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The pathogenesis of rosacea has not been fully elucidated. It is currently believed that genetic factors, local skin immune imbalance, neuroimmune and neurovascular dysfunction, skin barrier function abnormalities, microbiota imbalance, etc., are all involved in the occurrence and development of rosacea. This review summarizes research progress in the pathophysiological pathogenesis of rosacea.
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Novel drug delivery system offers several advantages which could outweigh the benefits of other drug deliverysystems. The transdermal drug delivery system being one of them offers supremacy by by-passing the first passmetabolism which eventually helps in eradication of gastrointestinal irritation. However, the major drawback of thetransdermal drug delivery system is the hindrance created via the stratum corneum. This protective barrier of the skindoes not allow required penetration of the drug via skin into the systemic circulation. Thus, in order to overcome thishurdle, a replacement to this type of novel drug delivery system, namely, “microneedle drug delivery system” helpedto improve various pitfalls of transdermal drug delivery system, such as skin barrier function, restrictions towardusing of specific drugs only, bioavailability, patient compliance, diffusion rate, and plasma concentration level. Amicroneedle drug delivery system, thus, is advancement to transdermal drug delivery system which includes deliveryof drug via microneedle into systemic circulation, thus increasing patient compliance and avoiding problems renderedby transdermal drug delivery system.
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Objective@#To investigate the effects of comfrey cream combined with narrow-band UVB (NB-UVB) on skin barrier function and immune function in the patients with psoriasis vulgaris.@*Methods@#A total of 100 patients with psoriasis vulgaris admitted from March 2016 to June 2017 were enrolled in the study. They were randomly divided into observation group (Purple Cream + NB-UVB) and control group (NB- UVB), 50 cases in each group. Psoriasis lesion area and severity index (PASI) and degree of pruritus were evaluated before treatment, after 2 weeks and 4 weeks of treatment. The skin barrier function and immune related indicators were compared between the two groups before and after the treatment.@*Results@#After treatment, the PASI score and pruritus score of the observation group and the control group showed a decreasing trend, and the observation group decreased more significantly. The interaction between the two groups at different time points, and between groups and at different time points were statistically significant (t values were 3.462, 2.833, P<0.05). After treatment, the water content of the stratum corneum (54.34% ± 5.04% vs. 49.03% ± 5.26%, t=5.154) and the sebum content (143.03 ± 11.60 μg/cm2 vs. 130.79 ± 14.54 μg/cm2, t=4.653) in the observation group were higher than those in the control group, and the transepidermal water loss (TEWL) [15.87 ± 4.22 g/(h•m2) vs. 19.87 ± 3.06 g/(h•m2), t=5.426] in the observation group was lower than that in the control group (P<0.05). The CD4+ (42.06% ± 4.68% vs. 33.01% ± 3.07%, t=11.433), CD4+/CD8+ (20.89 ± 3.44 vs. 26.03 ± 3.44, t=8.209) in observation group and control group were increased after treament, while CD8+(1.89% ± 0.29% vs. 1.43% ± 0.27%, t=7.471) was decreased, the observation group was superior to the control group (P<0.05).@*Conclusions@#Treatment of vulgaris vulgaris with comfrey cream combined with NB-UVB can improve symptoms and improve skin barrier function and immune function.
