Antioxidants used in skin care formulations

The formation of free radicals is a widely accepted pivotal mechanism leading to skin aging. Free radicals are highly reactive molecules with unpaired electrons that can directly damage various cellular structural membranes, lipids, proteins, and DNA. The damaging effects of these reactive oxygen species are induced internally during normal metabolism and externally through various oxidative stresses. The production of free radicals increases with age, while the endogenous defense mechanisms that counter them decrease. This imbalance leads to the progressive damage of cellular structures, and thus, results in accelerated aging. Antioxidants are substances that can provide protection from endogenous and exogenous oxidative stresses by scavenging free radicals. Topical antioxidants are available in multivariate combinations through over-the-counter skin care products that are aimed at preventing the clinical signs of photoaging.     

Sarcoid granulomas of the skin produced by acrylic and nylon fibres

The introduction into the skin of organic or inorganic substances can produce sarcoid-like granulomas. Two new granulomas of this type are described related to acrylic and nylon fibres. The aetiological diagnosis of such lesions can be confirmed by the identification of these synthetic materials within the-granuloma cells, using histochemical techniques used in the textile industry. An ‘individual factor’, probably immunological in nature, may be implicated.     

Die kutane Mikrodialyse Anwendung in der Dermatologie

The determination of concentrations of exogenous or endogenous substances in the dermis, e.g. for pharmacokinetic studies, is technically difficult. Performing skin biopsies or inducing suction blisters results in the disintegration of the tissue and allows only single measurements. Recently, cutaneous microdialysis, a new simple and minimally invasive technique for continuously measuring of substances in the dermis in vivo, has been introduced in dermatological research. According to the principle of dialysis, a semipermeable membrane is inserted in the dermis and due to a concentration gradient between the interstitial space and a perfusate, substances diffuse through the pores of the membrane and can be analyzed in the dialysate. Cutaneous microdialysis represents a useful technique for pharmacokinetic or pharmacodynamic studies as well as for investigations regarding cutaneous physiology and pathophysiology.     

Detection of papillomavirus common antigens in lesions of skin and mucosa

HPV infections are associated with many proliferative lesions of cutaneous and mucosal squamous epithelium. PV genus-specific (common) antigens can be detected by immunocytochemical techniques in approximately 50% of lesions (warts and papillomas) without dysplastic changes. Dysplastic lesions of squamous epithelium are less likely to be permissive for viral expression: squamous neoplasias are rarely, if ever, productively infected. Almost any tissue that has been processed for pathology or exfoliative cytologie preparations can be reliably stained for the presence of papillomavirus common antigens. A positive staining reaction is interpreted as meaning that the lesion is associated with HPV infection and that it has a potential for being contagious.     

Mucocutaneous Splendore-Hoeppli phenomenon

Splendore-Hoeppli phenomenon (asteroid bodies) is the in vivo formation of intensely eosinophilic material (radiate, star-like, asteroid or club-shaped configurations) around microorganisms (fungi, bacteria and parasites) or biologically inert substances. This study presents a literature review concerning Splendore-Hoeppli reaction in the mucocutaneous diseases. It examines the histopathological features, nature and differential diagnosis of this reaction. It also discusses the mucocutaneous infections and the non-infective diseases associated with it. Available studies indicate that several mucocutaneous infections can generate Splendore-Hoeppli reaction. The fungal infections include sporotrichosis, pityrosporum folliculitis, zygomycosis, candidiasis, aspergillosis and blastomycosis. The bacterial infections include botryomycosis, nocardiosis and actinomycosis. The parasitic conditions include orbital pythiosis, strongyloidiasis, schistosomiasis and cutaneous larva migrans. In addition, Splendore-Hoeppli reaction may be seen with non-infective pathology such as hypereosinophilic syndrome and allergic conjunctival granulomas. The Splendore-Hoeppli reaction material comprises antigen-antibody complex, tissue debris and fibrin. Although the exact nature of this reaction is unknown, it is thought to be a localized immunological response to an antigen-antibody precipitate related to fungi, parasites, bacteria or inert materials. The characteristic formation of the peribacterial or perifungal Splendore-Hoeppli reaction probably prevents phagocytosis and intracellular killing of the insulting agent leading to chronicity of infection. To conclude, Splendore-Hoeppli reaction is a tell tale of a spectrum of infections and reactive conditions. The molecular pathways involved in the development of this reaction are open for future investigations.     

