Simple procedure to evaluate mid-face sagging: A pilot study from Taiwan

An easy and objective way to evaluate mid-face sagging is marking straight lines between the nasal alar and the mandibular angle, one in the supine and the other in an upright position. The maximal distance between the two lines drawn is measured. Statistic analyses shows that this maximum distance demonstrates positive correlation with age and body mass index that reflects the level of mid-face sagging. This simple method may be utilised to evaluate the effect of anti-ageing treatment on the face in the context of mid-face sagging.     

Subchronic exposure of titanium dioxide nanoparticles to hairless rat skin

The evaluation of the biological effects of industrial nanoparticles on the skin is necessary for their risk assessment. To clarify the influence of TiO₂ nanoparticles on the skin, we carried out a subchronic exposure study of TiO₂ nanoparticles to hairless rat skin. W/O emulsion containing 10 wt% TiO₂ nanoparticles and control emulsion was applied to the dorsal skin of Hairless Wistar Yagi rats once a day for a maximum period of 56 consecutive days. After 2, 4 and 8 weeks, skin samples were taken from the exposed skin area. Histopathologically, the particles were only located in the stratum corneum layer of epidermis and follicular epithelium. Focal parakeratosis and spongiosis were observed in the epidermis. Transmission electron microscopy with energy‐dispersive X‐ray spectrometry (EDX) analysis failed to show TiO₂ nanoparticles in the viable skin areas. There was no evidence of TiO₂ penetration in the viable skin areas. In addition, titanium contents in several organs were determined using inductively coupled plasma mass spectroscopy. Increased titanium concentration was detected in lung samples of the TiO₂ emulsion‐treated groups after 8 weeks. It was most likely that the presence of TiO₂ in the lungs was not caused by direct absorption of nanoparticles from the skin but was due to rats inhaling the nanoparticle. We did not find any obvious evidences of nano‐TiO₂ particle skin penetration using several morphological methods after the subchronic exposure. We believe that the influence of subchronic exposure of TiO₂ is not significant based on our study.     

A pilot study of treatment of lentigo maligna with 5% imiquimod cream

BACKGROUND: Lentigo maligna (LM) is an in situ form of malignant melanoma, and surgical excision is often unsatisfactory. Imiquimod cream is an immune response modifier and induces a predominantly T-helper 1 type response. OBJECTIVES: Assessment of histological and clinical response of surgically resectable LM after treatment with 5% imiquimod cream. METHODS: Six patients with LM were treated with 5% imiquimod cream daily for 6 weeks. The whole site of the original lesion was then excised. Clinical and histological and appearances were measured using clinical response and histological grading scores. RESULTS: Complete or almost complete clearance of pigmentation with minimal residual histological evidence of LM was observed in four patients, one patient showed no clinical or histological improvement, and the remaining patient had almost no residual pigmentation clinically after treatment yet histopathological changes remained as severe as before treatment. CONCLUSIONS: Topical imiquimod cream merits further investigation as a new therapy for LM.     

口服低剂量甲氨蝶呤致皮肤毒性反应

报告1例口服低剂量甲氨蝶呤致皮肤毒性反应。患者男,45岁,全身皮肤反复红斑及鳞屑7年,加重伴溃疡及疼痛40 d。皮损组织病理检查：表皮细胞坏死,表皮下裂隙及水疱,真皮浅层血管周围中等量淋巴细胞浸润。诊断：甲氨蝶呤致皮肤毒性反应。     

A pilot study of fluorescence diagnosis of basal cell carcinoma using a digital flash light-based imaging system

Background/purpose: Fluorescence diagnosis (FD) is a promising method for the non‐invasive detection of tumor boundaries. We aimed to investigate the clinical utility of a flash light‐based fluorescence imaging system. Methods: Sixteen patients with basal cell carcinomas were included in this pilot study. FD was performed using a 20% 5‐aminolevulinic acid (ALA) cream. The FD tumor area was determined 3 h after the ALA application using a digital flash light‐based fluorescence imaging system and an image analysis system. The tumor area was also assessed by means of the clinical diagnosis (CD) based on the normal colored picture. The tumors were excised following the FD procedure, but according to the clinically diagnosed lesional area. Results: Though there was a very strong correlation between the tumor areas assessed by FD and CD, the mean tumor area that was visualized by FD was significantly smaller than the tumor area determined by CD. The mean±SD FD/CD ratio was 0.78±0.11 in total. In 81.3% of cases, complete tumor excision was achieved. Conclusion: This pilot study indicates that the FD technology may be less sensitive than CD, and refinements of the technique along with larger systematic trials on the sensitivity and specificity of FD are required.     