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Patients with diabetes mellitus (DM) often suffer from diverse skin disorders, which might be attributable to skin barrier dysfunction. To explore the role of lipid alterations in the epidermis in DM skin disorders, we quantitated 49 lipids (34 ceramides, 14 free fatty acids (FFAs), and cholesterol) in the skin epidermis, liver, and kidneys of db/db mice, a Type 2 DM model, using UPLC-MS/MS. The expression of genes involved in lipid synthesis was also evaluated. With the full establishment of hyperglycemia at the age of 20 weeks, remarkable lipid enrichment was noted in the skin of the db/db mice, especially at the epidermis and subcutaneous fat bed. Prominent increases in the ceramides and FFAs (>3 fold) with short or medium chains (Subject(s)
Animals
, Humans
, Mice
, Ceramides
, Diabetes Mellitus
, Diabetes Mellitus, Type 2
, Epidermis
, Fatty Acids, Nonesterified
, Hyperglycemia
, Kidney
, Liver
, Receptors, Cytoplasmic and Nuclear
, Skin
, Stearoyl-CoA Desaturase
, Subcutaneous Fat
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Objective To investigate the effects of comfrey cream combined with narrow-band UVB (NB-UVB) on skin barrier function and immune function in the patients with psoriasis vulgaris. Methods A total of 100 patients with psoriasis vulgaris admitted from March 2016 to June 2017 were enrolled in the study. They were randomly divided into observation group (Purple Cream + NB-UVB) and control group (NB- UVB), 50 cases in each group. Psoriasis lesion area and severity index (PASI) and degree of pruritus were evaluated before treatment, after 2 weeks and 4 weeks of treatment. The skin barrier function and immune related indicators were compared between the two groups before and after the treatment. Results After treatment, the PASI score and pruritus score of the observation group and the control group showed a decreasing trend, and the observation group decreased more significantly. The interaction between the two groups at different time points, and between groups and at different time points were statistically significant (t values were 3.462, 2.833, P<0.05). After treatment, the water content of the stratum corneum (54.34% ±5.04% vs. 49.03% ±5.26%, t=5.154) and the sebum content (143.03 ±11.60 μg/cm2 vs. 130.79 ±14.54 μg/cm2, t=4.653) in the observation group were higher than those in the control group, and the transepidermal water loss (TEWL) [15.87 ± 4.22 g/(h?m2) vs. 19.87 ± 3.06 g/(h?m2), t=5.426] in the observation group was lower than that in the control group (P<0.05). The CD4+(42.06% ±4.68% vs. 33.01% ±3.07%, t=11.433), CD4+/CD8+(20.89 ±3.44 vs. 26.03 ± 3.44, t=8.209) in observation group and control group were increased after treament, while CD8+(1.89% ± 0.29% vs. 1.43% ± 0.27%, t=7.471) was decreased, the observation group was superior to the control group (P<0.05). Conclusions Treatment of vulgaris vulgaris with comfrey cream combined with NB-UVB can improve symptoms and improve skin barrier function and immune function.
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Objective To observe the clinical efficacy of Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment for the treatment of facial seborrheic dermatitis. Methods A total of 92 patients with facial seborrheic dermatitis were randomly divided into treatment group and control group,46 cases in each group. The treatment group was treated with oral use of Recipe for Clearing Heat and Removing Dampness combined with external use of Butyl Flufenamate Ointment, and the control group was only treated with external use of Butyl Flufenamate Ointment. The treatment for the two groups covered 4 weeks. Before treatment and on treatment day 7, 14 and 28, scores of clinical symptoms, related skin barrier function indexes,and the serum level of cathepsin S(Cat S)in the two groups were observed. Results(1)On treatment day 14,28,the total effective rate in the treatment group was 84.8％, 89.1％,and that in the control group was 65.2％,71.7％ respectively,the difference being significant(P < 0.05).(2)On treatment day 7,14,28, the scores of clinical symptoms in the two groups were obviously decreased(P < 0.05 compared with those before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.05).(3) On treatment day 7,14,28,facial sebum secretin,skin water content,and transepidermal water loss(TEWL) of the treatment group were improved to various degrees compared with those of the control group,the differences being significnat(P < 0.05 or P < 0.01).(4)On treatment day 28,serum Cat S of the two groups was markedly decreased(P < 0.01 compared with that before treatment),and the decrease in the treatment group was superior to that in the control group (P < 0.01). Conclusion Recipe for Clearing Heat and Removing Dampness combined with Butyl Flufenamate Ointment exerts certain effect for the treatment of facial seborrheic dermatitis.
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Transdermal drug delivery offers a number of advantages including improved patient compliance, sustained release, avoidance of gastric irritation, as well as elimination of pre-systemic first-pass effect. However, the skin barrier function limits the transdermal penetration of macromolecular drugs. Microneedle arrays can remarkably increase the skin permeability for drugs, especially macromolecular drugs, by forming microchannels in the skin. In recent years, the types and usages of microneedle have made great progress. This review focuses on remarking the wound repair and pharmacology evaluation, as well as introduces the microneedle percutaneous drug delivery system.
