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Objective To investigate changes in thickness of the skin and muscular layer during the treatment with botulinum toxin A injections in patients with glabellar lines.Methods Twenty-six subjects with moderate to severe glabellar lines were enrolled into this study,who received botulinum toxin A injections in Peking Union Medical College Hospital from August 2017 to February 2018.Before the injections,4 and 16 weeks after the injections,thickness of the dermis at the injection site was measured by using 50 MHz high-frequency ultrasound,and full thickness of the skin and thickness of the muscular layer were measured with 20 MHz high-frequency ultrasound.Repeated measures analysis of variance,paired ttest and Bonferroni method were used to compare the pretreatment and posttreatment tissue thicknesses measured by using high-frequency ultrasound.Results Before the injections,the thickness of the dermis,full thickness of the skin,thickness of the muscular layer were 2.01 ± 0.48,4.32 ± 0.73 and 4.51 ± 0.67 mm respectively.No significant difference was observed among the pretreatment,4-and 16-week posttreatment thickness of the dermis (F =1.94,P =0.199),while there were significant differences among the pretreatment,4-and 16-week posttreatment full thickness of the skin and thickness of the muscular layer (F =6.28,24.19,P =0.020,＜ 0.001 respectively).Four weeks after the injections,the full thickness of the skin significantly increased (4.88 ± 0.93 mm,t =3.72,P =0.004),while the thickness of the muscular layer significantly decreased (3.82 ± 0.79 mm,t =4.65,P =0.001)compared with the pretreatment thicknesses.Sixteen weeks after the injections,the full thickness of the skin (4.61 ± 0.73 mm) and thickness of the muscular layer (4.38 ± 0.90 mm) did not significantly differ from those before and 4 weeks after the injections (all P ＞ 0.016 7).Conclusions Botulinum toxin A injections can change the thickness of the subcutaneous tissue and muscular layer.High-frequency ultrasound can be applied to the evaluation of efficacy and to follow-up after the treatment of glabellar lines with botulinum toxin A injections.
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Objective@#To investigate the therapeutic outcome of expanded scalp flaps pedicled with superficial temporal vessel for the reconstruction of large facial defects.@*Method@#From Dec 2014 to Oct 2016, 10 cases with large facial skin defects were treated with expanded scalp flaps pedicled with superficial temporal vessel and delayed laser hair removal.Extra expanded scalp flaps were collected as experimental groups. Normal skin(forehead, temporal scalp, cheek, upper eyelid, lower eyelid and nasal dorsum)of 10 cases were collected for control, to compare skin thickness.All patients were followed at least 6 months.@*Results@#There was no significant difference of skin thickness between the expanded scalp flaps and cheek, forehead, nasal dorsum skin(P>0.05). But upper eyelid and lower eyelids skin was significantly thinner than other local skin tissuein controls, and expanded scalp flap (P<0.05). The expanded scalp flap matched well with surrounding tissues in color, texture and thickness.@*Conclusions@#It is a good option to repair large facial skin defects with expanded scalp flaps, pedicled with superficial temporal vessel, and laser hair removal, though its shortcoming in eyelid skin defect repairment.
