Comparative study of transepidermal water loss in patients with and without hyperhidrosis by closed-chamber measurer in an air-conditioned environment / Estudo comparativo da perda transepidérmica de água em pacientes com e sem hiperidrose por mensurador de câmara fechada em ambiente climatizado

ABSTRACT Objective To evaluate the difference in transepidermal water loss in patients diagnosed with hyperhidrosis and healthy subjects, in an air-conditioned environment. Methods Twenty patients diagnosed with hyperhidrosis and 20 healthy subjects were subjected to quantitative assessment using a closed-chamber device, in six previously established sites. Results The measurements showed different transepidermal water loss values for healthy subjects and patients with hyperhidrosis, especially in the hands and feet. In the Control Group, the median for the hands was 46.4g/m2/hour (p25: 36.0; p75: 57.6), while in the Hyperhidrosis Group, the median was 123.5g/m2/hour (p25: 54.3; p75: 161.2) - p<0.001. For the feet, the Control Group had a median of 41.5g/m2/hour (p25: 31.3; p75: 63.5) and the Hyperhidrosis Group, 61.2g/m2/hour (p25: 32.3; p75: 117) - p<0.02. Measurements of the axillas also showed differences. In the Control Group, the median was 14.8g/m2/hour (p25: 11.8; p75: 19.0) and, in the Hyperhidrosis Group, 83.5g/m2/hour (p25: 29.5; p75: 161.7) - p<0.001. Conclusion Measuring transepidermal water loss is sufficient for diagnosis and follow-up of patients with hyperhidrosis.

RESUMO Objetivo Avaliar a diferença entre a perda transepidérmica de água aferida entre pacientes com e sem diagnóstico de hiperidrose, em ambiente climatizado. Métodos Foram selecionados 20 pacientes com diagnóstico de hiperidrose e 20 hígidos, submetidos à aferição de maneira quantitativa, com mensurador de câmara fechada, em seis locais previamente estabelecidos. Resultados As medidas realizadas mostraram valores diferentes de perda transepidérmica de água em pessoas hígidas e naquelas com hiperidrose, principalmente em mãos e pés. No Grupo Controle, a mediana das aferições em mãos foi 46,4g/m2/hora (p25: 36,0; p75: 57,6), enquanto, no Grupo Hiperidrose, obtivemos a mediana de 123,5g/m2/hora (p25: 54,3; p75: 161,2) - p<0,001. Já nos pés, a mediana no Grupo Controle foi 41,5g/m2/hora (p25: 31,3; p75: 63,5) e, no Grupo Hiperidrose, foi 61,2g/m2/hora (p25: 32,3; p75: 117) - p<0,02. As medidas das regiões axilares também mostraram diferença. No Grupo Controle, obtivemos mediana 14,8g/m2/hora (p25: 11,8; p75: 19,0) e, no Hiperidrose, 83,5g/m2/hora (p25: 29,5; p75: 161,7) - p<0,001. Conclusão A mensuração da perda transepidérmica de água é suficiente para diagnóstico e acompanhamento de pacientes com hiperidrose.

Skin barrier in rosacea

Abstract Recent studies about the cutaneous barrier demonstrated consistent evidence that the stratum corneum is a metabolically active structure and also has adaptive functions, may play a regulatory role in the inflammatory response with activation of keratinocytes, angiogenesis and fibroplasia, whose intensity depends primarily on the intensity the stimulus. There are few studies investigating the abnormalities of the skin barrier in rosacea, but the existing data already show that there are changes resulting from inflammation, which can generate a vicious circle caused a prolongation of flare-ups and worsening of symptoms. This article aims to gather the most relevant literature data about the characteristics and effects of the state of the skin barrier in rosacea.

Effects of Topical N-Acetylcysteine on Skin Hydration/Transepidermal Water Loss in Healthy Volunteers and Atopic Dermatitis Patients

No abstract available.

