Influence of Diabetes Mellitus on the Biomechanical Properties of the Human Skin as Measured Using the Cutometer: A Case-Control Study

OBJECTIVE: Longstanding diabetes mellitus has been suggested to cause several skin problems associated with biomechanical skin properties. However, the association between impaired skin properties and diabetic peripheral neuropathy (DPN) has not been clarified. This study aimed to investigate the biomechanical properties of the diabetic human skin and their relationship with DPNs. METHODS: This case-control study included 39 chronic diabetic patients and 41 matched healthy controls. The diabetic group was divided into subgroups according to the presence of diabetic sensorimotor polyneuropathy (DSPN) and peripheral autonomic neuropathy (PAN) as determined by the results of nerve conduction study and sympathetic skin response test, respectively. Different skin regions were measured using the non-invasive Cutometer instrument (Courage and Khazaka Electronic GmbH, Cologne, Germany). The following skin parameters were compared between the groups: distensibility (Uf), elasticity (Ua/Uf and Ur/Uf), and viscoelasticity (Uv/Ue). The impact of DPNs, participant age, and diabetes duration on the investigated skin properties was analyzed. RESULTS: The diabetic group showed higher Uf values, and lower Ua/Uf, Ur/Uf, and Uv/Ue values, compared to the control group. However, no significant differences in biomechanical skin properties were noted between diabetic patients with PAN and without PAN. There were also no differences in the investigated skin properties between diabetic patients with DSPN and without DSPN. Diabetes duration and participant age of both groups had a significant impact on the skin properties. CONCLUSION: A long-term hyperglycemic state could induce inferior biomechanical skin properties in the peripheral limbs; however, this phenomenon seems unrelated to DPNs.

Measurement of Skin Elastic Properties by Cutometer in Normal Korean Individuals and Comparison with Dermaflex / 대한피부과학회지

BACKGROUND: Many studies about the skin elastic properties have been performed until now using diverse methods. Suction methods using Dermaflex and Cutometer are most prevalently used. OBJECTIVE: We performed this study to obtain the normal range of skin elastic properties using Cutometer and to know the correlation between the data of Cutometer and those of Dermaflex. METHODS: Eleven different anatomical sites were measured in 46 healthy young volunteers (M:=23:3) by Cutometer. The same anatomical sites were also measured by Dermaflex in sixteen volunteers(M:=8:). RESULTS: When measured by Cutometer, skin elasticity and distensibility were generally higher in the central part of the body than the distal portion, showing the distal gradient. There were differences according to sexes and a part of them were significant. When we compared Cutometer with Dermaflex, they were closely related to each other in the data about distensibility, there was a weak correlation in the data of elasticity. No correlation was detected between Cutometer and Dermaflex in the data about hysteresis. CONCLUSION: This study suggests the Korean standard values of elastic properties in their twenties by Cutometer. The values measured by Cutometer and Dermaflex were not interchangeable although they were the same in the aspect of theoretical concept. These features should be considered in the future study measuring skin elastic properties.

The Effect of pH on Sodium Lauryl Sulfate Irritancy Potential

Five volunteers received patch tests with 5% sodium lauryl sulfate (SIS) in solutions of differing pH. The irritant effect was monitored by visual scoring as well as by a laser Doppler vlelocimeter, evaporimeter, cutometer, and colorimeter. The non-invasive methods used in this study with the exception of the cutometer were effective in the evaluation of skin irritation. No significant differences in the skin responses to SIS in different pH solutions were found either clinically or by the non-invasive methods used for quantification. It was concluded that the pH of SIS is not a major factor in the degree of skin irritation produced by SIS.