Cutaneous effects and therapeutic uses of heat with emphasis on infrared radiation

Short-term foot warming impacts foot sensitivity and body sway differently in older adults

BACKGROUND

Aging is accompanied by loss of foot skin sensitivity and reduced postural control. Increasing foot temperature can improve both skin sensitivity and postural control in adults. However, it remains unclear whether similar effects can be observed in older adults.

RESEARCH QUESTION

Can foot warming improve postural control in older adults, similar to observations in younger adults?

METHODS

Two foot warming protocols were conducted in 18 older adults (14 women, 4 men) to increase foot temperature by using infrared radiation to (1) warm the plantar aspect and (2) the skin of the entire foot and ankle area. We assessed the foot skin sensitivity before and after warming, considering tactile stimulation and center of pressure (CoP) displacement during 30-s standing with eyes open and closed.

RESULTS AND SIGNIFICANCE

Both foot warming protocols led to similar increases in skin temperature (∼6 °C) compared to the basal condition, but only warming the entire foot and ankle area increased foot sensitivity for the different regions assessed. No main effects or interactions were found for CoP variables in response to the two warming protocols. The short-term effects identified after warming the entire foot and ankle region suggest that this might be a strategy to improve skin sensitivity in older adults as observed in younger adults, but this was not the case for CoP. Future research should clarify whether the magnitude and long-lasting effects of warming could be determinant of CoP results.

Effects of mineral complex material treatment on 2,4- dinitrochlorobenzene-induced atopic dermatitis like-skin lesions in mice model

Background

Atopic dermatitis (AD) is a chronic allergic inflammatory skin disease characterized by complex pathogenesis including skin barrier dysfunction, immune-redox disturbances, and pruritus. Prolonged topical treatment with medications such as corticosteroids, calcineurin inhibitors, and T-cell inhibitors may have some potential side-effects. To this end, many researchers have explored numerous alternative therapies using natural products and mineral compounds with antioxidant or immunomodulatory effects to minimize toxicity and adverse-effects. In the current study, we investigated the effects of mineral complex material (MCM) treatment on 2, 4-dinitrochlorobenzene (DNCB)-induced AD-like skin lesions in SKH-1 hairless mice.

Methods

Animals were divided into four groups; normal control (NC), negative control treated with DNCB only (DNCB only), positive control treated with DNCB and tacrolimus ointment (PC) and experimental group treated with DNCB and MCM patch (MCM). Skin inflammation and lesion severity were investigated through analyses of skin parameters (barrier score and strength, moisture and trans-epidermal water loss level), histopathology, immunoglobulin E, and cytokines. In addition, reactive oxygen species (ROS), nitric oxide (NO), glutathione peroxidase (GPx), and catalase (CAT) levels were measured in both serum and skin lysate.

Results

Our results demonstrates that MCM patch improved the progression of AD-like skin lesions by significantly increasing skin barrier strength and decreasing trans-epidermal water loss. Additionally, dermal administration of MCM patch significantly reduced epidermal thickness, ROS, and NO levels in skin lysate. Furthermore, we found that MCM suppressed the levels of AD-involved (Th₁ and Th₂) cytokines such as IL-2, IFN-γ, and IL-4 in blood. In addition, the levels of other Th_1, and Th₂ and inflammatory cytokines such as IL-1β, TNF-α, IL-6, IL-12(p70) and IL-10 were found lowest in the MCM group than in the DNCB only and PC groups. Moreover, we found total serum IgE level significantly increased after DNCB treatment, but decreased in the PC and MCM groups.

Conclusion

Taken together, our findings suggest that MCM application may have beneficial effects either systemic or regional on DNCB-induced AD lesional skin via regulation of the skin barrier function and immune-redox response.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12906-021-03259-5.

Effects of Far-infrared Ray on Temozolomide-treated Glioma in Rats

BACKGROUND/AIM

Malignant glioma is a rapidly progressive primary brain cancer. The aim of the study was to investigate the effect of far-infrared ray (FIR) on temozolomide (TMZ)-treated glioma in rats.

MATERIALS AND METHODS

Male, 8-week old, Fischer 344 inbred rats with glioma were randomly divided into three study groups (20 rats in each group). The control group received saline only once daily for 5 days. The TMZ group received TMZ (30 mg/kg) once daily for 5 days. The TMZ plus FIR group received TMZ (30 mg/kg) once daily for 5 days and infrared-c irradiation of 40 min twice daily for 4 weeks. The relative tumor fold and the expression of hypoxia-induced factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were compared using one-way ANOVA at the end of study.