Changes of epidermodysplasia verruciformis in benign skin lesions: the EV acanthoma

Foci of histological changes of epidermodysplasia verruciformis (EV) were noted in five benign skin lesions. These skin lesions included an intradermal nevus, a pigmented seborrheic keratosis, an isolated papule on the forearm, a perianal lesion, and an acantholytic acanthoma. Because the changes resembled true EV so strongly despite the absence of clinical EV in these patients, we searched for EV-human papilloma virus (HPV) types in these skin lesions. Polymerase chain reaction (PCR) analysis on the formalin-fixed, paraffin-embedded blocks was performed. As a positive control, we included tissue from two HIV-positive patients with clinical EV proven by biopsy. Studies were also performed on five other archived biopsies that did not show changes of EV on multiple tissue sections. A nested PCR method detected EV-HPV types in three of the five benign skin lesions showing EV changes as well as in the positive controls. EV changes and EV-HPV can be found incidentally on biopsy in the absence of clinical EV; when such changes are the major histopathological finding in an isolated skin lesion, the lesion should be termed an EV acanthoma.     

Tumoral calcinosis in scleroderma

A 36-year-old female patient with scleroderma/Sjögren's syndrome developed multiple cystic tumors on the dorsal aspect of her left hand, right elbow, and left shoulder joint two years after the onset of scleroderma. Histologically, amorphous eosinophilic substances located in subcutaneous tissue showed a strong positive reaction to PTAH and rosindole stain, and focal positive reaction to Von Kossa stain. Rheumatoid rice body like substances with chalky fluid were discharged from tumoral lesions. From these results, this case was diagnosed as tumoral calcinosis secondary to connective tissue degeneration due to the pathogenetic mechanism underlying scleroderma/Sjögren's syndrome.     

Hypertrophic allergic contact dermatitis from hair dye

We report a case of hypertrophic allergic contact dermatitis probably due to p-phenylenediamine (PPDA) in a 26-year-old female, which developed at the sites of application of a black hair dye to the skin. Histological examination revealed an eczematous process. The lesions subsided completely except for leukoderma that remained on the leg. Patch tests showed positive reactions to PPDA, p-aminophenol and Disperse Orange 3. PPDA, which was one of the components of the dye, was considered to be the primary sensitizer because it was the only substance able to reproduce at the patch test site both the hypertrophic pattern and the permanent leukoderma found in the patient's lesions. To explain the difference in reaction between PPDA and the other 2 para-group substances, we speculate that they are due to different quantities of reactive intermediates, oxidation products and free radicals, produced by these substances.     

Post-traumatic eczema

Thirteen cases of eczema that followed acute cutaneous trauma were observed. On the basis of the present case series, the following conclusions may be drawn: 1. Cutaneous trauma may precipitate eczema. 2. The trauma is sufficient to cause obvious tissue damage accompanied by an inflammatory or regenerative response. 3. Eczema usually begins within a few weeks of acute injury at the site of the cutaneous trauma. 4. Eczema may occur as an isolated idiopathic reaction or as an isomorphic reaction either preceding or following the appearance of an endogenous eczematous condition in nontraumatized skin. 5. Individual lesions of post-traumatic eczema may persist or recur for long periods of time. 6. The occurrence of post-traumatic eczema following occupational injury has important medicolegal implications.     

