A dermocosmetic formulation containing Vichy volcanic mineralizing water, Vitreoscilla filiformis extract, niacinamide, hyaluronic acid, and vitamin E regenerates and repairs acutely stressed skin

The exposome has an impact on skin from life-long exposure. Acute short-term exposure to exposome stressors can also alter skin functions such as skin physical barrier and immune defenses, leading to skin dryness, sensitivity, flares of inflammatory skin conditions, or viral reactivations. Probiotics are defined as live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host. An extract produced by lysing Vitreoscilla filiformis (VfeV) cultured in Vichy volcanic mineralizing water (VVMW) has properties of probiotic fractions. In this review, we present in vivo and ex vivo studies with a dermocosmetic formulation containing 80% VVMW, 5% VfeV, 4% niacinamide (vitamin B3), 0.4% hyaluronic acid, and 0.2% vitamin E (M89PF) to evaluate the clinical efficacy in preventing and repairing stressed skin. Skin barrier benefits of M89PF were shown in studies after the skin was exposed to sudden thermal changes, after skin irritation by tape stripping, and in sleep-deprived women. M89PF significantly accelerated skin renewal compared to untreated skin. Skin antioxidant defense activity of M89PF was shown after exposure to stress from UVA plus cigarette smoke aggression. Skin microbiome recovery after acute stress from a harsh cleanser was significantly better in M89PF-treated skin compared to bare skin. Clinical benefits of M89PF on correcting clinical signs of stressed skin were shown in both Caucasian and Asian women exposed to a stressful lifestyle and various external (pollution, tobacco smoking, solar radiation) and internal (poor sleep, stressful work, unbalanced diet, and alcohol consumption) exposome factors. M89PF also showed depigmenting properties on dark spots in Asian women. Further clinical studies are now warranted to evaluate the efficacy of M89PF as adjuvant care to prevent and repair skin barrier disruption and reinforce skin defenses in skin exposed to acute stresses.

A combination of Vitreoscilla filiformis extract and Vichy volcanic mineralizing water strengthens the skin defenses and skin barrier

Probiotics are live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host. Semiactive, non-replicating bacteria or extracts used in dermocosmetics have interesting properties for skin quality. Vitreoscilla filiformis is cultured by a fermentation process to obtain an extract. It is considered as a probiotic fraction and topical application of this extract has shown activity to strengthen the skin physical barrier function and maintain good homeostasis of skin defenses. Vichy volcanic mineralizing water (VVMW) is a pure, highly mineralized water that has been shown to strengthen the skin against exposome aggressions. This manuscript reviews properties of probiotic fractions used in skin care, especially studies on an extract of V. filiformis grown in a medium containing VVMW (VfeV) and evaluated in combination with VVMW. Skin barrier function: In normal human epidermal keratinocyte cultures, the combination of 10% VVMW and 0.002% VfeV significantly increased transglutaminase, filaggrin, involucrin, claudin-1, and zonula occludens-1 in comparison with the controls. Antimicrobial peptide defenses: The combination of 16.7% VVMW and 0.1% VfeV increased the expression of β-defensin-4A and S100A7. Skin immune defense functions: In lipopolysaccharide-stimulated peripheral blood mononuclear cells, the combination of 16.7% VVMW and 0.1% VfeV down-regulated IL-8, TNF-α, IL-12/IL-23p40, and increased IL10 and IL-10/IL-12 ratio compared to the control. Additionally, the combination of 79% VVMW plus 5% VfeV protected Langerhans cells in skin explants exposed to ultraviolet radiation. In conclusion, the combination of VfeV plus VVMW has properties to strengthen the skin barrier by stimulating skin differentiation and tight junctions, biochemical defenses by stimulating antimicrobial peptides, and cellular immune defenses by increasing the IL-10/IL-12 ratio and by protecting Langerhans cells challenged by ultraviolet radiation.

