Socks with an U-shaped 3D discharge element are capable to reduce dynamic plantar pressures under the central forefoot

Cushioning for the central and plantar zone of the forefoot, integrated into the body of the sock, could reduce excess pressures in that zone. The objective of this study was to verify the capacity of a sock with a cushioning element to reduce forefoot plantar pressures relative to the same sock model without that element. Dynamic plantar pressures were measured in a sample of 38 participants (25 women and 13 men) using the FootScan plate system following the two-step protocol. Measurements were made in three situations selected at random – barefoot, wearing control socks, and wearing the experimental cushioned socks. Maximum pressures were analysed in seven zones of the forefoot (hallux, lesser toes, and 1st to 5th metatarsal heads). The zone of greatest plantar pressure was in all situations located under the 3rd metatarsal head. The pressure was lower (p = 0.009) under the 2nd metatarsal head with the experimental sock (10.2 ± 3.1 N/cm²) than with the other two conditions – barefoot (11.8 ± 3.7 N/cm²) and control sock (11.9 ± 4.9 N/cm²). The 3rd metatarsal head presented lower plantar pressures (p = 0.004) with the experimental sock (12.6 ± 3.8 N/cm²) than barefoot (14.5 ± 4.9 N/cm²). The experimental socks, with plantar cushioning, were able to effectively reduce the plantar pressures on the central part of the forefoot. This reduction may lead to less discomfort for subjects suffering pain in this area, It may also result in avoiding the appearance of possible skin lesions associated with excess pressure (such as calluses, corns, or blisters).     

Evaluating the effects of sedentary behaviour on plantar skin health in people with diabetes

BackgroundDiabetes-Related Foot Ulcers (DRFUs) are a common and devastating consequence of Diabetes Mellitus and are associated with high morbidity, mortality, social and economic costs. Whilst peak plantar pressures during gait are implicated cited as a major contributory factor, DRFU occurrence has also been associated with increased periods of sedentary behaviour. The present study was designed aimed to assess the effects of sitting postures on plantar tissue health.MethodsAfter a period of acclimatisation, transcutaneous oxygen tensions (T_CPO₂) and inflammatory cytokines (IL-1α and IL-1RA) were measured at the dorsal and plantar aspects of the forefoot before, during and after a 20-min period of seated-weight-bearing in participants with diabetes (n = 11) and no diabetes (n = 10). Corresponding interface pressures at the plantar site were also measured.ResultsDuring weight-bearing, participants with diabetes showed increases in tissue ischaemia which were linearly correlated proportional to plantar pressures (Pearson's r = 0.81; p < 0.05). Within the healthy group, no such correlation was evident (p > 0.05). There were also significant increases in post seated weight-bearing values for ratio for IL-1α and IL-1RA, normalised to total protein, post seated weight-bearing in participants with diabetes compared to healthy controls.ConclusionThis study shows that prolonged sitting may be detrimental to plantar skin health. It highlights the need to further examine the effects of prolonged sitting in individuals, who may have a reduced tolerance to loading in the plantar skin and soft tissues.     

Microrelief of the skin using a light transmission method

The recently developed Skin Visiometer, based on light transmission through blue-coloured silicone replicas, was used to study skin microrelief. Calibrated metal plates displaying lines with depths between 6 and 361 microns, were used to determine the accuracy, sensitivity and reproducibility of the technique as well as the parameters of importance during measurement. The precision of the measurements was particularly good between 10 microns and 361 microns. The sensitivity of the method was between 10 and 20 microns. Replicas of volar forearm skin were taken from four groups (n = 15) of male and female volunteers in the age ranges 20 to 30 years and 55 to 65 years. In addition to the instrumental roughness parameters (Rz, Rt, Rm and Ra), the surface of the furrows, the number of primary and secondary lines and the number of intersections were determined. For both sexes, significantly lower values were observed for Rz, Rm and Rt in the younger age group than in the older age group. In addition, the numbers of primary and secondary lines and the number of intersections were higher, pointing to a more structured microrelief in younger forearm skin. Diurnal rhythm, the relative humidity of the measuring room and the position of the forearm were found to be significant factors, while room temperature and precleansing of the skin with mild products were not. Following the application of a hydrating cream (twice daily for 14 days) to the forearm skin of the older female age group, the Rz, Rt, Rm and Ra decreased, while the other parameters measured, except for the surface taken in by the lines, increased, indicating that the microrelief was modified towards the typical pattern observed in young skin.     

