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Background: Large and complex defects requiring reconstruction are challenging for orthopaedic surgeons. The use of human acellular dermal (HAD) matrices to augment large soft tissue defects such as those seen in massive rotator cuff tears, knee extensor mechanism failures and neglected Tendo-Achilles tears has proven to be a valuable tool in surgeons reconstructive armamentarium. Different methods for allograft decellularization and preservation alter the native properties of the scaffold. Traditional processing and preservation methods have shown to have drawbacks that preclude its widespread use. Some of the common issues include inferior biomechanical properties, the risk of rejection, limited customization, difficulty in storing and transporting, the requirement of pre-operative preparation, and last but not the least increased cost. Methods: We describe a novel processing and preservation method utilizing a two-step non-denaturing decellularization method coupled with preservation using a water-sequestering agent (glycerol) to remove immunogenic components while retaining biomechanical properties. The efficiency of this novel process was compared with the traditional freeze-drying method and verified by histological evaluation and biomechanical strength analysis. Results: The absence of cellular components and matrix integrity in hematoxylin and eosin-stained glycerol-preserved HAD (gly-HAD) samples compared to freeze-dried HAD (FD-HAD) demonstrated effective yet gentle decellularization. Biomechanical strength analysis revealed that gly-HADs are stronger with an ultimate tensile load to the failure strength of 210 N compared to FD-HAD (124N). The gly-HADs were found to have an optimal suture–retention strength of 126 N. Finally, sterility testing of the resultant grafts was checked to ensure a sterility assurance level of 10−6 to establish implantability. Conclusion: The novel processing and preservation technique is described in this paper to create a Human Acellular Dermis with higher biomechanical strength and superior histological characteristics. The processing and preservation technique ensured high sterility assurance levels to establish implantability. [ABSTRACT FROM AUTHOR]

The current investigation aims to study the embryonic dermis formed in the early stages of development and identify the initial interstitial components of the dermis that serve as biological and structural scaffolds for the development of the dermal tissue. To investigate the dermal structure, the current study used morphological and immunological techniques. TCs identified by TEM. They had a cell body and unique podomeres and podoms. They formed a 3D network spread throughout the dermis. Homocellular contact established between them, as well as heterocellular contacts with other cells. Immunohistochemical techniques using specific markers for TCss CD34, CD117, and VEGF confirmed TC identification. TCs represent the major interstitial component in the dermal tissue. They established a 3D network, enclosing other cells and structures. Expression of VEGF by TC promotes angiogenesis. TCs establish cellular contact with sprouting endothelial cells. At the site of cell junction with TCs, cytoskeletal filaments identified and observed to form the pseudopodium core that projects from endothelial cells. TCs had proteolytic properties that expressed MMP-9, CD68, and CD21. Proteolytic activity aids in the removal of components of the extracellular matrix and the phagocytosis of degraded remnants to create spaces to facilitate the development of new dermal structures. In conclusion, TCs organized the scaffold for the development of future dermal structures, including fibrous components and skin appendages. Studying dermal TCs would be interested in the possibility of developing therapeutic strategies for treating different skin disorders and diseases. [ABSTRACT FROM AUTHOR]

Advancing the development of point‐of‐care testing (POCT) sensors that utilize interstitial fluid (ISF) presents considerable obstacles in terms of rapid sampling and analysis. Herein, an innovative strategy is introduced that involves the use of a 3D‐printed, hollow microneedle array patch (MAP), in tandem with a vacuum tube (VT) connected through a hose, to improve ISF extraction efficiency and facilitate expedited analysis. The employment of negative pressure by the VT allows the MAP device to effectively gather ≈18 µL of ISF from the dermis of a live rabbit ear within a concise period of 5 min. This methodology enables the immediate and minimally invasive measurement of glucose levels within the body, employing personal healthcare meters for quantification. The fusion of the VT and MAP technologies provides for their effortless integration into a comprehensive and mobile system for ISF analysis, accomplished by preloading the hose with custom sensing papers designed to detect specific analytes. Moreover, the design and functionality of this integrated VT‐MAP system are intuitively user‐friendly, eliminating the requirement for specialized medical expertise. This feature enhances its potential to make a significant impact on the field of decentralized personal healthcare. [ABSTRACT FROM AUTHOR]

Past nuclear accident occurrences raised strong concerns which led to research on nuclear safety. One of the major causes of nuclear accidents is the impeded circulation of core coolant, leading to decay heat removal cessation and rapid temperature rise. If uncontrolled, this results in critical heat flux, loss of coolant accidents, and core dryout. Detailed melted core relocation (i.e., nuclear fuel, graphite, and zircaloy) needs to be investigated through interface capture and multimaterial flow model coupling, which have not been done in previous studies. This work aims to investigate the impacts of temperature and core material composition on the flow dynamics during core relocation. In this study, mass fraction is discretized using a streamlined upwind Petrov–Galerkin method spatially and a modified Crank–Nicolson method temporally to accurately capture fluid interfaces using a high-order accurate flux-limiter. Two core material composition cases (individual material properties case and bulk material properties case) were considered to assess the impact of temperature and core materials composition on both flow dynamics and computational time. Temperature has a significant impact on core material transport and corium flow dynamics during core relocation. Bulk materials properties case has greater impact of temperature on its corium resulting in faster materials transport, but with higher computation time. [ABSTRACT FROM AUTHOR]

Objective: The present study was designed to investigate whether acellular dermal matrix (ADM) grafts could prevent Frey's syndrome (FS) and improve esthetic scores following parotidectomy. Methods: From January 2015 to December 2019, 175 patients underwent parotidectomy. We divided the patients into two groups: the ADM group and the control group. We included in each group 30 patients according to a propensity score matched analysis. Results: FS was subjective in 1 patient (3%) from the ADM group and 9 patients (30%) from the control group (P =0.015). Patients in the ADM group had a subjective esthetic score of 6.1 + 1.7 compared with 5.2 + 1.7 in the control group. The subjective esthetic score for patients in the ADM group was higher than that for patients in the control group (P =0.040). Conclusion: The present clinical study suggests that ADM grafts are effective in preventing FS and improving esthetic scores after parotidectomy. [ABSTRACT FROM AUTHOR]

While histological diagnosis of Paget disease of vulva is mostly straightforward, identifying and confirming invasion can be challenging. Often invasion is accompanied by epidermal hyperplasia, marked inflammatory response and desmoplastic reaction. Diagnosis of invasion in Paget disease portends a poor outcome. We report findings from a recurrent primary vulvar Paget disease where overall histomorphology of possible invasive disease is unusual and raises a possibility of displacement of Paget cells in the dermis. We compare histology of the index case with known invasive vulvar Paget disease cases retrieved from our pathology archives. Unique histomorphology in the index case suggests a possibility of previous excision related dermal displacement of Paget cells. [ABSTRACT FROM AUTHOR]

