621例上海女性最小红斑量测定

目的 通过测定上海成年女性的最小红斑量,探讨并分析年龄和皮肤颜色对皮肤光敏性的影响程度.方法 测定上海某社区内621名健康女性的最小红斑量值,并选择窄谱分光光度仪对志愿者皮肤颜色进行测定,观察皮肤颜色与最小红斑量的相关性.结果 31～40岁女性MED中位数为39.04s,而41～50岁组和51～60岁组MED中位数均为24.99 s;31～40岁组的MI值和EI值与MED值相关系数分别为0.366和0.315,而年龄大的组别中其相关系数相对较小.结论 随着年龄增长,皮肤对紫外线敏感性增强,皮肤颜色与最小红斑量密切相关.

Abstract：

Objective To determinate the minimal erythema dose (MED) of adult females and to analyze the influence of age and skin color on skin photosensitivity. Methods MED was determined in 621healthy adult females in Shanghai region, and narrow-band spectrophotometer was used to detect the skin color of these subjects. The correlation between skin color and MED was assessed. Results The median MED was 39.04 in testees aged between 31 and 40 years, 24.99 in those aged between 41 and 50 years and in those between 51 and 60 years. The correlation indice were 0.366 and 0.315 between MI and MED and between EI and MED respectively in testees aged between 31 and 40 years, relatively higher than those in testees over 40 years of age. Conclusions The sensitivity of skin to ultraviolet rays increases with age, and there is a close relationship between the skin color and MED.     

浙江省339例迟发型白癜风临床分析

Objective To study clinical features and epidemiology of late onset vitiligo in Zhejiang province.Methods Using a standardized questionnaire,clinical analysis was carried out in 339 patients who developed vitiligo after 30 years of age(late onset)as well as on 758 patients developing vitiligo before 30 years of age(early onset)as control.The findings were analyzed by SPSS 16.0 software.Results There were 229 females and 110 males in the 339 patients with late onset vitiligo,while of the 758 patients with early onset vitiligo,375 were males and 383 females.In late onset vitiligo,the average onset age was 45.4±10.8 years with head and neck as the predilection sites.A significant increase was observed in the proportion of patients with upper limbs as the primary location in patients with late onset vifiligo than in those with early onset vitiligo(22.7%vs 12.9%,χ2=16.73,P<0.05).Compared with patients with early onset vitiligo,the prevalence of segmental vitiligo and localized vitiligo decreased (9.4%vs 20.1%,11.2% vs 16.5%,both P<0.05),while that of sporadic vifiligo and extremity vitiligo increased(57.8%vs 50.1%,16.8%vs 10.8%,both P<0.05)in those with late onset vitiligo.Of the patients with late onset vitiligo,252 (74.3%)were in progressive stage and 105(31.0%)suffered from leukotrichia.No significant difference was found in the prevalence of autoimmune or endocrine disorders between patients with late onset vitiligo and those with early onset vitiligo(8.8%vs 5.9%,P>0.05),while increased incidence of thyroid diseases and diabetes mellitus was noted in patients with late onset vitiligo(both P<0.05).A family history was observed in 31(9.1%)patients with late onset vitiligo and 97(12.8%)patients with early onset vitiligo(P>0.05).Compared with early onset vitiligo,late onset vitiligo was more vulnerable to environmental factors,and mental factors appeared to be the primary influencing factor.Conclusion There are some differences in clinical and epidemiological profiles between late onset vitiligo and early onset vitiligo.     