他扎罗汀倍他米松乳膏人体皮肤耐受性研究

目的 探讨健康志愿者单次或多次局部外用不同浓度的他扎罗汀倍他米松乳膏后,健康皮肤对受试药物的耐受性,预测受试药物对人体皮肤潜在的不良反应及其强度.方法 34例单次给药受试者分为6组,分别进行他扎罗汀与倍他米松浓度均为0.025％、0.05％、0.1％、0.15％、0.2％、0.25％的单次给药耐受性试验.12例多次给药受试者分为2组,分别进行他扎罗汀与倍他米松浓度均为0.2％、0.15％每天给药1次、连续给药7d的多次给药耐受性试验.观察受试者给药前后体征、实验室检查、给药部位皮肤反应及主观感觉、内源性皮质醇水平的变化,以及经皮吸收进入系统循环的药物量.结果 试验中未发生严重不良事件.单次给药34例受试者用药后均未出现与受试药物有关的不良反应,各项观察指标均未发现与受试药物有关的异常改变.多次给药12例受试者在开始给药后0～7d给药部位无任何异常皮肤反应及自觉不适症状,给药后14 d(停药后7 d)0.2％组6例受试者中5例、0.15％组6例受试者中2例,给药部位皮肤出现轻度刺激反应症状;其他各项观察指标均未发现与受试药物有关的异常改变.结论 他扎罗汀与倍他米松乳膏单次给药的最大耐受剂量为0.25％他扎罗汀和0.25％倍他米松.0.15％他扎罗汀和0.15％倍他米松连续给药7d是比较安全的.     

The effect of 4 barrier creams on the absorption of water, benzene, and formaldehyde into excised human skin

The effect of 4 barrier creams on the absorption of (3H)-water (14C)-benzene and (14C)-formaldehyde into excised human skin was studied. The control skin and the barrier cream treated skin were exposed to the test substance for 0.5 hr, whereupon the amount absorbed was determined. The results indicated that the experimental cream "Water barrier" reduced the absorption of water and benzene but not formaldehyde. Kerodex 71 cream slightly reduced the absorption of benzene and formaldehyde. The barrier creams Petrogard and "Solvent barrier" did not affect the absorption of any of the substances studied. The use of these creams against percutaneous absorption is questioned.     

Efficacy of skin barrier creams

2 barrier creams (BC) were evaluated against the anionic detergent sodium lauryl sulphate (SLS) using a new human test model. In the repetitive irritation test (RIT) on human skin, the irritant SLS is applied to the ventral forearm of Healthy volunteers daily for 2 weeks. 1%, 5%, and 10% SLS is exposed to the skin for 30 min. using a glass cup 2.5 cm in diameter. The BC is applied 30 min before the irritant. Cutaneous irritation is assessed on a score for erythema (0 to 5+), and quantified by various biophysical techniques: transepidermal water loss (TEWL) by evaporimetry, skin blood flow volume (BFV) by laser-Doppler velocimetry, and -skill colour bi colorimetry (La^* value). 10 subjects were tested with SLS on one forearm without pretreatment (control) and with Taktosan Salbe as BC on the other forearm. A 2nd panel of 10 subjects was tested in the same way with SLS and Marly skin as BC. Taktosan Salbe was extremely effective in reducing the irritation by SLS: there were significant differences regarding all lest parameters for 10% SLS in the 2nd week. The most differentiating parameter was TEWL, revealing statistical differences as early as the 1st week for 10%. SLS and Taktosan Salbe, while the least differentiating sensitivity was found for La^*. In contrast, there was no significant suppression of irritancy in any parameter with Marly skin, either in the 1st week or in the 2nd week with any concentration of SLS. The results show the differentiating potential of the model developed. Results obtained with the previously described animal model are confirmed- Noninvasive biophysical techniques, particularly TEWL measurements, might be extremely valuable in identifying new active ingredients of BC.     

