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Kluger N. Dermatoporosis in a portrait by Eero Järnefelt (1863-1937). J Am Geriatr Soc 2024. [PMID: 39431518 DOI: 10.1111/jgs.19240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 09/19/2024] [Accepted: 09/27/2024] [Indexed: 10/22/2024]
Affiliation(s)
- Nicolas Kluger
- Department of Dermatology, Allergology and Venereology, Helsinki University Hospital, Helsinki, Finland
- Société Française des Sciences Humaines sur la Peau (SFSHP), Maison de la Dermatologie, Paris, France
- ISIS, International Society of Iconodiagnosis, Paris, France
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2
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Martyts A, Sachs D, Hiebert P, Junker H, Robmann S, Hopf R, Steenbock H, Brinckmann J, Werner S, Giampietro C, Mazza E. Biomechanical and biochemical changes in murine skin during development and aging. Acta Biomater 2024; 186:316-329. [PMID: 39009208 DOI: 10.1016/j.actbio.2024.07.013] [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: 04/10/2024] [Revised: 06/21/2024] [Accepted: 07/10/2024] [Indexed: 07/17/2024]
Abstract
Aging leads to biochemical and biomechanical changes in skin, with biological and functional consequences. Despite extensive literature on skin aging, there is a lack of studies which investigate the maturation of the tissue and connect the microscopic changes in the skin to its macroscopic biomechanical behavior as it evolves over time. The present work addresses this knowledge gap using multiscale characterization of skin in a murine model considering newborn, adult and aged mice. Monotonic uniaxial loading, tension relaxation with change of bath, and loading to failure tests were performed on murine skin samples from different age groups, complemented by inflation experiments and atomic force microscopy indentation measurements. In parallel, skin samples were characterized using histological and biochemical techniques to assess tissue morphology, collagen organization, as well as collagen content and cross-linking. We show that 1-week-old skin differs across nearly all measured parameters from adult skin, showing reduced strain stiffening and tensile strength, a thinner dermis, lower collagen content and altered crosslinking patterns. Surprisingly, adult and aged skin were similar across most biomechanical parameters in the physiologic loading range, while aged skin had lower tensile strength and lower stiffening behavior at large force values. This correlates with altered collagen content and cross-links. Based on a computational model, differences in mechanocoupled stimuli in the skin of the different age groups were calculated, pointing to a potential biological significance of the age-induced biomechanical changes in regulating the local biophysical environment of dermal cells. STATEMENT OF SIGNIFICANCE: Skin microstructure and the emerging mechanical properties change with age, leading to biological, functional and health-related consequences. Despite extensive literature on skin aging, only very limited quantitative data are available on microstructural changes and the corresponding macroscopic biomechanical behavior as they evolve over time. This work provides a wide-range multiscale mechanical characterization of skin of newborn, adult and aged mice, and quantifies microstructural correlations in tissue morphology, collagen content, organization and cross-linking. Remarkably, aged skin retained normal hydration and normal biomechanical function in the physiological loading range but showed significantly reduced properties at super-physiological loading. Our data show that age-related microstructural differences have a profound effect not only on tissue-level properties but also on the cell-level biophysical environment.
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Affiliation(s)
- Anastasiya Martyts
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - David Sachs
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Paul Hiebert
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, 8093 Zürich, Switzerland
| | - Håvar Junker
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Serjosha Robmann
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Raoul Hopf
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland
| | - Heiko Steenbock
- Institute of Virology and Cell Biology, University of Lübeck, 23562 Lübeck, Germany
| | - Jürgen Brinckmann
- Institute of Virology and Cell Biology, University of Lübeck, 23562 Lübeck, Germany; Department of Dermatology, University of Lübeck, 23562 Lübeck, Germany
| | - Sabine Werner
- Institute of Molecular Health Sciences, Department of Biology, ETH Zürich, 8093 Zürich, Switzerland
| | - Costanza Giampietro
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dübendorf, Switzerland
| | - Edoardo Mazza
- Institute for Mechanical Systems, Department of Mechanical and Process Engineering, ETH Zürich, 8092 Zürich, Switzerland; Empa, Swiss Federal Laboratories for Materials Science and Technology, 8600 Dübendorf, Switzerland.
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3
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Konstantinou E, Longange E, Kaya G. Mechanisms of Senescence and Anti-Senescence Strategies in the Skin. BIOLOGY 2024; 13:647. [PMID: 39336075 PMCID: PMC11428750 DOI: 10.3390/biology13090647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 09/30/2024]
Abstract
The skin is the layer of tissue that covers the largest part of the body in vertebrates, and its main function is to act as a protective barrier against external environmental factors, such as microorganisms, ultraviolet light and mechanical damage. Due to its important function, investigating the factors that lead to skin aging and age-related diseases, as well as understanding the biology of this process, is of high importance. Indeed, it has been reported that several external and internal stressors contribute to skin aging, similar to the aging of other tissues. Moreover, during aging, senescent cells accumulate in the skin and express senescence-associated factors, which act in a paracrine manner on neighboring healthy cells and tissues. In this review, we will present the factors that lead to skin aging and cellular senescence, as well as ways to study senescence in vitro and in vivo. We will further discuss the adverse effects of the accumulation of chronic senescent cells and therapeutic agents and tools to selectively target and eliminate them.
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Affiliation(s)
- Evangelia Konstantinou
- Department of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1206 Geneva, Switzerland; (E.K.); (E.L.)
| | - Eliane Longange
- Department of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1206 Geneva, Switzerland; (E.K.); (E.L.)
| | - Gürkan Kaya
- Department of Medicine, University of Geneva, Rue Michel-Servet 1, CH-1206 Geneva, Switzerland; (E.K.); (E.L.)
- Departments of Dermatology and Clinical Pathology, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, CH-1205 Geneva, Switzerland
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4
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Kotani T, Naito Y, Sonobe S, Egawa J, Kawaguchi M. Deep Dissecting Hematoma Requiring Surgical Removal During Veno-Venous Extracorporeal Membrane Oxygenation Management: A Case Report. Cureus 2024; 16:e65976. [PMID: 39221330 PMCID: PMC11365819 DOI: 10.7759/cureus.65976] [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] [Accepted: 08/01/2024] [Indexed: 09/04/2024] Open
Abstract
Deep dissecting hematoma (DDH) is a disease in which minor trauma leads to the formation of an extensive hematoma. If left untreated, this can result in significant skin necrosis. Therefore, early treatment following a precise diagnosis is essential. However, the complexity of the disease may require differentiating it from soft tissue infections. A 58-year-old man with severe coronavirus disease 2019 (COVID-19) pneumonia developed skin complications such as purpura and blisters on his right upper extremity while undergoing veno-venous extracorporeal membrane oxygenation (VV-ECMO). We initially suspected a soft tissue infection or venous perfusion defect caused by the VV-ECMO cannula; however, these conditions were not observed. After making an exploratory incision, we diagnosed the patient with DDH and performed hematoma removal and skin grafting. The initial symptoms of DDH include erythema, swelling, and pain. It is important to differentiate DDH from soft tissue infections, especially necrotizing fasciitis, which is a more urgent condition. Because a surgical incision is necessary for the diagnosis and treatment of DDH, we do not hesitate to perform an exploratory incision to prevent skin necrosis, thereby contributing to early healing.
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Affiliation(s)
- Taichi Kotani
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, JPN
| | - Yusuke Naito
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, JPN
| | - Shota Sonobe
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, JPN
| | - Junji Egawa
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, JPN
| | - Masahiko Kawaguchi
- Department of Anesthesiology, Nara Medical University, Kashihara, Nara, JPN
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5
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Draelos Z, Bogdanowicz P, Saurat JH. Top weapons in skin aging and actives to target the consequences of skin cell senescence. J Eur Acad Dermatol Venereol 2024; 38 Suppl 4:15-22. [PMID: 38881445 DOI: 10.1111/jdv.19648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/13/2023] [Indexed: 06/18/2024]
Abstract
Skin aging has long been considered a purely cosmetic problem. However, as life expectancy increases, skin aging is taking on a functional dimension that goes beyond cosmetics and appearance. Preventive or therapeutic strategies are needed to target cellular senescence, a key process underlying the alterations in skin function and appearance that occur with aging, as well as to address the age-related skin changes associated with 'dermatoporosis' and chronic skin insufficiency/fragility syndrome. Thus, given the need for effective anti-aging products that improve both the appearance and function of the skin, it is essential to distinguish active ingredients that have been proven to be effective, among the large number of available over-the-counter cosmeceuticals. This brief review focuses on a core group of topical actives, describing their clinical effects on senescence and aging, and their molecular mechanisms of action. These actives include hyaluronic acid, which has hydrating and viscoelastic properties and has been shown to reduce skin atrophy; retinaldehyde, which activates retinoid receptors and increases cutaneous elasticity; vitamins C and E, which provide stable oxidative protection; and niacinamide, which reduces inflammation and mitigates the effects of senescence.
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Affiliation(s)
- Z Draelos
- Dermatology Consulting Services, PLLC, Department of dermatology Duke University School of Medicine, High Point, North Carolina, USA
| | - P Bogdanowicz
- Department of Pharmacology and Clinical Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - J-H Saurat
- University of Geneva, Geneva, Switzerland
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6
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Cristina L, Nyffeler RW. Extensive skin laceration on the forearm due to closed reduction of a dislocated shoulder. A case report. Trauma Case Rep 2024; 51:101001. [PMID: 38835528 PMCID: PMC11148510 DOI: 10.1016/j.tcr.2024.101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2024] [Indexed: 06/06/2024] Open
Abstract
We report the case of an 80-year-old man who suffered an anteroinferior shoulder dislocation with rupture of the rotator cuff following a fall. An attempt at closed reduction under analgosedation resulted in extensive skin laceration on the elbow and forearm. The wound treatment was complex and resulted in numerous complications.