Vichy volcanic mineralizing water has unique properties to strengthen the skin barrier and skin defenses against exposome aggressions

Exposome aggressions are known to weaken certain skin functions, such as skin barrier and skin defense functions. Vichy volcanic mineralizing water (VVMW) percolates through volcanic and magmatic rocks in the Auvergne region in France to create a pure, highly mineralized water containing 15 minerals for a total mineral concentration of 5.2 g/L. Here, we provide an overview of the main results of in vitro and ex vivo studies (keratinocyte cultures, 3D reconstructed skin model, skin explants) and clinical studies to evaluate the effect of VVMW on key skin functions to help elucidate how it counteracts exposome aggressions on the skin. Properties to strengthen the skin barrier: VVMW stimulated the synthesis of tight junction proteins and keratinocyte differentiation markers in vitro. In clinical studies, VVMW accelerated cell turnover and improved skin hydration. Properties to strengthen skin antioxidant defense: VVMW stimulated the expression of antioxidant defense markers and had a higher stimulatory effect than a competitor thermal water on the expression of superoxide dismutase, catalase, and glutathione peroxidase in keratinocytes in vitro. In vivo, VVMW restored endogenous catalase activity after exposure to UVA radiation. Anti-inflammatory action: VVMW reduced substance P-induced inflammation ex vivo and lactic acid-induced stinging in vivo. Topical application of VVMW in subjects with sensitive skin showed soothing and decongestant effects by reducing skin dryness and erythema. After sodium lauryl sulfate -induced skin barrier disruption, recovery from redness and erythema was faster following application of VVMW compared to a competitor water or untreated skin. These studies illustrate that VVMW has unique properties to repair and regenerate the skin barrier, as well as to strengthen antioxidant and immune defenses, which help protect the skin against exposome aggressions.

Reasons for Discontinuation of dupilumab in Adult Atopic Dermatitis in Clinical Practice

Dupilumab, an anti-IL-4ɑ monoclonal antibody, has shown a positive benefit-risk ratio when treating moderate to severe atopic dermatitis (AD) in clinical studies (1). High persistence on dupilumab has recently been reported in clinical-practice setting with 77% of patients remaining in treatment for 12 months in a retrospective study including 1,963 patients with AD but reasons for discontinuation were not investigated (2).

Effectiveness of a formulation containing peptides and vitamin C in treating signs of facial ageing: three clinical studies

OBJECTIVE

Vitamin C and peptides are widely used in cosmetic products but there is a paucity of clinical studies showing that the formulations are effective in treating signs of facial ageing. These 3 clinical studies evaluated the effectiveness of an anti-ageing formula containing natural vitamin C (10%), biopeptides (rice and lupin), hyaluronic acid, and Vichy volcanic mineralising water, in amber glass ampoules with no preservatives (Peptide-C ampoules).

METHODS

Dansyl chloride fluorescence labelling compared cell turnover for Peptide-C ampoules vs untreated skin in 32 female subjects. Study 2, an open clinical study, evaluated the efficacy on wrinkles of Peptide-C ampoules by investigator clinical scoring based on Dynamical Atlas visual assessment (N = 40) and subject self-assessment questionnaires (N = 47). Study 3, an open clinical study, evaluated wrinkles by instrumental quantification with 3D fringe projection analysis (N = 40) and subject questionnaires (N = 51).

RESULTS

The mean cell turnover was faster for skin treated with Peptide-C ampoules compared to untreated skin (17.1 days vs. 19.2 days; P < 0.0001). In study 2, after 28 days application of Peptide-C ampoules, clinical grading of crow's-feet wrinkles, forehead wrinkles and nasolabial folds decreased by 9%, 11% and 5%, respectively (all P < 0.05 vs baseline). Of 47 subjects, 77%, 64% and 79% indicated their skin seemed smoothed out, fine lines were less visible, and skin complexion was more radiant, respectively. In study 3, the number of wrinkles decreased by 11.5% after 29 days application of Peptide-C ampoules vs baseline (P < 0.05) and 65% of subjects responded the fine lines were less visible.

CONCLUSION

This formulation of a combination of anti-ageing ingredients in ampoules, allowing a minimalist formula, showed significant results on improving facial wrinkles and radiance.

[Extra-facial Lever granuloma on a herpes zoster scar: Wolf's isotopic response]

BACKGROUND

Granuloma faciale (GF), or facial granuloma of Lever, is an uncommon dermatosis occurring classically on the face. We report a case of a GF on zoster scars located on the trunk, which is a highly particular isotopic response.

PATIENTS AND METHODS

A 60-year-old man with a sole history of left lumbar zoster presented with a skin lesion present for two months. Clinical examination revealed a 2.5-cm papular erythematous lesion that was both infiltrated and pruritic. This lesion was situated precisely on zoster scars. Lab tests revealed no abnormalities. Histopathologic examination showed an inflammatory process without neovessels but rich in eosinophils with chronic vasculitis and polymorphic infiltrate, on which basis GF was diagnosed.