RESULTS

The relative tumor fold of the TMZ+FIR group was significantly higher compared to the control group, and was borderline higher compared to the TMZ group at Day 7. The relative tumor fold of TMZ+FIR group was significantly higher compared to the control group and the TMZ group at Days 14, 21 and 28. HIF-1α expression of TMZ+FIR group was borderline higher compared to the control group at Day 28. The VEGF expression of TMZ+FIR group was significantly higher compared to the control group and the TMZ group at Day 28.

CONCLUSION

FIR might increase the growth of glioma under TMZ treatment in rats possibly via increasing VEGF expression, but not HIF-1α expression.

Heat shock antagonizes UVA-induced responses in murine melanocytes and melanoma cells: an unexpected interaction

The skin is under the influence of oscillatory factors such as light and temperature. This organ possesses a local system that controls several aspects in a time-dependent manner; moreover, the skin has a well-known set of opsins whose function is still unknown. We demonstrate that heat shock reduces Opn2 expression in normal Melan-a melanocytes, while the opposite effect is found in malignant B16-F10 cells. In both cell lines, UVA radiation increases the expression of Opn4 and melanin content. Clock genes and Xpa, a DNA repair gene, of malignant melanocytes are more responsive to UVA radiation when compared to normal cells. Most UVA-induced effects are antagonized by heat shock, a phenomenon shown for the first time. Based on our data, the heat produced during UV experiments should be carefully monitored since temperature represents, according to our results, an important confounding factor, and therefore it should, when possible, be dissociated from UV radiation. The responses displayed by murine melanoma cells, if proven to also take place in human melanoma, may represent an important step in cancer development and progression.

Functionalized Textile Based Therapy for the Treatment of Atopic Dermatitis

Atopic dermatitis (AD) is a common chronic inflammatory skin condition characterized by intense puritus and skin dryness. The pathogenesis for AD has not been fully understood to date. Complementary therapies are very popular as effective treatment for AD among clinical practitioners. This study presents a comprehensive review of published works associated with textiles-based complementary therapies for AD treatment such as wet-wrap dressing, functionalized textiles, and the application of hydrogel techniques in the textile industry to provide a better understanding of the development and design of new textiles-based transdermal therapies.

Triggered release of model drug from AuNP-doped BSA nanocarriers in hair follicles using IRA radiation

Recent advances in the field of dermatotherapy have resulted in research efforts focusing on the use of particle-based drug delivery systems for the stimuli-responsive release of drugs in the skin and skin appendages, i.e. hair follicles and sebaceous glands. However, effective and innocuous trigger mechanisms which result in the release of the drugs from the nanocarriers upon reaching the target structures are still lacking. For the first time, the present study demonstrated the photo-activated release of the model drug fluorescein isothiocyanate (FITC) from topically applied gold nanoparticle-doped bovine serum albumin (AuNPs-doped BSA) particles (approx. 545nm) using water-filtered infrared A (IRA) radiation in the hair follicles of an ex vivo porcine skin model. The IRA radiation-induced plasmonic heating of the AuNPs results in the partial decomposition or opening of the albumin particles and release the model drug, while control particles without AuNPs show insignificant release. The results demonstrate the feasibility of using IRA radiation to induce release of encapsulated drugs from plasmonic nanocarriers for the targeting of follicular structures. However, the risk of radiation-induced skin damage subsequent to repeated applications of high infrared dosages may be significant. Future studies should aim at determining the suitability of lower infrared A dosages, such as for medical treatment regimens which may necessitate repeated exposure to therapeutics.

STATEMENT OF SIGNIFICANCE

Follicular targeting using nanocarriers is of increasing importance in the prophylaxis and treatment of dermatological or other diseases. For the first time, the present study demonstrated the photo-activated release of the model drug fluorescein isothiocyanate (FITC) from topically applied gold nanoparticle-doped bovine serum albumin (AuNPs-doped BSA) particles using water-filtered infrared A (IRA) radiation in the hair follicles of an ex vivo porcine skin model. The results demonstrate the feasibility of using wIRA radiation to induce release of encapsulated drugs for the targeting of follicular structures, and provide a new vision on the development of optically addressable delivery systems for controlled release of drugs in the skin and skin appendages, i.e. hair follicles and sebaceous glands.

