≤ 0.0001) and lower a* values (p ≤ 0.05) at all follow-up visits compared with the control group, indicating lower skin pigmentation and redness, respectively. Skin color L* and a* values remained unchanged over time for the control group but were significantly different at all follow-up visits compared to baseline (p ≤ 0.0001 and p ≤ 0.05, respectively) for the treatment group. There was an increasing trend for sebum content in the control group, which was not observed in the treatment group. Both groups showed improvements over time in other skin physiology parameters.

Conclusions

The current analysis demonstrates the efficacy of LVS plus basic moisturizer compared with basic moisturizer alone to reduce skin pigmentation and redness, as well as to mitigate sebum production, in Chinese women exposed to air pollution.     

Analysis of the Conjunctival Microbiome in Patients with Atopic Keratoconjunctivitis and Healthy Individuals

BackgroundAtopic dermatitis (AD) has been clarified that imbalance of bacterial and fungal communities in the skin and gut play key roles in immunologic dysfunction. Atopic keratoconjunctivitis (AKC), one of severe ophthalmic manifestation of AD, could be related with dysbiosis as same as AD.ObjectiveIn this case-control study, the roles of conjunctival microbial communities in AKC were evaluated by a comparative analysis with healthy controls (HCs).Methods16S rRNA sequencing was used to construct libraries of compositional information for a total of 30 volunteers including 20 patients with AKC and 10 HCs.ResultsIn the results, variation in the conjunctival taxonomic composition was higher in patients with AKC than in the HC group. In an analysis of relative abundance at the genus level, some taxa significantly differed between groups, including Ralstonia, Staphylococcus, Pseudomonas, Proteus, Haemophilus, and Bifidobacterium (p<0.05). Beta diversity was significantly higher in patients with AKC than in HCs (PERMANOVA, p=0.004).ConclusionThe results indicated that the diversity and composition of the microbiome differs between patients with AKC and HCs.     

Mitochondrial dysfunction in affected skin and increased mitochondrial DNA in serum from patients with psoriasis

Psoriasis is characterized by keratinocyte proliferation and chronic inflammation, but the pathogenesis is still unclear. Dysregulated mitochondria (mt) could lead to reduced apoptosis and extracellular secretion of mtDNA, acting as “innate pathogen” triggering inflammation. Serum was obtained from healthy volunteers and psoriatic patients. Mitochondrial DNA was extracted from the serum and amplified with quantitative PCR (qPCR). Punch biopsies were obtained from lesional and non‐lesional psoriatic skin (10 cm apart) and from healthy volunteers, were placed in RNA later and were stored at ?80°C until RNA was extracted and cDNA was synthesized; gene expression of uncoupling protein 2 (UCP2), Dynamin‐related protein 1 (Drp1) and calcineurin, involved in the regulation of mitochondria function, was detected with qPCR. Mitochondrial DNA was significantly increased (7s, P = 0.0496 and Cytochrome B, CytB, P = 0.0403) in the serum of psoriatic patients (n = 63) as compared to controls (n = 27). Gene expression was significantly reduced for UCP2 (P = 0.0218), Drp1 (P = 0.0001) and calcineurin (P = 0.0001) in lesional psoriatic skin, as compared to non‐lesional or control skin. Increased serum extracellular mtDNA in psoriatic patients and decreased expression of mitochondrial regulatory proteins in psoriatic skin suggest increased inflammation and reduced keratinocyte apoptosis, respectively. Inhibitors of mtDNA secretion and/or UCP2 stimulants may be potential treatment options.     

Expression of human neutrophil proteins in acne vulgaris

Background In acne vulgaris patients, the presence of a dysregulation of the production of innate and specific antimicrobial peptides has been postulated. Objective This study aims to determine whether human neutrophil proteins (HNP) 1–3 are expressed in acne patients. Materials and methods HNP 1–3 expression was investigated in 35 acne patients treated with isotretinoin and in 25 healthy subjects. At the beginning of the study, two skin biopsies were taken from acne patients; one biopsy was taken from an established pustule and one from uninvolved skin, and the biopsies were repeated after treatment. Only one biopsy was obtained from controls. Results The statistical analysis showed that pustular lesions of acne patients had significantly higher levels of perivascular and interstitial HNP 1–3 expression when compared with the biopsy of uninvolved skin of these patients (P = 0.003, P = 0.001, respectively) and with that of healthy controls (P = 0.007, P = 0.014, respectively). Isotretinoin treatment achieved a decrease in the perivascular and interstitial HNP 1–3 expression of pustular lesions (P = 0.01, P = 0.001, respectively). Conclusion Our current study demonstrates the novel observation that a recently identified antimicrobial peptide, HNP 1–3, is expressed in neutrophils of acne inflammation but not in uninvolved skin of these patients. These results suggest that HNP 1–3 may contribute to the development of inflammatory lesions of acne.     