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Objective To measure the thickness and echo density of the skin at multiple sites of healthy adults by using high-frequency ultrasound.Methods A total of 50 healthy volunteers were enrolled from Department of Dermatology and Venereology,China-Japan Friendship Hospital between June and December in 2018,including 33 females and 17 males aged 22-69 years.The thickness and echo density of the epidermis,dermis and epidermis-dermis layer were detected by using high-frequency ultrasound at 12 sites,including the forehead,cheek,chest,abdomen,and the inner and outer sides of the upper arm,forearm,thigh and leg.The means of two groups were compared by using t test,and means of several groups were compared by using one-way analysis of variation.Results High-frequency skin ultrasound images differed among different anatomical sites.There were significant differences in the thickness and echo density of the epidermis,dermis and epidermis-dermis layer among the 12 sites (P ＜ 0.05).The epidermis was thickest at the inner side of the thigh (160.68 μm ± 25.71 μm),the dermis was thickest at the cheek(1 828.78 μm ± 399.10 μm),and the epidermis-dermis layer was thickest at the cheek (1 943.48 μm ± 402.4 μm).The echo density of the epidermis,dermis and epidermis-dermis layer was highest at the inner side of the leg (152.27 ± 21.56),forearm (52.71 ± 15.57) and forearm (62.56 ± 15.76) respectively.The thickness of the epidermis,dermis and epidermis-dermis layer at the forehead,cheek and the inner side of the forearm was significantly higher in male volunteers than in female volunteers (P ≤ 0.05 or ＜ 0.01),while the echo density of the dermis and epidermis-dermis layer at the forehead,cheek and the outer side of the leg was significantly lower in male volunteers than in female volunteers (P ＜ 0.05 or 0.01).Conclusion Differences exist in skin thickness and echo density among different anato mical sites and between male and female healthy adults.
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Objective To investigate imaging characteristics of human skin in different sites by using 20-MHz and 50-MHz high-frequency ultrasonography,and to compare the reliability of skin thickness measurement by the above two approaches of ultrasonography.Methods A total of 39 healthy volunteers aged 18-39 years were enrolled into this study.Then,20-MHz and 50-MHz ultrasonography were separately performed to image 20 different sites on the body,and the thickness of the epidermis and dermis were measured and evaluated by 3 dermatologists independently.The ultrasonic images were analyzed,and the intraclass correlation coefficient (ICC) was used to assess and compare the reliability of skin thickness measurement by 20-MHz and 50-MHz ultrasound.Results The ICC values were less than or close to 0.7 in epidermal thickness measurement at almost all the tested sites between 20-MHz and 50-MHz ultrasonography,suggesting poor reliability.However,20-MHz and 50-MHz ultrasonography showed excellent reliability in dermal thickness measurement with the ICC greater than 0.75 at almost all the tested smooth and flat body sites.The 20-MHz ultrasound could provide clear images of the dermis and subcutaneous tissue,while 50-MHz ultrasound could only provide clearer images of the dermis in details.In some uneven sites with complex anatomical structures,20-MHz and 50-MHz ultrasound probes had their own advantages and disadvantages in imaging depth and detail resolution.Conclusions The 20-MHz and 50-MHz ultrasono-graphy both can serve as non-invasive imaging techniques to show structures of the epidermis and dermis better.In different parts of human body,ultrasound frequencies should be selected according to their imaging characteristics.
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Objectives@#To determine the skin and subcutaneous thickness of adult diabetic Filipinos using ultrasonography. @*Methodology@#We studied 293 Filipino diabetic adults who had ultrasonographic measurements of their skin thickness (ST) and subcutaneous thickness (SCT) at common insulin injection sites.@*Results@#The mean ST ranges from 1.76 mm to 2.75mm. The mean SCT ranges from 6.91 mm to 19.1 mm. The anterior thigh area has the thinnest mean ST and SCT. On the other hand, the buttocks have the thickest mean ST and area of abdomen has the thickest mean SCT. On multiple regression analysis, the predictors for skin thickness are injection site, age, BMI, gender and insulin use, however the overall influence of all these factors on skin thickness is variable at best. @*Conclusion@#Skin thickness among Filipinos varies marginally depending on injection site being thickest at the buttocks and thinnest at the thighs. On the other hand, there is greater variability in SCT depending on the injection site, being thickest at the abdominal area and thinnest at the anterior thigh.
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Diabetes Mellitus , Injections, SubcutaneousABSTRACT
This study to evaluate the effect of hormone replacement therapy ( HRT ) and low-dose combinated oral pill on skin thickness , lipid profile and blood chemistry on menopausal woman.This study was carried out in one year randomized prospective study. 36 women were divided into 18 women receiving HRT and the other 18 receiving low-dose oral pill. The result of this study showed an increase in skin thickness (collagen) in both groups. But Those received low dose oral pill showed more . The increase of the skin thickness can prevent osteoporosis. The administration of HRT or low-dose oral pill could cause allteration in blood lipip profile and blood chemistry. But The changes were still within in normal limit. The administration of low-dose oral pill can be considered in postmeno-pausal women.