Dermatophytoses are fungal infections of the skin, hair, and nails that affect approximately 25% of the global population. Occlusive clothing, living in a hot humid environment, poor hygiene, proximity to animals, and crowded living conditions are important risk factors. Dermatophyte infections are named for the anatomic area they infect, and include tinea corporis, cruris, capitis, barbae, faciei, pedis, and manuum. Tinea incognito describes steroid-modified tinea. In some patients, especially those who are immunosuppressed or who have a history of corticosteroid use, dermatophyte infections may spread to involve extensive skin areas, and, in rare cases, may extend to the dermis and hair follicle. Over the past decade, dermatophytoses cases not responding to standard of care therapy have been increasingly reported. These cases are especially prevalent in the Indian subcontinent, and Trichophyton indotineae has been identified as the causative species, generating concern regarding resistance to available antifungal therapies. Antifungal-resistant dermatophyte infections have been recently recognized in the United States. Antifungal resistance is now a global health concern. When feasible, mycological confirmation before starting treatment is considered best practice. To curb antifungal-resistant infections, it is necessary for physicians to maintain a high index of suspicion for resistant dermatophyte infections coupled with antifungal stewardship efforts. Furthermore, by forging partnerships with federal agencies, state and local public health agencies, professional societies, and academic institutions, dermatologists can lead efforts to prevent the spread of antifungal-resistant dermatophytes. [ABSTRACT FROM AUTHOR]

Aims: Plaque‐type blue naevi are rare melanocytic tumours presenting as large, pigmented plaques at birth or during childhood. There is a risk for malignant transformation, but no larger comprehensive studies exist and the diagnosis is challenging, especially on limited biopsy material. The aim is to describe the clinicopathological features and behaviour of the disease more comprehensively. Methods and results: We retrieved eight plaque‐type blue naevi, presenting as large, pigmented plaques (median = 7 cm; range = 3–26) most frequently affecting the scalp (four) followed by the cheek, arm, abdominal wall and gluteal cleft (one each), with a slight female predilection. Median age at time of biopsy was 39.5 years (range = 15–90), but three tumours had been present at birth and one since childhood. Histopathologically, the tumours were poorly circumscribed and composed of cellular fascicles of uniform spindle cells in a background of variably prominent pigmented dendritic cells affecting dermis and subcutaneous tissues. The majority had mutations in GNAQ. One tumour showed malignant transformation, characterised by an expansile nodule of pleomorphic epithelioid melanocytes with rhabdoid morphology, high mitotic activity and areas of necrosis. This patient developed metastatic melanoma to lymph nodes. All patients are alive with a median follow‐up of 60 months. Conclusion: Plaque‐type blue naevi are diagnostically challenging tumours with risk for malignant transformation. Awareness and familiarity with the salient clinicopathological features are necessary for reliable diagnosis, and long‐term clinical follow‐up is required to monitor for malignant transformation. [ABSTRACT FROM AUTHOR]

The reconstruction of patients who possess multi morbid medical histories remains a challenge. With the ever-increasing number of patients with diabetes, infections, and trauma, there is a consistent need for promotion of soft tissue healing and a reliable substrate to assist with every aspect of soft tissue reconstruction, as well as the loss of fascial domain. Several proprietary products filled some of these needs but have failed to fulfill the needs of the clinician when faced with reconstructing multiple soft tissue systems, such as the integument and the musculoskeletal system. In this paper we discuss the use of decellularized human dermis (DermaPure®, Tissue Regenix, Universal City, TX, USA) through which a unique human tissue processing technique (dCELL® technology, Tissue Regenix, Universal City, TX, USA) and the creation of multiple product forms have proven to exhibit versatility in a wide range of clinical needs for successful soft tissue reconstruction. The background of human tissue processing, basic science, and early clinical studies are detailed, which has translated to the rationale for the success of this unique soft tissue substrate in orthoplastic reconstruction, which is also provided here in detail. [ABSTRACT FROM AUTHOR]

A wide variety of biomaterials has been developed to assist in wound healing, including acellular animal and human‐derived protein matrices. However, millions of patients worldwide still suffer from non‐healing chronic wounds, demonstrating a need for further innovation in wound care. To address this need, a novel biomaterial, the human keratin matrix (HKM), was developed, characterised, and tested in vitro and in vivo. HKM was found to be degradation‐resistant, and a proteomics analysis showed it to be greater than 99% human keratin proteins. PCR revealed adult human epidermal keratinocytes (HEKa) grown in contact with HKM showed increased gene expression of keratinocyte activations markers such as Epidermal Growth Factor (EGF). Additionally, a cytokine microarray demonstrated culture on HKM increased the release of cytokines involved in wound inflammatory modulation by both HEKa cells and adult human dermal fibroblasts (HDFa). Finally, in a murine chronic wound model, full‐thickness wounds treated weekly with HKM were smaller through the healing process than those treated with human amniotic membrane (AM), bovine dermis (BD), or porcine decellularized small intestinal submucosa (SIS). HKM‐treated wounds also closed significantly faster than AM‐ and SIS‐treated wounds. These data suggest that HKM is an effective novel treatment for chronic wounds. [ABSTRACT FROM AUTHOR]

Mammalian melanin is produced in melanocytes and accumulated in melanosomes. Melanogenesis is supported by many factors derived from the surrounding tissue environment, such as the epidermis, dermis, and subcutaneous tissue, in addition to numerous melanogenesis-related genes. The roles of these genes have been fully investigated and the molecular analysis has been performed. Moreover, the role of paracrine factors derived from epidermis has also been studied. However, the role of dermis has not been fully studied. Thus, in this review, dermis-derived factors including soluble and insoluble components were overviewed and discussed in normal and abnormal circumstances. Dermal factors play an important role in the regulation of melanogenesis in the normal and abnormal mammalian skin. [ABSTRACT FROM AUTHOR]

Background: Fordyce granules, sometimes referred to as Fordyce dots, are aberrant sebaceous glands that present as diminutive, non-painful, elevated lesions exhibiting a yellowish or whitish hue, measuring 1 to 3 mm in diameter, and manifesting inside the oral cavity. Likewise, these particles may also be seen in the vaginal region and inside the oral cavity. Aim: The primary objective of the current study is to evaluate the potential association between Fordyce granules and the skin type of individuals who seek dental care at the Dental Clinics of Qassim University. Materials and Methods: The current cross-sectional research was undertaken at the Dental Clinics of Qassim University, with a sample of 87 patients diagnosed with Fordyce's granules. The research consisted of a heterogeneous sample of participants, including individuals of all genders, ranging in age from 18 to 85 years. The study included a comprehensive evaluation of several anatomical regions to identify the existence of Fordyce's granules. This examination was conducted by a single examiner who had undergone calibration. Additionally, the participants' skin types were established using the Baumann Skin Typing System questionnaire. The data that was gathered was afterward analyzed utilizing statistical methods via the use of SPSS software. A pre-set significance level was established at P < 0.05. Results: The distribution of skin types among the study participants with Fordyce's granules were found to be oily skin (51.3%), dry skin (47.9%), sensitive skin (49.3%), and resistant skin (56.3%). The results of the research showed that there was no statistically significant correlation between the two variables, i.e. skin type and the presence of Fordyce's granules. This conclusion is supported by the increased P values of 0.941 for those with oily skin and 0.785 for individuals with dry skin. Conclusion: No relation between skin type and Fordyce's granules in the current study. [ABSTRACT FROM AUTHOR]