High‐frequency p16INK4A promoter methylation is associated with histone methyltransferase SETDB1 expression in sporadic cutaneous melanoma

Epigenetic mechanisms participate in melanoma development and progression. The effect of histone modifications and their catalysing enzymes over euchromatic promoter DNA methylation in melanoma remains unclear. This study investigated the potential association of p16^INK4A promoter methylation with histone methyltransferase SETDB1 expression in Greek patients with sporadic melanoma and their correlation with clinicopathological characteristics. Promoter methylation was detected by methylation‐specific PCR in 100 peripheral blood samples and 58 melanoma tissues from the same patients. Cell proliferation (Ki‐67 index), p16^INK4A and SETDB1 expression were evaluated by immunohistochemistry. High‐frequency promoter methylation (25.86%) was observed in tissue samples and correlated with increased cell proliferation (P = 0.0514). p16^INK4A promoter methylation was higher in vertical growth‐phase (60%) melanomas than in radial (40%, P = 0.063) and those displaying epidermal involvement (P = 0.046). Importantly, p16^INK4A methylation correlated with increased melanoma thickness according to Breslow index (P = 0.0495) and marginally with increased Clark level (I/II vs III/IV/V, P = 0.070). Low (1–30%) p16^INK4A expression was detected at the majority (19 of 54) of melanoma cases (35.19%), being marginally correlated with tumor lymphocytic infiltration (P = 0.078). SETDB1 nuclear immunoreactivity was observed in 47 of 57 (82.46%) cases, whereas 27 of 57 (47.37%) showed cytoplasmic immunoexpression. Cytoplasmic SETDB1 expression correlated with higher frequency of p16^INK4A methylation and p16^INK4A expression (P = 0.033, P = 0.011, respectively). Increased nuclear SETDB1 levels were associated with higher mitotic count (0–5/mm² vs >5/mm², P = 0.0869), advanced Clark level (III‐V, P = 0.0380), epidermal involvement (P = 0.0331) and the non‐chronic sun exposure‐associated melanoma type (P = 0.0664). Our data demonstrate for the first time the association of histone methyltransferase SETDB1 with frequent methylation of the euchromatic p16^INK4A promoter and several prognostic parameters in melanomas.     

Stimulated human melanocytes express and release interleukin‐8, which is inhibited by luteolin: relevance to early vitiligo

Vitiligo is a disorder of depigmentation, for which the pathogenesis is as yet unclear. Interleukin (IL)‐8 (CXCL8) is a key inflammatory chemokine. We investigated the regulation of IL‐8 production in human melanocytes, and the IL‐8 serum levels and skin gene expression in patients with vitiligo and in controls. Cultured melanocytes were stimulated for 24 h with tumour necrosis factor (TNF) 100 ng/mL and IL‐1β 10 ng/mL, with or without pretreatment with luteolin 50 μmol/L for 30 min, and IL‐8 release was measured by ELISA. Serum cytokines were measured by a microbead array. Skin biopsies were taken from healthy subjects (n = 14) as well as from marginal lesional and nonlesional skin from patients with vitiligo (n = 15). IL‐8 gene expression was evaluated by quantitative real time PCR. Both TNF and IL‐1β stimulated significant IL‐8 release (P < 0.01) from melanocytes, whereas pretreatment with luteolin significantly inhibited this effect (P < 0.01). IL‐8 gene expression was significantly increased in vitiligo compared with control skin (P < 0.05). IL‐8 may be involved in vitiligo inflammation. Inhibition by luteolin of IL‐8 release could be useful for vitiligo therapy.     

Effectiveness of combined use of targeted pressure energy,radiofrequency, and high-intensity focused electromagnetic fields to improve skin quality and appearance of fat and muscle tissue in different body parts

Background

Inevitable signs of aging are especially noticeable in middle to elder age when stretch marks, loose skin, cellulite, and body-contour changes naturally appear.

Aims

To verify efficacy of high-intensity focused electromagnetic field (HIFEM), radiofrequency (RF), and Targeted Pressure Energy (TPE) combination treatment to address unfavorable changes in skin, fat, and muscle tissue.