The Effect of Evening Primrose Oil for the Prevention of Xerotic Cheilitis in Acne Patients Being Treated with Isotretinoin: A Pilot Study

BACKGROUND: The most common adverse effects of oral isotretinoin are cheilitis, skin dryness, dry eyes, and conjunctivitis, whereas evening primrose oil (EPO) is known to improve skin moisture and transepidermal water loss (TEWL) in healthy adults and atopic patients. OBJECTIVE: To evaluate the clinical efficacy and safety of EPO in preventing xerotic cheilitis in acne patients being treated with oral isotretinoin. METHODS: Forty Korean volunteers of Fitzpatrick skin types III and IV, having moderate acne, were enrolled and randomized to receive either isotretinoin with or without EPO for 8 weeks. The efficacy of treatment was evaluated on the basis of global acne grading system scores, number of inflammatory and noninflammatory lesions, TEWL, corneometry, physician's global assessment, and patient satisfaction. RESULTS: The results after 8 weeks of treatment showed that the TEWL of the lip increased significantly during isotretinoin treatment, whereas the TEWL of the hand dorsum showed no significant change. The increase of the TEWL of the lip was more definite in the control group than in the experimental group. The number of acne lesions decreased significantly in both groups, and there were no differences between them. CONCLUSION: Our study suggests that the addition of EPO improved xerotic cheilitis in acne patients being treated with oral isotretinoin. However, besides TEWL and corneometry assessments, additional studies are required for a complete understanding of the role of EPO in xerotic cheilitis in acne patients being treated with oral isotretinoin.

Effect of Emollients Containing Vegetable-Derived Lactobacillus in the Treatment of Atopic Dermatitis Symptoms: Split-Body Clinical Trial

BACKGROUND: Atopic dermatitis (AD) patients suffer from xerosis. Proper skin care, including the use of emollients, may help improve xerosis and minimize disease exacerbation. Lactobacillus sakei probio 65, isolated from the Korean vegetable-based product kimchi, can decrease interleukin 4 and immunoglobulin E levels and inhibit Staphylococcus aureus. Moreover, it has reportedly shown positive dermatological effects in both animal and clinical studies. OBJECTIVE: To compare the effects of an emollient that contains Lactobacillus (treated) with a normal emollient (control) on AD. METHODS: This double-blind, randomized, split-body clinical trial involved 28 patients with AD. The patients applied the Lactobacillus-containing emollient on one side of their body and the control emollient on the other side twice daily for 4 weeks. Trans-epidermal water loss (TEWL) and skin capacitance were evaluated and investigator global assessment and the visual analogue scale (VAS) were administered on weeks 0, 1, 2, and 4. RESULTS: The treated sides had significantly lower TEWL and VAS values and significantly higher skin capacitance values over time than the control sides. CONCLUSION: Topical application of Lactobacillus-containing emollients may improve the skin permeability of patients with AD.

The Use of Matriderm and Autologous Skin Graft in the Treatment of Full Thickness Skin Defects

BACKGROUND: For patients with full thickness skin defects, autologous Split-thickness skin grafts (STSG) are generally regarded as the mainstay of treatment. However, skin grafts have some limitations, including undesirable outcomes resulting from scars, poor elasticity, and limitations in joint movement due to contractures. In this study, we present outcomes of Matriderm grafts used for various skin tissue defects whether it improves on these drawbacks. METHODS: From January 2010 to March 2012, a retrospective review of patients who had undergone autologous STSG with Matriderm was performed. We assessed graft survival to evaluate the effectiveness of Matriderm. We also evaluated skin quality using a Cutometer, Corneometer, Tewameter, or Mexameter, approximately 12 months after surgery. RESULTS: A total of 31 patients underwent STSG with Matriderm during the study period. The success rate of skin grafting was 96.7%. The elasticity value of the portion on which Matriderm was applied was 0.765 (range, 0.635-0.800), the value of the trans-epidermal water loss (TEWL) was 10.0 (range, 8.15-11.00) g/hr/m2, and the humidification value was 24.0 (range, 15.5-30.0). The levels of erythema and melanin were 352.0 arbitrary unit (AU) (range, 299.25-402.75 AU) and 211.0 AU (range, 158.25-297.00 AU), respectively. When comparing the values of elasticity and TEWL of the skin treated with Matriderm to the values of the surrounding skin, there was no statistically significant difference between the groups. CONCLUSIONS: The results of this study demonstrate that a dermal substitute (Matriderm) with STSG was adopted stably and with minimal complications. Furthermore, comparing Matriderm grafted skin to normal skin using Cutometer, Matriderm proved valuable in restoring skin elasticity and the skin barrier.

