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Lichterfeld-Kottner A, Vogt A, Tomova-Simitchieva T, Blume-Peytavi U, Kottner J. Effects of loading and prophylactic dressings on the sacral and heel skin: An exploratory cross-over trial. Int Wound J 2021; 18:909-922. [PMID: 33939289 PMCID: PMC8613394 DOI: 10.1111/iwj.13596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 01/21/2023] Open
Abstract
Pressure ulcers/injuries are caused by sustained loading and deformation of skin and underlying soft tissues. Prophylactic dressings are recommended as an adjunct to other preventive measures such as repositioning and offloading. The aim of this study was to investigate the effects of prophylactic soft silicone multi‐layered foam dressings on the skin structure and function of the two most common pressure areas, sacrum and heel, with and without loading. An exploratory randomised cross‐over trial using intra‐individual comparisons was conducted. Eight healthy volunteers (mean age 27.5 years) were assigned to three groups and either spent 2.5 hours on a standard hospital mattress lying in supine position with and without dressings or spent 2.5 hours with dressings applied but without loading. Skin temperature, stratum corneum, and epidermal hydration increased in all groups irrespective of wearing a dressing and/or loading. Mean roughness decreased at the heels. Reactive hyperaemia and the release of interleukin 1 alpha were associated with loading only. Results suggest that the occlusive effects of dressings are similar or only slightly greater than those observed with non‐loading or loading without dressings. Thus, a dressing does not cause additional irritation or skin changes during loading but it may reduce the inflammatory response.
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Affiliation(s)
- Andrea Lichterfeld-Kottner
- Department of Geriatrics and Medical Gerontology, Geriatrics Research Group, Nursing Research Group, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Annika Vogt
- Department of Dermatology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tsenka Tomova-Simitchieva
- Department of Dermatology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Blume-Peytavi
- Department of Dermatology and Allergology, Clinical Research Center for Hair and Skin Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Kottner
- Charite Center for Health and Human Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Lechner A, Rancan F, Hadam S, Vogt A, Blume‐Peytavi U, Kottner J. Comparing the effects of three different multilayer dressings for pressure ulcer prevention on sacral skin after prolonged loading: An exploratory crossover trial. Wound Repair Regen 2020; 29:270-279. [DOI: 10.1111/wrr.12883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/06/2020] [Accepted: 12/08/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Anna Lechner
- Department of Dermatology, Venereology and Allergy, Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - Fiorenza Rancan
- Department of Dermatology, Venereology and Allergy, Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - Sabrina Hadam
- Department of Dermatology, Venereology and Allergy, Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - Annika Vogt
- Department of Dermatology, Venereology and Allergy, Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - Ulrike Blume‐Peytavi
- Department of Dermatology, Venereology and Allergy, Clinical Research Center for Hair and Skin Science Charité – Universitätsmedizin Berlin Berlin Germany
| | - Jan Kottner
- Charité Center Health and Human Sciences Charité – Universitätsmedizin Berlin Berlin Germany
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Berekméri A, Tiganescu A, Alase AA, Vital E, Stacey M, Wittmann M. Non-invasive Approaches for the Diagnosis of Autoimmune/Autoinflammatory Skin Diseases-A Focus on Psoriasis and Lupus erythematosus. Front Immunol 2019; 10:1931. [PMID: 31497014 PMCID: PMC6712514 DOI: 10.3389/fimmu.2019.01931] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/30/2019] [Indexed: 12/27/2022] Open
Abstract
The traditional diagnostic gold standard for inflammatory skin lesions of unclear etiology is dermato-histopathology. As this approach requires an invasive skin biopsy, biopsy processing and analysis by specialized histologists, it is a resource intensive approach requiring trained healthcare professionals. In many health care settings access to this diagnostic approach can be difficult and outside emergency cases will usually take several weeks. This scenario leads to delayed or inappropriate treatment given to patients. With dramatically increased sensitivity of a range of analysis systems including mass spectrometry, high sensitivity, multiplex ELISA based systems and PCR approaches we are now able to "measure" samples with unprecedented sensitivity and accuracy. Other important developments include the long-term monitoring of parameters using microneedle approaches and the improvement in imaging systems such as optical coherence tomography. In this review we will focus on recent achievements regarding measurements from non-invasive sampling, in particular from plucked hair and skin tape-strips which seem well suited for the diagnosis of lupus erythematosus and psoriatic inflammation, respectively. While these approaches will not replace clinical observation-they can contribute to improved subgroup diagnosis, stratified therapeutic approaches and have great potential for providing molecular and mechanistic insight in to inflammatory skin diseases.
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Affiliation(s)
- Anna Berekméri
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Ana Tiganescu
- Faculty of Medicine and Health, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom
| | - Adewonuola A. Alase
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
| | - Edward Vital
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Martin Stacey
- Faculty of Biological Sciences, School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Miriam Wittmann
- Faculty of Medicine and Health, Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, United Kingdom
- Leeds Biomedical Research Centre, National Institute for Health Research, Leeds Teaching Hospitals, Leeds, United Kingdom
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Pfannes EK, Weiss L, Hadam S, Gonnet J, Combardière B, Blume-Peytavi U, Vogt A. Physiological and Molecular Effects of in vivo and ex vivo Mild Skin Barrier Disruption. Skin Pharmacol Physiol 2018; 31:115-124. [DOI: 10.1159/000484443] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/19/2017] [Indexed: 11/19/2022]
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Vogt A, Pfannes EKB, Fimmel S, Hadam S, Andruck A, Kottner J, Blume-Peytavi U. Infundibular protein and RNA microarray analyses from affected and clinically non-affected scalp in male androgenetic alopecia patients. Exp Dermatol 2017; 26:518-521. [PMID: 28266729 DOI: 10.1111/exd.13326] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2017] [Indexed: 11/30/2022]
Abstract
Non-invasive sample collection methods could facilitate clinical research on hair diseases. In an exploratory experimental study on six male volunteers with untreated androgenetic alopecia (AGA), Hamilton-Norwood stage IIIv-IV, skin surface and infundibular protein as well as RNA extracts from plucked hair follicles were analyzed from frontal skin, vertex and clinically unaffected occiput. Slightly increased levels of inflammatory markers were only found in AGA-affected scalp skin and infundibulum, not in RNA from plucked hair follicles. RNA expression profiles point towards differential expression of genes involved in hair cycle regulation, hair keratin production, but also RNA methylation and ion channel regulation.
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Affiliation(s)
- Annika Vogt
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Eva K B Pfannes
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sabine Fimmel
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sabrina Hadam
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Annette Andruck
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Kottner
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Blume-Peytavi
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
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