Methods

The device simultaneously emitting monopolar RF and TPE energies was consecutively combined with simultaneous HIFEM+RF procedure in 32 subjects (21–64 years, 17.4–33.5 kg/m²) for treatment of thighs (N = 15; back, inner, or front), buttocks/saddlebags (N = 7), abdomen (N = 8), and upper arms (N = 2). All patients underwent four weekly, combined treatments of 30-min HIFEM+RF procedure followed by 15–30 min RF+TPE, depending on treatment area. Circumferential measurements, digital photographs, subject satisfaction, and comfort questionnaires were assessed up to 3-months post-treatment.

Results

Majority of participants found treatments comfortable, no adverse events occurred. Subjects showed substantial improvement in all treated areas from 1-month follow-up. Combination of HIFEM+RF, monopolar RF, and TPE resulted in significant circumference decrease. Generally, more pronounced results were seen at 3 months when subjects showed −5.2 cm on abdomen, −3.0 cm on thighs, and −5.5 cm on saddlebags, respectively. Ninety-four percent of subjects were satisfied with treatment results, most noticed improvement in cellulite, skin laxity, and muscle definition.

Conclusions

Results showed high patient satisfaction and efficacy in improving body contour and skin quality. Combining simultaneous HIFEM+RF procedure with simultaneous monopolar RF+TPE treatments considerably enhanced body contour and skin tissue. The procedure proved versatile and may effectively treat multiple body parts.     

Comparison of bacterial microbiota in skin biopsies from normal and psoriatic skin

Microorganisms have been implicated in the pathogenesis of psoriasis. Previous studies of psoriasis and normal skin have used swabs from the surface rather than skin biopsies. In this study, biopsies were taken from 10 patients with psoriasis and 12 control subjects from unmatched sites. Samples were analysed with massive parallel pyrosequencing on the 454 platform targeting the 16S rRNA gene and the variable regions V3–V4. The samples grouped into 19 phyla, 265 taxon and 652 operational units (OTUs) at 97% identity. A cut-off abundance level was set at 1%. The three most common phyla in both normal and psoriasis skin were Firmicutes (39% psoriasis, 43% normal skin), Proteobacteria (38% psoriasis, 27% normal skin) and Actinobacteria (5% psoriasis, 16% normal skin, p = 0.034). In trunk skin, Proteobacteria were present at significantly higher levels in psoriasis compared to controls (52 vs. 32%, p = 0.0113). The commonest genera were Streptococci in both psoriasis (32%) and normal skin (26%). Staphylococci were less common in psoriasis (5%) than in controls (16%), as were Propionibacteria (psoriasis 0.0001669%, controls 0.0254%). Both Staphylococci and Propionibacteria were significantly lower in psoriasis versus control limb skin (p = 0.051, 0.046, respectively). This study has shown some differences in microbiota between psoriasis and normal skin. Whether these are of primary aetiological significance, or secondary to the altered skin of psoriasis remains to be determined.     

Settling down time following initial sitting and its relationship with comfort and discomfort

This study examined the subjective rating of wheelchair comfort and discomfort (numerical rating scale questionnaire) and the duration of objective in-chair movement reduction “settling down time” following initial contact with the seating surface. Healthy young subjects (n = 22) sat for 5 min on contoured foam or wood cushion surfaces fitted to otherwise identical wheelchairs. Force sensing resistors attached to each quadrant of the sitting interface measured the relative movements of the subjects over time.A significant correlation was found between settling down time (SDT) and reported leg/feet discomfort (p = 0.003; correlation co-efficient = 0.44); and a significant negative correlation was found between SDT and overall comfort (p = 0.015; correlation co-efficient = −0.36). When comparing cushion surfaces: SDT was significantly longer (p < 0.0001) for subjects sitting on wood (5.8 s) compared to contoured foam (3.9 s); Leg/feet discomfort was significant higher (p = 0.007) for subjects sitting on wood (1.1 out of 10) compared to contoured foam (0.3 out of 10); Overall discomfort was significant higher (p = 0.009) for subjects sitting on wood (1.3 out of 10) compared to contoured foam (0.5 out of 10); Comfort was significantly lower (p = 0.001) for subjects sitting on wood (6.5 out of 10) compared to contoured foam (8.3 out of 10); Support was significantly lower (p = 0.001) for subjects sitting on wood (6.4 out of 10) compared to contoured foam (8 out of 10).The results of this study suggest that the shape and firmness of the surface at the buttock–wheelchair interface can affect a subject’s SDT following initial contact with the seat as well as their perception of comfort and discomfort. In addition, there appears to be a relationship between longer SDT’s and increased discomfort ratings, and shorter SDT’s and increased comfort ratings. Therefore, testing for SDT’s may be useful in the indirect objective assessment of wheelchair cushions and possibly other types of seating surfaces with design differences that aim to improve comfort and minimize discomfort.     