大连汉族414名正常人皮肤摩擦系数检测

目的 探讨大连汉族正常人皮肤摩擦系数是否与性别和年龄有关.方法 414名汉族志愿者参加本项研究,年龄2个月至79岁,男187例,女227例;平均年龄(35.80±1.33)岁.根据生长发育期将其分为3组:0～12岁为青春期前组;20～40岁为青壮年组;60～80岁为老年组.利用Courage-Khazaka多功能皮肤生理仪Frictiometer(R) FR 770 and Corneometer(R) CM 825探头分别测量不同部位皮肤摩擦系数和角质层的含水量(电容).结果 在男性,除老年组前额部位皮肤摩擦系数明显低于手背部位外(P＜0.05),在其他各年龄组中,各部位之间皮肤摩擦系数差异无统计学意义;而在女性,除青壮年组前额部位的皮肤摩擦系数明显低于手背和眼外眦部位外(P＜0.001),在其他各年龄组中,各部位之间皮肤摩擦系数差异也无统计学意义.在男性,同一部位各年龄组之间皮肤摩擦系数差异无统计学意义;然而在女性的前额部位,老年的皮肤摩擦系数明显大于青春期前和青壮年(P值均＜0.01);在女性的眼外眦和手背部位,青壮年的皮肤摩擦系数明显大于青春期前和老年(P值均＜0.01).除青壮年女性手背和眼外眦部位的皮肤摩擦系数明显大于男性外(P分别＜0.05和0.001),在其他各年龄组和各部位中,男女间皮肤摩擦系数差异无统计学意义.在青壮年男性,各部位皮肤摩擦系数与角质层的含水量呈正相关性(前额r=0.6342,P＜0.0001;眼外眦r=0.4501,P＜0.001;手背r=0.3627,P＜0.01);而在女性,仅老年前额和眼外眦的皮肤摩擦系数与角质层含水量呈正相关性(前额r=0.2797,P＜0.05;眼外眦r=0.486,P＜0.001).结论 汉族正常人皮肤摩擦系数与性别、年龄、部位及角质层含水量有关.

Abstract：

Objective To determine whether skin friction coefficient (SFC) is associated with gender and age in a normal Chinese Han population. Methods A total of 414 Chinese Han subjects including 187males and 227 females, who were aged from 0.15 to 79 years (mean age: 35.80 ± 1.33 years), were enrolled in this study. According to human development stages, subjects were divided into pre-puberty group (aged 0 - 12years), young group (aged 20 - 40 years) and old group (aged 60 - 80 years). SFC and stratum corneum capacitance were measured with A Frictiometer(R) FR 770 and Corneometer(R) CM 825 (C&K MPA 5), respectively,on the dorsal hand, forehead, as well as canthus. Results SFC was higher on the dorsal hand than on the forehead in old males (P ＜ 0.05 ), and higher on the dorsal hand and canthus than on the forehead in young females (both P ＜ 0.001 ), while no significant difference was observed between the three measured sites in other groups of females or males (all P ＞ 0.05 ). In males, SFC on each measured site was similar among the three groups. In contrast, SFC was significantly higher on the forehead of females in aged than in young and pre-puberty groups (both P ＜ 0.01 ), and on the canthus and dorsal hand of females in young than in pre-puberty and aged groups (all P ＜ 0.01 ). The SFC on the canthus and dorsal hands of young females was higher than that of age-matched males (P ＜ 0.0001 and 0.05, respectively). A positive correlation was found between SFC and stratum corneum hydration in young males (foreahead: r = 0.6342, P ＜ 0.0001; canthus: r = 0.4501, P ＜0.001; dorsal hands: r = 0.3627, P ＜ 0.01 ). Moreover, SFC on the forehead (r = 0.2797, P ＜ 0.05) and canthus (r = 0.486, P ＜ 0.001 ) was also positively correlated with stratum corneum hydration in old females.Conclusion Skin friction coefficient varies with age, gender, body sites and stratum comeum hydration in normal Han populations.     

基底细胞癌组织病理类型与性别、年龄及部位的相关性分析

目的 分析基底细胞癌(BCC)组织病理类型与性别、年龄及部位的相关性.方法 回顾性分析2000年1月到2009年4月共243例BCC的临床病理资料,应用SPSS 13.0软件对资料进行分析.结果 243例BCC中,男118例,女125例,男女比例为0.94:1;平均年龄(65.16±12.62)岁;好发于头颈部,占77.4%;结节型是最常见的病理类型,占53.9%,其次为浅表型和浸润-硬化型,分别占18.9%和18.5%.女性患者就诊年龄早于男性(P＜0.05).不同组织病理类型BCC的性别构成差异无统计学意义(P＞0.05).浅表型BCC好发于躯干部位,就诊年龄早于非浅表型,女性就诊年龄早于男性,差异均有统计学意义(P＜0.05).结节型、浸润-硬化型及微小结节型BCC好发于头颈部,就诊年龄较晚,男女患者就诊年龄无差异(P＞0.05).结论 不同组织病理类型BCC的临床特征不同,可能存在不同的发病机制.