Clinical use of a ceramide-based moisturizer for treating dogs with atopic dermatitis

In humans, skin barrier dysfunction is thought to be responsible for enhanced penetration of allergens. Similar to conditions seen in humans, canine atopic dermatitis (CAD) is characterized by derangement of corneocytes and disorganization of intercellular lipids in the stratum corenum (SC) with decreased ceramide levels. This study was designed to evaluate the effects of a moisturizer containing ceramide on dogs with CAD. Dogs (n = 20, 3~8 years old) with mild to moderate clinical signs were recruited and applied a moisturizer containing ceramide for 4 weeks. Transepidermal water loss (TEWL), skin hydration, pruritus index for canine atopic dermatitis (PICAD) scores, and canine atopic dermatitis extent and severity index (CADESI) scores of all dogs were evaluated. Skin samples from five dogs were also examined with transmission electron microscopy (TEM) using ruthenium tetroxide. TEWL, PICAD, and CADESI values decreased (p < 0.05) and skin hydration increased dramatically over time (p < 0.05). Electron micrographs showed that the skin barrier of all five dogs was partially restored (p < 0.05). In conclusion, these results demonstrated that moisturizer containing ceramide was effective for treating skin barrier dysfunction and CAD symptoms.

Insensible Water Loss during the First Week of Life of Extremely Low Birth Weight Infants Less than 25 Gestational Weeks under High Humidification

PURPOSE: Extremely-low-birth-weight infants (ELBWIs), especially those or =26-GW (n=65) infants nursed in 60% humidity. RESULTS: Survival rate until discharge was 33%, 82%, 75% and 89.3% in 22-GW, 23-GW, 24-GW and > or =26-GW infants, respectively. Compared to > or =26-GW infants, fluid intake and IWL was higher in 22-GW and 23-WG, but not as different in 24-GW. At postnatal day (P) 3-5, urine output was significantly lower in > or =26-GW infants than in the other age groups. Serum sodium level was significantly higher in 22-, 23- and 24-GW (P1-2) than in > or =26-GW infants. Hypernatremia (>150 mEq/dl sodium) was more frequent in 22-GW (71%), 23-GW (41%) and 24-GW (21%) than in > or =26-GW infants (14%). CONCLUSION: High-humidity environments significantly decreased fluid intake and improved electrolyte imbalance in 24-GW, but not in 22- and 23-GW infants. Increased IWL in the latter might be related to more immature skin, implicating the need for additional nurturing conditions.

Partial Seizures Manifesting as Apnea Only in Preterm Infant

PURPOSE: Extremely-low-birth-weight infants (ELBWIs), especially those or =26-GW (n=65) infants nursed in 60% humidity. RESULTS: Survival rate until discharge was 33%, 82%, 75%, and 89.3% in 22-GW, 23-GW, 24-GW, and > or =26-GW infants, respectively. Fluid intake and IWL was higher in 22-GW and 23-WG, but not different in 24-GW, than in > or =26-GW infants. At postnatal days (P) 3-5, the urine output was significantly lower in > or =26-GW infants than in the other age groups. Serum sodium level was significantly higher in 22-, 23-, and 24-GW (P1-2) than in > or =26-GW infants. Hypernatremia (>150 mEq/dl sodium) was more frequent in 22-GW (71%), 23-GW (41%), and 24-GW (21%) than in > or =26-GW infants (14%). CONCLUSION: High-humidity environments significantly decreased fluid intake and improved electrolyte imbalance in 24-GW, but not 22- and 23-GW, infants. Increased IWL in the latter might be related to more immature skin, and implicates the need for additional nurturing conditions.