In this paper, a temperature-controlled angle selection device based on a photonic bandgap is proposed, consisting of MLC-6608 liquid crystal (MLC) and common electrolytes stacked in layers. This device has an angular transmission stability for electromagnetic waves over a wide frequency band (600–660 THz). A high transmissivity (T > 0.85) area, also called an angle window, is formed at 25 ° and 75 ° , and an area of zero transmissivity is formed beyond the angle window. The MLC is temperature-responsive, and the range of angle selection can be expanded or narrowed by temperature adjustment. When the MLC is replaced by the biological sample, it shows good sensing performance. It can be used to detect in vitro dermis, in vivo stratum corneum, and in vivo epidermis and it is of great significance in medicine, with a sensing sensitivity of 90.91 ° /refractive index unit. [ABSTRACT FROM AUTHOR]

Background: Hydradermabrasion, also known as "HydraFacial," is an exfoliative cosmetic procedure for skin rejuvenation that has gained popularity. Despite its increasing popularity, clinical studies validating its efficacy with non‐invasive assessment of histological changes to the skin, are scarce. In this study, we used Line‐Field Confocal Optical Coherence Tomography (LC‐OCT), an optical imaging device, to non‐invasively visualize microscopic changes to skin anatomy after hydradermabrasion treatment. Materials/Methods: Eight volunteers (Fitzpatrick skin types II–V) were recruited for this study. Images, using LC‐OCT (DeepLive, DAMAE medical) were obtained before and after hydradermabrasion and at 2 weeks post‐treatment. A commercially available hydradermabrasion device was utilized to perform the dermabrasion. Results: In the epidermis, initially, a decrease in the average thickness of the stratum corneum, from 9.42 to 6.67 µm was visualized in LC‐OCT images after hydradermabrasion. However, at 2 weeks of follow‐up, the average stratum corneum thickness was 9.75 µm, resulting in an overall increase in the average thickness after treatment. Improved homogenization of the stratum corneum and decreased number of undulations in the epidermis post‐treatment were also visualized. In all the subjects, the superficial dermis appeared stretched, which returned to baseline by the 2‐week follow‐up. At the 2‐week follow‐up, there were no visible differences in the quality and quantity of collagen fibers in the dermis. Conclusion: In our study, LC‐OCT images of the epidermis and dermis demonstrated microscopic features of skin rejuvenation when treated with hydradermabrasion. Thus, not only highlighting the efficacy of hydradermabrasion but also the potential of LC‐OCT to serve as a tool for visualizing the microscopic effects of cosmetic procedures on skin anatomy. [ABSTRACT FROM AUTHOR]

T-cell recruitment to skin tissues is essential for inflammation in different cutaneous diseases; however, the mechanisms by which these T cells access the skin remain unclear. High endothelial venules expressing peripheral node address in (PNAd), an L-selectin ligand, are located in secondary lymphoid organs and are responsible for increasing T-cell influx into the lymphoid tissues. They are also found in non-lymphoid tissues during inflammation. However, their presence in different common inflammatory cutaneous diseases and their correlation with T-cell infiltration remain unclear. Herein, we explored the mechanisms underlying the access of T cells to the skin by investigating the presence of PNAd-expressing vessels in different cutaneous diseases, and its correlation with T cells' presence. Skin sections of 43 patients with different diseases were subjected to immunohistochemical and immunofluorescence staining to examine the presence of PNAd-expressing vessels in the dermis. The correlation of the percentage of these vessels in the dermis of these patients with the severity/grade of CD3+ T-cell infiltration was assessed. PNAd-expressing vessels were commonly found in the skin of patients with different inflammatory diseases. A high percentage of these vessels in the dermis was associated with increased severity of CD3+ T-cell infiltration (P < 0.05). Additionally, CD3+ T cells were found both around the PNAd-expressing vessels and within the vessel lumen. PNAd-expressing vessels in cutaneous inflammatory diseases, characterized by CD3+ T-cell infiltration, could be a crucial entry point for T cells into the skin. Thus, selective targeting of these vessels could be beneficial in cutaneous inflammatory disease treatment. In our study, we observed that PNAd-expressing vessels, identified as a crucial gateway for CD3+ T-cell entry into secondary lymph nodes, are a hallmark feature in the dermis across various CD3+ T-cell-mediated cutaneous diseases. This observation correlates with the extent of CD3+ T-cell infiltration within these conditions, suggesting that PNAd-expressing vessels may serve as a critical conduit for CD3+ T cells into the skin. Graphical Abstract [ABSTRACT FROM AUTHOR]

Bioinks play a fundamental role in skin bioprinting, dictating the printing fidelity, cell response, and function of bioprinted 3D constructs. However, the range of bioinks that support skin cells' function and aid in the bioprinting of 3D skin equivalents with tailorable properties and customized shapes is still limited. In this study, we describe a bioinspired design strategy for bioengineering double crosslinked pectin-based bioinks that recapitulate the mechanical properties and the presentation of cell-adhesive ligands and protease-sensitive domains of the dermal extracellular matrix, supporting the bioprinting of bilayer 3D skin models. Methacrylate-modified pectin was used as a base biomaterial enabling hydrogel formation via either chain-growth or step-growth photopolymerization and providing independent control over bioink rheology, as well as the mechanical and biochemical cues of cell environment. By tuning the concentrations of crosslinker and polymer in bioink formulation, dermal constructs were bioprinted with a physiologically relevant range of stiffnesses that resulted in strikingly site-specific differences in the morphology and spreading of dermal fibroblasts. We also demonstrated that the developed thiol-ene photo-clickable bioinks allow for the bioprinting of skin models of varying shapes that support dermis and epidermis reconstruction. Overall, the engineered bioinks expand the range of printable biomaterials for the extrusion bioprinting of 3D cell-laden hydrogels and provide a versatile platform to study the impact of material cues on cell fate, offering potential for in vitro skin modeling. [ABSTRACT FROM AUTHOR]

Microneedle drug delivery has recently emerged as a clinical method, and dissolving microneedles (DMNs) offer exclusive simplicity and efficiency, compared to the other kinds of microneedles. The tips of most currently available DMNs are cone/house-shaped to result in a lower penetration force. Penetration of the needle tips into the skin relies mainly on the back tape or external pressure, and their adhesion to the skin is relatively low. In addition, only the drug in the part of tips that are pierced into the dermis can be dissolved, resulting in drug waste. Inspired from the barbed structure of the honeybee stinger, we reported substrate-free DMNs with a barbed structure by a dual-molding process, which is suitable for mass production. Those DMNs showed 3-fold greater adhesion force between the needle tips and the skin, better dissolution and deeper penetration than house-shaped DMNs in vivo under the same conditions. For the in situ treatment of psoriasis in mice, the barbed DMNs required only the half dose of house-shaped DMNs to achieve similar efficacy. We reported substrate-free DMNs with barbed structure by dual-molding process, which showed 3-fold greater adhesion force between needle tips and skin, better dissolution and deeper penetration than house-shaped one. [Display omitted] [ABSTRACT FROM AUTHOR]

