[The dark face of cosmetics. A justified or excessive diatribe?]. / COSMÉTIQUES, SANTÉ ET ENVIRONNEMENT. Actualisation d'une diatribe justifiée ou exagérée?

In recent years, the population and producers of consumer products became aware of deleterious effects of some substances on human health and environment. Cosmetic products are part of such concern. What are the risks currently involved? The so-called "natural", "bio" or "green" products, do they represent an ideal panacea? This topic has a complex issue because documents available for the general public are of unequal quality, and objective scientifc publications remain rare and prone to controversies.

[Dermatoporosis, a vintage for atrophoderma and transparent skin]. / La dermatoporose, un "vintage" de l'atrophodermie et de la "peau transparente".

Skin ageing occasionally manifests itself at long-term by severe atrophoderma. Systemic or topical corticotherapy exerts an atrophic impact mimicking the effects of old age. Such atrophoderma condition has been described as transparent skin about 40 years ago, and it received more recently the new denomination of dermatoporosis. Such condition stands out in the medical history to induce clinical consequences. They are sometimes prominent introducing diverse lesions such as Bateman purpura, stellate scars and wounds following minor trauma.

[Striae distensae, colors and mechanobiology]. / Les vergetures, leurs couleurs et leur mécanobiologie.

Striae distensae represent a common skin condition, corresponding to a physiological event particularly developed during adolescence, pregnancy and gain in body weight. In addition, these lesions are induced by the Cushing syndrome or an intense corticotherapy. The viscoelastic properties of the skin are altered and vary according to the severity of striae distensae. Otherwise, the colours of striae distensae vary with time in response to the mechanobiology of blood vessels and melanocytes.

[Skin reactions to tattoo ink]. / Réactions cutanées à l'encre de tatouage.

Ritual and artistic tattoos rely on the use of numerous pigments which are not all entirely inert once placed in the dermis. The compositions of some tattoo inks are identified. However, new but less well identified compounds appear on the market. Allergic reactions can be present under different aspects. They may correspond to allergic contact dermatitis or to photodermatitis. Other reactions include allergic hypersensitivity reactions as well as lichenoid, granulomatous or pseudolymphoma reactions. Pulsed light and laser are typically used for regular tattoo removal. These procedures are not indicated in inflamed tattoos. Indeed, the pigment dispersed during photolysis may perpetuate the reaction. Pseudotattoos due to the stratum corneum staining are frequently responsible for photoeczema.

Assessment of parenting and developmental problems in toddlers: development and feasibility of a structured interview.

BACKGROUND: Assessment of (early signs of) parenting and developmental problems in young children by preventive child health care (CHC) workers is recommended, but no validated instruments exist. The aim of this project was to develop and test an instrument for early detection and assessment of problems in toddlers, using the perspectives and experience of both the parent and the professional. METHODS: Using an iterative process, we adapted and expanded a structured interview on need for parenting support into the Structured Problem Analysis of Raising Kids (SPARK). The SPARK consists of 16 subject areas, ranging from somatic health to family issues. The SPARK was tested in daily practice for feasibility and discriminative capacity. The sample consisted of all toddlers aged 18 months living in Zeeland, a province of the Netherlands, during the study period (n= 1140). RESULTS: The response rate was 97.8%. Although the median level of support needed according to the SPARK was low, 4.5% of the toddlers and their parents required intensive help or immediate action. The risk assessment showed 2.9% high, 16.5% increased and 80.6% low risk for parenting and developmental problems. The risk assessment of the CHC professional was associated with known risk factors for child maltreatment. CONCLUSIONS: This study shows that a structured interview, named the SPARK, is feasible in daily practice and clarifies risks and care needs for parenting and developmental problems in toddlers.

[Chilblains, differential diagnosis and risk factors]. / Les engelures, stigmates des affres climatiques.

Chilblain results from environmental nonfreezing cold exposure. It is a localized inflammatory lesion most frequently localized on the toes and fingers. Chilblains are often idiopathic, but they may be part of lupus erythematosus.