The Clinical Efficacy of Mometasone Furoate in Multi-Lamellar Emulsion for Eczema: A Double-blinded Crossover Study

BACKGROUND: Topical application of corticosteroids also has an influence on skin barrier impairment. Physiological lipid mixtures, such as multi-lamellar emulsion (MLE) containing a natural lipid component leads to effective recovery of the barrier function. OBJECTIVE: The purpose of this study was to conduct an evaluation of the therapeutic efficacy and skin barrier protection of topical mometasone furoate in MLE. METHODS: A multi-center randomized, double-blind, controlled study was performed to assess the efficacy and safety of mometasone furoate cream in MLE for Korean patients with eczema. The study group included 175 patients with eczema, who applied either mometasone furoate in MLE cream or methylprednisolone aceponate cream for 2 weeks. Treatment efficacy was evaluated using the physician's global assessment of clinical response (PGA), trans-epidermal water loss (TEWL), and visual analogue scale (VAS) for pruritus. Patients were evaluated using these indices at days 4, 8, and 15. RESULTS: Comparison of PGA score, TEWL, and VAS score at baseline with those at days 4, 8, and 15 of treatment showed a significant improvement in both groups. Patients who applied mometasone furoate in MLE (74.8%) showed better results (p<0.05) than those who applied methylprednisolone aceponate (47.8%). The TEWL improvement ratio was higher in the mometasone furoate in MLE group than that in the methylprednisolone aceponate group, and VAS improvement was also better in the mometasone furoate in MLE group. CONCLUSION: Mometasone furoate in MLE has a better therapeutic efficacy as well as less skin barrier impairment than methylprednisolone aceponate.

Safety Evaluation of Stamp Type Digital Microneedle Devices in Hairless Mice

BACKGROUND: Microneedles provide a minimally invasive means to transport molecules into the skin. A number of specific strategies have been employed to use microneedles for transdermal delivery. OBJECTIVE: The purpose of this study was to investigate the safety of two new digital microneedle devices (Digital Hand(R) and Digital Pro(R); Bomtech Electronics Co., Ltd., Seoul, Korea) for the perforation of skin in skin-hairless-1 mice. This device replaces conventional needles and is designed specifically for intradermal delivery. METHODS: We used two newly developed digital microneedle devices to perforate the skin of skin-hairless-1 mice. We conducted a comparative study of the two digital microneedle devices and DTS(R) (Disk type-microneedle Therapy System; DTS lab., Seoul, Korea). To evaluate skin stability, we performed visual and dermatoscopic inspections, measurements of transepidermal water loss, and biopsies. RESULTS: The two novel digital microneedle devices did not induce significant abnormalities of the skin on visual or dermatoscopic inspection, regardless of needle size (0.25~2.0 mm). No significant histopathological changes, such as inflammatory cell infiltration, desquamation of the stratum corneum, or disruption of the basal layer, were observed. The digital microneedle devices and microneedle therapy system produced similar results on measures of skin stability. CONCLUSION: These two novel digital microneedle devices are safe transdermal drug delivery systems.