Based on the extended Huygens–Fresnel principle, the analytical formula for a Generalized Hermite cosh-Gaussian beam (GHchGB) propagating through human upper dermis tissue is derived in this paper. From the derived formula, numerical illustrative examples are performed to illustrate the propagation properties of the considered beam in human upper dermis tissue. Results show that the evolution of the intensity pattern of GHchGB depends strongly on the source beam parameters such as Gaussian beam waists, decentered cosh parameter, hollowness parameter, beam orders and wavelength. It is found that the GHchGB with a smaller parameter in the human upper dermis evolves into the Gaussian beam faster as the propagation distance increases. This observation suggests that the resistance of the GHchGB against turbulence increases as the source parameter increases. The significance of the obtained results has the potential application in the development of bio-optical disease detection and treatment technology. [ABSTRACT FROM AUTHOR]

Antibody‐secreting cells (ASCs) produce immunoglobulin (Ig) G and IgE autoantibodies in secondary lymphoid organs. Evidence also suggests their existence in the skin in various chronic inflammatory conditions, and in association with CXCL12 and CXCL13, they regulate the recruitment/survival of ASCs and germinal center formation to generate ASCs, respectively. However, the presence of IgG and IgE in bullous pemphigoid (BP) lesions needs to be addressed. Here, we aimed to analyse BP skin for the presence of IgG and IgE and the factors contributing to their generation, recruitment, and persistence. Skin samples from 30 patients with BP were stained to identify ASCs and the immunoglobulin type they expressed. The presence of tertiary lymphoid organ (TLO) elements, which generate ASCs in non‐lymphoid tissues, and the chemokines CXCL12 and CXCL13, which regulate the migration/persistence of ASCs in lymphoid tissues and formation of TLOs, respectively, were evaluated in BP skin. BP skin harboured ASCs expressing the two types of antibodies IgG and IgE. ASCs were found in high‐grade cellular aggregates containing TLO elements: T cells, B cells, CXCL12+ cells, CXCL13+ cells and high endothelial venules. IgG+ ASCs were detected among these aggregates, whereas IgE+ ASCs were dispersed throughout the dermis. CXCL12+ fibroblast‐like cells were located close to ASCs. The inflammatory microenvironment of BP lesions may contribute to the antibody load characteristic of the skin of patients with BP by providing a site for the presence of ASCs. CXCL13 and CXCL12 expression may contribute to the generation and recruitment/survival of ASCs, respectively. [ABSTRACT FROM AUTHOR]

Background: Although the paracrine effects of mesenchymal stem/stromal cells (MSCs) have been recognized as crucial mediators of their regenerative effects on tissue repair, the potential of MSC secretomes as effective substitutes for cellular therapies remains underexplored. Methods: In this study, we compared MSCs from the human dermis (DSCs) and adipose tissue (ASCs) with their secretomes regarding their efficacy for skin wound healing using a translationally relevant murine model. Results: Proteomic analysis revealed that while there was a substantial overlap in protein composition between DSC and ASC secretomes, specific proteins associated with wound healing and angiogenesis were differentially expressed. Despite a similar angiogenic potential in vivo, DSC and ASC secretomes were found to be less effective than cells in accelerating wound closure and promoting tissue remodeling. Conclusions: Overall, secretome-treated groups showed intermediary results between cells- and control-treated (empty scaffold) groups. These findings highlight that although secretomes possess therapeutic potential, their efficacy might be limited compared to cellular therapies. This study contributes to the growing understanding of MSC secretomes, emphasizes the need for further protocol optimization, and offers insights into their potential applications in regenerative medicine. [ABSTRACT FROM AUTHOR]

Background: The growth of benign cutaneous masses causes the overlaying skin to expand and become thinner, especially at the central, most projected point. In this retrospective study, a surgical technique comprising an elliptical skin excision was employed to account for these skin changes. Methods: This retrospective study enrolled 980 patients with benign masses. Preoperatively, all patients underwent ultrasonography to evaluate the mass depth and thickness of the attached skin, and mass excision was performed using the elliptical skin-excision method. The operative time was recorded, and complications and esthetic outcomes were assessed using the Cutometer® and the modified Vancouver Scar Scale (mVSS) during 1- and 3-month follow-up visits. Results: The mean operative time (17.48 ± 3.46 min) was significantly shorter than that of conventional methods (p < 0.05). Cutometer parameters showed no significant differences from those of intact skin. The average mVSS scores were 5.21 ± 1.42 and 3.50 ± 1.79 at 1- and 3-month follow-ups, respectively. Conclusions: Mass excision with an elliptical skin attachment resulted in improved esthetic results and easy removal. The attached skin enabled convenient handling without damaging the capsule or other adjacent structures, leaving a thick dermis on both wound edges. Thus, this technique resulted in minimal scarring. [ABSTRACT FROM AUTHOR]

Objectives Our previous studies have demonstrated that the Damage Associated Molecular Pattern (DAMP) protein, S100A4, is overexpressed in the involved skin and peripheral blood of patients with SSc. It is associated with skin and lung involvement, and disease activity. By contrast, lack of S100A4 prevented the development of experimental dermal fibrosis. Herein we aimed to evaluate the effect of murine anti-S100A4 mAb 6B12 in the treatment of preestablished experimental dermal fibrosis. Methods The effects of 6B12 were assessed at therapeutic dosages in a modified bleomycin-induced dermal fibrosis mouse model by evaluating fibrotic (dermal thickness, proliferation of myofibroblasts, hydroxyproline content, phosphorylated Smad3-positive cell count) and inflammatory (leukocytes infiltrating the lesional skin, systemic levels of selected cytokines and chemokines) outcomes, and transcriptional profiling (RNA sequencing). Results Treatment with 7.5 mg/kg 6B12 attenuated and might even reduce pre-existing dermal fibrosis induced by bleomycin as evidenced by reduction in dermal thickness, myofibroblast count and collagen content. These antifibrotic effects were mediated by the downregulation of TGF-β/Smad signalling and partially by reducing the number of leukocytes infiltrating the lesional skin and decrease in the systemic levels of IL-1α, eotaxin, CCL2 and CCL5. Moreover, transcriptional profiling demonstrated that 7.5 mg/kg 6B12 also modulated several profibrotic and proinflammatory processes relevant to the pathogenesis of SSc. Conclusion Targeting S100A4 by the 6B12 mAb demonstrated potent antifibrotic and anti-inflammatory effects on bleomycin-induced dermal fibrosis and provided further evidence for the vital role of S100A4 in the pathophysiology of SSc. [ABSTRACT FROM AUTHOR]

This study evaluated the morphology of alpacas skin. Biopsies were collected and samples were fixed in 10 % neutral buffered formalin for histological procedures. The sections were stained with hematoxylin and eosin, picrosirius red and Masson’s trichrome. Types I, III and IV collagen were analyzed by immunohistochemistry. The derma presented sebaceous and sweat glands, as well as follicular groups with medullated fibers. Type I and type IV collagen were observed at epidermis and dermis as well as in glandular structures and hair follicles. The collagen III, was observed only in dermis. [ABSTRACT FROM AUTHOR]

Immunohistochemical detection of the LYVE-1 marker in healthy human full-thickness skin (the epidermis and the dermis) was carried out. LYVE-1 expression was found in the endothelium of lymphatic capillaries located in the papillary dermis, in the endothelium of larger lymphatic vessels of the reticular dermis, and in fibroblasts, which indicates their joint participation in hyaluronan metabolism. LYVE-1+ staining detected for the first time in cells of the stratum basale, the stratum spinosum, and the stratum granulosum of healthy human epidermis indicates their participation in hyaluronan metabolism and allows us to consider the spaces between epidermis cells as prelimphatics. [ABSTRACT FROM AUTHOR]

