101
|
Maotsela T, Danha G, Muzenda E. Utilization of Waste Cooking Oil and Tallow for Production of Toilet “Bath” Soap. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.promfg.2019.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
102
|
Sim JK, Ahn B, Doh I. Truncated Hollow Cone Probe for Assessing Transepidermal Water Loss and Skin Hardness. ACS Sens 2018; 3:2246-2253. [PMID: 30354079 DOI: 10.1021/acssensors.8b00272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This study proposes a skin analysis device using a truncate hollow cone (THC) probe for measuring both transepidermal water loss (TEWL) and skin hardness. Because skin health is closely related to the epidermal barrier function and skin mechanical property, it is important to measure their biophysical indicators at the same time, to understand skin conditions and diagnose skin disorders such as atopic dermatitis and systemic sclerosis. Previous skin analyzers, however, required different probes with different protocols for each biophysical indicators, which makes the measurement inconvenient and increases the measurement uncertainty. The present device consists of a THC probe equipped with humidity and force sensors, and an actuator that simultaneously measure both TEWL and skin hardness which indicate the integrity of the epidermal barrier function and the skin mechanical property, respectively. Using artificial reference skins, the prototype device showed the TEWL with a sensitivity and linearity of 0.011 (%/s)/(g/m2/h) and 99.5%, and the hardness with 0.075 N/(Shore 00) and 97.6%, respectively, which are within the appropriate range for the properties of human skin. The on-body measurement of five subjects showed that the proposed device could measure both the TEWL and skin hardness without any crosstalk from each other. The proposed device has great potential for in-depth analysis of the health status of the skin which could indicate various skin diseases.
Collapse
Affiliation(s)
- Jai Kyoung Sim
- Center for Medical Convergence Metrology, Korea Research Institute of Standards and Science (KRISS), 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Bongyoung Ahn
- Center for Medical Convergence Metrology, Korea Research Institute of Standards and Science (KRISS), 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
- Department of Medical Physics, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| | - Il Doh
- Center for Medical Convergence Metrology, Korea Research Institute of Standards and Science (KRISS), 267 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
- Department of Medical Physics, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon 34113, Republic of Korea
| |
Collapse
|
103
|
Seaweeds as Source of Bioactive Substances and Skin Care Therapy—Cosmeceuticals, Algotheraphy, and Thalassotherapy. COSMETICS 2018. [DOI: 10.3390/cosmetics5040068] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Riverine, estuarine, and coastal populations have always used algae in the development of home remedies that were then used to treat diverse health problems. The empirical knowledge of various generations originated these applications, and their mechanism of action is, in most cases, unknown, that is, few more scientific studies would have been described beyond simple collection and ethnographic recording. Nevertheless, recent investigations, carried out with the purpose of analyzing the components and causes that alter the functioning and the balance of our organism, are already giving their first results. Water, and especially sea water is considered as essential to life on our planet. It sings all the substances necessary and conducive to the development of the living being (minerals, catalysts, vitamins, amino acids, etc.). Oceans cover over 70% of Earth, being home to up to 90% of the organisms in the planet. Many rich resources and unique environments are provided by the ocean. Additionally, bioactive compounds that multiple marine organisms have a great potential to produce can be used as nutraceuticals, pharmaceuticals, and cosmeceuticals. Both primary and secondary metabolites are produced by algae. The first ones are directly implicated in development, normal growth, or reproduction conditions to perform physiological functions. Stress conditions, like temperature changes, salinity, environmental pollutants, or UV radiation exposure cause the performance of secondary metabolites. In algae, proteins, polysaccharides, fatty acids, and amino acids are primary metabolites and phenolic compounds, pigments, vitamins, sterols, and other bioactive agents, all produced in algae tissues, are secondary metabolites. These algal active constituents have direct relevance in cosmetics.
Collapse
|
104
|
Marsh E, Gonzalez DG, Lathrop EA, Boucher J, Greco V. Positional Stability and Membrane Occupancy Define Skin Fibroblast Homeostasis In Vivo. Cell 2018; 175:1620-1633.e13. [PMID: 30415836 DOI: 10.1016/j.cell.2018.10.013] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 09/10/2018] [Accepted: 10/02/2018] [Indexed: 01/15/2023]
Abstract
Fibroblasts are an essential cellular and structural component of our organs. Despite several advances, the critical behaviors that fibroblasts utilize to maintain their homeostasis in vivo have remained unclear. Here, by tracking the same skin fibroblasts in live mice, we show that fibroblast position is stable over time and that this stability is maintained despite the loss of neighboring fibroblasts. In contrast, fibroblast membranes are dynamic during homeostasis and extend to fill the space of lost neighboring fibroblasts in a Rac1-dependent manner. Positional stability is sustained during aging despite a progressive accumulation of gaps in fibroblast nuclei organization, while membrane occupancy continues to be maintained. This work defines positional stability and cell occupancy as key principles of skin fibroblast homeostasis in vivo, throughout the lifespan of mice, and identifies membrane extension in the absence of migration as the core cellular mechanism to carry out these principles.
Collapse
Affiliation(s)
- Edward Marsh
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - David G Gonzalez
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | | | - Jonathan Boucher
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - Valentina Greco
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA; Departments of Dermatology & Cell Biology, Yale Stem Cell Center, Yale Cancer Center, Yale School of Medicine, New Haven, CT 06510, USA.
| |
Collapse
|
105
|
Tippavajhala VK, Magrini TD, Matsuo DC, Silva MGP, Favero PP, De Paula LR, Martin AA. In Vivo Determination of Moisturizers Efficacy on Human Skin Hydration by Confocal Raman Spectroscopy. AAPS PharmSciTech 2018; 19:3177-3186. [PMID: 30136174 DOI: 10.1208/s12249-018-1143-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/06/2018] [Indexed: 12/16/2022] Open
Abstract
This research work deals with in vivo testing of the efficacy of commercial moisturizer products on the hydration of human skin, as there are various in vitro and ex vivo studies questioning their activity. Confocal Raman spectroscopy was used for this purpose of assessing the efficacy of moisturizers on skin hydration mainly owing to its simple, non-invasive, non-destructive, timesaving, and cost-effective nature. Water content and natural moisturizing factor (NMF) of stratum corneum were analyzed and compared using this method at high wavenumber (2500-4000 cm-1) and fingerprint (400-1800 cm-1) spectral regions, respectively, as these two parameters are correlated to skin hydration. Four commercial moisturizer products of different brands were tested on volar forearm region of healthy human female volunteers. This study was conducted for a period of 30 days with 0, 7, and 30 days as time points of analysis. The results of this study clearly indicate that not all the moisturizer products hydrate the skin to the expected levels, and this extent of skin hydration varies with duration of application of these products.
Collapse
|
106
|
Seweryn A. Interactions between surfactants and the skin - Theory and practice. Adv Colloid Interface Sci 2018; 256:242-255. [PMID: 29685575 DOI: 10.1016/j.cis.2018.04.002] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/03/2018] [Accepted: 04/04/2018] [Indexed: 01/14/2023]
Abstract
One of the primary causes of skin irritation is the use of body wash cosmetics and household chemicals, since they are in direct contact with the skin, and they are widely available and frequently used. The main ingredients of products of this type are surfactants, which may have diverse effects on the skin. The skin irritation potential of surfactants is determined by their chemical and physical properties resulting from their structure, and specific interactions with the skin. Surfactants are capable of interacting both with proteins and lipids in the stratum corneum. By penetrating through this layer, surfactants are also able to affect living cells in deeper regions of the skin. Further skin penetration may result in damage to cell membranes and structural components of keratinocytes, releasing proinflammatory mediators. By causing irreversible changes in cell structure, surfactants can often lead to their death. The paper presents a critical review of literature on the effects of surfactants on the skin. Aspects discussed in the paper include the skin irritation potential of surfactants, mechanisms underlying interactions between compounds of this type and the skin which have been proposed over the years, and verified methods of reducing the skin irritation potential of surfactant compounds. Basic research conducted in this field over many years translate into practical applications of surfactants in the cosmetic and household chemical industries. This aspect is also emphasized in the present study.