Efficacy of skin barrier creams

An animal model for the evaluation of skin protective creams against chemical irritants is described. The irritants were applied daily for 2 weeks to shaved back skin of young guinea pigs: sodium tauryl sulphate (5% aq.: 30 min), sodium hydroxide (0,5% aq.; 2 min). and toluene (20'i. eth.; 2 mint. "The harrier cream was applied 2 h prior to and immediately after exposure to the irritant. Control animals were treated with the irritant only. The irritant reaction was scored on a 4–point scale for erythema and quantified with regard to transepidennal water loss (TEWL) by evaporime-try and skin blood flow volume (BFV) by laser Doppler velocimetry. A total of 90 guinea pigs, consisting of" individual panels of 5 to 10 animals, was tested. While one barrier cream (Slokoderm) significantly suppressed the irritation due 10 sodium lauryl sulphate and toluene, the other (Contra-Alkalh failed to do so and even aggravated the response, which was particularly evident with sodium hydroxide. This model may be useful in developing more effective barrier creams.     

A quantitative study of hydration level of the skin surface and erythema on conventional and microclimate management capable mattresses and hospital beds

BackgroundIn addition to pressure itself, microclimate factors are gaining more attention in the understanding of the development of pressure ulcers. While there are already various products to reduce pressure on sore-prone areas to prevent pressure ulcers, there are only a few mattresses/hospital beds that actively influence skin microclimate. In this study, we investigated if microclimate management capable mattresses/hospital beds can influence skin hydration and skin redness/erythema.MethodsWe included 25 healthy subjects in our study. Measurements were made using Courage & Khazaka Multi Probe Adapter MPA with Corneometer CM825 and Mexameter MX18 to determine skin hydration of the stratum corneum and skin redness/erythema before and after the subjects were lying in conventional (Viskolastic® Plus, Wulff Med Tec GmbH, Fedderingen, Germany and Duo™ 2 mattress, Hill-Rom GmbH Essen, Germany) or microclimate management capable mattresses/hospital beds (ClinActiv + MCM™ and PEARLS AFT, Hill-Rom GmbH Essen, Germany).ResultsWhile there was no difference in skin redness/erythema on the different mattresses/hospital beds, skin hydration of the stratum corneum decreased significantly in an air fluidized bed compared to baseline values and values measured on standard mattress/Viskolastic® Plus.ConclusionAir-fluidized therapy reduces skin hydration and therefore could contribute to prevent moisture associated ulcers. Changes in skin hydration as one important factor of skin microclimate can be detected after a short time of incubation and even before an erythema appears.     

Millimeter wave reflectivity used for measurement of skin hydration with different moisturizers

Background/aims: A new non‐invasive method for determining the free water content in human skin has been developed. The method analyzes the reflection of millimeter (mm) wavelength electromagnetic waves. The amount of reflection of mm waves depends on an electrical property (namely, the permittivity) of the skin, and this depends upon the free water content of the various skin layers. The aim of the present study was to use the mm wave reflectometry method for determination of free water content in healthy skin treated with different hydrating substances. Methods: Skin lotion, pure water, glycerol, and petroleum jelly (an occlusive substance) were used for hydration of skin. The amount of free water was calculated using the permittivity values of skin layers found from fitting a three layer skin model to measured reflection data. The skin model consisted of (1) the stratum corneum (SC), (2) the viable epidermis plus the dermis, and (3) fat layers. Results: Mm wave reflection was significantly affected by the water content of the thick SC of the palm but not by the very thin SC of the forearm. Treatment of the forearm and palm skin with different hydrating substances produced notable changes of the free water content in the SC, but not in the viable epidermis or dermis. The greatest hydration was produced by pure water and skin lotion, and the lowest by petroleum jelly. However, petroleum jelly produced prolonged retention of water in the SC following its hydration by other moisturizers. The content of free water was found to return to its baseline value after removal of moisturizers in as short a time as 8.3 min. Conclusion: The study shows that mm wave reflectometry can be used as a sensitive technique for the non‐invasive determination of water content in living skin.     