The effect of domestic laundry processes on fungal contamination of socks

Tinea pedis is a common chronic skin disease. The role of contaminated clothes as a possible source of reinfection is not fully understood. This study was conducted to evaluate the efficacy of domestic laundering at different temperatures in the eradication of fungal pathogens from contaminated socks. Samples from 81 socks worn by patients suffering from tinea pedis underwent domestic laundering at either 40 °C or 60 °C. The socks were dried at room temperature; fungal cultures were taken from two samples from, respectively, the toe and heel areas of the socks. Samples from socks washed at 40 °C revealed 29 (36%) positive fungal cultures, of which 14 came from the toe and 15 from the heel areas of socks. Trichophyton rubrum was isolated in four specimens, and Aspergillus spp. were found in 20 (70%) specimens. Samples from the same socks washed at 60 °C revealed five (6%) positive fungal cultures, of which three came from the toe and two from the heel areas of socks. Only Aspergillus spp. were detected. Yeasts were eradicated at 40 °C. Contravening current trends for energy saving and environmental protection, laundering at low temperatures is not effective in eradicating fungal pathogens, which requires high‐temperature laundering at 60 °C.     

The usefulness of sebum check film for measuring the secretion of sebum

Patients with atopic dermatitis (AD) often present with dry skin, and the reduced secretion of sebum may be responsible for the impaired skin barrier function. A sebum check film enables the patient to self-evaluate the skin sebum content. This study compared the sebum check film with a sebumeter. The skin sebum content of the forehead was measured using a sebum check film and a sebumeter. The findings of the sebum content of healthy controls showed that the sebum dot fields on the sebum check film were significantly correlated with the sebum content measured using the sebumeter (r = 0.774, p < 0.001). In addition, the sebum fields on the sebum check film of AD patients (n = 26) were significantly less than those on the sebum check film of the controls (n = 30; p < 0.05). Furthermore, the analysis of the sebum fields on the sebum check film of the AD patients was significantly correlated with their sebum content findings that were obtained using a sebumeter (r = 0.592, p < 0.01). These findings indicate that the sebum check film is easy to use for measuring the sebum secretion and is suitable for self-checking the sebum contents by AD patients for daily skin care.     

Interleukin‐6 receptor alpha blockade improves skin lesions in a murine model of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease, characterized by antinuclear autoantibodies (ANA) and immunocomplexes, commonly affecting kidneys, skin, heart, lung or even the brain. We have shown that JunB^Δep mice develop a SLE phenotype linked to increased epidermal Interleukin (IL)‐6 secretion. Blocking of IL‐6 receptor alpha (IL‐6Rα) is considered as therapeutic strategy for the treatment of SLE. JunB^Δep and wild‐type mice were treated for short (5 weeks) or long term (21 weeks) with the IL‐6Rα‐blocking antibody MR16‐1. Skin and kidney of mice were investigated by histology and immunofluorescence, and in addition, kidneys were analysed by electron microscopy. Furthermore, soluble IL‐6R (sIL‐6R), antihistone and antinucleosome antibodies levels were measured and associated with disease parameters. Treatment with MR16‐1 resulted in significant improvement of SLE‐like skin lesions in JunB^Δep mice, compared to untreated mice. The sIL‐6R amount upon long‐term treatment with MR16‐1 was significantly higher in JunB^Δep versus untreated JunB^Δep (P = 0.034) or wild‐type mice (P = 0.034). MR16‐1 treatment over these time spans did not significantly improve kidney pathology of immunoglobulin deposits causing impaired function. Significantly higher antihistone (P = 0.028) and antinucleosome antibody levels (P = 0.028) were measured in MR16‐1‐treated JunB^Δep mice after treatment compared to levels before therapy. In conclusion, blockade of IL‐6Rα improves skin lesions in a murine SLE model, but does not have a beneficial effect on autoimmune‐mediated kidney pathology. Inhibition of IL‐6R signalling might be helpful in lupus cases with predominant skin involvement, but combinatorial treatment might be required to restrain autoantibodies.