Collapse
|
107
|
Histological and mechanical evaluation of antifreeze peptide (Afp1m) cryopreserved skin grafts post transplantation in a rat model. Cryobiology 2018; 82:27-36. [PMID: 29679551 DOI: 10.1016/j.cryobiol.2018.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 03/27/2018] [Accepted: 04/17/2018] [Indexed: 11/22/2022]
Abstract
The objective of this study was to evaluate the use of Afp1m as a cryopreservative agent for skin by examining the transplanted skin histological architecture and mechanical properties following subzero cryopreservation. Thirty four (34) rats with an average weight of 208 ± 31 g (mean ± SD), were used. Twenty four (n = 24) rats were equally divided into four groups: (i) immediate non-cryopreserved skin autografts (onto same site), (ii) immediate non-cryopreserved skin autografts (onto different sites), (iii) skin autografts cryopreserved with glycerol for 72 h and (iv) skin autografts cryopreserved with Afp1m for 72 h at -4 °C. Rounded shaped full-thickness 1.5-2.5 cm in diameter skin was excised from backs of rats for the autograft transplantation. Non-cryopreserved or cryopreserved auto skin graft were positioned onto the wound defects and stitched. Non-transplanted cryopreserved and non-cryopreserved skin strips from other ten rats (n = 10) were allowed for comparative biomechanical test. All skin grafts were subjected to histological and mechanical examinations at the end of day 21. Histological results revealed that tissue architecture especially the epidermal integrity and dermal-epidermal junction of the Afp1m cryopreserved skin grafts exhibited better histological appearance, good preservation of tissue architecture and structural integrity than glycerolized skin. However, there was no significant difference among these groups in other histological criteria. There were no significant differences among the 4 groups in skin graft mechanical properties namely maximum load. In conclusion, Afp1m were found to be able to preserve the microstructure as well as the viability and function of the skin destined for skin transplantation when was kept at -4 °C for 72 h.
Collapse
|
108
|
Biological connective tissues exhibit viscoelastic and poroelastic behavior at different frequency regimes: Application to tendon and skin biophysics. Acta Biomater 2018; 70:249-259. [PMID: 29425716 DOI: 10.1016/j.actbio.2018.01.041] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 10/18/2022]
Abstract
In this study, a poroviscoelastic finite element model (FEM) was developed and used in conjunction with an AFM-based wide-bandwidth nanorheology system to predict the frequency-dependent mechanical behavior of tendon and dermis subjected to compression via nanoindentation. The aim was to distinguish between loading rates that are dominated by either poroelasticity, viscoelasticity, or the superposition of these processes. Using spherical probe tips having different radii, the force and tip displacement were measured and the magnitude, E∗, and phase angle, ϕ, of the dynamic complex modulus were evaluated for mouse supraspinatus tendon and mouse dermis. The peak frequencies of the phase angle were associated with the characteristic time constants of poroelastic and viscoelastic material behavior. The developed FE model could predict the separate poroelastic and viscoelastic responses of these soft tissues over a 4 decade frequency range, showing good agreement with experimental results. We observed that poroelasticity was the dominant energy dissipation mechanism for mouse dermis and supraspinatus tendon at higher indentation frequencies (102 to 104 Hz) whereas viscoelasticity was typically dominant at lower frequencies (<102 Hz). These findings show the underlying mechanical behavior of biological connective tissues and give insight into the role played by these different energy dissipation mechanisms in governing the function of these tissues at nanoscale. STATEMENT OF SIGNIFICANCE Soft biological tissues exhibit complex, load- and time-dependent mechanical behavior. Evaluating their mechanical behavior requires sophisticated experimental tools and numerical models that can capture the fundamental mechanisms governing tissue function. Using an Atomic-force-microscopy-based rheology system and finite element models, the roles of the two most dominant time-dependent mechanisms (poroelasticity and viscoelasticity) that govern the dynamic loading behavior of mouse skin and tendon have been investigated. FE models were able to predict and quantify the contribution of each mechanism to the overall dynamic response and confirming the presence of these two distinct mechanisms in the mechanical response. Overall, these results provide novel insight into the viscoelastic and poroelastic properties of mouse skin and tendon and promote better understanding of the underlying origins of each mechanism.
Collapse
|
109
|
Abstract
The skin is one of the most physiologically important organs where the organism comes into contact with the external environment and is often a site where pathogen entry first occurs. Thus, a better understanding of the specialized cellular behavior of the immune system in the skin may be important for the improved treatment of diseases. Here, we describe in detail a procedure to image the dorsal mouse ear skin, using a customized ear stage and its associated coverslip holder, with an upright multiphoton microscope. As a demonstrative example, we describe the specific protocol for visualizing robust neutrophil trafficking in albino lysozyme-EGFP mice in response to zymosan particles. Instructive sections are provided for the mouse ear preparation, intradermal delivery of zymosan, design and use of the custom ear stage, as well as a solution for the uninterrupted live imaging of mice during prolonged sessions within a dark box. The mouse ear is easily accessible for imaging, and unlike most other organs, does not require any invasive surgery to be performed.
Collapse
|
110
|
De Matteis V, Rinaldi R. Toxicity Assessment in the Nanoparticle Era. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1048:1-19. [PMID: 29453529 DOI: 10.1007/978-3-319-72041-8_1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The wide use of engineered nanomaterials in many fields, ranging from biomedical, agriculture, environment, cosmetic, urged the scientific community to understand the processes behind their potential toxicity, in order to develop new strategies for human safety. As a matter of fact, there is a big discrepancy between the increased classes of nanoparticles and the consequent applications versus their toxicity assessment. Nanotoxicology is defined as the science that studies the effects of engineered nanodevices and nanostructures in living organisms. This chapter analyzes the physico-chemical properties of the most used nanoparticles, the way they enter the living organism and their cytoxicity mechanisms at cellular exposure level. Moreover, the current state of nanoparticles risk assessment is reported and analyzed.
Collapse
Affiliation(s)
- Valeria De Matteis
- Dipartimento di Matematica e Fisica "Ennio De Giorgi", Università del Salento, Lecce, Italy.
| | - Rosaria Rinaldi
- Dipartimento di Matematica e Fisica "Ennio De Giorgi", Università del Salento, Lecce, Italy
| |
Collapse
|
111
|
Quantitation of 24-Hour Moisturization by Electrical Measurements of Skin Hydration. J Wound Ostomy Continence Nurs 2017; 44:487-491. [PMID: 28877115 DOI: 10.1097/won.0000000000000363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this study was to quantify the effects of several moisturizers on hydration of the stratum corneum by measuring their effect on electrical conductance over a 24-hour period. DESIGN Double-blind, randomized controlled trial. SUBJECTS AND SETTING Twenty-five healthy female volunteers aged 18 to 65 years with dry skin on the lower legs and no other known dermatologic pathology participated in the study. Additional exclusion criteria were pregnant or taking anti-inflammatory steroids. The study was carried out in a clinical research facility in Winnipeg, Manitoba, Canada. METHODS Subjects underwent a 3-day conditioning period using a natural soap bar on the lower legs and no application of moisturizer to the skin. Participants then came to the test site and equilibrated for at least 30 minutes under controlled conditions of temperature and humidity. After baseline hydration measurements on test sites on the lower legs of each subject, a single application of each of 5 test products at a dose of 2 mg/cm was made. Skin hydration was assessed by electrical conductance measurements with a specialized probe. The probe was briefly placed on the skin surface with light pressure, and the measurement recorded in units of microsiemens (μS). Conductance was measured at 2, 4, 6, 8, and 24 hours after product applications. RESULTS Although all but 1 of the test products increased conductance at 2 hours, only 2 moisturizers containing high levels of glycerin (products C and E) maintained increased conductance relative to baseline at 24 hours, +37.8 (P < .001) and +103.5 (P < .001), respectively. CONCLUSIONS Moisturizers containing high levels of glycerin can provide a measurable moisturization benefit as determined by skin conductance for at least 24 hours after a single application.