Hedgehog ringworm in humans and a dog.

We report 3 related cases of human dermatophytosis and 1 dog dermatophytosis likely caused by contact with a European hedgehog. Trichophyton erinacei was isolated from stratum corneum samples. This type of zoophilic dermatophytosis is rare in south-east Belgium and probably in the rest of the country as well.

[Pimecrolimus (Elidel) for a variety of skin diseases]. / Le pimecrolimus (Elidel) hors des sentiers battus.

Pimecrolimus is an immune downregulator that belongs to the class of calcineurin inhibitors. Its efficacy is recognized for the topical treatment of the mild to moderate types of atopic dermatitis. In addition, the drug shows activity in a series of other dermatitides. We report a review of the international literature about this topic.

Migrants and the meaning of parenthood: involuntary childless Turkish migrants in The Netherlands.

BACKGROUND: Parenthood motives of infertile Turkish migrant men and women in The Netherlands are compared with those of infertile Dutch men and women. Additionally, the question of whether the importance of various parenthood motives of Turkish migrants are related to the degree of adaptation to the Dutch culture was investigated. METHODS: Questionnaires were administered to 58 involuntary childless Turkish migrant men and women and 162 involuntary childless Dutch men and women. RESULTS: Individual parenthood motives were most important to both Turkish migrant and Dutch men and women. While social motives were quite important to Turkish migrants, they were unimportant to Dutch men and women. Four aspects of adaptation (norms and values, social integration, skills, absence of feelings of loss related to migration) were negatively related to the importance of social parenthood motives for Turkish migrant women. For Turkish migrant men two aspects of adaptation (traditions and absence of loss) were negatively related to the importance of social parenthood motives. CONCLUSION: Turkish migrant and Dutch men and women differ in the importance of social motives. However, Turkish migrants who are more adapted to the Dutch culture give less importance to social parenthood motives.

High-resolution epiluminescence colorimetry of striae distensae.

BACKGROUND: Colours of striae distensae are often different from that of the surrounding skin. A close look using dermoscopy discloses distinct patterns of melanized networks at these sites. The aim of the study was to design a method of high-\resolution analytical analysis of the skin colours using the combination of photographic dermoscopy and small field reflectance colorimetry. METHODS: Clinical photographs were taken from striae distensae and their surrounding skin using a Dermaphot (Heine Optotechnik, Hersching, Germany). A final magnification of 125x was obtained on paper photographs. The reflectance colorimeter Visi-Chroma VC-100 (Biophotonics, Lessines, Belgium) was used to measure colours of the pigmentary networks in the L*a*b* system. Differential colour parameters (deltaE*ab, deltaL*, deltaa*, deltab*) were calculated for each case between the lesional and the surrounding normal skin, and between the melanized reticulated pattern and the enclosed lighter areas. RESULTS: Objective colorimetric assessments distinguished four distinct types, namely striae albae, striae rubrae, striae caeruleae and striae nigrae. The latter peculiar hyperpigmented type of striae distensae was specifically identified by epiluminescence examination in dark-skinned subjects. The fine-melanized honeycomb network present on the adjacent intact skin was reshaped inside striae in a streaky pattern perpendicular to the striae axis. Strong linear correlations were found between all combinations of deltaL* and deltab* evaluating colours of the reticulated and the honeycomb alveolar patterns both inside and outside the striae distensae. By contrast, no correlations were found between deltaa* and the other colorimetric parameters. CONCLUSION: The direct and/or indirect influences of melanocyte mechanobiology appear to have a prominent effect on the various colours of striae distensae.

[Gaia, light and the biosphere]. / Gaïa, lumière et biosphère.

Some aspects of life are tightly bound to light exposure. Photosynthesis, chronobiology and various manifestations of the socio-cultural behaviour are typical examples.

Striae distensae in darker skin types: the influence of melanocyte mechanobiology.

