Skin blotting: a noninvasive technique for evaluating physiological skin status.

OBJECTIVE: The skin performs important structural and physiological functions, and skin assessment represents an important step in identifying skin problems. Although noninvasive techniques for assessing skin status exist, no such techniques for monitoring its physiological status are available. This study aimed to develop a novel skin-assessment technique known as skin blotting, based on the leakage of secreted proteins from inside the skin following overhydration in mice. The applicability of this technique was further investigated in a clinical setting. DESIGN: Skin blotting involves 2 steps: collecting proteins by attaching a damp nitrocellulose membrane to the surface of the skin, and immunostaining the collected proteins. The authors implanted fluorescein-conjugated dextran (F-DEX)-containing agarose gels into mice and detected the tissue distribution of F-DEX under different blotting conditions. They also analyzed the correlations between inflammatory cytokine secretion and leakage following ultraviolet irradiation in mice and in relation to body mass index in humans. MAIN RESULTS: The F-DEX in mice was distributed in the deeper and shallower layers of skin and leaked through the transfollicular and transepidermal routes, respectively. Ultraviolet irradiation induced tumor necrosis factor secretion in the epidermis in mice, which was detected by skin blotting, whereas follicular tumor necrosis factor was associated with body mass index in obese human subjects. These results support the applicability of skin blotting for skin assessment. CONCLUSIONS: Skin blotting represents a noninvasive technique for assessing skin physiology and has potential as a predictive and diagnostic tool for skin disorders.

Morphological characteristics of and factors related to moisture-associated dermatitis surrounding malignant wounds in breast cancer patients.

PURPOSE: Patients with malignant breast wounds (MBWs) have multiple symptoms. In particular, care for exudates or peri-wound moisture-associated dermatitis (MAD) is difficult. However, MAD has not been distinguished from peri-wound dermatitis. Therefore, care for patients with MAD has not been well established. The aim of this study was to describe morphological characteristics of MAD in MBWs and link morphological characteristics of MAD to related factors. METHODS: We conducted a qualitative descriptive study and a cross-sectional study. Data were collected by qualitative participant observation and structured interviews. The qualitative descriptive study was conducted using the 'morphoqualitative analysis' method. Data analyses were performed using qualitative research methods. In the cross-sectional study, the participants were classified into 2 groups for comparison: with MAD (MAD group) and without MAD (non-MAD group). RESULTS: Characteristics of 24 MBWs were examined. Morphoqualitative analyses of data generated 17 subcategories and 3 categories. We could morphologically define MAD by findings of 'radial shape matching the dressing' and 'half-fusiform shape over the dressing'. Regarding factors related to MAD, necrotic tissue type was significantly more severe in the MAD group than in the non-MAD group (p = 0.048). Wound exudate leakage was significantly more frequent in the MAD group than in the non-MAD group (p = 0.013). CONCLUSION: Our study provides several points for nursing MBWs. Morphoqualitative analyses of MAD are quite important for evaluating possible causes of MAD as well as selecting effective interventions.

Skin fragility in obese diabetic mice: possible involvement of elevated oxidative stress and upregulation of matrix metalloproteinases.

The purpose of this study was to test the hypothesis that obese diabetic mice exhibit marked skin fragility, which is caused by increased oxidative stress and increased matrix metalloproteinase (MMP) gene expression in the subcutaneous adipose tissue. Scanning electron microscopy of skin samples from Tsumura-Suzuki obese diabetic (TSOD) mice revealed thinner collagen bundles, and decreased density and convolution of the collagen fibres. Furthermore, skin tensile strength measurements confirmed that the dorsal skin of TSOD mice was more fragile to tensile force than that of non-obese mice. The mRNA expressions of heme oxygenase 1 (Hmox1), a marker of oxidative stress, Mmp2 and Mmp14 were increased in the adipose tissue of TSOD mice. Antioxidant experiments were subsequently performed to determine whether the changes in collagen fibres and skin fragility were caused by oxidative stress. Strikingly, oral administration of the antioxidant dl-α-tocopherol acetate (vitamin E) decreased Hmox1, Mmp2 and Mmp14 mRNA expressions, and improved the skin tensile strength and structure of collagen fibres in TSOD mice. These findings suggest that the skin fragility in TSOD mice is associated with dermal collagen damage and weakened tensile strength, and that oxidative stress and MMP overexpression in the subcutaneous adipose tissue may, at least in part, affect dermal fragility via a paracrine pathway. These observations may contribute to novel clinical interventions, such as dietary supplementation with antioxidants or application of skin cream containing antioxidants, which may overcome skin fragility in obese patients with diabetes.