Collapse
|
112
|
Mota AH, Rijo P, Molpeceres J, Reis CP. Broad overview of engineering of functional nanosystems for skin delivery. Int J Pharm 2017; 532:710-728. [DOI: 10.1016/j.ijpharm.2017.07.078] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 07/19/2017] [Accepted: 07/24/2017] [Indexed: 02/06/2023]
|
113
|
De Matteis V. Exposure to Inorganic Nanoparticles: Routes of Entry, Immune Response, Biodistribution and In Vitro/In Vivo Toxicity Evaluation. TOXICS 2017; 5:toxics5040029. [PMID: 29051461 PMCID: PMC5750557 DOI: 10.3390/toxics5040029] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/09/2017] [Accepted: 10/09/2017] [Indexed: 12/12/2022]
Abstract
The development of different kinds of nanoparticles, showing different physico-chemical properties, has fostered their large use in many fields, including medicine. As a consequence, inorganic nanoparticles (e.g., metals or semiconductors), have raised issues about their potential toxicity. The scientific community is investigating the toxicity mechanisms of these materials, in vitro and in vivo, in order to provide accurate references concerning their use. This review will give the readers a thorough exploration on the entry mechanisms of inorganic nanoparticles in the human body, such as titanium dioxide nanoparticles (TiO₂NPs), silicon dioxide nanoparticles (SiO₂NPs), zinc oxide nanoparticles (ZnONPs), silver nanoparticles (AgNPs), gold nanoparticles (AuNPs) and quantum dots (QDsNPs). In addition, biodistribution, the current trends and novelties of in vitro and in vivo toxicology studies will be discussed, with a particular focus on immune response.
Collapse
Affiliation(s)
- Valeria De Matteis
- Dipartimento di Matematica e Fisica "Ennio De Giorgi", Università del Salento, Via Arnesano, 73100 Lecce, Italy.
| |
Collapse
|
114
|
Adams EM, Champagne AM, Williams JB, Allen HC. Interfacial properties of avian stratum corneum monolayers investigated by Brewster angle microscopy and vibrational sum frequency generation. Chem Phys Lipids 2017; 208:1-9. [PMID: 28807615 DOI: 10.1016/j.chemphyslip.2017.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 08/04/2017] [Accepted: 08/06/2017] [Indexed: 10/19/2022]
Abstract
The outermost layer of skin, the stratum corneum (SC), contains a complex mixture of lipids, which controls the rate of cutaneous water loss (CWL) in reptiles, mammals, and birds. However, the molecular structure of SC lipids and how molecular configurations influence CWL is poorly understood. Here, the organization and structure of SC lipids extracted from birds were investigated by means of Langmuir films. Properties of lipids from the SC of arid and semi-arid adapted larks, known to have a low CWL, were compared with lipids extracted from the SC of mesic lark species with higher CWL to gain insight into how structure impacts CWL. Film properties were probed with surface pressure-area isotherms, Brewster angle microscopy (BAM), and vibrational sum frequency generation (VSFG). Results indicate organization and ordering of SC lipids in the arid-adapted hoopoe lark was vastly different from all other species, forming a miscible, rigid monolayer, whereas monolayers from semi-arid and mesic species were immiscible and disordered. Probing of interfacial water structure reveals that film morphology determines organization of water molecules near the monolayer; monolayers with a porous morphology had an increased population of water molecules that are weakly hydrogen-bonded. In general, CWL appears related to the miscibility and ordering of lipid components within the SC, as well as the ability of these lipids to interact with water molecules. From a broader perspective, CWL in larks appears linked to both the SC lipid composition and the aridity of the species' environment.
Collapse
Affiliation(s)
- Ellen M Adams
- Department of Chemistry & Biochemistry, The Ohio State University, Columbus, OH, 43210, United States
| | - Alex M Champagne
- Department of Biology, University of Southern Indiana, Evansville, IN, 47712, United States
| | - Joseph B Williams
- Department of Evolution, Ecology and Organismal Biology, The Ohio State University, Columbus, OH, 43210, United States
| | - Heather C Allen
- Department of Chemistry & Biochemistry, The Ohio State University, Columbus, OH, 43210, United States.
| |
Collapse
|
115
|
Pullar JM, Carr AC, Vissers MCM. The Roles of Vitamin C in Skin Health. Nutrients 2017; 9:E866. [PMID: 28805671 PMCID: PMC5579659 DOI: 10.3390/nu9080866] [Citation(s) in RCA: 269] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 08/07/2017] [Accepted: 08/09/2017] [Indexed: 12/30/2022] Open
Abstract
The primary function of the skin is to act as a barrier against insults from the environment, and its unique structure reflects this. The skin is composed of two layers: the epidermal outer layer is highly cellular and provides the barrier function, and the inner dermal layer ensures strength and elasticity and gives nutritional support to the epidermis. Normal skin contains high concentrations of vitamin C, which supports important and well-known functions, stimulating collagen synthesis and assisting in antioxidant protection against UV-induced photodamage. This knowledge is often used as a rationale for the addition of vitamin C to topical applications, but the efficacy of such treatment, as opposed to optimising dietary vitamin C intake, is poorly understood. This review discusses the potential roles for vitamin C in skin health and summarises the in vitro and in vivo research to date. We compare the efficacy of nutritional intake of vitamin C versus topical application, identify the areas where lack of evidence limits our understanding of the potential benefits of vitamin C on skin health, and suggest which skin properties are most likely to benefit from improved nutritional vitamin C intake.
Collapse
Affiliation(s)
- Juliet M Pullar
- Department of Pathology, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand.
| | - Anitra C Carr
- Department of Pathology, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand.
| | - Margreet C M Vissers
- Department of Pathology, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand.
| |
Collapse
|
116
|
Richters RJH, Falcone D, Uzunbajakava NE, Varghese B, Caspers PJ, Puppels GJ, van Erp PEJ, van de Kerkhof PCM. Sensitive Skin: Assessment of the Skin Barrier Using Confocal Raman Microspectroscopy. Skin Pharmacol Physiol 2017; 30:1-12. [PMID: 28122376 DOI: 10.1159/000452152] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 09/27/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND/AIMS Sensitive skin (SS), a frequently reported condition in the Western world, has been suggested to be underlined by an impaired skin barrier. The aim of this study was to investigate the skin barrier molecular composition in SS subjects using confocal Raman microspectroscopy (CRS), and to compare it with that of non-SS (NSS) individuals as well as atopic dermatitis (AD) and allergic rhinoconjunctivitis (AR) subjects, who frequently report SS. METHODS Subjects with SS (n = 29), NSS (n = 30), AD (n = 11), and AR (n = 27) were included. Stratum corneum (SC) thickness, water, ceramides/fatty acids, and natural moisturizing factor (NMF) were measured by CRS along with transepidermal water loss and capacitance on the ventral forearm, thenar, and cheek. Sebum levels were additionally measured on the forearm and cheek. RESULTS No differences between SS and NSS subjects were found regarding SC thickness, water, and NMF content, yet a trend towards lower ceramides/fatty acids was observed in the cheek. Compared to AD subjects, the SS group showed higher ceramides/fatty acid content in the forearm, whereas no differences emerged with AR. The correlation of macroscopic biophysical techniques and CRS was weak, yet CRS confirmed the well-known lower content of NMF and water, and thinner SC in subjects with filaggrin mutations. CONCLUSION The skin barrier in SS is not impaired in terms of SC thickness, water, NMF, and ceramides/fatty acid content. The failure of biophysical techniques to follow alterations in the molecular composition of the skin barrier revealed by CRS emphasizes a strong need in sensitive and specific tools for in vivo skin barrier analysis.