Abstract：

Objective To analyze the relationship of histopathological subtypes of basal cell carcinoma (BCC) with gender,age and anatomical location of skin lesions.Methods The clinical and histopathological data on 243 cases of BCC collected from Jan 2000 to Apr 2009 were reviewed retrospectively.Data analysis was carried out by using SPSS 13.0 software.Results A total of 243 patients were included in this study,including 118 males and 125 females with the male/female ratio being 0.94:1.The average age of patients was 65.16 ± 12.62 years.Head and neck were the predilection (77.4%) sites of BCC in these patients.Nodular type (53.9%) was the most common type,followed by the superficial type (18.9%) and infiltrative-morphoeic (sclerosing) type (18.5%).The age at visit was younger in female patients than in male patients(P ＜ 0.05),no significant difference was observed in the gender composition among patients with different subtypes of BCC (P ＞ 0.05).Superficial BCC was more common on the trunk; the age at visit was younger in patients with superficial BCC than in those with other subtypes of BCC,and younger in female patients than in male patients (all P ＜ 0.05).Nodular,infiltrative-morphoeic and micronodular subtypes of BCC showed a predilection for the head and neck with an old age at visit,and no differences were observed in the age at visit between female and male patients with these subtypes of BCC (au P ＞ 0.05).Conclusions Different subtypes of BCC show different clinical features,which may be attributed to their different pathogenesis.     

月经期、妊娠期性生活

In order to investigate the sexual desire,coital frequency and sexual psychology during menstrual period and pregnancy,200 women of child-bearing age and 142 mothers were interviewed.The data for the women of child-bearing age revealed that 6.2% had no change in sexual desire during menstrual period,13% had increase in libido premenstruation,7% had marked increment in libido midmenstruation and 18% had hypereroticism postmenstruation;no one experienced hypoeroticism.97.5% abstained from sexual intercourse during menstrual period,while 2.5% had casual or occasional intercourse.The data for mothers revealed that coital frequencies before pregnancy were 6-7 times/week in 3.5% of subjects,4-5times/week in 7.7%,2-3 times/week in 53.5%,once/week in 26.8%.once/two weeks in 7.7%,and once/1-3months in 0.8%,while 88.7% had a tendency of decrease in coital frquency during each of the three trimesters of gregnancy,and 11.3% had no sexual intercourse at all during all the course of pregnancy.The decline in sexual activity was due to the following reasons:a)the woman‘s fears of abortion,premature labor,“inflammation“ and physical disomfort associated with intercourse in 97.9% of cases;b)reduced libido during pregnancy in 1.4%;and c) the husband‘s sexual dysfunction in 0.7%.The mother‘s incidence reta postpartum and the child‘s perinatal fatality rate and incidence rate were zero percent in toth the women who had sexuality during pregnancy and those who had not,there being no difference between the two groups.     

Excellent long term patient and renal allograft survival after ABO-incompatible kidney transplantation:Experience of one center

AIM: To investigate the long-term results of ABOincompatible(ABOi) kidney transplantation in a single center in Greece.METHODS: Thirty consecutive ABOi kidney transplantations were performed from June 2005 to December 2013. All patients received rituximab one month prior to transplantation. Immunoadsorption therapy was performed for the removal of anti-A/B Ig G antibodies until the titer was ≤ 1:16. Additional apheresis sessions were performed post-operatively. Intravenous immunoglobulin and oral immunosuppression consisting of tacrolimus(TAC) in combination with either everolimus or mycophenolate acid was administered. We compared the long term results of our ABOi group to those of a matched group of 30 ABO compatible(ABOc) living kidney recipients with similar baseline characteristics. The ABOc recipients received an immunosuppressive regimen consisting of TAC and mycophenolate acid. All patients in both groups received induction therapy with Basiliximab or Daclizumab, whereas corticosteroids were instituted on the day of surgery. During the followup period, indication biopsies were performed and interpreted by an experienced nephropathologist. The parameters we analyzed included the following: Donor/recipient age, gender, blood type, human leukocyte antigen mismatches, panel reactive antibodies, primary cause of renal failure, mean time on dialysis, immunosuppressive regimen, patient survival, graft outcome, incidence of rejections, surgical and infectious complications.RESULTS: The mean follow-up period was 6 years(range 1 to 9 years). A mean of 5.0 ± 3.0(range 0-14) pre-transplant immunoadsorptions were required in order to reach the target titer. Patient survival in ABOi group in comparison to ABOc group at 1, 3, 5 and 8 years did not differ significantly(100% vs 100%, 96% vs 100%, 92% vs 100% and 92% vs 100%, P = ns). Additionally, graft survival was similar in the two groups at the same time points(100% vs 100%, 96% vs 96%, 92% vs 96% and 81% vs 92%, P = ns). The mean serum creatinine and the estimated glomerular filtration rate by the modification of diet in renal disease formula at 1, 3, 5 and 8 years did not differ significantly between ABOi and ABOc group. None of the patients in the ABOi group developed acute or chronic antibodymediated rejection evidenced by histological signs. Four patients(13.3%) in the ABOi group and 3(10%) in the ABOc group experienced acute cellular rejection, which was treated successfully in all cases. Bacterial and viral infections were also similar between the two groups.CONCLUSION: ABOi kidney transplantation is a safe and effective alternative that enables kidney transplantation in countries with unacceptably long deceaseddonor waiting lists.     