A novel fractional micro-plasma radio-frequency technology for the treatment of facial scars and rhytids: A pilot study

Abstract

Introduction: Fractional ablative and non-ablative lasers have gained popularity in the treatment of acne scars and rhytids due to their efficacy and improved tolerability. Plasma and radio frequency (RF) have also emerged as methods for ablative or non-ablative energy delivery. We report preliminary experience with a novel fractional micro-plasma RF device for the treatment of facial acne scars and rhytids. Methods: Sixteen patients with facial acne scars or rhytids were treated at 4-week intervals. Treatment parameters were titrated to an immediate end point of moderate erythema. The clinical end point for cessation of treatment was the attainment of satisfactory clinical results. Results were monitored photographically up to 3 months after treatment. Results: Acne scars showed marked improvement after two to four treatments. Facial rhytids demonstrated reduced depth after two treatments and marked improvement after four treatments. Treatment was well tolerated by all participants, with transient erythema and short downtime. These results provide initial evidence for the safety and effectiveness of fractional micro-plasma RF as a low-downtime and well-tolerated modality for the treatment of acne scars and facial rhytids.     

Investigation of micronized titanium dioxide penetration in human skin xenografts and its effect on cellular functions of human skin-derived cells

Abstract:  Titanium dioxide (TiO₂) nanoparticles are ubiquitously used materials in everyday life (e.g. paints, household products and plastic goods). However, despite the wide array of common applications, their pathogenetic role was also suggested under certain conditions (e.g. pulmonary neoplasias and lung fibrosis). From a dermatological point of view, it is also of great importance that TiO₂ also serves as a physical photoprotective agent in sunscreens and is widely used in various cosmetic products. However, the effect of TiO₂ on human cutaneous functions is still unknown. Therefore, in the current study, we investigated the in vivo penetration of TiO₂ via human skin transplanted to immunodeficient mice and, furthermore, we measured the in vitro effects of nanoparticles on various functional properties of numerous epidermal and dermal cells in culture. Hereby, using various nuclear microscopy methods, we provide the first evidence that TiO₂ nanoparticles in vivo do not penetrate through the intact epidermal barrier. However, we also report that TiO₂, when exposed directly to cell cultures in vitro , exerts significant and cell-type dependent effects on such cellular functions as viability, proliferation, apoptosis and differentiation. Therefore, our novel findings will hopefully inspire one to systemically explore in future, clinically oriented trials whether there is indeed a risk from micronized TiO₂-containing products on skin with an impaired stratum corneum barrier function.     

Prediction of chemical absorption into and through the skin from cosmetic and dermatological formulations

Background  To date, risk assessment following topical exposure to cosmetic/dermatological formulations cannot be precisely evaluated.
Objectives  To provide a tool for optimization of active permeation into/through skin and for risk assessment.
Methods  A predictive model was developed for estimating the cumulative mass of a chemical absorbed into and across the skin from a cosmetic/dermatological formulation. Account was taken of (i) the ionization state of the chemical, to correct the skin/vehicle partition coefficient; and (ii) the nature of the cosmetic/dermatological formulation. Three specific assumptions were made: firstly, steady-state transport across the skin was achieved despite application of a finite dose of chemical; secondly, vehicle effects were small relative to the precision of the prediction; and, thirdly, each formulation could be treated as an oil-in-water emulsion, in which only that fraction of the chemical in the aqueous phase was available to partition into the stratum corneum. A database of 101 ex vivo human skin experiments involving 36 chemicals was analysed.
Results  For 91% of the data, the difference between predicted and experimental values was less than a factor 5; when the aforementioned corrections were not used, on the other hand, only 26% of the data was well predicted. The model was successfully applied to predict skin absorption of two compounds not included in the database, for which in vitro percutaneous penetration from cosmetic vehicles have been measured.
Conclusion  A model has been developed to predict the mass of a chemical absorbed into and through the skin from a cosmetic or dermatological formulation.     

