皮肤科学基础

980001 脂类混合物对人体皮肤的生物学效应/徐承水（山东曲阜师范大学生物系）…//皮肤病与性病.-1997,19（3）.-1～3 利用从哺乳动物脑组织提取的含有胆固醇、神经醇磷脂和脂肪酸三种脂的混合物,对皮肤水分含量的影响进行了初步实验观察。对18例（男女各9例）临床志愿者的实验观察发现,外用5小时后,治疗组皮肤角质层的水分含量比基质对照组高57％;治疗组皮肤水分丢失量比基质对照组低24.7％（P<0.01）。用药24     

保湿护肤品

皮肤的屏障功能被破坏时，表皮内的水分会经过角质层丢失，使皮肤变得干燥，从而引起或加重一些皮肤疾病。该文介绍了皮肤的屏障功能以及保湿护肤品中有效成分的作用机制。     

洁肤产品温和及保湿性能的临床评价方法

角质层处于皮肤最外层。在阻止皮肤水分流失及阻止外界刺激物侵人方面起到重要作用。角质层中水分状态会影响角质正常生理过程（如皮肤表皮脱落、脂质屏障形成及天然保湿因子形成等）。水分可以使皮肤保持柔韧性以抵抗外界机械压力,水分也是角质层维持正常生物功能的重要因素。许多因素会导致角质水分流失从而导致不同程度的角质功能紊乱。     

皮肤天然保湿的研究概况

正常而富有弹性的皮肤与人体皮肤中天然的保湿系统有着密切的关系．保湿剂是人们日常皮肤护理品中的一个重要部分，用以保持角质层的水分，维持皮肤弹性，促进皮肤屏障功能的修复。在返朴归真崇尚自然的今天，天然的保湿剂是未来保湿剂发展的趋势。     

保湿眼膜对眼周皮肤滋润作用的评价

目的：评价保湿眼膜产品对眼周皮肤的滋润护理作用。方法：采用皮肤水分仪Corneometer检测保湿眼膜产品对眼周皮肤水分含量的影响。结果：双眼外眦外侧使用含保湿眼膜的组合产品2．4、8h后皮肤水分含量比空白对照区升高．差异有统计学意义（P〈0．05）;使用1、2、3周后的皮肤水分含量仍比使用前高,差异有统计学意义（P〈0．05）;而未使用保湿眼膜的对照产品在3周内对皮肤水分含量的作用不明显（P〉0．05）。结论：眼周皮肤的护理不仅需要使用普通的护肤产品,更需要使用针对眼周皮肤生理特性的保湿眼膜产品,才能有效地滋润眼周皮肤,起到保养护理的效果。     

白三烯B4与银屑病患者血清混合物皮下注射导致小鼠皮肤银屑样病理变化

研究表明：白三烯B4（LTB4）在银屑病的发病中起着重要作用，本采用LTB4与银屑病患血清混合物皮下注射导致小鼠皮肤银屑病样病理改变。     

皮肤保湿功能与保湿剂的应用

保湿剂是人们日常皮肤护理产品中的一个重要部分，用以保持角质层的水分，维持皮肤弹性，促进皮肤屏障功能的修复，加入特殊成分的保湿剂还有美白、抗老化等作用。在皮肤科临床工作中，保湿剂有良好的治疗与辅助治疗作用，可建议患者选用合适产品，不良反应亦需注意。     

润肤剂对皮肤病的辅助治疗

人体皮肤具有重要的屏障功能，它保护机体免受外界环境中机械的、物理的、化学的和生物的有害因素的损伤，既具有保留机体各种营养物质、电解质和水分的作用，又能阻止外来物质（如抗原）入侵机体犤１犦。润肤剂是一种能为皮肤角质层表面提供油性层的物质，可为角质层的表面提供一种能防止水分丧失的油层，使水分储留在角质层下方，促使水分回到角质形成细胞中，使角质形成细胞因含水量充足而肿胀，从而使细胞间裂隙消失。润肤剂还可进入角质层上层，模拟缺损脂质的屏障作用。通过润肤剂使表皮屏障得以修复，防止或减少了环境触发因素如金黄…     