Effect of air purifier on indoor air quality and atopic dermatitis

PURPOSE: High level of indoor air pollutant may cause aggravation of atopic diseases long with various allergic respiratory diseases especially in people who spend mostly of their lives indoors. The aim of this study was to evaluate the effect of air purifier on the reduction of relevant hazards in indoors and the improvement of atopic dermatitis (AD). METHODS: A total of 24 families, consisted of 18 AD families and 6 normal control families, were enrolled in this study. We examined air quality and AD severity before the installation of air purifiers and after twenty-four weeeks. The assessment of air quality included fine particles (particulate matter, PM2.5 and PM10), gaseous contaminants (CO, CO2, volatile organic compounds [VOCs], formaldehyde, NO2) and density of offloating microorganisms. Severity of AD was assessed by SCORing atopic dermatitis (SCORAD) index and transepidermal water loss (TEWL). RESULTS: At the end of study, particular air pollutants and VOCs of gaseous air pollutants decreased in both groups (P<0.01). In AD group, SCORAD index decreased from 23.45+/-4.34 to 15.42+/-6.53 (-18.5%) and TEWL decreased from 33.78+/-5.16 to 26.89+/-5.66 (-18.7%) (P<0.01 and P<0.01, respectively). However, the value of total immunoglobulin E and eosinophil did not show significant changes in both groups compared with baseline. CONCLUSION: These results suggested that air purifier may improve severity of AD by reducing air pollutants like fine particles and VOCs. Our preliminary study could provide a basis for using air purifier to prevent aggravation of AD.

Analysis of Colonization and Genotyping of the Exotoxins of Staphylococcus aureus in Patients with Atopic Dermatitis

BACKGROUND: The skin of atopic dermatitis (AD) patients has a high susceptibility to Staphylococcus aureus colonization, and the toxins produced by S. aureus may aggravate AD by acting as superantigens. OBJECTIVE: The purpose of this study was to evaluate the relationship of the skin barrier function, colonization of S. aureus, and the clinical severity of AD. We also examined the predominant toxin genes produced in Korean AD patients. METHODS: Thirty-nine patients with AD were evaluated for clinical severity and skin barrier function by using Severity Scoring of Atopic Dermatitis (SCORAD) index and transepidermal water loss (TEWL). S. aureus was isolated from the forearm, popliteal fossa, and anterior nares of AD patients (n=39) and age-matched controls (n=40); the toxin genes were analyzed by performing multiplex polymerase chain reaction. RESULTS: TEWL showed a statistically significant correlation with clinical severity in patients with AD (p<0.05). TEWL was correlated with the number of S. aureus colonization sites and the presence of nasal colonization, but these results were not statistically significant. S. aureus strains were isolated in 64.1% of the 39 AD patients. The SCORAD index and AD severity were strongly correlated with the number of colonization sites. The predominant toxin gene found in AD patients was staphylococcal enterotoxin a (sea) only, which was produced in 52.6% of patients. The toxin genes sea and toxic shock syndrome toxin-1 (tsst-1) were found together in 42.1%, while tsst-1 only was found in 5.3% of the patients. CONCLUSION: S. aureus strains were isolated in 64.1% of the 39 AD patients. Skin barrier function, as measured by TEWL, revealed a statistically significant correlation with clinical severity in AD patients. The SCORAD index and severity of AD was strongly correlated with the number of colonization. The most common toxin gene was sea in the Korean AD patients and this gene might have an important role in the pathogenesis of AD.

The Clinical Efficacy, Safety and Functionality of Anion Textile in the Treatment of Atopic Dermatitis

BACKGROUND: Several previous studies have suggested the improvement of atopic dermatitis (AD) in response to special fabrics. In particular, beneficial effects have been reported, following the use of anion textiles. OBJECTIVE: The purpose of this study is to evaluate the effectiveness and safety of an anion textile in patients suffering from AD. METHODS: We compared an anion textile with a pure cotton textile. Fifty-two atopic patients (n=52) were enrolled and divided into two groups. The patients in the test (n=25) and control (n=19) groups wore undergarments made of an anion textile or pure cotton over a period of 4 weeks. The overall severity of disease was evaluated using the SCORing atopic dermatitis (SCORAD) index, whereas, the treatment efficacy was measured using a Tewameter(R) (Courage & Khazaka, Cologne, Germany), Mexameter(R) (Courage & Khazaka) and Corneo meter(R) (Courage & Khazaka). RESULTS: At the end of the study, a significant decrease in the SCORAD index was observed among the patients with AD in the test group (mean SCORAD decreased from 47.2 to 36.1). Similarly, improvements in the mean transepidermal water loss, skin erythema and stratum corneum hydration were significantly greater among the patients with AD in the test group than in the control group. CONCLUSION: Anion textiles may be used to significantly improve the objective and subjective symptoms of AD, and are similar in terms of comfort to cotton textiles. The use of anion textiles may be beneficial in the management of patients with AD.

