[Use of oral oxybutynin at 7.5 mg per day in primary hyperhidrosis]. / Utilisation de l'oxybutynine a la posologie de 7.5 mg par jour dans le traitement des hyperhidroses primitives.

Oxybutynin is being increasingly being prescribed in the treatment of hyperhidrosis but currently, there is no precise dosage for this treatment. Nine patients were treated for primary hyperhidrosis resistant to conventional therapies with oxybutynin between January to May 2010. The treatment was progressively increased at 7.5 mg per day. Oxybutynin efficacy was evaluated by iodine starch test and biometrological measurements at 2 and 4 weeks of treatment. Hyperhidrosis Disease Severity Scale (HDSS) and Dermatology Life Quality Index (DLQI) were obtained for each patient. The means of HDSS and DLQI were respectively 3.2 +/- 0.7 and 17.0 +/- 5.1 before treatment and were 1.8 +/- 0.4 and 4.6 +/- 4.4 at 4 weeks of treatment. Oxybutynin at 7.5 mg per day significantly decreased intensity and area of sweat for palms but not for soles. Trans Epidermal Water Loss, conductance, pH and Skin temperature were modified with treatment. Oxybutynin at 7.5 mg per day has improved patient's quality of life. Efficiency of oxybutynin in primary palmar hyperhidrosis was proved by biometrological measurements and iodine starch test.

Geometrical analysis of the V-Y advancement flap applied to a keystone flap.

BACKGROUND: The V-Y advancement flap and, more recently, the keystone flap are commonly used to cover skin defects. Both flaps allow for primary closure after advancement by substituting the initial defect for a narrower defect distributed over a greater length. The first objective of this study was to develop a geometrical analysis of the V-Y advancement flap. The second objective was to explain the benefit of using the keystone flap compared to a single V-Y advancement flap. MATERIAL AND METHOD: A geometrical analysis is proposed using a two-dimensional analysis in which the flaps are assumed to have a rigid-body behaviour. First, in the case of the V-Y advancement flap, a trigonometric relationship is defined between the distance of closure before and after advancement, thus implying the value of the flap's apex angle. Second, by considering the keystone flap as the association of three V-Y advancement flaps, the trigonometric relationship is applied to the keystone flap. RESULTS: In the case of the V-Y advancement flap, the optimal apex angles are between 20° and 60°. At less than 20°, the length of the flap increases in an exaggerated manner. At greater than 60°, the distance of closure, particularly at the apex of the flap where a corner stitch is performed, is greater than the distance of closure of the initial defect. In the case of the keystone flap, the width of the final defect around the flap is clearly smaller and more regular compared to the final defect around a single V-Y advancement flap. CONCLUSION: The geometrical analysis of the V-Y advancement flap in our description illustrates the major benefit of the keystone flap over a single V-Y advancement flap.

Use of the Reviscometer for measuring cosmetics-induced skin surface effects.

BACKGROUND/PURPOSE: The Reviscometer RVM600 that measures resonance running time (RRT) has been shown to be inversely related to the skin stiffness. However, very few publications describe the use of this instrument for testing the effect of cosmetic products. METHODS: Slight xerotic skin condition was induced by using an alkaline soap for 1 week. Skin has then been rehydrated with a lotion or further dehydrated and dried with sodium lauryl sulfate (SLS). Skin condition at the different stages of the study was evaluated by visual assessment for dryness and redness and by non-invasive methods (Corneometer, Cutometer, Reviscometer, Evaporimeter and squamometry). RESULTS: All methods showed highly significant changes after the slight drying phase with the soap usage. They illustrated skin repair after lotion treatment and further skin impairment after SLS application. Nevertheless, the Reviscometer was able to better statistically discriminate between the treatments (water, lotion, SLS) than the Cutometer . Measurement of the RRT along the transversal axis of the forearms was the most sensitive for differentiating between normal and dry skin and between the treatments on the basis of skin mechanical properties. CONCLUSION: The Reviscometer RVM600 is a sensitive instrument able to detect slight skin surface effect of cosmetics. Combined with published literature on the interpretation of RRT measurements on polymeric gel or in different skin conditions (elderly skin and photoaged skin), the Reviscometer looks to be a recommendable instrument to measure slight changes in SC stiffness/suppleness induced by cosmetic products.

A new method to measure in vivo human skin hydrophobia.

Until now, the wettability of the skin has been only estimated through the measurement of its critical surface tension (Zisman), or surface free energy. These methods give information on the behaviour of the surface with water, but cannot quantify its behaviour with other polar liquids. In this paper we propose to express both the hydrophilia of the skin (Hi) by the ratio of its critical surface tension (gamma(c)) to the water surface tension (gamma(H(2)O)), and its hydrophobia (Ho) by the ratio of the difference between the critical surface tension (gamma(c)), and the value of the water surface tension (gamma(H(2)O)) normalized by the latter. By using this proposed parameter, it should be possible to classify skin surfaces according to their affinities to water, which is of major importance in Cosmetology as well as in biology. We also discuss the relationship between surface hydrophilia (Hi) and polarity (P) as defined by Wu, and water adhesion tension (tau(o)) as described by Vogler. The gamma(c) of untreated skin was 27.3 +/- 3.6 mJ m(-2), confirming previous data, and consequently basal Hi was 38%. Either cleaning with ether or hydration by occlusion induced a diminution of the wetting capacity of the surface and consequently a decrease of Hi to 29% and 33%, respectively. In contrast, washing the skin surface with soap and water increased surface Hi to 43%.