Subject(s)
Menopause , Hormone Replacement Therapy , Skinfold ThicknessABSTRACT
Objective To investigate the effects of rosiglitazone on serum levels of tumor necrosis factor-? (TNF-?),interleukin-6 (IL-6),C-reactive protein (C-RP) and superoxide dismutase (SOD),and early skin changes in the diabetic rats.Methods The rats were divided into normal control group (C group,n=13),diabetic control group (DC group,n=13),diabetes and insulin treatment group (DI group,n=13),diabetes and rosiglitazone treatment group (DR group,n=13).The diabetic rat models were established with high-fat diet for 2 weeks followed by intraperitoneal injection of 35 mg/kg streptozotocin injection,the rats were idenfied as diabetic when their fasting blood glucose (FBG) over 7.0 mmol/L.The living rats were given corresponding treatment,subcutaneous injection of 1 to 2 U/d insulin,intragastric injection of 5 mg/(kg?d) rosiglitazone,or sterile water.Heart blood samples of rats from each group were collected to measure TNF-?,IL-6,C-RP and SOD levels in the 16th weekend.Also the skin was taken for pathological observation and full-thickness as well as dermal thickness measurements.Results The serum levels of IL-6,TNF-? and C-RP in diabetic group were significantly higher than those in normal group (P
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Objective To observe the histopathological features of early skin lesions and serum inflammatory mediators changes in the diabetes mellitus(DM) rats.Methods A total of 50 Wistar rats at 8 to 10 weeks of age were divided into normal control group(C group,n=25) and diabetic group(DC group,n=25).The rats of DC group were given a high-glucose and high-fat diet for 2 weeks to induce insulin resistance and then an intraperitoneal injection of 35 mg/kg streptozotocin.All 25 rats were identified to be diabetic models with their fasting blood glucose over ≥7.0 mmol/L.Four rats of C group or DC group were killed to take the skin tissues in the 4th,8th and 12th weekend.In the 16th week,the heart blood samples of the left 13 rats of C group and 10 rats of DC group were collected to measure TNF-?,IL-6 and C-RP levels,and the skin samples were also taken for pathological observation and full-thickness and dermal thickness measurement.Results In the 16th week,the TNF-?,IL-6 and C-RP levels of DC group were significantly higher than the normal group(P
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This study was aimed to observe the effect of hormone replacement therapy (HRT) of estradiol 2 mg + 1 mg acetate noretisterone administered continuously on FSH hormone, lipid profile, blood chemistry, and skin thickness in menopausal women. The duration of HRT administration was 6 months. The subjects of the study were 35 menopausal women. The study was conducted from January 2001 to June 2001. After HRT administration of 6 months, a significant decrease of FSH was observed. No effect of HRT was found in bilirubin level; however, there was a slight increase of alkali phosphatase enzyme, and a signifcant increase in SGOT and SGPT. HRT caused a decrease of total cholesterol level and triglyceride level. In addition, a slight increase of LDL level and significant decrease of HDL level were observed. HRT administration with progesterone synthetic noretisterone showed an increase of skin collagen synthesis, which was indicated by the significant increase of skin thickness.
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Women's Health , Menopause , Hormone Replacement Therapy , Skinfold ThicknessABSTRACT
BACKGROUND: Skin thickness for parameter of skin aging has been analysed with various methods. Skin thickness variations between the young and the old has been studied with various methods such as biopsies, calipers, micrometers, computer tomography, ultrsonography. But none of these methods evaluates skin thickness exactly. OBJECTIVE: For the evaluation of age-dependent skin thickness changes, we compared the skin thickness of an old-aged group and a young group with 20MHz-ultrasonography. METHODS: In order to identify the skin thickness variation between different age groups, 60 subjects, 30 aged 23-33, and 30 over 60, were studied with 20MHz-high frequency ultrasonogrphy (Dermascan C, Cortex Technology, Hadsund, Denmark) on fourteen skin sites. This machine was designed to measure the thickness from the top of the epidermis to the bottom of the dermis. After storage of cross-sectional skin imaging, skin thickness was calculated with a computer assisted image-analysis program. Skin thickness of the old was analysed by age, sex, height and weight.