辽宁地区531例寻常性银屑病患者临床流行病学调查

目的 探讨寻常性银屑病的临床流行病学特征.方法 采用统一设计的临床流行病学调查问卷,应用EpiData3.1和SPSS13.0程序软件进行数据处理与分析.结果 531例寻常性银屑病患者中男女比例为1.31:l;患者的平均首次发病年龄为(25.7±13.1)岁;皮损表现以点滴状银屑病居多(49.5%),发病部位以下肢为首;有家族史者发病年龄早于无家族史者(P＜0.05);病情加重季节主要为春季和冬季.结论 寻常性银屑病的发生无性别差异,环境与遗传因素在寻常性银屑病的发生、发展中起重要作用.

Abstract：

Objective To describe the clinical and epidemiological characteristics of psoriasis vulgaris in Liaoning region.Methods Five hundred and thirty-one outpatients with psoriasis vulgaris were surveyed by using a consensusly-designed questionnaire.EpiData3.1 and SPSS13.0 statistical softwares were used for data analysis.Results In the 531 patients with psoriasis vulgaris, the male to female ratio was 1.31: 1, and the average age at the first onset was 25.7±13.1 years.Guttate lesions were the commonest clinical manifestation,and observed in 49.5% of these patients.Lower limbs seemed to be the predilection site.The age at onset was younger in patients with family history than in those without(22.5±12.6 years vs.26.9 + 13.2 years, t=3.437,P＜ 0.05).The exacerbation of psoriasis vulgaris often occurred in winter or spring.Conclusions There seems no gender difierence in the development of psoriasis vulgaris, environmental and genetic factors appear to play an important role in the initiation and development of psoriasis vulgaris.     

Alleviating Skin Barrier Disruption,Skin Inflammation,and Pruritus: A Moisturizing Spray Containing β-Glucan and Panthenol

Objective: Inflammatory skin diseases were proved to be associated with dry skin-induced pruritus. However, the relationship between skin inflammation, skin barrier function, and pruritus remains unclarified. The present study aimed to explore this relationship using an acetone-ether-water (AEW) mouse model, and to investigate the anti-itch effects of the combined application of β-glucan and panthenol in a moisturizing spray in this mouse model.Methods: A dry skin-induced chronic pruritus mouse ...     

准分子激光治疗白癜风的临床疗效与安全性研究

Objective To assess the efficacy and safety of 308 nm excimer laser in the treatment of different types of vitiligo at different stages. Methods A total of 128 patients with vitiligo, who had 317 depigmented patches, were recruited in this study and treated with 308 nm excimer laser once a week for at least 8 weeks. The degree of repigmentation was evaluated and adverse effects were recorded at the end of every treatment and last treatment. Results All patients received efficacy and safety evaluation. Of the 317 patches, 97.5% achieved repigmentation at different degrees, 71.8% got more than 25% repigmentation, and 50.8% got more than 75% repigmentation. The degree of repigmentation increased with the number of treatments. A better response was observed in the lesions on the face and neck than those on the mink and limbs, and in short-duration (<1 year) lesions than in long-duration (≥1 year) lesions. And the lesions on extremities and mueosa showed a poorer response compared with those at other sites. There was no statistical difference in clinical efficacy between active vitiligo and stable vitiligo, or between adults and children. Moreover, the treatment was well tolerated. Conclusion 308 nm excimer laser is effective in the treatment of vitiligo with rapid onset, favorable tolerability and few adverse effects.     