DISCUSSION

GF is a localized form of cutaneous small-vessel vasculitis. Although it usually affects the face, extra-facial locations also exist. The original character of this presentation, aside from the location, is the occurrence of this GF on a zoster scar, which corresponds to Wolf's isotopic response. This phenomenon, described by R. Wolf, comprises the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease, usually herpes. The physiopathology is still unclear. This differs from isomorphic reactions such as Koebner's reaction, which consists of the appearance at an injury site of skin lesions typical of an existing dermatosis but not a new disorder.

CONCLUSION

This is a rare case of Wolf's isotopic response with GF, of which, to our knowledge, there are no reports in the literature.

[Vaccination status in psoriasis patients on immunosuppressant therapy (including biologics)]

OBJECTIVES

To evaluate the vaccine coverage of psoriasis patients prior to initiating or changing immunosuppressant therapy, and to verify that the prescribed vaccines have been administered.

PATIENTS AND METHODS

We conducted a bi-centre, observational, cross-sectional study over 9 months. Psoriasis patients in whom immunosuppressant therapy (comprising cyclosporine, methotrexate, etanercept, infliximab, adalimumab or ustekinumab) was indicated were included. Medical history, previous treatments, vaccination status, viral serology results (for hepatitis B, measles, and chickenpox), and reasons for non-vaccination were assessed via questionnaire.

RESULTS

Sixty-eight patients were included. One third brought their immunization records. Overall, 54.4% had already received immunosuppressant therapy; of these, 9 were up to date for influenza and 3 were up to date for pneumococcus. Only one patient was up to date for all of the recommended vaccinations. A total of 61% of patients were seronegative for hepatitis B. The following vaccines were updated: DTP (in 2 patients), DTP-pertussis (12), influenza (22), pneumococcus (45), and hepatitis B (6). None of the three patients with plans to travel to yellow fever-endemic countries had been vaccinated. In all, 53 (78%) stated that they had already had chickenpox and 43 (63.2%) stated that they had had one of the following three diseases: measles, rubella, or mumps. Fifty-two patients were serologically tested for chickenpox, and 98% were immunized. The most common reasons for not updating the immunization schedule were the absence of any notification or proposal by the patient's doctor and oversight.

CONCLUSION

This study should help raise awareness among patients and health professionals concerning the new vaccination recommendations for a population particularly at risk of infection.

[Immunoallergic skin manifestations associated with new pets: three cases]

BACKGROUND

The number of household pets increased greatly during the twentieth century, with numbers of new pets (NP, i.e. any pets other than cats and dogs) rising especially sharply over the last decade.

PATIENTS AND METHODS

We first of all report the case of a female patient with eczema lesions on areas skin coming into contact with a ferret, with removal of the animal resulting in wound healing, followed by two patients presenting atypical polymorphous erythema reactions induced by dermatophytes present in their pet rat.

DISCUSSION

While the most common allergies are respiratory, allergic skin reactions, both immediate and delayed, may also result from contact with these new allergens. The animal itself or its environment may be the cause.

[Acquired haemophilia A: two cases]

BACKGROUND

Acquired haemophilia A (AH) is an uncommon bleeding disorder that presents as multiple, disseminated spontaneous subcutaneous bleeds. Diagnosis may be made on the basis of prolonged activated partial thromboplastin time (aPTT). The severity of the disease is associated with the low risk of haemoglobin levels and with potential links with other diseases.

OBSERVATIONS

Two men were hospitalized for extensive and spontaneous subcutaneous hematoma. In both cases, the International Normalized Ratio (INR) was normal, but aPTT was 3 times higher than normal. Autoantibodies against coagulation factor VIII confirmed the diagnosis of AH. The patients received immunomodulatory treatment. In one patient, diffuse large B-cell lymphoma was discovered one year after successful treatment of AH.

DISCUSSION

AH may be revealed by areas of bruising, subutaneous haematomas mimicking erythema nodosum, and muscle pain. APTT results alone can prompt the biologist to screen for factor VIII inhibitors. Aside from the risk of fatal bleeding, in half of all cases, the prognosis is determined by associated disorders such as blood dyscrasias, solid tumours, autoimmune diseases, use of certain medicines and pregnancy. After treatment for bleeding complications, therapy focuses on restoring the coagulation time. The aim of immunomodulatory therapy is to stem production of autoantibodies against coagulation factor VIII.