INVESTIGATIONS INTO THE PATHOGENESIS OF ACUTE CUTANEOUS ANGIITIS

SUMMARY.– In this study of necrotizing (polymorphonuclear) angiitis, immunoglobulins and complement are often traceable in and about the superficial dermal blood vessels, serum immunoglobulins are raised, and during cropping of the lesions the serum complement may be low.
The commoner lymphocytic angiitis differs in that abnormalities of serum immunoglobulins and of organ-specific and non-specific circulating antibodies are seldom found.
Three experimental varieties of polymorphonuclear angiitis are considered in the pathogenesis of necrotizing angiitis:
(1) The Arthus reaction with circulating antibodies of high specificity to the antigen; (2) The local Shwartzman reaction, probably a non-immune phenomenon but triggered by endotoxin release, immune complexes, and other non-specific materials; and (3) Circulating immune complexes sludging out in vessels where the flow of blood is sluggish. Clinical and experimental data implicate each of these.
Some contributions of individual cell types other than polymorphonuclear cells and lymphocytes in the angiitic infiltrate are mentioned: the mast cell may not be degranulated; the red cell may be inert; the eosinophil's role remains mysterious; the platelet probably provides vasoactive substances and encourages early fibrin deposition.
For the rash of necrotizing angiitis to develop, perhaps a specific Arthus type reaction initiates the process in the cutaneous vessels and then the inflammatory response is perpetuated by non-specific factors as in the local Shwartzman reaction.     

Immunohistochemical study of lysozyme in lupus miliaris disseminatus faciei

The lysozyme activity in tissue samples from patients with lupus miliaris disseminatus faciei (LMDF), sarcoidosis and foreign body granuloma was investigated using the immunoperoxidase technique. The majority of epithelioid cells and giant cells in LMDF and sarcoidosis showed strong lysozyme staining in their cytoplasm. However, most macrophages and giant cells in foreign body granulomas, including granulomatous reactions to epidermal cysts and other foreign materials, stained weakly for lysozyme or were negative. These results suggest that LMDF is different from the foreign body reaction to inert substances, and may be induced by an immunological mechanism associated with cell-mediated immunity.     

Inflammatory and neoplastic lesions of penile gland and periglandular regions

Lesions of the male external genitalia have always been a source of great concern to those affected. In unprecedented fashion, mostly as a result of the education received through the mass media, the public's anxiety has reached its zenith. Professional advice is being sought for any recently discovered scratch or mark for fear it may herald the onset of a socially unacceptable lesion or a disease with no known cure, ie, herpes, AIDS. Penile lesions not routinely seen by the practicing physician may be overlooked or considered inconsequential and thus result in improper treatment or the lack of treatment where it may otherwise have been indicated.A chapter devoted to penile lesions can be quite extensive, and limitations must be placed. It is our purpose to familiarize the reader with several important lesions that may be encountered in general clinical practice. Many of these lesions are of unknown etiology and equally have no known effective treatment. Oftentimes, a properly informed physician need do no more than reassure the patient in order to alleviate his fears.     

Granuloma from liquid silicone

In recent years, the demand for cosmetic interventions to augment soft tissue by injecting different substances has increased, due to their apparent innocuity. However, these procedures are not free from adverse reactions, such as the formation of foreign body granulomas, a phenomenon described in literature with most of the materials used. We report the case of a female patient with inflammatory lesions of the face, whose diagnosis was made after the histopathological study, which revealed a granuloma caused by liquid silicone.     

ROSACEA-LIKE DERMATITIS: CONTRAINDICATION OR INTOLERANCE, REACTION TO STRONG STEROIDS

Summary.— Data for 9 selected patients were used to show that rosacea-like dermatitis (RLD) is to be regarded as an intolerance reaction of seborrhoeic skin to topically-applied strong corticosteroids, such as betamethasone valerate and fluocinolone acetonide. A comparison of the geographical ranges of RLD and the use of strong corticosteroids shows that, in all countries considered, strong corticosteroids had been introduced long before RLD was observed. RLD can be cured by use of a powder suspension that is free from corticosteroids or fatty substances.     