Analytical control of preservative labelling on skin creams

Contents of 23 preservatives (22 permitted and 1 non-permitted) were analysed in 67 skin creams to verify whether these products complied with the Cosmetic Directive with respect to ingredient labelling, as well as with respect to maximum allowed concentrations of the respective preservatives. The preservatives selected for the analysis were: parabens, 2-phenoxyethanol, benzoic acid, 4-hydroxybenzoic acid, sorbic acid, salicylic acid, formaldehyde and formaldehyde releasers, 3:1 mixture of 5-chloro-2-methyl-4-isothiazolin-2-one and 2-methyl-4-isothiazolin-2-one (Kathon CG), 2-bromo-2-nitropropane-1,3-diol (Bronopol), 5-bromo-2-nitro-1,3-dioxane (Bronidox) and methyldibromo glutaronitrile. 1 or more parabens were present in 87% (n=58) of the investigated products, 2-phenoxy ethanol in 49% (n=33) of the products, and formaldehyde/formaldehyde releasers were present in 51% (n=34) of the products. Kathon CG was found in 3 products, acid preservatives (except salicylic acid) in 8 products, Bronopol in 5 products, and methyldibromo glutaronitrile was present in 4 products. The contents of all of the target preservatives in the skin creams were within the maximum allowed concentrations of the respective substances. Incorrect ingredient labelling with respect to paraben content was found in 10% (n=7) of the investigated products, 33% (n= 22) of the products were not declared for the content of formaldehyde/formaldehyde releaser, and 7% (n=5) products were incorrectly labelled for the content of 2-phenoxyethanol. In 1 of the products containing Kathon CG, the ratio of 5-chloro-2-methyl-4-isothiazolin-2-one to 2-methyl-4-isothiazolin-2-one (1.4:1) was not correct. 4 of the 8 products containing acid preservatives were not labelled for the content of these substances. All in all, in 45% (n=30) of the investigated skin creams ingredient labelling was incorrect with respect to preservative contents. The proportion of incorrect labelling is reduced to 23% (n = 15), when the formaldehyde content in skin creams below 30 ppm is not accounted.     

Influence of ageing on the in vivo extensibility of human skin at a low stress

Summary The response of the forearm skin to a 9 · 10^-3 N · m torque was measured on 141 subjects aged 3–89 years. The results for each age class were ajusted to a skin thickness of 1 mm by use of a skinfold caliper. Results indicate a maximum skin thickness around the age of 40 years. Standardised skin extensibility decreases with age, the skin of females being less extensible than that of males. These results, which should be considered in relation to the total water content of the skin, are compared to those of other papers dealing with this subject.     

Sweet's Syndrome Limited on the Palms and Soles: A Case Report

Sweet''s syndrome was first described as a reactive dermatosis characterized by sudden onset of fever, leukocytosis, and erythematous plaques infiltrated with neutrophils. Therefore, Sweet''s syndrome is also known as acute febrile neutrophilic dermatosis. However, subsequently, it became clear that fever and neutrophilia in Sweet''s syndrome vary depending on the case, and several other characteristics have been described. The lesions in Sweet''s syndrome are typically observed not only in the limbs but also in the face, neck, and upper trunk. A 28-year-old female without a specific medical history presented in a hospital following the complaint of painful erythematous patches and pustules on her palms and soles. She had no previous history of palmoplantar pustulosis and other infections or malignancies. A skin biopsy showed diffuse dermal infiltration of neutrophils. Laboratory tests showed increased neutrophil count and erythrocyte sedimentation rate. After systemic corticosteroid administration was initiated, the lesions gradually disappeared. The patient was subsequently diagnosed with Sweet''s syndrome according to histology, clinical feature, and response to treatment. However, there have been few reports of Sweet''s syndrome confined to the individuals'' palms and soles. According to the literatures, although the dorsum of the hand is frequently affected, the palmoplantar involvement as in our case appears to be rare.     