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Affiliation(s)
- Luca Cristina
- Orthopädie Sonnenhof KLG, Bern, Switzerland
- Campus Stiftung Lindenhof Bern (Campus SLB), Bern, Switzerland
| | - Richard W Nyffeler
- Orthopädie Sonnenhof KLG, Bern, Switzerland
- Campus Stiftung Lindenhof Bern (Campus SLB), Bern, Switzerland
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7
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Micheels P, Porcello A, Bezzola T, Perrenoud D, Quinodoz P, Kalia Y, Allémann E, Laurent A, Jordan O. Clinical Perspectives on the Injectability of Cross-Linked Hyaluronic Acid Dermal Fillers: A Standardized Methodology for Commercial Product Benchmarking with Inter-Injector Assessments. Gels 2024; 10:101. [PMID: 38391431 PMCID: PMC10888303 DOI: 10.3390/gels10020101] [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: 01/10/2024] [Revised: 01/20/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
The injectability of cross-linked hyaluronic acid (HA) dermal fillers is influenced by polymer concentration, polymer cross-linking type and degree, the presence of lidocaine or other functional excipients, types of syringes, and injection techniques. Finished product injectability constitutes a critical quality attribute for clinical injectors, as it strongly influences product applicability and ease of use in aesthetic medicine. While injectable product extrusion force specifications are provided by the respective device manufacturers, the qualitative informative value of such datasets is low for injectors wishing to compare product brands and technologies from an injectability standpoint. Therefore, the present study comparatively assessed 28 cross-linked HA dermal fillers (JUVÉDERM®, Restylane®, BELOTERO®, TEOSYAL RHA®, and STYLAGE® brands) using various injectability benchmarking setups for enhanced clinical-oriented relevance. Manual product injections were performed by three specialized and experienced clinicians, whereas automatic product extrusion was performed using a Texture Analyzer instrument. The various hydrogel products were injected into ex vivo human skin and into SimSkin® cutaneous equivalents to appropriately account for injection-related counterpressure. The injectability results revealed important variability between and within product brands, with a strong influence of the local anesthetic lidocaine, HA contents, and needle gauge size. Critical appraisals of the investigated products were performed, notably from manufacturing process-based and clinical ease of application-based standpoints, centered on respective experimental injectability quality levels. Generally, it was confirmed that each HA-based dermal filler product requires specific expertise for optimal injection, mainly due to differing viscoelastic characteristics and injectability attributes. Overall, the present study set forth evidence-based and clinical-oriented rationale elements confirming the importance for injectors to work with injectable products with which they are experienced and comfortable to optimize clinical results.
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Affiliation(s)
| | - Alexandre Porcello
- School of Pharmaceutical Sciences, University of Geneva, CH-1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CH-1211 Geneva, Switzerland
| | | | | | | | - Yogeshvar Kalia
- School of Pharmaceutical Sciences, University of Geneva, CH-1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CH-1211 Geneva, Switzerland
| | - Eric Allémann
- School of Pharmaceutical Sciences, University of Geneva, CH-1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CH-1211 Geneva, Switzerland
| | - Alexis Laurent
- Regenerative Therapy Unit, Lausanne University Hospital, University of Lausanne, CH-1015 Lausanne, Switzerland
- Manufacturing Department, TEC-PHARMA SA, CH-1038 Bercher, Switzerland
- Manufacturing Department, LAM Biotechnologies SA, CH-1066 Epalinges, Switzerland
| | - Olivier Jordan
- School of Pharmaceutical Sciences, University of Geneva, CH-1211 Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CH-1211 Geneva, Switzerland
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8
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Saad FA. Gene Therapy for Skin Aging. Curr Gene Ther 2024; 25:2-9. [PMID: 38529607 DOI: 10.2174/0115665232286489240320051925] [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: 10/09/2023] [Revised: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 03/27/2024]
Abstract
Extrinsic and intrinsic factors contribute to skin aging; nonetheless, they are intertwined. Moreover, intrinsic skin aging mirrors age-related declines in the entire human body's internal organs. There is evidence that skin appearance is an indicator of the general health of somebody or a visual certificate of health. Earlier, it was apparent that the intrinsic factors are unalterable, but the sparkling of skin aging gene therapy on the horizon is changing this narrative. Skin aging gene therapy offers tools for skin rejuvenation, natural beauty restoration, and therapy for diseases affecting the entire skin. However, skin aging gene therapy is an arduous and sophisticated task relying on precise interim stimulation of telomerase to extend telomeres and wend back the biological clock in the hopes to find the fountain of youth, while preserving cells innate biological features. Finding the hidden fountain of youth will be a remarkable discovery for promoting aesthetics medicine, genecosmetics, and healthy aging. Caloric restriction offers ultimate health benefits and a reproducible way to promote longevity in mammals, while delaying age-related diseases. Moreover, exercise further enhances these health benefits. This article highlights the potential of skin aging gene therapy and foretells the emerging dawn of the genecosmetics era.
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Affiliation(s)
- Fawzy A Saad
- Department of Gene Therapy, Saad Pharmaceuticals, Juhkentali 8, Tallinn, 10132, Estonia
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9
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Rossi M, Knowles HJ, Del Fattore A. Editorial: Advances in the endocrine role of the skeleton volume II. Front Endocrinol (Lausanne) 2023; 14:1345813. [PMID: 38174336 PMCID: PMC10761473 DOI: 10.3389/fendo.2023.1345813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Michela Rossi
- Bone Physiopathology Research Unit, Translational Pediatrics and Clinical Genetics Research Division, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Helen J. Knowles
- Botnar Institute for Musculoskeletal Sciences, Nuffield Department of Orthopaedics Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Andrea Del Fattore
- Bone Physiopathology Research Unit, Translational Pediatrics and Clinical Genetics Research Division, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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10
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Truchetet A, Goetz C, Bursztejn AC. Prevalence and comorbidities of dermatoporosis: A French prospective observational study in general medicine consultation. J Eur Acad Dermatol Venereol 2023; 37:e1465-e1467. [PMID: 37471483 DOI: 10.1111/jdv.19366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/18/2023] [Indexed: 07/22/2023]
Affiliation(s)
- A Truchetet
- Department of General Medicine, Faculty of Medicine of Nancy and University of Lorraine, Nancy, France
| | - C Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, Metz, France
| | - A C Bursztejn
- Department of Dermatology, Allergology and Venereology, Nancy University Central Hospital and University of Lorraine, Nancy, France
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11
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Agrawal R, Hu A, Bollag WB. The Skin and Inflamm-Aging. BIOLOGY 2023; 12:1396. [PMID: 37997995 PMCID: PMC10669244 DOI: 10.3390/biology12111396] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/24/2023] [Accepted: 10/27/2023] [Indexed: 11/25/2023]
Abstract
With its unique anatomical location facing both the external and internal environment, the skin has crucial functions, including shielding the body from damage caused by ultraviolet radiation and chemicals, preventing water loss, acting as a primary barrier against pathogens, participating in metabolic processes like vitamin D production and temperature control and relaying information to the body through sensory and proprioceptor nerves. Like all organ systems, skin is known to undergo multiple changes with aging. A better understanding of the mechanisms that mediate aging-related skin dysfunction may allow the creation of targeted therapeutics that have beneficial effects not only on aged skin but also on other organs and tissues that experience a loss of or decline in function with aging. The skin is the largest organ of the body and can contribute to serum inflammatory mediator levels. One alteration known to occur with age is an impairment of skin barrier function; since disruption of the barrier is known to induce inflammation, skin may be a major contributor to the sustained, sub-clinical systemic inflammation associated with aging. Such "inflamm-aging" may underlie many of the deleterious changes observed in aged individuals. This review explores the role of age-related skin changes, skin inflammation and inflamm-aging.
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Affiliation(s)
- Rashi Agrawal
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (R.A.); (A.H.)
| | - Anne Hu
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (R.A.); (A.H.)
| | - Wendy B. Bollag
- Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA; (R.A.); (A.H.)
- Charlie Norwood VA Medical Center, Augusta, GA 30904, USA
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA 30912, USA
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12
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Yuceler Kacmaz H, Kahraman H, Cinar SL, Ozkan F. Skin properties associated with skin tears in older adults: A case-control study. J Tissue Viability 2023; 32:585-589. [PMID: 37839901 DOI: 10.1016/j.jtv.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/15/2023] [Accepted: 09/24/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The world population is growing rapidly and skin problems such as skin tears (STs) are more common in aging skin due to changes in the epidermis and dermis. Identification of ageing related skin properties, which are risk factors for STs, is essential for the development of ST prevention protocols. OBJECTIVE The aim of this study was to reveal the skin properties related to epidermal function and dermal associated with STs. MATERIAL AND METHODS A prospective case-control study was conducted with a sample of 36 older adults, 18 participants with ST and 18 participants without ST, in two elderly care centers. Tewameter TM 210 was used to measure transepidermal water loss, the Sebumeter SM810 was used to measure sebum, and Cutometer Dual MPA 580 was used to measure skin viscoelasticity (R0-R9). The differences of skin properties between groups were analyzed using the independent t-test and Mann-Whitney U test. RESULTS The case group had a mean age of 77,17 ± 9,7 and the control group had a mean age of 75,33 ± 6,8. It was determined that there were more ecchymosis (p < 0.000), hematoma (p = 0.008), and ST history (p = 0.001) in the case group. Older adults in the case group were more frail than the control group (p = 0.044). Regarding the score of the skin properties, the case group showed that the TEWL levels of the older adults in the case group were lower (p = 0.031) compared to the control groups. There was a significant difference between the groups and R0, R2, R5, and R7. While R0 was higher in the case group, R2, R5, and R7 were lower than the control group. CONCLUSION Older adults with ST showed differences in skin properties compared to those without ST, especially transepidermal water loss, and viscoelasticity (R0, R2, R5, R7). The results of this study suggest that some changes in skin properties may be a risk factor for STs.
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Affiliation(s)
- Hatice Yuceler Kacmaz
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Hilal Kahraman
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
| | - Salih Levent Cinar
- Erciyes University, Faculty of Medicine, Department of Dermatology, Kayseri, Turkey.
| | - Filiz Ozkan
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey.