Collapse
Affiliation(s)
- Renée J H Richters
- Radboud Institute for Molecular Life Sciences (RIMLS), Nijmegen, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
117
|
Akinshina A, Das C, Noro MG. Effect of monoglycerides and fatty acids on a ceramide bilayer. Phys Chem Chem Phys 2016; 18:17446-60. [PMID: 27302426 DOI: 10.1039/c6cp01238h] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Monoglycerides and unsaturated fatty acids, naturally present in trace amounts in the stratum corneum (top layer of skin) lipid matrix, are commonly used in pharmaceutical, cosmetic and health care formulations. However, a detailed molecular understanding of how the oil additives get incorporated into the skin lipids from topical application and, once incorporated, how they affect the properties and integrity of the lipid matrix remains unexplored. Using ceramide 2 bilayers as skin lipid surrogates, we use a series of molecular dynamics simulations with six different natural oil ingredients at multiple concentrations to investigate the effect of the oils on the properties and stability of the bilayers. The six oils: monoolein, monostearin, monoelaidin, oleic acid, stearic acid and linoleic acid - all having the same length of the alkyl chain, C18, but a varying degree of saturation, allow us to systematically address the effect of unsaturation in the additives. Our results show that at low oil concentration (∼5%) the mixed bilayers containing any of the oils and ceramide 2 (CER2) become more rigid than pure CER2 bilayers due to more efficient lipid packing. Better packing also results in the formation of larger numbers of hydrogen bonds between the lipids, which occurs at the expense of the hydrogen bonds between lipids and water. The mixed bilayers with saturated or trans-unsaturated oils remain stable over the whole range of oil concentration. In contrast, the presence of the oils with at least one cis-double bond leads to bilayer instability and complete loss of bilayer structure at the oil content of about 50-65%. Two cis-double bonds in the lipid tail induce bilayer disruption at even lower concentration (∼30%). The mixed bilayers remain in the gel phase (without melting to a fluid phase) until the phase transition to a non-bilayer phase occurs. We also demonstrate that the stability of the bilayer strongly correlates with the order parameter of the lipid tails.
Collapse
Affiliation(s)
- Anna Akinshina
- Institute of Skin Integrity and Infection Prevention, School of Human and Health Sciences, University of Huddersfield, HD1 3DH, Huddersfield, UK.
| | | | | |
Collapse
|
118
|
A Mouse Model of Hyperproliferative Human Epithelium Validated by Keratin Profiling Shows an Aberrant Cytoskeletal Response to Injury. EBioMedicine 2016; 9:314-323. [PMID: 27333029 PMCID: PMC4972546 DOI: 10.1016/j.ebiom.2016.06.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/02/2016] [Accepted: 06/06/2016] [Indexed: 12/20/2022] Open
Abstract
A validated animal model would assist with research on the immunological consequences of the chronic expression of stress keratins KRT6, KRT16, and KRT17, as observed in human pre-malignant hyperproliferative epithelium. Here we examine keratin gene expression profile in skin from mice expressing the E7 oncoprotein of HPV16 (K14E7) demonstrating persistently hyperproliferative epithelium, in nontransgenic mouse skin, and in hyperproliferative actinic keratosis lesions from human skin. We demonstrate that K14E7 mouse skin overexpresses stress keratins in a similar manner to human actinic keratoses, that overexpression is a consequence of epithelial hyperproliferation induced by E7, and that overexpression further increases in response to injury. As stress keratins modify local immunity and epithelial cell function and differentiation, the K14E7 mouse model should permit study of how continued overexpression of stress keratins impacts on epithelial tumor development and on local innate and adaptive immunity. Persistence of HPV infection in epithelial premalignancy is not fully understood. HPV16 E7 expression in skin induces expression of “stress” keratin. “Stress” keratin induction is also observed in human actinic keratosis. Induction of “stress” keratins persists after skin grafting of E7-expressing skin. Disruption of E7-Retinoblastoma binding abrogates keratin misregulation.
“Stress” keratins modify local immunity and epithelial cell function and differentiation. Thus, identification and validation of a suitable mouse model to study the influence of stress keratin expression normally and during tumor development is important. Mice that transgenically express high-risk HPV16 E7 oncoprotein in the skin (K14E7) presents with epithelial hyperplasia and is used for modeling HPV-associated pre-cancer. We show that “stress” keratins are induced in the K14E7 epithelium, similar to skin from patients with actinic keratosis. Thus the K14E7 mouse should permit study of how continued overexpression of stress keratins impacts on epithelial tumor development and on local immunity.
Collapse
|
119
|
Southgate G, Bradbury S. Management of incontinence-associated dermatitis with a skin barrier protectant. ACTA ACUST UNITED AC 2016; 25:S20-9. [PMID: 27172503 DOI: 10.12968/bjon.2016.25.9.s20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The skin performs many important protective functions, one of which is to act as a barrier to moisture, irritants and bacteria. Good management of patients' skin is a fundamental part of nursing care to prevent development of complex and distressing problems, such as pressure ulceration and incontinence-associated dermatitis (IAD). IAD is skin breakdown related to faecal and/or urinary incontinence, which requires adoption of a structured skin care regimen, including regular skin inspection, cleansing and the use of skin barrier protectants, to proactively protect the skin from irritant bodily fluids. Six case studies using Medi Derma-S skin barrier protectants on patients with IAD highlighted the potential for improved clinical outcomes on skin either vulnerable or compromised due to the effects of incontinence. Positive observations were noted with regard to improvement in skin condition, pain and discomfort, promotion of independence and prevention of deterioration of concurrent pressure damage.
Collapse
Affiliation(s)
- Geraldine Southgate
- Assistant Practitioner, Oxfordshire Community Bladder and Bowel Service, Oxford Health NHS Foundation Trust
| | | |
Collapse
|
120
|
Jacquoilleot S, Sheffield D, Olayanju A, Sison-Young R, Kitteringham NR, Naisbitt DJ, Aleksic M. Glutathione metabolism in the HaCaT cell line as a model for the detoxification of the model sensitisers 2,4-dinitrohalobenzenes in human skin. Toxicol Lett 2015; 237:11-20. [PMID: 26022718 DOI: 10.1016/j.toxlet.2015.05.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 05/20/2015] [Accepted: 05/21/2015] [Indexed: 12/31/2022]
Abstract
Glutathione (GSH) is the most prominent antioxidant in cells and the co-factor of an important set of enzymes involved in the skin metabolic clearance system, glutathione S-transferases (GST). Here, we describe an LC-MS (liquid chromatography-mass spectroscopy) method to measure GSH and its disulfide form (GSSG) in HaCaT cells and a 3D Reconstructed Human Epidermis (RHE) model. In our assay, the basal level of GSH in both systems was in the low nmol/mg soluble protein range, while the level of GSSG was systematically below our limit of quantification (0.1 μM). We found that 2,4-dinitrohalobenzenes deplete the GSH present in HaCaT cells within the first hour of exposure, in a dose dependent manner. The level of GSH in HaCaT cells treated with a single non-toxic dose of 10 μM of dinitrohalobenzene was also shown to increase after two hours. While cells treated with 1-chloro-2,4-dinitrobenzene (DNCB) and 1-fluoro-2,4-dinitrobenzene (DNFB) repleted GSH to levels similar to untreated control cells within 24h, 1-bromo-2,4-dinitrobenzene (DNBB) seemed to prevent such a repletion and appeared to be the most toxic compound in all assays. A mathematical modelling of experimental results was performed to further rationalise the differences observed between test chemicals. For this purpose the biological phenomena observed were simplified into two sequential events: the initial depletion of the GSH stock after chemical treatment followed by the repletion of the GSH once the chemical was cleared. Activation of the nuclear factor E2-related factor 2 (Nrf2) pathway was observed with all compounds within two hours, and at concentrations less than 10 μM. These data show that GSH depletion and repletion occur rapidly in skin cells and emphasize the importance of conducting kinetic studies when performing in vitro experiments exploring skin sensitization.
