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Soto‐Moreno A, Montero‐Vilchez T, Diaz‐Calvillo P, Molina‐Leyva A, Arias‐Santiago S. The impact of photodynamic therapy on skin homeostasis in patients with actinic keratosis: A prospective observational study. Skin Res Technol 2023; 29:e13493. [PMID: 38017667 PMCID: PMC10684974 DOI: 10.1111/srt.13493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AKs), but there is little information on how PDT affects skin barrier function. The objectives of this study are: To compare skin barrier function between skin with AKs and healthy skin and to evaluate the impact of PDT on skin homeostasis in patients with AKs. METHODS A prospective observational study was conducted in patients with AKs to evaluate epidermal barrier function and skin homeostasis before and 1 ek after receiving PDT. RESULTS A total of 21 subjects were included in the study, male/female ratio was 17:4, mean age was 75.86 years. The number of AKS observed before starting treatment was reduced with respect to those diagnosed 1 month after starting PDT (14.83 vs. 1.91, p < 0.0001). Application of PDT for treating AKs modifies epidermal barrier function. Immediately after the first session temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH) and total antioxidant capacity (TAC) increased while pH decreased on lesional skin. After 1-month follow-up, the only remained change was the increased in SCH. Higher increases in temperature were observed when using occlusive PDT compared to mixed modality. 5-ALA and M-ALA seem to have a similar impact on skin barrier. CONCLUSIONS PDT can improve skin barrier function in patients with AKs. Skin homeostasis parameters can be used to assess efficacy and optimize dosing.
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Affiliation(s)
- Alberto Soto‐Moreno
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
| | - Trinidad Montero‐Vilchez
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
| | - Pablo Diaz‐Calvillo
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
| | - Alejandro Molina‐Leyva
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
| | - Salvador Arias‐Santiago
- Dermatology DepartmentHospital Universitario Virgen de las NievesGranadaSpain
- TECe19‐Dermatología Clínica y TraslacionalInstituto de Investigación Biosanitaria ibs. GRANADAGranadaSpain
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Kichou H, Bonnier F, Dancik Y, Bakar J, Michael-Jubeli R, Caritá AC, Perse X, Soucé M, Rapetti L, Tfayli A, Chourpa I, Munnier E. Strat-M® positioning for skin permeation studies: A comparative study including EpiSkin® RHE, and human skin. Int J Pharm 2023; 647:123488. [PMID: 37805151 DOI: 10.1016/j.ijpharm.2023.123488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 10/09/2023]
Abstract
In the development and optimization of dermatological products, In Vitro Permeation Testing (IVPT) is pivotal for controlled study of skin penetration. To enhance standardization and replicate human skin properties reconstructed human skin and synthetic membranes are explored as alternatives. Strat-M® is a membrane designed to mimic the multi-layered structure of human skin for IVPT. For instance, in Strat-M®, the steady-state fluxes (JSS) of resorcinol in formulations free of permeation enhancers were found to be 41 ± 5 µg/cm2·h for the aqueous solution, 42 ± 6 µg/cm2·h for the hydrogel, and 40 ± 6 µg/cm2·h for the oil-in-water emulsion. These results were closer to excised human skin (5 ± 3, 9 ± 2, 13 ± 6 µg/cm2·h) and surpassed the performance of EpiSkin® RHE (138 ± 5, 142 ± 6, and 162 ± 11 µg/cm2·h). While mass spectrometry and Raman microscopy demonstrated the qualitative molecular similarity of EpiSkin® RHE to human skin, it was the porous and hydrophobic polymer nature of Strat-M® that more faithfully reproduced the skin's diffusion-limiting barrier. Further validation through similarity factor analysis (∼80-85%) underscored Strat-M®'s significance as a reliable substitute for human skin, offering a promising approach to enhance realism and reproducibility in dermatological product development.