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13
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Griffiths TW, Watson REB, Langton AK. Skin ageing and topical rejuvenation strategies. Br J Dermatol 2023; 189:i17-i23. [PMID: 37903073 DOI: 10.1093/bjd/ljad282] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 11/01/2023]
Abstract
Skin ageing is a complex process involving the additive effects of skin's interaction with its external environment, predominantly chronic sun exposure, upon a background of time-dependent intrinsic ageing. Skin health and beauty is considered one of the principal factors perceived to represent overall 'health and wellbeing'; thus, the demand for skin rejuvenation strategies has rapidly increased, with a worldwide annual expenditure expected to grow from $US24.6 billion to around $US44.5 billion by 2030 (https://www.databridgemarketresearch.com/reports/global-facial-rejuvenation-market). Skin rejuvenation can be achieved in several ways, ranging from laser and device-based treatments to chemical peels and injectables; however, topical skin care regimes are a mainstay treatment for ageing skin and all patients seeking skin rejuvenation can benefit from this relatively low-risk intervention. While the most efficacious topical rejuvenation treatment is application of tretinoin (all-trans retinoic acid) - a prescription-only medicine considered to be the clinical 'gold standard' - a hybrid category of 'cosmeceutical' products at the midpoint of the spectrum of cosmetics and pharmaceutical has emerged. This article reviews the clinical manifestations of skin ageing and the available topical treatments for skin rejuvenation, including retinoids, peptides and antioxidants.
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Affiliation(s)
- Tamara W Griffiths
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Rachel E B Watson
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- A*STAR Skin Research Laboratory (A*SRL), Agency for Science, Technology and Research (A*STAR), Republic of Singapore
| | - Abigail K Langton
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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14
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Hiramoto K, Kubo S, Tsuji K, Sugiyama D, Iizuka Y, Hamano H. The Effect of Bacillus coagulans Induced Interactions among Intestinal Bacteria, Metabolites, and Inflammatory Molecules in Improving Natural Skin Aging. Dermatopathology (Basel) 2023; 10:287-302. [PMID: 37873804 PMCID: PMC10594509 DOI: 10.3390/dermatopathology10040037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Lactic acid bacteria consumption serves several health benefits to humans. However, their effect on natural skin aging is still unclear. METHODS This study examined the effects of skin naturalization (particularly skin drying) by administering a spore-bearing lactic acid bacteria (Bacillus coagulans) in mice for 2 years. RESULTS B. coagulans administration improved the natural skin of mice and significantly increased proportions of the genera Bacteroides and Muribaculum, among other intestinal bacteria. As metabolites, increases in nicotinic acid, putrescin, and pantothenic acid levels and a decrease in choline levels were observed. Increased hyaluronic acid, interleukin-10, and M2 macrophage levels indicate aging-related molecules in the skin. Intestinal permeability was also suppressed. Thus, these changes together improved natural skin aging. CONCLUSIONS This study revealed that B. coagulans administration improved the natural skin aging in mice. This enhancement might be induced by the interaction of alterations in intestinal flora, metabolites, or inflammatory substances.
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Affiliation(s)
- Keiichi Hiramoto
- Department of Pharmaceutical Sciences, Suzuka University of Medical Science, Suzuka 513-8670, Japan
| | - Sayaka Kubo
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., Tokyo 140-8170, Japan; (S.K.); (K.T.); (D.S.); (Y.I.); (H.H.)
| | - Keiko Tsuji
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., Tokyo 140-8170, Japan; (S.K.); (K.T.); (D.S.); (Y.I.); (H.H.)
| | - Daijiro Sugiyama
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., Tokyo 140-8170, Japan; (S.K.); (K.T.); (D.S.); (Y.I.); (H.H.)
| | - Yasutaka Iizuka
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., Tokyo 140-8170, Japan; (S.K.); (K.T.); (D.S.); (Y.I.); (H.H.)
| | - Hideo Hamano
- Research Department, Daiichi Sankyo Healthcare Co., Ltd., Tokyo 140-8170, Japan; (S.K.); (K.T.); (D.S.); (Y.I.); (H.H.)
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15
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Thietart S, Rozes A, Tubach F, Marot S, Marcelin AG, Raux M, Vallet H, Riou B, Boddaert J, Zerah L. In-hospital mortality of older patients with COVID-19 throughout the epidemic waves in the great Paris area: a multicenter cohort study. BMC Geriatr 2023; 23:573. [PMID: 37723419 PMCID: PMC10507910 DOI: 10.1186/s12877-023-04236-y] [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: 11/27/2022] [Accepted: 08/16/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Mortality is high in older patients hospitalized with COVID-19. Previous studies observed lower mortality during the Omicron wave, yet no data is available on older patients. The objective was to compare in-hospital mortality between the Omicron and previous waves in older patients hospitalized with COVID-19. METHODS This retrospective observational multicenter cohort study used the Greater Paris University Hospitals Group's data warehouse (38 hospitals). Patients aged ≥ 75 years with a confirmed COVID-19 diagnosis and hospitalized from March 2020 to January 2022 were included. The study period was divided into five waves. The fifth wave (January 1st to 31st 2022) was considered as the Omicron wave as it was the predominant variant (≥ 50%), and was compared with waves 1 (March-July 2020), 2 (August-December 2020), 3 (January-June 2021) and 4 (July-December 2021). Primary outcome was in-hospital mortality. Secondary outcome was occurrence of ICU admission or in-hospital death. Multivariate logistic regression was performed, with a sensitivity analysis according to variant type. RESULTS Of the 195,084 patients hospitalized with COVID-19, 19,909 patients aged ≥ 75 years were included (median age 85 [IQR 79-90] years, 53% women). Overall in-hospital mortality was 4,337 (22%), reaching 345 (17%) during wave 5. Waves 1 and 3 were significantly associated with increased in-hospital mortality in comparison with wave 5 (adjusted Odds Ratios aOR 1.42 [95%CI 1.21-1.66] and 1.56 [95%CI 1.33-1.83] respectively). Waves 1 to 3 were associated with an increased risk of occurrence of ICU admission or in-hospital death in comparison with wave 5: aOR 1.29 [95% CI 1.12 to 1.49] for wave 1, aOR 1.25 [95% CI 1.08 to 1.45] for wave 2 and aOR 1.56 [95% CI 1.36 to 1.79] for wave 3. Sensitivity analysis found that Omicron variant was associated with decreased mortality, in comparison with previous variants. CONCLUSIONS Mortality was lower during the 5th Omicron wave in the older population, but remained high, implying that this variant could be considered as "milder" but not "mild". This persistently high mortality during the 5th Omicron wave highlights the importance of including older patients in clinical trials to confirm the benefit/risk balance of COVID-19 treatments in this fragile population.
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Affiliation(s)
- Sara Thietart
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié- Salpêtrière, Département de Gériatrie, Paris, France
| | - Antoine Rozes
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié Salpêtrière, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, Paris, F75013, France
| | - Florence Tubach
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Unité de Recherche Clinique PSL-CFX, CIC-1901, Paris, F75013, France
| | - Stéphane Marot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Virologie, Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Virologie, Paris, France
| | - Mathieu Raux
- Sorbonne Université, INSERM, UMRS1158, AP-HP, Hôpital Pitié-Salpêtrière, Département d'Anesthésie Réanimation, Paris, France
| | - Hélène Vallet
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), AP-HP, Hôpital Saint Antoine, Département de Gériatrie, Paris, France
| | - Bruno Riou
- Sorbonne Université, UMRS INSERM 1166, IHU ICAN, AP-HP, Hôpital Pitié- Salpêtrière, Département des Urgences, Paris, France
| | - Jacques Boddaert
- Sorbonne Université, INSERM, Centre d'Immunologie et des Maladies Infectieuses (Cimi-Paris), Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Gériatrie, Paris, France
| | - Lorène Zerah
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Pitié-Salpêtrière, Département de Gériatrie, Paris, France.
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Romano F, Serpico D, Cantelli M, Di Sarno A, Dalia C, Arianna R, Lavorgna M, Colao A, Di Somma C. Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne) 2023; 14:1231580. [PMID: 37693364 PMCID: PMC10484397 DOI: 10.3389/fendo.2023.1231580] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation. VD deficiency has been linked to OP because it inhibits the body's capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.
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Affiliation(s)
- Fiammetta Romano
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Domenico Serpico
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariateresa Cantelli
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Antonella Di Sarno
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Carmine Dalia
- Internal Medicine S. Maria Della Pietà Hospital Nola, Nola, Italy
| | - Rossana Arianna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariarosaria Lavorgna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Annamaria Colao
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
| | - Carolina Di Somma
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
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17
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Bortolozo F, Rinaldi M, Souza P, Schütz Paschoal Â, Lemperle G. Dermatoporosis in Upper Limbs Treated With Polymethylmethacrylate Microspheres Using the BioSculpt® Technique. Cureus 2023; 15:e43789. [PMID: 37605716 PMCID: PMC10440045 DOI: 10.7759/cureus.43789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2023] [Indexed: 08/23/2023] Open
Abstract
Dermatoporosis is a syndrome of fragility or chronic cutaneous insufficiency. It presents with localized violaceous spots on the extensor face of the upper limbs of older people, with signs such as senile purpura, actinic purpura, or Bateman purpura, in addition to atrophy of the skin and subcutaneous tissue. These lesions can be painful and a source of morbidity. We report a case of an 80-year-old patient presented for the treatment of dermatoporosis in the upper limbs with polymethylmethacrylate (PMMA) using the BioSculpt®technique. The photographic and ultrasonographic clinical responses of the soft tissue were evaluated before and after nine months of treatment.
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Affiliation(s)
| | | | - Priscila Souza
- Biomedical Sciences, Fernanda Bortolozo Clinic, Balneário Camboriú, BRA
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18
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Kaya A, Saurat JH, Kaya G. Senotherapeutic Effect of Retinaldehyde and Hyaluronate Fragments in Dermatoporosis. Dermatopathology (Basel) 2023; 10:168-172. [PMID: 37366799 DOI: 10.3390/dermatopathology10020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/28/2023] Open
Abstract
Cellular senescence is one of the important mechanisms of skin aging. In a recent study, we have shown that in patients with dermatoporosis, an extreme senescence condition of the skin, cells positive for p16Ink4a, a biomarker of senescence, were significantly increased in the epidermis. Senescent cells can develop a senescence-associated secretory phenotype (SASP) comprising pro-inflammatory cytokines, chemokines, and other soluble factors, leading to chronic inflammation and tissue dysfunction. These senescent cells and SASP pathways represent therapeutic targets for the development of senotherapeutics either by inducing selective cell death of senescent cells called senolytics, or suppressing markers of the SASP, called senomorphics. In this study where we conducted a retrospective immunohistochemical analysis of p16Ink4a expression in the skin samples of dermatoporosis patients included in a previous clinical study, we describe the senotherapeutic effect of retinaldehyde (RAL) and intermediate-size hyaluronate fragments (HAFi). Topical application of RAL and HAFi significantly reduced the number of p16Ink4a-positive cells in the epidermis and dermis in dermatoporosis patients which also showed a significant clinical improvement.