The role of optical radiations in skin cancer

Purpose. Electromagnetic radiation with wavelength in the range 100 nm to 1 mm is known as optical radiation and includes ultraviolet radiation, the visible spectrum, and infrared radiation. The deleterious short- and long-term biological effects of ultraviolet radiation, including melanoma and other skin cancers, are well recognized. Infrared radiation may also have damaging biological effects. Methods. The objective of this review was to assess the literature over the last 15 years and to summarize correlations between exposure to optical radiation and the risk of melanoma and other cancers. Results. There is a clear correlation between exposure to UV radiation and the development of skin cancer. Most importantly, a strong association between artificial UV radiation exposure, for example, tanning devices, and the risk of melanoma and squamous cell carcinoma has been clearly demonstrated. There is no clear evidence that exposure to IR and laser radiation may increase the risk of skin cancer, although negative health effects have been observed. Conclusions. Preventative strategies that involve provision of public information highlighting the risks associated with exposure to sunlight remain important. In addition, precautionary measures that discourage exposure to tanning appliances are required, as is legislation to prevent their use during childhood.

The clinical efficacy, safety and functionality of anion textile in the treatment of atopic dermatitis

BACKGROUND

Several previous studies have suggested the improvement of atopic dermatitis (AD) in response to special fabrics. In particular, beneficial effects have been reported, following the use of anion textiles.

OBJECTIVE

The purpose of this study is to evaluate the effectiveness and safety of an anion textile in patients suffering from AD.

METHODS

We compared an anion textile with a pure cotton textile. Fifty-two atopic patients (n=52) were enrolled and divided into two groups. The patients in the test (n=25) and control (n=19) groups wore undergarments made of an anion textile or pure cotton over a period of 4 weeks. The overall severity of disease was evaluated using the SCORing atopic dermatitis (SCORAD) index, whereas, the treatment efficacy was measured using a Tewameter® (Courage & Khazaka, Cologne, Germany), Mexameter® (Courage & Khazaka) and Corneo meter® (Courage & Khazaka).

RESULTS

At the end of the study, a significant decrease in the SCORAD index was observed among the patients with AD in the test group (mean SCORAD decreased from 47.2 to 36.1). Similarly, improvements in the mean transepidermal water loss, skin erythema and stratum corneum hydration were significantly greater among the patients with AD in the test group than in the control group.

CONCLUSION

Anion textiles may be used to significantly improve the objective and subjective symptoms of AD, and are similar in terms of comfort to cotton textiles. The use of anion textiles may be beneficial in the management of patients with AD.

Impact of near-infrared radiation in dermatology

Sunlight that reaches the human skin contains solar energy composed of 6.8% ultraviolet (UV), 38.9% visible light and 54.3% infrared radiation. In addition to natural near-infrared (NIR), human skin is increasingly exposed to artificial NIR from medical devices and electrical appliances. Thus, we are exposed to tremendous amounts of NIR. Many studies have proven the effects of UV exposure on human skin and skin cancers but have not investigated well the effects of NIR exposure. Furthermore, many of the previous NIR studies have used NIR resources without a water filter or a contact cooling. With these resources, a substantial amount of NIR energy is absorbed in the superficial layers and only limited NIR energy can be delivered to deeper tissues. Thus, they could not sufficiently evaluate the effects of incident solar NIR. In order to simulate solar NIR that reaches the skin, a water filter is essential because solar NIR is filtered by atmospheric water. In reality, NIR increases the surface temperature and induces thermal effects so a contact cooling is needed to pursue the properties of NIR. I clarify that NIR can penetrate the skin and non-thermally affect the subcutaneous tissues, including muscle and bone marrow, using a NIR resource with a water filter and a cooling system. I would like to emphasize the biological effects of NIR which have both merits and demerits. Appropriate NIR irradiation induces dermal heating thermally and non-thermally induces collagen and elastin stimulation, which results in skin tightening. NIR also induces non-thermal DNA damage of mitotic cells, which may have the potential application for treating cancer. However, as continuous NIR exposure may induce photoaging and potentially photocarcinogenesis, we should consider the effect of, not only UV, but also NIR and the necessity for protection against solar NIR. Here, this paper introduces the new aspects of the biological effects of NIR radiation.

Chronic heat treatment causes skin wrinkle formation and oxidative damage in hairless mice

We have previously demonstrated that heat shock could induce expression of matrix metalloproteinases (MMPs) in skin cells. These results implicated that chronic heat treatment may cause skin wrinkles. Therefore, in the present study, we investigated the effects of chronic heat treatment (43 °C, 30 min, 3 times/week, 6 weeks) on wrinkle formation in skin of hairless mice. We found that repetitive heat treatment induced skin wrinkles after a period of 6 weeks in skin of hairless mice. Histologically, heat treatment resulted in increased thickness of the epidermis and dermis. And repetitive heat treatment resulted in significantly increased expression of MMP-13 protein and mRNA, but not MMP-2 and -9, in skin of hairless mice. We also demonstrated that activities of antioxidant enzymes, catalase, and superoxide dismutase (SOD), were reduced by chronic heat treatment. In addition, oxidative damage was increased in skin of mice after chronic exposure to heat shock. Taken together, our results suggested that chronic exposure of the skin to heat can cause skin wrinkling. And, increase of MMP-13, decrease of antioxidant enzymes activity, and consequent oxidative damage by chronic heat treatment may play an important role in development of skin aging in hairless mice.