CONCLUSION

AH must be considered rapidly in order to reduce the risk of bleeding emergencies and to screen for potential related diseases.

[Indolent lymphoma of the ear]

INTRODUCTION

In 2007, Petrella et al. identified a new entity: CD8 T-cell indolent lymphoma of the ear.

CASE REPORT

A 40-year-old man presented a nodular erythematous and violaceous painless lesion on his right ear that had appeared four months earlier. Excision histology revealed a non-epidermotropic T-cell proliferation infiltrating the entire dermis and subcutis but with sparing of a grenz zone. The monotonous infiltrate was positive for CD8, CD3, CD5 and TIA-1, and negative for CD30, CD4, CD56, ALK and EMA. The Mib1 proliferation index was 20%. Lyme serology and PCR for EBV were negative. Additional examinations showed no extracutaneous involvement.

DISCUSSION

CD8+ indolent lymphoma is an entity first described in 2007 and reported in the literature in 15 patients. Lesions are located on the nose or external ear. It comprises a non-epidermotropic proliferation of CD8+ T lymphocytes negative for CD4, CD30, CD56, CD57, granzyme B and perforin. The Mib1 proliferation index is low. This new entity appears neither in the 2005 World Health Organization/European Organization for Research and Treatment of Cancer (WHO/EORTC) classification of cutaneous lymphomas nor in the WHO 2008 Classification of tumours of haematopoietic and lymphoid tissues. Surgical treatment or radiotherapy is sufficient, and unlike aggressive, epidermotropic CD8+ T lymphomas chemotherapy is not required.

Indentations in the terminal cisternae of slow- and fast-twitch muscle fibers from normal and paraplegic rats

Indentations in the terminal cisternae were measured in freeze-fracture replicas of extensor digitorum longus (EDL) and soleus muscles from normal rats and from rats in which the spinal cord had been transected at the midthoracic level 6 weeks earlier. The density of indentations was compared with contraction time and characteristics of K-contractures. In paraplegic rats, the average soleus contraction time decreased from 89 to 46 msec and the average number of indentations, per micrometer of terminal cisternae, increased from 0.9 to 5.0. The EDL contraction time decreased from 35 to 31 msec and the indentations increased from 7.3 to 8.1. In spite of the considerable scatter in the data, there was a clear correlation between indentation density and contraction time. Similarly, indentation density was correlated with the voltage dependence of tension generated during K-contractures. The results show that the density of indentations can be modulated by afferent neural activity and support the hypothesis that indentations play an important role in excitation-contraction coupling.

Indentations in the terminal cisternae of amphibian and mammalian skeletal muscle fibers

Indentations (hillocks and dimples) in the terminal cisternae of mammalian and amphibian skeletal muscle fibers were studied using freeze-fracture and serial thin-section techniques. The structures were seen in all muscles and had a regular separation from each other and from the T-tubule. Indentations were smaller than fenestrations and formed concavities in, but not macromolecular pores through, the terminal cisternae. The average numbers of indentations in rat muscles (measured along the length of the terminal cisternae, within 150 nm of the triadic junction) varied from 0.9 per micrometer in soleus fibers to 9.6 per micrometer in posterior cricoarytenoid fibers. The average numbers in amphibian sartorius fibers varied from 1.6 to 3.6 per micrometer in muscles from different species. The regular alignment of the indentations along the triad, as well as a close correlation between their numbers and the contractile properties of the muscle, suggest that they function in contractile activation and may represent sites of calcium release from the terminal cisternae.

A freeze-fracture study of normal and dystrophic C57BL mouse muscle

Freeze-fracture replicas of normal and dystrophic C57BL mouse muscle and kidney were examined to see whether here was a deficit in plasmalemmal particles which others suggest is a feature of dystrophies. When compared with normal membranes there was an increase in the particle density in dystrophic extensor digitorum longus muscle, a decrease in dystrophic soleus muscle, and no change in dystrophic kidney. Therefore there was not a general deficit in intramembrane particles in this dystrophic tissue. Indirect evidence supported the hypothesis that abnormalities in dystrophic mouse muscles are caused by abnormal motor input. The density of indentations, parallel to the T-tubule, on the flat surface of the terminal cisternae can be modulated by the motor nerve. Changes were found in indentation density in dystrophic muscle which were similar to changes seen after transection of the spinal cord in the mid-thoracic region. There were parallel changes in contractile properties and indentation density in dystrophic fibers.