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Affiliation(s)
- Aysin Kaya
- Department of Clinical Pharmacology and Toxicology, University of Geneva, 1211 Geneva, Switzerland
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, 1211 Geneva, Switzerland
| | - Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, 1211 Geneva, Switzerland
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19
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Guadanhim LRS, Miot HA, Soares JLM, Silva SAM, Leonardi GR, Lopes RD, Bagatin E. Efficacy and Safety of Topical or Oral Hydrolyzed Collagen in Women with Dermatoporosis: A Randomized, Double-Blind, Factorial Design Study. Dermatol Ther (Heidelb) 2023; 13:523-534. [PMID: 36547800 PMCID: PMC9884723 DOI: 10.1007/s13555-022-00859-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dermatoporosis defines the progressive chronic cutaneous insufficiency syndrome. Stage I is characterized by cutaneous atrophy, senile purpura, and stellate pseudoscars. OBJECTIVE To assess clinical, histologic, quality of life, and biophysical effects of oral and/or topical hydrolyzed collagen (HC) on forearm skin of postmenopausal women with Dermatoporosis stage I. METHODS Double-blind randomized placebo-controlled factorial design study. Two groups of menopausal women with stage I dermatoporosis on forearms were randomized to oral HC 5 g/day or matching placebo, and also to topical serum 2.5% HC or matching placebo once a day, for 6 months. RESULTS A total of 56 women, age range 60-93 years (mean 69.5 ± 7.3 years) were included. Comparing data from baseline and after 6 months, no significant difference was observed for each intervention nor their comparison, for all efficacy parameters: clinical and quality of life scores, dermal elasticity, thickness and echogenicity, and histologic and immunohistochemical markers (p > 0.1). LIMITATIONS Larger studies to confirm our findings are warranted. CONCLUSIONS In menopausal women with stage I dermatoporosis, oral or topical collagen peptides used alone or in combination do not have benefits on forearm skin after 6 months of intervention, and therefore should not be used routinely in this population. CONSORT flow chart.
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Affiliation(s)
- Lilia R S Guadanhim
- Department of Dermatology, Universidade Federal de São Paulo/UNIFESP, Rua Botucatu, 821 - 5o andar, São Paulo, Brazil.
| | - Hélio A Miot
- Department of Dermatology, Universidade Estadual de São Paulo/UNESP, Botucatu, Brazil
| | - Juliana L M Soares
- Department of Dermatology, Universidade Federal de São Paulo/UNIFESP, Rua Botucatu, 821 - 5o andar, São Paulo, Brazil
| | - Silas A M Silva
- Faculty of Pharmaceutical Sciences, Universidade Estadual de Campinas/UNICAMP, Campinas, Brazil
| | - Gislaine R Leonardi
- Faculty of Pharmaceutical Sciences, Universidade Estadual de Campinas/UNICAMP, Campinas, Brazil
| | - Renato D Lopes
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Ediléia Bagatin
- Department of Dermatology, Universidade Federal de São Paulo/UNIFESP, Rua Botucatu, 821 - 5o andar, São Paulo, Brazil
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20
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Bandeira MA, Schmidt FMQ, Nogueira PC, Rosa T, Felizardo RDM, Villela de Castro DL, Woo K, Santos VLCG. The prevalence of skin tears and associated factors in hospitalised patients with cancer. J Wound Care 2022; 31:579-584. [PMID: 35797254 DOI: 10.12968/jowc.2022.31.7.579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Oncology patients are vulnerable to skin breakdown. The primary purpose of this study was to estimate the prevalence of skin tears (STs) in hospitalised patients with cancer and to explore related sociodemographic and clinical factors. METHOD This was an observational, epidemiological, cross-sectional study conducted in an oncology hospital in the city of São Paulo. All STs were classified using the STAR Classification adapted and validated for Brazil. RESULTS Of the 341 patients evaluated, 22 had STs, equating to a prevalence of 6.5%. A higher number of STs were noted on the lower limbs (26.9%) than on other body areas. The main factors associated with STs were the use of anticoagulants, the presence of ecchymosis and the use of incontinence briefs. CONCLUSION This study contributed to a better understanding of the epidemiology of STs in hospitalised patients with cancer, as well as its associated factors. Results may inform nursing professionals with regard to the need to develop prevention strategies and early interventions.
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Affiliation(s)
| | | | - Paula C Nogueira
- Medical-Surgical Nursing Department University of São Paulo, School of Nursing, São Paulo, SP, Brazil
| | - Talita Rosa
- University of São Paulo, School of Nursing, São Paulo, SP, Brazil
| | | | | | - Kevin Woo
- School of Nursing, School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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21
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Managing Skin Ageing as a Modifiable Disorder—The Clinical Application of Nourella® Dual Approach Comprising a Nano-Encapsulated Retinoid, Retilex-A® and a Skin Proteoglycan Replacement Therapy, Vercilex®. COSMETICS 2022. [DOI: 10.3390/cosmetics9020031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Skin ageing is a progressive, but modifiable, multi-factorial disorder that involves all the skin’s tissues. Due to its wide range of physiological and psychosocial complications, skin ageing requires rigorous clinical attention. In this review, we aim to encourage clinicians to consider skin ageing as a disorder and suggest a novel, dual approach to its clinical treatment. Topical retinoids and per-oral proteoglycans are promising, non-invasive, therapeutic modalities. To overcome the low bioavailability of conventional free retinoids, Nourella® cream with Retilex-A® (Pharma Medico, Aarhus, Denmark) was developed using a proprietary nano-encapsulation technology. The nano-encapsulation is a sophisticated ‘permeation/penetration enhancer’ that optimises topical drug delivery by increasing the surface availability and net absorption ratio. Treatment adherence is also improved by minimising skin irritation. Interventional evidence suggests the greater efficacy of Retilex-A® in improving skin thickness and elasticity compared with conventional free forms. It is also reported that the rejuvenating efficacy of Retilex-A® and tretinoin are comparable. Another skin anti-ageing approach is proteoglycan replacement therapy (PRT) with Vercilex®. Vercilex® in Nourella® tablet form has the potential to ameliorate proteoglycan dysmetabolism in aged skin by activating skin cells and improving collagen/elastin turnover. Replicated clinical trials evidenced that PRT can significantly enhance the density, elasticity and thickness of both intrinsically aged and photoaged skin. Evidently, Vercilex® and Retilex-A® share a range of bioactivities that underlie their synergistic activity, as observed in a clinical trial. Dual therapy with Nourella® tablets and cream produced greater effects on skin characteristics than monotherapy with each of the two treatments. In conclusion, Nourella® cream and tablets are safe and effective treatments for skin ageing; however, combining the two in a ‘dual skin rejuvenation system’ significantly improves treatment outcomes.
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22
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Dos Santos Guadanhim LR, Nasser AI, Soares JLM, Sañudo A, Brandão C, Bagatin E. Dermatoporosis and osteoporosis: cross-sectional pilot study. Int J Dermatol 2022; 61:e331-e333. [PMID: 35108399 DOI: 10.1111/ijd.16128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 11/14/2021] [Accepted: 01/11/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Lilia R Dos Santos Guadanhim
- Department of Dermatology, Escola Paulista de Medicina (EPM) - Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
| | - Ana I Nasser
- Department of Dermatology, Escola Paulista de Medicina (EPM) - Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
| | - Juliana L M Soares
- Department of Dermatology, Escola Paulista de Medicina (EPM) - Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
| | - Adriana Sañudo
- Department of Preventive Medicine, Escola Paulista de Medicina (EPM) - Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
| | - Cynthia Brandão
- Discipline of Endocrinology - Department of Medicine, Escola Paulista de Medicina (EPM) - Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
| | - Edileia Bagatin
- Department of Dermatology, Escola Paulista de Medicina (EPM) - Universidade Federal de São Paulo (UNIFESP), Sao Paulo, Brazil
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Hamdan R, Zwetyenga N, Macheboeuf Y, Ray P. Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221135257. [PMID: 36388635 PMCID: PMC9647285 DOI: 10.1177/2050313x221135257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022] Open
Abstract
A deep dissecting hematoma is the most serious complication of dermatoporosis,
consisting of a rapidly expanding blood collection that splits the hypodermis
from the muscle fascia. A several-week time lapse between a minor trauma-induced
superficial hematoma and its sudden evolution into a rapidly spreading deep
dissecting hematoma is unusual. We report the case of a 70-year-old woman with
long-term oral anticoagulation and dermatoporosis who suddenly developed a
rapidly spreading right-leg deep dissecting hematoma 1 month after minor trauma,
for which a surgical debridement and drainage were performed. Only local care
and absorbent dressings were used to manage the post-operative wound, and within
4 months, the wound had healed. In this report, we emphasize the importance of
preventing deep dissecting hematoma in patients who are at risk as well as the
need to weigh the benefits and risks of anticoagulants when dermatoporosis
cutaneous signs are present. A limb-threatening deep dissecting hematoma may
develop suddenly, even weeks after a minor impact. In order to prevent skin
necrosis from occurring, caregivers, patients, and carers must be able to
identify this condition early on.