血尿素氮在重症急性胰腺炎中的意义

目的是分析重症急性胰腺炎（SAP）患者的血尿素氮（BUN）在重症监护病房（ICU）住院时间及预后中的意义。方法对2008年1月。2010年6月SAP病例进行分析,并分为住院时间延长组和不延长组;观察人住ICU时血BUN水平对其ICU住院时间及预后的影响。结果病死率单因素分析发现：Ranson评分、血BUN、血糖、腹腔室隔综合征、血钙及氧分压与患者的病死率相关;二维多因素非条件Logistic回归分析（Forward：LR法）发现：Ranson评分和血BUN与病死率关系最密切。ICU住院时间延长组相比不延长组患者,其入院时BUN有显著升高（P=0．006）,危险度（OR）为1．030,95％可信区间（CI）1．01～1．098,截断值为30mg／dl,其特异性为89％,敏感性为62％。结论BUN作为单一检验指标,临床检测方便、费用低,适于临床预测SAP患者ICU的住院时间及预后。     

Histological demonstration of initial lymphatics in human skin: comparison between different extension techniques

Summary Initial lymphatic vessels (IL) are difficult to demonstrate histologically in excised normal skin, as they are usually completely collapsed. In this report three different methods (vacuum extension, large traction extension, and small traction extension) are described by which human skin specimens can be mechanically extended. After extension specimens were Epon enbedded and the IL counted and their diameters measured. The greatest number of lymphatic vessels was found in specimens extended by vacuum, and the smallest number in small specimens extended by traction. The highest density of lymphatic vessels was found 50–300 m below the epidermis. Our data reveal that vacuum extension is useful for investigating questions concerning the topography of IL, whereas preparations extended by traction are more suitable for obtaining information about single lymphatic vessels.     

The increase in skin hydration after application of emollients with different amounts of lipids.

Emollients can increase the water content in the stratum corneum by delivery of their water to the skin, and by occlusion. These two mechanisms were studied using three preparations with different concentrations of lipids. The products were applied to the skin and then removed by cleaning the surface after 5 and 40 min. The increase in skin water loss following removal of product residue was considered as a release of excess water in the skin. Exposure of the skin to pure petrolatum for 5 min gave no increase in the water loss from the skin surface following removal of the product residue. A lipid rich cream (66% lipids) gave a significant increase, but the highest increase was found after removal of an ordinary cream (27% lipids). Release of water from the skin indicates that water in the creams had previously been absorbed into the skin. The occluding properties of the products were determined after 40 min of exposure. Petrolatum reduced the water loss by approximately 50% and the other products by 16%. The occlusion caused an increase of water in the skin, which resulted in a release of water following removal of the products. The release was related to the reduction of water loss. Thus petrolatum gave a higher release of water than the other emollients.     

The mechanism of skin lipids influencing skin status

Skin lipids, compose of sebocyte-, keratinocyte-, and microbe- derived lipids, dramatically influence skin status by different mechanisms. (I) Physical chemistry function: They are “mortar” to establish the physico-chemical barrier function of skin; (II) Biochemistry function: They function as signals in the complex signaling network originating at the epidermal level; (III) Microecology function: Sebocyte- and keratinocyte-derived lipids vary the composition of microbial skin flora, and microorganisms metabolize them to produce lipids as signal starting signaling transduction. Importantly, further research needs lipidiomics, more powerful analytical ability and high-throughput manner, to identify skin lipid components into individual species. The validation of lipid structure and function to research the process that lipid species involved in. Additional, the integration of lipidomics data with other omics strategies can develop the power to study the mechanism of skin lipids influencing skin status.