Collapse
Affiliation(s)
- Sandrine Jacquoilleot
- Unilever, Safety and Environmental Assurance Centre, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK.
| | - David Sheffield
- Unilever, Safety and Environmental Assurance Centre, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK
| | - Adedamola Olayanju
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, Sherrington Building, Ashton Street, The University of Liverpool, Liverpool L69 3GE, UK
| | - Rowena Sison-Young
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, Sherrington Building, Ashton Street, The University of Liverpool, Liverpool L69 3GE, UK
| | - Neil R Kitteringham
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, Sherrington Building, Ashton Street, The University of Liverpool, Liverpool L69 3GE, UK
| | - Dean J Naisbitt
- MRC Centre for Drug Safety Science, Department of Molecular and Clinical Pharmacology, Sherrington Building, Ashton Street, The University of Liverpool, Liverpool L69 3GE, UK
| | - Maja Aleksic
- Unilever, Safety and Environmental Assurance Centre, Colworth Science Park, Sharnbrook, Bedfordshire, MK44 1LQ, UK
| |
Collapse
|
121
|
Wang HMD, Chen CC, Huynh P, Chang JS. Exploring the potential of using algae in cosmetics. BIORESOURCE TECHNOLOGY 2015; 184:355-362. [PMID: 25537136 DOI: 10.1016/j.biortech.2014.12.001] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 11/30/2014] [Accepted: 12/01/2014] [Indexed: 05/18/2023]
Abstract
The applications of microalgae in cosmetic products have recently received more attention in the treatment of skin problems, such as aging, tanning and pigment disorders. There are also potential uses in the areas of anti-aging, skin-whitening, and pigmentation reduction products. While algae species have already been used in some cosmetic formulations, such as moisturizing and thickening agents, algae remain largely untapped as an asset in this industry due to an apparent lack of utility as a primary active ingredient. This review article focuses on integrating studies on algae pertinent to skin health and beauty, with the purpose of identifying serviceable algae functions in practical cosmetic uses.
Collapse
Affiliation(s)
- Hui-Min David Wang
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung 807, Taiwan; Graduate Institute of Natural Products, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Ching-Chun Chen
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Pauline Huynh
- Ecole de Biologie Industrielle, École de Biologie Industrielle, 95094, France
| | - Jo-Shu Chang
- Department of Chemical Engineering, National Cheng Kung University, Tainan 701, Taiwan; Center for Biosciences and Biotechnology, National Cheng Kung University, Tainan 701, Taiwan; Research Center for Energy Technology and Strategy, National Cheng Kung University, Tainan 701, Taiwan.
| |
Collapse
|
122
|
Woo SW, Rhim DB, Kim C, Hwang JK. Effect of Standardized Boesenbergia pandurata Extract and Its Active Compound Panduratin A on Skin Hydration and Barrier Function in Human Epidermal Keratinocytes. Prev Nutr Food Sci 2015; 20:15-21. [PMID: 25866745 PMCID: PMC4391536 DOI: 10.3746/pnf.2015.20.1.15] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 01/12/2015] [Indexed: 01/17/2023] Open
Abstract
The skin plays a key role in protecting the body from the environment and from water loss. Cornified envelope (CE) and natural moisturizing factor (NMF) are considered as the primary regulators of skin hydration and barrier function. The CE prevents loss of water from the body and is formed by cross-linking of several proteins. Among these proteins, filaggrin is an important protein because NMF is produced by the degradation of filaggrin. Proteases, including matriptase and prostasin, stimulate the generation of filaggrin from profilaggrin and caspase-14 plays a role in the degradation of filaggrin. This study elucidated the effects of an ethanol extract of Boesenbergia pandurata (Roxb.) Schltr., known as fingerroot, and its active compound panduratin A on CE formation and filaggrin processing in HaCaT, human epidermal keratinocytes. B. pandurata extract (BPE) and panduratin A significantly stimulated not only CE formation but also the expression of CE proteins, such as loricrin, involucrin, and transglutaminase, which were associated with PPARα expression. The mRNA and protein levels of filaggrin and filaggrin-related enzymes, such as matriptase, prostasin, and caspase-14 were also up-regulated by BPE and panduratin A treatment. These results suggest that BPE and panduratin A are potential nutraceuticals which can enhance skin hydration and barrier function based on their CE formation and filaggrin processing.
Collapse
Affiliation(s)
- Seon Wook Woo
- Department of Biotechnology, Yonsei University, Seoul 120-749, Korea
| | - Dong-Bin Rhim
- Department of Biomaterials Science and Engineering, Yonsei University, Seoul 120-749, Korea
| | - Changhee Kim
- Department of Biotechnology, Yonsei University, Seoul 120-749, Korea
| | - Jae-Kwan Hwang
- Department of Biotechnology, Yonsei University, Seoul 120-749, Korea ; Department of Biomaterials Science and Engineering, Yonsei University, Seoul 120-749, Korea
| |
Collapse
|
123
|
Stiefel C, Schwack W. Photoprotection in changing times - UV filter efficacy and safety, sensitization processes and regulatory aspects. Int J Cosmet Sci 2014; 37:2-30. [DOI: 10.1111/ics.12165] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Accepted: 09/20/2014] [Indexed: 12/14/2022]
Affiliation(s)
- C. Stiefel
- Institute of Food Chemistry; University of Hohenheim; Garbenstrasse 28 70599 Stuttgart Germany
| | - W. Schwack
- Institute of Food Chemistry; University of Hohenheim; Garbenstrasse 28 70599 Stuttgart Germany
| |
Collapse
|
124
|
Anderson DJ, Marathe J, Pudney J. The structure of the human vaginal stratum corneum and its role in immune defense. Am J Reprod Immunol 2014; 71:618-23. [PMID: 24661416 DOI: 10.1111/aji.12230] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 02/18/2014] [Indexed: 01/23/2023] Open
Abstract
The superficial layers of the human vaginal epithelium, which form an interface between host and environment, are comprised of dead flattened cells that have undergone a terminal cell differentiation program called cornification. This entails extrusion of nuclei and intercellular organelles, and the depletion of functional DNA and RNA precluding the synthesis of new proteins. As a consequence, the terminally differentiated cells do not maintain robust intercellular junctions and have a diminished capacity to actively respond to microbial exposure, yet the vaginal stratum corneum (SC) mounts an effective defense against invasive microbial infections. The vaginal SC in reproductive-aged women is comprised of loosely connected glycogen-filled cells, which are permeable to bacterial and viral microbes as well as molecular and cellular mediators of immune defense. We propose here that the vaginal SC provides a unique microenvironment that maintains vaginal health by fostering endogenous lactobacilli and retaining critical mediators of acquired and innate immunity. A better understanding of the molecular and physicochemical properties of the vaginal SC could promote the design of more effective topical drugs and microbicides.