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Affiliation(s)
- Hichem Kichou
- Université de Tours, EA 6295 Nanomédicaments et Nanosondes, Faculté de Pharmacie, 31 Avenue Monge, 37200 Tours, France
| | - Franck Bonnier
- LVMH Recherche, 185 Av. de Verdun, 45800 Saint-Jean-de-Braye, France
| | - Yuri Dancik
- Certara UK Ltd., Simcyp Division, Level 2-Acero, 1 Concourse Way, Sheffield S1 2B1, UK
| | - Joudi Bakar
- Université Paris-Saclay, Faculté de Pharmacie, Lip(sys)(2) « Lipides, Systèmes Analytiques et Biologiques », 17 avenue des sciences, 91400 Orsay, France
| | - Rime Michael-Jubeli
- Université Paris-Saclay, Faculté de Pharmacie, Lip(sys)(2) « Lipides, Systèmes Analytiques et Biologiques », 17 avenue des sciences, 91400 Orsay, France
| | - Amanda C Caritá
- Université de Tours, EA 6295 Nanomédicaments et Nanosondes, Faculté de Pharmacie, 31 Avenue Monge, 37200 Tours, France
| | - Xavier Perse
- Université de Tours, EA 6295 Nanomédicaments et Nanosondes, Faculté de Pharmacie, 31 Avenue Monge, 37200 Tours, France
| | - Martin Soucé
- Université de Tours, EA 6295 Nanomédicaments et Nanosondes, Faculté de Pharmacie, 31 Avenue Monge, 37200 Tours, France
| | - Laetitia Rapetti
- Alphenyx, 430 avenue du Maréchal Lattre de Tassigny, 13009 Marseille, France
| | - Ali Tfayli
- Université Paris-Saclay, Faculté de Pharmacie, Lip(sys)(2) « Lipides, Systèmes Analytiques et Biologiques », 17 avenue des sciences, 91400 Orsay, France
| | - Igor Chourpa
- Université de Tours, EA 6295 Nanomédicaments et Nanosondes, Faculté de Pharmacie, 31 Avenue Monge, 37200 Tours, France
| | - Emilie Munnier
- Université de Tours, EA 6295 Nanomédicaments et Nanosondes, Faculté de Pharmacie, 31 Avenue Monge, 37200 Tours, France.
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Jarząbek‐Perz S, Dziedzic M, Kołodziejczak A, Rotsztejn H. Split-face evaluation: Gluconolactone plus oxybrasion versus gluconolactone plus microneedling. The effects on skin parameters. Skin Res Technol 2023; 29:e13353. [PMID: 37357656 PMCID: PMC10209840 DOI: 10.1111/srt.13353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/05/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND The application of polyhydroxy acids and alpha-hydroxy acids to the skin is often used in cosmetology. To enhance the effect of gluconolactone chemical peeling, a combined method including water-oxygen oxybrasion or microneedle mesotherapy can be used. OBJECTIVES To evaluate skin parameters such as hydration, sebum, pH and TEWL after application of a 10% gluconolactone chemical peel in combination with oxybrasion and microneedling. MATERIALS AND METHODS Twenty-one Caucasian women participated in the study. A series of three split face treatments was carried out at 1-week intervals. Oxybrasion was performed on the right side of the face and micro-needle mesotherapy on the left side. A 10% gluconolactone solution was applied to the entire face. Before the first and third treatments and 2 weeks after the last treatment, skin parameters were evaluated. Photographic documentation was also made before and after the treatment series. RESULTS AND CONCLUSION Evaluation of skin parameters using Courage & Khazaka 580 Multi Probe Adapter probes (Courage + Khazaka electronic GmbH, Cologne, Germany) showed an increase in hydration and a decrease in sebum, pH and TEWL for both treatments. There were no statistically significant differences between the treatments. Combining chemical peeling of gluconolactone with oxybrasion and microneedle mesotherapy is a good method to seal the hydrolipid barrier and increase skin hydration.