A study of diurnal variation in wrinkles on the human face

We recently evaluated diurnal variations in facial skin elasticity and thickness and reported a decrease in skin thickness and an increase in skin elasticity in the afternoon compared with the morning. This phenomenon may be associated with the effect of gravity on dermal fluids. There have been no reports on the diurnal variation in wrinkles on the face, and we now describe such a study. The subjects of this study included 38 healthy Japanese males and females (mean age 34 years). Wrinkles on their foreheads, in the corners of their eyes and in their nasolabial grooves were evaluated. Replicas were obtained and skin thickness and skin elasticity measured in the morning (0830–1000 hours) and in the afternoon (1530–1700 hours) of the same day. Image analysis of the replicas showed significant aggravation of wrinkles in all areas of the face in the afternoon compared with the morning. The results of skin thickness and skin elasticity were in agreement with those of our last study. Swelling tended to occur in the morning due to the effects of gravity during sleep. Therefore, wrinkles may be swollen in the morning. Furthermore, repeated movements of the face due to changes of facial expression may gradually increase wrinkle formation and depth from the morning to the afternoon.     

From skin microrelief to wrinkles. An area ripe for investigation

Skin microrelief alters progressively with age. Wrinkles do not result from these changes but are superimposed upon them. Wrinkles result from structural changes in the epidermis, dermis and hypodermis. Four types of wrinkles can be recognized. Type 1 wrinkles are atrophic. Type 2 wrinkles are elastotic. Type 3 wrinkles are expressional. Type 4 wrinkles are gravitational. Each type of wrinkle is characterized by distinct microanatomical changes and each type of wrinkle develops in specific skin regions. Each is likely to respond differently to treatment. Skin microrelief and skin folds can be identified on histological examination. By contrast, only minimal dermal changes are found beneath permanent or reducible wrinkles compared with immediately adjacent skin. A series of objective and non-invasive methods is available to quantify the severity of wrinkling.     

Cutaneous photodamage in Koreans: influence of sex, sun exposure, smoking, and skin color

BACKGROUND: Severe wrinkles and pigmentary changes of the exposed skin indicate substantial damage due to UV radiation. Many investigators believe that the principal manifestation of photodamage in Asians is pigmentary change rather than wrinkles. However, to our knowledge, no well-designed study has investigated the characteristics of cutaneous photodamage in Asian skin. OBJECTIVE: To access the severity of wrinkles and dyspigmentation in Koreans exposed to sun and who smoked. METHODS: We developed new photographic scales for grading wrinkles and dyspigmentation in 407 Koreans to assess the severity of the wrinkles and dyspigmentation. We interviewed subjects to determine cumulative sun exposure and smoking history, and measured the skin color of individual subjects. RESULTS: Our photographic scales provided a reliable evaluation of photodamage severity in Koreans. The pattern of wrinkling in both sexes is similar, but women tended to have more severe wrinkles (prevalence odds ratio, 3.7). However, the pattern of dyspigmentation differed between the sexes. Seborrheic keratosis is the major pigmentary lesion in men, whereas hyperpigmented macules are the prominent features in women. Cigarette smoking is an independent risk factor for wrinkles, but not for dyspigmentation, in Koreans, and causes additive detrimental effects to wrinkles induced by aging and sun exposure. The constitutive skin color did not show any correlation with wrinkles or dyspigmentation. However, facultative pigmentation (sun exposure index) may reflect lifetime sun exposure, and it shows a good correlation with wrinkles in Koreans. CONCLUSION: Wrinkling is a major feature of photoaging in Koreans, as are pigmentary changes; smoking, sun exposure, and female sex are independent risk factors for wrinkles.     

Comparison of age-related changes in facial wrinkles and sagging in the skin of Japanese, Chinese and Thai women