Collapse
Affiliation(s)
- Deborah J Anderson
- Department of Obstetrics and Gynecology, Boston University School of Medicine, Boston, MA, USA; Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | | |
Collapse
|
125
|
Comparative SAXS and DSC study on stratum corneum structural organization in an epidermal cell culture model (ROC): impact of cultivation time. Eur J Pharm Sci 2013; 50:577-85. [PMID: 23770376 DOI: 10.1016/j.ejps.2013.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 06/01/2013] [Accepted: 06/02/2013] [Indexed: 11/20/2022]
Abstract
Cell cultured skin equivalents present an alternative for dermatological in vitro evaluations of drugs and excipients as they provide the advantage of availability, lower variability and higher assay robustness compared to native skin. For penetration/permeation studies, an adequate stratum corneum barrier similar to that of human stratum corneum is, however, a prerequisite. In this study, the stratum corneum lipid organization in an epidermal cell culture model based on rat epidermal keratinocytes (REK organotypic culture, ROC) was investigated by small-angle X-ray scattering (SAXS) in dependence on ROC cultivation time and in comparison to native human and rat stratum cornea. In addition, the thermal phase behavior was studied by differential scanning calorimetry (DSC) and barrier properties were checked by measurements of the permeability of tritiated water. The development of the barrier of ROC SC obtained at different cultivation times (7, 14 and 21 days at the air-liquid interface) was connected with an increase in structural order of the SC lipids in SAXS measurements: Already cultivation for 14 days at the air-liquid interface resulted overall in a competent SC permeability barrier and SC lipid organization. Cultivation for 21 days resulted in further minor changes in the structural organization of ROC SC. The SAXS patterns of ROC SC had overall large similarities with that of human SC and point to the presence of a long periodicity phase with a repeat distance of about 122Å, e.g. slightly smaller than that determined for human SC in the present study (127Å). Moreover, SAXS results also indicate the presence of covalently bound ceramides, which are crucial for a proper SC barrier, although the corresponding thermal transitions were not clearly detectable by DSC. Due to the competent SC barrier properties and high structural and organizational similarity to that of native human SC, ROC presents a promising alternative for in vitro studies, particularly as it can be obtained under overall rather straightforward cell culture conditions and thus low assay costs.
Collapse
|
126
|
Sharma AM, Uetrecht J. Bioactivation of drugs in the skin: relationship to cutaneous adverse drug reactions. Drug Metab Rev 2013; 46:1-18. [DOI: 10.3109/03602532.2013.848214] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
127
|
Reid ML, Benaouda F, Khengar R, Jones SA, Brown MB. Topical corticosteroid delivery into human skin using hydrofluoroalkane metered dose aerosol sprays. Int J Pharm 2013; 452:157-65. [DOI: 10.1016/j.ijpharm.2013.04.083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/15/2013] [Accepted: 04/28/2013] [Indexed: 11/30/2022]
|
128
|
Müller G, Langer J, Siebert J, Kramer A. Residual antimicrobial effect of chlorhexidine digluconate and octenidine dihydrochloride on reconstructed human epidermis. Skin Pharmacol Physiol 2013; 27:1-8. [PMID: 23887383 DOI: 10.1159/000350172] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 02/15/2013] [Indexed: 12/21/2022]
Abstract
The objective of the present investigation was to examine the residual antimicrobial activity after a topical exposure of reconstructed human epidermis (RHE) to equimolar solutions of either chlorhexidine digluconate (CHG, 0.144% w/v) or octenidine dihydrochloride (OCT, 0.1% w/v) for 15 min. RHE-associated antiseptic agents were more effective on Staphylococcus aureus than on Pseudomonas aeruginosa. S. aureus was not detected after 24 h of contact, which demonstrated a microbicidal efficacy of greater than 5-log10 reduction. In contrast, P. aeruginosa was reduced by approximately 2 log10 at the same incubation time, which parallels the growth of the initial inoculum. This result could be interpreted either as a microbiostatic effect or as an adherence of P. aeruginosa to a low positively charged surface. Small amounts of CHG and OCT can penetrate the stratum corneum. Using these antiseptic agents, the viability of keratinocytes was reduced to 65-75% of that of the untreated RHE control following 24 h incubation in the presence of test microorganisms. With consideration of antimicrobial activity and cytotoxic effect, OCT corresponds better to a biocompatible antiseptic agent than CHG.
Collapse
Affiliation(s)
- G Müller
- Institute of Hygiene and Environmental Medicine, Ernst-Moritz-Arndt-University Greifswald, Germany
| | | | | | | |
Collapse
|
129
|
Desouza ED, Atiya IA, Al-Ebraheem A, Wainman BC, Fleming DE, McNeill FE, Farquharson MJ. Characterization of the depth distribution of Ca, Fe and Zn in skin samples, using synchrotron micro-x-ray fluorescence (SμXRF) to help quantify in-vivo measurements of elements in the skin. Appl Radiat Isot 2013; 77:68-75. [DOI: 10.1016/j.apradiso.2013.02.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 02/20/2013] [Accepted: 02/21/2013] [Indexed: 01/03/2023]
|
130
|
Ho CL, Yang CY, Lin WJ, Lin CH. Ecto-nucleoside triphosphate diphosphohydrolase 2 modulates local ATP-induced calcium signaling in human HaCaT keratinocytes. PLoS One 2013; 8:e57666. [PMID: 23536768 PMCID: PMC3594229 DOI: 10.1371/journal.pone.0057666] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Accepted: 01/23/2013] [Indexed: 11/18/2022] Open
Abstract
Keratinocytes are the major building blocks of the human epidermis. In many physiological and pathophysiological conditions, keratinocytes release adenosine triphosphate (ATP) as an autocrine/paracrine mediator that regulates cell proliferation, differentiation, and migration. ATP receptors have been identified in various epidermal cell types; therefore, extracellular ATP homeostasis likely determines its long-term, trophic effects on skin health. We investigated the possibility that human keratinocytes express surface-located enzymes that modulate ATP concentration, as well as the corresponding receptor activation, in the pericellular microenvironment. We observed that the human keratinocyte cell line HaCaT released ATP and hydrolyzed extracellular ATP. Interestingly, ATP hydrolysis resulted in adenosine diphosphate (ADP) accumulation in the extracellular space. Pharmacological inhibition by ARL 67156 or gene silencing of the endogenous ecto-nucleoside triphosphate diphosphohydrolase (NTPDase) isoform 2 resulted in a 25% reduction in both ATP hydrolysis and ADP formation. Using intracellular calcium as a reporter, we found that although NTPDase2 hydrolyzed ATP and generated sustainable ADP levels, only ATP contributed to increased intracellular calcium via P2Y2 receptor activation. Furthermore, knocking down NTPDase2 potentiated the nanomolar ATP-induced intracellular calcium increase, suggesting that NTPDase2 globally attenuates nucleotide concentration in the pericellular microenvironment as well as locally shields receptors in the vicinity from being activated by extracellular ATP. Our findings reveal an important role of human keratinocyte NTPDase2 in modulating nucleotide signaling in the extracellular milieu of human epidermis.
Collapse
Affiliation(s)
- Chia-Lin Ho
- Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
| | - Chih-Yung Yang
- Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Wen-Jie Lin
- Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
| | - Chi-Hung Lin
- Institute of Microbiology and Immunology, National Yang-Ming University, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
131
|
Theerawatanasirikul S, Suriyaphol G, Thanawongnuwech R, Sailasuta A. Histologic morphology and involucrin, filaggrin, and keratin expression in normal canine skin from dogs of different breeds and coat types. J Vet Sci 2012; 13:163-70. [PMID: 22705738 PMCID: PMC3386341 DOI: 10.4142/jvs.2012.13.2.163] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The purpose of this study was to measure the thickness of canine epidermis at various anatomical sites according to localization of cornified envelopes (involucrin and filaggrin), keratins (keratin 10, 5), and their mRNA expression. This was done in the skin of five breeds of dogs including seven poodles, six golden retrievers, six Shih Tzus, four pugs, and four Labrador retrievers. Epidermal thickness of the stratum corneum and nucleated epidermal layer was significantly different. The greatest thickness was observed in the digital web area and the thinnest epidermis was in the axilla. Epidermal thickness was also significantly different between the breeds (p < 0.05). Immunohistochemical staining scores revealed significant decreases of involucrin, filaggrin, and keratin 10 in the ventral and weight-bearing sites, and a relative increase of keratin 5 (p < 0.05). q-PCR analysis showed that their the levels of mRNA were positively correlated with expression of the corresponding proteins in skin samples (p < 0.05). The present study is the first to report the relationship between epidermal gene expression and histologic morphology of the skin in normal dogs. Further studies will be essential to fully understand the pathogenesis of skin barrier dysfunctions in canines.