Skin perceives and reacts to external mechanical forces to create resistance against the external environment. Excessive or inappropriate stimuli of pressure may lead to cellular alterations of the skin and the development of both benign and malignant skin disorders. We conducted a comprehensive literature review to delve into the pressure-induced and aggravated skin disorders and their underlying pressure-related mechanisms. Dysregulated mechanical responses of the skin give rise to local inflammation, ischemia, necrosis, proliferation, hyperkeratosis, impaired regeneration, atrophy, or other injurious reactions, resulting in various disease entities. The use of personal devices, activities, occupations, weight bearing, and even unintentional object contact and postures are potential scenarios that account for the development of pressure-related skin disorders. The spectrum of these skin disorders may involve the epidermis (keratinocytes and melanocytes), hair follicles, eccrine glands, nail apparatuses, dermis (fibroblasts, mast cells, and vasculature), subcutis, and fascia. Clarifying the clinical context of each patient and recognizing how pressure at the cellular and tissue levels leads to skin lesions can enhance our comprehension of pressure-related skin disorders to attain better management. [ABSTRACT FROM AUTHOR]

Hypertrophic scars (HTS) develop from an excessive synthesis of structural proteins like collagen and a decreased expression of proteoglycans such as decorin. Previous research has demonstrated that decorin expression is significantly down‐regulated in HTS, deep dermal tissue, and thermally injured tissue, reducing its ability to regulate pro‐fibrotic transforming growth factor‐beta 1 (TGF‐β1) and normal fibrillogenesis. However, treatment of HTS fibroblasts with interferon‐alpha 2b (IFN‐α2b) has been shown to reduce excessive collagen synthesis and improve HTS by reducing serum TGF‐β1 levels. The expression of decorin isoforms in HTS is currently unknown and the effects of TGF‐β1 and IFN‐α2b on decorin, decorin isoform expression and type 1 collagen are of great interest to our group. Dermal fibroblasts were treated with TGF‐β1 and/or IFN‐α2b, for 48 h. The expression and secretion of decorin, decorin isoforms and type 1 collagen were quantified with reverse transcription‐quantitative polymerase chain reaction, immunofluorescence staining and enzyme‐linked immunosorbent assays. The mRNA expression of decorin and each isoform was significantly reduced in HTS fibroblasts relative to normal skin. TGF‐β1 decreased the mRNA expression of decorin and decorin isoforms, whereas IFN‐α2b showed the opposite effect. IFN‐α2b significantly inhibited TGF‐β1's effect on the mRNA expression of type I collagen alpha 1 in papillary dermal fibroblasts and overall showed relative effects of inhibiting TGF‐β1. These data support that a further investigation into the structural and functional roles of decorin isoforms in HTS pathogenesis is warranted and that IFN‐α2b is an important agent in reducing fibrotic outcomes. [ABSTRACT FROM AUTHOR]

Besides cellular changes in the dermis aging takes place in the extracelluar matrix (ECM). Lack of homoeostasis leads to dysregulation and loss of collagen, elastin, and hyaluronic acid as main structures of the ECM. Adding hyaluronic acid and amino acids as important factors to reconstruct the collagen system is a very promising method to reestablish homoeostasis in the ECM. The importance of the exact concentration of the ingredients must be underlined. [ABSTRACT FROM AUTHOR]

Background: Aplasia cutis congenita (ACC) of the vertex with bone defect is a rare and begnin anomaly that can involve the epidermis, dermis, and subcutaneous tissues of the scalp with significant bone defect Bajpai and Pal (J Pediatr Surg 38(2):e4, 2003). When associated with skull defect, this rare malformation carries the risk of severe complications such as rupture of the superior sagittal sinus or infections. Methods and results: We report a case of aplasia cutis congenita of the scalp with skull defect measuring 9 × 10 cm and an exposed sagittal sinus in a newborn. Both conservative and surgical methods have been proposed to treat this condition. In our case, conservative treatment was planned led to complete epithelization and the patient was healing well at 5 years of follow-up. Conclusions: ACC of the vertex with a large scalp defects present a management dilemma Rocha et al. (Clin Case Rep 3(10):841–4, 2015). Based on a review of the literature, we report this case to demonstrate that even for the largest skin and bone defects, an initial conservative approach may allow for complete wound closure without the need for early surgical intervention. [ABSTRACT FROM AUTHOR]

Skin aging is characterized by changes in its structural, cellular, and molecular components in both the epidermis and dermis. Dermal aging is distinguished by reduced dermal thickness, increased wrinkles, and a sagging appearance. Due to intrinsic or extrinsic factors, accumulation of excessive reactive oxygen species (ROS) triggers a series of aging events, including imbalanced extracellular matrix (ECM) homeostasis, accumulation of senescent fibroblasts, loss of cell identity, and chronic inflammation mediated by senescence‐associated secretory phenotype (SASP). These events are regulated by signaling pathways, such as nuclear factor erythroid 2‐related factor 2 (Nrf2), mechanistic target of rapamycin (mTOR), transforming growth factor beta (TGF‐β), and insulin‐like growth factor 1 (IGF‐1). Senescent fibroblasts can induce and accelerate age‐related dysfunction of other skin cells and may even cause systemic inflammation. In this review, we summarize the role of dermal fibroblasts in cutaneous aging and inflammation. Moreover, the underlying mechanisms by which dermal fibroblasts influence cutaneous aging and inflammation are also discussed. [ABSTRACT FROM AUTHOR]

Nevus lipomatosus still imposes diagnostic, categorization, and etiologic challenges. Even though an intradermal adipose tissue is a histopathologic prerequisite, the lesions are clinically divided into classic multiple forms and a solitary variant, which some consider a separate so‐called lipofibroma clinicopathologic entity. This further complicates the true prevalence, classification and etiopathogenesis of nevus lipomatosus. Case reports and series studies have reflected either consistent or variable and sometimes conflicting clinicopathologic findings. A few have reported electron microscopic findings. Immunohistochemistry is lacking. We report two multiple and four solitary forms of nevus lipomatosus in six patients, highlighting their salient histopathologic features and immunohistochemical profile. Both forms showed intradermal groups of perivascular S100+ lipogenic and CD34+ mesenchymal cells intermixed with scattered CD1a+ and FXIIIa+ dendrocytes, CD3 lymphocytic and CD117 mast cells in a fibromyxoid milieu. Epidermal nevoid and comedonal follicular alterations, attenuated dermal connective tissue and adnexal structures were variably present in both forms. We compared our findings with seven series of studies reporting classic and solitary forms. Both forms showed similar histopathologic findings, comparable clinicopathologic features, predominantly pelvic, and shoulder girdle distribution patterns in bimodal age onsets. Even though some lipomatous skin lesions clinically and histopathologically overlap with nevus lipomatosus, certain findings are helpful distinguishing features. Small intradermal islands of lipocytic fibroplasia have characteristic perivascular milieu that may function as a niche of preadipose CD34 mesenchymal stem cells. They are most likely represented in the dermis of the pelvic and shoulder areas in certain individuals prone to maintain these embryonic reservoirs, which are clinically manifested at different ages. Some may have unifocal or multifocal residues reflecting multiple and solitary forms. [ABSTRACT FROM AUTHOR]