物理性皮肤病

20141327三种波长发光二极管光对光老化皮肤的作用研究／吉杰（上海市皮肤病医院），丁蕙琳，王晓鑫…／／中华皮肤科杂志．-2014，47（3）.-166～171 选择14例皮肤光老化受试者，随机于其一侧前臂伸侧三个区域，分别予530nm，630nm及850nm LED光照射，每周3次，共12次。对照射部位皮肤进行皮肤镜检查，并比较照射前、照射第2，4和6周皮肤角质层含水量、经皮水分丢失量（TEWL）以及反映皮肤颜色的皮肤亮度（L＊值）和皮肤黑素指数（MI值）的变化。     

温和保湿洁肤产品对干燥皮肤的临床功效

1 角质功能及其影响因素 角质处于皮肤表皮最外层,在保持皮肤健康和弹性方面起着至关重要的作用.角质层是半渗透性的保护层,又可称为皮肤的水分屏障,可以使皮肤免受外界伤害,保持基础水分,以及防止表皮干燥 [1]. 角质层的生物功能取决于其生理结构的完整度.天然保湿因子是角质层保持水分平衡的关键成分之一,天然保湿因子是由氨基酸及其衍生物组成的一类水溶性小分子化合物,合成于角质细胞中.而细胞间脂质神经酰胺、脂肪酸和胆固醇组成了高度有序排列的层状结构,在每个角质细胞周围形成微屏障系统,从而保护天然保湿因子的流失[2、3].组成皮肤水分屏障的蛋白质和脂质如果受到损害,会导致角质水分状态不稳定,从而导致生物过程失调等连锁反应,最终导致非正常的表皮脱落[4].由此可见,保持皮肤屏障组成完整对角质功能及皮肤健康非常重要.     

Involvement of melanocortin-1 receptor in the hyperpigmentation of human skin autografts

Hyperpigmentation frequently occurs in human skin autografts resulting in an unsatisfactory appearance. This study aimed to elucidate the role of melanocortin-1 receptor in the hyperpigmentation process of skin autografts by analyzing the expression of melanocortin-1 receptor. The data were correlated with the amount of melanin in autografted human skin and normal skin determined in a previous study. Immunohistochemistry, western blotting and quantitative real-time polymerase chain reaction were carried out to detect the expression and distribution of melanocortin-1 receptor in skin autografts including full-thickness skin autografts, split-thickness skin autografts and normal full-thickness skin. Fontana-Masson stain was used to detect melanin in all types of skin specimens. The expression level of melanocortin-1 receptor in autografted skin was much higher than that in control normal skin, and thinner split-thickness skin autografts had higher levels of expression of melanocortin-1 receptor than thicker grafts. The amount of melanin in skin autografts was significantly increased compared with normal skin. The expression of melanocortin-1 receptor correlated well with the amount of melanin in the epidermis of skin autografts. These results indicate that melanogenesis is dramatically enhanced in skin autografts by the melanocortin-1 receptor, and suggest that overexpression of melanocortin-1 receptor may play an important role in the hyperpigmented process of skin autografts. This study provides a novel mechanism for hyperpigmentation in skin autografts.     