Skin Characteristics in Patients with Pityriasis Versicolor Using Non-Invasive Method, MPA5

BACKGROUND: Skin pigmentary changes of pityriasis versicolor may occur as either hyperpigmented or hypopigmented lesions, depending on the outcome of interactions between Malassezia yeasts and the skin, such as lipoperoxidation process, stimulus of inflammatory cell to melanocytes, and increased thickness of keratin layer. OBJECTIVE: To investigate skin characteristic factors that enhance the susceptibility to Malassezia yeasts and provoke different color changes of pityriasis versicolor patients. METHODS: To clarify these factors, we investigated the skin characteristics of pityriasis versicolor patients, using a non-invasive method known as MPA 5(R) (Courage and Khazaka, Germany). A total of 90 normal healthy subjects and 30 pityriasis versicolor patients were included in this study. RESULTS: Both hyperpigmented and hypopigmented pityriasis versicolor skin lesions showed higher humidity, increased sebum excretion rate and increased transepidermal water loss (TEWL) values than normal healthy subjects. But no significant difference of specific Malassezia yeasts species between hyperpigmented and hypopigmented skin lesions was evident. CONCLUSION: These results indicate that higher humidity and increased sebum level provide a better growing environment of Malassezia yeasts in the skin, leading to the assumption that interaction between Malassezia yeasts and skin barrier materials makes disruption of skin barrier causing increased TEWL.

Changes in Transepidermal Water Loss and Skin Hydration according to Expression of Aquaporin-3 in Psoriasis

BACKGROUND: Aquaporins (AQPs) are a family of water transporting proteins present in many mammalian epithelial and endothelial cell types. Among the AQPs, AQP3 is known to be a water/glycerol transporter expressed in human skin. OBJECTIVE: The relationship between the expression level of AQP3 and transpidermal water loss (TEWL) in the lesional and peri-lesional skin of psoriasis-affected patients, and skin hydration in the lesional and peri-lesional skin of psoriasis patients, was investigated. METHODS: The expression of AQP3 in psoriasis-affected and healthy control skin was determined using immunohistochemical and immunofluroscence staining. TEWL and skin hydration were measured using a Tewameter(R) TM210 (Courage & Khazaka, Cologne, Germany) and a Corneometer(R) CM 820 (Courage & Khazaka), respectively. RESULTS: AQP3 was mainly expressed in the plasma membrane of stratum corneum and the stratum spinosum in normal epidermis. Unlike the normal epidermis, AQP3 showed decreased expression in the lesional and peri-lesional epidermis of psoriasis. TEWL was increased, and skin hydration was decreased, in the lesional and peri-lesional skin of psoriasis patients, compared with the healthy control sample. CONCLUSION: Although various factors contribute to reduced skin hydration in the lesional and peri-lesional skin of psoriasis, AQP3 appears to be a key factor in the skin dehydration of psoriasis-affected skin.