An extract of Polypodium leucotomos appears to minimize certain photoaging changes in a hairless albino mouse animal model: A pilot study

Chronic ultraviolet B (UVB) exposure of human or murine skin is known to induce cutaneous photoaging and enhanced carcinogenic risk. An extract of Polypodium leucotomos (PL), a tropical fern plant, has been known to exhibit interesting antioxidant and photoprotective properties against acute exposure to ultraviolet radiation. The objective of this preliminary (or pilot) study was to determine the photoprotective role of topically applied Polypodium leucotomos extract in the prevention or amelioration of cutaneous changes of photoaging in hairless mice. PL-treated mice showed significant reduction of skinfold thickness than those observed in PL-untreated controls. Additionally, PL-treated mice showed a significantly lower degree of histologic parameters of photoaging damage, including dermal elastosis, compared with positive control mice. Interestingly, PL treatment also showed reduction in the number of mice showing skin tumors at 8 weeks after the cessation of the UVB exposure protocol. The results of this preliminary study illustrate that PL treatment helped to ameliorate and to partially inhibit some of the histologic damage associated with photoaging of skin and appeared to contribute to a decrease in the prevalence of UVB-induced skin tumors in mice.     

Qualitative and quantitative comparison of heat separated epidermis and dermatomed skin in percutaneous absorption studies

Transepidermal water loss (TEWL), mainly regulated by the stratum corneum, was quantitatively correlated to percutaneous absorption of compounds in human and suggested for the ex vivo assessment of skin integrity. The present study investigated qualitatively and quantitatively the relevance of 100-μm heat separated epidermis (HSE) in percutaneous absorption studies as compared to 500-μm dermatomed skin by dual complementary approaches. Percutaneous absorption of caffeine delivered from aqueous solution through dermatomed skin or HSE specimens (n = 9) was measured using vertical static diffusion cells coupled with an unventilated evaporimeter enabling the assessment of TEWL and skin integrity for 21 h. Permeation of caffeine exhibited different finite dose-like profiles ranged according to the thickness of skin specimens (cumulative dose absorbed up to 21 h: 11.5 ± 11.5 μg/cm² and 29.4 ± 36.2 μg/cm² through dermatomed skin and HSE, respectively). Normalized TEWL and caffeine fluxes were similar through dermatomed skin and HSE suggesting that the intrinsic permeability properties of both models were undifferentiated over time. Interestingly, a significant relationship was shown between TEWL and caffeine fluxes, suggesting the usefulness of TEWL measurement as an element in the estimation of percutaneous drug absorption. In conclusion, the present showed that percutaneous absorption through HSE was qualitatively and quantitatively similar to dermatomed skin when TEWL as endogenous standard and skin thickness were considered in permeability data comparisons.     

Correlation of serum procalcitonin with the severity of skin and skin structure infections – a pilot study

Background: Procalcitonin (PCT) is a specific biomarker for early detection of bacterial infections. While the usefulness of procalcitonin in severe conditions such as sepsis is well established, its relevance in the diagnosis and prognosis of localized cutaneous bacterial infections is unknown. Our aim was to initially evaluate if PCT is a useful parameter for predicting the severity of skin and skin structure infections (SSSI). Furthermore, the correlation of PCT levels with C‐reactive protein (CRP), leukocyte counts, erythrocyte sedimentation rate (ESR), and body temperature was investigated. Patients and Methods: Serum PCT, routine laboratory parameters, and body temperature were regularly examined in 50 consecutive patients with SSSI requiring inpatient intravenous antibiotic treatment. Patients were classified into 2 groups according to the guidelines developed by the FDA (U.S. Food and Drug Administration) as having either an uncomplicated (SSSI) or a complicated skin and skin structure infection (cSSSI). Results: No significant correlation could be detected between the length of inpatient antibiotic treatment and PCT on days 1, 2, 3, and the maximum value on these days. The same result was found when uncomplicated SSSI and complicated SSSI (cSSSI) were evaluated separately. However, PCT levels were significantly higher in the latter. Furthermore, PCT levels showed a significant correlation with CRP, leukocyte count, ESR, and body temperature. Conclusion: PCT might be a useful additional tool for initial diagnosis and monitoring of patients with SSSI.