Possible functional impairment of Langerhans' cells in vitiliginous skin. Reduced ability to elicit dinitrochlorobenzene contact sensitivity reaction and decreased stimulatory effect in the allogeneic mixed skin cell lymphocyte culture reaction

We used patch testing to compare the ability to elicit contact sensitivity to dinitrochlorobenzene (DNCB) of uninvolved with vitiliginous skin of 31 patients with vitiligo. The induction of DNCB contact sensitivity was possible in the vitiliginous skin in the same way as in normal skin. The DNCB contact sensitivity reactions, however, were generally diminished in vitiliginous skin, although the number of cases showing similar DNCB contact reactivity between normal and vitiliginous skin increased when the sensitization procedure was performed in vitiliginous skin instead of normal skin. On the other hand, delayed skin reactions to intradermally injected Candida albicans antigen were not suppressed in vitiliginous skin. The number of Langerhans' cells was not decreased in vitiliginous skin as compared with that of normal skin. The epidermal cells derived from vitiliginous skin, however, tended to show a lower stimulatory effect in the allogeneic mixed skin cell lymphocyte culture reaction than those from normal skin. These results suggest a possibility of functional impairment of Langerhans' cells in vitiliginous skin.     

Appearance benefits of skin moisturization

Background/purpose: Skin hydration is essential for skin health. Moisturized skin is generally regarded as healthy and healthy looking. It is thus speculated that there may be appearance benefits of skin moisturization. This means that there are corresponding changes in the optical properties when skin is moisturized. Methods: The appearance of the skin is the result of light reflection, scattering and absorption at various skin layers of the stratum corneum, epidermis, dermis and beyond. The appearance benefits of skin moisturization are likely primarily due to the changes in the optical properties of the stratum corneum. We hypothesize that the major optical effect of skin moisturization is the decrease of light scattering at the skin surface, i.e., the stratum corneum. This decrease of surface scattering corresponds to an increase of light penetration into the deeper layers of the skin. An experiment was conducted to measure the corresponding change in skin spectral reflectance, the skin scattering coefficient and skin translucency with a change in skin hydration. In the experiment, skin hydration was decreased with the topical application of acetone and alcohol and increased with the topical application of known moisturizers and occlusives such as PJ. Result and conclusion: It was found that both the skin spectral reflectance and the skin scattering coefficient increased when the skin was dehydrated and decreased when the skin was hydrated. Skin translucency increased as the skin became moisturized. The results agree with the hypothesis that there is less light scattering at the skin surface and more light penetration into the deeper skin layers when the skin is moisturized. As a result, the skin appears darker, more pinkish and more translucent.     

The difference between the constitutive and facultative skin color does not reflect skin phototype in Asian skin

BACKGROUND/PURPOSE: The assessment of the sensitivity of human skin to ultraviolet (UV) radiation is important in the area of phototherapy, photodermatoses, photo-aging, photo-carcinogenesis, and photo-protection. Some reports have shown that quantitatively measured skin color is a good indicator for predicting UV sensitivity to human skin in Caucasians. In this study, our aim was to define the correlation between skin color and the skin phototype assessed by the Fitzpatrick method in Asian brown skin. METHODS: A total of 180 medical students with similar life styles were included in this study. Their skin phototype was classified according to the system introduced by Fitzpatrick. Then, using a Minolta Spectrophotometer CM-2002, their skin color was determined on the buttocks and forehead. The buttock color was taken as the constitutive skin color, and the forehead color as the facultative skin color. Using these measured values, we compared the skin color with the skin phototype to find their correlation. Also, we investigated whether the difference between the constitutive and facultative skin colors of each individual had a relationship with his or her skin phototype. RESULTS: The constitutive skin color became darker with increasing skin phototype, and this change was statistically significant. As for the facultative skin color, it also became darker with increasing skin phototype, but was less well correlated with the skin phototype than the constitutive skin color. However, the difference between the constitutive and facultative skin colors did not show consistent results in predicting the skin phototype. CONCLUSION: In this study, we found that the constitutive skin color can be a good indicator of the skin phototype. However, the difference between the constitutive and facultative skin colors of each individual does not give any meaningful information for the assessment of his or her skin phototype in Asian skin.     