Eficácia do uso de membrana semipermeável em neonatos pré-termo na redução de perdas transepidérmicas / The effectiveness of using semipermeable membrane in preterm infants to reduce transepidermal losses / Eficacia del uso de membrana semipermeable en neonatos prematuros para reducción de pérdidas transepidérmicas

Neste estudo, investigou-se a eficácia do uso da membrana semipermeável na pele de recém-nascido pré-termo sobre a evolução da perda ponderal e valores da glicemia, cota hídrica, densidade urinária e sódio. Estudo experimental, tipo ensaio clínico randomizado, realizado no período de março a agosto de 2008, na Unidade de Terapia Intensiva Neonatal, de uma maternidade pública, na cidade de Fortaleza-Ceará, Brasil. A amostra foi constituída de 42 recém-nascidos pré-termo. Os dados foram apresentados em tabelas e quadros. Na aplicação da membrana semipermeável, os recém-nascidos pré-termos do Grupo de Intervenção tiveram uma diminuição de níveis de sódio e de exigências fluidas diárias, como também apresentaram menores episódios de hiperglicemia e a densidade urinária foi mantida dentro dos padrões de normalidade. A membrana semipermeável é, de fato, um recurso terapêutico eficaz para minimizar as perdas de água transepidérmicas.

An investigation was made on the effectiveness of using semipermeable membrane on the skin of preterm infants on the evolution of weight loss and blood glucose values, water share, urine specific gravity and sodium. This is an experimental study, of the randomized clinical trial type, carried out from March to August 2008 in the Neonatal Intensive Care Unit of the Teaching Maternity Assis Chateaubriand (TMAC) in the city of Fortaleza-Ceará. The sample consisted of 42 preterm infants. The data were presented in tables and charts. In the application of the semipermeable membrane, the preterm infants of the intervention group (IG) had a decrease in the sodium levels and the daily flow demands, they also presented fewer hyperglycemia episodes and the urinary density was kept within normal patterns. The semipermeable membrane is, in fact, an effective therapeutic resource to minimize transepidermal water losses.

Investigar la eficacia del uso de membrana semipermeable en piel de recién nacido prematuro acerca de evolución de pérdida ponderal y valores de glucemia, cota hídrica, densidad urinaria y sodio. Estudio experimental, tipo ensayo clínico randomizado, realizado de marzo a agosto de 2008 en Unidad de Terapia Intensiva Neonatal de una maternidad pública en Fortaleza-Ceará, Brasil. La muestra se constituyó de 42 recién nacidos prematuros. Los datos se presentaron en tablas y cuadros. En aplicación de membrana semipermeable, los recién nacidos prematuros del Grupo de Intervención tuvieron una disminución de niveles de sodio y de exigencias fluidas diarias, también presentaron episodios menores de hiperglucemia y la densidad urinaria se mantuvo dentro de los patrones normales. La membrana semipermeable es, de hecho, un recurso terapéutico eficaz para minimizar las pérdidas de agua transepidérmicas.

Angelica archengelica extract induced perturbation of rat skin and tight junctional protein [ZO-1] of HaCaT cells

Herbal enhancers compared to the synthetic ones have shown less toxis effects. Coumarins have been shown at concentrations inhibiting phospoliphase C-Y [Phc-Y] are able to enhance tight junction [TJ] permeability due to hyperpoalation of Zonolous Occludense-1 [ZO-1] proteins. The purpose of this study was to evaluate the influence of ethanolic extract of Angelica archengelica [AA-E] which contain coumarin on permeation of repaglinide across rat epidermis and on the tight junction plaque protein ZO-1 in HaCaT cells. Transepidermal water loss [TEWL] from the rat skin treated with different concentrations of AA-E was assessed by Tewameter. Scanning and Transmission Electron Microscopy [TEM] on were performed on AA-E treated rat skin portions. The possibility of AA-E influence on the architecture of tight junctions by adverse effect on the cytoplasmic ZO-1 in HaCaT cells was investigated. Finally, the systemic delivery of repaglinide from the optimized transdermal formulation was investigated in rats. The permeation of repaglinide across excised rat epidermis was 7-fold higher in the presence of AA-E [5% w/v] as compared to propylene glycol:ethanol [7:3] mixture. The extract was found to perturb the lipid microconstituents in both excised and viable rat skin, although, the effect was less intense in the later. The enhanced permeation of repaglinide across rat epidermis excised after treatment with AA-E [5% w/v] for different periods was in concordance with the high TEWL values of similarly treated viable rat skin. Further, the observed increase in intercellular space, disordering of lipid structure and corneocyte detachment indicated considerable effect on the ultrastructure of rat epidermis. Treatment of HaCaT cell line with AA-E [0.16% w/v] for 6 hrs influenced ZO-1 as evidenced by reduced immunofluorescence of anti-TJP1 [ZO-1] antibody in Confocal Laser Scanning Microscopy studies [CLSM] studies. The plasma concentration of repaglinide from transdermal formulation was maintained higher and for longer time as compared to oral administration of repaglinide. Results suggest the overwhelming influence of Angelica archengelica in enhancing the percutaneous permeation of repaglinide to be mediated through perturbation of skin lipids and tight junction protein [ZO-1]

