Elderly adults and skin disorders: common problems for nondermatologists

Knowledge, Attitude, Reception, and Preventive Practices Towards Skin Photoaging Among the General Population in Jazan, Saudi Arabia

Introduction Skin photoaging is caused by prolonged exposure to sunlight, particularly ultraviolet rays (UV). High cumulative levels of UV radiation may cause burning, photoallergic or phototoxic reactions, pigmentary changes, photoaging, and even immunosuppression and skin cancers. Therefore, this study aims to assess knowledge, attitude, reception, and preventive practices towards skin photoaging among the Jazan general population in Saudi Arabia and its determinants. Methods A descriptive cross-sectional study was conducted among the general population of Jazan, Saudi Arabia, who were aged 18 years and above and agreed to participate in the study. The calculated minimum sample size was 385. An online, semi-structured, self-administered questionnaire was distributed conveniently in Google Forms through social media platforms. It included four sections: The first section was about sociodemographic characteristics. The second section assessed the smoking, exercise, and healthy diet behavior of participants and the use of sunscreen. The third section assessed the knowledge regarding the photoaging process and its preventive measures utilization using three-point Likert scale questions. The fourth section assessed attitudes towards the photoaging process and its preventive measures through three-point Likert scales. Results The study included 452, of which 243 (53.76%) were aged 18-30 years, 258 (57.08%) were females, and 272 (60.18%) had white skin color. Approximately 417 (92.26%) were nonsmokers. Sixty-eight percent (372) spent 1-3 hours in the sun. Social media was the primary source of information on photoaging 81 (17.92%). Around 234 (51.77%) defined photoaging correctly. Regarding sunscreen usage, 58 (12.83%) always use sunscreen, and 177 (39.16%) never use it. However, 191 (42.26%) recognized the correct sunscreen application. Approximately 233 (51.5%) and 240 (53.1%) of respondents had fair knowledge and a positive attitude regarding photoaging and sunscreen use. Being female, pursuing university and postgraduate education, and taking information on photoaging from a physician were linked to a higher knowledge of photoaging (p<0.05). Participants who never use sunscreen had lower knowledge than those who always use it (p<0.001). None of the demographic factors was associated with the attitude towards sunscreen use (p>0.05). Conclusion There is a substantial gap in knowledge and preventive practices related to skin photoaging among the Jazan general population in Saudi Arabia. Gender, education level, and information sources influence knowledge levels. Targeted educational interventions are needed to enhance awareness and promote healthier practices, particularly sun exposure and photoaging prevention.

N-Terminal Acetylation and C-Terminal Amidation of Spirulina platensis-Derived Hexapeptide: Anti-Photoaging Activity and Proteomic Analysis

Ultraviolet (UV) irradiation is a potent inducer for skin photoaging. This paper investigated the anti-photoaging effects of the acetylated and amidated hexapeptide (AAH), originally identified from Spirulina platensis, in (Ultraviolet B) UVB-irradiated Human immortalized keratinocytes (Hacats) and mice. The results demonstrated that AAH had much lower toxicity on Hacats than the positive matrixyl (81.52% vs. 5.32%). Moreover, AAH reduced MDA content by 49%; increased SOD, CAT, and GSH-Px activities by 103%, 49%, and 116%, respectively; decreased MMP-1 and MMP-3 expressions by 27% and 29%, respectively, compared to UVB-irradiated mice. Employing isobaric tags for relative and absolute quantitation (iTRAQ)-based proteomics, 60 differential proteins were identified, and major metabolic pathways were determined. Network analysis indicated that these differential proteins were mapped into an interaction network composed of two core sub-networks. Collectively, AAH is protective against UVB-induced skin photoaging and has potential application in skin care cosmetics.

Immunological and non-immunological mechanisms of allergic diseases in the elderly: biological and clinical characteristics

A better hygiene, a Westernized diet, air pollution, climate changes, and other factors that influence host microbiota, a key player in the induction and maintenance of immunoregulatory circuits and tolerance, are thought to be responsible for the increase of allergic diseases observed in the last years. The increase of allergic diseases in elderly is related to the presence of other factors as several comorbidities that should interfere with the development and the type of allergic reactions. A central role is played by immunosenescence responsible for modifying response to microbiota and triggering inflamm-ageing. In addition, in elderly there is a shift from Th1 responses vs. Th2, hence favouring allergic responses. Better understanding of the mechanisms of immunosenescence and its effects on allergic inflammation will most certainly lead to improved therapy.

An integrative metabolomics and transcriptomics study to identify metabolic alterations in aged skin of humans in vivo

Background

Aging human skin undergoes significant morphological and functional changes such as wrinkle formation, reduced wound healing capacity, and altered epidermal barrier function. Besides known age-related alterations like DNA-methylation changes, metabolic adaptations have been recently linked to impaired skin function in elder humans. Understanding of these metabolic adaptations in aged skin is of special interest to devise topical treatments that potentially reverse or alleviate age-dependent skin deterioration and the occurrence of skin disorders.