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Affiliation(s)
- Sylwia Jarząbek‐Perz
- Department of Cosmetology and Aesthetic Dermatology, Faculty of PharmacyMedical University of LodzLodzPoland
| | - Marta Dziedzic
- Department of Cosmetology and Aesthetic Dermatology, Faculty of PharmacyMedical University of LodzLodzPoland
| | - Anna Kołodziejczak
- Department of Cosmetology and Aesthetic Dermatology, Faculty of PharmacyMedical University of LodzLodzPoland
| | - Helena Rotsztejn
- Department of Cosmetology and Aesthetic Dermatology, Faculty of PharmacyMedical University of LodzLodzPoland
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Kalvodová A, Dvořáková K, Petrová E, Michniak-Kohn BB, Zbytovská J. The Contest of Nanoparticles: Searching for the Most Effective Topical Delivery of Corticosteroids. Pharmaceutics 2023; 15:pharmaceutics15020513. [PMID: 36839836 PMCID: PMC9962773 DOI: 10.3390/pharmaceutics15020513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/16/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Owing to their complicated pathophysiology, the treatment of skin diseases necessitates a complex approach. Conventional treatment using topical corticosteroids often results in low effectiveness and the incidence of local or even systemic side effects. Nanoformulation of potent anti-inflammatory drugs has been selected as an optimal strategy for enhanced topical delivery of corticosteroids. In order to assess the efficiency of various nanoformulations, we formulated hydrocortisone (HC) and hydrocortisone-17-butyrate (HCB) into three different systems: lipid nanocapsules (LNC), polymeric nanoparticles (PNP), and ethosomes (ETZ). The systems were characterized using dynamic light scattering for their particle size and uniformity and the morphology of nanoparticles was observed by transmission electron microscopy. The nanosystems were tested using ex vivo full thickness porcine and human skin for the delivery of HC and HCB. The skin penetration was observed by confocal microscopy of fluorescently labelled nanosystems. ETZ were proposed as the most effective delivery system for both transdermal and dermal drug targeting but were also found to have a profound effect on the skin barrier with limited restoration. LNC and PNP were found to have significant effects in the dermal delivery of the actives with only minimal transdermal penetration, especially in case of HCB administration.
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Affiliation(s)
- Aneta Kalvodová
- Department of Organic Technology, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Kristýna Dvořáková
- Department of Organic Technology, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Eliška Petrová
- Department of Organic Technology, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
| | - Bozena B. Michniak-Kohn
- Center for Dermal Research (CDR), Life Sciences Building, Rutgers University, Piscataway, NJ 08854, USA
| | - Jarmila Zbytovská
- Department of Organic Technology, Faculty of Chemical Technology, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Charles University, Heyrovského 1203, 500 05 Hradec Králové, Czech Republic
- Correspondence:
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Gonzalez-Bravo A, Montero-Vilchez T, Arias-Santiago S, Buendia-Eisman A. The Effect of Sunscreens on the Skin Barrier. Life (Basel) 2022; 12:life12122083. [PMID: 36556448 PMCID: PMC9784273 DOI: 10.3390/life12122083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/03/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
Transepidermal water-loss (TEWL), stratum-corneum hydration (SCH), erythema, elasticity, pH and melanin, are parameters of the epidermal barrier function and skin homeostasis that objectively indicate the integrity of the skin barrier. Sunscreens are necessary to protect people from skin cancer, but could modify the skin barrier function. Nevertheless, there are not many studies on their impact on skin homeostasis. The aim of this study is to evaluate the impact of sunscreens on the epidermal-barrier function and skin homeostasis of healthy individuals. A prospective observational study was designed. TEWL, SCH, erythema, elasticity, pH and melanin were measured on the cheek and volar region of the forearm, using non-invasive methods before and after applying sunscreen. Four different sunscreens were tested, one full-body sunscreen and three facial sunscreens. The study included 51 healthy volunteers, 72.5% (37/51) women, with a mean age of 41.63 years. After full-body sunscreen application, temperature increased by 0.68 °C (p < 0.001), pH by 0.16 units (p < 0.001), and elasticity by 0.22% (p = 0.039), while melanin decreased by 10.95 AU (p < 0.001), erythema by 28.79 AU (p < 0.001) and TEWL by 0.66 g·m−2·h−1 (p = 0.019). On the cheek, facial sunscreen 1 increased temperature by 0.51 °C, TEWL 0.7 g·m−2·h−1 (p < 0.05), pH by 0.12 units (p < 0.001) and elasticity by 0.059% (p < 0.001), but decreased erythema by 19.87 AU (p < 0.05) and SCH by 5.63 AU (p < 0.001). Facial sunscreen 2 increased temperature by 0.67 °C, TEWL by 1.93 g·m−2·h−1 (p < 0.001), pH by 0.42 units (p < 0.001) and elasticity by 0.12% (p < 0.01), but decreased melanin by 15.2 AU (p = 0.000), erythema by 38.61 AU (p < 0.05) and SCH by 10.80 AU (p < 0.01). Facial sunscreen 3 increased temperature by 1.15 °C, TEWL by 2.29 g·m−2·h−1 (p < 0.001), pH by 0.46 units (p < 0.001) and elasticity by 0.15% (p < 0.01), but decreased erythema by 35.7 (p < 0.05) and SCH by 10.80 AU (p < 0.01). In conclusion, sunscreen could slightly modify the skin-barrier function. All of them decreased erythema, likely in relation to anti-inflammatory power.