Collapse
Affiliation(s)
- Sirin Theerawatanasirikul
- Department of Veterinary Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok 10330, Thailand
| | | | | | | |
Collapse
|
132
|
Baroni A, Buommino E, De Gregorio V, Ruocco E, Ruocco V, Wolf R. Structure and function of the epidermis related to barrier properties. Clin Dermatol 2012; 30:257-62. [DOI: 10.1016/j.clindermatol.2011.08.007] [Citation(s) in RCA: 222] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
133
|
Kutzscher L. Management of Irritant Contact Dermatitis and Peripherally Inserted Central Catheters. Clin J Oncol Nurs 2012; 16:E48-55. [DOI: 10.1188/12.cjon.e48-e55] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
134
|
Ahmed-Lecheheb D, Cunat L, Hartemann P, Hautemanière A. Prospective observational study to assess hand skin condition after application of alcohol-based hand rub solutions. Am J Infect Control 2012; 40:160-4. [PMID: 21839542 DOI: 10.1016/j.ajic.2011.04.323] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Revised: 04/19/2011] [Accepted: 04/19/2011] [Indexed: 01/01/2023]
Abstract
BACKGROUND The use of alcohol-based hand rub solutions (ABHRSs) in health care settings has been associated with increased hand hygiene compliance and reduced rates of nosocomial infection. Deterioration in hand skin condition leads to impaired barrier function, changes in skin flora, and increased bacterial shedding. Thus, poor skin condition can increase the risk of infection. This study evaluated the hand skin condition and dermal tolerance among health care workers (HCWs) after ABHRS application. METHODS The study group comprised 231 HCWs (34% nurses, 22% nurse assistants, and 15% hospital cleaners). The mean participant age was 40 years. Stratum corneum hydration and superficial sebum content and surface pH of the skin were measured on the back and palm of each participant's dominant hand before and after ABHRS use. A self-assessment questionnaire was administered to collect information about the participants, their skin problems, and their perception of the ABHRS. RESULTS The study group was 83% females. Skin hydration at the 2 assessment sites was markedly increased after ABHRS use (P < .0001). The mean pH value did not change significantly on the back of the hand, but did change significantly on the palm (P = .012). The superficial sebum content decreased significantly on the palm (P < .0001), but not on the back of the hand. HCWs reported excellent or good skin tolerance of ABHRS in 73% of cases. CONCLUSION ABHRSs are well tolerated and do not dry the skin. pH and superficial sebum values decreased slightly, but these decreases did not affect skin barrier function. Values remained within the physiological range.
Collapse
|
135
|
Active regulation of the epidermal calcium profile. J Theor Biol 2012; 301:112-21. [PMID: 22386578 DOI: 10.1016/j.jtbi.2012.02.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2011] [Revised: 02/13/2012] [Accepted: 02/15/2012] [Indexed: 12/23/2022]
Abstract
A distinct calcium profile is strongly implicated in regulating the multi-layered structure of the epidermis. However, the mechanisms that govern the regulation of this calcium profile are currently unclear. It clearly depends on the relatively impermeable barrier of the stratum corneum (passive regulation) but may also depend on calcium exchanges between keratinocytes and extracellular fluid (active regulation). Using a mathematical model that treats the viable sublayers of unwounded human and murine epidermis as porous media and assumes that their calcium profiles are passively regulated, we demonstrate that these profiles are also actively regulated. To obtain this result, we found that diffusion governs extracellular calcium motion in the viable epidermis and hence intracellular calcium is the main source of the epidermal calcium profile. Then, by comparison with experimental calcium profiles and combination with a hypothesised cell velocity distribution in the viable epidermis, we found that the net influx of calcium ions into keratinocytes from extracellular fluid may be constant and positive throughout the stratum basale and stratum spinosum, and that there is a net outflux of these ions in the stratum granulosum. Hence, the calcium exchange between keratinocytes and extracellular fluid differs distinctly between the stratum granulosum and the underlying sublayers, and these differences actively regulate the epidermal calcium profile. Our results also indicate that plasma membrane dysfunction may be an early event during keratinocyte disintegration in the stratum granulosum.
Collapse
|
136
|
Fernandes CR, Fonseca NM, Rosa DM, Simões CM, Duarte NMDC. Brazilian Society of Anesthesiology Recommendations for Safety in Regional Anesthesia. Rev Bras Anestesiol 2011; 61:668-94, 366-81. [DOI: 10.1016/s0034-7094(11)70077-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
137
|
Dillon MB. Skin as a potential source of infectious foot and mouth disease aerosols. Proc Biol Sci 2011; 278:1761-9. [PMID: 21450741 DOI: 10.1098/rspb.2010.2430] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This review examines whether exfoliated, virus-infected animal skin cells could be an important source of infectious foot and mouth disease virus (FMDV) aerosols. Infectious material rafting on skin cell aerosols is an established means of transmitting other diseases. The evidence for a similar mechanism for FMDV is: (i) FMDV is trophic for animal skin and FMDV epidermis titres are high, even in macroscopically normal skin; (ii) estimates for FMDV skin cell aerosol emissions appear consistent with measured aerosol emission rates and are orders of magnitude larger than the minimum infectious dose; (iii) the timing of infectious FMDV aerosol emissions is consistent with the timing of high FMDV skin concentrations; (iv) measured FMDV aerosol sizes are consistent with skin cell aerosols; and (v) FMDV stability in natural aerosols is consistent with that expected for skin cell aerosols. While these findings support the hypothesis, this review is insufficient, in and of itself, to prove the hypothesis and specific follow-on experiments are proposed. If this hypothesis is validated, (i) new FMDV detection, management and decontamination approaches could be developed and (ii) the relevance of skin cells to the spread of viral disease may need to be reassessed as skin cells may protect viruses against otherwise adverse environmental conditions.
Collapse
Affiliation(s)
- Michael B Dillon
- Lawrence Livermore National Laboratory, PO Box 808, L-103, Livermore, CA 94551, USA.
| |
Collapse
|
138
|
Effects of sizes and conformations of fish-scale collagen peptides on facial skin qualities and transdermal penetration efficiency. J Biomed Biotechnol 2010; 2010:757301. [PMID: 20625414 PMCID: PMC2896882 DOI: 10.1155/2010/757301] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2010] [Accepted: 04/03/2010] [Indexed: 12/21/2022] Open
Abstract
Fish-scale collagen peptides (FSCPs) were prepared using a given combination of proteases to hydrolyze tilapia (Oreochromis sp.) scales. FSCPs were determined to stimulate fibroblast cells proliferation and procollagen synthesis in a time- and dose-dependent manner. The transdermal penetration capabilities of the fractionationed FSCPs were evaluated using the Franz-type diffusion cell model. The heavier FSCPs, 3500 and 4500 Da, showed higher cumulative penetration capability as opposed to the lighter FSCPs, 2000 and 1300 Da. In addition, the heavier seemed to preserve favorable coiled structures comparing to the lighter that presents mainly as linear under confocal scanning laser microscopy. FSCPs, particularly the heavier, were concluded to efficiently penetrate stratum corneum to epidermis and dermis, activate fibroblasts, and accelerate collagen synthesis. The heavier outweighs the lighter in transdermal penetration likely as a result of preserving the given desired structure feature.