Infrared radiation does not enhance the frequency of ultraviolet radiation-induced skin tumors, but their growth behaviour in mice

There is increasing concern about the interaction between infrared radiation (IR) and ultraviolet radiation (UVR) with regard to carcinogenesis because prolonged solar exposure is associated with an increased cumulative load not only of UVR but also of IR. We recently demonstrated that IR-pretreatment reduces UVR-induced apoptosis. As this might support the survival of UVR-damaged cells and thus carcinogenesis, we performed an in vivo photocarcinogenesis study. One group of mice were treated with IR prior to each UVR exposure; additional groups were treated with IR or UVR alone. IR alone did not induce skin cancer. UVR-induced tumor formation was not enhanced in IR-pretreated mice, but, in contrast, seemed to occur with delay. This correlated with a reduction of p53 mutated clones in the skin. However, once developed, tumors in IR-pretreated mice grew faster which was confirmed by their enhanced Ki-67 expression. The enhanced aggressiveness of tumors derived from IR-pretreated mice was associated with a higher prevalence of sarcomas than epithelial tumors. Hence, the impact of IR on UVR-induced carcinogenesis has to be interpreted with caution. Although IR may delay the onset of UVR-induced tumors, it might contribute to a worse outcome by shifting these tumors into a more aggressive phenotype.

Determination of the influence of IR radiation on the antioxidative network of the human skin

Production of free radicals in the human skin subsequent to IR irradiation has been demonstrated by means of two different methods. The first technique, based on resonance Raman spectroscopy, enables the non-invasive measurements of the kinetics of cutaneous carotenoid antioxidants beta-carotene and lycopene, subsequent to IR irradiation. Obtained degradation of the cutaneous carotenoids was a hint but not evidence that IR irradiation can produce free radicals in the skin. Therefore, the direct observation sustaining the production of free radicals subsequent to IR irradiation in the skin was performed in-vitro by electron paramagnetic resonance spectroscopy. Enzymatic processes as well as heat shock-induced radicals in the human skin are presumably involved in the energy transfer from IR irradiation into the molecules of the skin. Protection strategy for human skin against IR-induced free radicals based on the increase in the concentration of antioxidants by means of antioxidant-rich supplementation is discussed.

Infrared radiation confers resistance to UV-induced apoptosis via reduction of DNA damage and upregulation of antiapoptotic proteins

Infrared radiation (IR) is increasingly used for wellness purposes. In this setting, it is frequently combined with UV radiation, primarily for tanning purposes. The impact of IR on UV-induced carcinogenesis is still unclear. Hence, we investigated the interplay between IR and UV with regard to UV-induced apoptosis. Pretreatment of murine keratinocytes with IR before UV reduced the apoptotic rate. Likewise, the number of sunburn cells was reduced in mice preexposed to IR before UV. The amounts of UV-induced DNA damage were reduced by IR both in vitro and in vivo. This was not observed in DNA repair-deficient mice. UV-induced downregulation of the antiapoptotic proteins FLIP(L) and BCL-X(L) was prevented by IR, whereas the proapoptotic protein BAX was downregulated. These data indicate that IR reduces UV-induced apoptosis that may be mediated by several pathways, including reduction of DNA damage and induction of antiapoptotic proteins. The antiapoptotic effects of IR may support the survival of UV-damaged cells and thus carcinogenesis. As, however, IR reduces UV-induced DNA damage, the balance between these two effects may be important. Thus, in vivo carcinogenesis studies are required to define the role of IR and its interaction with UV in photocarcinogenesis.

Infrared exposure induces an angiogenic switch in human skin that is partially mediated by heat

BACKGROUND

Angiogenesis plays an important role in physiological and pathological conditions of the skin. Although acute ultraviolet-induced skin angiogenesis has been investigated, little is known about the distinct effects of acute infrared (IR) radiation on angiogenesis in human skin.

OBJECTIVES

To elucidate the molecular regulation of the angiogenic switch by acute near-IR radiation or by a single heat treatment in human skin in vivo.