Effect of skin pH for wrinkle formation on Asian: Korean,Vietnamese and Singaporean

Background Skin pH may be influenced by various factors, such as hydration of stratum corneum, rate of sebum excretion rate, transepidermal water loss (TEWL) and sweating in relation to skin ageing. Objective The aim of this study was to evaluate the correlation between skin pH and wrinkle formation that is directly related to ageing. In addition, we investigated the factors related to skin ageing by comparing the association between skin pH and other skin properties. Methods Three hundred volunteers were selected from three countries: Korea, Vietnam and Singapore. Hydration on the stratum corneum, the rate of sebum excretion rate, melanin index, TEWL and skin temperature on the cheek were measured in a controlled room, and wrinkle length and depth using replicas were compared with skin pH variation. Results The mean and standard deviation of skin surface pH among the three countries were 5.510 ± 0.625. The greatest gap of skin pH that revealed significant differences for skin properties was represented between the Koreans and the Vietnamese. For all three countries, skin hydration, melanin contents, wrinkle length, wrinkle depth and skin temperature were significantly correlated with skin pH. Factors related to skin moisturizing, such as skin hydration, sebum excretion rate and skin temperature, were negatively correlated with skin pH. Wrinkle length and depth decreased as skin pH became more acidic. Conclusions Skin properties displayed various values depending on skin pH. In particular, wrinkle formation significantly decreased as skin pH becomes more acidic. We conclude that skin pH is determined by skin properties, such as skin hydration, sebum excretion rate, melanin concentration, TEWL and skin temperature that affects wrinkle formation.     

辛辣食物影响咪唑烷基脲刺激皮肤的动物实验

目的观察辛辣食物对咪唑烷基脲皮肤刺激性的影响,为预防和诊治化妆品皮炎提供科学依据。方法将64只家兔随机分为对照组、酒精组、辣椒组、酒精+辣椒混合组,再将每组家兔进一步分为完整皮肤组和破损皮肤组,分别用0.6%咪唑烷基脲进行单次或多次皮肤刺激实验。并单次刺激皮肤24h及多次刺激皮肤(1次/d)7d后,予肉眼和组织病理评分。结果单次刺激皮肤后,酒精组和混合组破损皮肤出现皮肤刺激反应,该两组与对照组和辣椒组的差异有统计学意义(P均<0.05);多次皮肤刺激后,辣椒组、酒精组和混合组破损皮肤处出现轻、中和重度皮肤刺激反应,该3组与对照组相比,差异有统计学意义(P均<0.05)。各组单次和多次皮肤刺激反应大体和组织病理评分与各组辛辣物质家兔体征的评分之间显著相关(P<0.05)。结论食用辛辣食物会明显增强咪唑烷基脲的皮肤刺激性,且食用辛辣刺激食物越多,对皮肤刺激性越重。     

The colour of blood in skin: a comparison of Allen's test and photonics simulations

Background: The colour of the skin reflects many physiological and pathological states of an individual. Usually, the skin colour is examined by the bare eye alone. Several scaling systems have been developed to quantify the sensory evaluation of skin colour. In this work, the reflectance of the skin is measured directly using an objective instrument. Haemoglobin inside the dermal circulation is one of the key factors of skin colour and it also has a major role in the appearance of many skin lesions and scars. To quantitatively measure and analyse such conditions, the relation between the skin colour and the haemoglobin concentration in the skin needs to be resolved. Methods: To examine the effect of blood concentration on the skin colour, five Allen's tests were performed on 20 persons. The skin colour change was measured using a spectrophotometer by changing the blood concentration by the Allen's test. Light interaction with the skin was simulated with a Monte Carlo model, tuning the blood concentration parameter until the simulated and the measured spectra matched, yielding the relationship between the skin colour and the blood concentration. Results: The simulation produced spectra similar to those measured. The change in the blood concentration in the simulation model and in the skin produced changes similar to the spectra. The reflectance of the skin was found to be a nonlinear function of the blood concentration. Conclusion: The relationship found between skin colour and blood concentration makes it possible to quantify those skin conditions expressed by blood volume better than plain colour.     