Background: Although the paracrine effects of mesenchymal stem/stromal cells (MSCs) have been recognized as crucial mediators of their regenerative effects on tissue repair, the potential of MSC secretomes as effective substitutes for cellular therapies remains underexplored. Methods: In this study, we compared MSCs from the human dermis (DSCs) and adipose tissue (ASCs) with their secretomes regarding their efficacy for skin wound healing using a translationally relevant murine model. Results: Proteomic analysis revealed that while there was a substantial overlap in protein composition between DSC and ASC secretomes, specific proteins associated with wound healing and angiogenesis were differentially expressed. Despite a similar angiogenic potential in vivo, DSC and ASC secretomes were found to be less effective than cells in accelerating wound closure and promoting tissue remodeling. Conclusions: Overall, secretome-treated groups showed intermediary results between cells- and control-treated (empty scaffold) groups. These findings highlight that although secretomes possess therapeutic potential, their efficacy might be limited compared to cellular therapies. This study contributes to the growing understanding of MSC secretomes, emphasizes the need for further protocol optimization, and offers insights into their potential applications in regenerative medicine. [ABSTRACT FROM AUTHOR]

Organoids have attracted extensive attention in the field of hair follicle (HF) tissue engineering and regeneration. However, HF organoid implantation faces a number of difficulties, such as low viability ratios, invasive trauma, and complicated procedures. To overcome these issues, a convenient and minimally invasive delivery approach with high efficiency and cell viability is required. Here, HF organoid‐loaded methacrylated gelatin‐cryomicroneedles (GelMA‐cryoMNs) that are capable of efficient transdermal delivery and can maintain the viability of the embedded organoids are developed. The GelMA‐cryoMNs are fabricated by a stepwise cryogenic molding process using a balanced ratio of cryopreservation agents and GelMA hydrogel. They can be inserted easily into porcine skin and melted without leaving residue after delivering the organoids. In vitro and in vivo, organoids delivered by the cryoMNs retain cell viability, self‐assembly, and differentiation ability. In mice, HF organoid‐loaded GelMA‐cryoMNs are delivered to the superficial dermis, resulting in subsequent HF development and the formation of an array of biomimetic hair tufts that broke through the skin surface. A promising strategy is provided here for biomimetic hair neogeneration that benefits from minimal invasion, low cost, and simple fabrication. The GelMA‐cryoMNs developed here could also have broader applications in tissue engineering and organ regeneration. [ABSTRACT FROM AUTHOR]

Melasma relapse is almost common after discontinuation of conventional treatment. Recent studies suggesting that photoaging dermis is the main pathomechanism of melasma, emphasize the dermal targeting therapy. We investigated maintenance effect of microneedling radiofrequency (RF) for melasma treatment. Subjects with melasma were administered oral tranexamic acid and triple combination cream for 2 months and a randomly assigned half face was treated with RF. After discontinuation of conventional therapy, the half face RF continued monthly over 6 months. Modified melasma area severity index (mMASI) score and L* value by a chromameter were collected monthly. Fifteen subjects were enrolled and eleven completed the 8-month study. At 2nd month of conventional therapy, all subjects showed improvement with a 64% reduction in mMASI score. With continuous RF treatment, the improvement was well maintained; whereas in untreated side, the Δ L* gradually decreased, returning to the baseline after the conventional therapy ended. The continuous microneedling RF therapy is beneficial in maintaining the conventional therapy of melasma suggesting the protective effect of dermal targeting therapy in melasma development. (Clinical Trial registration number: NCT05710068, date of first registration: 02/02/2023). [ABSTRACT FROM AUTHOR]

Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission. [ABSTRACT FROM AUTHOR]

This paper presents the results of an experimental study of the interaction of a candidate sacrificial material (SM) for a light water reactor melt trap with corium at the Lava-B test-bench. The candidate sacrificial material is a combination of aluminum oxide and a lead layer. The idea of using such a combination of SM is based on the fact that when the lead layer interacts with corium, there will be an increase in the intensity of heat removal from the corium, as well as the chemical interaction between the corium and SM due to the high heat-conducting properties of lead. This approach will improve the efficiency of corium localization in the melt trap compared to the current set of sacrificial material. Experiments have shown active melting and boiling of lead during its interaction with corium. This is confirmed both by the readings of thermocouples and by the X-ray diffraction phase analysis of the deposit material formed on the walls of the melt receiver (MR) of the Lava-B bench, sampled after the experiment. The experiment results show that the lead layer reduces the rate of increase in the temperature of the corium and increases the rate of erosion of the ceramic part of the SM. With these circumstances, it is possible to conclude that the use of aluminum oxide with a lead layer is promising in practice. [ABSTRACT FROM AUTHOR]

Background: Desmoplastic fibroblastoma (collagenous fibroma) is a rare soft tissue tumor that usually arises in the subcutis or skeletal muscle. Cases superficial to fascia are unusual and can cause diagnostic difficulty. We present 11 cases of superficial desmoplastic fibroblastoma involving a wide anatomic distribution. Methods: Archives were searched using the term "desmoplastic fibroblastoma" over a 10‐year period (2012–2022). Cases superficial to fascia were retrieved, and available clinicopathologic features were recorded. Only cases involving the dermis were included. Results: Eleven cases were identified, all of which were received in consultation. Tumors involved the head and neck (2), lower extremity (2), back (2), foot (1), shoulder (1), axilla (1), hand (1), and breast (1). Each consisted of a hypocellular proliferation of bland stellate to spindled fibroblasts set in a collagenous to focally myxoid stroma. The immunohistochemical stains available for review demonstrated SMA positivity (4/7) and negative immunoreactivity for CD34 (0/6), EMA (0/3), desmin (0/3), and S100 (0/7). Conclusions: Desmoplastic fibroblastoma may present superficially in the dermis to subcutis, posing a potential source of diagnostic difficulty. Recognition of the characteristic histopathologic features of desmoplastic fibroblastoma with judicial use of immunohistochemical stains should allow for accurate diagnosis. [ABSTRACT FROM AUTHOR]

In photoaged human skin, type I collagen fragmentation impairs dermal extracellular matrix (ECM) integrity, resulting in collapsed/contracted fibroblasts with reduced type I procollagen synthesis. Injections of cross‐linked hyaluronic acid (CL‐HA) reverse these deleterious changes. To investigate the time course and effects of biochemical changes induced by injected CL‐HA, particularly whether fibroblast activation leads to accumulation/deposition of dermal collagen, we injected CL‐HA into photoaged skin of human participants over 60 years‐old and performed biochemical/microscopic analyses of skin samples. Beginning 1 week post‐injection and lasting 6–9 months, fibroblasts exhibited activation, including increased immunostaining and gene expression of markers of type I collagen synthesis, such as heat shock protein 47 and components of the transforming growth factor‐β pathway. At 1 week post‐injection, multiphoton microscopy revealed elongation/stretching of fibroblasts, indicating enhanced dermal mechanical support. At 4 weeks, second‐harmonic generation microscopy revealed thick collagen bundles densely packed around pools of injected CL‐HA. At 12 months, accumulation of thick collagen bundles was observed and injected CL‐HA remained present in substantial amounts. Thus, by occupying space in the dermal ECM, injected CL‐HA rapidly and durably enhances mechanical support, stimulating fibroblast elongation and activation, which results in thick, densely packed type I collagen bundles accumulating as early as 4 weeks post‐injection and continuing for at least a year. These observations indicate that early and prolonged clinical improvement following CL‐HA injection results from space‐filling and collagen deposition. As type I collagen has an estimated half‐life of 15 years, our data provide the foundations for optimizing the timing/frequency of repeat CL‐HA injections. [ABSTRACT FROM AUTHOR]