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Affiliation(s)
- Rémy Hamdan
- Department of Angiology, Dijon Bourgogne University Hospital, Dijon, France
| | - Narcisse Zwetyenga
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery, Dijon Bourgogne University Hospital, Dijon, France
| | - Yvan Macheboeuf
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery, Dijon Bourgogne University Hospital, Dijon, France
| | - Patrick Ray
- Department of Emergency Medicine, Dijon Bourgogne University Hospital, Dijon, France
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Chanca L, Fontaine J, Kerever S, Feneche Y, Forasassi C, Meaume S, Colboc H. Prevalence and risk factors of dermatoporosis in older adults in a rehabilitation hospital. J Am Geriatr Soc 2021; 70:1252-1256. [PMID: 34918778 DOI: 10.1111/jgs.17618] [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: 11/10/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The term dermatoporosis (DP) is used to describe the clinical signs and functional consequences of age-related extreme skin fragility. It is associated with potentially severe complications, including deep dissecting hematomas and extended skin lacerations. No studies have evaluated the prevalence and risk factors of DP in adults aged 75 and older. METHODS The aim of our study was to assess the prevalence, complications, and risk factors of DP in a cohort of older patients hospitalized in a rehabilitation center. A case-control, single-center study was conducted between September and October 2020 in our rehabilitation ward, Rothschild Hospital, Paris, France. A senior dermatologist and a resident in geriatric medicine performed a systematic dermatological examination. The presence of DP, its stage, its location, and complications were collected, as were demographical data, comorbidities, past sun exposure, skin phototype, treatments, and biological data. RESULTS A total of 101 patients (62 women, median age 86 years [extreme values 75-104]) were included. The overall prevalence of DP was 27%. Stage 1 was the most frequent. DP was mainly located on the upper limbs. Ten (37%) patients had a DP complication: eight (30%) skin lacerations and two (7%) deep dissecting hematomas. Multivariate analysis revealed a significant association between DP and age (odds ratio [OR] 5.82, 95% confidence interval [CI] 1.67-24.92, p = 0.009), smoking (OR 8.67, 95% CI 2.59-34.85, p = 0.001), recreational sun exposure (OR 4.23, 95% CI 1.30-15.21, p = 0.02), and anticoagulant therapy (OR 4.53, 95% CI 1.32-17.26, p = 0.02). CONCLUSION Our study is the first to analyze the prevalence and risk factors of DP in older adults in rehabilitation. Frequency of DP makes it relevant for the geriatrician and should be described more to prevent potential severe complications. A multicentric study, with inpatients and outpatients, could evaluate the prevalence of DP in a more representative older adult population.
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Affiliation(s)
- Laura Chanca
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Juliette Fontaine
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Sébastien Kerever
- Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, DMU PARABOL, AP-HP. Nord, Paris, France.,Fédération Hospitalo-Universitaire PROMICE, INSERM UMR-S 942 MASCOT, Université de Paris, Paris, France
| | - Yohann Feneche
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Christine Forasassi
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Sylvie Meaume
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Hester Colboc
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
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Ruini C, Daxenberger F, Gust C, Schuh S, French LE, Welzel J, Sattler EC. [Advances in optical coherence tomography]. Hautarzt 2021; 72:1048-1057. [PMID: 34698874 DOI: 10.1007/s00105-021-04905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2021] [Indexed: 11/29/2022]
Abstract
Optical coherence tomography (OCT) has been able to establish itself in recent years not only in academic-scientific, but also in everyday dermatological practice. Its focus lies on epithelial tumors of the skin, which can be diagnosed intuitively and within a few seconds. Thus, basal cell carcinomas, actinic keratoses, and different stages of field cancerization can be diagnosed and monitored for response to therapy or possible recurrence. This often helps to avoid invasive sample extraction. Recently, the field of OCT and its latest advancement, dynamic OCT (D-OCT), has been expanded to include non-oncologic dermatological diseases. This encompasses inflammatory dermatoses and the analysis of physiological skin parameters such as hydration. Thanks to automated vascular imaging and the measurement of objective parameters such as epidermal thickness, blood flow at depth, optical attenuation coefficient, and skin roughness, more and more characteristics of the skin can be studied in a noninvasive and standardized way. New potential areas of application are eczema, contact allergic dermatitis, psoriasis, rosacea, telangiectasia, acute and chronic wounds, melasma and nevus flammeus but also melanocytic lesions.
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Affiliation(s)
- Cristel Ruini
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland. .,Doctorate School (PhD) in Clinical and Experimental Medicine, University of Modena and Reggio Emilia, Modena, Italien.
| | - Fabia Daxenberger
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Charlotte Gust
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Sandra Schuh
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Lars E French
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Elke C Sattler
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
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Hersant B, SidAhmed-Mezi M, Aboud C, Niddam J, Levy S, Mernier T, La Padula S, Meningaud JP. Synergistic Effects of Autologous Platelet-Rich Plasma and Hyaluronic Acid Injections on Facial Skin Rejuvenation. Aesthet Surg J 2021; 41:NP854-NP865. [PMID: 33534905 DOI: 10.1093/asj/sjab061] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Many therapeutic options are currently available for facial skin rejuvenation, but little evidence exists about the efficacy of combining such procedures. OBJECTIVES The aim of this study was to assess and investigate the synergistic effect of hyaluronic acid (HA) and autologous platelet-rich plasma (a-PRP) injections on facial skin rejuvenation. METHODS For this randomized controlled prospective study, 93 eligible patients were enrolled and randomized into 3 intervention groups to undergo a series of 3 treatment sessions with either a-PRP, HA, or a mixture of a-PRP and HA (Cellular Matrix; Regen Lab) injected into facial cheeks. RESULTS A total of 93 patients were included. Treatment with Cellular Matrix led to a very significant improvement in the overall facial appearance compared with treatment with a-PRP or HA alone (P < 0.0001). Participants treated with Cellular Matrix showed a 20%, 24%, and 17% increase in FACE-Q score at 1, 3, and 6 months posttreatment, respectively. For the HA group, the improvement in FACE-Q score was 12%, 11%, and 6% at 1, 3, and 6 months posttreatment, respectively, whereas for the a-PRP group the improvement was 9%, 11%, and 8% at 1, 3, and 6 months posttreatment, respectively. Biophysical measurements showed significantly improved skin elasticity for the Cellular Matrix group compared with the groups receiving a-PRP or HA alone. No serious adverse events were reported. CONCLUSIONS Combining a-PRP and HA seems to be a promising treatment for facial rejuvenation with a highly significant improvement in facial appearance and skin elasticity compared with a-PRP or HA alone. LEVEL OF EVIDENCE: 3
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Affiliation(s)
- Barbara Hersant
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Mounia SidAhmed-Mezi
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Celine Aboud
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Jeremy Niddam
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Samuel Levy
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Thibaud Mernier
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Simone La Padula
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - Jean-Paul Meningaud
- Department of Plastic and Cosmetic Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
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Olsen J, Gaetti G, Grandahl K, Jemec GBE. Optical coherence tomography quantifying photo aging: skin microvasculature depth, epidermal thickness and UV exposure. Arch Dermatol Res 2021; 314:469-476. [PMID: 34109468 DOI: 10.1007/s00403-021-02245-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 04/29/2021] [Accepted: 05/22/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Photo aging predominantly occurs in the face, neck and hands due to UVA and UVB irradiation. It is associated with skin cancer and histological studies indicate thinning of the epidermis and elastosis occurs. Dynamic Optical coherence tomography (D-OCT) is a non-invasive imaging tool able to visualize the epidermis and upper dermis and its blood vessels as well as to evaluate epidermal thickness (ET) and blood flow. OBJECTIVE To investigate ET and blood vessel depth using D-OCT in human subjects correlated to UV exposure. METHODS We evaluated data from 249 healthy adults, that had D-OCT-scans conducted at four different regions (forehead, neck, arm and hand) and correlated ET and blood vessel depth with occupational UV exposure (total standard erythema dose, Total SED), season and demographic data. RESULTS Regional differences in ET and blood vessel depth were found (p values < 0.001). Multiple linear regressions showed a seasonal effect on both ET (- 0.113 to - 0.288 µm/day, p values < 0.001) and blood vessel depth (0.168-0.347 µm/day, p values < 0.001-0.007) during August-December. Significant age-related decrease of ET was seen in forehead, arm and hand (0.207-0.328 µm/year, p values = 0.002-0.18) and blood vessel depth in forehead (0.064-0.553 µm/year, p values = 0.01-0.61). Males had thicker epidermis (3.92-10.93 µm, p values = 0.002-0.15). CONCLUSION Changing seasons are a major predictor of both ET and blood vessel depth, showing strongest effect in non-exposed areas, suggesting a systemic effect, possibly due to seasonal vitamin D fluctuation. Sex, age and occupational UV exposure affect ET. This study demonstrated the feasibility of D-OCT to evaluate epidermal thickness and blood vessel depth.
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Affiliation(s)
- Jonas Olsen
- Department of Dermatology, Health Sciences Faculty, Zealand University Hospital, University of Copenhagen, Sygehusvej 10, 4000, Roskilde, Denmark. .,Department of Internal Medicine, Herlev and Gentofte Hospital, 2730, Herlev, Denmark.
| | - Giovanni Gaetti
- Department of Dermatology, Health Sciences Faculty, Zealand University Hospital, University of Copenhagen, Sygehusvej 10, 4000, Roskilde, Denmark
| | - Kasper Grandahl
- Department of Occupational and Social Medicine, Copenhagen University Hospital Holbæk, Smedelundsgade 60, 4300, Holbæk, Denmark
| | - Gregor Borut Ernst Jemec
- Department of Dermatology, Health Sciences Faculty, Zealand University Hospital, University of Copenhagen, Sygehusvej 10, 4000, Roskilde, Denmark
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Risk scoring tool for forearm skin tears in Japanese older adults: A prospective cohort study. J Tissue Viability 2021; 30:155-160. [PMID: 33741206 DOI: 10.1016/j.jtv.2021.02.010] [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: 09/24/2020] [Revised: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 11/21/2022]
Abstract
[Aim] Because painful skin tears frequently occur in older patients, the prevention of skin tears is fundamental to improve their quality of life. However, a risk assessment tool for skin tears has not been established yet in Japan. Therefore, we aimed to propose a risk scoring tool for skin tears in Japanese older adult. [Methods] We conducted a prospective cohort study with 6-month follow-up in two long-term care hospitals in Japan. A total of 257 inpatients were recruited. Patient and skin characteristics were collected at baseline, and the occurrence of forearm skin tears were examined during follow-up. To develop a risk scoring tool, we identified risk factors, and converted their coefficients estimated in the multiple logistic regression analysis into simplified scores. The predictive accuracy of the total score was evaluated. [Results] Of 244 participants, 29 developed forearm skin tears during the follow-up period, a cumulative incidence of 13.5%. Senile purpura, pseudoscar, contracture, and dry skin were identified as risk factors for skin tears. Their weighted scores were 6, 4, 5, and 6, respectively. The area under the receiver operating characteristic curve of the total score was 0.806. At a cut-off score of 12, the sensitivity was 0.86, and the specificity was 0.67. [Conclusion] Our forearm skin tear risk scoring tool showed high accuracy, whereas specificity was low. This tool can contribute to prevent forearm skin tears in Japanese older adults.