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Humans , Biopsy , Dermis , Epidermis , Skin Aging , Skin , UltrasonographyABSTRACT
BACKGROUND: Osteoporosis is developed by progressive decrease of bone rnass from decreased collagen content of bone. Accurate measurement of bone collagen is necessary for the diagnosis of osteoporosis and it is possible by bone biopsy, however bone biopsy is not easy in clinical practice. Skin collagen is consist with type I collagen which is same type of bone collagen and progressive decrease of bone collagen is reflected by decrease of skin collagen. Since skin thickness reflect skin collagen amount, skin thickness measurement may be a useful method for the evaluation of osteoporosis. So ultrasonic skin thickness measurement was developed for the evaluation of osteoporosis. METHODS: A randomly selected 200 women aged fram 30 to 71 years old were asked to have their skin thickness measured as well as lumbar vertebral DXA(Norland, USA) bone densitometry. Except for the two women who failed to complete the study, 45(22.7%) of these women were diagnosed as normal, 74(37.4%) were osteopenic and 79(39.9%) were diagnosed as osteoporosis patients using the WHO criteria. Skin thickness was measured using 20MHz Osteoson DCIII (Minhorst, Germany) at the medial side of the upper arm. A minimal of Two scans were measured and the mean value was cakulated automatically. RESULTS: The correlation coefficient of skin thickness and age was -0.121(ns), DXA BMD(bone mineral density) and age was -0.420(P<0.01), skin thickness and DXA BMD L2-L4 was 0.181(P<0.05). Skin thickness was significantly correlated with body weight(correlation coefficient 0.254, P<0.01) and BMI(correlation coefficient 0.195, P<0.01). Furthermore, the mean and standard deviation of skin thickness in normal BMD group was 0.94+-0.021mm, osteopenic group was 0.92+-0.006mm, and osteoporotic group was 0.89+-0.018mm. There was statistically significant difference in the mean values of skin thickness between the three groups even adjusted with age and BMI(P<0.05). The mean and standard deviation of skin tbickness of healthy 20-40 year old women was 1.11+-0,023mm and their mean and standard deviation of L2-L4 mean BMD was 1.17+-0.145mg/cm2. The diagnostic predictability of skin thickness less than 1mm as the risk of osteoporosis(BMD T score less than -1.0) was evaluated. The sensitivity and the specificity of skin thickness less than 1mm being osteoporotic were 78,2% and 57.8% respectively. The positive and negative predictive value of the skin thickness less than 1mm being osteoporotic were 82.2% and 36.5% respectively. CONCLUSION: This study indicate that the skin thickaess measured with the ultrasound method show good correlatian with the bone density measured with conventional DXA at the lumbar vertebra and the skin thickness less than 1mm on the medial side of the opper arm is relatively sensitive in diagnosing osteoporosis risk in Korean women. The authors suggested that a large randomized control study to define the relationship between the skin thickness and the other determinants of bone turnover in the near future.