Schwannomas synonymously known as neurilemmomas or neurinomas are uncommon benign neoplasms of neural sheath origin. They account for 5% of all benign soft-tissue tumors. 6%-8% of tumors occur intracranially and 25%-45% occur extracranially in the head-and-neck region, of which cutaneous schwannomas located in the dermis or subcutaneous tissue in the head and neck are an unusual entity. Of the seven subtypes described by Erlandson, ancient schwannoma is a very rare distinctive histopathological variant resulting from long-term degenerative changes and accounts for 0.8% of all soft-tissue tumors. This seminal article is a systematic review of schwannomas in the ear in its entirety from 1977 to 2023 along with a case report of a profusely bleeding cutaneous ancient schwannoma occurring in the mastoid region in a swelling of a short duration of 6 months in a 75 year old female. To the best of our knowledge, this case has two firsts to its credit. It is the first reported case of an ancient schwannoma in the mastoid region and also the first reported case presenting with bleeding from the schwannoma. Due to its rarity, ancient schwannoma must be included in the differential diagnosis for any bleeding mass in the ear to avoid an erroneous diagnosis of malignancy. [ABSTRACT FROM AUTHOR]

Background: Total meniscectomy for treating massive meniscal tears may lead to joint instability, cartilage degeneration, and even progressive osteoarthritis. The meniscal substitution strategies for advancing reconstruction of the meniscus deserve further investigation. Hypothesis: A decellularized meniscal scaffold (DMS) modified with collagen affinity stromal cell–derived factor (C-SDF1α) may facilitate meniscal regeneration and protect cartilage from abrasion. Study Design: Controlled laboratory study. Methods: The authors first modified DMS with C-SDF1α to fabricate a new meniscal graft (DMS-CBD [collagen-binding domain]). Second, they performed in vitro studies to evaluate the release dynamics, biocompatibility, and differentiation inducibility (osteogenic, chondrogenic, and tenogenic differentiation) on human bone marrow mesenchymal stem cells. Using in vivo studies, they subjected rabbits that received medial meniscectomy to a transplantation procedure to implement their meniscal graft. At postoperative weeks 6 and 12, the meniscal regeneration outcomes and chondroprotective efficacy of the new meniscal graft were evaluated by macroscopic observation, histology, micromechanics, and immunohistochemistry tests. Results: In in vitro studies, the optimized DMS-CBD graft showed notable biocompatibility, releasing efficiency, and chondrogenic inducibility. In in vivo studies, the implanted DMS-CBD graft after total meniscectomy promoted the migration of cells and extracellular matrix deposition in transplantation and further facilitated meniscal regeneration and protected articular cartilage from degeneration. Conclusion: The new meniscal graft (DMS-CBD) accelerated extracellular matrix deposition and meniscal regeneration and protected articular cartilage from degeneration. Clinical Relevance: The results demonstrate that the DMS-CBD graft can serve as a potential meniscal substitution after meniscectomy. [ABSTRACT FROM AUTHOR]

Nowadays, modern ultrasound machines and high-frequency transducers allow us to accurately assess the superficial soft tissues of the human body. In this sense, sonographic evaluation of the skin and related pathologies is progressively growing in the pertinent literature. To the best of our knowledge, a standardized sonographic protocol focused on the assessment of pathological skin scars is still lacking. As such, the main purpose of the present study was to propose a technical guide to sonographically assess skin scars in the daily practice of clinicians—starting from knowledge on their histopathological features. In order to standardize the ultrasound examination, a superficial-to-deep, layer-by-layer approach has been proposed to optimize its reproducibility and to promote a common language among the different healthcare providers. [ABSTRACT FROM AUTHOR]

In the course of severe accidents (SA) with the core melting, such a phenomenon as the energetic interaction of the melt with the coolant (steam explosion) may occur, which threatens the reactor vessel integrity and can be a trigger for hydrogen explosion. One of the main parameters determining the power of a steam explosion is the conversion ratio CR (another common designation is δ). The CR is the melt energy fraction converted into mechanical work as a result of the postulated steam explosion. In this study, the results of more than 190 experiments simulating the melt–coolant interaction are considered using the prototype corium melt (TROI, FARO, KROTOS-KFC, ZREX, ANL) and the non-prototypical melts (KROTOS Huhtiniemi, MISTEE, SUW, WUMT, MIXA, EXPO-FITS, FITS, ALPHA, WFCI, etc.). On the basis of the results of this study, the dependences of the maximum value of the conversion ratio on the following parameters were obtained: the melt mass reduced to the coolant mass (Mm/Mf); the ratio of the reduced value of the coolant subcooling to the saturation temperature to the reduced value of the melt overheating above the melting temperature to the melting temperature (); the ratio of components in the corium (Zr, UO2, and others). The dependences obtained are supposed to be used to specify existing semiempirical procedures for assessment of the power of steam explosions in order to decrease their conservativeness in the framework of safety justification for operating NPP and those to be designed with VVER reactor plants. [ABSTRACT FROM AUTHOR]

The present study examined whether sweat glands are present in the skin of sub-Antarctic fur seals, Arctocephalus tropicalis, using standard histological procedures and light microscopy. Aspects of the microanatomy and histology of skin were described to elucidate structure and function. Sweat glands were present both in the furred areas of the body trunk, as well as in naked skin areas of the flippers. The density of the apocrine sweat glands appeared higher in fur-covered areas than in naked areas, while the size of sweat glands was similar amongst naked and fur-covered skin. The superficial position of sweat glands in the dermis of naked skin areas and the large, coiled, tubular nature of the secretory portion seem to indicate sweat gland activity in contrast to the deep lying, narrow sweat glands in fur-covered areas. [ABSTRACT FROM AUTHOR]

Objective: Misdiagnosed/chronic Achilles tendon injuries are rare and disabling for patients. The surgical treatment of these rare injuries aims to ensure the tendon heals mechanically and biologically. This is the prerequisite for a good clinical and functional outcome and reduces recurrences. The main aim of the study is to present a surgical technique that has proven to be original, reproducible, and capable of guaranteeing solid tendon repair and optimal tissue regeneration. Methods: We treated five patients, four males and one female, with the one‐step double augmentation technique. All patients of this study complained of pain, but above all severe functional limitation that Achilles tendon injury had been causing for more than a month. In this study, we widely described the surgical technique, original and not found in the literature, which provides a biological graft (allograft of decellularized dermis) and homologous, thrombin‐activated, platelet‐rich plasma (H‐PRP) in a single step. Surgical approach, always used by the first author, respected predefined steps: careful dissection and preparation of the peritendinous tissues from suture to the end of the procedure, tenorrhaphy, and augmentation with allopatch to obtain a mechanically effective repair to avoid recurrences, and finally "biological" augmentation with a unit of homologous, thrombin activated, PRP. We offered to all patients a regenerative rehabilitation program post‐operatively. Results: All patients were evaluated clinically (functional clinical tests and questionnaires) and instrumentally (elastic‐sonography and perfusion MRI). The obtained results have been evaluated at a minimum follow‐up of 18 months and a maximum of 24 months. In all patients pain was resolved, and district function and kinetic chains improved with resumption of daily activities, work, and sports. Conclusion: The present study confirmed the regenerative potential of decellularized dermis allograft and PRP (homologous and thrombin‐activated). The same approach can also be exploited in cases of severe tendon destructuring and limited "intrinsic" regenerative potential at any age. The proposed one‐step surgical technique of a double augmentation therefore appears useful, safe, reproducible, and applicable in all chronic tendon lesions with low regenerative potential. [ABSTRACT FROM AUTHOR]