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29
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Vanzi V, Toma E. Deep dissecting haematoma in patients with dermatoporosis: implications for home nursing. Br J Community Nurs 2021; 26:S6-S13. [PMID: 33688761 DOI: 10.12968/bjcn.2021.26.sup3.s6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Dermatoporosis is a chronic cutaneous insufficiency/fragility syndrome with a high prevalence in older adults. Dermatoporotic skin becomes thin and fragile and tends to tear. It may lead to deep dissecting haematomas (DDHs) as a final stage of dermatoporosis, which is a clinical emergency. Management can be challenging, as patients with lower-limb haematomas are frequently older and affected by multiple comorbidities, or are probably on medications that negatively influence wound healing. This article describes the essential role of nurses in prevention, early recognition and wound management of DDHs in patients with dermatoporosis.
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Affiliation(s)
- Valentina Vanzi
- Clinical Nurse Specialist in Wound Care, IRCCS Bambino Gesù Children's Hospital, Center of Excellence of Nursing Scholarship, Rome, Italy
| | - Elena Toma
- Clinical Nurse Specialist in Wound Care, Independent Tissue Viability Consultant, Rome, Italy
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30
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Siperstein R, Wikramanayake TC. Intense Pulsed Light as a Treatment for Senile Purpura: A Pilot Study. Lasers Surg Med 2020; 53:926-934. [PMID: 33615512 DOI: 10.1002/lsm.23358] [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: 06/12/2020] [Revised: 11/01/2020] [Accepted: 11/08/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND OBJECTIVES Senile purpura is a common condition characterized by recurrent ecchymoses in the elderly on the extensor surfaces of the forearms, hands, and legs. Our objective is to assess the efficacy and safety of a protocol using intense pulsed light (BBL; Sciton Inc., Palo Alto, CA) to improve the appearance of senile purpura on subjects' extensor forearms. STUDY DESIGN/MATERIALS AND METHODS Five subjects over 65 years of age, with ecchymotic lesions measuring over 1 cm on each forearm and five younger subjects under 35 years of age, without any ecchymotic lesions, were included in the study. The subjects were treated on one randomized forearm with a new intense pulsed light protocol for four weekly sessions. Photographs and subject questionnaires were taken weekly before each treatment as well as 1 month after all treatments. Skin biopsies were taken 1 day after the last of four weekly treatments. Histological analysis, including hematoxylin and eosin, elastic van Gieson, and Masson's Trichrome staining, were carried out to assess both the epidermal thickness and dermal connective tissue structure. The protocol consists of multiple passes using an intense pulsed light (BBL; Sciton Inc.) device in which the wavelength, filter, and fluence are adjusted for each step. Step 1 uses infrared light (800-1,400 nm), high intensity, a smooth adapter, and a constant motion technique. Step 2 employs a 590-nm filter with two different fluences and step 3 utilizes a 560-nm filter. The fluence of steps 2-3 is increased by 1 J each treatment if no side effects are noted. RESULTS Using a new intense pulsed light protocol in subjects with senile purpura, both the number and square area of ecchymoses on the treated arm were significantly reduced (P = 0.02 and P = 0.04, respectively, paired t test) as compared with the untreated arm at 1 month after four weekly treatments. Despite this pilot study including challenging cases of subjects on both inhaled and injected corticosteroids and blood thinners, all subjects with senile purpura had at least a 50% reduction in the total square area of their ecchymoses on their treated arm. There were no significant or long-lasting side effects, and all subjects reported satisfaction with the treatment with a desire to continue treatments on their control arm. Blinded evaluators were able to select 100% of the time in the subjects with senile purpura, which was the treated arm as compared with the control arm when reviewing photographs from 1 month after the last treatment. In addition, several subjects were noted to have a significant improvement in the appearance of hemosiderin deposition and photodamage. Histologically, intense pulsed light treatments significantly increased epidermal thickness in elderly subjects by 21.14% (P = 0.0153, two-tailed, paired t test), to levels comparable with young subjects. Such restoration is consistent with the other histological observations by blinded evaluators of more abundant and organized collagen fibers in the dermis and reduced aggregates of disorganized elastin fibers. CONCLUSION This new intense pulsed light protocol is safe and effective in improving the clinical appearance of senile purpura as well as preventing future lesions by improving the structure of the skin by increasing epidermal thickness and improving collagen and elastic fiber morphology. The treatment was well-tolerated, adverse effects were minimal, and there was high patient satisfaction. Lasers Surg. Med. 2020. © 2020 Wiley Periodicals LLC.
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Affiliation(s)
- Robyn Siperstein
- Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Siperstein Dermatology Group, 9897 Hagen Ranch Road, Boynton Beach, Florida, 33472
| | - Tongyu C Wikramanayake
- Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, 1600 NW 10th Avenue, RMSB 2023A, Miami, Florida, 33136
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31
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Glass GE. Cosmeceuticals: The Principles and Practice of Skin Rejuvenation by Nonprescription Topical Therapy. Aesthet Surg J Open Forum 2020; 2:ojaa038. [PMID: 36776759 PMCID: PMC9905273 DOI: 10.1093/asjof/ojaa038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Aesthetic practice relies on a harmonious relationship between medicine and commerce. Bridging the gap is a large number of skincare products that make therapeutic claims while avoiding the regulatory framework of pharmaceuticals. In this gray area, clinicians find themselves poorly disposed to counsel patients wisely as the industry is expanding faster than empirical evidence of efficacy and safety can be acquired. To serve our patients and engage with industry, we must understand the theoretical principles and evaluate the clinical evidence in practice. Objectives The purpose of this paper is to classify cosmeceuticals by method of action, explain how they work in principle with reference to skin aging, and evaluate the clinical evidence for them. Methods A literature and cosmetic clinic website search was conducted to establish a list of the most commonly advertised cosmeceuticals, and a peer-reviewed literature search was then conducted to establish the clinical evidence for them. Results A huge number of cosmeceuticals are marketed for skin rejuvenation but almost invariably they fall into 1 of 4 categories. These include the induction of tissue repair mechanisms, inflammatory modulation, scavenging of reactive oxygen species, or a combination of the 3. With the exception of retinol derivatives and hydroxy acids, the clinical evidence is limited, despite promising preclinical evidence for several cosmeceuticals. Conclusions Cosmeceuticals reside within a highly competitive ecosystem and are often brought to market based on preclinical, not clinical evidence. Success and failure will largely be governed by the establishment of clinical evidence in retrospect.
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Affiliation(s)
- Graeme Ewan Glass
- Associate Professor of Clinical (Plastic) Surgery, Weill Cornell Medical College, New York and Qatar
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32
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Roig-Rosello E, Rousselle P. The Human Epidermal Basement Membrane: A Shaped and Cell Instructive Platform That Aging Slowly Alters. Biomolecules 2020; 10:E1607. [PMID: 33260936 PMCID: PMC7760980 DOI: 10.3390/biom10121607] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/11/2022] Open
Abstract
One of the most important functions of skin is to act as a protective barrier. To fulfill this role, the structural integrity of the skin depends on the dermal-epidermal junction-a complex network of extracellular matrix macromolecules that connect the outer epidermal layer to the underlying dermis. This junction provides both a structural support to keratinocytes and a specific niche that mediates signals influencing their behavior. It displays a distinctive microarchitecture characterized by an undulating pattern, strengthening dermal-epidermal connectivity and crosstalk. The optimal stiffness arising from the overall molecular organization, together with characteristic anchoring complexes, keeps the dermis and epidermis layers extremely well connected and capable of proper epidermal renewal and regeneration. Due to intrinsic and extrinsic factors, a large number of structural and biological changes accompany skin aging. These changes progressively weaken the dermal-epidermal junction substructure and affect its functions, contributing to the gradual decline in overall skin physiology. Most changes involve reduced turnover or altered enzymatic or non-enzymatic post-translational modifications, compromising the mechanical properties of matrix components and cells. This review combines recent and older data on organization of the dermal-epidermal junction, its mechanical properties and role in mechanotransduction, its involvement in regeneration, and its fate during the aging process.
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Affiliation(s)
- Eva Roig-Rosello
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305, CNRS-Université Lyon 1, SFR BioSciences Gerland-Lyon Sud, 7 Passage du Vercors, 69367 Lyon, France;
- Roger Gallet SAS, 4 rue Euler, 75008 Paris, France
| | - Patricia Rousselle
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR 5305, CNRS-Université Lyon 1, SFR BioSciences Gerland-Lyon Sud, 7 Passage du Vercors, 69367 Lyon, France;
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33
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Stephen-Haynes J. The what, who, why and how of skin tears in the community and care homes. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2020; 29:S14-S17. [PMID: 33180615 DOI: 10.12968/bjon.2020.29.20.s14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Skin tears frequently occur following a simple trauma, but can become chronic and complex wounds if inappropriately assessed and managed, particularly if on the lower leg. It is important for health professionals, patients and carers to understand the principles of prevention and the importance of fundamental skin care. Identifying those at risk can help with the development of a specific preventive approach. This article offers a brief overview of the International Skin Tear Advisory Panel (ISTAP) best practice recommendations for holistic strategies to promote and maintain skin integrity.