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Objective To evaluate the effect of topical olive oil, vaseline cream and menthol ointment on skin barrier function of patients with senile xerosis. Methods Totally 32 participants with senile xerosis were enrolled in this randomized double-blind self-controlled study for 8 weeks. Four black square spaces were marked on bilateral forearms of each volunteer, and three were treated with olive oil, vaseline cream and menthol ointment, respectively, once a day for 8 weeks, and the last one was taken as control. Skin barrier function was evaluated at 2, 4, and 8 weeks after experiment by measuring the water content of the stratum corneum, transepidermal water loss (TKWL), and skin pH value. Results Compared with the control group, the water contents of stratum corneum in the olive oil, vaseline cream and menthol ointment groups were significantly increased (P<0.05), and the TEWL value and skin pH value were significantly decreased (P<0.05) at 8 weeks. There were no significant difference in the water content of stratum corneum, TEWL value, or pH value between 3 experiment groups. Conclusion Topical olive oil can improve the skin barrier function of patients with senile xerosis, and vaseline cream and menthol ointment also can repair the skin barrier function.
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Objective To evaluate the efficacy of Qingpeng ointment for the treatment of asteatotic eczema and its effect on skin barrier function.Methods A self-controlled clinical study was performed.Totally,78 patients with asteatotic eczema symmetrically located on both lower extremities were enrolled into this study.The left and right lower extremities of these patients were treated with Qingpeng ointment (Qingpeng group) and hydrocortisone butyrate ointment (hydrocortisone butyrate group) respectively,twice a day for 4 consecutive weeks.At the end of treatment,therapeutic effect and skin barrier function were compared between the 2 groups.Results The response rate was significantly higher in the hydrocortisone butyrate group than in the Qingpeng group after 1-and 2-week treatment (week 1:58.97％ vs.39.74％,x2 =5.77,P ＜ 0.05;week 2:76.92％ vs.60.26％,x2 =5.03,P ＜ 0.05),but insignificantly different between the 2groups after 4-week treatment (80.77％ vs.87.18％,P ＞ 0.05).Compared with the hydrocortisone butyrate group,theQingpeng group showed significantly increased water content of the stratum corneum after 4-week treatment (P ＜ 0.05),and decreased transepidermal water loss after 2-and 4-week treatment (both P ＜ 0.05).Conclusion Qingpeng ointment is safe and effective for the treatment of asteatotic eczema with gradually increasing and stable effects,and also has a favoring effect on the restoration of skin barrier function.
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Objective To evaluate the efficacy of light-emitting diode (LED) irradiation at 530 nm,630 nm and 850 nm in the treatment of photoaged skin.Methods A total of 14 adults with photoaged extensor forearm were recruited in this study.Three areas were selected at the extensor forearm in each of these subjects and received LED irradiation at 530 nm,630 nm and 850 nm,respectively,thrice a week for 12 sessions.Dermoscopy was used to visualize these areas before and after the irradiation,the Corueometer CM 825 to measure stratum corneum (SC) hydration,Tewameter TM 300 to determine transepidermal water loss (TEWL),and CM-2600d spectrophotometer to measure L* value and melanin index (MI).Tissue specimens were obtained from these areas irradiated with LED at 530 nm (n =5),630 nm (n =5) and 850 nm (n =4) separately before and 6 weeks after the initial irradiation,and subjected to histopathological examination.Results Both skin texture and pigmentation were improved in 10 and 7 testees after 12 sessions of LED irradiation at 630 nm and 850 nm,respectively,but the skin texture became rougher and pigmentation was increased in 7 testees after LED irradiation at 530 nm.After LED irradiation at 630 nm and 850 nm,the testees experienced an obvious increase in SC hydration ((37.9 ± 7.7) au and (34.5 ± 7.1) au at 6 weeks after the initial irradiation vs.(33.1 ± 6.1) au and (32.0 ± 7.0) au before irradiation,both P ＜ 0.05),but a significant decrease in TEWL value ((9.8-± 2.5) and (10.9 ± 2.5) g·m-2·h-1 at 6 weeks after the initial irradiation vs.(14.0 ± 1.8) and (14.2 ± 2.6) g·m-2·h-1 before irradiation),with no significant changes in L* value or MI (both P ＞ 0.05).No evident alteration was observed in SC hydration or TEWL value (both P ＞ 0.05),while the L* value significantly decreased (P ＜ 0.05) and MI increased (P ＜ 0.05) after LED irradiation at 530 nm.Histopathological examination showed photo-induced denaturation of collagen fibers and elastic fibers in the dermis of these subjects before irradiation,as well as nascent collagen fibers and elastic fibers in a more dense and regular arrangement after irradiation at the three wavelengths.Conclusions LED irradiation at both 630 nm and 850 nm can improve the appearance and barrier function of,and stimulate the proliferation and rearrangement of collagen fibers and elastic fibers in,photoaged skin,while LED irradiation at 530 nm increases skin pigmentation.