BACKGROUND: Differences in skin aging features between Asians and Caucasians are commonly known, whereas little is known about such differences in various Asian populations. OBJECTIVE: A survey was carried out in Tokyo, Shanghai and Bangkok to identify specific features of skin aging in each population and to evaluate whether our conventional photo scale is an appropriate tool for this type of comparative study. METHODS: Eighty-seven women residing in Tokyo, 100 women residing in Shanghai, and 90 women residing in Bangkok were examined by a specialist. Facial wrinkles (forehead, glabella, upper eyelid, crow's feet, lower eyelid, cheek, nasolabial groove and mouth corner) and cheek sagging were evaluated using photo scales previously obtained from Japanese subjects. Comparisons were made according to 10-year age groups. RESULTS: Women in Bangkok showed the most severe level of wrinkles, followed by those in Shanghai in the three groups. Significant differences were observed between Thai and Japanese women in the intensity of wrinkles at many facial sites. Chinese women had significantly more severe wrinkles in the area around the eyes compared to Japanese women, while Thai women had significantly more severe wrinkles in the lower halves of their faces compared to Chinese women. In cheek sagging scores, significant differences were observed between Japanese and Thai women in their 30s and 50s, but not between Japanese and Chinese women or between Chinese and Thai women in all age groups. CONCLUSION: These results indicate variations in skin aging features among women from three Asian cities thereby suggesting the diversity of Asian skin. Our scaling method proved to be appropriate for facial wrinkles, but required modification to compare cheek sagging among Asian populations.     

Effect of pregnancy and menopause on facial wrinkling in women

Women appear to be at greater risk of developing wrinkles with age than men. To evaluate the effect of pregnancy and menopause on facial wrinkling, a total of 186 Korean women volunteers aged between 20 and 89 years were interviewed for information on menstrual and reproductive factors. An 8-point photographic scale developed for assessing the severity of wrinkles in Asian skin was used. Cumulative sun exposure, both occupational and recreational, was estimated. In Korean women, the risk of facial wrinkling increases significantly with increasing number of full-term pregnancies (OR = 1.835, 95% confidence interval (CI) 1.017-3.314) and menopausal age (number of years since menopause) (OR = 3.909, 95% CI 1.071-14.275), while hormone replacement therapy is associated with a significantly lower risk for the development of facial wrinkling in postmenopausal women (OR = 0.221, 95% CI 0.047-0.949). Hypo-oestrogenism may play a part in the decrease of skin collagen leading to skin wrinkling in postmenopausal women.     

Age-related changes in skin wrinkles assessed by a novel three-dimensional morphometric analysis

BACKGROUND: A system has been developed whereby the morphology of the skin surface can be evaluated directly in three dimensions. This system employs a non-invasive device that utilizes white light of halogen origin, and which allows the computation of wrinkle depth and width, and other parameters of skin surface morphology. Using innovative engineering, an optical system has been devised so that light is transmitted via a slit and can be used to measure not only replicas of the skin but also the skin surface directly. The measurement area is 6.4 x 6.4 mm, and the theoretical resolution with a x 50 magnification lens is within 12.5 micro m. OBJECTIVES: To use this system to study age-related changes in the morphology of wrinkles at the eye corner areas of women of varying ages. METHODS: One hundred and one healthy women (age range 20-80 years) residing in the Tokyo area were the subjects used in this study. RESULTS: Wrinkles demonstrated a rapid increase in depth in women aged 40 years or older, and plateaued at the age of 60 years. Surface morphology parameters yielded results similar to those of age-related changes in wrinkles. CONCLUSIONS: This new analytical system provides a rapid and convenient non-invasive method to evaluate skin surface morphology in three dimensions, especially with respect to wrinkle formation. The results obtained using this system provide a deeper insight into the mechanistic relationship between wrinkles and skin elasticity.     

Skin ageing: a comparison between Chinese and European populations. A pilot study

BACKGROUND: Although limited data are available, it is commonly considered that Europeans and Asians have different skin ageing features. OBJECTIVES: The present studies have been carried out to evaluate the influence of age and sun-exposure on the main clinical signs of Asian skin ageing. METHODS: One hundred and sixty Chinese and 160 French age-matched women (age range: 20-60 years old) were clinically examined and scored by the same dermatologist. Facial wrinkles (crow's-feet, glabella and perioral wrinkles) and pigmented spots (on face and hands) were assessed in situ and standardized photographs of the face were taken. Lifelong sun-exposure was estimated from answers to a questionnaire. Comparisons were made between 10-year age groups. RESULTS: Results show that, for each facial skin area, wrinkle onset is delayed by about 10 years in Chinese women as compared to French women. Facial wrinkling rate over the years is linear in French women and not linear in Chinese women who appear to experience a fast ageing process between age 40 and 50. Pigmented spot intensity is a much more important ageing sign in Chinese women (severe for 30% of women over 40) than in French women (severe for less than 8% of women, irrespective of age). CONCLUSION: These first results underline that main skin ageing features (wrinkles, spots) progress differently in the Chinese and French women we have studied. They require to be confirmed on broad multicentre studies involving larger cohorts.     