Skin protection in bakers' apprentices

Skin protection measures - barrier creams, protective gloves - and skin care are widely recommended for the prevention of occupational hand dermatitis (HD) in skin risk professions, but there is hardly anything known about uptake levels of the measures. The objective of this controlled intervention study was to quantify the uptake and maintenance of skin protection and skin care measures in first-year bakers' apprentices. A total of 94 first-year bakers' apprentices were included in the study in September 2000. The apprentices were assigned to the skin protection and control group class-wise to reduce contamination. The skin protection group comprised 39 apprentices who were trained in skin protection measures at the beginning and after 4 weeks of training. 55 apprentices were assigned to the control group representing no skin protection intervention. Standardized interviews took place at the beginning of the training and at 4 monthly follow-ups (FU). The uptake of skin protection measures differed significantly between the groups (barrier cream p < 0.0001, protective gloves p = 0.046, skin care p = 0.025). Barrier cream use in the skin protection group was incorporated in the daily routine very well from the start and reached 100% at the end of the examination period (4th FU). At this time, only 3.2% of the controls used barrier creams. The level of acceptance of protective gloves (4th FU: skin protection group 43.3%; controls 32.3%) was considerably lower than that of barrier creams. The initial level of regular skin care was high in both groups (skin protection group 67.6%, controls 61.7%). After the intervention the acceptance of skin care rose to 88.9% in the skin protection group compared to 68.1% in the controls (4th FU). The present study has shown that skin protection and skin care measures can be introduced successfully in the daily routine of a skin risk occupation and high uptake and maintenance rates can be achieved.     

Stratum corneum hydration and skin surface pH in patients with atopic dermatitis

Atopic dermatitis (AD) is a chronically relapsing skin disease with genetic predisposition, which occurs most frequently in preschool children. It is considered that dryness and pruritus, which are always present in AD, are in correlation with degradation of the skin barrier function. Measurement of hydration and pH value of the stratum corneum is one of the noninvasive methods for evaluation of skin barrier function. The aim of the study was to assess skin barrier function by measuring stratum corneum hydration and skin surface pH of the skin with lesions, perilesional skin and uninvolved skin in AD patients, and skin in a healthy control group. Forty-two patients were included in the study: 21 young and adult AD patients and 21 age-matched healthy controls. Capacitance, which is correlated with hydration of stratum corneum and skin surface pH were measured on the forearm in the above areas by SM810/CM820/pH900 combined units (Courage AND Khazaka, Germany). The mean value of water capacitance measured in AD patients was 44.1 ± 11.6 AU (arbitrary units) on the lesions, 60.2 ± 12.4 AU on perilesional skin and 67.2 ± 8.8 AU on uninvolved skin. In healthy controls, the mean value was 74.1 ± 9.2 AU. The mean pH value measured in AD patients was 6.13 ± 0.52 on the lesions, 5.80 ± 0.41 on perilesional skin, and 5.54 ± 0.49 on uninvolved skin. In control group, the mean pH of the skin surface was 5.24 ± 0.40. The values of both parameters measured on lesional skin were significantly different (capacitance decreased and pH increased) from the values recorded on perilesional skin and uninvolved skin. The same held for the relation between perilesional and uninvolved skin. According to study results, the uninvolved skin of AD patients had significantly worse values of the measured parameters as compared with control group. The results of this study suggested the skin barrier function to be degraded in AD patients, which is specifically expressed in lesional skin.     

敏感性皮肤发病机制及其相关皮肤病的研究进展

敏感性皮肤常表现为皮肤受到轻微外界刺激后易产生不适感觉（包括潮红、瘙痒、烧灼、刺痛等）。敏感性皮肤发病机制主要涉及皮肤神经系统、皮肤屏障功能、皮肤血管系统、转录组学、反安慰剂效应等多方面。不少其他皮肤病（如特应性皮炎、玫瑰痤疮等）可伴敏感性皮肤的症状,易误诊误治。本文综述了敏感性皮肤的发病机制及相关皮肤病。