METHODS

We subjected 16 healthy volunteers to near-IR irradiation (six minimal heating doses) and 14 healthy volunteers to heat treatment (43 degrees C for 90 min), and skin specimens were obtained by punch biopsy for immunohistochemical, Western blot and reverse transcription-polymerase chain reaction analyses.

RESULTS

We observed that CD31-stained vessels in the upper dermis were increased after acute near-IR exposure, and that this was associated with the upregulation of vascular endothelial growth factor (VEGF) and the downregulation of thrombospondin (TSP)-2. During the application of near-IR to buttock skin, skin temperatures immediately increased from 32 degrees C up to 42 degrees C, as measured using a digital thermometer. Moreover, the expression of inducible heat shock protein 70 was increased after near-IR irradiation in human skin. Therefore, we investigated the effects of a single heat treatment on angiogenesis and on the expression of VEGF and TSP-2 in skin, and found that vascularization and VEGF expression were increased, whereas TSP-2 expression was reduced.

CONCLUSIONS

Our results suggest that IR radiation plays an important role in skin angiogenesis via regulation of the balance between the angiogenic inducer VEGF and the angiogenic inhibitor TSP-2, and that IR-induced skin angiogenesis might be partially caused by the effects of heat in human skin in vivo.

Minimal heating dose: a novel biological unit to measure infrared irradiation

BACKGROUND AND OBJECTIVE

Infrared (IR) rays, which comprise approximately 40% of the solar radiation which reaches the earth's surface, have received relatively scant attention. As no standard method has yet been agreed upon for the biological evaluation of IR irradiation, the objective of this study is to suggest a new unit for IR irradiation.

METHODS

The skin temperature of 38 Korean volunteers was measured after IR irradiation with varying irradiance.

RESULTS

Skin temperature after IR irradiation at an irradiance of 2.02 W/cm2 remained unchanged after 652+/-22 s (mean+/-standard error), which corresponds, in this case, to a total radiation dose of IR 1317.3+/-44.84 J/cm2. This quantity was designated as the minimal heating dose (MHD). We also demonstrated that MHD increased with increasing IR irradiance at lower IR irradiance (1.17 and 2.02 W/cm2), whereas it became constant at higher irradiance (2.87 and 3.22 W/cm2). No statistically significant correlations were detected between MHD and volunteers' ages, erythema index, or melanin index.

CONCLUSION

We propose 'MHD' as a biological unit for the measurement of IR irradiation.

A Geriatrician's Guide to the Use of the Physical Modalities in the Treatment of Pain and Dysfunction

The use of the physical modalities in the treatment of musculoskeletal conditions has a long and rich history. This article explores the various physical modalities and their indications, precautions, and contraindications, especially in their applied use in pain management. It also highlights the role of the physical modalities as agents for the management of pain in the geriatric population.

Repeated thermal therapy diminishes appetite loss and subjective complaints in mildly depressed patients

OBJECTIVE

We observed that repeated thermal therapy improved appetite loss and general well-being in patients with chronic heart failure. The purpose of this study is to clarify the effects of repeated thermal therapy in mildly depressed patients with appetite loss and subjective complaints.

METHODS

Twenty-eight mildly depressed inpatients with general fatigue, appetite loss, and somatic and mental complaints were randomly assigned to thermal therapy group (n = 14) or nonthermal therapy group (n = 14). Patients in the thermal therapy group were treated with 60 degrees C far-infrared ray dry sauna for 15 minutes and were then kept at bed rest with a blanket for 30 minutes once a day, 5 days a week for a total of 20 sessions in 4 weeks.

RESULTS

Four weeks after admission, somatic complaints, hunger, and relaxation scores significantly improved (p < .001, p < .0001, p < .0001, respectively) and mental complaints slightly improved (p = .054) in the thermal therapy group compared with the nonthermal therapy group. Furthermore, the plasma ghrelin concentrations and daily caloric intake in the thermal therapy group significantly increased compared with the nonthermal therapy group (p < .05).

CONCLUSIONS

These findings suggest that repeated thermal therapy may be useful for mildly depressed patients with appetite loss and subjective complaints.

Heat modulation of tropoelastin, fibrillin-1, and matrix metalloproteinase-12 in human skin in vivo

Photoaged skin contains elastotic materials in the upper reticular dermis. This phenomenon is commonly known as solar elastosis. In this study, we investigated the effects of heat on the expression of tropoelastin and fibrillin-1, two main components of elastic fibers, and on matrix metalloproteinase (MMP)-12, the most active MMP against elastin, in human skin in vivo. Heat was found to increase tropoelastin mRNA and protein expression in the epidermis and in the dermis. Fibrillin-1 mRNA and protein expression were increased by heat in the epidermis, but were decreased in the dermis. We found that pre-treatment of skin with N-acetyl cysteine or genistein for 24 h prior to heat treatment inhibited the heat-induced expression of tropoelastin, but not of fibrillin-1. These data indicate that reactive oxygen species may play a role in tropoelastin expression by heat, but not in fibrillin-1 expression. We also found that heat treatment increases MMP-12 mRNA and protein expression in human skin. Our results suggest that the abnormal production of tropoelastin and fibrillin by heat in human skin and that their degradation by various MMP, such as MMP-12, may contribute to the accumulation of elastotic material in photoaged skin.