INTRODUCTION: Striae distensae in White people are commonly described as being reddish at first and turning white in time. This dual perception has been challenged. Indeed, the color difference between striae distensae and their surrounding skin varies on a wide range in part depending upon typology. AIM: To study striae nigrae that are found only in subjects of darker complexion. MATERIALS AND METHODS: In the present study conducted in 44 darker skin adults, dermoscopy was combined to reflectance colorimetry. RESULTS: Striae nigrae exhibited hypermelanosis of the epidermal rete ridges crossing transversally the lesions in a laddering pattern. By contrast, striae albae showed only faint melanotic networks. CONCLUSIONS: As striae distensae are in part under the influence of skin stretching, their colors are likely to be controlled by some mechanobiological process activating or inhibiting melanogenesis in people of darker complexion. No argument involving an inflammatory mechanism is supported by the present observations.

[Clinical case of the month. Superficial angiomyxoma]. / Le cas clinique du mois. Angiomyxome superficiel.

Some cutaneous neoplasms are seemingly harmless, but they may prove to be problematic due to their propensity to invade or to recur. We present 2 cases of superficial angiomyxoma.

[Let us watch cutaneous cystic lesions. From derision to merit]. / Prenons garde aux lésions kystiques cutanées. Du dérisoire au méritoire.

Cutaneous cystic-like lesions do not always correspond to real epithelial cysts. Indeed, the histological examination may identify another benign tumour. But, in some instances, the surprise may be greater. We report three patients in whom lesions suggested clinically small cysts. However, they were malignant neoplasms corresponding to a malignant fibrous histiocytoma, an epithelioid angiosarcoma and a metastatic adenocarcinoma, respectively.

Assessment of topical hypopigmenting agents on solar lentigines of Asian women.

BACKGROUND: So-called darkened age spots encompass distinct pathological processes. The efficacy of topical depigmenting agents is difficult to objectivate. OBJECTIVE: To assess the hypopigmenting effect of three cosmetic formulations using objective biometrological methods. METHODS: 50 women of South-East Asian ancestry were enrolled in this pilot study. They had solar lentigines according to dermoscopic criteria. The lesions were treated by topical hypopigmenting formulations. Products were applied twice daily for 2 or 3 months. Assessments at 1-month intervals were made using narrow-band reflectance spectrophotometry, image analysis of video-recorded ultraviolet light reflection and photodensitometry- and image-analysis-assisted corneomelametry. RESULTS: A 20% azelaic acid formulation and another one containing 5% ascorbyl glucosamine, 1% kojic acid and alpha-hydroxyacid esters appeared inefficacious on solar lentigines. A stabilized soy extract showed a better although modest lightening effect when assessed by corneomelametry. The subclinical or faint mottled skin revealed by ultraviolet light examination better responded (p < 0.05) to treatments. CONCLUSION: Focal epidermal hyperpigmentation is better controlled by topical whitening agents when the increase in melanin content reflects a modest functional hyperactivity of melanocytes.

Analytic quantification of phototype-related regional skin complexion.

BACKGROUND/AIMS: Narrow-band spectrophotometry that yields melanin (M) and erythema (E) indexes is a convenient method for assessing skin colour. The objective of the study was to assess the phenotype-associated body site differences in skin complexion. METHOD: The Mexameter MX16 was used to record the skin colour in 137 subjects. Evaluations were made on the inner arm, volar forearm, dorsal forearm and forehead. RESULTS: The inner arm and volar forearm had similar values for each of the colorimetric values. The dorsal forearm exhibited the highest M values, and the forehead had the highest E values. Significant positive linear correlations were found between M values from the distinct body sites. The E values showed a correlation only between the inner arm and the volar forearm. CONCLUSION: Regional skin colour differences are obvious. Sun-exposed skin does not react in the same way on the forearm and forehead. Regional variations in M can be predicted from the innate M value. In contrast, the regional variability in E is highly variable among subjects.

Beneficial effects of softened fabrics on atopic skin.

