Functional and morphological studies of photodamaged skin on the hands of middle-aged Japanese golfers.

The skin of golfers' hands provides a suitable model to study the effect of chronic sun exposure, because one of their hands is exposed to the outer environment, especially sunlight, while the other one is always protected by a glove during play. Our purpose was to find out the influence of photodamage on the properties of the skin surface of middle-aged Japanese by using non-invasive methods. We measured hydration state, and water barrier function of the stratum corneum (SC) and the color of the skin of the dorsum of the hands. In a separate study, we evaluated the skin surface contour by using replicas taken from the skin in a slightly stretched or relaxed position. We found a significant decrease in hydration of the skin surface of the exposed skin as compared to that of the protected skin, whereas no such difference was found with transepidermal water loss, a parameter for water barrier function of the SC. Luminance of skin color was also reduced in the sun-exposed skin. Replica analysis revealed that large wrinkles developing in a relaxed position were more prominent on the exposed than on the protected skin, while fine furrows noted in a slightly stretched position were shallower on the former than the latter. The data obtained indicate that the chronically exposed skin of golfers' hands shows morphological and functional changes resulting from long time exposure to the outer environment especially sunlight. Furthermore, bioengineering non-invasive methods are found to be useful to detect early photodamage of the skin in a more quantitative fashion which is rather difficult to demonstrate clinically.

Irritancy of scrubbing up for surgery with or without a brush.

Hand washing is an indispensable procedure for surgical nurses. Although scrubbing up with a brush is preferable to prevent infections, it is not clear how irritating to the skin scrubbing with a brush is compared with hand washing without a brush. TEWL, high frequency conductance and pH were measured on the hand skin of the same group of nurses before and after daily hand washing for 11 days in different seasons, which were chosen as favourable and unfavourable periods for the condition of hand skin, namely the early summer and autumn. Additionally, we compared the antimicrobial effects on the skin of scrubbing up, using a palm stamp method. TEWL showed significantly higher values with brush washing than with simple hand washing only in the autumn. There was no significant difference in the measurement of high frequency conductance, pH or in the antimicrobial effects between the two washing techniques. Results showed the deleterious effects on the skin of hand washing, particularly that of using a brush in the cold season.

Successful treatment of a therapy-resistant severely pruritic skin eruption of malignancy-associated dermatomyositis with high-dose intravenous immunoglobulin.

Malignancy-associated dermatomyositis developing in a middle-aged Japanese female was successfully treated by removal of her gastric cancer. However, five years later, concomitant with catching a cold, her severely pruritic skin lesions recurred on exposed areas. Six years after the start of corticosteroid therapy for her annoying skin lesion, we started to treat her with high-dose intravenous immunoglobulin (IVIG) infusion therapy because of the difficulty of reducing the dosage of oral prednisone, that had secondarily induced adverse effects. After five courses of the therapy, her recalcitrant, pruritic, erythematous skin lesions improved dramatically, enabling a satisfactory reduction in the dosage of oral prednisone. There were no significant adverse side effects with IVIG.