Heat shock-induced matrix metalloproteinase (MMP)-1 and MMP-3 are mediated through ERK and JNK activation and via an autocrine interleukin-6 loop

Although many studies have been performed to elucidate the molecular consequences of ultraviolet irradiation, little is known about the effect of infrared radiation on skin aging. In addition to photons, heat is likely to be generated as a consequence of infrared irradiation, and heat shock is widely considered to be an environmental stress. Here we investigated the effect of heat shock on the expressions of matrix metalloproteinase (MMP)-1, MMP-2, and MMP-3 in cultured human skin fibroblasts. Heat shock induced the expression of MMP-1 and MMP-3, but not MMP-2, at the mRNA and protein levels in a temperature-dependent manner, and caused the rapid activation of three distinct mitogen-activated protein kinases (MAPK), extracelluar signal-regulated kinase (ERK), c-Jun N-terminal kinase (JNK), and p38 MAPK. The heat shock-induced MMP-1 and MMP-3 expression was suppressed by the inhibition of ERK and JNK but not by p38 MAPK inhibition. Furthermore, heat shock increased the synthesis and release of interleukin-6 (IL-6) into culture media. The specific inhibition of IL-6 using a monoclonal antibody against IL-6 greatly reduced the expression of MMP-1 and MMP-3 induced by heat shock. Taken together, our results suggest that ERK and JNK play an important role in the induction of MMP-1 and MMP-3 by heat shock and that the heat shock-induced expression of MMP-1 and MMP-3 is mediated via an IL-6-dependent autocrine mechanism.

Kératose lichénoïde striée et exposition prolongée aux infrarouges

BACKGROUND

We report a case of keratosis lichenoides chronica and prolonged exposure to a source of heat (infrared radiation).

CASE REPORT

A 35 year-old man was examined for a symmetric and reticulate dermatosis on the abdomen, the interior of arms and lower extremities. The lesions had progressed over several months. They were characterized by hyperpigmentation, erythematous, bullous and squamous papules. These lesions were associated with those of the scalp, evoking seborrheic dermatitis. The patient was exposed to a source of heat with an electric radiator on his bare chest everyday. The skin biopsy showed a lichenoid reaction. All these elements allowed to put the diagnosis of keratosis lichenoides chronica, probably actived by the infrared light.

DISCUSSION

Keratosis lichenoides chronica is a rare acquired dermatosis of the young adult. Its physiopathology remains elusive. This dermatosis is characterized by keratosic violaceous lichenoid papules distributed symmetrically. The eruption is usually asymptomatic. The histological examination indicates a lichenoid reaction. The progression is chronic and the disease is very resistant to therapy. Keratosis lichenoides chronica has never been described as being able to be induced by Koebner's phenomenon. In the literature, two cases of erythema ab igne were associated with lichen planus. For some authors, keratosis lichenoides chronica is an entity itself, for others it would be related to lichen planus. These arguments enabled us to diagnose keratosis lichenoides chronica probably activated by the infrared light.

Cutaneous effects of infrared radiation: from clinical observations to molecular response mechanisms

Human skin is exposed to infrared (IR) radiation (760 nm-1 mm) from natural as well as artificial sources that are increasingly used for cosmetic or medical purposes. Epidemiological data and clinical observations, however, indicate that IR radiation cannot be considered as totally innocuous to human skin. In particular, IR radiation, similar to ultraviolet radiation, seems to be involved in photoaging and potentially also in photocarcinogenesis. The molecular consequences resulting from IR exposure are virtually unknown. Recent studies, however, have begun to shed light on the basic molecular processes such as cellular signal transduction and gene expression triggered by exposure to IR radiation. In response to IR irradiation, mitogen-activated protein kinase signaling pathways were activated mediating the upregulation of matrix metalloproteinase-1 expression. This previously unrecognized molecular 'IR response' shows that IR radiation is capable of specifically interfering with cellular functions and provides a molecular basis for biological effects of IR on human skin.