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LeBlanc K, Woo KY, VanDenKerkhof E, Woodbury MG. Skin tear prevalence and incidence in the long-term care population: a prospective study. J Wound Care 2020; 29:S16-S22. [DOI: 10.12968/jowc.2020.29.sup7.s16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective: The World Health Organization estimates that between 2015 and 2050 the proportion of the world's population over 60 years old will nearly double from 12% to 22%. An often overlooked byproduct of ageing is the skin changes associated with it, which heighten the risk of developing skin tears. Despite this presumed increased risk, the true impact of skin tears across age groups and care settings is poorly understood. The purpose of the present study was to establish the prevalence and incidence of skin tears in the Ontario long-term care population. Method: A prospective study design was used to explore the prevalence and incidence of skin tears. Individuals from four long-term care facilities in Ontario were followed over four weeks. The participants were examined for skin tears at the beginning of the study and at week four to determine whether skin tears had occurred and to record the skin tear type and location. Results: A total of 380 individuals, aged 65 years and over, took part. The study found a skin tear prevalence of 20.8% and an incidence of 18.9% within four weeks. These results provide much needed data on the burden of skin tears in the long-term care population. Conclusion: The present study is an important first step towards developing a prevention programme targeting individuals at risk for skin tears in long-term care.
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Affiliation(s)
- Kimberly LeBlanc
- School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Kevin Y Woo
- School of Nursing, Queen's University, Kingston, Ontario, Canada
| | | | - M Gail Woodbury
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
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Shi Y, Yang R, Tu L, Liu D. Long non‑coding RNA HOTAIR promotes burn wound healing by regulating epidermal stem cells. Mol Med Rep 2020; 22:1811-1820. [PMID: 32582996 PMCID: PMC7411415 DOI: 10.3892/mmr.2020.11268] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 05/27/2020] [Indexed: 12/12/2022] Open
Abstract
Local transplantation of epidermal stem cells (ESCs) exerts a therapeutic effect on burn wounds. However, cell viability can impede their clinical application. HOX antisense intergenic RNA (HOTAIR) is involved in regulating adult tissue stem cells, as well as in developmental patterning and pluripotency. However, little is known about its role in regulating ESCs. The present study was performed to investigate the effects of HOTAIR in the modulation of ESCs and wound repair. Firstly, reverse transcription-quantitative PCR was used to detect the relative expression of HOTAIR during burn wound healing in mice to determine whether HOTAIR is associated with wound healing. Subsequently, ESCs derived from mouse skin were transfected with a lentiviral vector to overexpress or knockdown HOTAIR. The effects of HOTAIR on cell proliferation and differentiation were measured by 5-bromodeoxyuridine and MTT assays, and by assessing NANOG mRNA expression. Lastly, mice with burns were administered a subcutaneous injection of HOTAIR-overexpressing ESCs. Images were captured and histological analyses were performed to evaluate wound healing. The results revealed that the expression of HOTAIR gradually increased and peaked at day 7 post-burn and maintained at relatively high levels until day 14 post-burn during wound healing. Furthermore, overexpression of HOTAIR promoted ESC proliferation and maintained the stem cell state in vitro. By contrast, suppression of HOTAIR inhibited cell proliferation and cell stemness. It was also identified that HOTIR-overexpressing ESCs accelerated re-epithelialization and facilitated burn wound repair. In conclusion, the present findings confirmed an essential role of HOTAIR in the regulation of ESC proliferation and stemness. Therefore, targeting HOTAIR in ESCs may be a potentially promising therapy for burn wound healing.
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Affiliation(s)
- Yan Shi
- Burns Institute, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Ronghua Yang
- Burns Department, The First People's Hospital of Foshan, Foshan, Guangdong 528000, P.R. China
| | - Longxiang Tu
- Burns Institute, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Dewu Liu
- Burns Institute, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Villeneuve D, Lidove O, Chazerain P, Ziza JM, Sené T. Association between dermatoporosis and history of major osteoporotic fractures: A French prospective observational study in a general practice population. Joint Bone Spine 2020; 87:511-512. [PMID: 32360829 DOI: 10.1016/j.jbspin.2020.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/08/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Delphine Villeneuve
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France.
| | - Olivier Lidove
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Pascal Chazerain
- Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Jean-Marc Ziza
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Thomas Sené
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
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Bollag WB, Aitkens L, White J, Hyndman KA. Aquaporin-3 in the epidermis: more than skin deep. Am J Physiol Cell Physiol 2020; 318:C1144-C1153. [PMID: 32267715 DOI: 10.1152/ajpcell.00075.2020] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The skin is essential for terrestrial life. It is responsible for regulating water permeability and functions as a mechanical barrier that protects against environmental insults such as microbial infection, ultraviolet light, injury, and heat and cold, which could damage the cells of the body and compromise survival of the organism. This barrier is provided by the outer layer, the epidermis, which is composed predominantly of keratinocytes; keratinocytes undergo a program of differentiation to form the stratum corneum comprising the cornified squame "bricks" and lipid "mortar." Dysregulation of this differentiation program can result in skin diseases, including psoriasis and nonmelanoma skin cancers, among others. Accumulating evidence in the literature indicates that the water-, glycerol-, and hydrogen peroxide-transporting channel aquaporin-3 (AQP3) plays a key role in various processes involved in keratinocyte function, and abnormalities in this channel have been observed in several human skin diseases. Here, we discuss the data linking AQP3 to keratinocyte proliferation, migration, differentiation, and survival as well as its role in skin properties and functions like hydration, water retention, wound healing, and barrier repair. We also discuss the mechanisms regulating AQP3 levels, localization, and function and the anomalies in AQP3 that are associated with various skin diseases.
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Affiliation(s)
- Wendy B Bollag
- Charlie Norwood Veterans Affairs Medical Center, Augusta, Georgia.,Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia.,Department of Dermatology, Medical College of Georgia at Augusta University, Augusta, Georgia.,Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Lorry Aitkens
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Joseph White
- Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Kelly A Hyndman
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
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38
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Menzinger S, Saurat JH, Kaya G. Morphological Analysis of Dermatoporosis by in vivo Reflectance Confocal Microscopy and Ultrasonography. Dermatopathology (Basel) 2020; 6:279-287. [PMID: 32309277 PMCID: PMC7154283 DOI: 10.1159/000505990] [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: 10/14/2019] [Accepted: 01/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Dermatoporosis is defined as a chronic cutaneous fragility and insufficiency syndrome. It results from chronological aging, long-term and unprotected sun exposure, genetic factors, or the chronic use of topical and systemic corticosteroids. There is currently a lack of noninvasive tools for the evaluation and quantification of dermatoporosis. Objectives The aim of this study was to define the dermal-epidermal modifications which characterize dermatoporosis using noninvasive methods such as in vivo reflectance confocal microscopy (RCM) and ultrasound (US). Subjects and Methods Seventeen patients with stage I dermatoporosis and 14 healthy volunteers were included in the study. The posterior surface of the right forearm was analyzed in all subjects, and stellate pseudoscars and senile purpura in patients with dermatoporosis were analyzed when possible. We used a commercially available reflectance confocal microscope and measured different histometric parameters (thickness of the epidermis and its different layers, cellular architecture, aspect of the dermal-epidermal junction and the dermis). We also used a commercially available US skin system to define the dermal-epidermal thickness (DET) in all subjects. Results The DET measured with the US skin system was significantly different between the two groups: mean value 1.19 mm (volunteers group) versus 0.81 mm (patient group). The significant differences measured with RCM were (1) epidermal thickness, (2) number of dermal papillae, and (3) thickness of solar elastosis. Stellate pseudoscars are also characterized by a modified dermis, with a linear organization of the collagen bundles. Conclusion US and in vivo RCM are useful tools for the diagnosis of dermatoporosis. Dermal-epidermal atrophy, reduction of dermal papillae/area, and the thickness of dermal elastosis seem to be the major histometric parameters which characterize dermatoporosis.
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Affiliation(s)
- Sébastien Menzinger
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
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Goldberg DJ, Mraz-Robinson D, Granger C. Efficacy and safety of a 3-in-1 antiaging night facial serum containing melatonin, bakuchiol, and ascorbyl tetraisopalmitate through clinical and histological analysis. J Cosmet Dermatol 2020; 19:884-890. [PMID: 32061043 DOI: 10.1111/jocd.13329] [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: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Changes induced by intrinsic and extrinsic photoaging result in signs of skin aging including altered pigmentation and wrinkles. A 3-in-1 night facial serum (NFS) was developed to treat skin aging by antioxidative and retinoid-like mechanisms. OBJECTIVE To determine the clinical and histological effects of the 3-in-1 NFS on signs of skin aging, clinically and histologically. METHODS & MATERIALS Twenty-four subjects applied serum nightly for 12 weeks, and 12 subjects continued an extension study to 24 weeks. Clinical assessment of skin quality was performed by dermatologists. Skin biopsy was performed at 12 weeks to assess histological changes. RESULTS There was a global aesthetic improvement over the duration of the study: +1.21 points at 12 weeks; +1.25 at 24 weeks. Skin texture, pigmentation, erythema, skin tone, complexion, lines, and wrinkles all significantly improved (P < .05). There was also a significant reduction in photodamage, hyperpigmentation, and wrinkle scores, most notably horizontal forehead expression lines, and marionette lines (P < .05 for all). Dermal and epidermal thickness increased without reaching statistical significance. CONCLUSION The 3-in-1 NFS had clinically and statistically significant effects on signs of skin aging after 12 weeks, which became more pronounced after 24 weeks.