There is general concern about the possible cutaneous adverse effects of wearing garments treated with household laundry products, particularly on atopic skin. Our objective was to compare softened and non- softened fabrics in a forearm wet and dry test, under conditions simulating real-life conditions. Twenty atopic volunteers entered a single-blind 12-day (3 sessions per day) forearm wetting and drying test. Cotton fabrics were machine washed and liquid fabric conditioner was added or not to the final rinse. To simulate conditions of skin damage, a dilute solution of sodium lauryl sulphate was applied under occlusion to the forearm of each volunteer before the start of the study. Skin effects were evaluated by visual grading (redness, dryness and smoothness), squamometry and in vivo instrumental measurements (capacitance, transepidermal water loss and colorimetry). Rubbing of atopic skin with fabrics generally resulted in discrete to moderate alterations of the structure of the stratum corneum. Both for control and pre-irritated skin, all measured parameters indicated that softened fabric was less aggressive to the skin than unsoftened fabric. In the case of pre-irritated skin, the recovery of the skin was significantly faster when rubbed with softened than with unsoftened fabrics. In conclusion, softened fabrics help mitigate the skin condition in atopic patients.

Effect of the 585 nm flashlamp-pumped pulsed dye laser for the treatment of keloids.

BACKGROUND: Due to its potential effects on skin microcirculation and collagen metabolism, the 585 nm flashlamp-pumped pulsed dye laser has been proposed for treating abnormal scars. Indeed, one of the main problems with keloidal scars is their disfiguring erythematous color. OBJECTIVE: To assess the efficacy of the 585 nm pulsed dye laser on the appearance of keloids. METHODS: Eleven patients with skin phototypes II-IV and keloids were treated with the 585 nm pulsed dye laser. After one to three treatment sessions, clinical assessments of the scars were performed in combination with remittance spectroscopy measurements of the redness and melanin pigmentation. A group of nine keloids covered by silicone gel sheeting served as controls. Data were compared statistically. RESULTS: During laser treatments, a discrete decrease in redness of the scars was clinically reported. However, this improvement was not confirmed by the objective spectrophotometric data. No side effects, especially hyperpigmentation, were disclosed. The keloids redness was not improved in the control group. CONCLUSION: The 585 nm pulsed dye laser yields only minimal effects, if any, on the erythema of keloids. Similarly silicone gel sheeting does not modify the keloids redness.

Unraveling the patterns of subclinical pheomelanin-enriched facial hyperpigmentation: effect of depigmenting agents.

BACKGROUND: During photoaging, the density of melanin chromatophores is heterogeneous in the epidermis. AIMS: To define the patterns of pheomelanin-enriched melanotic hypermelanosis of the face in phototype II subjects and to assess the effect of depigmenting agents. Azelaic acid and glycolic acid were tested as well as a soy extract, reported to reduce pigmentation through interaction with the protease-activated receptor 2 (PAR-2) of keratinocytes. METHOD: Evaluations were made by image analysis of high magnification pictures obtained by a video camera equipped with an internal ultraviolet-emitting unit (Visioscan((R))). RESULTS: Three patterns of subclinical facial hypermelanosis were recognized including the spotty perifollicular type, the accretive globular type and the elongated type of the sunny side of wrinkles. Azelaic acid and the soy extract led to significant skin lightening after a 3-week treatment. By contrast, glycolic acid showed an inconsistent effect. CONCLUSION: Sensitive fluorescence video recording combined with image analysis represents an advance in the noninvasive assessment of the mottled subclinical skin pigmentation. The depigmenting effect observed with the soy extract indicates that the inhibition of PAR-2 may be a novel way to approach certain pigmentary disorders of the skin.

[Bites from stealthy arthropods from here to there]. / Morsures par des arthropodes furtifs d'ici et d'ailleurs.

Stealthy arthropods perpetrate their insults to humans through three distinct mechanisms including bites, stings or simple contact with the skin. The present review is a summary of the bite effects of spiders and diptera.