Contact allergy caused by new dental impression materials]

In 1965 a new group of polymeric materials has been introduced into dentistry which is used for temporary crowns, bridges and impression materials. In handling it contact may occur with all components of these impression materials (Scutan, Impregum). Contact over a long period may lead to allergic contact dermatitis. Epicutaneous tests in three dentists and a technical assistant revealed that the catalysts of the impression materials are responsible for contact allergy. In experiments with guinea pigs the strong sensitization capacity of the catalysts could be demonstrated. Methyl-dichlorbenzolsulfonat (catalyst of Impregum) showed a stronger effect than methyl-p-toluolsulfonat (catalyst of Scutan). Besides their allergenic properties these substances also act as primary irritants. As these materials are widespread in dentistry more attention should be payed at the risk of hand eczemas in dentists and dental personnel caused by the catalysts of Impregum and Scutan.     

Contact dermatitis in military personnel

Military personnel encounter the same allergens and irritants as their civilian counterparts and are just as likely to develop contact dermatitis from common exposures encountered in everyday life. In addition, they face some unique exposures that can be difficult to avoid owing to their occupational duties. Contact dermatitis can be detrimental to a military member's career if he or she is unable to perform core duties or avoid the inciting substances. An uncontrolled contact dermatitis can result in the member's being placed on limited-duty (ie, nondeployable) status, needing a job or rate change, or separation from military service. We present some common causes of contact dermatitis in military personnel worldwide and some novel sources of contact dermatitis in this population that may not be intuitive.     

Risk factors for the development of primary cutaneous melanoma

Melanoma is an important public health problem in the United States and worldwide. The incidence of melanoma continues to increase at a high rate and deaths from melanoma are also increasing. The endogenous risk factors that are currently recognized are in many cases surrogates for genetic markers yet to be determined. Exogenous risk factors need to be better defined and understood to help develop better public education programs that can change risk behaviors and subsequently lower future incidence and mortality from melanoma.     

Three Cases of Linear Lichen Planus Caused by Dental Metal Compounds

Three cases of linear lichen planus on the lower extremities unaccompanied by mucous lesions are described. Dental metal compounds were thought to be the precipitating factor in all cases. Skin lesions did not respond to topical steroid ointment or antihistaminies. Two cases showed a positive patch test reaction to gold (HAuCl₄) and a positive lymphocyte stimulation test to gold compound (Gold sodium thiomalate). One case showed a positive patch test reaction to mercury (HgCl₂), but a negative lymphocyte stimulation test. Suspected metal compounds were demonstrated in their dental materials. Removal of gold materials in one case gradually improved the lesions within 6 months with a transient erythematous swelling of the face shortly after removal of the metal. Both of these cases responded to oral disodium chromoglycate therapy. These results suggest that metal compound specific T cells might be responsible for the development of linear lichen planus.     

Novel method of minimally invasive removal of large lipoma after laser lipolysis with 980 nm diode laser

Lipomas are the most common benign tumor of the soft tissue, often presenting as soft, mobile subcutaneous masses. These lesions are often removed for cosmetic reasons, although they may be removed secondary to considerable discomfort or paresthesias. The large majority of lipomas appear as small, solitary lesions that are best removed by surgical excision. However, surgical removal of large (>10 cm) or multiple lesions may result in significant scarring. Tumescent local anesthesia and liposuction of larger lesions has been successful in a number of cases although this technique can be hindered by overly fibrous lesions. Laser lipolysis, performed alone or before liposuction, can further facilitate removal of these lesions. This technique is a minimally invasive and effective method of lipoma removal, resulting in an excellent cosmetic outcome. This report describes step-by-step removal of a large lipoma located on the back, as well as a review of currently employed techniques for minimally invasive treatment of lipomas.