New wrinkles on wrinkling: an 8‐year longitudinal study on the progression of expression lines into persistent wrinkles

Background While cumulative lifetime sun exposure is well recognized as having an important role in the progression of facial wrinkling, the role of facial expression has largely been overlooked, in part due to the lack of comprehensive longitudinal data on the change in both expression lines and persistent wrinkles with age. Objectives To track the detailed pattern of facial wrinkling in the same group of people over several years and to verify that expression lines evolve into persistent wrinkles. In addition, to identify factors predictive of a faster or slower rate of wrinkling. Methods Standardized images were captured at baseline and at 8 years of 122 women (ages 10–72 years, skin types I–VI) with and without a smiling expression. The wrinkle pattern with expression at baseline was compared with the pattern without expression at 8 years. Severity of facial wrinkling was quantified using computer‐based image analysis. Skin colour, hydration, sebum and pH were measured at baseline. A structured questionnaire captured demographic and lifestyle data at baseline and at 8 years. Results Each subject’s unique pattern of persistent facial wrinkling observed without expression at year 8 was predicted by the pattern of lines observed with a smiling expression at baseline. Having a drier, more alkaline stratum corneum, a lighter complexion, being middle‐aged (40s) or becoming menopausal were associated with faster persistent wrinkling. Conclusions Repeated skin flexure during facial expression causes persistent wrinkles. The pattern of expression lines predicts the pattern of future persistent wrinkles. Certain intrinsic and extrinsic factors are not causative, but influence the rate, of facial wrinkling.     

Is skin ageing in the elderly caused by sun exposure or smoking?

BACKGROUND: There is little clear evidence of a strong association between cumulative sun exposure and skin wrinkling. Contradictory findings also exist on the association between facial wrinkling and smoking status. OBJECTIVES: To identify the significant determinants of skin wrinkling in a cohort of older subjects and to assess whether skin wrinkling can be used as an objective measure of cumulative sun exposure. METHODS: This study was carried out in the South Glamorgan health district, Wales, U.K., between 1988 and 1991. A random sample of 792 older subjects (60 years and over) was obtained from the Health Authority register of patients registered with general practitioners. A range of phenotypic and environmental data was collected during a home visit by interview and examination by an experienced dermatology research fellow. Skin wrinkling/ageing was assessed by examining the face, neck and dorsum of the hand and scored on a 10-point ordinal scale. Cumulative sun exposure was assessed by asking subjects to estimate their average outdoor time during each of three periods of adult life. This measure showed acceptable repeatability (r = 0.64 for estimates obtained 1.4 years apart). RESULTS: The response rate was 71% and the mean age of participants was 71 years. The mean +/- SD skin ageing score was 5.5 +/- 1.5. In multiple logistic regression models only age and daily cigarette consumption were significantly associated with skin ageing. Cumulative sun exposure was significant on univariable analysis but this effect was removed by adjusting for age. Smoking 20 cigarettes per day was equivalent in effect to almost 10 years of chronological ageing. CONCLUSIONS: Smoking is an important determinant of macroscopic skin ageing/wrinkling in older subjects. This evidence suggests that skin ageing does not clearly provide an objective measure of cumulative ultraviolet exposure, and caution should be exercised before it is used in this way. The association between smoking and wrinkling provides important information for potential use in education campaigns to reduce smoking prevalence among young people.     

Association between smoking and cutaneous ageing in a Brazilian population

Objective This study aims to determine the relationship between smoking and cutaneous ageing. Methods A cross‐sectional study was carried out on 301 subjects (191 women and 110 men, aged between 25 and 86 years), of which 165 were non‐smokers and 136 were smokers and ex‐smokers. The association between tabagism and cutaneous ageing was controlled for other variables (solar exposure, age, skin phototype, sex, sunscreen use, alcohol consumption, coffee consumption, sports participation, body mass index, and history of relatives with precocious ageing). Results Analysis revealed that age, chronic solar exposure, skin phototype and tobacco load significantly contributed to the formation of facial wrinkles. The larger the tobacco load, the larger was the amount of facial wrinkling, with an odds ratio of 3.92 in ‘heavy’ smokers (> 40 packs/year) in relation to non‐smokers. Conclusion The results of this study point to smoking as one of the main factors involved in facial wrinkling. The relationship between smoking and cutaneous ageing is an important element in educational campaigns against tabagism.