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Affiliation(s)
- David J Goldberg
- Skin Laser and Surgery Specialists of NY and NJ, Hackensack, NJ, USA.,Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Deanne Mraz-Robinson
- Modern Dermatology of Connecticut, Westport, CT, USA.,Yale-New Haven Hospital, New Haven, CT, USA
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Drzymalski DM, Ward K, Hernandez JM, Hoot J, Au SC, Yang FSC, Azocar RJ. The effect of Tegaderm™ versus EyeGard® on eyelid erythema during general anesthesia: a randomized-controlled trial. Can J Anaesth 2020; 67:560-567. [DOI: 10.1007/s12630-020-01588-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/22/2019] [Accepted: 11/25/2019] [Indexed: 12/28/2022] Open
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Narda M, Brown A, Muscatelli-Groux B, Grimaud JA, Granger C. Epidermal and Dermal Hallmarks of Photoaging are Prevented by Treatment with Night Serum Containing Melatonin, Bakuchiol, and Ascorbyl Tetraisopalmitate: In Vitro and Ex Vivo Studies. Dermatol Ther (Heidelb) 2020; 10:191-202. [PMID: 31900804 PMCID: PMC6994585 DOI: 10.1007/s13555-019-00349-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Photoaging is a complex process that is chiefly the result of oxidative stress caused by ultraviolet (UV)-generated reactive oxygen species. To counter this process, we developed a 3-in-1 night facial serum (3-in-1 NFS) containing a combination of direct and indirect antioxidants and polyphenols that is designed to attenuate UV-generated free radicals and stimulate dermal protein synthesis. In clinical trials 3-in-1 NFS improved the appearance of photoaged skin. In this study we sought to identify some of the main histologic changes responsible for this. METHODS We performed an immunolabeling analysis of some of the salient epidermal and dermal proteins in 3-in-1 NFS-treated primary epidermal keratinocytes (HEKs) and dermal fibroblasts (HDFs) in vitro, and in UV-exposed skin explants ex vivo. Numbers of apoptotic sunburn cells following exposure of 3-in-1 NFS-treated skin explants to UV radiation were also determined. RESULTS We demonstrate that 3-in-1 NFS increases levels of filaggrin and aquaporin 3 in HEKs, and levels of collagen I and collagen III in HDFs in vitro. Levels of precursor procollagen type I and tropoelastin were increased in ex vivo skin explants. Numbers of apoptotic sunburn cells were significantly reduced in UV-exposed skin explants. These effects were only observed with the combination of ingredients in 3-in-1 NFS, suggesting that they have a synergistic effect on photoaged skin biology. CONCLUSION Our results show that some of the histological hallmarks of photoaging are improved with the use of 3-in-1 NFS.
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Wollina U, Lotti T, Vojvotic A, Nowak A. Dermatoporosis - The Chronic Cutaneous Fragility Syndrome. Open Access Maced J Med Sci 2019; 7:3046-3049. [PMID: 31850120 PMCID: PMC6910795 DOI: 10.3889/oamjms.2019.766] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 11/28/2022] Open
Abstract
Dermatoporosis is an important clinical condition leading to chronic skin fragility. It can be separated into primary and secondary subtypes, with the latter induced by medical drugs and environmental factors. Dermatoporosis can be classified into 4 major stages with increasing morbidity and mortality with the advanced stages. Its aetiology has been related to the epidermal hyalusome. Dermatoporosis is a cause of mortality in the intensive care unit and should be known not only by a dermatologist but another medical speciality as well. Prevention is of major importance. Therapeutic options are limited but available.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
| | - Torello Lotti
- Department of Dermatology, University of Rome "G. Marconi", Rome, Italy
| | | | - Andreas Nowak
- Department of Anesthesiology and Intensive Care Medicine, Emergency Medicine and Pain Management, Städtisches Klinikum Dresden, Dresden, Germany
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Lee CM, Watson REB, Kleyn CE. The impact of perceived stress on skin ageing. J Eur Acad Dermatol Venereol 2019; 34:54-58. [PMID: 31407395 DOI: 10.1111/jdv.15865] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 06/21/2019] [Indexed: 12/20/2022]
Abstract
Skin ageing can be divided according to phenotypical features into intrinsic (by the passage of time) and extrinsic (with the addition of the effects of environmental factors). Photoageing is by far the most researched factor of extrinsic ageing but the additional impact of other factors such as cigarette smoking and exposure to air pollution ought to be taken into account. One of the least researched topics in relation to extrinsic skin ageing is the impact of psychological stress. A contemporary review of response of human skin to stress describes the molecular mechanisms of extrinsic skin ageing, but has fallen short of explaining resilience to stress exhibited by people. Mechanisms to regulate gene expression, define cellular identity and promote functionality are responsible for the adaptive response to stressful events. Conversely, maladaptive response of human tissues to chronic stress appears to have an impact on gene regulation. Epigenetics is the study of heritable changes in organisms due to modifications in gene activity and expression, as opposed to the genetic code (DNA genome). Chronic stress appears to be an important factor in determining an individual's vulnerability to ageing and age-related comorbidities via epigenetic modifications. Forerunners in epigenetic research recognized the necessity of a reliable biomarker in order to develop a better understanding of the role of epigenomics in ageing. Genomic DNA methylation patterns (DNAm) appear to be valuable in age prediction but variability in specificity exists across species of mammals, human races and tissues. Neuroscience research appears to be leading the way in epigenomics whilst the lack of a valid and reliable DNAm-associated age predictor compatible with human skin tissue hinders research endeavours for the epigenetics of skin ageing.
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Affiliation(s)
- C M Lee
- Department of Dermatology, Frimley Park Hospital, Frimley, Surrey, UK
| | - R E B Watson
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - C E Kleyn
- Centre for Dermatology Research, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Tension subcutaneous haematomas associated with anticoagulants in the elderly: Do they have earlier morbidity and mortality than hip fractures? Rev Esp Cir Ortop Traumatol (Engl Ed) 2019. [DOI: 10.1016/j.recote.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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45
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[Reconstruction of lower limbs in old age-an interdisciplinary approach : Geriatric assessment, perioperative management, diagnostics and treatment targets]. Chirurg 2019; 90:795-805. [PMID: 31463658 DOI: 10.1007/s00104-019-01022-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Complex injuries of the lower extremities in geriatric patients with multiple pre-existing comorbidities represent an increasing challenge to an interdisciplinary team of surgeons. Functional reconstruction of the extremity through osteosynthesis, revascularization and defect coverage aims to preserve mobility and achieve an early return to activities of daily life at home, while avoiding major amputation and the associated risks regarding morbidity and mortality. An interdisciplinary assessment of geriatric patients regarding dystrophy of soft tissue and skín, cardiovascular and metabolic comorbidities as well as specific geriatric diagnostics are crucial steps in ensuring favorable outcomes. Perioperatively, all improvable risk factors should be actively optimized and a specialized interdisciplinary approach to treatment planning (extremity board) is absolutely necessary for success of treatment. It outlines the special features of the geriatric assessment, diagnostics, perioperative management and treatment targets.
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Kaya G, Kaya A, Sorg O, Saurat JH. Dermatoporosis: a further step to recognition. J Eur Acad Dermatol Venereol 2019; 32:189-191. [PMID: 29465833 DOI: 10.1111/jdv.14777] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- G Kaya
- Department of Dermatology, University of Geneva, Geneva, Switzerland
| | - A Kaya
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - O Sorg
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - J-H Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
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Dermatoporosis, a prevalent skin condition affecting the elderly: current situation and potential treatments. Clin Dermatol 2019; 37:346-350. [DOI: 10.1016/j.clindermatol.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kaya G, Kaya A, Saurat JH. Induction of Hyalurosome by Topical Hyaluronate Fragments Results in Superficial Filling of the Skin Complementary to Hyaluronate Filler Injections. Dermatopathology (Basel) 2019; 6:45-49. [PMID: 31700843 PMCID: PMC6827440 DOI: 10.1159/000500493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 11/19/2022] Open
Abstract
Hyaluronate (HA) plays a major role in the process of skin aging. The main use of HA has been for hydration and dermal fillers. Another approach, based on the discovery of the signaling effects of topically applied hyaluronate fragments (HAF), has subsequently been developed. It has been thoroughly demonstrated that topical applications of HAF of a very specific size induce HA filling of the epidermis and the upper dermis. These effects are particularly visible in dermatoporotic patients. Moreover, the combination of HA-based filler injections with topical applications of HAFs/retinoids showed an optimization of the effects of HA. Thus, a new classification of the different effects of HA is proposed here.
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Affiliation(s)
- Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Aysin Kaya
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
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Neuroendocrine Aspects of Skin Aging. Int J Mol Sci 2019; 20:ijms20112798. [PMID: 31181682 PMCID: PMC6600459 DOI: 10.3390/ijms20112798] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/28/2019] [Accepted: 06/06/2019] [Indexed: 12/21/2022] Open
Abstract
Skin aging is accompanied by a gradual loss of function, physiological integrity and the ability to cope with internal and external stressors. This is secondary to a combination of complex biological processes influenced by constitutive and environmental factors or by local and systemic pathologies. Skin aging and its phenotypic presentation are dependent on constitutive (genetic) and systemic factors. It can be accelerated by environmental stressors, such as ultraviolet radiation, pollutants and microbial insults. The skin’s functions and its abilities to cope with external stressors are regulated by the cutaneous neuroendocrine systems encompassing the regulated and coordinated production of neuropeptides, neurohormones, neurotransmitters and hormones, including steroids and secosteroids. These will induce/stimulate downstream signaling through activation of corresponding receptors. These pathways and corresponding coordinated responses to the stressors decay with age or undergo pathological malfunctions. This affects the overall skin phenotype and epidermal, dermal, hypodermal and adnexal functions. We propose that skin aging can be attenuated or its phenotypic presentation reversed by the topical use of selected factors with local neurohormonal activities targeting specific receptors or enzymes. Some of our favorite factors include melatonin and its metabolites, noncalcemic secosteroids and lumisterol derivatives, because of their low toxicity and their desirable local phenotypic effects.
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Vanzi V, Toma E. Recognising and managing age-related dermatoporosis and skin tears. Nurs Older People 2019; 30:26-31. [PMID: 29569862 DOI: 10.7748/nop.2018.e1022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 11/09/2022]
Abstract
Dermatoporosis is a chronic skin fragility syndrome, caused by age and environmental factors. People with dermatoporosis have skin whose protective mechanical function is reduced and which has a decreased tolerance for friction and shearing forces. Skin tears are another clinical consequence of age-associated skin vulnerability and people with dermatoporosis are at increased risk of skin tears. Dermatoporosis may also delay the healing of skin tears, making it vital that healthcare professionals are aware of this condition. Skin tears have profound effects on the health and well-being of older people, and these kinds of injuries are being seen more frequently in clinical practice as the average age of the population increases. The treatment of skin tears in three older people with dermatoporosis is discussed and the clinical decisions made in each case.
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Affiliation(s)
| | - Elena Toma
- Wound care, independent tissue viability consultant, Rome, Italy
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