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Affiliation(s)
- Alicia Gonzalez-Bravo
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain
| | - Trinidad Montero-Vilchez
- Dermatology Department, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
- Correspondence: or ; Tel.: +34-9580-23259
| | - Salvador Arias-Santiago
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain
- Dermatology Department, Virgen de las Nieves University Hospital, 18012 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Agustin Buendia-Eisman
- Dermatology Department, Faculty of Medicine, University of Granada, 18001 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Green M, Feschuk AM, Kashetsky N, Maibach HI. "Normal" TEWL-How Can it be Defined?: A Systematic Review. Exp Dermatol 2022; 31:1618-1631. [PMID: 35753062 DOI: 10.1111/exd.14635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/28/2022] [Accepted: 06/23/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Transepidermal water loss (TEWL), the total non-eccrine sweat water evaporating from a given area of epidermis over time, is a measurement of skin barrier integrity. Skin diseases (e.g. psoriasis and atopic dermatitis) often result in transient increases in TEWL, so knowledge of "normal" TEWL values may be used to predict disease progression in dermatological settings. Variables such as age, race, and anatomic location have been suggested to affect TEWL, but current regulatory agencies have failed to control for additional variables of interest. Thus, this review summarizes variables that may cause TEWL variation. METHODS A comprehensive literature search was performed using Embase, PubMed, and Web of Science to find human studies that provided data on variables affecting TEWL. RESULTS 31 studies, analyzing 22 affecting TEWL, were identified. Variables causing increased TEWL were mask-use (n=1), Dry Eye Disease (n=1), Chronic Venous Disease (n=1), Coronary Artery Disease (n=1), age (infants vs. adults) (n=4), nourishment in infants (n=1), stress within individuals (n=2), Body Mass Index (n=2), bathing versus showering (n=2), and scratching/friction (n=1). Variables with decreases in TEWL were genetic variability with SNPs on chromosome 9q34.3 (n=1) and cancer-cachexia (n=1). CONCLUSION We summarized 12 variables that impact TEWL and are not typically controlled for in experimental settings. Therefore, defining normal TEWL may currently be problematic. Thus, regulatory agencies should provide stricter guidelines on proper measurement of TEWL to minimize human introduced TEWL variation, and we should continue to examine factors impacting individual skin integrity.
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Affiliation(s)
- Maxwell Green
- Tulane University School of Medicine, New Orleans, USA
| | - Aileen M Feschuk
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland & Labrador, Canada
| | - Nadia Kashetsky
- Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland & Labrador, Canada
| | - Howard I Maibach
- Department of Dermatology, University of California San Francisco, San Francisco, California, United States
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Epidermal Barrier Function and Skin Homeostasis in Atopic Dermatitis: The Impact of Age. Life (Basel) 2022; 12:life12010132. [PMID: 35054525 PMCID: PMC8779900 DOI: 10.3390/life12010132] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/03/2022] [Accepted: 01/15/2022] [Indexed: 01/10/2023] Open
Abstract
Skin is damaged in atopic dermatitis (AD) patients. Age is also believed to have a negative effect on epidermal barrier function. The aim of this study was to investigate skin barrier function changes with age in AD patients. A cross-sectional study was conducted including 162 participants, 81 AD patients and 81 healthy volunteers. Skin barrier function parameters, such as transepidermal water loss (TEWL), erythema, temperature, stratum corneum hydration (SCH), pH, and elasticity, were evaluated. Healthy volunteers were evaluated on the volar forearm. AD patients were measured on two regions: on an eczematous lesion on the volar forearm and on a non-involved area 5 cm from the affected area. TEWL was lower on healthy skin than uninvolved AD skin (9.98 vs. 25.51 g·m−2·h−1, p < 0.001) and AD eczematous lesions (9.98 vs. 28.38 g·m−2·h−1, p < 0.001). SCH was lower on AD eczematous lesions than uninvolved AD skin (24.23 vs. 39.36 AU, p < 0.001) and healthy skin (24.23 vs. 44.36 AU, p < 0.001). Elasticity was lower on AD eczematous lesions than uninvolved AD skin (0.69 vs. 0.74, p = 0.038) and healthy skin (0.69 vs. 0.77, p = 0.014). A negative correlation was found between age and elasticity in all the population (r = −0.383, p < 0.001). This correlation was stronger in AD patients (r = −0.494, p < 0.001) than in controls (r = −0.266, p = 0.092). After conducting a linear regression model in AD patients adjusted by age, sex, and SCORing Atopic Dermatitis (SCORAD), it was found that elasticity was impaired by an increasing age (β = −0.004, p < 0.001) and a higher SCORAD (β = −0.003, p < 0.001). The skin barrier function is impaired by age and AD, reflected mainly in poor elasticity values in older AD patients.