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This study was aimed to observe the mechanism of Jia-Jian Xiao-Yao (JJXY) Powder improving facial skin barrier function of the hormone-dependent dermatitis patients. A total of 100 patients were randomly divided into two groups. In the treatment group, 50 cases were orally administered with JJXY Powder. In the control group, loratadine and vitamin EC particles were orally administered to the 50 cases. Thirty days is one treatment course. Changes of transepidermal water loss (TEWL), skin erythema amount and IL-4 were detected in patients of both groups before and after the treatment. The results showed that the clinical efficiency of treatment group and control group was 82.0% and 58.0%, respectively. In the treatment group, the TEWL and skin erythema amount were obviously decreased after the treatment (P < 0.05). In the treatment group, the decreasing range of serum IL-4 was significant compared to control group (P < 0.05). It was concluded that JJXY Powder is one of the effective methods for the treatment of facial hormone-dependent dermatitis. It is able to repair facial hormone-dependent dermatitis in patients with impaired skin barrier function and reduce the amount of skin erythema. The therapeutic mechanism may be related to the regulation of serum IL-4.
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The skin has a special significance in acupuncture. In acupuncture, the skin is both a site of both examination and treatment while providing an interface for information exchange with the external world. Various findings that appear on the body surface should not simply be understood as dermatologic findings, but considered as a reflection of the internal condition of the body, the external world and the mental condition. From this perspective, although acupuncture treatment use only simple stimuli, such as needles, and stimulate only specific sites on the body surface, they can produce therapeutic effects and regulate physical and mental functions<BR>In this symposium, we reviewed the relationship between skin and acupuncture by examining acupuncture and moxibustion treatments for specific dermatologic diseases and their clinical effects. As a result, we were able to reaffirm the above relationship from the perspective of an acupuncturist.<BR>The methods and clinical effects of acupuncture and moxibustion treatment were introduced for atopic dermatitis (by Egawa), tinea unguium (by Dr. Menjou), and the dermatologic symptoms of connective tissue diseases (by Dr. Kasuya). Moreover, Dr. Kagawa presented his research results related to the effects of acupunctural stimulation on the condition of the skin. Based on these research results, the possible effects of acupuncture treatment were discussed based on extensive application in fields such as dermatology, cosmetics, and anti-ageing. Regarding the significance of the skin (body surface) within the practice of acupuncture, it was reconfirmed that the skin reflects the condition of the organs and the mind, and examination of the skin may elucidate both mental and physical health. In addition, we also discussed the body surface as a site of both examination and treatment, and investigated the efficacy, potential for further development, and significance of acupuncture, which connect the skin with systemic functions.