Collapse
|
139
|
Abstract
A thorough examination of the skin is essential to screen various diseases accurately, evaluate the effectiveness of topically applied drugs and assess the results of dermatological surgeries such as skin grafts. The assessment of skin properties is also crucial in the cosmetics industry, where it is important to evaluate the effects skin care products have on these properties. The simplest and most widely used method of skin evaluation, the 'naked eye' assessment, enables researchers to assess only the skin surface and involves a large amount of inter-observer variability. Thanks to a great progress that has been made in physics, electronics and computer engineering in recent years, sophisticated imaging methods are increasingly available in day-to-day studies. The aim of this review was to present one of these techniques, namely the magnetic resonance imaging (MRI), and to discuss its possible use in skin examination and analysis. We present basic principles of MRI, as well as several interesting applications in the field of dermatology, and discuss the advantages and limitations of this method.
Collapse
Affiliation(s)
- J Stefanowska
- Department of Pharmaceutical Technology, Medical University of Gdansk, Gdansk, Poland
| | | | | |
Collapse
|
140
|
Chen SY, Wu HY, Sun CK. In vivo harmonic generation biopsy of human skin. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:060505. [PMID: 20059236 DOI: 10.1117/1.3269676] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The ability to in vivo image deep tissues noninvasively with a high resolution is strongly required for optical virtual biopsy. Higher harmonic generation microscopy, combined with second- and third-harmonic generation microscopies, is applied to 17 Asian volunteers' forearm skin. After continuous observation for 30 min, no visible damage was found. Our study proves that harmonic generation biopsy (HGB) is able to satisfy the safety requirement and to provide high penetrability (approximately 300 microm) and submicron resolution all at the same time and is a promising tool for future virtual biopsy of skin diseases. In contrast to a previous study on fixed human skin specimens, a much improved penetrability and much reduced resolution-degradation versus depth are found in this in vivo examination.
Collapse
|
141
|
Reid ML, Jones SA, Brown MB. Transient drug supersaturation kinetics of beclomethasone dipropionate in rapidly drying films. Int J Pharm 2009; 371:114-9. [DOI: 10.1016/j.ijpharm.2008.12.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Accepted: 12/18/2008] [Indexed: 10/21/2022]
|
142
|
Jones SA, Reid ML, Brown MB. Determining degree of saturation after application of transiently supersaturated metered dose aerosols for topical delivery of corticosteroids. J Pharm Sci 2009; 98:543-54. [PMID: 18548616 DOI: 10.1002/jps.21448] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A transiently supersaturated drug delivery system has the potential to enhance topical drug delivery via heightened thermodynamic activity. The aim of this work was to quantify the degree of saturation (DS) for transiently supersaturated formulations using three traditional and one novel in vitro assessment methods. Metered dose aerosols (MDA) were formulated containing saturated levels of beclomethasone dipropionate monohydrate (BDP) or betamethasone 17-valerate (BMV) within a pressurised canister, and included ethanol (EtOH), hydrofluoroalkane 134a propellant and poly(vinyl pyrrolidone). Attempts to determine the DS via the measurement of drug flux through synthetic membranes did not correlate and was shown to be dependent on the EtOH concentration. The inability of these methods to accurately assess the drug DS may be due to the transient nature of the formulation and the volatile solvents dehydrating the membrane. A mathematical equation that used the evaporation rate of the formulation was derived to determine the theoretical DS at various time points after MDA actuation. It was shown that the MDAs became supersaturated with a high DS, this enhanced drug release from the formulation and therefore these preparations have the potential to increase the amount of drug delivered into the skin.
Collapse
Affiliation(s)
- Stuart A Jones
- Pharmaceutical Science Research Division, King's College, London, London, UK.
| | | | | |
Collapse
|
143
|
Hashiguchi N, Tochihara Y. Effects of low humidity and high air velocity in a heated room on physiological responses and thermal comfort after bathing: An experimental study. Int J Nurs Stud 2009; 46:172-80. [DOI: 10.1016/j.ijnurstu.2008.09.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 09/16/2008] [Accepted: 09/19/2008] [Indexed: 11/25/2022]
|
144
|
Manipulation of corticosteroid release from a transiently supersaturated topical metered dose aerosol using a residual miscible co-solvent. Pharm Res 2008; 25:2573-80. [PMID: 18668352 DOI: 10.1007/s11095-008-9675-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 06/19/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE The creation of supersaturation transiently after application overcomes the issue of drug instability. However, if the solvents used to drive supersaturation evaporate too quickly, drug recrystallisation or rapid film drying can occur which will inhibit drug release. As such the effects of a residual solvent, poly(ethylene glycol) 400 (PEG), on the release, mobility and supersaturation kinetics of a transiently supersaturated formulation were studied. MATERIALS AND METHODS Metered dose aerosol (MDA) formulations consisting of hydrofluoroalkane 134a, ethanol, poly(vinyl pyrrolidone) K90, beclomethasone dipropionate (BDP), and 0%, 5% or 10% w/w PEG were prepared in canisters sealed with metered dose valves and tested for release and adhesion over time. RESULTS The addition of 10% PEG to the MDA formulation resulted in a significant reduction (p < 0.05) in steady state drug release rate (230.4 +/- 17.3 microg/cm(2)/h for 0% PEG MDA, 83.6 +/- 4.9 microg/cm(2)/h for 10% PEG MDA). The presence of PEG caused a delay in dose depletion (2 h for 0% PEG MDA versus 4 h for 10% PEG), retarded supersaturation kinetics and increased film drying time. CONCLUSION Whilst equivalent amounts of BDP were released, the residual solvent altered the drug release profile to achieve more constant delivery.
Collapse
|
145
|
Jungersted JM, Hellgren LI, Jemec GBE, Agner T. Lipids and skin barrier function--a clinical perspective. Contact Dermatitis 2008; 58:255-62. [PMID: 18416754 DOI: 10.1111/j.1600-0536.2008.01320.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The stratum corneum (SC) protects us from dehydration and external dangers. Much is known about the morphology of the SC and penetration of drugs through it, but the data are mainly derived from in vitro and animal experiments. In contrast, only a few studies have the human SC lipids as their focus and in particular, the role of barrier function in the pathogenesis of skin disease and its subsequent treatment protocols. The 3 major lipids in the SC of importance are ceramides, free fatty acids, and cholesterol. Human studies comparing levels of the major SC lipids in patients with atopic dermatitis and healthy controls have suggested a possible role for ceramide 1 and to some extent ceramide 3 in the pathogenesis of the disease. Therapies used in diseases involving barrier disruption have been sparely investigated from a lipid perspective. It has been suggested that ultraviolet light as a treatment increases the amount of all 3 major SC lipids, while topical glucocorticoids may lead to a decrease. Such effects may influence the clinical outcome of treatment in diseases with impaired barrier function. We have, therefore, conducted a review of the literature on SC lipids from a clinical perspective. It may be concluded that the number of human studies is very limited, and in the perspective of how important diseases of impaired barrier function are in dermatology, further research is needed.
Collapse
Affiliation(s)
- Jakob Mutanu Jungersted
- Department of Dermatology, Roskilde Hospital, University of Copenhagen, Køgevej 7-13, DK-4000 Roskilde, Denmark.
| | | | | | | |
Collapse
|
146
|
Nash JF, Matts PJ, Ertel KD. Maintenance of healthy skin: cleansing, moisturization, and ultraviolet protection. J Cosmet Dermatol 2007. [DOI: 10.1111/j.1473-2165.2007.00314.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
147
|
Jacobson MK, Kim H, Coyle WR, Kim M, Coyle DL, Rizer RL, Jacobson EL. Effect of myristyl nicotinate on retinoic acid therapy for facial photodamage. Exp Dermatol 2007; 16:927-35. [DOI: 10.1111/j.1600-0625.2007.00616.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
148
|
Ogg M, Petersen C. Surgical hand antisepsis; hand lotions and creams; gel overlays as artificial nails; benchmarking. AORN J 2007. [DOI: 10.1016/s0001-2092(07)60156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
149
|
Skin Health of Health Care Workers. Am J Infect Control 2006. [DOI: 10.1016/j.ajic.2006.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|