Pseudoceramide-Containing Physiological Lipid Mixture Reduces Adverse Effects of Topical Steroids

PURPOSE: Various therapeutic approaches have been suggested for preventing or reducing the adverse effects of topical glucocorticoids, including skin barrier impairment. Previously, we have shown that impairment of skin barrier function by the highest potency topical glucocorticoid, clobetasol 17-propinate (CP), can be partially prevented by co-application of a physiological lipid mixture containing pseudoceramide, free fatty acids, and cholesterol (multi-lamellar emulsion [MLE]). Skin atrophic effects of CP were also partially reduced by MLE. In this study, the preventive effects of MLE on the lowest potency topical glucocorticoid, hydrocortisone (HC), were investigated using animal models. METHODS: Anti-inflammatory activity of topical HC was evaluated using a 12-O-tetradecanoylphobol-13-acetate-induced skin edema model. Topical steroid induced adverse effects were evaluated using hairless mouse. RESULTS: The results showed that the anti-inflammatory activity was not altered by co-application of either MLE or hydrobase. However, co-application of MLE and 1.0% HC showed less impairment in the epidermal permeability barrier function, skin hydration, and skin surface pH compared with hydrobase. Stratum corneum integrity, evaluated by measuring trans-epidermal water loss after repeated tape stripping, showed less damage with MLE co-application. Long-term application of topical HC induced skin atrophy, measured by a reduction in skinfold and epidermal thickness and in the number of epidermal proliferating cell nucleus antigen (PCNA)-positive keratinocytes. Co-application of MLE did not affect the skinfold or epidermal thickness, but the number of PCNA-positive keratinocytes was less decreased with MLE use. CONCLUSIONS: These results suggest that co-application of MLE is effective in reducing the local adverse effects of low-potency topical glucocorticoids and supports the therapeutic efficacy of physiological lipid mixtures on skin barrier function.

Skin Characteristics after Fractional Photothermolysis

BACKGROUND: Fractional photothermolysis makes thousands of minute areas called microthermal treatment zones on the skin surface and transmits thermal injury to facilitate heat shock protein formation around the dermis. Potential side effects include acneiform eruption, herpes simplex virus outbreak, erythema, and post-inflammatory hyperpigmentation. OBJECTIVE: To investigate and compare the changes in the skin of Asian patients after two different fractional photothermolysis systems (FPS) on a split face. METHODS: A half-split face study was performed with 10,600 nm carbon dioxide FPS on the left and 1,550 nm erbium-doped FPS on the right side of the face. Only one session of laser irradiation and several biophysical measurements were done. RESULTS: Although both FPS proved to be effective in treating acne scar and wrinkle patients, a slightly higher satisfaction rating was seen with the 10,600 nm FPS treatment. Both types of FPS showed a significant increase in transepidermal water loss which decreased gradually after treatment and returned to pre-treatment level after 1 week. A decreased reviscometer score was sustained for a longer period in wrinkle areas treated with 10,600 nm FPS. CONCLUSION: Even though the changes in skin varied according to different FPS wave-length, adverse outcomes, such as increased erythema and TEWL were entirely subdued within 3 months of treatment.