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Szymańska A, Budzisz E, Erkiert-Polguj A. Long-term effect of azelaic acid peel on sebum production in acne. Dermatol Ther 2021; 35:e15186. [PMID: 34731527 DOI: 10.1111/dth.15186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 11/26/2022]
Abstract
Seborrhea and the associated oily skin are undoubtedly the problem of women and men around the world. The pathogenesis of acne vulgaris involves excessive activity of sebaceous glands, as well as disturbances in the composition of sebum. The aim of the study was to assess the severity of seborrhea in a group of acne vulgaris patients and to determine the effect of a 20% azelaic acid solution on the activity of sebaceous glands. Twenty seven women, aged 19-25 years, underwent a series of six treatments with the application of a 20% solution of azelaic acid to the face. The mean values of sebum level showed a decreasing tendency. On the forehead, the results were as follows-195.5 before the treatment and 162.7 2 weeks after the last treatment. Measurements of the right cheek decreased from 175.3 to 141.3 The measurements taken 3 months after the study were 151.3 on the forehead and 138.9 on the cheek. Similarly, the values determining the total number of acne lesions and the severity of the disease according to the IGA scale also changed significantly. Chemical peel with 20% azelaic acid shows long-term sebostatic action, which inhibits the formation of new acne lesions.
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Affiliation(s)
- Anna Szymańska
- Department of Cosmetic Raw Materials Chemistry, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Elzbieta Budzisz
- Department of Cosmetic Raw Materials Chemistry, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Anna Erkiert-Polguj
- Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
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Anna M, Magdalena SK. Evaluation of the influence of whole-body cryotherapy on selected skin parameters in healthy individuals: Pilot study. Cryobiology 2021; 100:77-80. [PMID: 33794188 DOI: 10.1016/j.cryobiol.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of the paper was to evaluate changes in selected skin parameters (hydration, sebum level and pH of the skin) after whole-body cryotherapy (WBC). MATERIAL AND METHODS The study encompassed of 16 individuals (8 men and 8 women), who participated in 15 WBC sessions. There were 4 measurements of skin parameters performed in the following way: prior to the first cryotherapy session, directly after the first session, after the 15th session, and after 3 weeks from the moment when the therapy was discontinued. RESULTS No significant differences were observed for hydration and skin pH. Sebum level significantly decreased after 2nd cryotherapy session. CONCLUSION Whole-body cryotherapy seems to be safe for skin.
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Affiliation(s)
- Misiorek Anna
- Institute of Applied Sciences, University School of Physical Education in Krakow, Al. Jana Pawła II 78, 31-571, Krakow, Poland.
| | - Szyszkowska-Kępińska Magdalena
- Institute of Applied Sciences, University School of Physical Education in Krakow, Al. Jana Pawła II 78, 31-571, Krakow, Poland.