[Photoaging and infrared radiation. Novel aspects of molecular mechanisms]

Human skin is exposed to infrared (IR) radiation (760 nm-1 mm) from natural and artificial sources. In particular, the use of IR for cosmetic and "wellness" purposes has become increasingly popular and viewed as completely safe. However, epidemiological data and clinical observations indicate that IR radiation cannot be considered as totally innocuous to human skin. In particular, IR radiation, just as UV radiation, seems to be involved in photoaging and potentially also in photocarcinogenesis. In recent studies the molecular mechanisms involved in this process such as cellular signal transduction and gene expression have been characterised. IR radiation induces the synthesis of matrix metalloproteinase-1 via the mitogen-activated protein kinase signalling pathway. Since this mechanism is a major pathophysiologic factor in UV-induced skin ageing, its activation by IR radiation points to a role of IR in premature skin ageing and indicates the potential need for protection against unwanted IR effects.

Promotive effects of far-infrared ray on full-thickness skin wound healing in rats

The biological effects of far-infrared ray (FIR) on whole organisms remain poorly understood. The aim of our study was to investigate not only the hyperthermic effect of the FIR irradiation, but also the biological effects of FIR on wound healing. To evaluate the effect of FIR on a skin wound site, the speed of full-thickness skin wound healing was compared among groups with and without FIR using a rat model. We measured the skin wound area, skin blood flow, and skin temperature before and during FIR irradiation, and we performed histological inspection. Wound healing was significantly more rapid with than without FIR. Skin blood flow and skin temperature did not change significantly before or during FIR irradiation. Histological findings revealed greater collagen regeneration and infiltration of fibroblasts that expressed transforming growth factor-beta1 (TGF-beta1) in wounds in the FIR group than in the group without FIR. Stimulation of the secretion of TGF-beta1 or the activation of fibroblasts may be considered as a possible mechanisms for the promotive effect of FIR on wound healing independent of skin blood flow and skin temperature.

Cigarette smoking-associated elastotic changes in the skin

BACKGROUND

Clinical features of the skin in persons who smoke include increased wrinkling, gauntness, and discoloration that has been termed smoker's face. The histologic changes in the sun-exposed skin of these patients have not been previously elucidated.

OBJECTIVE

The purpose of this study was to assess the amount of elastosis in the sun-exposed skin of smokers and nonsmokers.

METHODS

We evaluated the skin from the forehead and cheeks of 17 smokers and 14 nonsmokers for the presence of elastosis. With the use of a computer-generated analysis of tissue sections at 4 different levels, the amount of elastotic material was expressed as an average percent of the field staining for elastic tissue. Patients were also evaluated for the presence of other malignancies, arsenic and radiation exposure, and previous skin cancers.

RESULTS

There was a significantly greater amount of elastosis (P < .05) in the skin of patients who smoked compared with those patients who did not. No significant differences were found between the 2 groups with regard to the other parameters evaluated.

CONCLUSION

Cigarette smoking is associated with an increase in elastosis, which may contribute to the clinical features of "smoker's face."

Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of the skin and of temporal arteritis

Staining technique is paramount for detecting and assessing the severe degeneration that occurs in the elastic tissues of the skin and its arteries in response to prolonged exposure to actinic radiation. With a selective "controlled" hematoxylin-and-eosin stain, actinically damaged ("elastotic") elastic tissue stains blue, as Unna described, and contrasts with normal and simply hyperplastic elastic tissue, which stains red. "Special" elastic stains such as Orcein and Verhoeff do not demonstrate this difference. When resorptive (elastolytic) giant cell reactions develop in relation to actinically degenerate elastic tissue of the skin, the papules that arise tend to form expanding, annular rings. A previously used and appropriate name for these autoimmune lesions in the skin is actinic granuloma because this name highlights the likely actinic origin and pathogenesis of many such lesions. Granulomatous inflammation in connection with actinically degenerate internal elastic lamina appears to be the basis of temporal arteritis. Actinic granulomas may occur in the skin concurrently with temporal arteritis. A recent study of temporal arteritis strongly relates its elastic tissue changes to those of "accelerated" atherosclerosis.