Skin tears are traumatic wounds caused by mechanical forces, which can be caused by the removal of adhesive dressing. Although they are common – especially in individuals with vulnerable skin, such as older people – their prevalence is underestimated, they are often misdiagnosed and they have a high risk of developing into complex, chronic wounds. However, skin tears are largely preventable. There are a number of intrinsic and extrinsic factors relating to skin tears and preventive strategies that may be undertaken. Health professionals, patients and caregivers/family members should aim to manage modifiable intrinsic and extrinsic factors to promote and maintain skin integrity to prevent skin tears. Where a skin tear does occur, an evidence-based approach should be taken to management, with referral to specialist care if necessary. [ABSTRACT FROM AUTHOR]

Background. In this study, we established two rat models that mimic human submuscular and premuscular breast reconstruction. We analyzed the capsule formation according to surgical techniques and adjacent tissues, including the chest wall tissues, such as the ribs and acellular dermal matrices (ADMs) that come in contact with silicone implants. Methods. This study consisted of experiments on 12 Sprague–Dawley rats that underwent implant reconstruction using ADM. They were divided into two groups: rats that underwent dual-plane implantation (n = 6; group 1) and those that underwent premuscular implant insertion (n = 6; group 2). All rats were irradiated with 35 Gy of fractionated radiation. Three months after surgery, the histology and immunochemistry of the capsule tissues of the ADM, muscle, and chest wall were analyzed. Results. Overall capsule thickness was thicker in group 1. Based on the tissue in contact with the silicone implant, ADM had a thinner capsule, less inflammation, less fibrosis, and less vascularization than the muscle and chest wall tissues. Conclusions. This study described two rat models of clinically relevant implant-based breast reconstruction using a submuscular and premuscular plane, ADM, and irradiation. Overall, the premuscular implantation rat model was associated with a thinner capsule. The ADM in contact with the silicone implant, even after irradiation, had superior protection from radiation compared with the other tissues. [ABSTRACT FROM AUTHOR]

We hypothesized that the protein source in supplements and the insolation and ambient temperature changes in different seasons could cause changes in the skin of Nellore steers during the rearing phase on warm-climate pasture. The objective of this study was to evaluate the effects of replacing true protein (soybean meal) with NPN (extruded urea) in the supplement on the skin characteristics of steers grazing on Marandu grass pastures. Thirty-six Nellore steers with an average initial weight of 250.0 kg and 15 months of age were used. Skin biopsies were performed at three different times: summer, autumn, and winter. The protein source has effects on the length of the glandular portion, number of follicles, and gland area in steers during the rearing phase at different seasons of the year. In the summer, the skin presented a higher compact structure, while in the autumn and winter, the skin presented a sparser arrangement. Skin from steers that received soybean meal in supplement had a more significant number of follicles in the summer and a smaller area and length of sweat glands. The dermis thickness of steers supplemented with soybean meal was greater than that of urea supplemented. The epidermis thickness and dermis of the steers' skin were greater at the autumn (April). Sweat gland depth was greater in autumn (April) and winter (July) than in summer (December). The protein source in the supplement alters the skin characteristics by increasing of dermis thickness of Nellore steers during the growth phase. The insolation and ambient temperature changes in different seasons alter the skin structure by increasing the epidermis and dermis thickness, sweat glands depth, and glands area of the skin of steers during the growth phase. [ABSTRACT FROM AUTHOR]

This paper aims to demonstrate that using an eco-responsible technology called Plant Milking it is possible to produce a new active ingredient from the roots of Ipomoea batatas. Rich in dicaffeoyl quinate esters (DCQEs), this extract efficiently tackles several pathways leading to under eye dark circles to improve the eye contour aspect. A full transcriptomic study was done and demonstrated that genes involved in the main biological pathways leading to dark circles formation were downregulated. This study was completed by an evaluation of the effects of the active on vascularization using an innovative 3D vascularized dermis model, showing the active ingredient helps modulate the formation of new vessels. An ex-vivo assessment demonstrated it can re-densify the dermis. To confirm the benefits for consumers a clinical evaluation showed eye contour color was improved in only 7 days and eye stiffness was increased thanks to this Ipomoea batatas root extract. [ABSTRACT FROM AUTHOR]

The skin is a multi‐layered structure composed of the epidermis, dermis and hypodermis. The epidermis originates entirely from the ectoderm, whereas the dermis originates from various germ layers depending on its anatomical location; thus, there are different developmental patterns of the skin. Although the regulatory mechanisms of epidermal formation are well understood, mechanisms regulating dermis development are not clear owing to the complex origin. It has been shown that several morphogenetic pathways regulate dermis development. Of these, transforming growth factor‐β (TGF‐β) and fibroblast growth factor (FGF) signalling pathways are the main modulators regulating skin cell induction, fate decision, migration and differentiation. Recently, the successful generation of human skin by modulating TGF‐β and FGF signals further demonstrated the irreplaceable roles of these pathways in skin regeneration. This review provides evidence of the role of TGF‐β and FGF signalling pathways in the development of different skin layers, especially the disparate dermis of different body regions. This review also provides new perspectives on the distinct developmental patterns of skin and explores new ideas for clinical applications in the future. [ABSTRACT FROM AUTHOR]

Background: Histopathological differentiation of early mycosis fungoides (MF) from benign chronic inflammatory dermatoses remains difficult and often impossible, despite the inclusion of all available diagnostic parameters. Objective: To identify the most impactful histological criteria for a predictive diagnostic model to discriminate MF from atopic dermatitis (AD). Methods: In this multicentre study, two cohorts of patients with either unequivocal AD or MF were evaluated by two independent dermatopathologists. Based on 32 histological attributes, a hypothesis‐free prediction model was developed and validated on an independent patient's cohort. Results: A reduced set of two histological features (presence of atypical lymphocytes in either epidermis or dermis) was trained. In an independent validation cohort, this model showed high predictive power (95% sensitivity and 100% specificity) to differentiate MF from AD and robustness against inter‐individual investigator differences. Limitations.: The study investigated a limited number of cases and the classifier is based on subjectively evaluated histological criteria. Conclusion: Aiming at distinguishing early MF from AD, the proposed binary classifier performed well in an independent cohort and across observers. Combining this histological classifier with immunohistochemical and/or molecular techniques (such as clonality analysis or molecular classifiers) could further promote differentiation of early MF and AD. [ABSTRACT FROM AUTHOR]