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Montero-Vilchez T, Segura-Fernández-Nogueras MV, Pérez-Rodríguez I, Soler-Gongora M, Martinez-Lopez A, Fernández-González A, Molina-Leyva A, Arias-Santiago S. Skin Barrier Function in Psoriasis and Atopic Dermatitis: Transepidermal Water Loss and Temperature as Useful Tools to Assess Disease Severity. J Clin Med 2021; 10:jcm10020359. [PMID: 33477944 PMCID: PMC7833436 DOI: 10.3390/jcm10020359] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 01/05/2023] Open
Abstract
Multiple diagnostic tools are used to evaluate psoriasis and atopic dermatitis (AD) severity, but most of them are based on subjective components. Transepidermal water loss (TEWL) and temperature are skin barrier function parameters that can be objectively measured and could help clinicians to evaluate disease severity accurately. Thus, the aims of this study are: (1) to compare skin barrier function between healthy skin, psoriatic skin and AD skin; and (2) to assess if skin barrier function parameters could predict disease severity. A cross-sectional study was designed, and epidermal barrier function parameters were measured. The study included 314 participants: 157 healthy individuals, 92 psoriatic patients, and 65 atopic dermatitis patients. TEWL was significantly higher, while stratum corneum hydration (SCH) (8.71 vs. 38.43 vs. 44.39 Arbitrary Units (AU)) was lower at psoriatic plaques than at uninvolved psoriatic skin and healthy controls. Patients with both TEWL > 13.85 g·m−2h−1 and temperature > 30.85 °C presented a moderate/severe psoriasis (psoriasis area severity index (PASI) ≥ 7), with a specificity of 76.3%. TEWL (28.68 vs. 13.15 vs. 11.60 g·m−2 h−1) and temperature were significantly higher, while SCH (25.20 vs. 40.95 vs. 50.73 AU) was lower at AD eczematous lesions than uninvolved AD skin and healthy controls. Patients with a temperature > 31.75 °C presented a moderate/severe AD (SCORing Atopic Dermatitis (SCORAD) ≥ 37) with a sensitivity of 81.8%. In conclusion, temperature and TEWL values may help clinicians to determine disease severity and select patients who need intensive treatment.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
| | | | - Isabel Pérez-Rodríguez
- Dermatology Department, Faculty of Medicine, University of Granada,18001 Granada, Spain; (M.-V.S.-F.-N.); (I.P.-R.); (M.S.-G.)
| | - Miguel Soler-Gongora
- Dermatology Department, Faculty of Medicine, University of Granada,18001 Granada, Spain; (M.-V.S.-F.-N.); (I.P.-R.); (M.S.-G.)
| | - Antonio Martinez-Lopez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
| | | | - Alejandro Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
- Correspondence: ; Tel.: +34-958-023-422
| | - Salvador Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Avenida de Madrid, 15, 18012 Granada, Spain; (T.M.-V.); (A.M.-L.); (S.A.-S.)
- Instituto de Investigación Biosanitaria GRANADA, 18012 Granada, Spain;
- Dermatology Department, Faculty of Medicine, University of Granada,18001 Granada, Spain; (M.-V.S.-F.-N.); (I.P.-R.); (M.S.-G.)
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11
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Montero-Vilchez T, Soler-Góngora M, Martínez-López A, Ana FG, Buendía-Eisman A, Molina-Leyva A, Arias-Santiago S. Epidermal barrier changes in patients with psoriasis: The role of phototherapy. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2021; 37:285-292. [PMID: 33377542 DOI: 10.1111/phpp.12650] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Accepted: 12/25/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Some skin diseases may modify epidermal barrier function. Psoriasis is a chronic multi-systemic inflammatory disease that affects the epidermal barrier. Phototherapy is an option for treating psoriasis, but little is known about how epidermal barrier function is modified by phototherapy in psoriatic patients. OBJECTIVES (a) To compare skin homeostasis between involved and uninvolved skin in psoriatic patients with healthy controls (b) To evaluate changes in the epidermal barrier function in psoriatic patients treated with phototherapy. METHODS Sixty patients with plaque-type psoriasis and sixty gender and age-matched healthy controls were enrolled. Temperature, transepidermal water loss (TEWL), stratum corneum hydration (SCH), pH, elasticity, erythema and melanin index were measured using non-invasive tools in the healthy control and involved and uninvolved psoriatic skin before and after phototherapy. RESULTS Healthy controls had lower TEWL and erythema index and higher SCH than psoriatic patients, both at uninvolved psoriatic skin and psoriasis plaques. TEWL was higher at psoriasis plaques than at uninvolved skin (19.20 vs 11.57 g/h/m2 ; P < .001). Following phototherapy, a decreasing trend was observed for TEWL, of 1.03 (SD 0.75) and 0.97 (SD 0.81) g/h/m2 for uninvolved and involved skin respectively. SCH was significantly lower at psoriatic plaques than at uninvolved skin (7.32 vs 36.62Arbitrary Units [AU]; P < .001). SCH increased by 1.15AU (SD 0.26) on psoriatic plaques after the phototherapy session (P < .001). CONCLUSION Psoriatic plaques showed epidermal barrier dysfunction compared to uninvolved skin and healthy controls. Phototherapy may improve epidermal barrier function in psoriatic patients. SCH increased after a phototherapy session on the psoriatic plaques.