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Objective To analyze the skin barrier function in patients with facial steroid dermatitis.Methods Ninety-five patients with facial steroid dermatitis were enrolled into this study along with 25 healthy volunteers as controls.Transepidermal water loss(TEWL)and skin hydration were measured in 8 facial regions.including lesional skin in forehead,nasal tip,submaxilla,both cheeks and angulus oris,and non-lesional skin in the left posteior ear.Results Compared with the healthy group,the patients with steroid dermatitis had a significant higher value of TEWL on lower mandible,both angulus oris and cheeks(t:4.90,2.60,2.57,2.54,3.77,respectively,P＜0.01),while a significant lower level of skin hydration was noted on both angulus otis,right cheek and forehead(t=3.27,3.81,2.02,2.78,respectively,P＜0.05).Among the 8 test sites in both patients and controls,TEWL value decreased in the following order:submaxilla and both angulus oris＞both cheeks and forehead＞non lesional skin on the posteroir ear,and the decrease in skin water content was highest in submaxilla and both angnlus oris,followed by cheeks and forehead,and finally by left posterior ear.Conclusions In patients with facial steroid dermatitis,skin barrier function is disturbed on submaxilla,both angnlus oris and cheeks,and TEWL value is found to be higher in perioral area,while cheeks have a lower level of skin hydration.
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BACKGROUND: Several studies demonstrated that high concentration salicylic acid (beta hydroxy acid, BHA) peels were beneficial for acne, post inflammatory hyperpigmentation, melasma, oily skin, enlarged pores and surface roughness. OBJECTIVE: We have focused on the facial skin in acne patients after several BHA peels. METHODS: Thirty patients with acne vulgaris were included in this study. The peels were performed at 2 week intervals and sixteen patients completed a series of five peels. Stratum corneum hydration, skin surface lipid, skin pH, transepidermal water loss(TEWL) were measured at each visit and 2 weeks later after the last peel. RESULTS: The stratum corneum hydration, skin surface lipid, skin pH, TEWL did not show a statistically significant difference between the value of pretreatment and after five peels CONCLUSION: The results of this study suggest that BHA peels can be used to treat acne patients without disruption of normal skin function.
Subject(s)
Humans , Acne Vulgaris , Butylated Hydroxyanisole , Hydrogen-Ion Concentration , Hyperpigmentation , Melanosis , Salicylic Acid , SkinABSTRACT
BACKGROUND: Natural moisturizing factors such as sodium pyrrolidone carboxylic acid and lactic acid may play an important role in increasing the moisture retention of isolated stratum corneum and reducing the incidence of dry and flaky skin in vivo. Although the precise mechanism of surfactant irritancy is not fully understood, it has been suggested that barrier dysfunction of stratum corneum by surfactants results in skin changes such as scaling, erythema, and even fissuring. OBJECTIVE: We evaluated the effect of sodium pyrrolidone carboxylic acid(NaPCA) and lactic acid(LA) with several non-invasive measuring methods in the irritated skin reaction induced by sodium lauryl sulphate (SLS) in normal persons and atopic dermatitis patients. METHODS: After skin irritation for 24 hours with patch test of 1% SLS on five volar sites of right forearm, we applied nothing(A), 3% LA+3% NaPCA(B), 3% LA(C), 3% NaPCA(D), and vehi cle(E) twice a day respectively. Visual score, transepidermal water loss(TEWL), water holding capa city(WHC), and erythema index were measured at 30 min, 24hr, 48hr and 72hr after patch removal. RESULTS: 1. After 72hr, the visual scores of B and C were significantly lower than that of A(control) in atopic dermatitis patients, and that of C in normal persons was significantly lower than that of A, D, and E. 2. TEWL values of B and C in both the normal (after 72hr) and atopic dermatitis group (after 48hr and 72hr) were significantly lower than that of A. 3. WHC values of B, C, D in both the normal and atopic dermatitis group were significantly higher than that of A after 48hr and 72hr. 4. After 72hr, erythema indices by Mexameter of B, C, and D in both the normal and atopic dermatitis group were significantly lower than that of A and values of C were significantly lower than that of E. In the atopic dermatitis group, values of D were also significantly lower than that of E. 5. The mean visual score was significantly correlated with TEWL value and erythema index of Mexameter (r=0.58, r=0.64) and the TEWL value was significantly correlated with erythema index of Mexameter (r=0.64). CONCLUSION: These results suggest that topical application of a moisturizing factor might improve the surfactant-induced disruption of permeability barrier with improvement of the water holding capacity of the stratum corneum.