Subject(s)
Aged , Female , Humans , Arm , Biopsy , Bone Density , Collagen , Collagen Type I , Densitometry , Diagnosis , Osteoporosis , Osteoporosis, Postmenopausal , Sensitivity and Specificity , Skin , Spine , Ultrasonics , UltrasonographyABSTRACT
BACKGROUND: Several methods have been developed to measure skin thickness, including the use of the radiography, micrometer screw gauge, Harpenden's caliper, and ultrasound, but there are no reports to measure skin thickness using computed tomography. OBJECTIVE: We measured skin thickness on the CT films retrospectively. This study was to investigaste variations of skin thickness by age, gender, and different sites. METHODS: Skin thickness was measured on the CT films of 562 patients, including 357 males and 205 females who had undergone brain, chest, and abdominal CT in our hospital. Patients with endocrinologic, malignant, or collagen disease and those on antimetabolite or steroid therapy were excluded. Comparisons of histometric and computed tomographic methods weremade in 5 skin tumors and 1 localized lipodystrophy. Results: 1. The measurements of the skin thickness(mean) in examined sites varied from 0.84 to 3.07 milimeters : the posterior part at the level of the chest(aortic arch level) was the thickest and the anterior part at the level of the forehead(aortic arch level) was the thickest and the anterior part at the level of the forehead(frontal sinus level) was the thinnest. 2. Skin thickness in males wal generally thicker than in females : the anterior and lateral part at the level of the forehead(P<0.0001), the posterior part at the level of the bladder(P<0.2) were thicker in males than in females. 3. In each gender, the thickness of the skin increased with age of 40 or 60, and then decreased with age at every level. 4. Skin on posterior parts of the body was thicker than on other parts. 5. Unlike other levels, skin was thicker on the lateral parts than on the anterior parts at the levels of the forehead and bladder. 6. The measured skin thickness in about 7% greater in formalin fixed tissues than on CT films. CONCLUSION; Computed tomographic measurement of the skin thickness in a reliable method in the aquisition of normal values and their individual variations during cutaneous aging. Moreover, this method is useful in evaluating skin tumors and monitoring the response to therapy of inflammatory conditions.
Subject(s)
Female , Humans , Male , Aging , Brain , Collagen Diseases , Forehead , Formaldehyde , Lipodystrophy , Radiography , Reference Values , Retrospective Studies , Skin , Thorax , Tomography, X-Ray Computed , Ultrasonography , Urinary BladderABSTRACT
The authors have used a B-mode real-time sector scanner and a 10-MHz probe for measurement of the skin thickness at 21 different sites in healthy Koreans. Subjects consisted of 35 adults(17 males, 18 females) who were divided into three age groups .' young(20 39 years, 12 subjects), middle-aged(40 59 years, 13 subjects), and old(over 60 years, 10 subjects). The results were as follows. 1, The measurements of the skin thickness in examined sites varied from 1.99 to 4.59 milimeters . flexor aspect of the upper arm, dorsum of the hand, extensor aspect of the forearm and flexor aspect of the forearm were thinner, and heel, upper back, metatarsus were thicker than other sites. 2, The skin thickness in males was generally thicker than that in females '. cheek, extensor aspect of the thigh were highly significantly thicker (p<0.01), and chest, upper back, lower back, flexor aspect of the upper arm and extensor aspect of the lower leg were significantly thicker(p< 0.05) in males than in females, 3. The skin was thickest in the old age groups.
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Female , Humans , Male , Arm , Cheek , Forearm , Hand , Heel , Leg , Metatarsus , Skin , Thigh , Thorax , UltrasonographyABSTRACT
We studied skin thickness of the twelve body sites in 25 post-mortem subjects. The most thinnest and thickest sites of the skin layers are as follows(unit: um) l. In the horny layer, eyelid(13.16+/-5.44) and sole(420.83+182. 25), respectively 2. In the granular, eyelid, posterior ear, abdomen, back, thigh, forearrn(1 layer)and sole(3.4+/-0.59 layers), respectively 3. In the prickle cell layer(to rete ridge), forearm(50. 21+/-15. 36) and sole (174.72+/-84.41), respectively 4. In the prickle cell layer(to papillary dermis), abdomen (33. 05+/-10. 28) and sole (106.13+/-73.62), respectively 5. In the epidermis, eyelid (61.60+/-16.53) and sole (972.00+/-228. 16), rpspectively 6. In the dermis, eyelid(878.08+283. 56) and back(3596.05+/-1306.80), respectively.