Results

We investigated the global metabolic adaptions in human skin during aging with a combined transcriptomic and metabolomic approach applied to epidermal tissue samples of young and old human volunteers. Our analysis confirmed known age-dependent metabolic alterations, e.g. reduction of coenzyme Q10 levels, and also revealed novel age effects that are seemingly important for skin maintenance. Integration of donor-matched transcriptome and metabolome data highlighted transcriptionally-driven alterations of metabolism during aging such as altered activity in upper glycolysis and glycerolipid biosynthesis or decreased protein and polyamine biosynthesis. Together, we identified several age-dependent metabolic alterations that might affect cellular signaling, epidermal barrier function, and skin structure and morphology.

Conclusions

Our study provides a global resource on the metabolic adaptations and its transcriptional regulation during aging of human skin. Thus, it represents a first step towards an understanding of the impact of metabolism on impaired skin function in aged humans and therefore will potentially lead to improved treatments of age related skin disorders.

Electronic supplementary material

The online version of this article (doi:10.1186/s12864-017-3547-3) contains supplementary material, which is available to authorized users.

Topical corticosteroid concerns from the clinicians' perspective

PURPOSE

Topical corticosteroids concerns (TCC) are common in dermatology patients, possibly leading to non-adherence to topical corticosteroids (TCS) and poor disease control. Clinicians play a key role in that context, as they can reduce or reinforce these concerns. It is unknown, if clinicians have accurate knowledge of TCC to appropriately address this issue and whether they have concerns themselves to use TCS. This questionnaire-based study aimed to assess these two aspects.

MATERIALS AND METHODS

Accuracy of knowledge was defined by how close the clinicians' estimates were to reference values of our previous study, in which we had examined TCC in dermatology outpatients. Moreover, clinicians indicated whether they have concerns themselves to use TCS.

RESULTS

Totally 202 clinicians participated. They underestimated both the prevalence of TCC and the resulting non-adherence. Whereas most clinicians correctly estimated characteristics of patients with TCC and the impact of patient information, only 31% of clinicians knew that skin atrophy was the leading concern, and only 30% correctly ranked the reasons for TCC. 74% of the clinicians had at least minor concerns themselves.

CONCLUSION

The majority of clinicians may have inaccurate knowledge of certain aspects of TCC and own concerns to use TCS.

Skin aging caused by intrinsic or extrinsic processes characterized with functional proteomics

The skin provides protection against environmental stress. However, intrinsic and extrinsic aging causes significant alteration to skin structure and components, which subsequently impairs molecular characteristics and biochemical processes. Here, we have conducted an immunohistological investigation and established the proteome profiles on nude mice skin to verify the specific responses during aging caused by different factors. Our results showed that UVB-elicited aging results in upregulation of proliferating cell nuclear antigen and strong oxidative damage in DNA, whereas chronological aging abolished epidermal cell growth and increased the expression of caspase-14, as well as protein carbonylation. Network analysis indicated that the programmed skin aging activated the ubiquitin system and triggered obvious downregulation of 14-3-3 sigma, which might accelerate the loss of cell growth capacity. On the other hand, UVB stimulation enhanced inflammation and the risk of skin carcinogenesis. Collectively, functional proteomics could provide large-scale investigation of the potent proteins and molecules that play important roles in skin subjected to both intrinsic and extrinsic aging.

Treatment of seborrheic dermatitis: comparison of sertaconazole 2 % cream versus pimecrolimus 1 % cream

OBJECTIVE

Seborrheic dermatitis (SD) is an inflammatory skin disorder affecting the scalp, face, and trunk. The treatment of SD is an important issue in dermatology. This study aimed at comparing the efficacy of sertaconazole 2 % cream versus pimecrolimus 1 % cream in the treatment of SD.

METHODS

In this clinical trial study, 60 patients suffering from SD were studied. Thirty patients received local sertaconazole 2 % cream and in control group, 30 patients received pimecrolimus 1 % cream. Patients were recommended to use the cream twice a day for 4 weeks. At the beginning of referring and also 2 and 4 weeks after first visit, the patients were examined by a dermatologist to control improvement of clinical symptoms.

RESULTS

The mean age of members of the sertaconazole and pimecrolimus groups was 30.12 ± 12.56 and 34.67 ± 10.98 years, respectively. The highest level of satisfaction (90 %) was observed 28 days after sertaconazole application since it was 80 % in pimecrolimus group. The relationship between patients' satisfaction and receipt of sertaconazole cream (on the 28th day) was statistically significant (P = 0.006).

CONCLUSION

Sertaconazole 2 % cream may be an excellent alternative therapeutic modality for treating SD.