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Affiliation(s)
- Trinidad Montero-Vilchez
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Miguel Soler-Góngora
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Martínez-López
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | | | | | - Alejandro Molina-Leyva
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Salvador Arias-Santiago
- Dermatology Department, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain.,Dermatology Department, Faculty of Medicine, University of Granada, Granada, Spain
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12
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Batory M, Wołowiec-Korecka E, Rotsztejn H. The influence of topical 5% tranexamic acid at pH 2.38 with and without corundum microdermabrasion on pigmentation and skin surface lipids. Dermatol Ther 2020; 33:e14391. [PMID: 33034937 DOI: 10.1111/dth.14391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/17/2020] [Accepted: 10/03/2020] [Indexed: 11/29/2022]
Abstract
Tranexamic acid (TA) has anti-hemorrhagic effects; however, oral administration has been found to decrease hyperpigmentation. The aim of the work was to compare the effects of treatment with 5% tranexamic acid in combination with corundum microdermabrasion on skin pigmentation, redness, pH, transepidermal water loss (TEWL), sebum level and hydration of back surface and dorsal surface of the hand skin. Six treatments were performed every week on the back surface and both dorsal surfaces of the hands of 12 subjects. The entire back/both hands were treated with 5% tranexamic acid at pH 2.38; left side of the back or left hand were also subjected to corundum microdermabrasion. Skin parameters were measured using the Courage & Khazaka 580 Multi Probe Adapter. Clinical photos were taken using the Fotomedicus system. Significant differences between treatment methods were observed for melanin, erythema and pH. In addition, the two methods differed significantly with regard to the amount of sebum, TEWL and the level of moisture in the skin. Both methods gave similar acidic pH. Summing up tranexamic acid causes a significant reduction in epidermal melanogenesis, has a significant impact on the level of skin hydration, lipids of the epidermis and maintaining the proper TEWL. TA has a significant effect on reducing skin redness.
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Affiliation(s)
- Mirella Batory
- Faculty of Pharmacy, Department of Cosmetology and Aesthetic Dermatology, Medical University of Lodz, Lodz, Poland
| | | | - Helena Rotsztejn
- Faculty of Pharmacy, Department of Cosmetology and Aesthetic Dermatology, Medical University of Lodz, Lodz, Poland
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13
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A quantitative study of transepidermal water loss (TEWL) on conventional and microclimate management capable mattresses and hospital beds. J Tissue Viability 2019; 28:194-199. [DOI: 10.1016/j.jtv.2019.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022]
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Algiert-Zielińska B, Mucha P, Rotsztejn H. Effects of lactobionic acid peel, aluminum oxide crystal microdermabrasion, and both procedures on skin hydration, elasticity, and transepidermal water loss. J Cosmet Dermatol 2019; 18:1463-1474. [PMID: 30661294 DOI: 10.1111/jocd.12859] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 12/14/2018] [Accepted: 12/17/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Topical applications of alpha-hydroxy acids and poly hydroxy acids in the form of peels gained popularity. To enhance the effect of these substances, aluminum oxide crystal microdermabrasion can be used in one procedure. AIMS The assessment of skin hydration, elasticity, and TEWL after using lactobionic acid in the form of 20% peel and lactobionic acid in the form of 20% peel combined with aluminum oxide crystal microdermabrasion. MATERIAL AND METHODS The study involved 20 Caucasian female subjects. Six treatments were performed at weekly intervals, using the Split face method-20% LA was used on the left side of the face and aluminum oxide crystal microdermabrasion followed by 20% LA application on the right side of the face. RESULTS Corneometric measurement showed statistically significant differences between the hydration level for sessions 1 and 3 and 1 and 6. A higher hydration level was found on the side with the combined procedure. Tewametric measurement showed that the TEWL values were different for sessions 1 and 3 and 1 and 6-they decreased. There were no statistically significant differences between the two procedures. The cutometric measurement indicated statistically significant differences between skin elasticity for pairs in session 1 and 3 and 1 and 6. CONCLUSIONS The results of the study indicate that the combination of LA peel with microdermabrasion increases its moisturizing effect and improves skin elasticity. The use of both procedures also contributed to the decrease in TEWL; however, greater exfoliation of the epidermis in combined procedures resulted in slightly higher TEWL values.