Regulatory effects of heat on normal human melanocyte growth and melanogenesis: comparative study with UVB

Although energy-rich ultraviolet B (UVB) is considered to be primarily responsible for most of the effects associated with solar radiation, small energy recorded as heat appears to contribute to the biologic effects of solar radiation on the skin. We compared the effects of heat and UVB on normal human melanocyte functions. In monolayer culture the following was found. (i) Heat-treated melanocytes showed an increased dendricity and exhibited a larger cell body compared with nontreated melanocytes. (ii) After multiple treatments with UVB (20 mJ per cm2, 312 nm) or heat (42 degrees C for 1 h) for 3 d, melanocytes had a lower survival than nontreated melanocytes, but they resumed proliferation within 6 d in the same manner as seen in control. (iii) The expression levels of cell cycle regulators, p53 and p21 proteins, were increased after multiple treatments with UVB or heat. (iv) The tyrosinase (dopa-oxidase) activity per cell was increased after the multiple treatments with UVB or heat. (v) The number of dopa-positive melanocytes in coculture with keratinocytes in epithelial sheets was greatly increased by UVB or heat treatments. (vi) Similarly, the increased number of tyrosinase-related protein 1 positive melanocytes was seen in skin equivalents after UVB (100 mJ per cm2) or heat (42 degrees C for 1 h) treatments for 7 d. These results suggest that heat shares significant biologic activities with UVB in melanocyte functions. These results could be considered as one of the protective or adaptive responses of the skin pigmentary system to the environment.

Effects of near-infrared radiation on the epidermal proliferation and cutaneous immune function in mice

While ultraviolet radiation alters various cutaneous cell functions, little is known about the photobiological effects of infrared radiation (IR) on the skin except its local thermal effect. This study demonstrated that single exposure of mouse skin to near IR (0.7-1.3 microns) reversibly suppressed the proliferating activity of the epidermis, the density of Langerhans cells, and the ability of skin to induce contact hypersensitivity reaction. During the exposure, the ear surface temperature was elevated from a mean of 27 to 31.2 degrees C. The results suggest that near IR can modulate the epidermal proliferation and part of the skin immune system, with a mild thermal effect.

The clinical spectrum of actinic elastosis

A plethora of literature promoting our understanding of the differences between intrinsic (chronologic) aging versus extrinsic aging of the skin has been published during the last two decades. The predominant extrinsic factor is UV radiation; the functional, histologic, and clinical consequences are referred to as photoaging, or dermatoheliosis. Actinic elastosis refers specifically to the degenerative histologic alterations seen by light microscopy in sun-damaged skin. Multiple factors, including anatomic site, extent of sun exposure, and other physical or environmental factors affect the clinical appearance of these changes. We review the clinical spectrum of the actinic elastotic variants.

Infrared radiation suppresses ultraviolet B-induced sunburn-cell formation

Sunburn cell (SC) formation, a quantifiable measure of epidermal cell injury induced in mouse ear skin by ultraviolet-B (UVB) radiation (290-320 nm), was significantly decreased by pre-exposure to infrared radiation (IR), which elevated the surface temperature of ear lobes to 37-42 degrees C. An autoradiographic study demonstrated that the basal cell labelling indices were significantly reduced in a surface temperature-dependent manner by pre-exposure to IR. Taken together with our previous findings that SC formation depends upon the ratio of cycling to non-cycling cells, the present findings suggest that IR retards the cell cycle and, as a result, decreases SC formation. SC counts were not altered by post-UVB exposure to IR. The effect of IR or the IR-induced increase in surface temperature should be considered when studying cutaneous damage by UVB and sunlight.

Thermotolerance and the heat shock response in normal human keratinocytes in culture

Protective responses of normal human epidermal keratinocytes in culture, after exposure to elevated temperatures ("heat shock"), were examined. Cell viability, measured 24-48 h after a 20-min heat challenge at temperatures between 37 degrees C and 54 degrees C, declined sharply within a narrow 2 degrees-3 degrees C range. However, conditioning with a mild thermal pretreatment (40 degrees C or 42 degrees C for 1 h) protected the keratinocytes against a subsequent heat challenge. This induced thermotolerance was apparent when cells were challenged at 1, 3, and 6 h after the thermal pre-treatment, but disappeared by 24 h. Heating conditions that induce thermotolerance also stimulated the synthesis of heat-shock proteins (hsp) in these cells. Inductions of prominent 35S-methionine labeled bands at 70, 78, and 90 kDa were observed. However, the increases in synthesis of these heat-shock proteins did not correlate well with thermotolerance, because large increases were also observed at certain elevated temperatures that did not produce improved survival. Keratins observed in these cells (50 and 58 kDa classes) were not induced by heat shock. The development of thermotolerance, and the induction of hsp, were both completely blocked by 3'-deoxyadenosine (cordycepin), an inhibitor of newly synthesized messenger RNA, but not by adenosine, the normal analog. While heat-inducible mRNA apparently mediate some function important for the development of thermotolerance, the nature of that role remains speculative. Overall, our findings establish the existence of a functional thermal protective mechanism in human keratinocytes that appears to require the synthesis of new mRNA.