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Affiliation(s)
- Barbara Algiert-Zielińska
- Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Paulina Mucha
- Department of Cosmetic Raw Materials Chemistry, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Helena Rotsztejn
- Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
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15
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Batory M, Wołowiec-Korecka E, Rotsztejn H. The effect of various primers improving adhesiveness of gel polish hybrids on pH, TOWL and overall nail plates condition. J Cosmet Dermatol 2019; 18:1529-1538. [PMID: 30628153 DOI: 10.1111/jocd.12854] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/12/2018] [Accepted: 11/27/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Hybrid manicure is now a popular method of nail care and nail art, which is associated with its durability. Unfortunately, it has an adverse effect on pH, TOWL and overall nail plates condition and has not been investigated in detail so far. AIMS The aim of this study was to compare the pH and TOWL of the hand nails after using different primers. The effect of application time, breaks between applications and the method of curing and removal on those parameters and overall nail plates condition were evaluated. PATIENTS/METHODS An evaluation survey was conducted among 116 women. pH and TOWL measurements of the nail plate in 35 women were taken using the Courage & Khazaka. Clinical photos were made using the Fotomedicus system. RESULTS The measured pH values of the nail plate in the test group with gel polish hybrid on the nails were from 5.50 to 6.65, while after removal of the gel polish hybrid, the values ranged from 5.63 to 6.68. TOWL of the nail plate covered with gel polish hybrid ranged from 2.9 to 33.2 g/m2 /h, whereas after removal of hybrids-from 1.9 to 45.7 g/m2 /h. CONCLUSION Different forms of acid-free primers maintain a lower pH of the nail plate covered with a gel polish hybrid, while the acidic primer maintains higher values of the nail plate pH. The significant decrease in the nail plate TOWL following the application of gel polish hybrid indicates a reduced loss of water from the surface of the nail to the atmosphere.
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Affiliation(s)
- Mirella Batory
- Faculty of Pharmacy, Department of Cosmetology and Aesthetic Dermatology, Medical University of Lodz, Lodz, Poland
| | | | - Helena Rotsztejn
- Faculty of Pharmacy, Department of Cosmetology and Aesthetic Dermatology, Medical University of Lodz, Lodz, Poland
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16
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Evaluation of changes in selected skin parameters under the influence of extremely low temperature. Cryobiology 2019; 86:19-24. [DOI: 10.1016/j.cryobiol.2019.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2018] [Revised: 01/04/2019] [Accepted: 01/05/2019] [Indexed: 11/18/2022]
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17
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Batory M, Namieciński P, Rotsztejn H. Evaluation of structural damage and pH of nail plates of hands after applying different methods of decorating. Int J Dermatol 2018; 58:311-318. [PMID: 30246242 DOI: 10.1111/ijd.14198] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 06/18/2018] [Accepted: 08/06/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of nail polish, gel polish hybrid, gel nail, and acrylic nail powder and the removal of these formulas on the nail plates properties, particularly the influence of different coatings on morphology and pH. METHODS The morphology and structure of nail plates were analyzed with use of scanning electron microscopy. The pH values of the nail plates of hands were measured using the system Courage & Khazaka. RESULTS The analysis of morphology and structure of the surface of nail plates showed distinct changes caused by decorative coatings. The most common ones include fragility and splitting of the nails. The pH value measured in the whole group ranged from 5.21 to 7.00. CONCLUSIONS The methods used to prepare nails for decoration and all methods of removing the applied preparations damage the healthy nail plates. The most common changes are brittleness and nail splitting. The nail polish remover causes less damage than acetone, and the use of a nail drill machine and nail file causes the greatest destruction of nail plates. The biggest effect on the pH change has the gel polish hybrid, gel nail, and acrylic nail powder, causing the pH value of nail plates to rise above 6.0, whereas after the application of the nail polish, the pH of the plates was on average 5.8 which is closest to the normal value, assumed as physiological.
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Affiliation(s)
- Mirella Batory
- Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
| | - Piotr Namieciński
- Department of Operational Research, Faculty of Economics and Sociology, University of Lodz, Lodz, Poland
| | - Helena Rotsztejn
- Department of Cosmetology and Aesthetic Dermatology, Faculty of Pharmacy, Medical University of Lodz, Lodz, Poland
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